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Transjugular intrahepatic portosystemic shunt improves survival in anticoagulation-resistant hepatic sinusoidal obstructive syndrome patients:A multicenter retrospective study 认领 引用
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作者 Jing-Jing Tu Han Zhang +11 位作者 De-Run Kong Yan-Hong Feng Yue-Cheng Yu Tai-Shun Li Feng Zhang Wei Zhang Hui Xu Qin Yin Lei Wang Ming Zhang Jiang-Qiang Xiao Yu-Zheng Zhuge 《World Journal of Hepatology》 2026年第2期167-177,共11页
BACKGROUND Anticoagulation therapy is recommended during the acute or subacute stage for patients with pyrrolizidine alkaloid-hepatic sinusoidal obstruction syndrome(PAHSOS).Transjugular intrahepatic portosystemic shu... BACKGROUND Anticoagulation therapy is recommended during the acute or subacute stage for patients with pyrrolizidine alkaloid-hepatic sinusoidal obstruction syndrome(PAHSOS).Transjugular intrahepatic portosystemic shunts(TIPS)is suggested as a step-up treatment when patients do not respond to anticoagulants.However,more evidence of the efficacy of TIPS is needed.AIM To evaluate the effect of TIPS in these patients.METHODS Between January 2013 and September 2020,we retrospectively enrolled patients with PA-HSOS who did not respond to short-term anticoagulation therapy at four hospitals.The patients were divided into a TIPS treatment group and an anticoagulation therapy group.Baseline information and clinical characteristics were collected and recorded.Survival in both groups was the primary study endpoint and the risk factors for patient death were further analyzed.RESULTS A total of 99 patients were enrolled according to the inclusion and exclusion criteria(63 in the TIPS group and 36 in the anticoagulation therapy group).There were 17 deaths during the median follow-up time of 32.5 months.Treatment,age,aspartate aminotransferase,and serum total bilirubin were independent risk factors for predicting death.The survival of patients in the TIPS group was significantly greater than that of patients in the continuing anticoagulation therapy group(P=0.028).When stratified by the Drum-Tower Severity Scoring,in the TIPS group,mild and moderate patients had better outcomes than severe patients.CONCLUSION TIPS can improve the transplant-free survival rate in patients with PA-HSOS who do not respond to short-term anticoagulation therapy,and patients with mild and moderate Drum-Tower Severity Scoring grade can benefit from TIPS. 展开更多
关键词 Hepatic sinusoidal obstruction syndrome Hepatic veno-occlusive disease No response to anticoagulation therapy Gynura segetum Pyrrolizidine alkaloids Transjugular intrahepatic portosystemic shunts Transplant-free survival
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Effects of pegylated interferon on T cell receptor fingerprints in chronic hepatitis B patients with/without surface antigen clearance 认领 引用
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作者 Kun-Yan Hao Lei Tang +4 位作者 Guo-Bing Chen Wei Guo Zhan-Hui Wang Li-Peng Mao Yue-Cheng Yu 《World Journal of Hepatology》 2026年第7期73-84,共12页
BACKGROUND Chronic hepatitis B(CHB)remains a critical global health challenge,with few patients achieving spontaneous clearance of hepatitis B surface antigen(HBsAg),which is a key indicator of functional cure.T cell ... BACKGROUND Chronic hepatitis B(CHB)remains a critical global health challenge,with few patients achieving spontaneous clearance of hepatitis B surface antigen(HBsAg),which is a key indicator of functional cure.T cell plays an important role in HBsAg clearance.AIM To compare T cell receptor(TCR)fingerprints between patients with or without HBsAg clearance after pegylated interferon alpha-2b(PegIFNα-2b)added on nucleos(t)ide analogues(NAs).METHODS In this observational study,peripheral blood mononuclear cells(PBMCs)were isolated from six comparable CHB patients who achieved HBsAg clearance(Group-C)or not(Group-NC)after 48 weeks of PegIFNα-2b added to NA therapy.Patients in Group-C and Group-NC had comparable age,gender,baseline hepatitis B virus(HBV)DNA,HBsAg,hepatitis B envelop antigen(HBeAg),total bilirubin,alanine aminotransferase(ALT)and cirrhosis status.All patients had received at least one year of NA before PegIFNα-2b therapy.TCR repertoire profiles(fingerprints)were screened and compared by RNA sequencing and bioinformation analysis between the two groups.RESULTS Six male patients without cirrhosis were enrolled in this study,with three patients in each group.200 ng of RNA from each PBMC sample was extracted for standard RNA sequencing for construction of a complementary DNA library.Baseline levels of HBsAg,HBeAg,HBV DNA(0.05).It was found that compared to Group-NC,Group-C had significantly higher TCR diversity in bothαandβchain,including more unique clonotypes(P=0.017,P=0.038 respectively),more repertoire overlap(P=0.002,P=0.002 respectively),a broader complementarity-determining region3 length distribution,and higher Chao1 index(P=0.016,P=0.048 respectively).CONCLUSION Patients with HBsAg clearance had a more diverse and robust T cell response,which may correlate with HBsAg clearance status.These immune signatures may serve as potential reference indicators for PegIFNα-2b treatment response in CHB patients. 展开更多
关键词 Hepatitis B surface antigen clearance Pegylated interferonα-2b T cell receptor diversity Complementaritydetermining region 3 RNA sequencing Fingerprints
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Management of hepatitis C virus infection in hemodialysis patients 认领 引用 被引量：3
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作者 Yue-Cheng Yu Yue Wang +2 位作者 Chang-Lun He Mao-Rong Wang Yu-Ming Wang 《World Journal of Hepatology》 2014年第6期419-425,共7页
The prevalence of hepatitis C virus(HCV) infection in patients on maintenance hemodialysis(MHD) is relatively higher than those without MHD. Chronic HCV infection detrimentally affects the life quality and expectancy,... The prevalence of hepatitis C virus(HCV) infection in patients on maintenance hemodialysis(MHD) is relatively higher than those without MHD. Chronic HCV infection detrimentally affects the life quality and expectancy, leads to renal transplant rejection, and increases the mortality of MHD patients. With the application of erythropoietin to improve uremic anemia and avoid blood transfusion, the new HCV infections during MHD in recent years are mainly caused by the lack of stringent universal precautions. Strict implementation of universal precautions for HCV transmission has led to markedly decreased HCV infections in many hemodialysis units, but physicians still should be alert for the antiHCV negative HCV infection and occult HCV infection in MHD patients. Standard interferon alpha and pegylated interferon alpha monotherapies at a reduced dose arecurrently the main treatment strategies for MHD patients with active HCV replication, but how to increase the sustained virological response and decrease the side effects is the key problem. IFNα-free treatments with two or three direct-acting antivirals without ribavirin in MHD patients are waiting for future investigations. 展开更多
关键词 Hemodialysis Hepatitis C virus Epidemiology Risk factors Prophylaxis Treatment
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Optimization of hepatobiliary phase delay time of Gd-EOB-DTPA-enhanced magnetic resonance imaging for identification of hepatocellular carcinoma in patients with cirrhosis of different degrees of severity 认领 引用 被引量：6
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作者 Jian-Wei Wu Yue-Cheng Yu +2 位作者 Xian-Li Qu Yan Zhang Hong Gao 《World Journal of Gastroenterology》 SCIE CAS 2018年第3期415-423,共9页
AIM To optimize the hepatobiliary phase delay time(HBPDT) of Gd-EOB-DTPA-enhanced magnetic resonance imaging(GED-MRI) for more efficient identification of hepatocellular carcinoma(HCC) occurring in different degrees o... AIM To optimize the hepatobiliary phase delay time(HBPDT) of Gd-EOB-DTPA-enhanced magnetic resonance imaging(GED-MRI) for more efficient identification of hepatocellular carcinoma(HCC) occurring in different degrees of cirrhosis assessed by Child-Pugh(CP) score.METHODS The liver parenchyma signal intensity(LPSI), the liver parenchyma(LP)/HCC signal ratios, and the visibility of HCC at HBP-DT of 5, 10, 15, 20, and 25 min(i.e., DT-5, DT-10, DT-15, DT-20, and DT-25) after injection of GdEOB-DTPA were collected and analyzed in 73 patients with cirrhosis of different degrees of severity(including 42 patients suffering from HCC) and 18 healthy adult controls.RESULTS The LPSI increased with HBP-DT more significantly in the healthy group than in the cirrhosis group(F = 17.361, P < 0.001). The LP/HCC signal ratios had a significant difference(F = 12.453, P < 0.001) among various HBP-DT points, as well as between CP-A and CP-B/C subgroups(F = 9.761, P < 0.001). The constituent ratios of HCC foci identified as obvious hypointensity(+++), moderate hypointensity(++), and mild hypointensity or isointensity(+/-) kept stable from DT-10 to DT-25: 90.6%, 9.4%, and 0.0% in the CP-A subgroup; 50.0%, 50.0%, and 0.0% in the CP-B subgroup; and 0.0%, 0.0%, and 100.0% in the CP-C subgroup, respectively.CONCLUSION The severity of liver cirrhosis has significant negative influence on the HCC visualization by GED-MRI. DT-10 is more efficient and practical than other HBP-DT points to identify most of HCC foci emerging in CP-A cirrhosis, as well as in CP-B cirrhosis; but an HBP-DT of 15 min or longer seems more appropriate than DT-10 for visualization of HCC in patients with CP-C cirrhosis. 展开更多
关键词 Magnetic resonance imaging Gd-EOBDTPA Hepatobiliary phase Delay time Hepatocellular carcinoma Cirrhosis Optimization
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