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Hepatocellular carcinoma incidence post direct-acting antivirals in hepatitis C-related advanced fibrosis/cirrhosis patients in Australia

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Hepatobiliary & Pancreatic Diseases International 2020年第6期19卷 541-546页

作者： Patrick P Y Chan Miriam T Levy Nicholas Shackel scott A davison Emilia Prakoso Department of Gastroenterology and Hepatology Liverpool HospitalElizabeth StreetLiverpoolNSW 2170Australia South Western Clinical School University of New South WalesLiverpoolNSW 2170Australia Central Clinical School-The Faculty of Medicine and Health University of SydneyNSW 2050Australia

Background:Despite efficacy in HCV eradication,direct-acting antiviral(DAA)therapy has raised controversies around their impact on hepatocellular carcinoma(HCC)*** we reported the first Australian data on HCC incidence in DAA-treated HCV patients with advanced fibrosis/***:We conducted a retrospective single center study of DAA-treated HCV patients with advanced fibrosis/cirrhosis from April 2015 to December *** with prior HCC were included if they had complete response to HCC ***:Among 138 patients who completed DAA therapy,133(96.4%)achieved sustained virologic response(median follow-up 23.8 months).Ten had prior HCC and 5/10(50.0%)developed recurrence,while de novo HCC developed in 7/128(5.5%).Median time from DAA to HCC diagnosis was 34 weeks in recurrent HCC *** novo 52 weeks(P=0.159).In patients with prior HCC,those with recurrence(***)had shorter median time between last HCC treatment and DAA(12 vs.164 weeks,P<0.001).On bivariate analysis,failed sustained virologic response at 12 weeks(SVR12)(P=0.011),platelets(P=0.005),model for end-stage liver disease(MELD)score(P=0.029),alpha fetoprotein(AFP)(P=0.013),and prior HCC(P<0.001)were associated with HCC *** multivariate analysis,significant factors were prior HCC(OR=4.80;95%CI:1.47–48.50;P=0.010),failed SVR12(OR=2.83;95%CI:1.71–16.30;P=0.016)and platelets(OR=0.97;95%CI:0.95–0.99;P=0.009).Conclusions:Our study demonstrates a high incidence of recurrent HCC in HCV patients with advanced fibrosis/cirrhosis treated with *** associated with HCC development post-DAA were more advanced liver disease,failed SVR12 and prior HCC,with higher rates of recurrence in those who started DAA earlier.

关键词： Direct-acting antiviral Cirrhosis Hepatitis-C virus Hepatocellular carcinoma Recurrence

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Prospective randomized controlled trial evaluating cap-assisted colonoscopy vs standard colonoscopy

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World Journal of Gastroenterology 2010年第31期16卷 3905-3910页

作者： Hoi-Poh Tee Crispin Corte Hamdan Al-Ghamdi Emilia Prakoso John Darke Raman Chettiar Wassim Rahman scott davison Sean P Griffin Warwick S Selby Arthur J Kaffes Gastroenterology Unit Medical DepartmentHospital Tengku Ampuan AfzanJalan Tanah Putih25100 KuantanPahang Malaysia AW Morrow Gastroenter-ology and Liver Centre Royal Prince Alfred HospitalMissen-den RoadCamperdownNSW 2050Australia Gastroenterology Unit Medical DepartmentQueen Elizabeth HospitalKarung Berkunci No.202988586 Kota KinabaluMalaysia

AIM: To study the significance of cap-fitted colonoscopy in improving cecal intubation time and polyp detection rate. METHODS: This study was a prospective randomized controlled trial conducted from March 2008 to February 2009 in a tertiary referral hospital at Sydney. The primary end point was cecal intubation time and the secondary endpoint was polyp detection rate. Consecutive cases of total colonoscopy over a 1-year period were recruited. Randomization into either standard colonoscopy (SC) or cap-assisted colonoscopy (CAC) was performed after consent was obtained. For cases randomized to CAC, one of the three sizes of cap was used: D-201-15004 (with a diameter of 15.3 mm), D-201-14304 (14.6 mm) and D-201-12704 (13.0 mm). All of these caps were produced by Olympus Medical Systems, Japan. Independent predictors for faster cecal time and better polyp detection rate were also determined from this study. RESULTS: There were 200 cases in each group. There was no signif icant difference in terms of demographic characteristics between the two groups. CAC, when compared to the SC group, had no signif icant difference in terms of cecal intubation rate (96.0% vs 97.0%, P = 0.40) and time (9.94 ± 7.05 min vs 10.34 ± 6.82 min, P = 0.21), or polyp detection rate (32.8% vs 31.3%, P = 0.75). On the subgroup analysis, there was no significant difference in terms of cecal intubation time by trainees (88.1% vs 84.8%, P = 0.40), ileal intubation rate (82.5% vs 79.0%, P = 0.38) or total colonoscopy time (23.24 ± 13.95 min vs 22.56 ± 9.94 min, P = 0.88). On multivariate analysis, the independent determinants of faster cecal time were consultant-performed procedures (P < 0.001), male patients (P < 0.001), non-usage of hyoscine (P < 0.001) and better bowel preparation (P = 0.01). The determinants of better polyp detection rate were older age (P < 0.001), no history of previous abdominal surgery (P = 0.04), patients not having esophagogastroduodenoscopy in the same setting (P = 0.003),

关键词： Cap Hood Cecum Colonoscopy Cecal intubation Colonic polyps

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利用快速制备色谱技术提高天然产物的分离和纯化

利用快速制备色谱技术提高天然产物的分离和纯化

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多学科交叉，产学研联合，实现西部药用植物资源的可持续利用——第十届全国药用植物及植物药学术研讨会

作者： Rakesh Bose scott Anderson Kathy Lawrence Grace davison Discovery Sciences

天然产物依然是新药研发中的一个重要部分。粗提的样品中包含的先导化合物往往需要几步才能完全分离和纯化。常规的快速制备技术在使用中,会由于无法检测到非发光团而失败,或者缺少检测低含量样品而必须的灵敏度而失败。这个研究探讨了...

天然产物依然是新药研发中的一个重要部分。粗提的样品中包含的先导化合物往往需要几步才能完全分离和纯化。常规的快速制备技术在使用中,会由于无法检测到非发光团而失败,或者缺少检测低含量样品而必须的灵敏度而失败。这个研究探讨了一系列用常规方法难以分离的天然产物的纯化技术。论文中使用Reveleris(R)全息快速纯化色谱系统和高容量色谱柱得到的结果和数据展示出探索植物药可以变得更快速更轻松。

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12周或24周的索磷布韦+利巴韦林用于3至<12岁的基因2型或基因3型慢性丙型肝炎的儿童感染患者时安全有效

12周或24周的索磷布韦+利巴韦林用于3至<12岁的基因2型或基因3型...

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第十届全国疑难及重症肝病大会

作者： Philip Rosenthal Kathleen B.Schwarz Regino P Gonzalez-Peralta Chuan-Hao Lin Deirdre A.Kelly scott Nightingale William F.Balistreri Sanjay Bansal Maureen M.Jonas Benedetta Massetto Diana Brainard Rebecca Begley Jiang Shao Bandita Parhy Suzanne davison Cornelia Feiterna-Sperling Lynette A.Gillis Giuseppe Indolfi Etienne M.Sokal Karen F.Murray Stefan Wirth University of California San Francisco Johns Hopkins Hospital Pediatric Hepatology and Liver Transplantation University of Florida Children's Hospital Los Angeles

背景基于索磷布韦的治疗方案已被批准用于12至<18岁的青少年患者,但对于年龄更小的儿童患者而言,标准治疗方案仍然是长达48周的聚乙二醇化干扰素+利巴韦林。本研究评估了索磷布韦(SOF)+利巴韦林(RBV)全口服疗法用于3至<12岁的儿童患者...

背景基于索磷布韦的治疗方案已被批准用于12至<18岁的青少年患者,但对于年龄更小的儿童患者而言,标准治疗方案仍然是长达48周的聚乙二醇化干扰素+利巴韦林。本研究评估了索磷布韦(SOF)+利巴韦林(RBV)全口服疗法用于3至<12岁的儿童患者时的安全性和疗效。方法 3至<12岁的慢性HCVGT2或GT3儿童患者入组本项正在进行的开放标签研究,接受

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