De novo entecavir+adefovir dipivoxil+lamivudine triple-resistance mutations resulting from sequential therapy with adefovir dipivoxil, and lamivudine

Additional file 4: Figure S3. Electropherogram of rtM204 V+rtL180 M+rtA181 V+rtI169 V clone in Patient 3 (GenBank accession number: KU751729)

A Different Perspective for Management of Diabetes Mellitus: Controlling Viral Liver Diseases

Knowing how to prevent and treat diabetes mellitus (DM) earlier is essential to improving outcomes. Through participating in synthesis and catabolism of glycogen, the liver helps to regulate glucose homeostasis. Viral related liver diseases are associated with glycometabolism disorders, which means effective management of viral liver diseases may be a therapeutic strategy for DM. The present article reviews the correlation between DM and liver diseases to give an update of the management of DM rooted by viral liver diseases

Influence of Fasting Plasma Glucose Level on Admission of COVID-19 Patients: A Retrospective Study

Background. The coronavirus disease 2019 (COVID-19) is a serious global health threat and has spread dramatically worldwide. Prolonged viral shedding is associated with a more severe disease course and inflammatory reaction. Blood glucose levels were significantly associated with an increased hazard ratio (HR) for poor outcomes in COVID-19 patients. Objective. Previous studies focused primarily on the relationship between blood glucose and mortality or severe outcomes, but there were few research studies on the relationship between fasting plasma glucose (FPG) and duration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA positive status. To explore the relationship between FPG levels and prolonged duration of SARS-CoV-2 viral positivity, the clinical data of COVID-19 patients were analyzed. Method. In this retrospective study, 99 cases of COVID-19 patients in Beijing Ditan Hospital were recruited, and their clinical and laboratory findings at admission were collected and analyzed. Furthermore, the risk factors for prolonged duration of SARS-CoV-2 RNA shedding were identified, and the relationship between FPG levels and the prolonged presence of SARS-CoV-2 RNA was evaluated. Result. We found that elevated FPG levels were correlated with longer duration of SARS-CoV-2 RNA positivity, classification of COVID-19, imaging changes of chest CT, inflammation-related biomarkers, and CD8+ T cell number in COVID-19 patients. In a logistic regression model, after adjusting for gender and age, COVID-19 patients with elevated FPG were more likely to had longer duration of SARS-CoV-2 RNA positivity than those with normal FPG levels (OR 3.053 [95% CI 1.343, 6.936]). Conclusion. Higher FPG levels (≥6.1 mmol/l) at admission was an independent predictor for prolonged SARS-CoV-2 shedding, regardless of a known history of diabetes. It suggests that intensive monitoring and control of blood glucose are important for all COVID-19 patients

An investigation of minimal hepatic encephalopathy in patients with hepatitis B cirrhosis

ObjectiveTo investigate the prevalence of minimal hepatic encephalopathy (MHE) in patients with hepatitis B cirrhosis. MethodsA total of 105 patients with hepatitis B cirrhosis who visited Beijing Ditan Hospital, Capital Medical University, from June to December, 2012 were enrolled as cirrhosis group, and 105 healthy volunteers were enrolled as healthy control group. The number connection test (NCT), Stroop color-word test (CWT), and clock drawing test (CDT) were used to evaluate cognitive function. The t-test or the Wilcoxon rank-sum test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. ResultsCompared with the healthy control group, the cirrhosis group had significantly longer time spent on NCT-A, NCT-B, CWT-A, CWT-B, and CWT-C (t=-2.158, -2.372, -2.063, -2.611, and -4.325, all P＜0.05) and a significantly lower score of CDT-1 (t=2.884, P＜0.05). Of all patients with hepatitis B cirrhosis, 46 (43.81%) were diagnosed with MHE, among whom 24 (22.86%) had an abnormal information processing speed, 17 (16.19%) had an abnormal reaction inhibition ability, 15 (14.29%) had an abnormal visuospatial ability, and 10 (9.52%) had an abnormal set-shifting ability. ConclusionThere is a high detection rate of MHE in patients with hepatitis B cirrhosis and stable liver function, and a combination of neuropsychological tests can increase the detection rate of MHE

Characteristics and Clinical Significance of Intestinal Microbiota in Patients with Chronic Hepatitis B Cirrhosis and Type 2 Diabetes Mellitus

Background. Chronic hepatitis B cirrhosis is often accompanied by glucose metabolism disorder, and intestinal microbiota was closely related to both cirrhosis and diabetes. There are few studies on the role of intestinal microbiota in hepatitis B liver cirrhosis and diabetes mellitus (LCDM). The purpose of this study was to investigate the characteristics of intestinal microbiota in patients with LCDM and to evaluate the relationship between the severity of intestinal microbiota imbalance and clinical significance. Methods. A case-controlled study was conducted. People who met the inclusion and exclusion criteria of chronic HBV-related liver cirrhosis (LC), LCDM, and healthy controls (HC) were enrolled in, and their fecal and blood samples were collected. The V3-V4 region of 16s rDNA gene of fecal microbiota was sequenced; the bioinformatics analysis including α-diversity, β-diversity, and linear discriminant analysis (LDA) effect size (LEfSe) was performed; and the correlation between bacteria and clinical indexes was analyzed. Results. A total of 70 participants completed fecal and blood tests, including 20 HC, 20 LCDM, and 30 LC. The α diversity of intestinal microbiota in the LCDM decreased than that in the HC. The abundance of Proteobacteria, Streptococcus, Escherichia-Shigella, and Lactobacillus increased, while the abundance of Bacteroidota, Bacteroides, Prevotella, Faecalibacterium, and Lachnospira decreased in the LCDM compared with the HC. The abundance of Lactobacillus, Roseburia, and Veillonella and the degree of hepatitis B cirrhosis dysbiosis indicator (HBCDI) increased in the LCDM than in the LC. The abundance of Escherichia-Shigella, Veillonella, and Lactobacillus positively correlated with liver injury and fasting blood glucose (FBG) level. The abundance of Escherichia-Shigella, Veillonella, Streptococcus, and Lactobacillus increased more significantly when FBG and glycosylated hemoglobin level increased. Conclusion. Intestinal microbiota of patients with LCDM was significantly disordered, and the degree was more serious than that cirrhosis patients without diabetes

Porto-Sinusoidal Vascular Disease as the Cause of Portal Hypertension in Felty’s Syndrome: A Case Report and Literature Review

Felty’s syndrome (FS) is a disorder wherein patients with rheumatoid arthritis develop splenomegaly, neutropenia, and in some cases, portal hypertension without underlying cirrhosis. Esophageal variceal bleeding is a complication of FS in patients with portal hypertension. In contrast to splenectomy, few reports exist on the management of variceal bleeding with endoscopic therapy. Moreover, the long-term outcome has not been reported. We present a patient with esophageal variceal bleeding due to portal hypertension secondary to Felty’s syndrome. The patient was followed up for two years postendoscopy intervention. Literature review was performed and the histological features of portal hypertension in FS are discussed. The patient presented with a typical triad of rheumatoid arthritis (RA), splenomegaly, and neutropenia and was diagnosed as Felty’s syndrome in 2012. She was admitted to our hospital in September 2017 for esophageal variceal bleeding. At the time of admission, her liver function test was normal. Abdominal CT showed no signs of cirrhosis and portal vein obstruction. Liver biopsy further excluded diagnosis of cirrhosis and supported the diagnosis of porto-sinusoidal vascular disease (PSVD), which was previously named as noncirrhotic idiopathic portal hypertension (NCIPH). An upper abdominal endoscopy revealed gastric and esophageal varices. A series of endoscopies was performed to ligate the esophageal varices. The patient was followed up for two years and did not show rebleeding. In conclusion, comorbid PSVD might be a cause of portal hypertension in FS patients. The present case had excellent outcome in two years, which supported the use of endoscopic therapy for the management of variceal bleeding in FS patients. Further large prospective study is needed to confirm the findings

A Novel Diagnostic Nomogram for Noninvasive Evaluating Liver Fibrosis in Patients with Chronic Hepatitis B Virus Infection

Objective. To establish a novel nomogram for diagnosing liver fibrosis in patients with chronic hepatitis B virus (HBV) infection and verify the diagnostic performance of the established nomogram. Methods. Patients with chronic HBV infection who met the inclusion and exclusion criteria were enrolled in this retrospective study; 70% and 30% of patients were randomly assigned to training dataset and validation dataset, respectively. The risk factors for liver fibrosis were screened using the univariate and multivariate logistic regression analyses. Based on the results, a nomogram was established and verified. Results. 508 patients with chronic HBV infection were included in this study (n=355 for training dataset and n=153 for validation dataset). The logistic regression analysis showed that liver stiffness measurement (LSM), platelet (PLT) count, and prothrombin time (PT) were independent risk factors for liver fibrosis (P<0.01), which were used to establish the nomogram. The consistency index (C-index) of the nomogram established for diagnosing liver fibrosis was 0.875. The calibration line and the ideal line were consistent, which indicated that diagnosis of liver fibrosis by the established model was accurate. The values of area under the receiver operator characteristic (ROC) curve (AUROC) for diagnosing liver fibrosis by the nomogram were 0.857 and 0.862 in the training dataset and validation dataset, respectively, which were noticeably higher than those in the well-known serological models, including the aspartate aminotransferase- (AST-) to-platelet ratio index (APRI) scoring model, fibrosis-4 (FIB-4) scoring model, APAG model (including age, PT, albumin, and γ-glutamyl transferase), and S-index model (all P<0.05). Conclusion. LSM, PT, and PLT were found as independent risk factors for liver fibrosis. The established nomogram exhibited an excellent diagnostic performance, and it can more visually and individually evaluate the probability of liver fibrosis in patients with chronic HBV infection

Relationship between Cognitive Learning Psychological Classification and Neural Network Design Elements

This article first analyzes the research background of the design elements of cognitive psychology and neural networks at home and abroad, roughly understands the research status and research background of these two courses at home and abroad, and discusses the application of cognitive psychology to neural networks. The design method has not yet formed a systematic theoretical system. Then, a systematic theoretical analysis of the research in this article is carried out to analyze the relationship between the various characteristics of cognitive psychology and the design elements of the neural network, and it uses these relationships to guide the design practice. Second, it analyzes the relationship between the influence and interaction of cognitive psychology on neural network design and connects cognitive psychology with neural network design. Finally, according to the theoretical analysis and research of the system, the application of cognitive psychology in neural network design, design practice, and the relationship between the two are systematically reviewed. Through the exploratory research on cognitive psychology in neural network design, we can see that the combination of neural network design and psychology, art aesthetics, and other cross-disciplinary and multidisciplinary research is necessary, which can promote the scientific and technological progress of neural network design in the context of the information age and the improvement of public mental health. Under the background of the era in which the neural network design becomes the link between people's emotions and culture, we must fully understand the essential role of each element in neural network design and build a design concept based on cognitive psychology and emotional experience. It is hoped that the content of this topic can provide a certain reference value for the future development of neural network design and cognitive psychology and clarify the new development direction

Regulating Intestinal Microbiota in the Prevention and Treatment of Alcohol-Related Liver Disease

When alcohol-related liver disease occurs, the number and composition ratio of intestinal microorganisms will accordingly change. The alcohol-induced changes in the intestinal microbiota play a pivotal role in the process of developing the alcohol-related liver disease through the translocation of microbial products due to increased intestinal permeability. In recent years, therapeutic interventions with a concentration on regulating intestinal microbiota have been conducted for patients with alcohol-related liver disease. We aimed to provide a critical review and updates on the prevention and treatment of alcohol-related liver disease through regulating intestinal microbiota. A literature search was performed on the PubMed database for studies published in English about the therapeutic intervention with microbiota using animal models and patients with alcohol-related liver disease (1/2010–4/2020). The accumulating pieces of evidence suggest that the therapeutic use of probiotics, prebiotics, antibiotics, phages, or fecal microbial transplantation may have several influences on alcohol-related liver disease patients. Emergent data unveiled that these interventions can further regulate the composition of intestinal microbiota, minimize the negative impact of microbiota on the liver, and prevent disease progression from mild to severe alcoholic hepatitis, fibrosis, cirrhosis, or even liver cancer. The current review provides updates on the advances of therapeutic interventions with the effects of regulating intestinal microbiota on patients who have alcohol-related liver disease. In addition, the data gaps and research directions on further exploration of the role of intestinal microbiota for the management of the alcohol-related liver disease are also discussed