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Studies have suggested that glutamine synthetase (GS) is a potential marker of hepatocellular carcinoma (HCC). We aimed to evaluate the expression of GS in non-malignant liver tissue and serum GS levels in HCC, liver cirrhosis (LC), chronic hepatitis B (CHB), five kinds of extrahepatic diseases patients and healthy subjects. Immunohistochemistry (IHC) was used to assess GS expression in 260 liver tissue samples (from 120 HCC, 90 CHB stage 4, and 50 CHB stage 1-3 patients). Enzyme-linked immunosorbent assays of 325 samples (from 100 healthy donors, 33 CHB stage 1-3, 43 CHB stage 4, 111 HCC, and 45 extrahepatic diseases patients) were used to further analyze GS levels in serum. IHC studies showed the expression of GS in 70% of HCC patients, 46.7% of CHB stage 4 patients and 38% of CHB stage 1-3 patients. The χ tests showed significant difference between HCC samples and non-tumor tissues ( P = 0.001 for HCC vs. CHB stage 4, P = 0.000 for HCC vs. CHB). Consistent with this, serum GS levels are increased in HCC and CHB stage 1-4 patients. There are significant differences among all samples ( P = 0.000 for all), except CHB stage 1-3 versus CHB stage 4 ( P = 0.552). Based on multiple linear regressions, HCC, CHB stage 1-4 and AFP were significantly associated with serum GS levels. In addition, in HCC group, TNM and Child-Pugh were significantly associated with GS levels. Expression of GS is increased in HCC, LC, and CHB. It may be a new serum marker for liver disease. [ABSTRACT FROM AUTHOR]

This randomized, double-blind, placebo-controlled study was undertaken to evaluate the efficacy and safety of entecavir in Chinese patients with lamivudine-refractory chronic hepatitis B. One hundred forty-five lamivudine-refractory patients with chronic hepatitis B were randomized to double-blind treatment with oral entecavir 1 mg ( n = 116) or placebo ( n = 29) daily for 12 weeks, followed by 36 weeks of open-label entecavir treatment. The primary efficacy endpoint was the mean change from baseline in serum hepatitis B virus (HBV) DNA by polymerase chain reaction (PCR) assay at week 12. At week 12, the mean change from baseline in serum HBV DNA by PCR assay was –4.30 log10 copies/ml for patients on entecavir compared to –0.15 log10 copies/ml for patients on placebo ( P < .0001). Among patients with baseline serum alanine aminotransferase (ALT) >1 × upper limit of normal (ULN), a higher proportion of entecavir than placebo patients (68% vs. 6%, respectively) achieved ALT normalization by week 12 ( P < .0001). After 48 weeks of entecavir treatment, the mean change in HBV DNA by PCR assay was –5.08 log10 copies/ml, and 85% of patients with baseline ALT >1 × ULN had achieved ALT normalization. The safety profile of entecavir was similar to that of placebo during the first 12 weeks of blinded dosing. Entecavir was also well tolerated during 36 weeks of open-label treatment. Lamivudine-refractory chronic hepatitis B patients treated with entecavir demonstrated marked HBV DNA reduction and normalization of ALT in most cases. Entecavir treatment for 48 weeks was well tolerated. [ABSTRACT FROM AUTHOR]

Astragalus membranaceus (AM) has been widely used for treating liver diseases in traditional Chinese medicine. Experimental evidence indicates that it has antitumor potential. In this study, the effect of AM on hepatocarcinogenesis induced by diethylnitrosamine (DEN), two-thirds partial hepatectomy, and 2-acetylaminofluorene (2-AAF) (DEN-PH-AAF) was evaluated using glutathione S-transferase placenta form (GST-P) as marker. First, rats were injected intraperitoneally (i.p.) with DEN (200 mg/kg in saline), a two-thirds partial hepatectomy was carried out 2 weeks later, and the rats were then placed on a basal diet containing 0.02% AAF from week 3 to week 8 to induce hepatocarcinogenesis. The rats were given AM (90 mg/kg or 180 mg/kg body weight) by gavage from week 3 to week 8 (treatment groups). The formation of GST-P-positive foci and the expression of GST-P protein and mRNA caused by DEN-PH-AAF were reduced in the treatment groups, which clearly suggests that AM is effective in delaying DEN-PH-AAF-induced hepatocarcinogenesis. [ABSTRACT FROM AUTHOR]

Stronger Neo-Minophagen C (SNMC) is an intravenous drug with glycyrrhizin as the principal ingredient. The efficacy and safety of SNMC at two doses were evaluated on 194 patients with chronic hepatitis B in nine hospitals in China. They all had serum levels of alanine aminotransferase (ALT) exceeding twice the upper limit of normal (>80 IU/l). SNMC daily 100 and 40 ml were given for 4 weeks to the patients randomized into Group A (N=99) and Group B (N=95), respectively. Thereafter, all patients received oral glycyrrhizin (GLYCYRON Tab) 9 tablets a day for an additional 4 weeks. Primary end-point was ALT<1.5 times the upper limit of normal (60 IU/l) at completion of the 8-week therapy, and it was achieved by 73 patients (74%) in Group A and 74 (79%) patients in Group B; normalization of ALT levels (<40 IU/l) was accomplished in 58 (58%) and 54 (57%) patients in Groups A and B, respectively. SNMC was withdrawn in four (2%) patients due to mild and reversible side effects. Based on these results, SNMC is safe and efficacious in lowering or normalizing ALT levels in patients with chronic hepatitis B in China, and an induction dose of 40 ml daily is efficient in achieving maximal effects. [ABSTRACT FROM AUTHOR]

X-ray diffraction enhanced imaging (DEI) is a phase contrast technique that generates excellent contrast of biological soft tissues compared to conventional absorption radiography. We explore the application of DEI in the diagnosis of hepatic fibrosis. The produced refraction contrast images of fibrous rat liver samples show clearly abnormal liver architectures. Moreover, by comparing to histological pictures, different stages of fibrosis are discriminated, and the corresponding morphological features are analyzed. Besides, quantitative analyses of texture features are presented. The results reported herein show that DEI can be a potential noninvasive technique to diagnose and stage hepatic fibrosis. [ABSTRACT FROM AUTHOR]