Hepatogenous diabetes (HD) is a common complication of end-stage liver disease, and many studies have confirmed its adverse effect on prognosis. In recent ten years, a great number of studies have been conducted on the pathogenesis of HD and some progress has been made. This article reviews the research advances in the pathogenesis of HD, in order to provide a reference for the diagnosis and treatment of HD by clinicians.

Both diabetes mellitus and liver cirrhosis have high incidence rate and mortality rate around the world, and in recent ten years, scholars in China and globally have conducted many studies on the association between diabetes mellitus and liver cirrhosis. This article systematically reviews the advances in the basic and clinical research on the influence of diabetes mellitus on liver cirrhosis and its complications and summarizes possible mechanisms. The results show that diabetes mellitus can accelerate the process of liver fibrosis, increase the risk of complications and progression to liver cancer in patients with liver cirrhosis, and reduce their survival rate.

OBJECTIVE:To compare the clinical efficacy and safety of Jianpi shengxue tablets and Iron polysaccharide complex capsules in the treatment of nondialysis renal anemia. METHODS:A total of 60 nondialysis renal anemia patients in our hospital during Mar. 2016 to Mar. 2017 were divided into control group(30 cases)and observation group(30 cases)with random allocation concealment method according to random number and admission order. Both groups received routine treatment as rhEPO injection,Folic acid tablets,Vitamin B12 tablets. Based on it,control group was given Iron polysaccharide complex capsules 0.15 g orally,once a day;observation group was given Jianpi shengxue tablets 1.8 g orally,3 times a day. Both groups were treated for 12 weeks. Clinical efficacies were compared between 2 groups. The levels of Hb,RBC,HCT and Ret％ were observed before treatment and 2,4,8,12 weeks after treatment;the levels of SI,SF and TS were also observed before treatment and 8,12 weeks after treatment. The occurrence of ADR was recorded. RESULTS:Both groups completed the treatment. The total effective rate of observation group(86.67％)was significantly higher than control group(63.33％),with statistical significance(P<0.05). Before treatment,there was no statistical significance in the levels of Hb,RBC,HCT,Ret％,SI,SF or TS between 2 groups (P<0.05). After treatment,the levels of above indexes in 2 groups were significantly higher than before treatment,and observation group was significantly higher than control group(except for Ret％ at 8th week),with statistical significance(P<0.05). The case number of black stool and rust colored stool in observation group were significantly lower than control group,while the incidence of black-dyed teeth in observation group was significantly higher than control group, with statistical significance (P<0.05). CONCLUSIONS:Therapeutic efficacy of Jianpi shengxue tablets are significantly better than Polysaccharide iron complex capsules in the treatment of nondialysis renal anemia,and can significantly improve iron reserve and anaemia. But Jianpi shengxue tablets causes high incidence of black-dyed teeth.

Objective:In chronic hepatitis B (CHB) patients with previous 96-week treatment with tenofovir amibufenamide (TMF) or tenofovir disoproxil fumarate (TDF), we investigated the efficacy of sequential TMF treatment from 96 to 144 weeks.Methods:Enrolled subjects who were previously assigned (2:1) to receive either 25 mg TMF or 300 mg TDF with matching placebo for 96 weeks received extended or switched TMF treatment for 48 weeks. Efficacy was evaluated based on virological, serological, biological parameters, and fibrosis staging. Statistical analysis was performed using the McNemar test, t-test, or Log-Rank test according to the data. Results:593 subjects from the initial TMF group and 287 subjects from the TDF group were included at week 144, with the proportions of HBV DNA<20 IU/ml at week 144 being 86.2% and 83.3%, respectively, and 78.1% and 73.8% in patients with baseline HBV DNA levels ≥8 log10 IU/ml. Resistance to tenofovir was not detected in both groups. For HBeAg loss and seroconversion rates, both groups showed a further increase from week 96 to 144 and the 3-year cumulative rates of HBeAg loss were about 35% in each group. However, HBsAg levels were less affected during 96 to 144 weeks. For patients switched from TDF to TMF, a substantial further increase in the alanine aminotransferase (ALT) normalization rate was observed (11.4%), along with improved FIB-4 scores.Conclusion:After 144 weeks of TMF treatment, CHB patients achieved high rates of virological, serological, and biochemical responses, as well as improved liver fibrosis outcomes. Also, switching to TMF resulted in significant benefits in ALT normalization rates (NCT03903796).

Objective:In chronic hepatitis B (CHB) patients with previous 96-week treatment with tenofovir amibufenamide (TMF) or tenofovir disoproxil fumarate (TDF), we investigated the safety profile of sequential TMF treatment from 96 to 144 weeks.Methods:Enrolled subjects that previously assigned (2:1) to receive either 25 mg TMF or 300 mg TDF with matching placebo for 96 weeks received extending or switching TMF treatment for 48 weeks. Safety profiles of kidney, bone, metabolism, body weight, and others were evaluated.Results:666 subjects from the initial TMF group and 336 subjects from TDF group with at least one dose of assigned treatment were included at week 144. The overall safety profile was favorable in each group and generally similar between extended or switched TMF treatments from week 96 to 144. In subjects switching from TDF to TMF, the non-indexed estimated glomerular filtration rate (by non-indexed CKD-EPI formula) and creatinine clearance (by Cockcroft-Gault formula) were both increased, which were (2.31±8.33) ml/min and (4.24±13.94) ml/min, respectively. These changes were also higher than those in subjects with extending TMF treatment [(0.91±8.06) ml/min and (1.30±13.94) ml/min]. Meanwhile, switching to TMF also led to an increase of the bone mineral density (BMD) by 0.75% in hip and 1.41% in spine. On the other side, a slight change in TC/HDL ratio by 0.16 (IQR: 0.00, 0.43) and an increase in body mass index (BMI) by (0.54±0.98) kg/m 2 were oberved with patients switched to TMF, which were significantly higher than that in TMF group. Conclusion:CHB patients receiving 144 weeks of TMF treatment showed favorable safety profile. After switching to TMF, the bone and renal safety was significantly improved in TDF group, though experienceing change in metabolic parameters and weight gain (NCT03903796).