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| 1 | Chronic Hepatitis B Infection with Low Level Viremia Correlates with the Progression of the Liver Disease显示文摘Background and Aims:Currently,insufficient clinical data are available to address whether low-level viremia(LLV)observed during antiviral treatment will adversely affect the clinical outcome or whether treatment strategies should be altered if LLV occurs.This study compared the clinical out-comes of patients with a maintained virological response(MVR)and patients who experienced LLV and their treatment strategies.Methods:A retrospective cohort of 674 patients with chronic hepatitis B virus(HBV)infection who received antiviral treatment for more than 12 months was analyzed for the development of end-stage liver disease and treatment strategies during the follow-up period.End-stage liver disease included decompensated liver cirrhosis and hepatocellular carcinoma(HCC).Results:During a median 42-month follow-up,end-stage liver disease developed more frequently in patients who experienced LLV than in those who experienced MVR(7.73%and 15.85%vs.0.77%and 5.52%at 5 and 10 years,respectively;p=0.000).The trend was consistent after propensity score matching.In the high-risk group of four HCC risk models,LLV patients had a higher risk of HCC development(p<0.05).By Cox proportional hazard model analysis,LLV was an independent risk factor for end-stage liver disease and HCC(hazard ratio[HR]=6.280,confidence interval[CI]=2.081-18.951,p=0.001;HR=5.108,CI=1.392-18.737,respectively;p=0.014).Patients achieved a lower rate of end-stage liver disease by adjusting treatment compared to continuing the original treatment once LLV occurred(p<0.05).Conclusions:LLV is an independent risk factor for end-stage liver disease and HCC,and treatment adjustments can be considered. | Qian Zhang Hong Peng Xiaoqing Liu Huimin Wang Jinjie Du Xinhua Luo Hong Ren Peng Hu | 2021 | Journal of Clinical and Translational Hepatology2021，9，6： | 25 |
| 2 | Epithelial ovarian cancer:An overview显示文摘Ovarian cancer is the second most common gyneco-logical cancer and the leading cause of death in the United States. In this article we review the diagnosis and current management of epithelial ovarian cancer which accounts for over 95 percent of the ovarian malignancies. We will present various theories about the potential origin of ovarian malignancies. We will discuss the genetic anomalies and syndromes that may cause ovarian cancers with emphasis on Breast cancer type 1/2 mutations. The pathology and pathogenesis of ovarian carcinoma will also be presented. Lastly, we provide a comprehensive overview of treatment strategies and staging of ovarian cancer, conclusions and future directions. | Arpita Desai Jingyao Xu Kartik Aysola Yunlong Qin Chika Okoli Ravipati Hariprasad Ugorji Chinemerem Candace Gates Avinash Reddy Omar Danner Geary Franklin Anachebe Ngozi Guilherme Cantuaria Karan Singh William Grizzle Charles Landen Edward E Partridge Valerie Montgomery Rice E Shyam P Reddy Veena N Rao | 2014 | World Journal of Translational Medicine2014，3，1： | 10 |
| 3 | Re-evaluating Transarterial Chemoembolization Failure/Refractoriness:A Survey by Chinese College of Interventionalists显示文摘Background and Aims:The recognition of transarterial chemoembolization(TACE)failure/refractoriness among Chinese clinicians remains unclear.Using an online survey conducted by the Chinese College of Interventionalists(CCI),the aim of this study was to explore the recognition of TACE failure/refractoriness and review TACE application for hepatocellular carcinoma(HCC)treatment in clinical practice.Methods:From 27 August 2020 to 30 August 2020 during the CCI 2020 annual meeting,a survey with 34 questions was sent by email to 264 CCI clinicians in China with more than 10 years of experience using TACE for HCC treatment.Results:A total of 257 clinicians participated and responded to the survey.Most participants agreed that the concept of“TACE failure/refractoriness”has scientific and clinical significance(n=191,74.3%).Nearly half of these participants chose TACE-based combination treatment as subsequent therapy after so-called TACE failure/refractoriness(n=88,46.1%).None of the existing TACE failure/refractoriness definitions were widely accepted by the participants;thus,it is necessary to re-define this concept for the treatment of HCC in China(n=235,91.4%).Most participants agreed that continuing TACE should be performed for patients with preserved liver function,presenting portal vein tumor thrombosis(n=242,94.2%)or extrahepatic spread(n=253,98.4%),after the previous TACE treatment to control intrahepatic lesion(s).Conclusions:There is an obvious difference in the recognition of TACE failure/refractoriness among Chinese clinicians based on existing definitions.Further work should be carried out to re-define TACE failure/refractoriness. | Bin-Yan Zhong Wan-Sheng Wang Shen Zhang Hai-Dong Zhu Lei Zhang Jian Shen Xiao-Li Zhu Gao-Jun Teng Cai-Fang Ni | 2021 | Journal of Clinical and Translational Hepatology2021，9，4： | 9 |
| 4 | High Frame Rate Contrast-enhanced Ultrasound Helps Differentiate Malignant and Benign Focal Liver Lesions显示文摘Background and Aims:This study aimed to evaluate the diagnostic performance of high frame rate contrast-en-hanced ultrasound(H-CEUS)of focal liver lesions(FLLs).Methods:From July 2017 to June 2019,conventional con-trast-enhanced ultrasound(C-CEUS)and H-CEUS were per-formed in 78 patients with 78 nodules.The characteristics of C-CEUS and H-CEUS in malignant and benign groups and the differences between different lesion sizes(1-3 cm,3-5 cm,or>5 cm)of C-CEUS and H-CEUS were examined.The diagnostic performance of C-CEUS and H-CEUS was ana-lyzed.The chi-square test or Fisher’s exact test was used to assess inter-group differences.The receiver operating characteristic curve was plotted to determine the diagnostic performance of C-CEUS and H-CEUS.Results:There were significant differences in the enhancement area,fill-in direc-tion and vascular architecture between C-CEUS and H-CEUS for both benign and malignant lesions(all p=0.000-0.008),but there were no significant differences in washout results(p=0.566 and p=0.684,respectively).For lesions 1-3 cm in size,the enhancement area,fill-in direction,and vascular architecture on C-CEUS and H-CEUS were significantly dif-ferent(all p=0.000),unlike for lesions 3-5 cm or>5 cm in size.For differentiation of malignant from benign FLLs in the 1-3 cm group,H-CEUS showed sensitivity,specific-ity,accuracy,and positive and negative predictive values of 92.86%,95.0%,96.3%,90.48%and 93.75%,respectively,which were higher than those for C-CEUS(75.0%,70.0%,77.78%,66.67%and 72.91%,respectively).Conclusions:H-CEUS provided more vascular information which could help differentiate malignant from benign FLLs,especially for lesions 1-3 cm in size. | Xiang Fei Peng Han Bo Jiang Lianhua Zhu Wenshuo Tian Maodong Sang Xirui Zhang Yaqiong Zhu Yukun Luo | 2022 | Journal of Clinical and Translational Hepatology2022，10，1： | 8 |
| 5 | Clinical Course and Outcome Patterns of Acute-on-chronic Liver Failure:A Multicenter Retrospective Cohort Study显示文摘Background and Aims:Acute-on-chronic liver failure(ACLF)is acute decompensation of liver function in the setting of chronic liver disease,and characterized by high short-term mortality.In this study,we sought to investigate the clinical course of patients at specific time points,and to propose dynamic prognostic criteria.Methods:We assessed the clinical course of 453 patients with ACLF during a 12-week follow-up period in this retrospective multicenter study.The clinical course of patients was defined as disease recovery,improvement,worsening or steady patterns based on the variation tendency in prothrombin activity(PTA)and total bilirubin(TB)at different time points.Results:Resolution of PTA was observed in 231 patients(51%)at 12 weeks after the diagnosis of ACLF.Among the remaining patients,66(14.6%)showed improvement and 156(34.4%)showed a steady or worsening course.In patients with resolved PTA,the clinical course of TB exhibited resolved pattern in 95.2%,improved in 3.9%,and steady or worse in 0.8%.Correspondingly,in patients with improved PTA,these values for TB were 28.8%,27.3%,and 43.9%,respectively.In patients with steady or worsening PTA,these values for TB were 5.7%,32.3%,and 65.6%,respectively.Dynamic prognostic criteria were developed by combining the clinical course of PTA/TB and the clinical outcomes at 4 and 12 weeks after diagnosis in ACLF patients.Conclusions:We propose the following dynamic prognostic criteria:rapid progression,slow progression,rapid recovery,slow recovery,and slow persistence,which lay the foundation for precise prediction of prognosis and the improvement of ACLF therapy. | Man-Man Xu Ming Kong Peng-Fei Yu Ying-Ying Cao Fang Liu Bing Zhu Yi-Zhi Zhang Wang Lu Huai-Bin Zou Bin-Wei Duan Shao-Li You Shao-Jie Xin Tao Han Zhong-Ping Duan Yu Chen | 2021 | Journal of Clinical and Translational Hepatology2021，9，5： | 8 |
| 6 | Antibacterial photodynamic therapy:overview of a promising approach to fight antibiotic-resistant bacterial infections显示文摘Antibacterial photodynamic therapy(APDT)has drawn increasing attention from the scientific society for its potential to effectively kill multidrug-resistant pathogenic bacteria and for its low tendency to induce drug resistance that bacteria can rapidly develop against traditional antibiotic therapy.The review summarizes the mechanism of action of APDT,the photosensitizers,the barriers to PS localization,the targets,the in vitro-,in vivo-,and clinical evidence,the current developments in terms of treating Gram-positive and Gram-negative bacteria,the limitations,as well as future perspectives.Relevance for patients:A structured overview of all important aspects of APDT is provided in the context of resistant bacterial species.The information presented is relevant and accessible for scientists as well as clinicians,whose joint effort is required to ensure that this technology benefits patients in the post-antibiotic era. | Yao Liu Rong Qin Sebastian A.J.Zaat Eefjan Breukink Michal Heger | 2015 | Journal of Clinical & Translational Research2015，1，3： | 8 |
| 7 | Metabolic-associated Fatty Liver Disease(MAFLD):A Multi-systemic Disease Beyond the Liver显示文摘Nonalcoholic fatty liver disease(NAFLD)is a multisystemic clinical condition that presents with a wide spectrum of extrahepatic manifestations,such as obesity,type 2 diabetes mellitus,metabolic syndrome,cardiovascular diseases,chronic kidney disease,extrahepatic malignancies,cogni-tive disorders,and polycystic ovarian syndrome.Among NAFLD patients,the most common mortality etiology is cardiovascular disorders,followed by extrahepatic malignancies,diabetes mellitus,and liver-related complications.Furthermore,the severity of extrahepatic diseases is parallel to the severity of NAFLD.In clinical practice,awareness of the associations of concomitant diseases is of major importance for initiating prompt and timely screening and multidisciplinary management of the disease spectrum.In 2020,a consensus from 22 countries redefined the disease as metabolic(dysfunction)-associated fatty liver disease(MAFLD),which resulted in the redefinition of the corre-sponding population.Although the patients diagnosed with MAFLD and NAFLD mostly overlap,the MAFLD and NAFLD populations are not identical.In this review,we compared the associations of key extrahepatic diseases between NAFLD and MAFLD. | Eda Kaya Yusuf Yilmaz | 2022 | Journal of Clinical and Translational Hepatology2022，10，2： | 8 |
| 8 | Mitochondrial dysfunction as a mechanism of drug-induced hepatotoxicity:current understanding and future perspectives显示文摘Mitochondria are critical cellular organelles for energy generation and are now also recognized as playing important roles in cellular signaling.Their central role in energy metabolism,as well as their high abundance in hepatocytes,make them important targets for drug-induced hepatotoxicity.This review summarizes the current mechanistic understanding of the role of mitochondria in drug-induced hepatotoxicity caused by acetaminophen,diclofenac,anti-tuberculosis drugs such as rifampin and isoniazid,anti-epileptic drugs such as valproic acid and constituents of herbal supplements such as pyrrolizidine alkaloids.The utilization of circulating mitochondrialspecific biomarkers in understanding mechanisms of toxicity in humans will also be examined.In summary,it is well-established that mitochondria are central to acetaminophen-induced cell death.However,the most promising areas for clinically useful therapeutic interventions after acetaminophen toxicity may involve the promotion of adaptive responses and repair processes including mitophagy and mitochondrial biogenesis,In contrast,the limited understanding of the role of mitochondria in various aspects of hepatotoxicity by most other drugs and herbs requires more detailed mechanistic investigations in both animals and humans.Development of clinically relevant animal models and more translational studies using mechanistic biomarkers are critical for progress in this area.Relevance for patients:This review focuses on the role of mitochondrial dysfunction in liver injury mechanisms of clinically important drugs like acetaminophen,diclofenac,rifampicin,isoniazid,amiodarone and others.A better understanding of the mechanisms in animal models and their translation to patients will be critical for the identification of new therapeutic targets. | Anup Ramachandran Luqi Duan Jephte Y.Akakpo Hartmut Jaeschke | 2018 | Journal of Clinical & Translational Research2018，4，1： | 8 |
| 9 | Epidemiology and Clinical Outcomes of Metabolic(Dysfunction)-associated Fatty Liver Disease显示文摘Metabolic(dysfunction)-associated fatty liver disease(MAFLD)is currently the most common chronic liver disease and affects at least a quarter of the global adult population.It has rapidly become one of the leading causes of hepatocellular carcinoma and cirrhosis in Western countries.In this review,we discuss the nomenclature and definition of MAFLD as well as its prevalence and incidence in different geographical regions.Although cardiovascular disease remains the leading cause of death in MAFLD patients,the proportion of patients dying from hepatic complications increases sharply as the disease progresses to advanced liver fibrosis and cirrhosis.In addition,patients with MAFLD are at increased risk of various extrahepatic cancers.Although a causal relationship between MAFLD and extrahepatic cancers has not been established,clinicians should recognize the association and consider cancer screening(e.g.,for colorectal cancer)as appropriate. | Huapeng Lin Xinrong Zhang Guanlin Li Grace Lai-Hung Wong Vincent Wai-Sun Wong | 2021 | Journal of Clinical and Translational Hepatology2021，9，6： | 8 |
| 10 | Novel Prognostic Models for Predicting the 180-day Outcome for Patients with Hepatitis-B Virus-related Acute-on-chronic Liver Failure显示文摘Background and Aims:It remains difficult to forecast the 180-day prognosis of patients with hepatitis B virus-acuteon-chronic liver failure(HBV-ACLF)using existing prognostic models.The present study aimed to derive novel-innovative models to enhance the predictive effectiveness of the 180-day mortality in HBV-ACLF.Methods:The present cohort study examined 171 HBV-ACLF patients(non-survivors,n=62;survivors,n=109).The 27 retrospectively collected parameters included the basic demographic characteristics,clinical comorbidities,and laboratory values.Backward stepwise logistic regression(LR)and the classification and regression tree(CART)analysis were used to derive two predictive models.Meanwhile,a nomogram was created based on the LR analysis.The accuracy of the LR and CART model was detected through the area under the receiver operating characteristic curve(AUROC),compared with model of end-stage liver disease(MELD)scores.Results:Among 171 HBV-ACLF patients,the mean age was 45.17 years-old,and 11.7%of the patients were female.The LR model was constructed with six independent factors,which included age,total bilirubin,prothrombin activity,lymphocytes,monocytes and hepatic encephalopathy.The following seven variables were the prognostic factors for HBV-ACLF in the CART model:age,total bilirubin,prothrombin time,lymphocytes,neutrophils,monocytes,and blood urea nitrogen.The AUROC for the CART model(0.878)was similar to that for the LR model(0.878,p=0.898),and this exceeded that for the MELD scores(0.728,p<0.0001).Conclusions:The LR and CART model are both superior to the MELD scores in predicting the 180-day mortality of patients with HBV-ACLF.Both the LR and CART model can be used as medical decision-making tools by clinicians. | Ran Xue Jun Yang Jing Wu Zhongying Wang Qinghua Meng | 2021 | Journal of Clinical and Translational Hepatology2021，9，4： | 8 |
| 11 | Predictive Value of Inflammation Biomarkers in Patients with Portal Vein Thrombosis显示文摘Background and Aims:To investigate the usefulness of inflammation biomarkers to serve as a predictors of portal vein thrombosis(PVT)postoperatively(post)in patients with portal hypertension after splenectomy and periesophagogastric devascularization.Methods:A total of 177 liver cirrhosis patients were recruited from January 2013 to December 2017.They were divided into a PVT group(n=71)and a non-PVT group(n=106),according to ultrasound examination findings at 7-day post.Inflammation biomarkers involving platelet-to-lymphocyte ratio(PLR),neutrophil-to-lymphocyte ratio(NLR),monocyte-to-lymphocyte ratio(MLR),red blood cell distribution width-to-platelet ratio(RPR),mean platelet volume-to-platelet ratio(MPR)preoperatively(pre)and at 1,3,7-days post were recorded.Results:The univariate logistic regression analysis indicated that PLR(pre)(odds ratio(OR)=3.963,95%confidence interval(CI)=2.070–7.587,p<0.000),MLR(pre)(OR=2.760,95%CI=1.386–5.497,p=0.004),PLR(postday 7)(OR=3.345,95%CI=1.767–6.332,p=0.000)were significantly associated with the presence of PVT.The multivariate logistic regression analysis results indicated that PLR(pre)(OR=3.037,95%CI=1.463–6.305,p=0.003),MLR(pre)(OR=2.188,95%CI=1.003–4.772,p=0.049),PLR(post-day 7)(OR=2.166,95%CI=1.053–4.454,p=0.036)were independent factors for predicting PVT.Conclusions:The PLR(pre),MLR(pre),and PLR(post-day 7)are predictors of portal vein thrombosis post in patients with portal hypertension after splenectomy and periesophagogastric devascularization. | Jian-Bo Han Qing-Hua Shu Yu-Feng Zhang Yong-Xiang Yi | 2021 | Journal of Clinical and Translational Hepatology2021，9，3： | 7 |
| 12 | Characteristics and Inpatient Outcomes of Primary Biliary Cholangitis and Autoimmune Hepatitis Overlap Syndrome显示文摘Background and Aims:Primary biliary cholangitis(PBC)and autoimmune hepatitis(AIH)are hepatobiliary diseases of presumed immune-mediated origin that have been shown to overlap.The aim of this retrospective trial was to use national data to examine the characteristics and outcomes of patients hospitalized with overlapping PBC and AIH(PBC/AIH).Methods:The National Inpatient Sample was used to identify hospitalized adult patients with PBC,AIH,and PBC/AIH from 2010 to 2014 by International Classification of Diseases-Ninth Edition Revision codes;patients with hepatitis B virus and hepatitis C virus infection were excluded.Primary outcomes measures were in-hospital outcomes that included mortality,respiratory failure,septic shock,length of stay,and total hospital charges.Secondary outcomes were the clinical characteristics of PBC/AIH,including the comorbid extrahepatic autoimmune disease pattern and complications of cirrhosis.Results:A total of 3,478 patients with PBC/AIH were included in the study.PBC/AIH was associated with higher rates of Sjögren’s syndrome(p<0.001;p<0.001),lower rates of Crohn’s disease(p<0.05;p<0.05),and higher rates of cirrhosis-related complications when compared to PBC or AIH alone.There were similar rates of mortality between the PBC/AIH,PBC,and AIH groups.The PBC/AIH group had higher rates of septic shock when compared to the PBC group(p<0.05)and AIH group(p<0.05)after adjusting for possible confounders.Conclusions:PBC/AIH is associated with a lower rate of Crohn’s disease,a higher rate of Sjögren’s syndrome,higher rates of cirrhosis-related complications,and significantly increased risk of septic shock compared to PBC and AIH individually. | Yi Jiang Bing-Hong Xu Brandon Rodgers Nikolaos Pyrsopoulos | 2021 | Journal of Clinical and Translational Hepatology2021，9，3： | 7 |
| 13 | Clinical Validation of Global Coagulation Tests to Guide Blood Component Transfusions in Cirrhosis and ACLF显示文摘Background and Aims:Patients with cirrhosis and acuteon-chronic liver failure(ACLF)may have bleeding complications and need for invasive procedures.Point-of-care(POC)coagulation tests like thromboelastography(TEG)and Sonoclot may be better for guiding patient management than the standard coagulation tests(SCTs),like prothrombin time,platelet count and international normalized ratio.Methods:We prospectively compared and validated the POC tests and SCTs in 70 persons with ACLF and 72 persons with decompensated cirrhosis who had clinical bleeding and checked for episodes of re-bleeding and transfusion requirements.We assessed pre-procedure requirement of blood components when correction was done based on an SCT or POC strategy.Results:Episodes of bleeding were seen in 45%and 28%of ACLF and cirrhosis patient,respectively(p=0.036),with the major site of bleeding being gastrointestinal(31%and 16%,respectively).Platelet counts correlated with TEG-maximum amplitude in cirrhosis(p=0.045)and prothrombin time correlated positively with TEG-reaction(R)time(p=0.032),TEG-Clot kinetics(K)time(p=0.042),Son-activated clotting time(p=0.038)and negatively with clot rate(p=0.043)in ACLF,making these correctable target variables in POC transfusion algorithms.Of 223 procedures,transfusion of fresh frozen plasma and platelet concentrate was reduced by 25%(p=0.035)and 20.8%(p=0.045)by using a POC strategy in 76 patients.Correction of deranged Son-activated clotting time and TEG-reaction time was noted in 68%and 72%after 24 h of fresh frozen plasma transfusion in ACLF and 85%and 80%in cirrhosis,respectively.Conclusions:Our study clinically validates that POC tests can better detect coagulation defects and transfusion thresholds in ACLF and cirrhosis,whereas use of conventional tests appear to be less suitable in patients with clinical bleeding.Trial Registration:NCT04332484. | Madhumita Premkumar Rohit Mehtani Smita Divyaveer Kamal Kajal Anand VKulkarni Syed Ahmed Harmanpreet Kaur Harpreet Kaur Radhakrishna Dhiman Ajay Duseja Arka De | 2021 | Journal of Clinical and Translational Hepatology2021，9，2： | 7 |
| 14 | Circulating extracellular RNAs,myocardial remodeling,and heart failure in patients with acute coronary syndrome显示文摘Background:Given high on-treatment mortality in heart failure(HF),identifying molecular pathways that underlie adverse cardiac remodeling may offer novel biomarkers and therapeutic avenues.Circulating extracellular RNAs(ex-RNAs)regulate important biological processes and are emerging as biomarkers of disease,but less is known about their role in the acute setting,particularly in the setting of HF.Methods:We examined the ex-RNA profiles of 296 acute coronary syndrome(ACS)survivors enrolled in the Transitions,Risks,and Actions in Coronary Events Center for Outcomes Research and Education Cohort.We measured 374 ex-RNAs selected a priori,based on previous findings from a large population study.We employed a two-step,mechanism-driven approach to identify ex-RNAs associated with echocardiographic phenotypes(left ventricular[LV]ejection fraction,LV mass,LV end-diastolic volume,left atrial[LA]dimension,and LA volume index)then tested relations of these ex-RNAs with prevalent HF(N=31,10.5%).We performed further bioinformatics analysis of microRNA(miRNAs)predicted targets’genes ontology categories and molecular pathways.Results:We identified 44 ex-RNAs associated with at least one echocardiographic phenotype associated with HF.Of these 44 exRNAs,miR-29-3p,miR-584-5p,and miR-1247-5p were also associated with prevalent HF.The three microRNAs were implicated in the regulation p53 and transforming growth factor-βsignaling pathways and predicted to be involved in cardiac fibrosis and cell death;miRNA predicted targets were enriched in gene ontology categories including several involving the extracellular matrix and cellular differentiation.Conclusions:Among ACS survivors,we observed that miR-29-3p,miR-584-5p,and miR-1247-5p were associated with both echocardiographic markers of cardiac remodeling and prevalent HF.Relevance for Patients:miR-29c-3p,miR-584-5p,and miR-1247-5p were associated with echocardiographic phenotypes and prevalent HF and are potential biomarkers for adverse cardiac remodeling in HF. | Khanh-Van Tran Kahraman Tanriverdi Gerard P.Aurigemma Darleen Lessard Mayank Sardana Matthew Parker Amir Shaikh Matthew Gottbrecht Zachary Milstone Selim Tanriverdi Olga Vitseva John F.Keaney Catarina I.Kiefe David D.McManus Jane E.Freedman | 2019 | Journal of Clinical & Translational Research2019，5，1： | 7 |
| 15 | 3-year Treatment of Tenofovir Alafenamide vs.Tenofovir Disoproxil Fumarate for Chronic HBV Infection in China显示文摘Background and Aims:Tenofovir alafenamide(TAF)has similar efficacy to tenofovir disoproxil fumarate(TDF)but with improved renal and bone safety in chronic hepatitis B patients studied outside of China.We report 3-year results from two phase 3 studies with TAF in China(Clinicaltrials.gov:NCT02836249 and NCT02836236).Methods:Chinese hepatitis B e antigen(HBeAg)-positive and-negative chronic hepatitis B patients with viremia and elevated alanine aminotransferase were randomized 2:1 to TAF or TDF treatment groups and treated in a double-blind fashion for 144 weeks(3 years).Efficacy responses were assessed by individual study while safety was assessed by a pooled analysis.Results:Of the 334 patients(180 HBeAg-positive and 154 HBeAg-negative)randomized and treated,baseline characteristics were similar between groups.The overall mean age was 38 years and 73%were male.The mean HBV DNA was 6.4 log10 IU/mL.The median alanine aminotransferase was 88 U/L,and 37%had a history of antiviral use.At week 144,the proportion with HBV DNA<29 IU/mL was similar among the two groups,with TAF at 83%vs.TDF at 79%,and TAF at 93%vs.TDF at 92%for the HBeAg-positive and-negative patients,respectively.In each study,higher proportions of TAF than TDF patients showed normalized alanine aminotransferase(via the American Association for the Study of Liver Diseases and the China criteria)and showed loss of HBsAg;meanwhile,the HBeAg seroconversion rates were similar.Treatment was well-tolerated among the TAF patients,who showed a smaller median decline in creatinine clearance(−0.4 vs.−3.2 mL/min;p=0.014)and less percentage change in bone mineral density vs.TDF at hip(−0.95%vs.−1.93%)and spine(+0.35%vs.−1.40%).Conclusions:In chronic hepatitis B patients from China,TAF treatment provided efficacy similar to TDF but with better renal and bone safety at 3 years. | Jinlin Hou Qin Ning Zhongping Duan You Chen Qing Xie Fu-Sheng Wang Lunli Zhang Shanming Wu Hong Tang Jun Li Feng Lin Yongfeng Yang Guozhong Gong John FFlaherty Anuj Gaggar Shuyuan Mo Cong Cheng Gregory Camus Chengwei Chen Yan Huang Jidong Jia Mingxiang Zhang GS-US-320-0110 and GS-US-320-0108 China Investigators | 2021 | Journal of Clinical and Translational Hepatology2021，9，3： | 7 |
| 16 | Hepatocellular Carcinoma and the Role of Liver Transplantation:A Review显示文摘Hepatocellular carcinoma(HCC)is one of the leading causes of cancer deaths worldwide and liver transplantation(LT)is the only potentially curative treatment.Over the years,Milan criteria has been used for patient selection.There is ongoing research in this field with introduction of new biomarkers for HCC that can help guide future treatment.Furthermore,newer therapies for downstaging of the tumor are being implemented to prevent dropout from the transplant list.In addition,combination therapies for better outcome are under investigation.Interestingly,the concept of living-donor LT and possible use of hepatitis C virus-positive donors has been implemented as an attempt to expand the organ pool.However,there is a conflict of opinion between different centers regarding its efficacy and data is scarce.The aim of this review article is to outline the various selection criteria for LT,discuss the outcomes of LT in HCC patients,and explore future directions of LT for HCC.Therefore,a comprehensive PubMed/MEDLINE review was conducted.To expand our search,references of the retrieved articles were also screened for additional data.After selecting the studies,the authors independently reviewed them to identify the relevant studies.After careful evaluation 120 studies relevant to out topic are cited in the manuscript.Three tables and two figures are also included.In conclusion LT for HCC has evolved over the years.With the introduction of several expanded criteria beyond Milan,the introduction of bridging therapies,such as transcatheter arterial chemoembolization and radiofrequency ablation,and the approval of newer systemic therapies,it is evident that there will be more LT recipients in the future.It is promising to see ongoing trials and the continuous evolution of protocols.Prospective studies are needed to guide the development of a pre-LT criteria that can ensure low HCC recurrence risk and is not overly stringent,clarify the role of LDLT,and determine the optimal bridging therapies to LT. | Haris Muhammad Aniqa Tehreem Peng-Sheng Ting Merve Gurakar Sean Young Li Cem Simsek Saleh A.Alqahtani Amy K.Kim Ruhail Kohli Ahmet Gurakar | 2021 | Journal of Clinical and Translational Hepatology2021，9，5： | 7 |
| 17 | An-Luo-Hua-Xian Pill Improves the Regression of Liver Fibrosis in Chronic Hepatitis B Patients Treated with Entecavir显示文摘Background and Aims:Chronic hepatitis B(CHB)can cause liver fibrosis and lead to cirrhosis and cancer.As the effectiveness of antiviral therapy to reverse liver fibrosis is limited,We aimed to evaluate the effect of An-Luo-Hua-Xian pill(ALHX)on fibrosis regression in CHB patients treated with entecavir(ETV).Methods:Treatment-naïve patients with CHB were randomly treated with ETV alone or combined with ALHX(ETV+ALHX)between October 1,2013 and December 31,2020.Demographic,laboratory,and liver histology data before and after 78 weeks of treatment were collected.The Ishak fibrosis score(F)was used and fibrosis regression required a decrease in F of≥1 after treatment.Results:A total of 780 patients were enrolled,and 394 with a second liver biopsy after treatment were included in the per-protocol population,132 in ETV group and 262 in ETV+ALHX group.After 78 weeks of treatment,the fibrosis regression rate in the ETV+ALHX group was significantly higher than that of the ETV group at baseline F≥3 patients:124/211(58.8%)vs.45/98(45.9%),p=0.035.The percentage of patients with a decreased liver stiffness measurement(LSM)was higher in the ETV+ALHX group:156/211(73.9%)vs.62/98(63.%),p=0.056.Logistic regression analysis showed that ETV combined with ALHX was associated with fibrosis regression[odds ratio(OR)=1.94,p=0.018],and a family history of hepatocellular carcinoma was on the contrary.(OR=0.41,p=0.031).Conclusions:ETV combined with ALHX increased liver fibrosis regression in CHB patients. | Yi-Qi Liu Chi Zhang Jia-Wen Li Li-Hua Cao Zhan-Qing Zhang Wei-Feng Zhao Qing-Hua Shang Da-Zhi Zhang An-Lin Ma Qing Xie Hong-Lian Gui Guo Zhang Ying-Xia Liu Jia Shang Shi-Bin Xie Jun Li Xu-Qing Zhang Zhi-Qiang Zou Yu-Ping Chen Zong Zhang Ming-Xiang Zhang Jun Cheng Fu-Chun Zhang Li-Hua Huang Jia-Bin Li Qing-Hua Meng Hai-Bin Yu Yu-Qiang Mi Yan-Zhong Peng Zhi-Jin Wang Li-Ming Chen Fan-Ping Meng Wan-Hua Ren Lang Bai Yi-Lan Zeng Rong Fan Xian-Zhi Lou Wei-Feng Liang Hui Liu Hui Zhuang Hong Zhao Gui-Qiang Wang | 2023 | Journal of Clinical and Translational Hepatology2023，11，2： | 7 |
| 18 | Comparing the Diagnostic Criteria of MAFLD and NAFLD in the Chinese Population:A Population-based Prospective Cohort Study显示文摘Background and Aims:Metabolic dysfunction-associ-ated fatty liver disease(MAFLD)is a new concept,pro-posed in 2020;however,its applicability in Asia populations has yet to be evaluated.Therefore,we aimed to compare the difference in epidemiological and clinical characteris-tics between MAFLD and non-alcoholic fatty liver disease(NAFLD)among Asian populations.Methods:Based on the Jinchang cohort,30,633 participants were collected.The prevalence and incidence of MAFLD and NAFLD were used to analyze the epidemic characteristics and its overlapping effects.In addition,the corresponding clinical character-istics of the two diagnostic criteria populations were com-pared.Results:The prevalence rates of MAFLD and NAFLD were 21.03%and 18.83%,respectively.After an average 2.28-year follow-up,the incidence densities of MAFLD and NAFLD were 41.58 per 1,000 person-years and 37.69 per 1,000 person-years,respectively.With the increase of baseline age,body mass index(BMI),and waist circumfer-ence(WC)levels,the prevalence and incidence of MAFLD and NAFLD were on the rise(all ptrend<0.05).Among the total patients diagnosed at baseline or follow-up,most pa-tients had both MAFLD and NAFLD,accounting for 78.84%and 82.88%,respectively.Compared with NAFLD,MAFLD patients had greater proportions of males and metabolic diseases(diabetes,dyslipidemia),and had higher BMI,WC,liver enzymes,blood glucose,and lipid levels in the base-line diagnosis patients(p<0.05).Additionally,lean MAFLD patients had higher metabolic disorders than lean NAFLD patients(p<0.05).Conclusions:Compared with NAFLD,the newly proposed definition of MAFLD is more practical and accurate,and it can help identify more fatty liver pa-tients with high-risk diseases. | Cheng Yu Minzhen Wang Shan Zheng Miao Xia Hongyan Yang Desheng Zhang Chun Yin Ning Cheng Yana Bai | 2022 | Journal of Clinical and Translational Hepatology2022，10，1： | 7 |
| 19 | Added Value of Quantitative Apparent Diffusion Coefficients for Identifying Small Hepatocellular Carcinoma from Benign Nodule Categorized as LI-RADS 3 and 4 in Cirrhosis显示文摘Background and Aims:Correct identification of small hepa-tocellular carcinomas(HCCs)and benign nodules in cirrhosis remains challenging,quantitative apparent diffusion coeffi-cients(ADCs)have shown potential value in characterization of benign and malignant liver lesions.We aimed to explore the added value of ADCs in the identification of small(≤3 cm)HCCs and benign nodules categorized as Liver Imag-ing Reporting and Data System(LI-RADS)3(LR-3)and 4(LR-4)in cirrhosis.Methods:Ninety-seven cirrhosis patients with 109 small nodules(70 HCCs,39 benign nodules)of LR-3 and 4 LR-4 based on major and ancillary magnetic resonance imaging features were included.Multiparametric quantitative ADCs of the lesions,including the mean ADC(ADCmean),min-imum ADC(ADCmin),maximal ADC(ADCmax),ADC standard deviation(ADCstd),and mean ADC value ratio of lesion-to-liv-er parenchyma(ADCratio)were calculated.Regarding the joint diagnosis,a nomogram model was plotted using multivariate logistic regression analysis.The performance was assessed using the area under the receiver operating characteristic curve(AUC).Results:The ADCmean,ADCmin,ADCratio,and ADCstd were significantly associated with the identification of small HCC and benign nodules(p<0.001).For the joint diagnosis,the LI-RADS category(odds ratio[OR]=12.50),ADCmin(OR=0.14),and ADCratio(OR=0.12)were identified as independent factors for distinguishing HCCs from benign nodules.The joint nomogram model showed good calibration and discrimination,with a C-index of 0.947.Compared with the LI-RADS category alone,this nomogram model demon-strated a significant improvement in diagnostic performance,with AUC increasing from 0.820 to 0.967(p=0.001).Con-clusions:The addition of quantitative ADCs could improve the identification of small HCC and benign nodules catego-rized as LR-3 and 4 LR-4 in patients with cirrhosis. | Xi Zhong Hongsheng Tang Tianpei Guan Bingui Lu Chuangjia Zhang Danlei Tang Jiansheng Li Shuzhong Cui | 2022 | Journal of Clinical and Translational Hepatology2022，10，1： | 6 |
| 20 | Differentiation of Hepatocellular Carcinoma from Hepatic Hemangioma and Focal Nodular Hyperplasia using Computed Tomographic Spectral Imaging显示文摘Background and Aims:Hepatocellular carcinoma(HCC)is the most common primary hepatic malignancy.This study was designed to investigate the value of computed tomography(CT)spectral imaging in differentiating HCC from hepatic hemangioma(HH)and focal nodular hyperplasia(FNH).Methods:This was a retrospective study of 51 patients who underwent spectral multiple-phase CT at 40–140 keV during the arterial phase(AP)and portal venous phase(PP).Slopes of the spectral curves,iodine density,water density derived from iodine-and water-based material decomposition images,iodine uptake ratio(IUR),normalized iodine concentration,and the ratio of iodine concentration in liver lesions between AP and PP were measured or calculated.Results:As energy level decreased,the CT values of HCC(n=31),HH(n=17),and FNH(n=7)increased in both AP and PP.There were significant differences in IUR in the AP,IUR in the PP,normalized iodine concentration in the AP,slope in the AP,and slope in the PP among HCC,HH,and FNH.The CT values in AP,IUR in the AP and PP,normalized iodine concentration in the AP,slope in the AP and PP had high sensitivity and specificity in differentiating HH and HCC from FNH.Quantitative CT spectral data had higher sensitivity and specificity than conventional qualitative CT image analysis during the combined phases.Conclusions:Mean CT values at low energy(40–90 keV)and quantitative analysis of CT spectral data(IUR in the AP)could be helpful in the differentiation of HCC,HH,and FNH. | Weixia Li Ruokun Li Xiangtian Zhao Xiaozhu Lin Yixing Yu Jing Zhang Kemin Chen Weimin Chai Fuhua Yan | 2021 | Journal of Clinical and Translational Hepatology2021，9，3： | 6 |
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