Nucleic Acid Testing for the Detection of HBV DNA

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Chronic hepatitis B - New goals, new treatment

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Effectiveness of Chinese herbal medicine in treating liver fibrosis: a systematic review and meta-analysis of randomized controlled trials

<p>Abstract</p> <p>Background</p> <p>The studies on the effectiveness of Chinese herbal medicines (CHM) in treating liver fibrosis (LF) were not consistent. This study aims to systematically review the effectiveness of CHM on treating LF patients.</p> <p>Methods</p> <p>Databases including MEDLINE, AMED, EMBASE, The Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, TCMOnline, Chinese Biomedical Literature Database, and Chinese Medical Current Contents were searched up to March 2011. Randomized controlled trials (RCTs) involving LF patients receiving CHM, Western medicine, combined CHM and Western medicine compared with placebo, Western medicine or no intervention were included. LF markers including serum hyaluronic acid (HA), laminin (LN), procollagen type III (PC-III), type IV collagen (IV-C), matrix metalloproteinase (MMP), and tissue inhibitors of metalloproteinase (TIMP) were measured as primary outcomes. Liver biochemistry, including alanine aminotransferase (ALT) and aspartarte aminotransferase (AST), and improvement of related clinical symptoms were measured as secondary outcomes. Risk of bias of allocation sequence, allocation concealment, blinding, incomplete outcome data, selective outcome reporting, and other biases were assessed.</p> <p>Results</p> <p>Twenty-three RCTs with 2123 participants were analyzed in subgroups of types of comparison and study quality. Fifteen studies were graded as good quality. CHM alone and combined with Western medicine showed significant improvements in HA, LN, PC-III and IV-C compared with Western medicine alone. However, there were no significant differences observed between CHM and placebo treatments.</p> <p>Conclusion</p> <p>The current inconclusive results in determining the effectiveness of CHM treatment on LF, due to the poor methodological quality and high heterogeneity of the studies, suggests that large RCTs using standardized Chinese medicine syndrome diagnosis and CHM formulae with longer follow-up are required for further evaluation.</p

An investigation of the effectiveness of human resource management in the Hong Kong police

In the literature, there is the increasing trend to link human resource planning with strategic planning giving greater importance to, and greater involvement of, human resource management in organization strategy. Also the Hong Kong Police is a manpower oriented discipline force and the human resource management functions play a critical role in the effective management of these human resources. Therefore, the critical nature of the human resource management of the Hong Kong Police justifies a management report orientation where the focus is on the production of positive and practical recommendations. The objectives of the report are to evaluate the effectiveness of the existing human resource management system of the Hong Kong Police and also if and where appropriate to make recommendations designed to enhance the present system. In order to achieve the objectives, four aspects were evaluated. The first aspect is the human resource management goals of the Hong Kong Police. It was evaluated against the criteria of the extent to which it is consistent with the ii Vision, Statement of the Common Purposes and Values of the Police. The second aspect is its policies and practices of the each of the functions, which include 1. human resource planning (HRP), 2. recruitment and selection, 3. training and career development, 4. compensation and benefits management, 5. performance evaluation, 6. employee and labor relations, 7. counseling and 8. termination of the existing human resource management. It was evaluated through the comparison between the policies and practices of the each of the functions mentioned above and the corresponding theoretical functional goals. The third aspect is outcomes of human resource management, including complaints from the public, and opinions to it from the general public. It was evaluated against the overall goals of human resource management of the Hong Kong Police. The last but not the least, others, which are the things other than the above, factors viewed as relevant including what it has done during 1996 to 1999. Peters and Waterman Model was used as a framework for evaluating how well the Police was doing during this period. After considering all the aspects, we concluded that the Hong Kong Police did well in the planning process of the human resource management, as theoretically, the effectiveness of the human resource management was achieved. However, further improvement is needed in certain areas concerning the actual performance during the implementation, which may imply there are some problems that may affect the effectiveness of the human resource management of the Hong Kong Police. Based on the evaluation, we suggest that Competency Assessment Methods can be used as a framework for the Hong Kong Police to develop a set of competency for evaluating the performance of the employees. Also, a number of ways were suggested to improve the existing promotion mechanism. The supervisor’s recommendation involved in it can be improved by giving guidelines to the supervisors and having a group of supervisors to evaluate the performance of the employee. Also the recommendations should base on credible information. Moreover, feedback channels should be given to the employees to raise their opinions towards the decision in the promotion mechanism. In order to improve the competency of the supervisors, training should be given to strengthen their accountability for handling their work. Also a flexible and cafeteria benefits package was recommended to increase the flexibility of the existing benefits package iv for motivating the employees by giving autonomy to choose the benefits they need

The role of different viral biomarkers on the management of chronic hepatitis B

Chronic hepatitis B infection is a major public health challenge. With the advancement in technology, various components of the viral cycle can now be measured in the blood to assess viral activity. In this review article, we summarize the relevant data of how antiviral therapies impact viral biomarkers, and discuss their potential implications. Viral nucleic acids including hepatitis B virus (HBV) double-stranded deoxy-ribonucleic acid (DNA) and to a lesser extent, pre-genomic RNA, are readily suppressed by nucleos(t)ide analogues (NUCs). The primary role of these markers include risk prediction for hepatocellular carcinoma (HCC) and risk stratification for partial cure, defined as off-therapy virological control, or functional cure, defined as hepatitis B surface antigen (HBsAg) seroclearance plus undetectable serum HBV DNA for ≥6 months. Viral translational products including hepatitis e antigen, quantitative HBsAg and hepatitis B core-related antigen can be reduced by NUCs and pegylated interferon a. They are important in defining disease phase, delineating treatment endpoints, and predicting clinical outcomes including HCC risk and partial/functional cure. As the primary outcome of phase III trials in chronic hepatitis B is set as HBsAg seroclearance, appropriate viral biomarkers can potentially inform the efficacy of novel compounds. Early viral biomarker response can help with prioritization of subjects into clinical trials. However, standardization and validation studies would be crucial before viral biomarkers can be broadly implemented in clinical use

Hepatoprotective effects of berberine on carbon tetrachloride-induced acute hepatotoxicity in rats

Background: Berberine is an active compound in Coptidis Rhizoma (Huanglian) with multiple pharmacological activities including antimicrobial, antiviral, anti-inflammatory, cholesterol-lowering and anticancer effects. The present study aims to determine the hepatoprotective effects of berberine on serum and tissue superoxide dismutase (SOD) levels, the histology in tetrachloride (CCl 4)-induced liver injury.Methods: Sprague-Dawley rats aged seven weeks were injected intraperitoneally with 50% CCl 4 in olive oil. Berberine was orally administered before or after CCl 4 treatment in various groups. Twenty-four hours after CCl 4 injection, serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities, serum and liver superoxide dismutase (SOD) activities were measured. Histological changes of liver were examined with microscopy.Results: Serum ALT and AST activities significantly decreased in a dose-dependent manner in both pre-treatment and post-treatment groups with berberine. Berberine increased the SOD activity in liver. Histological examination showed lowered liver damage in berberine-treated groups.Conclusion: The present study demonstrates that berberine possesses hepatoprotective effects against CCl 4-induced hepatotoxicity and that the effects are both preventive and curative. Berberine should have potential for developing a new drug to treat liver toxicity. © 2010 Feng et al; licensee BioMed Central Ltd.published_or_final_versio

Genome-Wide Association Study of Hepatocellular Carcinoma in Southern Chinese Patients with Chronic Hepatitis B Virus Infection

One of the most relevant risk factors for hepatocellular carcinoma (HCC) development is chronic hepatitis B virus (HBV) infection, but only a fraction of chronic HBV carriers develop HCC, indicating that complex interactions among viral, environmental and genetic factors lead to HCC in HBV-infected patients. So far, host genetic factors have incompletely been characterized. Therefore, we performed a genome-wide association (GWA) study in a Southern Chinese cohort consisting of 95 HBV-infected HCC patients (cases) and 97 HBV-infected patients without HCC (controls) using the Illumina Human610-Quad BeadChips. The top single nucleotide polymorphisms (SNPs) were then validated in an independent cohort of 500 cases and 728 controls. 4 SNPs (rs12682266, rs7821974, rs2275959, rs1573266) at chromosome 8p12 showed consistent association in both the GWA and replication phases (ORcombined = 1.31–1.39; pcombined = 2.71×10−5–5.19×10−4; PARcombined = 26–31%). We found a 2.3-kb expressed sequence tag (EST) in the region using in-silico data mining and verified the existence of the full-length EST experimentally. The expression level of the EST was significantly reduced in human HCC tumors in comparison to the corresponding non-tumorous liver tissues (P<0.001). Results from sequence analysis and in-vitro protein translation study suggest that the transcript might function as a long non-coding RNA. In summary, our study suggests that variations at chromosome 8p12 may promote HCC in patients with HBV. Further functional studies of this region may help understand HBV-associated hepatocarcinogenesis

Expansion of Granulocytic, Myeloid-Derived Suppressor Cells in Response to Ethanol-Induced Acute Liver Damage

The dual role of ethanol in regulating both pro-inflammatory and anti-inflammatory response has recently been reported. Myeloid-derived suppressor cells (MDSCs) are one of the major components in the immune suppressive network in both innate and adaptive immune responses. In this study, we aim to define the role of a population expressing CD11b+Ly6GhighLy6Cint with immunosuppressive function in response to ethanol-induced acute liver damage. We find this increased granulocytic-MDSCs (G-MDSCs) population in the blood, spleen, and liver of mice treated with ethanol. Depletion of these cells increases serum alanine aminotransferase and aspartate aminotransferase levels, while G-MDSCs population adoptive transfer can ameliorate liver damage induced by ethanol, indicating the protective role in the early stage of alcoholic liver disease. The significant changes of T-cell profiles after G-MDSCs populations adoptive transfer and anti-Gr1 injection signify that both cytotoxic T and T helper cells might be the targeted cells of G-MDSCs. In the in vitro study, we find that myeloid precursors preferentially generate G-MDSCs and improve their suppressive capacity via chemokine interaction and YAP signaling when exposed to ethanol. Furthermore, IL-6 serves as an important indirect factor in mediating the expansion of G-MDSCs populations after acute ethanol exposure. Collectively, we show that expansion of G-MDSCs in response to ethanol consumption plays a protective role in acute alcoholic liver damage. Our study provides novel evidence of the immune response to acute ethanol consumption