Animals ; Cell Differentiation ; End Stage Liver Disease ; therapy ; Hepatocytes ; cytology ; Humans ; Mesenchymal Stromal Cells ; cytology

Liver failure caused by hepatitis B virus (HBV) infection is common in China, among which acute-on-chronic liver failure (ACLF) is the main type.Because the pathogenesis is complex and the diagnosis and treatment is difficult,HBV related ACLF has high mortality.In recent years, some progress has achieved in diagnosis and therapy of ACLF.This article reviews the new strategies and advances about HBV related ACLF on basis of researches at home and abroad,including the definition, mechanisms, management and prognosis assessment of ACLF.

Objective To investigate the characteristics of secondary infections in hepatitis B patients with acute-on-chronic liver failure(ACLF)and its impact on the prognosis. Methods Infection sites, clinical and etiological characteristics were retrospectively reviewed in 186 hospitalized patients with ACLF from the Third Affiliated Hospital of Sun Yat-sen University during January to December 2007. Logistic regression was used to analyze risk factors of secondary infections. Results In 186 patients with ACLF, 160 patients(86.0%) were complicated with infections, and the common sites of infections were abdominal cavity, biliary tract, lung and intestinal tract. The rates of secondary infections were higher in patients with serum albumin(Alb)≤30 g/L, total bilirubin(TBil)>342 μmol/L, prothrombin time(PT)>28 seconds, and those complicated with one or more complications(χ~2=5.4, 7.3, 21.3 and 14.7, P<0.05). The fatality rates of patients with and without infections were 74. 5%(119/160) and 42.3%(11/26), respectively, and the difference was of statistical significance(χ~2=10.9,P=0.000). Patients with multi-organ infections had a higher fatality rate(79.8%, 79/99)than those with one organ infections(65.6%, 40/61), and the difference was also significant(χ~2=4.0, P=0.045). Conclusion Patients with ACLF are liable to infection, and the severity is closely related with the prognosis.

By means of HPLC,the changes of endogenous hormones in the process of releasing dormancy in Fritillaria thunbergii Miq. seeds were determined. The results indicated that the content of GA3 had a process of increase while the content of ABA was reduced in general. The content of IAA showed a downward -plateau-upward-downward curve in the process of releasing dormancy. When the dormancy of the seeds were released attemperatures 8~10℃ and 3~5℃,changing pattern of each of the three endogenous hormones were similar,but the duration spanning each change were different.

Objective To study the SEN-V DNA in liver tissue from patients with non A to E hepatitis in Guangzhou area. Methods A set of primers according to the original sequence from GenBank were designed , and SEN-V DNA sequence was amplified by in situ-PCR in liver tissue. Results Two of 6 patients with non A to E hepatitis were found to be SEN-V-DNA positive in liver tissue. While 8 patients with HBV infection and 6 of other liver diseases including 2 of autoimmune liver disease, 1 of Dubin Johnson syndrome, 1 of fatty liver, 1 of the primary biliary cirrhosis and 1 of drug induced hepatitis were all SEN-V DNA negative. SEN-V DNA were mainly distributed in liver cell cytoplasm, partially in nucleus. There presented the phenomenon of cell fuse. SEN-V positive cells accounted for about 3%～10% of total cells.Conclusions SEN-V can be found in liver tissue of patients with non A to E hepatitis in south China. Maybe it can cause liver damage.

Hepatitis B virus (HBV)-related liver failure has an extremely high mortality rate and a complex pathogenesis,and since related mechanisms are not fully understood,it has been very difficult to diagnose and treat this disease in clinical practice.Apart from liver transplantation,there is still a lack of specific and effective drugs and therapies for the medical treatment of HBV-related liver failure.This article summarizes our experience and research achievements in the diagnosis and treatment of HBV-related liver failure,explores the association between host's genetic background and development and aggravation of chronic hepatitis B,and elaborates on the phenomenon of three attacks and the concept of four time phases.In the aspect of treatment,this article focuses on the clinical application of antiviral therapy,anti-infective therapy,glucocorticoids,and stem cell transplantation;for the evaluation of patients' condition,this article establishes a suitable system for evaluating the prognosis of HBV-related liver failure.

To investigate the changes of plasma adrenomedullin(ADM) and adrenotensin(ADT) levels and their clinical significance in the pathological process of congestive heart failure(CHF), plasma levels of ADM and ADT in 45 patients with CHF before and after treatment were measured by specific radioimmunoassay. The results indicated that before treatment, plasma levels of ADM in class Ⅱ and Ⅲ CHF patients were 51.46?4.52pg/ml, 70.39?3.22pg/ml and plasma levels of ADT in class Ⅱ and Ⅲ CHF patients were 29.98?1.13pg/ml, 33.45?0.91pg/ml, respectively,which were higher than those of the control subjects(24.12?1.59pg/ml and 24.89?2.19pg/ml, respectively)(P

1.0 ?10 7 copies/ml than those with lower HBV DNA levels both in combination group and lamivudine group (52.0% vs 25.8%, P= 0.04; 63.2% vs 28.6%, P= 0.03). Necro-inflammatory activity, fibrosis and the expression of HBV DNA showed no correlation with response rate in combination group. Among those who had higher levels of HBV DNA expression, seroconversion rate in combination group is higher than that in lamivudine group (46.2% vs 9.5%, P= 0.03). Conclusions The efficacy of combination therapy appeared to be better in patients with at least moderately elevated baseline ALT, high level of HBV DNA as well as HBV DNA expression in hepatocytes. Combination therapy may delay or diminish the development of YMDD mutation-related resistance to lamivudine.

Objectives To study the changes of plasma levels of proadrenomedullin N terminal peptide(PAMP) in patients with congestive heart faillure(CHF) before and after drug treatment and its significance.Methods Plasma PAMP levels in 45 patients with CHF and 7 heathy control subjects were measured by specific radioimmunoassy.Results The plasma PAMP levels in patients with CHF were significantly decreased with the deterioration of cardiac function.Plasma PAMP levels in 45 patients in NYHA class Ⅳ(2 79?0 89pg/mL) were significantly lower than those in class Ⅱ(6 24?1 71pg/mL)?class Ⅲ(7 38?1 28pg/mL) and control subjects(8 56?2 44pg/mL)(P

Objective To study the first metacarpal dorsal artery anatomy,and explore the flap based on the branch chain of the first metacarpal dorsal artery.To provide anatomical basis for clinical application of the flap.Methods The origin,courses and distribution of the branch chain of the first metacarpal dorsal artery from 8 fresh hand specimens perfused by red latex were explored from January,2015 to December,2016.Results There was a dorsal artery network in the dorsal side of the first metacarpal.The radial and ulnar dorsal artery of the first metacarpal originated from the radial artery and along the first metacarpal lateral margin to go down.The initial diameter of the radial dorsal artery was (0.82±0.06)mm.The initial diameter of the ulnar dorsal artery was (0.74±0.05) mm.And anastomosed with the dorsal branches of the thumb inherent arteries.The both inherent arteries of thumb give off dorsal branches count (2.62±0.34).The initial diameter of proximal dorsal branch was (0.32±0.03) mm.The initial diameter of distal dorsal branch was (0.24±0.08) mm.Conclusion The radial and ulnar dorsal vascular chain of the first metacarpal were constant.The anastomosed branches with the dorsal branches of the thumb inherent arteries were abundant.The free flap or retrograde flap based on the vsscular chain has reliable blood supply.And without destroyed the main artery of thumb.