Evaluation of the diagnostic efficacy of noninvasive diagnosis in patients with chronic viral hepatitis B complicated with nonalcoholic fatty liver disease and significant liver fibrosis

Objective:To evaluate the diagnostic efficacy of chronic viral hepatitis B(CHB)with significant liver fibrosis(S2)in patients with nonalcoholic fatty liver disease(NAFLD)by using noninvasive diagnosis and their combined models,and to explore their clinical features.Methods:A total of 104 inpatients with CHB diagnosed and complicated with NAFLD(hepatic steatosis suggested by liver biopsy)were retrospectively collected from January 2018 to January 2023 in the Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University.Liver biopsy was performed in all patients.General data,laboratory test results,liver hardness(LSM),FIB-4,APRI,GGT/PLT,AST/PLT and other results of patients were collected and grouped according to different fibrosis stages(S)to explore the clinical and pathological characteristics of patients with<S2 and S2 stages.Receiver operating characteristic curve was used to evaluate the diagnostic value of LSM,FIB-4,APRI,GGT/PLT,AST/PLT and their combined models in patients with significant liver fibrosis in CHB patients with NAFLD.Results:Among the 104 patients,there were 55 patients had S1 fibrosis,32 patients had S2 fibrosis,11 patients had S3 fibrosis and 6 patients had S4 fibrosis.Patients had<S2 fibrosis,ALT 33.75±17.15 U/L,AST 24.00(19.77,29.00)U/L,inflammation above G2 stage accounted for 92.72%,GGT/PLT 0.07(0.10,0.15),AST/PLT 0.09(0.10,0.15),LSM 8.70(6.80,10.10)kPa,FIB-41.07±0.51,APRI 0.26(0.22,0.28).In patients S2 fibrosis,ALT 42.14±21.39 U/L,AST 29.04(24.00,40.32)U/L,inflammation above G2 stage accounted for 97.95%,GGT/PLT 0.15(0.10,0.28),AST/PLT 0.14(0.10,0.26),GGT/PLT 0.15(0.10,0.28),AST/PLT 0.14(0.10,0.26).LSM 11.80(8.50,16.65)kPa,FIB-41.39±0.72,APRI 0.35(0.26,0.66),the difference between the two groups was statistically significant(P<0.05).The area under the receiver operator characteristic curves of the subjects of LSM,FIB-4,APRI,GGT/PLT and AST/PLT were 0.716,0.623,0.669,0.644 and 0.669(P<0.05),respectively.In the combined model,the area under the receiver operator characteristic curves of LSM combined with FIB-4,LSM combined with APRI,LSM combined with GGT/PLT and LSM combined with AST/PLT were 0.712,0.719,0.715 and 0.719,respectively(P<0.05).Conclusion:Although the currently commonly used Noninvasive diagnosis of liver fibrosis has certain diagnostic efficacy for significant liver fibrosis in CHB complicated with NAFLD,it cannot replace liver biopsy.Noninvasive Diagnosis can be used as an auxiliary method for regular clinical evaluation of liver biopsy.

Maternal Bias of Immunity to Her Offspring: Possibility of an Autoimmunity Twist out from Maternal Immunity to Her Young

The major interest in materno-foetal relation is why fetus is not rejected by the mother, even in a different genetic background. But in this article we have been investigating about the effect(s) of maternal antigenic stimulation or infection upon the active immune responses in her offspring. The results of various researchers have certainly pose significant problems as to the defense of infants against infectious agents, especially those introduced by their mothers. But we have already reported that maternal antigenic stimulation greatly suppresses the specific immune response of the offspring in a system of mouse vs. heterologous erythrocytes and other T-dependent antigens. This suppression was antigen specific and effective on 1/6 life of rodents. The mechanisms that concerned in this suppression were not antigen administered nor antibody produced in the mother. The supporting evidences were that this suppression was MHC restricted and limited in during pregnancy for induction between mother and her young. The system examined was separating genetic backgrounds that the haplotype was different in F2 family where half of the young were identical but not in remainder to the F1 mother mouse. From this backcross system, this suppression was MHC restricted, suggesting cell to cell contact with mother to her young. Moreover, cytokine level in both mother and her young, IFN-g levels was up-regulated in such a young whose mother was immunized with antigen. The significance of this phenomenon were accessed as biological and medical intervention especially for the mother and infant health care and prevention of hypersensitivities, autoimmune syndrome for her young after delivery.

Effect of paecilomyces hepiall chen on serum inflammatory factors,oxidative stress and renal function in patients with diabetic nephropathy

Objective: To investigate the effect of paecilomyces hepiall chen on serum inflammatory factors, oxidative stress and renal function in patients with diabetic nephropathy. Methods: A total of 124 cases of diabetic nephropathy patients were selected as the research object, based on the random data table they were divided into the control group and the observation group, 62 cases in each group, two groups of patients were given conventional treatment, on this basis, the patients in the control group were treated with valsartan capsules treatment, while patients in the observation group were given valsartan capsules combined with paecilomyces hepiall chen treatment. To compare the levels of blood pressure [systolic blood pressure (SBP), diastolic blood pressure (DBP)], inflammatory factor [tumor necrosis factor -α (TNF-α), high sensitive C reactive protein (hs-CRP)], oxidative stress [superoxide dismutase (SOD), malondialdehyde (MDA)] and renal function index [serum creatinine (Scr), urea nitrogen (BUN)] of the two groups before and after treatment. Results: Before treatment, there were no significantly different of the levels of SBP, DBP, TNF-α, hs-CRP, SOD, MDA, Scr and BUN between the two groups. After treatment, the observation group SBP, DBP, TNF-α, hs-CRP, MDA, Scr and BUN level were (135.71±15.64) mmHg, (84.96±13.97) mmHg, (46.37±5.92) ng/L, (5.99±0.94) mg/L, (20.91±2.38) μmol/L, (83.86±10.16) μmol/L and (6.53±1.37) mmol/L, were significantly lower than before treatment, and after treatment the TNF-α, hs-CRP, MDA, Scr and BUN in observation group were significantly lower than the control group;Compared with the levels in the same group before treatment, the two groups of SOD levels were significantly increased, and the observation group [(93.21±7.06) U/mL] was significantly higher than the control group ((79.84±6.12) U/mL)Conclusion: Paecilomyces hepiall chen on treatment of diabetic nephropathy, can effectively relieve chronic inflammation and oxidative stress, improve renal function, has an important clinical value.