OBJECTIVETo determine whether there are differences in both the right hepatic vein (RHV) morphology and the size of the angle between the inferior vena cava and the RHV in patients with membranous obstruction of the inferior vena cava (MOVC),in healthy individuals and in patients with cinhosis (HLC), in order to help guide development of an effective interventional treatment program.

METHODSConsecutive patients (n=248) were divided into the following three groups: group A (control; n=94), group B (MOVC patients; n=68), group C (HLC patients; n=86). The angle between the hepatic vein and inferior vena cava was measured and defined as the T value. The morphology of the RHV was classified as N, U, or I. The difference of the constituent ratio was compared among the three groups for the T value and the angle type.Measurement data was calculated as x ± s,and groups were compared using one-way ANOVA; count data was calculated as relative number, and groups were compared using the chi-square test.

RESULTSThe average T value of group B was significantly higher than that of group A (56.1 ± 13.7 vs. 49.3 ± 7.8, P=0.010) and of group C (vs. 51.5 ± 10.0, P < 0.001); the difference was statistically significant (F=8.750, P < 0.001), but there was no significant difference between the groups A and C.N-type proportion of B group was 48.5% (33/68), greater than that of group A(16.0%,15/94) and C (16.3%, 14/86), x² = 20.1, x² =18.6.U-type proportion of B group was 11.8% (8/68), smaller than that of groups A (28.7%,27/94) and C (37.2%, 32/86), 2 2 = 6.70, x² =12.8, and the differences were statistically significant (P < 0.01). For groups A and C, the N and U types were not significantly different.

CONCLUSIONThe angle between the RHV and the inferior vena cava in MOVC patients is morphologically different from that in healthy humans, with the angle value in MOVC patients being slightly larger. However, this difference is irrelevant to cirrhosis.

Hepatic Veins ; Humans ; Vena Cava, Inferior

OBJECTIVETo investigate the preventive effect of magnesium isoglycyrrhizinate against acute drug-induced liver damage from initial chemotherapy treatment in patients with gastrointestinal cancer.

METHODSA total of 216 cases with early stage gastric cancer and indications for systemic chemotherapy that had been diagnosed with gastrointestinal malignant tumors by pathology in our hospital were enrolled for study during the period of January 2011 to June 2013.Using a prospective randomized controlled study design,differences were assessed between groups treated with glycyrrhizic acid magnesium (experimental group; n=114) or glutathione (control group; n=102) and the FOLFOX regimen (n=104) or the XELOX regimen (n=112).Patients in the FOLFOX group received intravenous infusion of L-OHP (85 mg/m²) at day 1,followed by a bolus injection of 5-FU (400 mg/m²) at days 1-2 and continuous intravenous infusion of 5-FU (600 mg/m²) for 22 h at days 1-2,with one cycle comprising 2 weeks. Patients in the XELOX group received intravenous infusion of L-OHP (130 mg/m²) at day 1, followed by capecitabine (1 000 mg/m²) oral twice a day at days 1-14,with one cycle comprising 3 weeks.In the first cycle of chemotherapy,serum was extracted from the patients at 1 day before chemotherapy and 1 week after chemotherapy.An automated biochemistry analyzer was used to measure alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil) and alkaline phosphatase (ALP). Differences between groups were statistically analyzed by the t-test and x² test.

RESULTSAmong the total 216 cases treated with chemotherapy,40 showed hepatic biochemical abnormalities (12 cases in the experimental group, 28 cases in the control group), and the effect of prevention was significantly different between the two groups (10.53% vs. 27.25%; x² =10.219, P less than 0.005).The acute and subacute hepatic toxicity reaction degrees for the experimental and the control groups were: 0:94.78% vs. 88.2%; 1:5.3% vs. 11.8% (x² =6.99, P < 0.01). One week after chemotherapy, the liver biochemical indexes in the experimental group (ALT:35.93 ± 8.33 U/L; AST:24.84 ±2.91 U/L; TBil:13.29 ± 5.89 mumol/L; ALP:125.1 ± 53.61 U/L) were statically different from those in the control group (all P < 0.05). The liver biochemical indexes before and after chemotherapy were also significantly different between the experimental group (ALT:13.18t3.23 U/L; AST:5.39 ± 2.57 U/L; TBil:2.79 ± 0.23 mumol/L; ALP:52.08 ± 4.83 U/L) and the control group (all P < 0.05).One week after chemotherapy in the experimental group, the groups treated with the FOLFOX regimen or the XELOX regimen showed no statistical differences in the liver biochemical indexes.One week after chemotherapy in the control group, though, the groups treated with the FOLFOX regimen showed significantly lower AST (26.24 ± 3.50 U/L vs. 29.80 ± 6.57 U/L, t=-2.431, P < 0.05),but the residual liver biochemical indexes were not significantly different.In the experimental group, the FOLFOX group showed significantly lower ALP (53.44 ± 2.47 U/L vs. 56.58 ± 6.70 U/L, t =-2.201, P < 0.05), AST (6.48 ± 3.15U/L vs. 9.88 ± 4.57 U/L, t =-5.223, P < 0.05), but the residual liver biochemical index was not significantly different.

CONCLUSIONMagnesium isoglycyrrhizinate is an effective drug for the prevention of drug-induced liver damage after initial chemotherapy in patients with early stage gastrointestinal cancer.

Alanine Transaminase ; Alkaline Phosphatase ; Antineoplastic Combined Chemotherapy Protocols ; Aspartate Aminotransferases ; Bilirubin ; Chemical and Drug Induced Liver Injury ; Deoxycytidine ; analogs & derivatives ; Fluorouracil ; analogs & derivatives ; Gastrointestinal Neoplasms ; Glycyrrhizic Acid ; Humans ; Leucovorin ; Organoplatinum Compounds ; Prospective Studies ; Saponins ; Triterpenes

OBJECTIVETo investigate the role of p38MAPK and PI3K/AKT pathways in mitomycin (MMC)-induced apoptosis in the liver stem-like cell line WB-F344.

METHODSWB-F344 cells were exposed to MMC and apoptosis was evaluated by flow cytometry and DNA fragmentation. Phospho-MAPK and phospho-PI3K/AKT were detected by western blotting.

RESULTSMMC induced apoptosis in WB-F344 cells at 6h after addition of MMC; the maximum level of apoptosis was reached at 24h after MMC exposure. The apoptosis effects of MMC were concentration dependent and inhibited when the PI3K pathway was abolished by the specific inhibitor LY294002, but not inhibited when the p38MAPK pathway was abolished by inhibitor SB203508.

CONCLUSIONApoptosis of WB-F344 cells can be induced by MMC.Although MMC can activate both the PI3K/AKT and p38MAPK pathways, the apoptosis effect of MMC occurs via a PI3K pathway and is not dependent on the p38MAPK pathway.

Animals ; Apoptosis ; Blotting, Western ; Cell Line ; Chromones ; Flow Cytometry ; Mitomycin ; Morpholines ; Phosphatidylinositol 3-Kinases ; Proto-Oncogene Proteins c-akt ; Rats ; Signal Transduction ; p38 Mitogen-Activated Protein Kinases

OBJECTIVETo investigate the roles of PI3K/Akt signaling in the unfolded protein response (UPR) and non-UPR signaling pathways of endoplasmic reticulum stress and apoptosis in hepatocytes under conditions of saturated fatty acid-induced steatosis.

METHODSA steatosis model of hepatocytes (L02 cell and HepG2 cell line) was induced by palmitate sodium saturated fatty acids.The hepatocytes were divided into normal control group,experimental group (treated with palmitate sodium) and intervention group (treated with palmitate sodium and LY294002, a PI3K/Akt inhibitor). Cell apoptosis was detected by flow cytometry with Annexin V/PI double-staining.Western blot analysis was used to examine the protein expression of GRP78, PI3K, P-PI3K,Akt, P-Akt, CHOP and Bax.The F test and t-test were used in statistical analyses.

RESULTSFlow cytometry showed that palmitate sodium induced cell apoptosis in steatotic hepatocytes;moreover, a significant increase in cell apoptosis was observed in the palmitate sodium-induced steatotic hepatocytes in the presence of LY294002.For the normal control group, the experimental group and the intervention group, the apoptosis ratios of L02 cells were 4.41 ± 0.78% vs. 6.01 ± 1.49% vs. 19.50 ± 2.53% after 24 hours of treatment,and 12.56 ± 2.78% vs. 29.72 ± 6.39% vs. 44.60 ± 4.17% after 48 hours of treatment in respectively (all P < 0.05),and of HepG2 cells were 11.16 ± 1.15% vs. 17.50 ± 6.83% vs. 30.41 ± 3.62% after 24 hours of treatment, and 22.37 ± 1.24% vs. 33.85 ± 5.79% vs. 48.56 ± 4.21% after 48 hours of treatment (all P < 0.05). Western blot analysis showed that expression of GRP78 was significantly upregulated in the palmitate sodium-induced steatosis hepatocytes, indicating activation of endoplasmic reticulum stress. In addition, the palmitate sodium treatment also activated the PI3K/Akt pathway,induced expression of CHOP and Bax of the UPR and non-UPR signaling pathways respectively. Moreover, Pretreatment with LY294002 inhibited the palmitate sodium induced-phosphorylation of PI3K and Akt, and promoted upregulation of CHOP and Bax induced by palmitate sodium.

CONCLUSIONThe PI3K/Akt pathway may be involved in regulation of the UPR and non-UPR signaling pathways of endoplasmic reticulum stress and may promote apoptosis of hepatocytes by enhancing the expression of CHOP and Bax protein in saturated fatty acid-induced steatotic hepatocytes.

Animals ; Apoptosis ; Cell Line ; Endoplasmic Reticulum Stress ; Fatty Liver ; Heat-Shock Proteins ; Hepatocytes ; Humans ; Palmitic Acid ; Phosphatidylinositol 3-Kinases ; Phosphorylation ; Proto-Oncogene Proteins c-akt ; Signal Transduction ; Unfolded Protein Response ; Up-Regulation

OBJECTIVETo investigate the diagnostic value of serum Golgi protein-73 (GP73) combined with the AFP-L3% test for hepatocellular carcinoma.

METHODSComprehensive electronic and manual searches were performed to retrieve relevant studies on GP73 combined with AFP-L3% for diagnosis of hepatocellular carcinoma. After screening of the studies according to inclusion criteria and extraction of the data,meta-analysis was performed in Meta-disc 1.4 and Stata 12.0.

RESULTSEleven studies that met the inclusion criteria were selected from the total 138 references with potential relevance.The threshold effect was not found in the GP73 combined with AFP-L3% for the diagnosis of liver cancer.However,heterogeneity was found in this meta-analysis. The pooled sensitivity and specificity of GP73 combined with AFP-L3% was 0.853 and 0.960 respectively. The area under summary receiver operating characteristics curve was 0.948, and the Q index was 0.888.

CONCLUSIONGP73 combined with AFP-L3% can significantly improve the diagnostic sensitivity and specificity to a high level, and can improve the diagnosis rate of hepatocellular carcinoma.

Biomarkers, Tumor ; Carcinoma, Hepatocellular ; Humans ; Liver Neoplasms ; Membrane Proteins ; ROC Curve ; alpha-Fetoproteins

OBJECTIVETo study the influence of the sequence of three-dimensional conformal radiotherapy (3DCRT) and transcatheter arterial chemoembolization (TACE) on the efficacy and toxicity of treatment in patients with hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT).

METHODSA total of 65 patients who were diagnosed with primary HCC with PVTT were enrolled in the study from November 2008 to March 2012 and were randomly divided into the following two groups:group A,32 patients treated with 3DCRT followed by TACE; group B,33 patients treated with TACE followed by 3DCRT.

RESULTSThe total efficacy rates of groups A and B were 68.8% and 69.7% (x² =0.232, P < 0.793). The survival rates,effective percentage of PVTT and AFP remission rates were not significantly different between group A and group B.The exacerbation rate of liver function was significantly higher for group B than for group A (P < 0.05). No serious complication was found in the follow-up period for either group.

CONCLUSIONThe combination of 3DCRT and TACE is a relatively effective local treatment for patients with primary HCC and PVTT.Compared with TACE followed by 3DCRT, 3DCRT followed by TACE may have a negative influence on liver function.

Arteries ; Carcinoma, Hepatocellular ; Chemoembolization, Therapeutic ; Combined Modality Therapy ; Humans ; Liver Neoplasms ; Portal Vein ; Radiotherapy, Conformal ; Survival Rate ; Thrombosis ; Treatment Outcome

OBJECTIVETo investigate the efficacy and safety of telbivudine for blocking mother-to-child transmission of hepatitis B virus (HBV) in pregnant women with high viremia.

METHODSA total of 128 pregnant women with high HBV load (HBV DNA ≥ 1.0*10⁷ copies/ml and positive for hepatitis B surface antigen (HBsAg)) were enrolled in the study from January 2009 to January 2013 and divided into the following three groups:group A (n=42) treated with telbivudine at 12 weeks of gestation until postpartum 12 weeks; group B (n=41) treated with telbivudine at 20 to 28 weeks of gestation until postpartum 12 weeks; group C (n=45; control group) with no telbivudine treatment.All study participants were given compound giyeyrrhizin for liver protection. All infants born to the women from the three groups were vaccinated with hepatitis B immunoglobulin (200 IU) and the HBV vaccine (20 tg) ager birth. The mother-to-infant transmission of HBV was indicated by the presence of HBsAg in infants at 7 months after birth.The maternal HBV DNA levels of the women in the three groups were statistically compared with the HBsAg positive rates in their neonates.

RESULTSThere were no significant differences in the HBV DNA levels between the three groups before treatment (P more than 0.05). The pre-delivery level of HBV DNA in group A (0.553 ± 1.588 log10 copies/ml) and in group B (0.486 ± 1.429 log10 copies/ml) was significantly decreased compared to that in group C (7.698 ± 0.255 log10 copies/ml) (both P < 0.01).The post-delivery (12 weeks) level of HBV DNA in group A (0.381 ± 1.116 log10 copies/ml) and in group B (0.335 ± 1.073 log10 copies/ml) was significantly decreased compared to that in group C (7.728 ± 0.277 log10 copies/ml) (both P < 0.01).There were no significant differences in the HBV DNA levels between group A and group B (P > 0.05). No infants in group A or group B were HBsAg-positive,while the HBsAg-positive rote was 17.4% in group C (P=0.012; P=0.015).

CONCLUSIONSTelbivudine treatment starting from the 12th week of gestation or from the 20-28th week of gestation can significantly decrease the serum HBV DNA level in peripheral blood of pregnant women with high viremia and reduce the infection rate of HBV in their neonates.

Female ; Hepatitis B Surface Antigens ; Hepatitis B Vaccines ; Hepatitis B virus ; Humans ; Immunoglobulins ; Infant, Newborn ; Infectious Disease Transmission, Vertical ; Mothers ; Pregnancy ; Pregnancy Complications, Infectious ; Thymidine ; analogs & derivatives ; Viremia

OBJECTIVETo assess the relationship between nodular goiter and hepatitis C virus infection.

METHODSNinety-seven cases of early treatment in patients with chronic hepatitis C were collected for analysis.Data on patient age,sex,hepatitis duration and other general information were collected.In addition, data on clinical measures of thyroid function (including T3, t4, tSH) and thyroid autoantibodies (thyroid peroxidase antibody TPO-Ab, thyroglobulin antibody Tg-Ab), as well as findings from thyroid dimensional ultrasonography were collected. One hundred and eleven cases of early treatment in patients with chronic hepatitis B and 106 eases of females 40 years old or older with high risk of nodular goiter were collected for use as controls.The relationship between nodular goiter with thyroid function, thyroid autoantibodies levels,sex,age,and hepatitis C virus infection were statistically analyzed.

RESULTSThe prevalence rates of nodular goiter in the chronic hepatitis C group, the chronic hepatitis B group and the more than or equal to 40 year-old women with high risk of nodular goiter were 53.6%,36.9% and 59.4% respectively.The prevalence rates of nodular goiter in the chronic hepatitis C group and the more than or equal to 40 year-old women with high risk of nodular goiter were significantly higber than that in the chronic hepatitis B group (x² values: 5.820 and 10.996, P < 0.05). The average age of patients with chronic hepatitis C combined with nodular goiter was significantly higher than their counterparts without goiter (F=6.408, P < 0.05),and the prevalence rate in the more than or equal to 40 year-old women with high risk of nodular goiter was significantly higher than that of their counterparts who were less than 40 years-old (60.0% vs. 23.5%; x² =7.499, P less than 0.05). The prevalence of nodular goiter in patients with chronic hepatitis C was significantly greater for females than for males (62.1% vs. 41.0%; x 2 =4.152, P < 0.05).The prevalence of nodular goiter in patients with chronic hepatitis C was also significantly higher for females more than or equal to 40 years old than for males (70.2%, 33/47 vs. 45.5%,15/33; x² = 4.952, P < 0.05).The duration of hepatitis, thyroid function and thyroid autoantibodies were similar between the patients in the chronic hepatitis C group with or without nodular goiter.

CONCLUSIONSThe patients with chronic hepatitis C had a higher prevalence of nodular goiter,with an average of up to 53.6%, than the patients with chronic hepatitis B,and the women the more than or equal to 40 years old had even higher prevalence, at 70.2%, suggesting that patients with chronic hepatitis C should be routinely examined by thyroid ultrasound. Thyroid function and thyroid autoantibodies were not correlated with prevalence of goiter among the chronic hepatitis C patients.

Autoantibodies ; Female ; Goiter, Nodular ; Hepatitis B, Chronic ; Hepatitis C, Chronic ; Humans ; Male ; Prevalence