Etiologic Factor of Portal Hypertension in Chronic Hepatitis : Symposium on Methods for the Study of Hepatic Circulation; Hepatic Circulatory Disturbances in Liver Diseases

Objective: Our study aims to detect the sensitivity of the new biomarker miR-212 existing in serum exosomes along with other hepatocellular carcinoma biomarkers such as AFP (alpha-fetoprotein), CA125 (carbohydrate antigen-ca125), and Hbx protein in the diagnosis of HBV-related liver diseases. We also aim to study the roles of these biomarkers in the progression of chronic hepatitis B and provide scientific data to show the clinical value of these biomarkers. Methods: We selected 200 patients with HBV-infection (58 cases of chronic hepatitis B, 47 cases of hepatocellular carcinoma, 30 cases of compensatory phase cirrhosis, and 65 cases of decompensatory phase cirrhosis), 31 patients with primary liver cancer without HBV infection, and 70 healthy individuals as the control group. The expression level of serum AFP and CA125 was detected with electrochemiluminescence immunoassay. The expression level of the Hbx protein was detected with ELISA. Meanwhile, the expression level of miR-212 in serum was analyzed with RT-qPCR. We collected patients’ clinical information following the Child-Pugh classification and MELD score criterion, and statistical analysis was made between the expression level of miR-212 and the collected clinical indexes. Lastly, we predicted the target genes of the miR-212 and its functions using bioinformatics methods such as cluster analysis and survival prediction. Results: Compared to the control group, the expression level of miR-212 in HBV infected patients was remarkably increased (P<0.05), especially between the HBV-infection Hepatocellular carcinoma group and the non-HBVinfection liver cancer group (P<0.05). The expression of miR-212 was increased in patients’ Child-Pugh classification, MELD score, and TNM staging. Moreover, the sensitivity and specificity of miR-212 were superior to AFP, CA125, and HBx protein. Conclusion: There is a linear relationship between disease progression and expression level of miR-212 in the serum of HBV infected patients. This demonstrates that miR-212 plays a significant role in liver diseases. miR-212 is expected to be a new biomarker used for the diagnosis and assessment of patients with HBV-infection-related liver diseases.

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General anesthesia and hepatic circulation

Canadian Journal of Physiology and Pharmacology ◽

10.1139/y87-276 ◽

1987 ◽

Vol 65 (8) ◽

pp. 1762-1779 ◽

Cited By ~ 94

Author(s):

Simon Gelman

Keyword(s):

Blood Flow ◽

General Anesthesia ◽

Surgical Procedures ◽

Hepatic Blood Flow ◽

Portal Blood Flow ◽

Arterial Blood Flow ◽

Hepatic Circulation ◽

Arterial Blood ◽

Total Hepatic Blood Flow ◽

Circulatory Disturbances

This article describes hepatic circulatory disturbances associated with anesthesia and surgical intervention. The material is presented in three parts: part 1 describes the effects of general anesthetics on the hepatic circulation; part 2 deals with different factors related to surgical procedures and anesthesia; and part 3 analyzes the role of hepatic circulatory disturbances and hepatic oxygen deprivation in anesthesia-induced hepatotoxicity. The analysis of available data suggests that general anesthesia affects the splanchnic and hepatic circulation in various directions and to different degrees. The majority of anesthetics decreases portal blood flow in association with a decrease in cardiac output. However, hepatic arterial blood flow can be preserved, decreased, or increased. The increase in hepatic arterial blood flow, when it occurs, is usually not enough to compensate for a decrease in portal blood flow and therefore total hepatic blood flow is usually decreased during anesthesia. This decrease in total hepatic blood flow-has certain pharmacokinetic implications, namely a decrease in clearance of endogenous and exogenous substances with a high hepatic extraction ratio. On the other hand, a reduction in the hepatic oxygen supply might play a certain role in liver dysfunction occurring perioperatively. Surgical procedures–preparations combined with anesthesia have a very complex effect on the splanchnic and hepatic circulation. Within this complex, the surgical procedure–preparation plays the main role in developing circulatory disturbances, while anesthesia plays only a modifying role. Hepatic oxygen deprivation may play an important role in anesthesia-induced hepatotoxicity in different experimental models.

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Depressive symptoms and cognitive dysfunctions in patients with chronic hepatitis B

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1502006p ◽

2015 ◽

Vol 143 (1-2) ◽

pp. 6-11 ◽

Cited By ~ 1

Author(s):

Sladjana Pavic ◽

Neda Svirtlih ◽

Dragan Delic ◽

Aleksandra Radovanovic-Spurnic

Keyword(s):

Chronic Hepatitis ◽

Hepatitis B ◽

Chronic Hepatitis B ◽

Cognitive Dysfunction ◽

Cognitive Functions ◽

Liver Diseases ◽

Cognitive Disorders ◽

Chronic Liver ◽

Chronic Liver Diseases ◽

Healthy Persons

Introduction. Pronounced symptoms of depression and disorders of cognitive functions can be observed in patients with chronic hepatitis B. Objective. The objective of the study was evaluation of the severity of symptoms and predictive factors for depression and the existence of cognitive disorders in patients with chronic hepatitis B. Methods. A total of 150 respondents were included in this prospective study (50 patients with chronic hepatitis B, 50 patients with other chronic liver diseases and 50 healthy persons). The patients with chronic hepatitis B were homogeneous by age compared to healthy subjects (p=0.566) and patients with other chronic liver diseases (p=0.528). Assessment of intensity of depression was determined by the Hamilton Depression Rating Scale (HAMD). A Mini Mental State Examination (MMSE) test was used to investigate the presence of cognitive disorders. Results. Significantly expressed depression was observed in patients with chronic hepatitis B compared with healthy persons as well as the occurrence of cognitive dysfunction (p=0.00), while in comparison with the patients with chronic nonviral liver diseases, depression was statistically significantly less markedly expressed (p=0.003). Depression and cognitive dysfunction were more noticeable in patients with chronic hepatitis B in the stage of liver cirrhosis in relation to the early stage of the disease. Multivariate analysis of variables related to the sociodemographic characteristics showed that the most significant positive predictor of depression was more expressed in older age (over 50 years) (B=0.276; SE=0.092; p=0.004). Conclusion. Patients with chronic hepatitis B have a higher intensity of depression compared to healthy people, which is intensified with the progression of the disease. The highest expression of depression is expected in the elderly. Patients with chronic hepatitis B have a lower intensity of depression and fewer disorders of cognitive functions than patients with other chronic liver diseases.

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Diagnostic Performance of Two-dimensional Shear Wave Elastography in Advanced Liver Fibrosis: A Prospective Pathology-based Study

10.21203/rs.3.rs-122956/v1 ◽

2020 ◽

Author(s):

Yao-Kuang Huang ◽

Ren-Ching Wang ◽

Sheng-Shun Yang ◽

Shou-Wu Lee ◽

Hsin-Ju Tsai ◽

...

Keyword(s):

Chronic Hepatitis ◽

Liver Fibrosis ◽

Shear Wave ◽

Liver Diseases ◽

Diagnostic Performance ◽

Shear Wave Elastography ◽

Two Dimensional ◽

Liver Disorders ◽

Advanced Liver Fibrosis ◽

Invasive Method

Abstract Studies for evaluating the diagnostic performance of two-dimensional Shear-wave Elastography (2D-SWE) in a patient cohort including various liver disorders, remain limited. We aimed to evaluate the validity of 2D-SWE in the diagnosis of advanced liver fibrosis amongst patients with various liver disorders. In this pathology-based study, patients who underwent a liver biopsy for various benign liver diseases were prospectively recruited during the period between February, 2017 and September, 2020. Data of 2D-SWE, Fibrosis-4 Index (FIB-4), and Aspartate Aminotransferase to Platelet Ratio Index (APRI) were simultaneously collected. The cut-off values for predicting advanced fibrosis, i.e. Metavir fibrosis stage ≥ F3, were determined using Receiver Operating Characteristic (ROC) analysis. The diagnostic performance was evaluated and then compared by Area Under the ROC (AUROC). In total, 95 patients were recruited for study analysis. The diagnostic performance of 2D-SWE was significantly superior to that of both FIB-4 (AUROC: 0.88, 95% confidence interval [CI]: 0.80-0.94; vs 0.72, 95%CI: 0.62-0.81; p=0.001) and APRI (AUROC: 0.88, 95%CI: 80-0.94; vs 0.76, 95%CI: 0.66-0.84; p=0.007). With an optimal cutoff value of 9.3 kPa, the sensitivity and specificity were 90.91% and 76.47%, respectively. In subgroup analysis, the AUROC of 2D-SWE was the highest when compared to that of FIB-4 and APRI in patients with chronic hepatitis B, chronic hepatitis C, fatty liver, and concurrent hepatitis. 2D-SWE can therefore be a valid non-invasive method in the detection of advanced liver fibrosis in various liver diseases.

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