Publications by authors named "Yuemei Chen"

25 Publications

  • Page 1 of 1

miR-30a-5p targets Becn1 to ameliorate high-glucose-induced glomerular podocyte injury in immortalized rat podocyte cell line.

Am J Transl Res 2021 15;13(3):1516-1525. Epub 2021 Mar 15.

Department of Nephrology & Rheumatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine Shanghai, China.

Objective: Diabetic nephropathy (DN) is a serious kidney-based complication of diabetes, wherein podocyte injury is deemed crucial in the development of early stage. Various miRNAs, as report goes, is involved in the pathogenesis of varieties of kidney diseases including DN. In this study, we found a target relationship between miR-30a-5p and Becn1, of which there are few studies about the role in podocyte injury. We therefore used immortalized rat podocyte cell line to explore the role and molecular mechanism of miR-30a-5p targeting Becn1 gene in high-glucose-induced glomerular podocyte injury.

Methods: The mRNA and protein expressions of miR-30a-5p and Becn1 were detected respectively by quantitative reverse transcriptase PCR and western blotting. The proliferation, apoptosis, and the levels of interleukin (IL)-6 and tumor necrosis factor (TNF)-α were detected by MTT assay, flow cytometry, and enzyme-linked immuno sorbent assay, respectively. Intracellular reactive oxygen species (ROS), superoxide dismutase (SOD) and malondialdehyde (MDA) levels were also determined.

Results: Compared with normal group, miR-30a-5p in model groups were down-regulated, while Becn1 expression was significantly up-regulated, with slower proliferation, higher apoptosis rate, lower SOD level, and significantly higher ROS, MDA, IL-6, and TNF-α levels (all P<0.05). Overexpression of miR-30a-5p or Becn1 knock-out could lower Becn1 expression, apoptosis rate, promote proliferation, with relatively higher SOD level and lower ROS, MDA, Il-6, and TNF-α levels of model cells (all P<0.05).

Conclusion: Up-regulation of miR-30a-5p can suppress the expression of Becn1 to increase the growth and inhibit the apoptosis of immortalized rat podocyte cell line, therefore ameliorating podocyte injury induced by high glucose in vitro.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8014343PMC
March 2021

CO Capture With Absorbents of Tertiary Amine Functionalized Nano-SiO.

Front Chem 2020 28;8:146. Epub 2020 Feb 28.

School of Chemistry and Chemical Engineering, Southwest Petroleum University, Chengdu, China.

To improve CO adsorption performance of nanoparticle absorbents, a novel tertiary amine functionalized nano-SiO (NS-NR) was synthesized based on the 3-aminopropyltrimethoxysilane (KH540) modified nano-SiO (NS-NH) via methylation. The chemical structure and performances of the NS-NR were characterized through a series of experiments, which revealed that NS-NR can react with CO in water and nanofluid with low viscosity revealed better CO capture. The CO capture mechanism of NS-NR was studied by kinetic models. From the correlation coefficient, the pseudo second order model was found to fit well with the experiment data. The influencing factors were investigated, including temperature, dispersants, and cycling numbers. Results has shown the additional surfactant to greatly promote the CO adsorption performance of NS-NR because of the better dispersity of nanoparticles. This work proved that NS-NR yields low viscosity, high capacity for CO capture, and good regenerability in water. NS-NR with high CO capture will play a role in storing CO to enhanced oil recovery in CO flooding.
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http://dx.doi.org/10.3389/fchem.2020.00146DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7059254PMC
February 2020

Anti-inflammatory and cytotoxic carbazole alkaloids from Murraya kwangsiensis.

Phytochemistry 2020 Feb 12;170:112186. Epub 2019 Nov 12.

State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China. Electronic address:

Chemical investigation of the traditional Chinese medicine, Murraya kwangsiensis, led to the isolation of 16 undescribed biscarbazole alkaloids, kwangsines A-M, two undescribed natural products, (+/-)-bispyrayafoline C, and 19 known monomeric analogues. (±)-Bispyrayafoline C and (±)-kwangsines A-C are four pairs of biscarbazole atropisomers, and they were separated by chiral HPLC to obtain the optically pure compounds. The structures of the undescribed compounds were elucidated on the basis of HRESIMS and NMR data analysis. Their absolute configurations were assigned via comparison of the specific rotation, ECD exciton coupling method, as well as comparison of experimental and calculated ECD data. A compound showed significant inhibition on NO production in lipopolysaccharide-stimulated BV-2 microglial cells, and four compounds exhibited moderate cytotoxicities against HepG2 cells, with IC values less than 20 μM.
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http://dx.doi.org/10.1016/j.phytochem.2019.112186DOI Listing
February 2020

Corrigendum to "Bioactive carbazole and quinoline alkaloids from Clausena dunniana" [Phytochemistry 151 (2018) 1-8].

Phytochemistry 2019 Jul 30;163:196-197. Epub 2019 Apr 30.

State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing, 100191, PR China. Electronic address:

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http://dx.doi.org/10.1016/j.phytochem.2019.04.009DOI Listing
July 2019

Nitric oxide inhibitory coumarins from the roots and rhizomes of Notopterygium incisum.

Fitoterapia 2018 Nov 3;131:65-72. Epub 2018 Oct 3.

State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China. Electronic address:

Phytochemical study on the roots and rhizomes of Notopterygium incisum resulted in the isolation of six new coumarins, notoptetherins A - F (1-6), and 20 known analogues (7-26). Their structures were elucidated on the basis of extensive analyses of NMR and HRMS data, and the absolute configurations of 5 and 6 were established by Mo(AcO)-induced CD and exciton chirality, respectively. Moreover, a biomimetic synthesis of 6 from 21 was employed to confirm its absolute configuration. In a subsequent activity screening, compounds 12 and 17 exhibited potent inhibition against LPS-induced nitric oxide production in RAW 264.7 cells with IC values of 12.7 and 10.2 μM, respectively.
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http://dx.doi.org/10.1016/j.fitote.2018.10.002DOI Listing
November 2018

Bioactive carbazole and quinoline alkaloids from Clausena dunniana.

Phytochemistry 2018 Jul 4;151:1-8. Epub 2018 Apr 4.

State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing 100191, PR China. Electronic address:

Nine undescribed carbazole and quinoline alkaloids, named dunnines A-E, and 14 known analogues were isolated from the leaves and stems of Clausena dunniana. Their structures were elucidated on the basis of comprehensive analysis of NMR and HRMS spectroscopic data, and the absolute configurations were assigned via comparison of their specific rotations and calculated and experimental ECD data. (±)-Dunnines A-C and (±)-clausenawalline A are four pairs of biscarbazole atropisomers and (±)-dunnine D is a pair of dihydropyranocarbazole enantiomers. They were separated by chiral HPLC to obtain the optically pure compounds. Three compounds showed weak inhibitory effects on nitric oxide production stimulated by lipopolysaccharide in BV-2 microglial cells (IC > 50 μM); five compounds could significantly promote insulin secretion in HIT-T15 cell line (1.9-3.1-fold of the control, p < 0.01) at 40 μM, and nine compounds could inhibit the apoptosis of PC12 cell induced by 6-hydroxydopamine with IC values in the range of 10.9-47.2 μM.
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http://dx.doi.org/10.1016/j.phytochem.2018.03.009DOI Listing
July 2018

Development of diagnostic criteria and a prognostic score for hepatitis B virus-related acute-on-chronic liver failure.

Gut 2018 12 19;67(12):2181-2191. Epub 2017 Sep 19.

State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Objective: The definition of acute-on-chronic liver failure (ACLF) based on cirrhosis, irrespective of aetiology, remains controversial. This study aimed to clarify the clinicopathological characteristics of patients with hepatitis B virus-related ACLF (HBV-ACLF) in a prospective study and develop new diagnostic criteria and a prognostic score for such patients.

Design: The clinical data from 1322 hospitalised patients with acute decompensation of cirrhosis or severe liver injury due to chronic hepatitis B (CHB) at 13 liver centres in China were used to develop new diagnostic and prognostic criteria.

Results: Of the patients assessed using the Chronic Liver Failure Consortium criteria with the exception of cirrhosis, 391 patients with ACLF were identified: 92 with non-cirrhotic HBV-ACLF, 271 with cirrhotic HBV-ACLF and 28 with ACLF with cirrhosis caused by non-HBV aetiologies (non-HBV-ACLF). The short-term (28/90 days) mortality of the patients with HBV-ACLF were significantly higher than those of the patients with non-HBV-ACLF. Total bilirubin (TB) ≥12 mg/dL and an international normalised ratio (INR) ≥1.5 was proposed as an additional diagnostic indicator of HBV-ACLF, and 19.3% of patients with an HBV aetiology were additionally diagnosed with ACLF. The new prognostic score (0.741×INR+0.523×HBV-SOFA+0.026×age+0.003×TB) for short-term mortality was superior to five other scores based on both discovery and external validation studies.

Conclusions: Regardless of the presence of cirrhosis, patients with CHB, TB ≥12 mg/dL and INR ≥1.5 should be diagnosed with ACLF. The new criteria diagnosed nearly 20% more patients with an HBV aetiology with ACLF, thus increasing their opportunity to receive timely intensive management.
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http://dx.doi.org/10.1136/gutjnl-2017-314641DOI Listing
December 2018

Serum C-reactive protein predicts early mortality in hospitalized patients with HBV-related decompensated cirrhosis.

Medicine (Baltimore) 2017 Jan;96(4):e5988

Department of Ultrasonography, the First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang Department of Clinical Laboratory, The Sixth Affiliated Hospital of Xinjiang Medical University, Xinjiang Department of Clinical Laboratory, The People's Hospital of Xinjiang Uygur Autonomous Region, Tianshan District, Urumqi Department of Clinical Laboratory Department of Hand Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang, China.

The serum C-reactive protein (CRP) is an inflammatory marker. The aim of the present study was to elucidate whether CRP could serve as a potential surrogate marker for 30-day mortality in hospitalized patients with HBV-related decompensated cirrhosis (HBV-DeCi).This was a retrospective cohort study that included 140 patients with HBV-DeCi. All patients were followed up for 1-month. A panel of clinical and biochemical variables were analyzed for potential associations with outcomes using multiple regression models.The serum CRP was significantly higher in nonsurviving patients than in surviving patients. Multivariate analysis demonstrated that CRP levels (odds ratio: 1.047, P = 0.002) and the model for end-stage liver disease score (odds ratio: 1.370, P = 0.001) were independent predictors for mortality.Serum CRP is a simple marker that may serve as an additional predictor of 1-month mortality in hospitalized patients with HBV-DeCi.
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http://dx.doi.org/10.1097/MD.0000000000005988DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5287978PMC
January 2017

Lymphocyte-monocyte ratio at admission predicts possible outcomes in patients with acute-on-chronic liver failure.

Eur J Gastroenterol Hepatol 2017 Jan;29(1):31-35

aDepartment of Ultrasonography bDepartment of Clinical Laboratory, the First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang cDepartment of Clinical Laboratory, the Sixth Affiliated Hospital of Xinjiang Medical University, Xinjiang dDepartment of Clinical Laboratory, the People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China.

Background: The lymphocyte-monocyte ratio (LMR) in the peripheral blood is suggested to be a potential biomarker for predicting the clinical outcomes of several diseases. We aimed to evaluate the relative efficiency of LMR for predicting 3-month mortality in patients with acute-on-chronic liver failure (AoCLF).

Patients And Methods: In this study, 74 chronic hepatitis B patients, 90 AoCLF patients, and 70 healthy controls were followed up for 4 months. The primary endpoint was 3-month in-hospital mortality. Hematological and virological parameters as well as liver biochemistry were determined using blood samples ordered upon admission. A panel of clinical and biochemical variables were analyzed for potential associations with outcomes using Cox proportional hazards and multiple regression models.

Results: A significantly lower LMR was detected in AoCLF patients than in healthy controls and chronic hepatitis B groups (both P=0.001). The LMR inversely correlated with model for end-stage liver disease scores, and a lower LMR was associated with increased 3-month mortality. Multivariate analysis suggested that both LMR and model for end-stage liver disease scores were independent predictors of 3-month mortality (P<0.01).

Conclusion: A low LMR measured at admission is predictive of a poor prognosis in AoCLF patients.
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http://dx.doi.org/10.1097/MEG.0000000000000767DOI Listing
January 2017

One pot preparation of silver nanoparticles decorated TiO2 mesoporous microspheres with enhanced antibacterial activity.

Mater Sci Eng C Mater Biol Appl 2016 Aug 10;65:27-32. Epub 2016 Apr 10.

Shenzhen Key Laboratory of Polymer Science and Technology, Guangdong Research Center for Interfacial Engineering of Functional Materials, College of Materials Science and Engineering, Shenzhen University, Shenzhen 518060, China. Electronic address:

We report a simple "one-pot" solvothermal preparation of silver nanoparticles (Ag NPs) decorated mesoporous titania (TiO2) microspheres as an effective antibacterial agent. TBOT as Ti source was hydrolyzed and crystallized in media composed of acetic acid and ethanol, in which esterification catalyzed by TBOT occurred for in-situ "controlled water release". AgNO3 as Ag source was reduced by ethanol to form Ag NPs embedded in the TiO2 microspheres. The effect of AgNO3 and HAc on the morphology of Ag/TiO2 was investigated. The Ag/TiO2 with various Ag content showed excellent antibacterial activities with extremely low minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) against Escherichia coli and Staphylococcus aureus when compared with colloidal Ag NPs.
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http://dx.doi.org/10.1016/j.msec.2016.04.028DOI Listing
August 2016

Life-threatening complications of acute pancreatitis.

Intensive Care Med 2015 Jun 17;41(6):1145-6. Epub 2015 Apr 17.

Department of Laboratory Medicine, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, Sichuan, 610041, China.

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http://dx.doi.org/10.1007/s00134-015-3786-1DOI Listing
June 2015

Chemical and pharmacological progress on polyacetylenes isolated from the family apiaceae.

Chem Biodivers 2015 Apr;12(4):474-502

School of Chinese Materia Medica, Beijing University of Chinese Medicine, No. 6 Wangjing Southern Middle Ring Road, Chaoyang District, Beijing 100102, P. R. China, (phone/fax: +86-10-84738625).

This review presents an up-to-date survey of natural polyacetylenes isolated from the family Apiaceae, and their biosynthesis and biological activities up to May 2013, with 107 references. A total of 103 polyacetylenes from 72 species of 41 genera of Apiaceae have been isolated so far, among which falcarinol-type polyacetylenes are most widely distributed.
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http://dx.doi.org/10.1002/cbdv.201300396DOI Listing
April 2015

Evaluation of mean platelet volume in patients with hepatitis B virus infection.

Int J Clin Exp Med 2014 15;7(11):4207-13. Epub 2014 Nov 15.

Department of Clinical Laboratory, The First Affiliated Hospital, College of Medicine, Zhejiang University Hangzhou, China.

Objective: Mean platelet volume (MPV), which is determined by a routine complete blood count, is a parameter that is usually overlooked by clinicians. The present study was designed to investigate the association between MPV and different disease states in patients with hepatitis B virus (HBV) infection.

Methods: A total of 120 patients, including 17 with acute hepatitis B (AHB), 62 with chronic hepatitis B (CHB), and 41 with chronic severe hepatitis B (CSHB), as well as 58 healthy controls (HCs) were enrolled in the study. At study entry, blood samples were collected from all subjects to examine liver function and renal function, determine the international normalized ratio and perform routine hematological tests.

Results: We demonstrated that MPV was significantly increased in CSHB and CHB patients compared with HCs and AHB patients (all P<0.05). Among the patient groups, the CSHB patients had the highest MPV. Increased MPV was clinically associated with severe liver disease.

Conclusions: MPV is significantly increased in chronic HBV-infected patients and is associated with disease severity; thus, it may serve as an important biomarker.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4276190PMC
December 2014

Abnormal serum iron markers in chronic hepatitis B virus infection may be because of liver injury.

Eur J Gastroenterol Hepatol 2015 Feb;27(2):130-6

Departments of aClinical Laboratory bUltrasonography, the First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang, People's Republic of China.

Objective: In patients with chronic hepatitis B virus (HBV) infection, it is not known whether altered serum iron markers are directly because of the infection or the associated liver injury. We determined the serum iron status of patients with chronic HBV infection, and investigated whether it is HBV infection or HBV-related liver injury that likely causes abnormal serum iron markers in chronic HBV infection.

Materials And Methods: For a retrospective study, chronic HBV-infected patients (80 patients with cirrhosis and 76 patients without cirrhosis) and 58 healthy controls were enrolled. Serum alanine transaminase levels were measured to ascertain liver damage. Indicators of iron status included serum iron, ferritin, and transferrin.

Results: Compared with noncirrhotic patients and healthy controls, the serum transferrin of cirrhotic patients was lower and the serum iron and ferritin values were higher (P < 0.001, all). In cirrhotic patients, the serum iron and ferritin levels correlated positively with serum alanine transaminase levels and the transferrin levels were inversely related to both end-stage liver disease scores and iron levels (all P < 0.01).

Conclusion: Serum iron markers tended to be aberrant in chronic HBV-infected patients with cirrhosis. The liver injury associated with HBV infection, but not chronic HBV infection directly, is likely the main cause for iron metabolism disorder.
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http://dx.doi.org/10.1097/MEG.0000000000000247DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4280275PMC
February 2015

Evaluation of plasma exchange and continuous veno-venous hemofiltration for the treatment of severe avian influenza A (H7N9): a cohort study.

Ther Apher Dial 2015 Apr 3;19(2):178-84. Epub 2014 Nov 3.

State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China.

Avian influenza A (H7N9) is a severe disease with high mortality. Hypercytokinemia is thought to play an important role in the pathogenesis. This study was to investigate the efficiency of plasma exchange (PE) + continuous veno-venous hemofiltration (CVVH) on the removal of inflammatory mediators and their benefits in the management of fluid overload and metabolic disturbance. In total, 40 H7N9-infected patients were admitted to our hospital. Sixteen critically ill H7N9-infected patients received combination of PE and CVVH. Data from these 16 patients were collected and analyzed. The effects of PE + CVVH on plasma cytokine/chemokine levels and clinical outcomes were examined. H7N9-infected patients had increased plasma levels compared to healthy controls. After 3 h of PE + CVVH treatment, the cytokine/chemokine levels descended remarkably to lower levels and were maintained thereafter. PE + CVVH also benefited the management of fluid, cardiovascular dysfunction and metabolic disturbance. Of the 16 critically ill patients who received PE + CVVH, 10 patients survived. PE + CVVH decreased the plasma cytokine/chemokine levels significantly. PE + CVVH were also beneficial to the management of severe avian influenza A (H7N9).
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http://dx.doi.org/10.1111/1744-9987.12240DOI Listing
April 2015

A single-center experience of non-bioartificial liver support systems among Chinese patients with liver failure.

Int J Artif Organs 2014 Jun 2;37(6):442-54. Epub 2014 Jul 2.

*Qi Xia and Xiahong Dai contributed equally to this work.

Introduction: Liver failure is one of the most deadly, prevalent, and costly diseases worldwide. Non-bioartificial liver support systems (NBALs) have been shown to be effective in improving the clinical symptoms and laboratory parameters of patients with liver failure. The main aim of this large case series analysis was to investigate the status of NBALs and their effectiveness in improving survival in liver-failure patients.

Methods: In this retrospective study, 460 patients with liver failure who received NBAL treatment in addition to conventional medications were compared with 422 patients who were treated with conventional medications alone. Kaplan-Meier and life table analyses were used to estimate survival rates.

Results: Clinical outcomes were improved after NBAL treatment. The 30-day survival rates of subacute liver failure (SALF) patients were 63% among those who received NBALs and 21% among those who did not receive NBALs (p < 0.01). Similarly, the 30-day survival rate of acute-on-chronic liver failure (ACLF) patients who received NBALs was 47%, significantly higher than that of the non-NBAL patients (p < 0.05). The survival rates of ACLF patients with low Model for End-Stage Liver Disease (MELD) scores (MELD ≤ 20) were 64% and 40% among whom received NBALs and those who did not, respectively (p < 0.01).

Conclusions: NBAL treatment is helpful to improve the survival of patients with ALF, SALF or ACLF. ACLF patients with lower MELD scores showed improved outcomes relative to those with higher MELD scores.
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http://dx.doi.org/10.5301/ijao.5000341DOI Listing
June 2014

Serum ferritin concentration predicts mortality in patients with hepatitis B virus-related acute on chronic liver failure.

Arch Med Res 2014 Apr 20;45(3):251-6. Epub 2014 Mar 20.

Department of Emergency, the Second Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang, China. Electronic address:

Background And Aims: This study was designed to investigate the association between serum ferritin concentration (SF) and hepatitis B virus infected patients with acute-on-chronic liver failure (AoCLF). In addition, we analyzed whether SF levels are associated with mortality in AoCLF patients.

Methods: One hundred and seventeen patients, including 46 patients with chronic hepatitis B (CHB), 71 with AoCLF, and 55 healthy controls (HCs) were enrolled in this study. All patients were followed for 4 months. In all subjects, a blood sample was collected at admission to examine liver function, renal function, international normalized ratio, and SF levels. A total of six clinical chemistry and biochemical variables (e.g., model for end-stage liver disease [MELD] score, age, levels of SF, total protein, albumin, and alanine aminotransferase) were measured and analyzed for their association with outcomes by using Cox proportional hazards and multiple regression models.

Results: AoCLF patients had significantly higher SF levels at admission compared to HCs and CHB (all p = 0.001). Elevated SF levels were associated with increased severity of liver disease and 3-month mortality rate. Multivariate analysis demonstrated that SF levels and MELD score were independent predictors for mortality (both p <0.001).

Conclusion: The SF measured at admission may serve as an independent predictor for 3-month mortality rate in AoCLF patients.
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http://dx.doi.org/10.1016/j.arcmed.2014.03.004DOI Listing
April 2014

A modified MELD model for Chinese pre-ACLF and ACLF patients and it reveals poor prognosis in pre-ACLF patients.

PLoS One 2013 5;8(6):e64379. Epub 2013 Jun 5.

State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.

Background & Aims: Acute-on-chronic liver failure (ACLF) is one of the most deadly, prevalent, and costly diseases in Asia. However, no prognostic model has been developed that is based specifically on data gathered from Asian patients with ACLF. The aim of the present study was to quantify the survival time of ACLF among Asians and to develop a prognostic model to estimate the probability of death related to ACLF.

Methods: We conducted a retrospective observational cohort study to analyze clinical data from 857 patients with ACLF/pre-ACLF who did not undergo liver transplantation. Kaplan-Meier and Cox proportional hazards regression model were used to estimate survival rates and survival affected factors. The area under the receiver operating characteristic curve (auROC) was used to evaluate the performance of the models for predicting early mortality.

Results: The mortality rates among patients with pre-ACLF at 12 weeks and 24 weeks after diagnosis were 30.5% and 33.2%, respectively. The mortality rates among patients with early-stage ACLF at 12 weeks and 24 weeks after diagnosis were 33.9% and 37.1%, respectively. The difference in survival between pre-ACLF patients and patients in the early stage of ACLF was not statistically significant. The prognostic model identified 5 independent factors significantly associated with survival among patients with ACLF and pre-ACLF: the model for end-stage liver disease (MELD) score; age, hepatic encephalopathy; triglyceride level and platelet count.

Conclusion: The findings of the present study suggest that the Chinese diagnostic criteria of ACLF might be broadened, thus enabling implementation of a novel model to predict ACLF-related death after comprehensive medical treatment.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0064379PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3673980PMC
January 2014

24-h residual urine volume at hemodialysis initiation: a possible predictor for acute ischemic stroke incurrence in hemodialysis patients.

Clin Neurol Neurosurg 2013 May 13;115(5):557-61. Epub 2012 Jul 13.

Department of Nephrology, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai 200032, China.

Background: Residual renal function (RRF) recently has been confirmed to be a significant predictor of morbidity and mortality in hemodialysis (HD) patients. As RRF is not exactly the same with 24-h residual urine volume, the aim of our study is to evaluate the association of residual urine volume with acute ischemic stroke (AIS) among HD patients.

Methods: 282 patients starting chronic HD in our center during January 2005 and December 2008 were enrolled. The clinical data at HD initiation and the occurrence of AIS since starting HD were recorded and obtained from our database. According to the prevalence of AIS, we divided 282 patients into the AIS group (n=69) and non-AIS (n=213) group.

Results: A total of 69 (24.5%) patients suffered from AIS since HD initiation. Patients with AIS were much older, with more diabetes, had higher levels of hemoglobin, while lower levels of residual urine volume and serum uric acid. In multivariate logistic regression analysis, old age (OR, 1.036; 95% CI, 1.009-1.063; P=0.008), diabetes (OR, 2.385; 95% CI, 1.074-5.294; P=0.033) and 24-h residual urine volume<1290 ml at HD initiation (OR, 2.446; 95% CI, 1.219-4.907; P=0.012) was significant predictors for future AIS occurrence during HD.

Conclusion: This study indicates that residual urine volume levels at HD initiation are inversely associated with AIS risk in future in chronic HD patients. Besides, aging and diabetes should also be noticed for prevention of AIS.
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http://dx.doi.org/10.1016/j.clineuro.2012.06.028DOI Listing
May 2013

A clinical study on the treatment of severe hepatitis by a combined artificial liver.

Hepatogastroenterology 2012 Oct;59(119):2273-5

State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, China.

Background/aims: To focus on determining efficacy and safety of the combined artificial liver in treating severe hepatitis.

Methodology: Ten patients with acute and chronic severe hepatitis were chosen for this study. A total of 19 cases were treated with a combination of selective plasma absorption and selective plasma exchange and 1 was treated with plasma perfusion absorption. Clinical symptoms and physical signs were observed. In addition, the changes in biochemical markers, coagulation function, and aminogram before and after selective plasma perfusion absorption treatment were compared.

Results: Ten patients were able to tolerate the treatment; 8 patients were cured or improved whereas 2 worsened. Statistically significant differences (p<0.05) were observed in the serum levels of total bilirubin, direct bilirubin, indirect bilirubin, alanine transaminase, aspartate transaminase, alkaline phosphatase, total bile acids, albumin and globulin before and after the selective perfusion absorption treatment. In contrast, no statistically significant differences (p>0.05) were observed in the serum concentrations of potassium, sodium, creatinine and urea nitrogen, as well as in prothrombin time, partial thromboplastin time and aminogram changes.

Conclusions: The new perfusion absorber can markedly improve hepatic function without influencing the metabolism of micro-molecules and coagulation factors.
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http://dx.doi.org/10.5754/hge12025DOI Listing
October 2012

Plasma pentraxin 3 is associated with cardiovascular disease in hemodialysis patients.

Ren Fail 2011 ;33(10):998-1004

Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, PR China.

This cross-sectional study evaluates the associations of Pentraxin 3 (PTX3) and cardiovascular disease (CVD) in hemodialysis (HD) patients. Plasma was obtained from 98 maintenance HD patients before and after a session of HD and 50 age-matched healthy subjects. We measured plasma PTX3 levels by enzyme-linked immunosorbent assay. Our results showed that plasma PTX3 levels were significantly higher in HD patients compared with controls (1.87 vs. 1.11 ng/mL, p < 0.001), and increased acutely after a single HD session (post-HD 2.18 ng/mL vs. pre-HD 1.87 ng/mL, p < 0.001). Patients with CVD had higher plasma PTX3 levels than those without CVD (2.18 vs. 1.76 ng/mL, p < 0.05). Plasma PTX3 levels correlated positively with cardiac troponin T (ρ = 0.287, p = 0.007) and carotid artery intima-media thickness (ρ = 0.294, p = 0.043). High plasma PTX3 (>1.87 ng/mL) level was positively and independently associated with CVD (OR = 3.15, p = 0.024). Receiver operator characteristics analysis showed the correlation between PTX3 and CVD more closely than high sensitivity C-reactive protein (hs-CRP) in patients whose hs-CRP were higher than 3 mg/L. The area under the curve for PTX3 and hs-CRP was 0.655 (p = 0.047) and 0.562 (p = 0.458), respectively. Moreover, plasma PTX3 levels correlated negatively with body mass index, hemoglobin, pre-albumin, total cholesterol, triglyceride, and low-density lipoprotein. These data support the main conclusions: PTX3 levels are markedly elevated in HD patients; HD procedure itself induces PTX3 elevation; plasma PTX3 is associated with CVD in maintenance HD patients.
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http://dx.doi.org/10.3109/0886022X.2011.618969DOI Listing
February 2012

Effects of plasma from acute-on-chronic liver failure patients on immortalized human hepatocytes in vitro.

Hepatogastroenterology 2011 Jul-Aug;58(109):1328-33

Zhejiang University, Hangzhou, China.

Background/aims: The efficiency of bioartificial liver or cell transplantation for the treatment of liver failure may potentially be diminished by toxic agents accumulated in the patients blood. We investigated the effects of plasma from patients with acute-on-chronic liver failure on the structure and function of immortalized human hepatocytes (HepLL) in vitro.

Methodology: Plasma was pooled from 8 patients with acute or chronic liver failure. We utilized Transmission Electron Microscopy to observe the ultrastructure of HepLL cells and the activity of proliferation was examined by MTT assay. The percentage of apoptosis cells was measured through Annexin V-FITC apoptosis detection kit. The capacity for detoxification was analyzed using an ammonia elimination assay.

Results: HepLL cells continue to proliferate, even when exposed to plasma derived from patients with 100% liver failure. No significant apoptosis was measured within 48h. The capacity for ammonia elimination was not statistically decreased until 36h incubation with liver failure plasma.

Conclusions: Although the toxic effects of plasma from acute-on-chronic liver failure patients should not be ignored, HepLL cells can maintain their function, when exposed to AoCLF plasma, for at least 24h and could be used as a suitable cell source for a bioartificial liver support system.
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http://dx.doi.org/10.5754/hge11034DOI Listing
January 2012

Serum uric acid is inversely related to acute ischemic stroke morbidity in hemodialysis patients.

Am J Nephrol 2011 22;33(2):97-104. Epub 2010 Dec 22.

Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.

Aim: Elevated serum uric acid (sUA) is usually associated with a high occurrence of acute ischemic stroke (AIS) in the general population. The aim of this study is to evaluate the role of sUA in AIS among hemodialysis (HD) patients.

Methods: We followed up the occurrence of AIS in 226 HD patients for 18 months from January 2009 to June 2010. The parameters included demographic characteristics, duration of HD, sUA, serum albumin, and other parameters. Logistic regression was performed to evaluate the function of SUC levels in the occurrence of AIS.

Results: A total of 43 patients suffered from AIS. By univariate logistic regression analysis an inverse association was observed in sUA level with the risk of AIS (p = 0.005), but the significance of this inverse association was attenuated while adjusted for age, gender and pulse pressure (PP) (p = 0.029), and even weakened while adjusted for age, gender, PP and diabetes nephropathy (DN) (p = 0.065), and finally abolished after adjustment for age, gender, PP, DN, hsCRP and pre-albumin.

Conclusion: This study indicates an inverse association between sUC and the occurrence of AIS in HD patients. Demographic characteristics and malnutrition-microinflammation syndrome seem to play a significant role in this association.
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http://dx.doi.org/10.1159/000322966DOI Listing
June 2011

Prediction value of model for end-stage liver disease scoring system on prognosis in the acute on chronic liver failure patients with plasma exchange treatment.

ASAIO J 2010 Sep-Oct;56(5):475-8

Department of Clinical Laboratory, The First Affiliated Hospital, Zhejiang University, Hangzhou, People's Republic of China.

Hepatitis B virus-related acute-on-chronic liver failure (AoCLF) is associated with a high mortality rate. Plasma exchange (PE) is useful to bridge patients with AoCLF to liver transplantation or recovery. The aim of this study was to analyze the impact of the model for end-stage liver disease (MELD) score on 30-day survival in patients with AoCLF treated with PE or conventional medications and to evaluate the therapeutic effectiveness of PE. In this study, 62 enrolled patients with AoCLF who received PE treatment were compared with 131 patients treated with conventional medications. The MELD scores were calculated according to the original formula, and the 30-day survival in patients was recorded. The 30-day survival rate of the patients who received PE versus controls was 41.9% versus 25.2% (p < 0.05). The 30-day survival rate of patients in the PE group (50.0%) with a MELD score from 20 to 30 was higher than that of the control group (31.7%, p < 0.05); for MELD scores more than 30, there was no significant difference in two groups (8.3% vs. 0%, p > 0.05). PE seems to be efficacious and safe for the treatment of patients with AoCLF and significantly increased the survival rates of patients with a MELD score of 20-30.
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http://dx.doi.org/10.1097/MAT.0b013e3181e6bf13DOI Listing
January 2011

A metabonomic investigation on the biochemical perturbation in liver failure patients caused by hepatitis B virus.

J Proteome Res 2007 Jul 1;6(7):2413-9. Epub 2007 Jun 1.

Pharmaceutical Informatics Institute, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China.

A metabonomic study was performed to investigate the biochemical perturbation of the serum samples from liver failure patients induced by hepatitis B virus (HBV; n=24) and control normal subjects (n=23). The serum metabonome was detected using gas chromatography-mass spectrometry (GC-MS) technique integrated with a commercial mass spectral library for the peak identification. After peak deconvolution, identification, and matching, the acquired GC-MS data were normalized and processed by principal component analysis (PCA) and canonical discriminant analysis (CDA). Specific changes in the metabolic composition of serum samples from patients including amino acids (AAs) and glucose were shown in GC-MS total ion current (TIC) chromatograms. The distinctive biochemical difference between the healthy subjects and liver failure patients was displayed by the pattern recognition methods. We also found that the liver failure patients with different degree of severity categorized as MELD (model for end-stage of liver diseases) could be clearly classified by the corresponding metabonomic data. In comparison, the current routine clinical indices cannot characterize the global phenotyping of liver failure. The result demonstrated that the GC-MS technique is an alternative tool for the characterization of the metabolic perturbation and the metabonomic study promises to provide an integrative criterion to evaluate the severity and the prognosis of liver diseases.
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http://dx.doi.org/10.1021/pr060591dDOI Listing
July 2007