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New perspective on the natural course of chronic HBV infection

Frontiers of Medicine 2014年第2期8卷 129-134页

作者： Yong-Yuan Zhang Ke-Qin Hu Zhongping Duan HB Vtech LLC 13901 Lullaby RD Germantown MD 20874 USA Division of Gastroenterology and Hepatology University of California Irvine School of Medicine Orange CA 92868 USA You An Hospital Capital Medical University Beijing 100069 China

Chronic hepatitis B virus （HBV） infection is a significant threat to public health and an enormous burden on society. Mechanisms responsible for chronic HBV infection remain poorly understood. A better understanding of the natural course of chronic HBV infection may shed new light on the mechanisms underlying this disease and help in designing new antiviral strategies. natural course of chronic HBV infection is conventionally viewed as an uninterrupted process that is usually marked by HBV e antigen （HBeAg） seroconversion or characterized by different phases associated with assumed host responses to HBV infection. However, none of these descriptions captures or highlights the core events that determine the natural course of chronic HBV infection. In this review, we briefly present the current knowledge on this subject and explain the significance and implication of events that occur during infection. A pre-core mutant becomes predominant in the viral population following elimination of the wild-type virus in duck hepatitis B virus-chronically infected animals. The coupled events in which first there is viral clearance that clears wild-type virus and then there is the reinfection of wild-type virus cleared livers with mutant virus are highly relevant to understanding of the natural course of chronic HBV infection under both treated and untreated conditions. In our new perspective, a general natural course of chronic HBV infection comprises cycles of viral clearance and reinfection, and such cycles prolong the chronic HBV infection course. Reviewing published data on the natural course of chronic HBV infection can reduce the possibility of missing important points in the initial data interpretation.

关键词： hepatitis B virus chronic HBV infection natural course hepatitis B seroconversion

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Red cell distribution width/platelet ratio predicts decompensation of metabolic dysfunction-associated steatotic liver disease-related compensated advanced chronic liver disease

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World Journal of Gastroenterology 2025年第3期31卷 1-10页

作者： Ming-Hua Zheng Amedeo Lonardo Department of Hepatology MAFLD Research CenterThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhou 325000Zhejiang ProvinceChina Department of Internal Medicine Azienda Ospedaliero-Universitaria of Modena(2023)Modena 41126Italy

Prognostication of compensated advanced chronic liver disease(cACLD)is of paramount importance for the physician-and-patient communication and for rational clinical *** paper published by Dallio et al reports on red cell distribution width(RDW)/platelet ratio(RPR)as a non-invasive biomarker in predicting decompensation of metabolic dysfunction-associated steatotic liver disease(MASLD)-related *** from other biomarkers and algorithms,RPR is inexpensive and widely available,based on parameters which are included in a complete blood *** is computed on the grounds of two different items,one of which,RDW,mirrors the host’s response to a variety of disease stimuli and is *** second parameter involved in RPR,platelet count,is more specific and has been used in the hepatological clinic to discriminate cirrhotic from non-cirrhotic chronic liver disease for *** disease is the primary cause of mortality among MASLD subjects,followed by extra-hepatic cancers and liver-related ***,MASLD biomarkers should be validated not only in terms of liver-related events but also in the prediction of major adverse cardiovascular events and cardiovascular mortality and extra-hepatic *** sized multi-ethnic confirmatory investigation is required to define the role and significance of RPR in the stratification of MASLD-cACLD.

关键词： Cirrhosis Liver fibrosis natural course Prognostication Stratification

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What physicians should know about the management of chronic hepatitis B in children: East side story

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World Journal of Gastroenterology 2014年第13期20卷 3582-3589页

作者： Hun-Jee Choe Byung-Ho Choe Seoul National University College of Medicine Seoul 110-799South Korea Department of Pediatrics Kyungpook National University School of MedicineDaegu 700-721South Korea

Understanding the natural course of chronic hepatitis B virus(HBV)infection is very important for the management and treatment of chronic hepatitis B in *** on treatment guidelines,the management of HBV carriers and treatment of active hepatitis have been advancing and resulted in increased survival,as well as decreased risks of complications such as liver cirrhosis and hepatocellular *** of a continuing medical education(CME)program for primary physicians becomes an important responsibility of pediatric *** could prevent misdiagnosis and unnecessary treatment that could lead to liver complications or antiviral *** addition,education of patients and their parents is necessary to achieve better therapeutic outcomes.

关键词： Hepatitis B virus natural course Diagnosis Treatment Lamivudine Resistance

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Predictors of unfavorable outcome at 90 days in basilar artery occlusion patients

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World Journal of Clinical Cases 2022年第12期10卷 3677-3685页

作者： Yu-Chen Chiu Jia-Li Yang Wei-Chun Wang Hung-Yu Huang Wei-Liang Chen Pao-Sheng Yen Ying-Lin Tseng Hsiu-Hsueh Chen Sheng-Ta Tsai Department of Neurology An Nan HospitalChina Medical UniversityTainan 709204Taiwan College of Medicine China Medical UniversityTaichung 404332Taiwan Department of Anesthesiology China Medical University HospitalTaichung 404332Taiwan Department of Neurology China Medical University HospitalTaichung 404332Taiwan Department of Radiology China Medical University HospitalTaichung 404332Taiwan Department of Radiology Kuang Tien General HospitalTaichung 404332Taiwan Stroke Center China Medical University HospitalTaichung 404332Taiwan

BACKGROUND In a previous study,basilar artery occlusion(BAO)was shown to lead to death or disability in 80%of the *** treatment for BAO patients in the acute stage includes thrombolysis and intra-arterial thrombectomy,but not all patients benefit from these ***,understanding the predictors of outcome before initiating these treatments is of special *** To determine the predictors related to the 90-d clinical outcome in patients with BAO in an Asian *** We performed a retrospective case review of patients admitted to a tertiary stroke center between 2015 and *** used the international classification of diseases-10 criteria to identify cases of posterior circulation stroke.A neurologist reviewed every case,and patients fulfilling the criteria defined in the Basilar Artery International Cooperation Study were *** then analyzed the patients’characteristics and factors related to the 90-d *** We identified a total of 99 patients as real BAO *** these patients,33(33.3%)had a favorable outcome at 90 d(modified Rankin Scale:0–3).Moreover,72 patients received intra-arterial thrombectomy,while 13 patients received intravenous tissue-type plasminogen activator *** observed a favorable outcome in 33.3%of the cases and an unfavorable outcome in 66.7%of the *** found that the initial National Institutes of Health Stroke Scale(NIHSS)score and several BAO symptoms,including impaired consciousness,tetraparesis,and pupillary abnormalities,were significantly associated with an unfavorable outcome(P<0.05),while cerebellar symptoms were associated with a favorable outcome(P<0.05).In the receiver operating characteristic(ROC)analysis,the areas under the ROC curve of initial NIHSS score,impaired consciousness,tetraparesis,cerebellar symptoms,and pupillary abnormalities were 0.836,0.644,0.727,0.614,and 0.614,*** NIHSS score showed a higher AUROC(0.836)compared to BAO ***

关键词： Basilar artery occlusion National Institutes of Health Stroke Scale natural course Outcome Asian

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Uterine cervical carcinoma treated with chemoradiotherapy: impact of three-month MRI follow-up on clinical management and outcome

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Journal of Cancer Metastasis and Treatment 2021年第1期7卷 889-900页

作者： Helena Sundström Lennart Blomqvist Kristina Hellman Department of Molecular Medicine and Surgery Karolinska InstitutetStockholm 17176Sweden Department of Imaging and Physiology Karolinska University HospitalStockholm 17176Sweden Department of Women’s and Children’s Health Karolinska InstitutetStockholm 17176Sweden Department of Gynaecologic Cancer Theme CancerKarolinska University HospitalStockholm 17176Sweden.

Aim:The aim of this study was to evaluate the impact of MRI performed three months after treatment on further follow-up interventions and outcome in patients with uterine cervical carcinoma treated with definitive ***:Sixty consecutive women diagnosed with uterine cervical cancer FIGO 2009 stage IB1-IVA during 2011-2012 treated with definitive chemoradiotherapy/radiotherapy with curative intent at the Department of Gynaecological Oncology at Karolinska University Hospital were retrospectively included.A review of MRI reports and medical records with focus on follow-up interventions associated to imaging was ***:On follow-up MRI three months post treatment,29/60 women had complete remission(mrCR),24/60 women had partial remission(mrPR)and 7/60 had progressive disease(mrPD).In patients with mrCR,no additional procedures were *** group with mrPR had 27 additional MRIs,3 PET/CT examinations and 9 biopsy procedures,none leading to diagnosis of residual *** control rate was 96%after 6.5 months(median).No patient had cervical relapse only;2/53 had cervical relapse in combination with non-regional lymph nodes and distant *** was no statistically significant difference in overall survival between patients with mrCR and mrPR(HR=2.2,P=0.21).Conclusion:Patients with residual changes on MRI at three months post treatment have a low risk for locoregional *** this is not recognised,follow-up MRI results in unnecessary additional procedures with low impact on treatment *** studies are needed regarding the most appropriate imaging modality and timing of post-treatment evaluation.

关键词： Uterine cervical carcinoma chemoradiotherapy locoregional control MRI post-radiation changes relapse residual tumour natural course

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Molecular therapy and prevention of hepatocellular carcinoma

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Hepatobiliary & Pancreatic Diseases International 2003年第1期2卷 11-22页

作者： HubertE.Blum the

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in some areas of the world with an extremely poor prognosis. The major etiologic risk factors for HCC development include hepatitis B virus (HBV) and hepatitis C virus (HCV) infection, toxins (alcohol, aflatoxin BI) and various inherited metabolic liver diseases, such as hemochromatosis and alpha-1-antitrypsin deficiency. Central to the molecular pathogenesis of HCC are mutations of various genes and genetic/chromosomal instability that result from chronic liver disease and the associated enhanced liver cell regeneration and mitotic activity. Alterations in the structure or expression of several tumor suppressor genes and oncogenes have been described. In addition, mechanisms leading to genetic instability due to mismatch repair deficiency or chromosomal instability and aneuploidy due to defective chromosomal segregation appear to be involved. The prognosis of HCC patients is generally very poor. Most studies have shown a five-year survival rate of less than 5% in symptomatic patients. HCC has been found to be quite resistant to radio- or chemotherapy. Investigations of the natural history and clinical course of HCC revealed a long-term survival of patients only with small asymptomatic HCC that could be treated surgically or nonsurgically. For patients with advanced symptomatic HCC, novel therapeutic strategies such as gene therapy are urgently needed. Apart from exploring and refining new HCC treatment strategies, the implementation of the existing measures or the development of novel measures to prevent HCC is most important. Primary HCC prevention could have a major impact on the incidence of HCC. Further, secondary prevention of a local recurrence or of new HCC lesions in patients after successful surgical or nonsurgical HCC treatment is of paramount importance and is expected to significantly improve disease-free and overall survival rates of patients. Based on rapid scientific advanc

关键词： chronic liver diseases epidemiology gene therapy hepatocarcinogenesis immune therapy natural course oncolytic viruses primary prevention secondary prevention

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