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Advances in cell sources of hepatocytes for bioartificial liver

Hepatobiliary & pancreatic diseases International 2012年第6期11卷 594-605页

作者： xiao-ping pan , lan-juan li state key laboratory for diagnosis and treatment of infectious diseases, first affiliated hospital, zhejiang university school of medicine, hangzhou 310003, china state key laboratory for diagnosis and treatment of infectious diseases First Affiliated Hospital Zhejiang University School of Medicine Hangzhou 310003 China

BACKGROUND: Orthotopic liver transplantation (OLT) is the most effective therapy for liver failure. However, OLT is severely limited by the shortage of liver donors. Bioartificial liver (BAL) shows great potential as an alternative therapy for liver failure In recent years, progress has been made in BAL regarding genetically engineered cell lines, immortalized human hepatocytes, methods for preserving the phenotype of primary human hepatocytes, and other functional hepatocytes derived from stem cells. DATA SOURCES: A systematic search of PubMed and ISI Web of Science was performed to identify relevant studies in English language literature using the key words such as liver failure bioartificial liver, hepatocyte, stem cells, differentiation, and immortalization. More than 200 articles related to the cell sources of hepatocyte in BAL were systematically reviewed. RESULTS: Methods for preserving the phenotype of primary human hepatocytes have been successfully developed. Many genetically engineered cell lines and immortalized human hepatocytes have also been established. Among these cell lines the incorporation of BAL with GS-HepG2 cells or alginate encapsulated HepG2 cells could prolong the survival time and improve pathophysiological parameters in an animal model of liver failure. The cBAL111 cells were evaluated using the AMC-BAL bioreactor, which could eliminate ammonia and lidocaine, and produce albumin. Importantly, BAL loading with Hepli-4 cells could significantly improve the blood biochemical parameters, and prolong the survival time in pigs with liver failure. Other functional hepatocytes differentiated from stem cells, such as human liver progenitor cells, have been successfully achieved. CONCLUSIONS: Aside from genetically modified liver cell lines and immortalized human hepatocytes, other functionalhepatocytes derived from stem cells show great potential as cell sources for BAL. BAL with safe and effective liver cells may be achieved for clinical liver fa

关键词： bioartificial liver liver failure hepatocyte liver cell source stem cell differentiation immortalization

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key challenges to the development of extracorporeal bioartificial liver support systems

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Hepatobiliary & pancreatic diseases International 2012年第3期11卷 243-249页

作者： li-Fu Zhao, xiao-ping pan and lan-juan li state key laboratory for diagnosis and treatment of infectious diseases, first affiliated hospital, zhejiang university school of medicine, hangzhou 310003, china state key laboratory for diagnosis and treatment of infectious diseases First Affiliated Hospital Zhejiang University School of Medicine Hangzhou 310003 China

BACKGROUND: For nearly three decades, extracorporeal bioartificial liver (BAL) support systems have been anticipated as promising tools for the treatment of liver failure. However, these systems are still far from clinical application. This review aimed to analyze the key challenges to the development of BALs. DATA SOURCE: We carried out a PubMed search of Englishlanguage articles relevant to extracorporeal BAL support systems and liver failure. RESULTS: Extracorporeal BALs face a series of challenges. first, an appropriate cell source for BAL is not readily available. Second, existing bioreactors do not provide in vivolike oxygenation and bile secretion. Third, emergency needs cannot be met by current BALs. Finally, the effectiveness of BALs, either in animals or in patients, has been difficult to document. CONCLUSIONS: Extracorporeal BAL support systems are mainly challenged by incompetent cell sources and flawed bioreactors. To advance this technology, future research is needed to provide more insights into interpreting the conditions for hepatocyte differentiation and liver microstructure formation.

关键词： bioartificial liver liver failure cell source bioreactor

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diagnosis,treatment and prevention of severe acute respiratory syndrome coronavirus 2 infection in children:experts'consensus statement updatedforthe Omicron variant

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World Journal of Pediatrics 2024年第3期20卷 272-286页

作者： Rong-Meng Jiang Zheng-De Xie Yi Jiang xiao-Xia Lu Run-Ming Jin Yue-Jie Zheng Yun-xiao Shang Bao-ping Xu Zhi-Sheng liu Gen Lu Ji-Kui Deng Guang-Hua liu xiao-Chuan Wang Jian-She Wang Lu-Zhao Feng Wei liu Yi Zheng Sai-Nan Shu Min Lu Wan-Jun Luo Miao liu Yu-Xia Cui Le-ping Ye A-Dong Shen Gang liu li-Wei Gao li-juan Xiong Yan Bai li-Kai lin Zhuang Wei Feng-Xia Xue Tian-You Wang Dong-Chi Zhao Jian-Bo Shao Daniel Kwok-keung Ng Gary Wing-kin Wong Zheng-Yan Zhao Xing-Wang li Yong-Hong Yang Kun-ling Shen diagnosis and treatment Center of infectious diseases Beijing Ditan HospitalCapital Medical UniversityBeijing 100015China Beijing key laboratory of Pediatric Respiratory Infection diseases Key Laboratory of Major Diseases in ChildrenMinistry of EducationNational Clinical Research Center for Respiratory DiseasesResearch Unit of Critical Infection in ChildrenChinese Academy of Medical Sciences2019RU016Laboratory of Infection and VirologyBeijing Pediatric Research InstituteBeijing Children's HospitalCapital Medical UniversityNational Center for Children's HealthBeijing 100045China Department of Pediatrics Renmin Hospital of Wuhan UniversityWuhan 430060China Department of Respiratory Wuhan Children's HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430016China Department of Pediatrics Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022China Department of Respiratory Shenzhen Children's HospitalShenzhen 518038China Department of Pediatric Respiratory Shengjing Hospital Affiliated to China Medical UniversityShenyang 110004China Department of Respiratory Beijing Children's HospitalCapital Medical UniversityNational Clinical Research Center for Respiratory DiseasesNational Center for Children's HealthBeijing 100045China Department of Neurology Wuhan Children's HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430016China Department of Respiratory Guangzhou Women and Children's Medical CenterGuangzhou 510623China Department of infectious diseases Shenzhen Children's HospitalShenzhen 518038China Department of Pediatrics Fujian Branch of Shanghai Children's Medical CenterFujian Children's HospitalFuzhou350005China Department of Clinical Immunology and Allergy Children's Hospital of Fudan UniversityNational Center for Children's HealthShanghai 201102China Department of infectious diseases Children's Hospital of Fudan UniversityNational Center for Children's Health.Shanghai

It has been more than 3 years since the novel coronavirus(SARS-CoV-2)pandemic raged *** coronavirus disease 2019(COVID-19)has greatly influenced human *** to data from the World Health Organization(WHO),there were ove... 详细信息

关键词： prevention infection statement

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Prognostic models for acute liver failure

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Hepatobiliary & pancreatic diseases International 2010年第2期9卷 122-128页

作者： Du, Wei-Bo pan, xiao-ping li, lan-juan zhejiang Univ Sch Med Affiliated Hosp 1 State Key Lab Diag & Treatment Infect Dis Hangzhou 310003 Zhejiang Peoples R China

BACKGROUND: Acute liver failure (ALF) remains a dramatic and unpredictable disease with high morbidity and mortality. Early and accurate prognostic assessment of patients with ALF is critically important for optimum clinical pathway. DATA SOURCES: Five English-language medical databases, MEDliNE, Science Direct, OVID, Springer link and Wiley Interscience were searched for articles on 'acute liver failure', 'prognosis', and related topics. RESULTS: Multi-variable prognostic models including the King's College hospital criteria and the model for end-stage liver disease score have been widely used in determination of the prognosis of ALF, but the results are far from satisfactory. Other prognostic indicators including serum Gc-globulin, arterial blood lactate, serum phosphate, arterial blood ammonia, and serum alpha-fetoprotein are promising but await further assessement. CONCLUSIONS: A reliable prognostic model to be developed in the future should not only have predictive value for poor outcome but also help to predict the survival of patients without a liver transplantation. Further studies are necessary to assess the prognostic accuracy of any new models. (Hepatobiliary pancreat Dis Int 2010; 9: 122-128)

关键词： acute liver failure prognosis the King's College hospital criteria model for end-stage liver disease score liver transplantation

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sTREM-1 as promising prognostic biomarker for acute-on-chronic liver failure and mortality in patients with acute decompensation of cirrhosis

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World Journal of Gastroenterology 2024年第9期30卷 1177-1188页

作者： Song-Man Yu Hai li Guo-Hong Deng Xian-Bo Wang Xin Zheng Jin-Jun Chen Zhong-Ji Meng Yu-Bao Zheng Yan-Hang Gao Zhi-ping Qian Feng liu xiao-Bo Lu Yu Shi Jia Shang Ruo-Chan Chen Yan Huang Department of infectious diseases Xiangya HospitalCentral South UniversityChangsha 410000Hunan ProvinceChina Department of Gastroenterology Renji HospitalShanghai Jiao Tong University School of MedicineShanghai 200127China Department of infectious diseases Southwest HospitalThird Military Medical University(Army Medical University)Chongqing 400038China Center of Integrative medicine Beijing Ditan HospitalCapital Medical UniversityBeijing 100020China Department of infectious diseases Institute of Infection and ImmunologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430020Hubei ProvinceChina Department of infectious diseases Nanfang HospitalSouthern Medical UniversityGuangzhou 510515Guangdong ProvinceChina Department of infectious Disease Taihe HospitalHubei University of MedicineShiyan 442009Hubei ProvinceChina Department of infectious diseases The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510630Guangdong ProvinceChina Department of Hepatology The First Hospital of Jilin UniversityChangchun 130021Jilin ProvinceChina Department of liver Intensive Care Unit Shanghai Public Health Clinical CentreFudan UniversityShanghai 200093China Tianjin Institute of Hepatology Nankai University Second People's HospitalTianjin 300192China infectious Disease Center The First Affiliated Hospital of Xinjiang Medical UniversityUrumqi 830054Xinjiang Uygur Autonomous RegionChina The state key laboratory for diagnosis and treatment of infectious diseases The First Affiliated Hospital of School of MedicineZhejiang UniversityHangzhou 310003Zhejiang ProvineChina Department of infectious diseases Henan Provincial People's HospitalZhengzhou 463599Henan ProvineChina Department of infectious diseases Hunan Key Laboratory of Viral HepatitisXiangya HospitalCentral South UniversityChangsha 110051Hunan ProvineChina

BACKGROUND Acute decompensation(AD)of cirrhosis is associated with high short-term mortality,mainly due to the development of acute-on-chronic liver failure(ACLF).Thus,there is a need for biomarkers for early and accurate identification of AD patients with high risk of development of ACLF and *** triggering receptor expressed on myeloid cells-1(sTREM-1)is released from activated innate immune cells and correlated with various inflammatory *** To explore the prognostic value of sTREM-1 in patients with AD of *** A multicenter prospective cohort of 442 patients with cirrhosis hospitalized for AD was divided into a study cohort(n=309)and validation cohort(n=133).Demographic and clinical data were collected,and serum sTREM-1 was measured at *** enrolled patients were followed-up for at least 1 *** In patients with AD and cirrhosis,serum sTREM-1 was an independent prognosis predictor for 1-year survival and correlated with liver,coagulation,cerebral and kidney failure.A new prognostic model of AD(P-AD)incorporating sTREM-1,blood urea nitrogen(BUN),total bilirubin(TBil),international normalized ratio(INR)and hepatic encephalopathy grades was established and performed better than the model for end-stage liver disease(MELD),MELD-sodium(MELD-Na),chronic liver failure-consortium(CliF-C)ACLF and CliF-C AD ***,sTREM-1 was increased in ACLF and predicted the development of ACLF during first 28-d *** ACLF risk score incorporating serum sTREM-1,BUN,INR,TBil and aspartate aminotransferase levels was established and significantly superior to MELD,MELD-Na,CliF-C ACLF,CliF-C AD and P-AD in predicting risk of ACLF *** Serum sTREM-1 is a promising prognostic biomarker for ACLF development and mortality in patients with AD of cirrhosis.

关键词： Soluble triggering receptor expressed on myeloid cell-1 Acute decompensation Cirrhosis Acute-on-chronic liver failure Prognostic biomarker

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Evaluation of a novel choanoid fluidized bed bioreactor for future bioartificial livers

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World Journal of Gastroenterology 2014年第22期20卷 6869-6877页

作者： Cheng-Bo Yu xiao-ping pan liang Yu xiao-Peng Yu Wei-Bo Du Hong-Cui Cao Jun li ping Chen lan-juan li states key laboratory for diagnosis and treatment of infectious diseases First Affiliated HospitalSchool of MedicineZhejiang University Collaborative Innovation Center for diagnosis and treatment of infectious diseases

AIM: To construct and evaluate the functionality of a choanoid-fluidized bed bioreactor (CFBB) based on microencapsulated immortalized human hepatocytes.

关键词： Choanoid Fluidized bed Bioreactor Immortalized human hepatocytes Bioartificial liver

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Therapeutic potential of menstrual blood stem cells in treating acute liver failure

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World Journal of Gastroenterology 2019年第41期25卷 6190-6204页

作者： pan-pan Cen lin-xiao Fan Jie Wang Jia-Jia Chen lan-juan li Department of infectious diseases Hangzhou First People’s HospitalZhejiang University School of MedicineHangzhou 310006Zhejiang ProvinceChina state key laboratory for diagnosis and treatment of infectious diseases/National Clinical Research Center for infectious diseases/The first affiliated hospital Zhejiang University School of MedicineHangzhou 310003Zhejiang ProvinceChina

BACKGROUND Acute liver failure(ALF)is a significant and complex hepatic insult that may rapidly progress to life-threatening ***,menstrual blood stem cells(MenSCs)have been identified as a group of easily accessible mesenchymal stem cells with the advantages of non-invasive acquisition,low immunogenicity,a greater capacity of self-renewal and multi-lineage differentiation,making them promising candidates for stem cell-based therapy to revolutionize the treatment strategies for liver *** To investigate the therapeutic potential of MenSCs for treating ALF in pigs and to dynamically trace the biodistribution of transplanted *** MenSCs were labeled in vitro with PKH26,a lipophilic fluorescent *** treatment group received immediate transplantation of PKH26-labelled MenSCs(2.5×106/kg)via the portal vein after D-galactosamine injection,and the control group underwent sham *** survival time,liver function,and hepatic pathological changes were compared between the two *** major organs(liver,lungs and spleen)were extracted from animals and imaged directly with the In vivo Imaging System(IVIS)at the predetermined time *** regions of interest were drawn to quantify the cell uptake in different *** The labelling procedure did not affect the morphology,viability or multipotential differentiation of *** analysis showed that the levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL)and prothrombin time(PT)measured at selected time points 24 h after transplantation were significantly decreased in the treatment group(Ptreatment group compared with the control group(75.75±5.11 h vs 53.75±2.37 h,log rank,Pliver pathological tissue in the MenSC treatment group showed obviously increased numbers of remaining hepatocytes and a comparatively slight necrotic degree and *** addition,the IV

关键词： Menstrual blood stem cell Acute liver failure Cell transplantation Homing Labelling

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The Chinese Society of Clinical Oncology (CSCO): Clinical guidelines for the diagnosis and treatment of gastric cancer, 2023

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Cancer Communications 2024年第1期44卷 127-172页

作者： Feng-Hua Wang xiao-Tian Zhang Lei Tang Qi Wu Mu-Yan Cai Yuan-Fang li Xiu-juan Qu Hong Qiu Yu-Jing Zhang Jie-Er Ying Jun Zhang ling-Yu Sun Rong-Bo lin Chang Wang Hao liu Miao-Zhen Qiu Wen-Long Guan Sheng-Xiang Rao Jia-Fu Ji Yan Xin Wei-Qi Sheng Hui-Mian Xu Zhi-Wei Zhou Ai-ping Zhou Jing Jin Xiang-lin Yuan Feng Bi Tian-Shu liu Han liang Yan-Qiao Zhang Guo-Xin li Jun liang Bao-Rui liu lin Shen Jin li Rui-Hua Xu Department of Medical Oncology Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineGuangzhouGuangdongP.R.China Department of Gastrointestinal Oncology Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education)Peking University Cancer HospitalBeijingP.R.China Department of Radiology Peking University Cancer HospitalBeijingP.R.China Department of Endoscopy Center Peking University Cancer HospitalBeijingP.R.China Department of Pathology Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South ChinaCollaborative Innovation Center of Cancer MedicineGuangzhouGuangdongP.R.China Department of Gastric Surgery Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineGuangzhouGuangdongP.R.China Department of Medical Oncology The First Hospital of China Medical UniversityShenyangLiaoningP.R.China Department of Medical Oncology Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and TechnologyWuhanHubeiP.R.China Department of Radiotherapy Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineGuangzhouGuangdongP.R.China Department of Medical Oncology Zhejiang Cancer HospitalHangzhouZhejiangP.R.China Department of Medical Oncology Ruijin HospitalShanghai Jiaotong University School of MedicineShanghaiP.R.China Department of Surgical Oncology The Fourth Affiliated Hospital of Harbin Medical UniversityHarbinHeilongjiangP.R.China Department of Medical Oncology Fujian Cancer HospitalFuzhouFujianP.R.China Tumor Center The First Hospital of Jilin UniversityChangchunJilinP.R.China Department of General Surgery Nanfang HospitalSouthern Medical UniversityGuangzhouGuangdongP.R.China Department of Radiology Zhongshan HospitalFudan UniversityShanghaiP.R.China Department of

The 2023 update of the Chinese Society of Clinical Oncology(CSCO)Clini-cal Guidelines for Gastric Cancer focuses on standardizing cancer diagnosis and treatment in china,reflecting the latest advancements in evidence-based medicine,healthcare resource availability,and precision *** updates address the differences in epidemiological characteristics,clinicopatho-logical features,tumor biology,treatment patterns,and drug selections between Eastern and Western gastric cancer *** revisions include a structured template for imaging diagnosis reports,updated standards for molecular marker testing in pathological diagnosis,and an elevated recommendation for neoadju-vant chemotherapy in stage III gastric *** advanced metastatic gastric cancer,the guidelines introduce new recommendations for immunotherapy,anti-angiogenic therapy and targeted drugs,along with updated management strategies for human epidermal growth factor receptor 2(HER2)-positive and deficient DNA mismatch repair(dMMR)/microsatellite instability-high(MSI-H)***,the guidelines offer detailed screening recommendations for hereditary gastric cancer and an appendix listing drug treatment regimens for various stages of gastric *** 2023 CSCO Clinical Guidelines for Gastric Cancer updates are based on both Chinese and international clinical research and expert consensus to enhance their applicability and relevance in clinical practice,particularly in the heterogeneous healthcare landscape of china,while maintaining a commitment to scientific rigor,impartiality,and timely revisions.

关键词： Chinese Society of Clinical Oncology(CSCO) gastric cancer diagnosis surgery neoadjuvant adjuvant radiotherapy chemotherapy targeted therapy immunotherapy

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Effects of plasma from patients with acute on chronic liver failure on function of cytochrome P450 in immortalized human hepatocytes

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Hepatobiliary & pancreatic diseases International 2010年第6期9卷 611-614页

作者： Du, Wei-Bo pan, xiao-ping Yu, xiao-Peng Yu, Cheng-Bo Lv, Guo-liang Chen, Yu li, lan-juan zhejiang Univ Sch Med Affiliated Hosp 1 State Key Lab Diag & Treatment Infect Dis Hangzhou 310003 Zhejiang Peoples R China

BACKGROUND: The bioartificial liver is anticipated to be a promising alternative choice for patients with liver failure. Toxic substances which accumulate in the patients' plasma exert deleterious effects on hepatocytes in the bioreactor, and potentially reduce the efficacy of bioartificial liver devices. This study was designed to investigate the effects of plasma from patients with acute on chronic liver failure (AoCLF) on immortalized human hepatocytes in terms of cytochrome P450 gene expression, drug metabolism activity and detoxification capability. METHODS: Immortalized human hepatocytes (Hepli-2 cells) were cultured in medium containing fetal calf serum or human plasma from three patients with AoCLF. The cytochrome P450 (CYP3A5, CYP2E1, CYP3A4) expression, drug metabolism activity and detoxification capability of Hepli-2 cells were assessed by RT-PCR, lidocaine clearance and ammonia elimination assay. RESULTS: After incubation in medium containing AoCLF plasma for 24 hours, the cytochrome P450 mRNA expression of Hepli-2 cells was not significantly decreased compared with control culture. Ammonia elimination and lidocaine clearance assay showed that the ability of ammonia removal and drug metabolism remained stable. CONCLUSIONS: Immortalized human hepatocytes can be exposed to AoCLF plasma for at least 24 hours with no significant reduction in the function of cytochrome P450. Hepli-2 cells appear to be effective in metabolism and detoxification and can be potentially used in the development of bioartificial liver. (Hepatobiliary pancreat Dis Int 2010; 9:611-614)

关键词： acute on chronic liver failure bioartificial liver immortalized human hepatocyte cytochrome P450 cell culture

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Characterization of acute-on-chronic liver diseases: A multicenter prospective cohort study

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World Journal of Hepatology 2024年第5期16卷 809-821页

作者： Yuan-Yao Zhang Sen Luo Hai li Shu-Ning Sun Xian-Bo Wang Xin Zheng Yan Huang Bei-ling li Yan-Hang Gao Zhi-ping Qian Feng liu xiao-Bo Lu Jun-ping liu Hao-Tang Ren Yu-Bao Zheng Hua-Dong Yan Guo-Hong Deng liang Qiao Yan Zhang Wen-Yi Gu xiao-Mei Xiang Yi Zhou Yi-Xin Hou Qun Zhang Yan Xiong Cong-Cong Zou Jun Chen Ze-Bing Huang Xiu-Hua Jiang Ting-Ting Qi Yuan-Yuan Chen Na Gao Chun-Yan liu Wei Yuan Xue Mei Jing li Tao li Rong-Jiong Zheng Xin-Yi Zhou Jun Zhao Zhong-Ji Meng Department of infectious Disease Institute of Biomedical ResearchRegulatory Mechanism and Targeted Therapy for Liver Cancer Shiyan Key LaboratoryHubei provincial Clinical Research Center for Precise Diagnosis and Treatment of Liver CancerTaihe HospitalHubei University of MedicineShiyan 442000Hubei ProvinceChina Department of Gastroenterology Renji HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai 200120China Department of infectious diseases Southwest HospitalThe Third Military Medical University(Army Medical University)Chongqing 400000China Center of Integrative medicine Beijing Ditan HospitalCapital Medical UniversityBeijing 100020China Department of infectious diseases Institute of Infection and ImmunologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430020Hubei ProvinceChina Department of infectious diseases Hunan Key Laboratory of Viral HepatitisXiangya HospitalCentral South UniversityChangsha 110051Hunan ProvinceChina Hepatology Unit Department of Infectious DiseasesNanfang HospitalSouthern Medical UniversityGuangzhou 510515Guangdong ProvinceChina Department of Hepatology The First Hospital of Jilin UniversityChangchun 130021Jilin ProvinceChina Department of liver Intensive Care Unit Shanghai Public Health Clinical CentreFudan UniversityShanghai 200093China Tianjin Institute of Hepatology Nankai University Second People's HospitalTianjin 300192China infectious Disease Center The First Affiliated Hospital of Xinjiang Medical UniversityUrumqi 830054Xinjiang Uygur Autonomous RegionChina Department of infectious diseases and Hepatology The Second Hospital of Shandong UniversityJinan 250000Shandong ProvinceChina state key laboratory for diagnosis and treatment of infectious diseases Collaborative Innovation Center for Diagnosis and Treatment of Infectious DiseaseThe First Affiliated HospitalZhejiang University School of MedicineHangzhou 310000Zhejiang ProvinceChina Department of infectious diseases The Thir

BACKGROUND Acute-on-chronic liver disease(AoCLD)accounts for the majority of patients hospitalized in the Department of Hepatology or infectious *** To explore the characterization of AoCLD to provide theoretical guidance for the accurate diagnosis and prognosis of *** Patients with AoCLD from the Chinese Acute-on-Chronic liver Failure(ACLF)study cohort were included in this *** clinical characteristics and outcomes,and the 90-d survival rate associated with each clinical type of AoCLD were analyzed,using the Kaplan-Meier method and the log-rank *** A total of 3375 patients with AoCLD were enrolled,including 1679(49.7%)patients with liver cirrhosis acute decompensation(LC-AD),850(25.2%)patients with ACLF,577(17.1%)patients with chronic hepatitis acute exacer-bation(CHAE),and 269(8.0%)patients with liver cirrhosis active phase(LC-A).The most common cause of chronic liver disease(CLD)was HBV infection(71.4%).The most common precipitants of AoCLD was bacterial infection(22.8%).The 90-d mortality rates of each clinical subtype of AoCLD were 43.4%(232/535)for type-C ACLF,36.0%(36/100)for type-B ACLF,27.0%(58/215)for type-A ACLF,9.0%(151/1679)for LC-AD,3.0%(8/269)for LC-A,and 1.2%(7/577)for *** HBV infection is the main cause of CLD,and bacterial infection is the main precipitant of *** most common clinical type of AoCLD is *** diagnosis and timely intervention are needed to reduce the mortality of patients with LC-AD or ACLF.

关键词： Acute-on-chronic liver disease Acute-on-chronic liver failure liver cirrhosis Clinical features Prognosis

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