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Advances in the application of anti-inflammatory and liver-protecting drugs in treatment of autoimmune hepatitis

Journal of Clinical Hepatology.2017;33(3):588-592. doi:10.3969/j.issn.1001-5256.2017.03.042

Autoimmune hepatitis (AIH) is the first liver disease which has proved responsive to gluc()orticoids,and the standard therapeutic method is hormone combined with azathioprine.Given that some patients fail to reach the standard of immunosuppressive therapy,and the long-term use of immunosuppressive therapy has many adverse effects,it is necessary to reasonably use anti-inflammatory and liver-protecting drugs to minimize the dose of immunosuppressants,control liver inflammation,reduce the damage of liver cells,and delay the progression of the disease.This paper reviews the advances in the application of anti-inflammatory and liver-protecting drugs in the treatment of AIH,in order to help clinicians make rational decisions.

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New strategies for diagnosis and treatment of hepatitis B virus-related liver failure

Fangji YANG ; Liang PENG ; Zhiliang GAO

Journal of Clinical Hepatology.2017;33(3):582-587. doi:10.3969/j.issn.1001-5256.2017.03.041

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.

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Application of antibacterial agents in patients with liver cirrhosis

Dan HAN ; Xingshun QI ; Xiaozhong GUO

Journal of Clinical Hepatology.2017;33(3):567-571. doi:10.3969/j.issn.1001-5256.2017.03.038

Bacterial infection is frequently seen in patients with liver cirrhosis,and the most common type of bacterial infection is spontaneous bacterial peritonitis (SBP).In clinical practice,antibacterial agents are widely used in the treatment of SBP.In addition,antibacterial agents can reduce rebleeding and mortality rates in patients with upper gastrointestinal bleeding.However,in order to avoid bacterial resistance,the appropriate use of antibacterial agents is very important.This article reviews the indications and resistance of antibacterial agents in patients with liver cirrhosis.

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Research advances in association between matrix metalloproteinases and liver fibrosis

Hongyan GE ; Shihua ZHANG

Journal of Clinical Hepatology.2017;33(3):563-566. doi:10.3969/j.issn.1001-5256.2017.03.037

Liver injury caused by various reasons can lead to the occurrence of liver fibrosis,which is the pathological process from chronic liver disease to liver cirrhosis.Liver fibrosis is caused by the increased synthesis and reduced degradation of extracellular matrix (ECM).ECM is mainly degraded by matrix metalloproteinases (MMP),and therefore,MMP play an important role in the progression and.diagnosis/treatment of liver fibrosis.This article reviews the research advances in the association between MMP and liver fibrosis.

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Regulatory effect of natural killer cells on hepatic stellate cells and their role in liver fibrosis

Tianyang LI ; Zhengkun TU ; Lishan SU

Journal of Clinical Hepatology.2017;33(3):558-562. doi:10.3969/j.issn.1001-5256.2017.03.036

Hepatic stellate cell (HSC) activation is closely associated with the progression of liver fibrosis.As an important component of the innate immune system,natural killer (NK) cells are enriched in the liver and play a key role in host defense against viral infection and tumor,and their anti-fibrotic effect has also been confirmed.NK cells can reduce liver fibrosis by killing early-activated or senescent HSCs or secreting interferon-γ.This article summarizes related research advances in recent years,and introduces the molecular immunological mechanism of NK cells in regulating HSCs and their potential anti-fibrotic effect based on the function and phenotype of NK cells and HSCs.

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Primary sclerosing cholangitis with dermatomyositis:a case report

Chunwu ZHU ; Jili YUAN ; Chenghai LIU

Journal of Clinical Hepatology.2017;33(3):528-531. doi:10.3969/j.issn.1001-5256.2017.03.029

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Expression of long non-coding RNA H19 in serum in patients with acute pancreatitis and its clinical significance

Baojun LI ; Lai HUANG ; Yuanxin SUN

Journal of Clinical Hepatology.2017;33(3):492-496. doi:10.3969/j.issn.1001-5256.2017.03.019

Objective To investigate the expression of the long non-coding RNA (IncRNA) H19 in the serum of patients with acute pancreatitis and its clinical significance.Methods A total of 82 patients who were diagnosed with acute pancreatitis in Emergency Department and Department of General Surgery in Shenyang Emergency Center from January 2013 to December 2015 were enrolled,and 20 healthy subjects were enrolled as normal controls.Peripheral blood samples were collected from the patients with acute pancreatitis and healthy subjects,the serum was separated,and RNA was extracted.Real-time PCR was used to measure the expression of lncRNA H19,and the correlation between the expression of H19 and other clinical and pathological parameters was analyzed.The t-test was used for comparison of continuous data between groups,and the chi-square test was used for comparison of categorical data between groups.The receiver operating characteristic (ROC) curve was used to evaluate the value of lncRNA H19 in the diagnosis of acute pancreatitis.Results The acute pancreatitis group had a significantly higher H19 expression level in serum than the healthy control group (t =2.364,P =0.020).The severe acute pancreatitis group had higher expression of lncRNA H19 than the mild acute pancreatitis group (t =2.111,P =0.037),and the patients with a Balthazar CT grade above grade C had significantly higher relative expression of lncRNA H19 than those with CT grade ≤ C (t =2.312,P =0.022).The ROC curve showed that H19 measurement helped with the diagnosis of acute pancreatitis with an area under the ROC curve of 0.752 (95％ CI:0.636-0.867,P ＜ 0.01).Conclusion Patients with acute pancreatitis have increased expression of IncRNA H19 in serum,and therefore,H19 has certain clinical significance in the diagnosis of acute pancreatitis and the evaluation of disease severity.

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Novel molecular diagnostic markers for liver fibrosis

Jinghua DU ; Yuemin NAN

Journal of Clinical Hepatology.2017;33(3):445-450. doi:10.3969/j.issn.1001-5256.2017.03.009

Liver fibrosis is an important pathological stage for the progression of chronic liver diseases to liver cirrhosis.Timely and accurate assessment of fibrosis degree plays an important role in guiding the treatment of chronic liver diseases.With the development of molecular biology techniques and wide application of molecular diagnostic techniques,the measurement of novel serum molecular diagnostic markers may contribute to the early diagnosis and precise treatment of liver fibrosis.A number of novel serum molecular markers with a diagnostic value have been identified,including fibroblast factor,matrix metalloproteinases and their inhibitors,extracellular matrix-related markers,and non-coding RNAs.In addition,genomics,proteomics,and metabolomics also have certain diagnostic values.

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Role of liver sinusoidal endothelial cells in the development and progression of liver fibrosis and related therapeutic strategy

Yanqin DU ; Jun WU ; Dongliang YANG

Journal of Clinical Hepatology.2017;33(3):438-444. doi:10.3969/j.issn.1001-5256.2017.03.008

Liver sinusoid endothelial cells are the first defense mechanism that protects the liver against various injuries,and they also play a significant role in the development of liver fibrosis and liver cirrhosis caused by chronic liver injury.They are involved in liver fibrosis by mediating liver inflammation,participating in sinusoid capillarization and revascularization,activating hepatic stellate cells,secreting many proinflammatory cytokines,participating in extracellular matrix formation,and mediating liver microcirculation disturbance.Clarification of these mechanisms helps to identify new targets and develop new regimens for the treatment of liver fibrosis.

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An excerpt of portal hypertensive bleeding in cirrhosis: risk stratification, diagnosis and management-2016 practice guidance by the American Association for the Study of Liver Diseases

Dan HAN ; Xingshun QI ; Yang YU

Journal of Clinical Hepatology.2017;33(3):422-427. doi:10.3969/j.issn.1001-5256.2017.03.004

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