BACKGROUND The impact of entecavir(ETV),tenofovir disoproxil fumarate(TDF),and tenofovir alafenamide fumarate(TAF)on long-term recurrence and overall survival in patients with hepatitis B cirrhosis-related hepatocellu...BACKGROUND The impact of entecavir(ETV),tenofovir disoproxil fumarate(TDF),and tenofovir alafenamide fumarate(TAF)on long-term recurrence and overall survival in patients with hepatitis B cirrhosis-related hepatocellular carcinoma(HCC)who AIM To compare the 3-year recurrence and survival rates among HCC patients receiving these three first-line oral anti-hepatitis B virus(anti-HBV)agents after RFA.METHODS This retrospective cohort study included patients with hepatitis B cirrhosis who were initially diagnosed with HCC at Tianjin Third Central Hospital,China,from August 2018 to December 2020,and had complete clinical data.All patients were followed up for at least 144 weeks.Cox regression analysis was performed to identify independent risk factors for HCC recurrence.Recurrence-free survival was analyzed using Kaplan-Meier curves,and Cox regression models were constructed after adjusting for gamma-glutamyl transferase,alpha-fetoprotein,and Barcelona Clinic Liver Cancer staging.RESULTS A total of 319 patients receiving oral anti-HBV therapy were divided into three groups:ETV group(n=191),TDF group(n=76),and TAF group(n=52).At 6 and 12 months,there were no significant differences in recurrence rates between the groups.However,at 24 and 36 months,the TDF and TAF groups exhibited significantly lower recurrence rates compared with the ETV group[24 months:TDF,hazard ratio(HR)=0.51,95%confidence interval(CI):0.29-0.91,P=0.022;TAF,HR=0.54,95%CI:0.28-1.03,P=0.046;36 months:TDF,HR=0.57,95%CI:0.35-0.93,P=0.025;TAF,HR=0.54,95%CI:0.31-0.96,P=0.037].The 3-year mortality rates were similar across the three groups(ETV:21.47%,TDF:18.42%,TAF:23.08%;P=0.790).CONCLUSION Among patients with hepatitis B cirrhosis-related HCC,TDF and TAF are associated with lower 2-year and 3-year HCC recurrence rates after curative RFA treatment compared with ETV.However,there were no significant differences in 3-year mortality rates between the ETV,TDF,and TAF groups.展开更多
BACKGROUND Patients with chronic hepatitis B(CHB)require long-term antiviral therapy.The effects of different antiviral drugs on kidney function are unclear.There is a lack of effective markers for monitoring early re...BACKGROUND Patients with chronic hepatitis B(CHB)require long-term antiviral therapy.The effects of different antiviral drugs on kidney function are unclear.There is a lack of effective markers for monitoring early renal impairment.AIM To investigate the rate of abnormal renal function index and related potential hazards in patients with CHB.METHODS Clinical data of patients with CHB with urinaryβ2-microglobulin(β2-M)detec-tion,including demographic characteristics,hepatitis B virus(HBV)DNA,serum liver function(alanine aminotransferase,aspartate aminotransferase,total bilirubin,direct bilirubin),serum renal function(urea nitrogen,creatinine),blood lipid index(high density lipoprotein,low density lipoprotein,cholesterol,trigly-ceride),liver imaging,and other routine tests were retrospectively collected.The normal level of urinaryβ2-M and estimated glomerular filtration rate(eGFR)is defined as<0.173 mg/L and≥90 mL/min/1.73 m^(2),retrospectively.The pro-portion of patients with abnormal renal function index and related risk factors were analyzed.RESULTS A total of 500 patients with CHB were enrolled;these patients were aged 44.7±10.8 years,67.2%(336/500)were male,57.2%(286/500)were treated with anti-viral drugs,and 52.2%(261/500)had an HBV-related family history.In total,28.8%(144/500)of patients had fatty liver,35.0%(175/500)had liver fibrosis,and 13.2%(66/500)had cirrhosis.The proportion of patients with eGFR<90 mL/min/1.73 m^(2) was 43.2%(216/500),and the abnormal rate of urinaryβ2-M was 56.2%(281/500).There was no significant difference in the abnormal rate of urinaryβ2-M between the untreated group and the antiviral treated group(54.2%vs 57.7%;P=0.25).The abnormal rate ofβ2-M after long-term entecavir treatment(more than 1 year)was 54.6%(89/163).In the treatment group,56.4%(92/163)of patients with eGFR≥90 mL/min/1.73 m^(2) had abnormal urinaryβ2-M.CONCLUSION In patients with CHB,a higher proportion had greater urinaryβ2-M levels than eGFR for renal injury.Male patients should pay more attention to renal function and use antiviral regimens with a renal safety profile.展开更多
目的:探讨人参皂苷Rb1对高糖培养SD大鼠海马神经元糖原合成激酶(GSK)3β/胰岛素降解酶(IDE)信号转导通路及β淀粉样蛋白(Aβ蛋白)分泌的影响。方法:原代培养新生24 h SD大鼠海马神经元分别接种在不同条件的培养基中,分为正常组、高糖组...目的:探讨人参皂苷Rb1对高糖培养SD大鼠海马神经元糖原合成激酶(GSK)3β/胰岛素降解酶(IDE)信号转导通路及β淀粉样蛋白(Aβ蛋白)分泌的影响。方法:原代培养新生24 h SD大鼠海马神经元分别接种在不同条件的培养基中,分为正常组、高糖组、氯化锂组以及Rb1组。上述培养基中培养72 h,Western blotting法检测其磷酸化GSK3β(pGSK3β)、总GSK3β(tGSK3β)和IDE蛋白的表达,RT-PCR法检测GSK3β,IDE mRNA的表达,ELISA法检测细胞上清液中Aβ蛋白的分泌。结果:与正常组相比,高糖组p/tGSK3β蛋白比值增加,IDE蛋白及mRNA减少,Aβ蛋白分泌增加(P<0.05);与高糖组相比,氯化锂组和Rb1组p/tGSK3β蛋白比值下降,IDE蛋白及mRNA表达增加,Aβ蛋白分泌减少(P<0.05);与氯化锂组相比,Rb1组p/tGSK3β蛋白,IDE蛋白及mRNA,Aβ蛋白分泌增加无明显差异;4组GSK3βmRNA的表达无明显差异。结论:人参皂苷Rb1可能通过减少GSK3β的磷酸化,下调pGSK3β/GSK3β的比值,上调IDE的表达,从而减少海马神经元Aβ蛋白的分泌。展开更多
基金Supported by Tianjin Health Project of China,No.TJWJ2022XK029.
文摘BACKGROUND The impact of entecavir(ETV),tenofovir disoproxil fumarate(TDF),and tenofovir alafenamide fumarate(TAF)on long-term recurrence and overall survival in patients with hepatitis B cirrhosis-related hepatocellular carcinoma(HCC)who AIM To compare the 3-year recurrence and survival rates among HCC patients receiving these three first-line oral anti-hepatitis B virus(anti-HBV)agents after RFA.METHODS This retrospective cohort study included patients with hepatitis B cirrhosis who were initially diagnosed with HCC at Tianjin Third Central Hospital,China,from August 2018 to December 2020,and had complete clinical data.All patients were followed up for at least 144 weeks.Cox regression analysis was performed to identify independent risk factors for HCC recurrence.Recurrence-free survival was analyzed using Kaplan-Meier curves,and Cox regression models were constructed after adjusting for gamma-glutamyl transferase,alpha-fetoprotein,and Barcelona Clinic Liver Cancer staging.RESULTS A total of 319 patients receiving oral anti-HBV therapy were divided into three groups:ETV group(n=191),TDF group(n=76),and TAF group(n=52).At 6 and 12 months,there were no significant differences in recurrence rates between the groups.However,at 24 and 36 months,the TDF and TAF groups exhibited significantly lower recurrence rates compared with the ETV group[24 months:TDF,hazard ratio(HR)=0.51,95%confidence interval(CI):0.29-0.91,P=0.022;TAF,HR=0.54,95%CI:0.28-1.03,P=0.046;36 months:TDF,HR=0.57,95%CI:0.35-0.93,P=0.025;TAF,HR=0.54,95%CI:0.31-0.96,P=0.037].The 3-year mortality rates were similar across the three groups(ETV:21.47%,TDF:18.42%,TAF:23.08%;P=0.790).CONCLUSION Among patients with hepatitis B cirrhosis-related HCC,TDF and TAF are associated with lower 2-year and 3-year HCC recurrence rates after curative RFA treatment compared with ETV.However,there were no significant differences in 3-year mortality rates between the ETV,TDF,and TAF groups.
文摘BACKGROUND Patients with chronic hepatitis B(CHB)require long-term antiviral therapy.The effects of different antiviral drugs on kidney function are unclear.There is a lack of effective markers for monitoring early renal impairment.AIM To investigate the rate of abnormal renal function index and related potential hazards in patients with CHB.METHODS Clinical data of patients with CHB with urinaryβ2-microglobulin(β2-M)detec-tion,including demographic characteristics,hepatitis B virus(HBV)DNA,serum liver function(alanine aminotransferase,aspartate aminotransferase,total bilirubin,direct bilirubin),serum renal function(urea nitrogen,creatinine),blood lipid index(high density lipoprotein,low density lipoprotein,cholesterol,trigly-ceride),liver imaging,and other routine tests were retrospectively collected.The normal level of urinaryβ2-M and estimated glomerular filtration rate(eGFR)is defined as<0.173 mg/L and≥90 mL/min/1.73 m^(2),retrospectively.The pro-portion of patients with abnormal renal function index and related risk factors were analyzed.RESULTS A total of 500 patients with CHB were enrolled;these patients were aged 44.7±10.8 years,67.2%(336/500)were male,57.2%(286/500)were treated with anti-viral drugs,and 52.2%(261/500)had an HBV-related family history.In total,28.8%(144/500)of patients had fatty liver,35.0%(175/500)had liver fibrosis,and 13.2%(66/500)had cirrhosis.The proportion of patients with eGFR<90 mL/min/1.73 m^(2) was 43.2%(216/500),and the abnormal rate of urinaryβ2-M was 56.2%(281/500).There was no significant difference in the abnormal rate of urinaryβ2-M between the untreated group and the antiviral treated group(54.2%vs 57.7%;P=0.25).The abnormal rate ofβ2-M after long-term entecavir treatment(more than 1 year)was 54.6%(89/163).In the treatment group,56.4%(92/163)of patients with eGFR≥90 mL/min/1.73 m^(2) had abnormal urinaryβ2-M.CONCLUSION In patients with CHB,a higher proportion had greater urinaryβ2-M levels than eGFR for renal injury.Male patients should pay more attention to renal function and use antiviral regimens with a renal safety profile.
