Summary The pathogenesis of HBV-associated liver failure is very complicated and it has achieved great progress in recent *** the recent literature,combining with the novel findings of our research team,here,we summar...
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Summary The pathogenesis of HBV-associated liver failure is very complicated and it has achieved great progress in recent *** the recent literature,combining with the novel findings of our research team,here,we summarized the pathogenesis of HBV-associated liver failure as follows:l)both host and viral factors are contributed to the pathogenesis of HBV-associated liver failure.2)polymorphisms G-201A from CXCL10,-592C and -819C from IL-10 are closely related to hepatitis flares and liver failure.3)genotype C and B,particularly B/C co-infection,are correlated with liver failure.4) quasispecies studies during antiviral therapy by using NAs is quite important.5)attention should be paid to missed detection in HBV DNA by real-time PCR. Liver failure is a condition in which rapid deterioration of liver function results in altered mentation and *** etiology of liver failure shows worldwide variations,and its prominent causes include drug-induced liver injury,viral hepatitis,autoimmune liver disease and shock or *** most other countries,in China,liver failure has been termed as severe hepatitis and is caused mainly by hepatitis B virus(HBV) infection(at least 60%-80%).1 According to the diagnostic and treatment guidelines for liver failure recommended by the Chinese Medical Association in 2006,2 liver failure could be classified four difference types as table 1. Persistent HBV infection and HBV-related liver diseases have been considered as a multi-factorial and polygenic disorder with viral,environmental and host genetic *** pathogenesis of HBV-associated liver failure is very complex and needs more studies to *** host and viral factors are contributed to the pathogenesis of HB V-associated liver *** the literature in recent years,combining with the novel findings of our research team,here,we summarized the pathogenesis of HBV-associated liver failure as follows. The Progress of Pathogenesis Host Factors
AIMS:The underlying pathogenesis of fulminant viral hepatitis(FVH) has not been fully *** a subset of regulatory T cells,CD3+CD4-CD8- double negative(DN) T cells can suppress T cell *** this study,we present new insig...
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AIMS:The underlying pathogenesis of fulminant viral hepatitis(FVH) has not been fully *** a subset of regulatory T cells,CD3+CD4-CD8- double negative(DN) T cells can suppress T cell *** this study,we present new insights into the immune mediated mechanisms involved in FVH caused by murine hepatitis virus strain 3(MHV-3). METHODS:The phenotype and cytokines of DN T cells were detected by flow cytometric *** levels of mfgl2 were measured by real-time PCR and *** function of mfgl2 was measured by PCA. RESULTS:After MHV-3 infection,the proportions of DN T cells increased significantly in BALB/cJ mice,and splenic DN T cells expressing high levels of CD69 were recruited by MHV- 3 infected hepatocytes to the *** levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST) and total bilirubin(TBil) increased,accompanied by massive hepatocyte *** DN T cells were predominantly consisted of a TCRαβ+ subset expressing high levels of CD44,and did not produce cytokine except *** transfer of this subset of DN T cells to the MHV-3 infected mice resulted in an increase of murine fibrinogen—like protein 2(mfgl2) expression in association with massive fibrin deposition in the *** MHV-3 infection,membrane mfgl2 expression and functional procoagulant activity(PCA) increased remarkably in the DN T cells. Introduction of a recombinant adenovirus which encoded a microRNA specifically targeting mfgl2 gene (Ad-mfgl2-miRNA) in vivo significantly inhibited the hepatic expression of mfgl2,increased mice ***,under this condition,adoptive transfer of the DN T cells accelerated the disease progression and reversed the benefit from mfgl2 gene silence,led to a 100%death. CONCLUTION:Our results demonstrated that DN T cell-derived mfgl2 may serve as an important effector molecule contributing to the pathogenesis of MHV-3-induced FVH.
Background/Aims:Hepatitis B related acute-on-chronic liver failure has a poor prognosis with very high ***,most prognostic predictive models of liver failure are complicated and offer suboptimal *** in entecavir-treat...
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Background/Aims:Hepatitis B related acute-on-chronic liver failure has a poor prognosis with very high ***,most prognostic predictive models of liver failure are complicated and offer suboptimal *** in entecavir-treated patients with HBV-ACLF is limited. This study was designed to evaluate the efficacy and safety of entecavir in patients with HBV-ACLF and to develop a novel model(Tongji prognostic predictory model,TPPM) for prognostic prediction of HBV-ACLF patients. Methods:In this retrospective study,248 patients with HBV-ACLF were *** were no signifcant differences in baseline clinical and virological characteristics between patients treated with and without entecavir. Results:The 1- and 3-month survival rates of patients in the entecavir-treated group were 72.58%and 61.29%,significantly higher than that in NA-free group which were 53.23%and 45.97%. The entecavir-treated group also achieved a better improvement of MELD score when compared with the *** multivariate logistic regression,high INR for prothrombin time,≥2 Complications and high total bilirubin,but not HBV DNA,were independent predictors of liver-related mortality. By Hosmer and Lemeshow test,TPPM for HBV-ACLF with a very good degree of fit with disease *** on this unique group of patients,the TPPM scoring offered a better prediction value in both specificity and sensitivity for 3-month mortality of patients with HBV-ACLF compared with MELD scoring system with statistically significant *** the patients with HBV-ACLF,using a cutoff of 0.22 for 3-month predicted mortality by TPPM,the positive predictive value was 93.6%, with a negative predictive value of 91.3%. Conclusions:Entecavir treatment prevents disease progression and increased the survival of patients with *** established TPPM scoring system offers superior predictoiy value in both specificity and sensitivity for HBV-ACLF patients when compared with MELD.
Background Initial cases of 2009 pandemic influenza A(H1N1) virus infection having been reported mostly represented a mild *** the number of infected persons increased in our country,more severe infections were report...
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Background Initial cases of 2009 pandemic influenza A(H1N1) virus infection having been reported mostly represented a mild *** the number of infected persons increased in our country,more severe infections were reported in the second half of last *** first severely ill patient in our hospital was confirmed in October 26,2009. Methods During October 26,2009 and January 23,2010,totally 71 cases treated in our hospital who developed community acquired pneumonia from confirmed or clinically suspected 2009 pandemic influenza A(H1N1) were observed in this study,including both hospitalized patients and outpatients. Real-time reverse-transcriptase-polymerase-chain-reaction(RT-PCR) testing was used to confirm *** data were collected retrospectively and *** 3-month follow up, high-resolution chest CT and lung function tests were performed. Results Of the 71 cases,median age was 41(IQR 28 to 56) years;63.4%were male,54.9%had at least one underlying medical condition.68 patients received antiviral treatment,and 33 received intravenous corticosteroids.36 of 71 patients developed acute respiratory distress syndrome during the *** 25 patients who were treated by mechanical ventilation,14 survived with noninvasive ventilation,and 10 required invasive ventilation.9 patients died at a median of 16(IQR 10 to 24) days after onset of *** risk factors were identified to be independently associated with death analyzed by multivariate Cox regression:progressing dyspnea after resolution of fever(relative risk,5.667;95%CI,1.312 to 24.475;P=0.020) and higher APACHE II score on presentation(relative risk for each point,1.329;95%CI,1.156 to 1.527;P < 0.001).At 3-month follow up of H1N1 pneumonia survivors,ground-glass opacities still existed in most patients(82%) with smaller extent,and lung function tests revealed that decreased diffusing capacity for carbon monoxide of mild degree is the most common(60%) abnormality. Conclusions We id
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