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Liu Y.,Tianjin Medical University | Han T.,Tianjin Medical University | Zhu Z.-Y.,Tianjin Institute of Hepatobiliary Disease | Li Y.,Tianjin Medical University
Clinics and Research in Hepatology and Gastroenterology | Year: 2014

Background and aim: In the previous study, we found serum thymosin β4 (Tβ4) levels were associated with mortality in liver failure patients. In this study, we try to evaluate the prognostic value of Tβ4 in acute-on-chronic liver failure (AoCLF) patients by comparing with the Child-Pugh (CTP) and Model for End-Stage Liver Disease (MELD) scores. Methods: Serum Tβ4 levels were measured by enzyme-linked immunosorbent assay (ELISA), and the CTP and MELD scores were calculated for each patient. Results: Serum Tβ4 levels of AoCLF patients [0.4120 (0.2447-0.7492). μg/mL] were lower than healthy controls [9.2710 (5.1660-13.2485). μg/mL] (P<. 0.001). AoCLF patients were divided into survival and death group. Compared to survivors, lower Tβ4 concentrations, higher CTP and MELD scores (P<. 0.001, respectively) were observed in AoCLF patients who died. There were negative correlations between Tβ4 levels and CTP scores (P<. 0.001), MELD scores (P<. 0.001). A CTP score of 11.5, a MELD score of 21.63 and a Tβ4 concentration of 0.3840. μg/mL were identified as the cut-off values for the stratification of AoCLF patients. MELD. ≥. 21.63 combined with Tβ4. <. 0.3840. μg/mL can more exactly discriminate between the patients who would survive and die. Conclusions: Serum Tβ4 concentration has appreciable value to evaluate the short-term prognosis of AoCLF patients, although Tβ4 is not superior to MELD. The combination of Tβ4 and MELD scores are more effective in assessing the prognosis of AoCLF patients. © 2014 Elsevier Masson SAS. Source


Pei Y.Z.,Tianjin Institute of Hepatobiliary Disease
Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology | Year: 2011

To investigate the discrepancy of HBsAg titre and correlation of HBV DNA levels among patients with chronic hepatitis B (CHB), HBV-related liver cirrhosis (LC) and hepatocellular carcinoma (HCC). HBsAg titre and HBV DNA in serum samples were measured among 47 CHB, 72 LC and 54 HCC cases using Abbott chemiluminescence and fluorescence quantitative PCR, respectively. Statistical analyses among multiple groups, between two groups and about the correlation were performed using Kruskal-Wallis test, Mann-Whitney U test and Spearman test, respectively. The median HBsAg titre level in serum samples decreased from 2361.10 IU/ml in CHB cohort to 1001.64 IU/ml in LC cohort and 594.35 IU/ml in HCC cohort, suggesting a statistically significant difference (x2 = 24.394, P less than 0.05). Moreover, HBsAg titre in CHB group was significantly higher than that in LC group ( Z = -3.754, P less than 0.05). CHB patients had significantly higher HBsAg titre than HCC cases ( Z = -4.630, P less than 0.05). However, there was no statistically significant difference in HBsAg titre between LC and HCC group. Among HBeAg positive patients, HBsAg titre decreased from 3259.83 IU/ml in CHB group to 1077.30 IU/ml in LC group and 789.72 IU/ml in HCC group, indicating a significant difference (x2 = 15.643, P less than 0.01). Among HBeAg negative patients, HBsAg titre declined from 1669.00 IU/ml in CHB group to 1001.64 IU/ml in LC group and 582.05 IU/ml in HCC group, suggesting of a significant difference (x2 = 6.423, P less than 0.05). Positive correlation between HBsAg titre and HBV DNA was found in CHB ( r = 0.297, P less than 0.05), LC (r = 0.346, P less than 0.05) and HCC (r = 0.452, P less than 0.05), respectively. HBsAg titre level in serum decreased progressively from CHB to LC and HCC group. There were positive correlations between HBsAg titre and HBV DNA level in CHB, LC and HCC. Source


Han L.,Tianjin Medical University | Han T.,Tianjin Medical University | Han T.,Tianjin Institute of Hepatobiliary Disease | Nie C.,Tianjin Medical University | And 2 more authors.
Clinics and Research in Hepatology and Gastroenterology | Year: 2015

Background and aim: It has been shown that mean platelet volume (MPV) can be used as a prognostic biomarker in some chronic diseases. The aim of the present study is to investigate the possible association between MPV and clinical outcome and prognosis in patients with HBV-related acute-on-chronic liver failure (HBV-ACLF) within 4 weeks. Methods: This study included 64 patients with HBV-ACLF, 19 chronic hepatitis B (CHB) patients, 27 patients with hepatitis B-related cirrhosis (CR, Child-Pugh A/B), 51 healthy subjects (healthy controls [HC]). The complete blood counts and biochemical examination of blood were obtained after 12. h of fasting. In the ACLF group, the relationships between the prognosis and the MPV were analyzed. Results: At baseline, a statistically significant increase in MPV was shown in patients with ACLF (median 9.5, range 7.1-14.1) compared with HC (8.0, 7.2-11.9, P<. 0.001), CR (8.4, 5.9-11.1, P<. 0.001) and CHB (8.3, 7.3-12.0, P<. 0.001). The MPV value was positively correlated with model of end-stage liver disease (MELD) score and international normalized ratio (INR). The MPV level was significantly increased in nonsurvivors than survivors. High MPV level showed a significantly lower survival rate (P= 0.001). Multivariate logistic regression analysis showed that only MPV level was independent factor predicting poor short-term outcomes. Conclusion: MPV values at presentation were higher among nonsurvivors than survivors, and this parameter was well correlated with liver function parameters and may be used as a predictor for 4-week mortality rate in patients with HBV-ACLF. © 2014 Elsevier Masson SAS. Source


Zhang Q.,Tianjin Medical University | Han T.,Tianjin Third Central Hospital | Han T.,Tianjin Institute of Hepatobiliary Disease | Han T.,Tianjin Key Laboratory of Artificial Cells | And 10 more authors.
Journal of Medical Virology | Year: 2015

In clinical practice, establishing a subsequent optimum treatment for chronic hepatitis B patients with a history of multiple NAs treatment failures, including a suboptimal response to a final therapy with combined ETV and ADV, is a complicated but crucial challenge. This study investigated the efficacy and safety of a tenofovir rescue regimen in these patients. A total of six eligible patients were enrolled and were switched to a tenofovir rescue regimen. At baseline, the genotypes and genotypic mutations of the reverse transcriptase and surface gene were determined by ultra-deep pyrosequencing, and further clonal analyses of the reverse transcriptase domain were performed to identify multidrug-resistant HBV strains. In addition, HBV DNA levels, serology, and biochemistry parameters were monitored at baseline and every 3 months, and abdominal ultrasonography was performed at baseline and every 6 months. All patients were confirmed to harbor LAM-related resistant HBV strains. After switching to the tenofovir rescue treatment, all patients had an undetectable level of HBV DNA within 6 months and achieved normalization of the ALT level within 9 months. These virological and biochemical responses persisted until the end of the observation period. None of the patients developed clinical deterioration or any adverse events related to the tenofovir therapy during the median 16.5-month follow-up. In conclusion, the tenofovir rescue regimen can be employed confidently as a highly effective and safe treatment choice following a suboptimal response to ETV plus ADV therapy for a subset of chronic hepatitis B patients with a history of multiple unsuccessful antiviral treatments. © 2015 Wiley Periodicals, Inc. Source


Zhang Q.,Tianjin Medical University | Han T.,Tianjin Medical University | Han T.,Tianjin Institute of Hepatobiliary Disease | Han T.,Tianjin Key Laboratory of Artificial Cells | And 7 more authors.
Hepatology Research | Year: 2016

Aim: To compare the prognosis between the patients with progression into acute-on-chronic liver failure (ACLF) from acute deterioration of pre-existing chronic liver disease and patients without this progression, and to determine predictors of this disease progression. Methods: We retrospectively analyzed clinical data from 285 patients admitted with acute worsening of pre-existing chronic liver disease within 4 weeks characterized by total bilirubin (TBIL) of 51 μM/L or more and prothrombin activity (PTA) of more than 40% but less than 70%, which did not meet the Asia-Pacific Association for the Study of the Liver criteria for ACLF. Patient survival was estimated by Kaplan-Meier analysis and subsequently compared by log-rank test. Independent predictors of disease progression were determined using univariate analysis and multivariate Cox regression analysis. Results: The 90-day survival rates significantly worsened in patients with progression into ACLF compared with those without this progression. Baseline TBIL, baseline Model for End-Stage Liver Disease (MELD) score, and the maximum changing rates of PTA level and Child-Turcotte-Pugh (CTP) score were independently associated with progression into ACLF in patients with acute deterioration of pre-existing chronic liver disease. Conclusion: Patients with acute worsening of pre-existing chronic liver disease characterized by TBIL of 51 μM/L or more and PTA of more than 40% but less than 70% should receive aggressive prediction and prevention of ACLF development. Baseline TBIL, baseline MELD score, and the maximum changing rates of PTA level and CTP score may early predict the progression into ACLF. © 2016 The Japan Society of Hepatology. Source

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