Background and Aims:Chronic hepatitis B(CHB)can cause liver fibrosis and lead to cirrhosis and cancer.As the effectiveness of antiviral therapy to reverse liver fibrosis is limited,We aimed to evaluate the effect of A...Background and Aims:Chronic hepatitis B(CHB)can cause liver fibrosis and lead to cirrhosis and cancer.As the effectiveness of antiviral therapy to reverse liver fibrosis is limited,We aimed to evaluate the effect of An-Luo-Hua-Xian pill(ALHX)on fibrosis regression in CHB patients treated with entecavir(ETV).Methods:Treatment-naïve patients with CHB were randomly treated with ETV alone or combined with ALHX(ETV+ALHX)between October 1,2013 and December 31,2020.Demographic,laboratory,and liver histology data before and after 78 weeks of treatment were collected.The Ishak fibrosis score(F)was used and fibrosis regression required a decrease in F of≥1 after treatment.Results:A total of 780 patients were enrolled,and 394 with a second liver biopsy after treatment were included in the per-protocol population,132 in ETV group and 262 in ETV+ALHX group.After 78 weeks of treatment,the fibrosis regression rate in the ETV+ALHX group was significantly higher than that of the ETV group at baseline F≥3 patients:124/211(58.8%)vs.45/98(45.9%),p=0.035.The percentage of patients with a decreased liver stiffness measurement(LSM)was higher in the ETV+ALHX group:156/211(73.9%)vs.62/98(63.%),p=0.056.Logistic regression analysis showed that ETV combined with ALHX was associated with fibrosis regression[odds ratio(OR)=1.94,p=0.018],and a family history of hepatocellular carcinoma was on the contrary.(OR=0.41,p=0.031).Conclusions:ETV combined with ALHX increased liver fibrosis regression in CHB patients.展开更多
Background:Few data are available regarding the progression of liver disease and therapeutic efficacy in chronic hepatitis B(HBV)carriers infected by mother-to-child transmission(MTCT).This study aimed to investigate ...Background:Few data are available regarding the progression of liver disease and therapeutic efficacy in chronic hepatitis B(HBV)carriers infected by mother-to-child transmission(MTCT).This study aimed to investigate these two aspects by comparing the adult chronic HBV carriers in MTCT group with those in horizontal transmission group.Methods:The 683 adult chronic HBV patients qualified for liver biopsy including 191 with MTCT and 492 with horizontal transmission entered the multi-center prospective study from October 2013 to May 2016.Biopsy results from 217 patients at baseline and 78 weeks post antiviral therapy were collected.Results:Patients infected by MTCT were more likely to have e antigen positive(68.6%vs.58.2%,x^2=-2.491,P=0.012)than those with horizontal transmission.However,in patients with MTCT,levels of alkaline phosphatase(ALP)(P=0.031),Fibroscan(P=0.013),N-terminal propeptide of Type III procollagen(PIIINP)(P=0.014),and Laminin(LN)(P=0.006)were high,in contrast to the patients with horizontal transmission for whom the levels of albumin(ALB)(P=0.041),matrix metalloproteinase-3(MMP-3)(P=0.001)were high.The 47.2% of patients with MTCT and 36.8%of those with horizontal transmission had significant liver fibrosis(P=0.013).Following antiviral therapy for 78 weeks,21.2%and 38.0%patients with MTCT and horizontal transmission acquired hepatitis B e antigen(HBeAg)clearance,respectively(P=0.043),and the virological response rates were 54.7%and 74.1%in the MTCT and horizontal groups,respectively(P=0.005).MTCT was a risk factor for HBeAg clearance and virological response.Conclusion:Adult patients with MTCT were more prone to severe liver diseases,and the therapeutic efficacy was relatively poor,which underlined the importance of earlier,long-term treatment and interrupting perinatal transmission.展开更多
The“underfilled trinity”model of foreland-basin stratigraphy was proposed based on the observation that the initial sedimentary stages along the western and northern front of the western and central Alps were repres...The“underfilled trinity”model of foreland-basin stratigraphy was proposed based on the observation that the initial sedimentary stages along the western and northern front of the western and central Alps were represented by shallow-water carbonates(Calcaires a Nummulites)overlain by hemipelagic marls(Marnes Bleues)and capped by siliciclastic turbidites(Gr es d'Annot).Subsequently,this model has been widely accepted and applied in foreland basins worldwide.We here re-investigated the Eocene-Oligocene sedimentary succession of the Western Alps to check its validity.Major geological features of this region include:i)the existence of a Cretaceous-Eocene unconformity spanning more than 25 Myr in the studied sections;ii)a virtually synchronous age of the Calcaires a Nummulites,Marnes Bleues,and Gr es d'Annot formations across the Western Alps;iii)a long-term deepening-upward trend,from inner to outer ramp,documented by the Calcaires a Nummulites,followed by the pelagic Marnes Bleues and by the Gr es d'Annot turbidites;iv)the provenance of the Gr es d'Annot Formation from the Maures-Est erel Massif and/or CorsicaSardinia block in the south,rather than from the Alpine orogen in the east.By integrating field observations,sedimentological,biostratigraphic,and provenance analyses,we found the Eocene“underfilled foreland”model too simplistic and inadequate to explain the basin evolution in the western Alpine region.Based on the alternative scenario proposed herein,the Annot and Barr^eme basins formed in the late Eocene(40-35 Ma)in an extensional/transtensional setting during a period of major change in tectonic stress fields across western Europe on the upper plate of the Apennine subduction.展开更多
基金supported by National Science and Technology Major Project(2013ZX10002005 and 2017ZX10203202).
文摘Background and Aims:Chronic hepatitis B(CHB)can cause liver fibrosis and lead to cirrhosis and cancer.As the effectiveness of antiviral therapy to reverse liver fibrosis is limited,We aimed to evaluate the effect of An-Luo-Hua-Xian pill(ALHX)on fibrosis regression in CHB patients treated with entecavir(ETV).Methods:Treatment-naïve patients with CHB were randomly treated with ETV alone or combined with ALHX(ETV+ALHX)between October 1,2013 and December 31,2020.Demographic,laboratory,and liver histology data before and after 78 weeks of treatment were collected.The Ishak fibrosis score(F)was used and fibrosis regression required a decrease in F of≥1 after treatment.Results:A total of 780 patients were enrolled,and 394 with a second liver biopsy after treatment were included in the per-protocol population,132 in ETV group and 262 in ETV+ALHX group.After 78 weeks of treatment,the fibrosis regression rate in the ETV+ALHX group was significantly higher than that of the ETV group at baseline F≥3 patients:124/211(58.8%)vs.45/98(45.9%),p=0.035.The percentage of patients with a decreased liver stiffness measurement(LSM)was higher in the ETV+ALHX group:156/211(73.9%)vs.62/98(63.%),p=0.056.Logistic regression analysis showed that ETV combined with ALHX was associated with fibrosis regression[odds ratio(OR)=1.94,p=0.018],and a family history of hepatocellular carcinoma was on the contrary.(OR=0.41,p=0.031).Conclusions:ETV combined with ALHX increased liver fibrosis regression in CHB patients.
文摘Background:Few data are available regarding the progression of liver disease and therapeutic efficacy in chronic hepatitis B(HBV)carriers infected by mother-to-child transmission(MTCT).This study aimed to investigate these two aspects by comparing the adult chronic HBV carriers in MTCT group with those in horizontal transmission group.Methods:The 683 adult chronic HBV patients qualified for liver biopsy including 191 with MTCT and 492 with horizontal transmission entered the multi-center prospective study from October 2013 to May 2016.Biopsy results from 217 patients at baseline and 78 weeks post antiviral therapy were collected.Results:Patients infected by MTCT were more likely to have e antigen positive(68.6%vs.58.2%,x^2=-2.491,P=0.012)than those with horizontal transmission.However,in patients with MTCT,levels of alkaline phosphatase(ALP)(P=0.031),Fibroscan(P=0.013),N-terminal propeptide of Type III procollagen(PIIINP)(P=0.014),and Laminin(LN)(P=0.006)were high,in contrast to the patients with horizontal transmission for whom the levels of albumin(ALB)(P=0.041),matrix metalloproteinase-3(MMP-3)(P=0.001)were high.The 47.2% of patients with MTCT and 36.8%of those with horizontal transmission had significant liver fibrosis(P=0.013).Following antiviral therapy for 78 weeks,21.2%and 38.0%patients with MTCT and horizontal transmission acquired hepatitis B e antigen(HBeAg)clearance,respectively(P=0.043),and the virological response rates were 54.7%and 74.1%in the MTCT and horizontal groups,respectively(P=0.005).MTCT was a risk factor for HBeAg clearance and virological response.Conclusion:Adult patients with MTCT were more prone to severe liver diseases,and the therapeutic efficacy was relatively poor,which underlined the importance of earlier,long-term treatment and interrupting perinatal transmission.
基金financially supported by National Natural Science Foundation of China projects (91755209,41525007)。
文摘The“underfilled trinity”model of foreland-basin stratigraphy was proposed based on the observation that the initial sedimentary stages along the western and northern front of the western and central Alps were represented by shallow-water carbonates(Calcaires a Nummulites)overlain by hemipelagic marls(Marnes Bleues)and capped by siliciclastic turbidites(Gr es d'Annot).Subsequently,this model has been widely accepted and applied in foreland basins worldwide.We here re-investigated the Eocene-Oligocene sedimentary succession of the Western Alps to check its validity.Major geological features of this region include:i)the existence of a Cretaceous-Eocene unconformity spanning more than 25 Myr in the studied sections;ii)a virtually synchronous age of the Calcaires a Nummulites,Marnes Bleues,and Gr es d'Annot formations across the Western Alps;iii)a long-term deepening-upward trend,from inner to outer ramp,documented by the Calcaires a Nummulites,followed by the pelagic Marnes Bleues and by the Gr es d'Annot turbidites;iv)the provenance of the Gr es d'Annot Formation from the Maures-Est erel Massif and/or CorsicaSardinia block in the south,rather than from the Alpine orogen in the east.By integrating field observations,sedimentological,biostratigraphic,and provenance analyses,we found the Eocene“underfilled foreland”model too simplistic and inadequate to explain the basin evolution in the western Alpine region.Based on the alternative scenario proposed herein,the Annot and Barr^eme basins formed in the late Eocene(40-35 Ma)in an extensional/transtensional setting during a period of major change in tectonic stress fields across western Europe on the upper plate of the Apennine subduction.
