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| 1 | Survival and prognostic factors in hepatitis B virus-related acute-on-chronic liver failure显示文摘AIM:To investigate the survival rates and prognostic factors in patients with hepatitis B virus-related acuteon-chronic liver failure(HBV-ACLF).METHODS:Clinical data in hospitalized patients with HBV-ACLF admitted from 2006 to 2009 were retrospectively analyzed.Their general conditions and survival were analyzed by survival analysis and Cox regression analysis.RESULTS:A total of 190 patients were included in this study.The overall 1-year survival rate was 57.6%.Patients not treated with antiviral drugs had a significantly higher mortality[relative risk(RR)=0.609,P=0.014].The highest risk of death in patients with ACLF was associated with hepatorenal syndrome(HRS)(RR=2.084,P=0.026),while other significant factors were electrolyte disturbances(RR=2.062,P=0.010),and hepatic encephalopathy(HE)(RR=1.879,P<0.001).CONCLUSION:Antiviral therapy has a strong effect on the prognosis of the patients with HBV-ACLF by improving their 1-year survival rate.HRS,electrolyte disturbances,and HE also affect patient survival. | Kun Huang Jin-Hua Hu Hui-Fen Wang Wei-Ping He Jing Chen XueZhang Duan Ai-Min Zhang Xiao-Yan Liu | 2011 | World Journal of Gastroenterology2011，17，29： | 32 |
| 2 | Acute-on-chronic liver failure:recent update显示文摘Acute on chronic liver failure(ACLF) was first described in 1995 as a clinical syndrome distinct to classic acute decompensation.Characterized by complications of decompensation,ACLF occurs on a background of chronic liver dysfunction and is associated with high rates of organ failure and significant short-term mortality estimated between45%and 90%.Despite the clinical relevance of the condition,it still remains largely undefined with continued disagreement regarding its precise etiological factors,clinical course,prognostic criteria and management pathways.It is concerning that,despite our relative lack of understanding of the condition,the burden of ACLF among cirrhotic patients remains significant with an estimated prevalence of 30.9%.This paper highlights our current understanding of ACLF,including its etiology,diagnostic and prognostic criteria and pathophysiology.It is evident that further refinement of the ACLF classification system is required in order to detect high-risk patients and improve short-term mortality rates.The field of metabolomics certainly warrants investigation to enhance diagnostic and prognostic parameters,while the use of granulocyte-colony stimulating factor is a promising future therapeutic intervention for patients with ACLF. | Azeem Alam Ka Chun Suen Daqing Ma | 2017 | The Journal of Biomedical Research2017，31，4： | 16 |
| 3 | High frequency of thrombocytopenia in patients with acute-on-chronic liver failure treated with linezolid显示文摘BACKGROUND:Linezolid is an effective antibiotic reagent for Gram-positive bacterial infection;its most common side effect is thrombocytopenia.However,the incidence of thrombocytopenia in patients with acute-on-chronic liver failure(ACLF)who underwent linezolid therapy was unclear.The present study was to evaluate the incidence of thrombocytopenia in ACLF and non-ACLF patients treated with linezolid and the risk factors of thrombocytopenia in these patients.METHODS:Thirty-five patients with ACLF who had been subjected to intravenous administration of 600 mg linezolid every 12 hours for more than 7 days were categorized as a ACLF treatment(ACLF-T)group,72 patients without ACLF treated with the same dosage of linezolid were recruited as a non-ACLF treatment(NACLF-T)group,and 70 patients with ACLF without linezolid treatment served as an ACLF control(ACLF-C)group.The incidences of thrombocytopenia in different groups were compared at day 14.Risk factors were investigated using logistic regression analysis.RESULTS:The incidence of thrombocytopenia at day 14 was significantly higher in the ACLF-T group than in the ACLF-C group(20/35 vs 24/70,P=0.025)and in the NACLF-T group(20/35 vs 9/72,P<0.001).Multivariate analysis showed that the ratio of platelet count(day 7/day 0)<1(OR=10.021;P=0.012) and the baseline platelet count(OR=0.985;P=0.036)were independent risk factors of thrombocytopenia at day 14 of linezolid therapy.CONCLUSIONS:The benefits of linezolid treatment should outweigh the risk of thrombocytopenia in patients with ACLF Moreover,it is necessary to closely monitor the platelet count during linezolid therapy especially in the patients with de creased platelet count at day 7 of linezolid therapy. | Yi-Min Zhang Wei Yu Ning Zhou Jian-Zhou Li Li-Chen Xu Zhong-Yang Xie Ying-Feng Lu Lan-Juan Li | 2015 | Hepatobiliary & Pancreatic Diseases International2015，14，3： | 8 |
| 4 | Protective effects of ACLF sera on metabolic functions and proliferation of hepatocytes co-cultured with bone marrow MSCs in vitro显示文摘AIM:To investigate whether the function of hepatocytes co-cultured with bone marrow mesenchymal stem cells (MSCs) could be maintained in serum from acute-onchronic liver failure (ACLF) patients.METHODS:Hepatocyte supportive functions and cytotoxicity of sera from 18 patients with viral hepatitis B-induced ACLF and 18 healthy volunteers were evaluated for porcine hepatocytes co-cultured with MSCs and hepatocyte mono-layered culture,respectively.Chemokine profile was also examined for the normal serum and liver failure serum.RESULTS:Hepatocyte growth factor (HGF) and Tumor necrosis factor;tumor necrosis factor (TNF)-α were remarkably elevated in response to ACLF while epidermal growth factor (EGF) and VEGF levels were significantly decreased.Liver failure serum samples induced a higher detachment rate,lower viability and decreased liver support functions in the homo-hepatocyte culture.Hepatocytes co-cultured with MSCs could tolerate the cytotoxicity of the serum from ACLF patients and had similar liver support functions compared with the hepatocytes cultured with healthy human serum in vitro.In addition,cocultured hepatocytes maintained a proliferative capability despite of the insult from liver failure serum.CONCLUSION:ACLF serum does not impair the cell morphology,viability,proliferation and overall metabolic capacities of hepatocyte co-cultured with MSCs in vitro. | Xiao-Lei Shi Jin-Yang Gu Yue Zhang Bing Han Jiang-Qiang xiao Xian-Wen Yuan Ning Zhang Yi-Tao Ding | 2011 | World Journal of Gastroenterology2011，17，19： | 8 |
| 5 | 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 |
| 6 | Advanced therapeutic strategies for HBV-related acute-on-chronic liver failure显示文摘BACKGROUND: Acute-on-chronic liver failure(ACLF) is increasingly recognized as a distinct clinical entity and is associated with a high short-term mortality. The most common cause of ACLF is chronic hepatitis B worldwide. Currently, there is no standardized approach for the management of ACLF and the efficacy and safety of therapeutic modalities are uncertain.DATA SOURCES: Pub Med and Web of Science were searched for English-language articles. The search criteria focused on clinical trials and observational studies on the treatment of patients with HBV-related ACLF.RESULTS: Therapeutic approaches for ACLF in patients with chronic hepatitis B included nucleos(t)ide analogues, artificial liver support systems, immune regulatory therapy, stem cell therapy and liver transplantation. All of these therapeutic approaches have shown the potential to improve liver function and increase patients' survival rate, but most of the studies were not randomized or controlled.CONCLUSION: Substantial challenges for the treatment of HBV-related ACLF remain and further basic research and randomized controlled clinical trials are needed. | Xin-Yu Liu Feng Peng Ya-Jie Pan Jun Chen | 2015 | Hepatobiliary & Pancreatic Diseases International2015，14，4： | 6 |
| 7 | 不同阶段HBV相关ACLF患者外周血DC及T淋巴细胞免疫功能特点研究显示文摘目的比较不同阶段的HBV相关慢加急性(亚急性)肝衰竭(HBV-ACLF)患者外周血树突状细胞(DC)、T淋巴细胞(TC)相关细胞免疫功能,阐述DC-TC轴在HBV-ACLF发病过程中可能的细胞免疫学机制。方法 HBV-ACLF患者30例,分为早期组15例与中晚期组15例,另设健康对照组8例,以外周血来源的PBMC体外分离诱导培养DC与TC,应用流式细胞计数检测DC细胞表型HLA-DR、CD80、CD86、CD83、CD1α的表达率,及TC表面分子CD3+、CD4+T、CD8+T淋巴细胞百分比,并检测DC上清液中IFN-α、IL-4的分泌水平,比较不同阶段HBV-ACLF患者免疫细胞及炎性因子表达的差异。结果与健康人比较,HBV-CLF患者DC表型HLA-DR、CD1α、CD83、CD80、CD86表达率显著下降(t值分别为5.3356、13.269、10.8742、13.3685和23.021,均P<0.01),DC分泌因子IFN-α显著升高(t值为16.4569,P<0.01);TC表面分子CD3+、CD4+T、CD4+/CD8+细胞比值显著下降(t值分别为7.4441、12.5557、11.0771,均P<0.01),CD8+T细胞百分比显著上升(t=4.4359,P<0.01);HBV-ACLF患者中晚期组DC表型CD83、CD86表达率显著低于早期组(P值分别为:0.0000,0.0057),DC分泌因子IFN-α表达在早期组显著增多(P=0.0000),IL-4表达在中晚期组显著增多(P=0.0000),TC表面分子中晚期组CD4+T细胞百分比、CD4+/CD8+细胞比值显著下降(P值分别为:0.0268、0.0002),CD8+T细胞百分比显著上升(P=0.0001)。结论不同阶段HBV-ACLF患者的DC、TC功能状态均表现为细胞免疫功能低下,中晚期患者的细胞免疫功能更为低下;HBV-ACLF全病程存在促/抑炎性细胞因子功能紊乱,早期患者存在炎症因子过度释放,中晚期患者存在抗炎症细胞因子表达增强。 | 张涛 吉婧 刘鹏 纪恩茹 陈斌 黄裕红 孙克伟 | 2014 | 肝脏2014，19，12： | 4 |
| 8 | Establishment of a new acute-on-chronic liver failure model显示文摘To establish an animal model of acute-on-chronic liver failure(ACLF) that would replicate the pathological process of ACLF in humans, rats were administered porcine serum(PS) for 11 weeks. Liver fibrosis was determined by pathological and biochemical assessments. The animals then were injected with D-galactosamine(D-gal) and lipopolysaccharide(LPS). The survival times of animals with cirrhosis and ACLF were determined over 48 h. Other animals were killed at 0, 4, 8 and 12 h after administration of D-gal/LPS. Liver injury was assessed by histopathological analysis and biochemical indices, and apoptosis was detected by Western blot and TUNEL analysis. After PS administration for 11 weeks the serum levels of hyaluronic acid and N-procollagen type III peptide increased significantly, and serious fibrosis and cirrhosis was observed at weeks 10 and 11. Cirrhotic rats were injected with D-gal/LPS to induced ACLF; the rate of mortality over 48 h was 80%. ALT and AST levels increased markedly at 4 h, but decreased significantly at8 and 12 h post-treatment. The total bilirubin, direct bilirubin, and total bile acids levels increased markedly at 8 and 12 h. Clotting times, TNF-α and IL-6 levels increased significantly, except for 12 h post-treatment.Apoptosis, inflammation and necrosis were elevated as determined by hematoxylin-eosin staining and TUNEL assays. BCL-2 levels decreased significantly, While BAX levels increased significantly.Cytochrome c expression peaked at 8 h postD-gal/LPS treatment. In conclusion, an ACLF model induced by PS and D-gal/LPS was established and the underlying mechanisms of ACLF development were explored. | Fangfang Li Luyang Miao Hua Sun Yuyang Zhang Xiuqi Bao Dan Zhang | 2017 | Acta Pharmaceutica Sinica B2017，7，3： | 4 |
| 9 | 不同类型HBV相关慢加急性肝衰竭患者外周血Treg和CD8^(+)T细胞及其相关细胞因子变化显示文摘目的探索调节性T细胞(Treg)和CD8^(+)T细胞及其相关细胞因子在乙型肝炎病毒相关慢加急性肝衰竭(HBV-ACLF)患者中的表达变化及其临床意义。方法选取慢性乙型肝炎(CHB)患者47例,乙肝肝硬化(HBC)患者50例,慢性乙型肝炎相关ACLF(CHB-ACLF)患者42例以及乙肝肝硬化相关ACLF(HBC-ACLF)患者45例,同时选取20例健康体检者作为健康对照(HC)。采用全自动生化分析仪测定研究对象的肝功指标,流式细胞术(FCM)检测Treg以及CD8^(+)T细胞比例,采用酶联免疫吸附测定法(ELISA)检测外周血中转化生长因子β(TGF-β)、白介素10(IL-10)、穿孔素(Perforin)和颗粒酶B(Granzyme B)的表达水平,采用Pearson法分析研究对象Treg和CD8^(+)T细胞以及相关细胞因子与肝功指标的相关性。结果CHB组患者Treg(8.84±0.77)%及相关细胞因子TGF-β(70.25±11.58)ng/mL和IL-10(6.03±1.40)pg/mL水平显著高于HC组(均P<0.05),同时CD8^(+)T细胞(32.64±5.26)%及其相关细胞因子Perforin(69.65±11.95)pg/mL和Granzyme B(37.51±3.71)pg/mL水平亦显著高于HC组(均P<0.05);而CHB-ACLF组患者Treg(5.52±0.69)%及相关细胞因子TGF-β(51.57±10.35)ng/mL和IL-10(3.28±1.05)pg/mL水平显著低于CHB组(均P<0.05),但CD8^(+)T细胞(36.94±4.94)%及其相关细胞因子Perforin(71.91±13.10)pg/mL和Granzyme B(97.53±8.93)pg/mL水平显著高于CHB组(均P<0.05)。HBC组患者Treg(8.15±1.13)%及相关细胞因子TGF-β(75.19±15.54)ng/mL和IL-10(5.85±0.74)pg/mL水平显著高于HC组(均P<0.05),同时CD8^(+)T细胞(33.60±4.00)%及其相关细胞因子Perforin(60.10±9.21)pg/mL和Granzyme B(41.61±5.06)pg/mL水平亦显著高于HC组(均P<0.05);而HBC-ACLF组患者Treg(4.72±0.78)%及相关细胞因子TGF-β(46.84±7.80)ng/mL和IL-10(4.24±1.22)pg/mL水平显著低于HBC组(均P<0.05),但CD8^(+)T细胞(42.57±4.68)%及其相关细胞因子Perforin(74.21±12.51)pg/mL和Granzyme B(88.89±9.61)pg/mL水平同样显著高于HBC组(均P<0.05)。相关性分析显示,Treg及其细胞因子水平与CD8^(+)T细胞及其细胞因子水平呈负相关,Treg及其细胞因子水平与肝功指标成负相关,而CD8^(+)T细胞及其细胞因子水平与肝功指标成正相关(均P<0.05)。结论Treg和CD8^(+)T细胞及其细胞因子在HBV-ACLF患者中发生显著改变,Treg及其细胞因子水平与疾病严重程度成负相关,CD8^(+)T细胞及其细胞因子水平与疾病严重程度成正相关。HBV-ACLF发生时,Treg对CD8^(+)T细胞功能的抑制作用减弱,从而引起的机体促炎反应增强、抗炎反应减弱,可能是介导HBV-ACLF发病的重要因素。 | 于明凯 朱玥洁 谢忻汝 麦尔哈巴·艾斯卡尔 张峰波 尹紫月 鲁晓擘 丁剑冰 | 2022 | 中国病原生物学杂志2022，17，5： | 3 |
| 10 | Overview on acute-on-chronic liver failure显示文摘肝失败(LF ) 在各种各样的病原学导致的肝的合成, detoxification,和新陈代谢被定义为严重机能障碍。LF 的临床的表示典型地包括严重黄疸,凝结混乱,肝的 encephalopathy,和腹水。LF 能被分类进尖锐 LF, acute-on-chronic LF (ACLF ) ,和长期的 LF。ACLF 与唯一的临床的表示和结果作为不同症候群被表明了。ACLF 的严厉,治愈可能性,和可逆性吸引了可观的注意。在 ACLF 相关的概念,诊断标准,致病,和治疗的显著开发被完成了。然而,这疾病,特别它的诊断标准,仍然保持争论。在这份报纸,我们全身地由彻底地比较在东方和西方之间的重要调查结果从它的定义,病原学, pathophysiology,病理,和临床的表示考察了 ACLF 的当前的理解到管理从另外的区域的国家,以及那些。我们也讨论了争吵,挑战,和对为 ACLF 支持诊断和治疗的标准化和优化的未来研究的需要。 | Jing Zhang Shan Gao Zhongping Duan Ke-Qin Hu | 2016 | Frontiers of Medicine2016，10，1： | 3 |
| 11 | 健脾利湿养肝通过P2X7R调节ACLF mDC降低免疫炎症的研究显示文摘目的:研究中药健脾利湿养肝通过P2X7R调节慢加急性肝衰竭(ACLF)模型大鼠肝脏树突状细胞(DC)的聚集,降低肝脏免疫炎症,探讨健脾养肝利湿方治疗ACLF的作用机制。方法:利用免疫法建立ACLF模型,随机分为模型组和实验组,模型组给予生理盐水灌胃,实验组给予健脾利湿养肝方灌胃,治疗1周。10%水合氯醛麻醉腹主动脉取血处死,留取肝脏标本行HE、免疫组化、Western blot、RT-PCR检测。结果:实验组较模型组可以降低ACLF模型大鼠AST、ALT、PT、INR,提高PTA,差异具有统计学意义(P <0. 05); Western blot结果显示实验组较模型组P2X7R、髓样树突状细胞(mDC)在肝内的表达降低,差异具有统计学意义(P <0. 05); RT-PCR显示实验组较模型组P2X7R、m DC基因表达降低,差异具有统计学意义(P <0. 05)。结论:中药健脾利湿养肝方可以通过降低ACLF模型大鼠P2X7R的表达降低肝脏内mDC的表达,减少DC在肝脏的聚集,降低肝脏的免疫炎症。 | 韩志毅 张卫 周小舟 孙新锋 马文峰 | 2019 | 辽宁中医杂志2019，46，5： | 1 |
| 12 | 抗病毒治疗对低病毒载量的乙肝ACLF患者生存率的影响分析显示文摘目的:探讨对低病毒载量的由于乙肝引起的急性肝功能失常进行抗病毒治疗后的患者生存情况。方法:根据患者意愿分为低病毒载量抗病毒治疗组和低病毒载量未抗病毒治疗组,二组患者均给予相同的护肝、支持、改善微循环、促进肝细胞再生、防治可能出现的并发症等方面的综合治疗。低病毒载量未抗病毒治疗组不作任何其他治疗。低病毒载量抗病毒治疗组在此基础上同时进行口服拉米夫定.用药量为每天100毫克,空腹服用,连续进行两个月治疗并进行治疗后的生存率判断。结果:低病毒栽量抗病毒治疗组在同一疗程时间内的治疗效果远大于低病毒载量未抗病毒治疗组。在治疗两个月后低病毒栽量抗病毒治疗组的患者中有34例病情出现好转,病死5例,有3例患者的病情维持现状,未见好转,生存率为88%。低病毒载量未抗病毒治疗组患者中有32例出现好转,病死7例,3例维持现状未见好转,生存率为83%。结论:抗病毒治疗可提高低病毒载量的乙型肝炎引起的慢加急性肝衰竭患者的生存率。 | 曾宝芳 贾玉成 王秋月 李慧贵 | 2014 | 药物与人2014，27，A03： | 1 |
| 13 | PCT、Th17和Tregs在ACLF中的表达及与预后的关系显示文摘目的分析降钙素原(PCT)、T辅助细胞17(Th17)、调节性T细胞(Tregs)在慢加急性肝衰竭(ACLF)患者中的表达及与预后的关系。方法收集2018年1月至2020年2月西南医科大学附属医院收治的106例ACLF患者(ACLF组),其中早期41例,中期39例,晚期26例。另选取本院同期97例健康体检志愿者(对照组),99例慢性乙型肝炎患者(CHB组)。比较不同人群、不同时期ACLF患者PCT、Th17、Tregs表达水平,并分析影响ACLF患者预后的危险因素,计算PCT、Th17、Tregs对患者预后不良的预测价值。结果PCT、Th17、Tregs表达水平:ACLF组>CHB组>对照组,晚期>中期>早期,差异均有统计学意义(P<0.05)。106例ACLF患者中预后良好75例(70.75%),预后不良31例(29.25%)。不同性别、年龄、AST、ALB、PAlb在预后良好组与预后不良组之间比较差异均无统计学意义(P>0.05),WBC、CRP、NEU、AFP、PCT、Th17、Tregs指标在两组间比较差异均有统计学意义(P<0.05)。多元Logistic回归分析结果显示,WBC、CRP、NEU、AFP、PCT、Th17、Tregs为影响ACLF患者预后不良的独立危险因素(P<0.05)。PCT+Th17+Tregs联合预测ACLF预后不良敏感度和特异度分别为0.872、0.717,AUC,明显高于三者单独预测(P<0.05)。结论PPCT、Th17、Tregs表达与ACLF患者病情严重程度、预后存在密切联系,监测三因子水平变化可为临床治疗及预后评估提供一定参考。 | 倪艳 程玲 蒋玉凤 | 2022 | 分子诊断与治疗杂志2022，14，8： | 1 |
| 14 | HBV相关慢加急性肝衰竭患者外周血中Th1、Th2细胞及其细胞因子的变化和临床价值研究显示文摘目的 探讨辅助性T细胞亚群1(Th1)、辅助性T细胞亚群2(Th2)细胞及其细胞因子水平在HBV相关慢加急性肝衰竭(HBV associated acute-on-chronic liver failure, HBV-ACLF)疾病进展中的相关变化。方法 选取2020年12月-2021年7月新疆医科大学第一附属医院感染中心确诊的45例HBV-ACLF患者为ACLF组,45例慢性乙型肝炎(Chronic hepatitis B,CHB)患者为CHB组,同期30例无任何肝病史的健康体检者为健康对照组(HC组)。采用流式细胞术检测Th1、Th2、Th1/Th2水平,采用酶联免疫吸附测定实验检测γ-干扰素(γ-interferon, IFN-γ)和白介素-4(Interleukin, IL-4)表达水平,分析HBV-ACLF患者肝功指标、终末期肝病模型(Model for end-stage liver disease, MELD)评分与Th1、Th2细胞及其细胞因子的相关性。采用受试者工作特征曲线(Receiver operator characteristic curve,ROC)分析上述指标对HBV-ACLF患者疾病严重程度的评判能力。结果 3组血浆丙氨酸氨基转移酶(Alanine aminotransferase, ALT)、天门冬氨酸氨基转移酶(Aspartate aminotransferase, AST)、总胆红素(Total-bilirubin, T-BIL)等肝功指标,Th1、Th2、Th1/Th2、IFN-γ和IL-4等表达水平均存在显著差异(P均<0.05)。相关性分析发现,Th2、Th1/Th2、IFN-γ与肝功指标和MELD评分显著相关(r>0.4或r<-0.4,P<0.05),且Th1/Th2水平与MELD评分呈强正相关(r>0.7)。ROC曲线发现,Th1、Th2、Th1/Th2及IFN-γ等指标对HBV-ACLF患者的疾病严重程度具有良好的预测能力。结论 在HBV-ACLF疾病进展中Th1、Th2、Th1/Th2、IFN-γ及IL-4表达水平存在显著改变,这对HBV-ACLF的疾病严重程度的预测具有较高的应用价值。 | 于明凯 朱玥洁 李敏 何月月 谢忻汝 张峰波 鲁晓擘 丁剑冰 | 2023 | 新疆医科大学学报2023，46，3： | 1 |
| 15 | HBV-ACLF患者“胃气”相关预后模型的建立显示文摘目的探讨中医'胃气'理论在分析HBV-ACLF患者预后中所发挥的作用,并尝试建立HBV-ACLF患者'胃气'相关预后模型,使中医'有胃气则生,无胃气则死'的经典理论在HBV-ACLF患者中实现量化和具体化,为从'胃气'角度分析HBV-ACLF患者预后提供思路和方法。方法采用回顾性研究方法,收集天津市第二人民医院收治的HBVACLF患者83例,以8周作为事件终点,分为存活组(52例)和死亡组(31例),统计0周中医'胃气'症状评分以及CHE、ALB、TG、PTA、Glu、Cr、TC、AFP指标信息,进行分析统计,建立判别函数模型。结果两组患者'食欲减退'、'恶心'、'呕吐'、'腹胀'、'大便秘结'及中医'胃气'评分数值具有统计学意义(P<0.05);两组CHE、PTA、Glu、TC、AFP值差异具有统计学意义(P<0.05);将中医'胃气'症状评分及CHE、PTA、Glu、TC、AFP作为自变量引入判别函数方程,建立的Fisher判别函数方程为:Y=-2.217~0.248('胃气'评分)+0.0001303CHE+0.010PTA+0.347Glu-0.005TC+0.0000939AFP。结论中医'胃气'理论对于HBV-ACLF患者的预后评估具有指导意义,所建立的'胃气'相关预后模型性对HBV-ACLF患者短期预后具有较好的预测作用。 | 郭丽颖 袁晨翼 贾建伟 李秋伟 苗静 | 2016 | 中华肿瘤防治杂志2016，23，S1： | 1 |
| 16 | Coronavirus Disease-2019(COVID-19)and the Liver显示文摘Within a year of its emergence,coronavirus disease-2019(COVID-19)has evolved into a pandemic.What has emerged during the past 1 year is that,apart from its potentially fatal respiratory presentation from which the severe acute respiratory syndrome-coronavirus-2(SARS-CoV-2)derives its name,it presents with a myriad of gastrointestinal(GI)and liver manifestations.Expression of the angiotensinconverting enzyme-2(ACE-2)receptor throughout the GI tract and liver,which is the receptor for the SARS-CoV-2,may be responsible for the GI and liver manifestations.Besides acting directly via the ACE-2 receptor,the virus triggers a potent immune response,which might have a role in pathogenesis.The virus leads to derangement in liver function tests in close to 50%of the patients.The impact of these derangements in patients with a normal underlying liver seems to be innocuous.Severe clinical presentations include acute decompensation and acute-on-chronic liver failure in a patient with chronic liver disease,leading to high mortality.Evolving data suggests that,contrary to intuition,liver transplant recipients and patients with autoimmune liver disease on immunosuppression do not have increased mortality.The exact mechanism underlying why immunosuppressed patients fare well as compared to other patients remains to be deciphered.With newer variants of COVID-19,which can spread faster than the original strain,the data on hepatic manifestations needs to be updated to keep a step ahead of the virus. | Anshuman Elhence Manas Vaishnav Sagnik Biswas Ashish Chauhan Abhinav Anand Shalimar | 2021 | Journal of Clinical and Translational Hepatology2021，9，2： | 0 |
| 17 | ACLF炉中的脱硫探讨显示文摘本文以脱硫热力学和动力学为依据,探讨了在ACLF炉中影响脱硫的几个主要因素,炉渣碱度。熔池温度及时间等,分析了生产现场炉渣碱度与脱硫率的关系.熔池温度与脱硫平均速率的关系,以及加热时间与脱硫率的关系。 | 岳振峰 | 1997 | 四川冶金1997，19，4： | 0 |
| 18 | Critically Ill COVID-19 Patient with Chronic Liver Disease-Insights into a Comprehensive Liver Intensive Care显示文摘The novel coronavirus-related coronavirus disease 2019(COVID-19)pandemic has been relentless in disrupting and overwhelming healthcare the world over.Clinical outcomes of COVID-19 in patients with chronic comorbidities,especially in those with metabolic syndrome,are well documented.Chronic liver disease and cirrhosis patients are a special subgroup,among whom the management of COVID-19 is challenging.Understanding the pathophysiology of COVID-19 in patients with cirrhosis and portal hypertension improves our identification of at-risk patients for disease progression that will further help compartmentalize generalized and specialized treatment options in this special patient group.In this exhaustive review,we critically review the impact of COVID-19 on the liver and in chronic liver disease and cirrhosis patients.We further discuss common features associated with the pathophysiology of COVID-19 and cirrhosis,based on the renin-angiotensin system and deliberate current literature on guidelines for the treatment of COVID-19 and extrapolate the same to the cirrhosis population to provide a concise and stepwise,evidence-based management for cirrhosis patients with severe and critical COVID-19.There are no specific management guidelines for cirrhosis patients with COVID-19 and current recommendations for treatment are as per guidelines for general population.Nevertheless,specific issues like avoiding corticosteroids in decompensated patients with variceal bleeding,suspected sepsis,high grade hepatic encephalopathy and acute kidney injury,use of early mechanical ventilation strategies in those with severe ascites and hepatopulmonary syndrome,avoidance of remdesivir in advanced liver disease,and application of liver-specific severity scores for prognostication and identification of futility need to be highlighted. | Cyriac Abby Philips Kamna Kakkar Moby Joseph Praveen Kumar Yerol Rizwan Ahamed Sasidharan Rajesh Philip Augustine | 2021 | Journal of Clinical and Translational Hepatology2021，9，4： | 0 |
| 19 | Nonselective beta‐blockers reduce mortality in patients with acute‐on‐chronic liver failure显示文摘Aim:Nonselective beta‐blockers(NSBBs)can reduce the incidence of complications in patients with cirrhosis and prolong survival.The safety and efficacy of NSBBs in real‐world settings in patients with acute‐on‐chronic liver failure(ACLF)identified by the Asian Pacific Association for the Study of Liver criteria are unknown.This study aimed to assess the safety and efficacy of NSBBs in patients with Asian Pacific Association for the Study of Liver(APASL)‐defined ACLF Methods:In this retrospective,multicenter study,patients with ACLF with complete 30 days follow‐up from January 2019 to December 2021 were included.The primary objective was to compare 30‐day mortality among standard of care(SOC)and NSBB(+SOC)groups.The secondary objectives were to compare the incidence of infection,variceal bleed,and recompensation among both the groups.Results:A total of 346 patients were included.Only 26%(n=89)of them received NSBBs,while 74%(n=257)received only SOC.On Kaplan-Meier analysis,the incidence of mortality was 21%(95%confidence interval[CI]:16.20-26.50)in SOC group compared to only 8%(95%CI:3.22-15.53)in NSBB group at Day 30(p=0.005).Similarly,mortality in SOC group was 63%(95%CI:56.81-69.00)compared to 46%(95%CI:35.44-57.00)in NSBB group at 1 year(p=0.001).NSBB therapy could not reduce the incidence of infections or variceal bleed.Forty‐seven percent of patients in the SOC group and 73%of patients in the NSBB group(p<0.001)recompensated.Carvedilol was prescribed in 77.5%and propranolol in 22.5%of patients.Conclusions:NSBBs reduce mortality without any effect on infection or variceal bleed in patients with ACLF.However,only one in four ACLF patients are suitable for NSBB therapy. | Anand V.Kulkarni Madhumita Premkumar Karan Kumar Juned A.Khan Baqar A.Gora Sowmya Tirumalle Sameer Shaik Mithun Sharma Rajesh Gupta Nageshwar D.Reddy Padaki N.Rao | 2022 | Portal Hypertension & Cirrhosis2022，1，1： | 0 |
| 20 | 基于ERSA理念下的集束化护理管理在ACLF患者DPMAS治疗中的应用 | 龚燕花 | 2021 | 中文科技期刊数据库(全文版)医药卫生2021，，6： | 0 |
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