BACKGROUND Metabolic associated fatty liver disease(MAFLD)is a novel concept proposed in 2020.AIM To compare the characteristics of MAFLD and MAFLD with hepatitis B virus(HBV)infection.METHODS Patients with histopatho...BACKGROUND Metabolic associated fatty liver disease(MAFLD)is a novel concept proposed in 2020.AIM To compare the characteristics of MAFLD and MAFLD with hepatitis B virus(HBV)infection.METHODS Patients with histopathologically proven MAFLD from a single medical center were included.Patients were divided into MAFLD group(without HBV infection)and HBV-MAFLD group(with HBV infection).Propensity score matching was utilized to balance the baseline characteristics between two groups.RESULTS A total of 417 cases with MAFLD were included,359(86.1%)of whom were infected with HBV.There were significantly more males in the HBV-MAFLD group than in the MAFLD group(P<0.05).After propensity score matching,58 pairs were successfully matched with no significant differences found in gender,age,body mass index,lipid levels,liver enzymes,and the other metabolic associated comorbidities between the two groups(P>0.05).The rank sum test results showed that the degree of liver steatosis in the MAFLD group was more severe than that in the HBV-MAFLD group,while the degree of inflammation and fibrosis in the liver was less severe(P<0.05).In multivariate analysis,HBV infection was associated with significantly lower grade of hepatic steatosis[odds ratio(OR)=0.088,95%confidence interval(CI):0.027-0.291]but higher inflammation level(OR=4.059,95%CI:1.403-11.742)and fibrosis level(OR=3.016,95%CI:1.087-8.370)after adjusting for age,gender,and other metabolic parameters.CONCLUSION HBV infection is associated with similar metabolic risks,lower steatosis grade,higher inflammation,and fibrosis grade in MAFLD patients.展开更多
BACKGROUND Ascites is the most common complication of cirrhosis.Current pharmacological interventions,such as diuretics,often become ineffective in advanced stages due to diuretic resistance.Sodium-glucose co-transpor...BACKGROUND Ascites is the most common complication of cirrhosis.Current pharmacological interventions,such as diuretics,often become ineffective in advanced stages due to diuretic resistance.Sodium-glucose co-transporter 2(SGLT2)inhibitors have demonstrated potential in enhancing urinary sodium excretion and mitigating sodium-fluid retention.This study aims to evaluate the effects of SGLT2 inhibitors on the fractional excretion of sodium(FENa)in patients with cirrhotic ascites.AIM To determine whether adjunctive therapy with the SGLT2 inhibitor empagliflozin increases FENa compared with standard care alone in patients with cirrhosis and refractory ascites,and to evaluate its short-term safety profile.METHODS The effect of SGLT2 inhibitor empagliflozin on FENa in patients with cirrhosis and refractory ascites is a multicenter,open-label,randomized controlled trial.A total of 70 patients with refractory ascites secondary to cirrhosis will be enrolled and randomly assigned to receive either empagliflozin 10 mg daily plus standard care or standard care alone for 14 consecutive days.The primary outcome is the change in FENa from baseline to day 14.Secondary outcomes include 24-hour urinary sodium excretion,urine volume,ascites volume(assessed by ultrasound),body weight,and safety indicators.Exploratory outcomes include changes in components of the reninangiotensin-aldosterone system.RESULTS This article reports the study protocol only.No participant data have been collected or analyzed for this manuscript.CONCLUSION This protocol evaluates whether empagliflozin,added to standard therapy,increases sodium excretion and reduces fluid overload in refractory ascites.展开更多
Objective:To investigate the actions of cytokine profile in the immune cells by a seven amino acid peptide mimic from HVR1 of HCV (GQTYTSG,named 7P).Methods:The peripheral blood mononuclear cells (PBMCs) from 17 healt...Objective:To investigate the actions of cytokine profile in the immune cells by a seven amino acid peptide mimic from HVR1 of HCV (GQTYTSG,named 7P).Methods:The peripheral blood mononuclear cells (PBMCs) from 17 healthy blood donors were stimulated with 7P,and the cytokine levels in CD4+CD8-,CD4-CD8+ T cells,NK,NKT cells were analyzed by the intracellular cytokine staining.Results:The frequency of cells which secreted interferon-γ (IFN-γ) was found to be significantly increased in all cells,interleukin-10(IL-10) was significantly increased in CD4+CD8-,CD4-CD8+ T cells but decreased in NK,NKT cells,and tumor necrosis factor-α (TNF-α) was decreased in CD4+CD8-,CD4-CD8+ but increased in NK cells.Conclusion:7P could induce a cytokine profile in different immune cells in vitro and there was some difference between the CD4+CD8-,CD4-CD8+ T cells which represented the adaptive immunity cells and NK,NKT cells which represented the innate immunity cells.This kind of variation of cytokine profile might contribute to anti-virus and anti-inflammatory immune reaction.展开更多
Background： Cirrhosis is a common complication of chronic hepatitis B. It remains unclear if viral and biochemical parameters at baseline affect virological response to entecavir and therefore warrant investigation. ...Background： Cirrhosis is a common complication of chronic hepatitis B. It remains unclear if viral and biochemical parameters at baseline affect virological response to entecavir and therefore warrant investigation. In the present study, we aimed to eval uate the efficacy of entecavir therapy by monitoring virological response at the end of the 3^rd month of treatment and try to figure out whether baseline factors could help predict it in a cohort of hepatitis B virus （HBV） compensated cirrhosis patients and to determine the cut-off value of a predicting parameter.Methods： A total of 91 nucleos（t）ide-naive patients with HBV induced cirrhosis （compensatory stage） were enrolled in a prospective cohort. HBV DNA and alanine aminotransferase （ALT） were tested at baseline and monitored every 3-6 months after starting therapy. Results： Of all 91 patients, the median follow-up time was 12 （9-24） months. Overall, 64 patients （70.3%） achieved virological response in the 3^rd month. Univariate analysis showed that the 3^rd month virological response can be predicted by baseline HBV DNA levels （P 〈 0.001, odds ratio [OR]： 2.13, 95% confidence interval [CI]： 1.44-3.15）, ALT value （P = 0.023, OR： 1.01, 95% CI： 1.00 1.01 ） and hepatitis B e antigen （HBeAg） negativity （P = 0.016, OR： 0.30, 95% CI： 0.11-0.80）. Multiple regression analysis showed baseline H BV DNA level was the only parameter related to full virological response. Higher baseline HBV DNA strata indicated a higher probability that HBV DNA remains detectable at the 3^rd month （P = 0.001）. Area under receiver operating characteristic curve for determining the 3^rd month virological response by baseline HBV DNA was 77.6% （95% CI： 66.7-85.2%）, with a best cut-offvalue of 5.8 log10. Conclusions： Baseline HBV DNA, HBeAg negativity, and ALT were independent factors contributing to virological response at the 3^rt month. Further, multiple regression showed that HBV DNA level was the only parameter predicting full virological response as early as the 3^rd month, in this cirrhosis cohort.展开更多
基金Supported by Chinese National 13th Five-Year Plan's Science and Technology Projects,No.2017ZX10202201.
文摘BACKGROUND Metabolic associated fatty liver disease(MAFLD)is a novel concept proposed in 2020.AIM To compare the characteristics of MAFLD and MAFLD with hepatitis B virus(HBV)infection.METHODS Patients with histopathologically proven MAFLD from a single medical center were included.Patients were divided into MAFLD group(without HBV infection)and HBV-MAFLD group(with HBV infection).Propensity score matching was utilized to balance the baseline characteristics between two groups.RESULTS A total of 417 cases with MAFLD were included,359(86.1%)of whom were infected with HBV.There were significantly more males in the HBV-MAFLD group than in the MAFLD group(P<0.05).After propensity score matching,58 pairs were successfully matched with no significant differences found in gender,age,body mass index,lipid levels,liver enzymes,and the other metabolic associated comorbidities between the two groups(P>0.05).The rank sum test results showed that the degree of liver steatosis in the MAFLD group was more severe than that in the HBV-MAFLD group,while the degree of inflammation and fibrosis in the liver was less severe(P<0.05).In multivariate analysis,HBV infection was associated with significantly lower grade of hepatic steatosis[odds ratio(OR)=0.088,95%confidence interval(CI):0.027-0.291]but higher inflammation level(OR=4.059,95%CI:1.403-11.742)and fibrosis level(OR=3.016,95%CI:1.087-8.370)after adjusting for age,gender,and other metabolic parameters.CONCLUSION HBV infection is associated with similar metabolic risks,lower steatosis grade,higher inflammation,and fibrosis grade in MAFLD patients.
基金Supported by Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support,No.ZLRK202533High-Level Public Health Technology Talent Project,No.2022-2-005the Scientific Research Project of Beijing You’an Hospital,2024,No.BJYAYY-YN2022-20.
文摘BACKGROUND Ascites is the most common complication of cirrhosis.Current pharmacological interventions,such as diuretics,often become ineffective in advanced stages due to diuretic resistance.Sodium-glucose co-transporter 2(SGLT2)inhibitors have demonstrated potential in enhancing urinary sodium excretion and mitigating sodium-fluid retention.This study aims to evaluate the effects of SGLT2 inhibitors on the fractional excretion of sodium(FENa)in patients with cirrhotic ascites.AIM To determine whether adjunctive therapy with the SGLT2 inhibitor empagliflozin increases FENa compared with standard care alone in patients with cirrhosis and refractory ascites,and to evaluate its short-term safety profile.METHODS The effect of SGLT2 inhibitor empagliflozin on FENa in patients with cirrhosis and refractory ascites is a multicenter,open-label,randomized controlled trial.A total of 70 patients with refractory ascites secondary to cirrhosis will be enrolled and randomly assigned to receive either empagliflozin 10 mg daily plus standard care or standard care alone for 14 consecutive days.The primary outcome is the change in FENa from baseline to day 14.Secondary outcomes include 24-hour urinary sodium excretion,urine volume,ascites volume(assessed by ultrasound),body weight,and safety indicators.Exploratory outcomes include changes in components of the reninangiotensin-aldosterone system.RESULTS This article reports the study protocol only.No participant data have been collected or analyzed for this manuscript.CONCLUSION This protocol evaluates whether empagliflozin,added to standard therapy,increases sodium excretion and reduces fluid overload in refractory ascites.
基金Supported by the National High Technology Research and Development Program of China(863 Program,No. 2006AA022494)
文摘Objective:To investigate the actions of cytokine profile in the immune cells by a seven amino acid peptide mimic from HVR1 of HCV (GQTYTSG,named 7P).Methods:The peripheral blood mononuclear cells (PBMCs) from 17 healthy blood donors were stimulated with 7P,and the cytokine levels in CD4+CD8-,CD4-CD8+ T cells,NK,NKT cells were analyzed by the intracellular cytokine staining.Results:The frequency of cells which secreted interferon-γ (IFN-γ) was found to be significantly increased in all cells,interleukin-10(IL-10) was significantly increased in CD4+CD8-,CD4-CD8+ T cells but decreased in NK,NKT cells,and tumor necrosis factor-α (TNF-α) was decreased in CD4+CD8-,CD4-CD8+ but increased in NK cells.Conclusion:7P could induce a cytokine profile in different immune cells in vitro and there was some difference between the CD4+CD8-,CD4-CD8+ T cells which represented the adaptive immunity cells and NK,NKT cells which represented the innate immunity cells.This kind of variation of cytokine profile might contribute to anti-virus and anti-inflammatory immune reaction.
文摘Background： Cirrhosis is a common complication of chronic hepatitis B. It remains unclear if viral and biochemical parameters at baseline affect virological response to entecavir and therefore warrant investigation. In the present study, we aimed to eval uate the efficacy of entecavir therapy by monitoring virological response at the end of the 3^rd month of treatment and try to figure out whether baseline factors could help predict it in a cohort of hepatitis B virus （HBV） compensated cirrhosis patients and to determine the cut-off value of a predicting parameter.Methods： A total of 91 nucleos（t）ide-naive patients with HBV induced cirrhosis （compensatory stage） were enrolled in a prospective cohort. HBV DNA and alanine aminotransferase （ALT） were tested at baseline and monitored every 3-6 months after starting therapy. Results： Of all 91 patients, the median follow-up time was 12 （9-24） months. Overall, 64 patients （70.3%） achieved virological response in the 3^rd month. Univariate analysis showed that the 3^rd month virological response can be predicted by baseline HBV DNA levels （P 〈 0.001, odds ratio [OR]： 2.13, 95% confidence interval [CI]： 1.44-3.15）, ALT value （P = 0.023, OR： 1.01, 95% CI： 1.00 1.01 ） and hepatitis B e antigen （HBeAg） negativity （P = 0.016, OR： 0.30, 95% CI： 0.11-0.80）. Multiple regression analysis showed baseline H BV DNA level was the only parameter related to full virological response. Higher baseline HBV DNA strata indicated a higher probability that HBV DNA remains detectable at the 3^rd month （P = 0.001）. Area under receiver operating characteristic curve for determining the 3^rd month virological response by baseline HBV DNA was 77.6% （95% CI： 66.7-85.2%）, with a best cut-offvalue of 5.8 log10. Conclusions： Baseline HBV DNA, HBeAg negativity, and ALT were independent factors contributing to virological response at the 3^rt month. Further, multiple regression showed that HBV DNA level was the only parameter predicting full virological response as early as the 3^rd month, in this cirrhosis cohort.
