Purpose Chronic hepatitis B (CHB) and metabolic associated fatty liver disease (MAFLD) are both important public health problems. The effect of concomitant MAFLD on patients with CHB is still unclear. This study aimed to explore the influence of MAFLD on liver fibrosis and inflammation in CHB patients with different hepatitis B e antigen (HBeAg) status. Patients and Methods We retrospectively collected the clinical data of 399 treatment-naïve CHB patients who underwent liver biopsy. All patients were divided into two groups (HBeAg± group). Logistic regression analysis was used to identify factors associated with liver inflammatory activity and significant fibrosis in patients with CHB. Multivariable logistic regressions were repeated in subgroups stratified by HBeAg status. Results In patients with CHB, MAFLD was independently associated with a risk of moderate-to-severe liver activity and significant fibrosis ( P <0.05). In the HBeAg-negative group, patients with MAFLD had significantly higher levels of alanine aminotransferase (ALT) ( P <0.05) and more severe liver inflammatory activity and fibrosis ( P <0.05) compared to those without MAFLD. MAFLD was independently associated with a risk of moderate-to-severe liver activity (A ≥3: OR 3.97, 95% CI 1.71–9.22, P =0.001) and significant fibrosis (F ≥2: OR 2.02, 95% CI 1.09–3.73, P =0.026). In the HBeAg-positive group, MAFLD was found to be independently associated with moderate-to-severe liver activity (OR 2.44, 95% CI 1.03–5.79, P =0.044) but not fibrosis ( P =0.618). Conclusion MAFLD is associated with the risk of liver fibrosis and inflammatory activity in HBeAg-negative CHB patients. Sufficient attention should be paid to the prevention and treatment of MAFLD in patients with CHB, especially in HBeAg-negative patients.

Talaromycosis is a life-threatening fungal disease commonly seen in patients with acquired immunodeficiency syndrome (AIDS), which is endemic in Southern China and Southeast countries. The diagnostic methods available for talaromycosis are relatively time-consuming and yield a high mortality. Therefore, early diagnosis of talaromycosis is extremely important. We aimed to determine a potential method for assisting in its early diagnosis. A total of 283 patients with AIDS admitted to our hospital were prospectively included in this cross-sectional study and divided into those with Talaromyces marneffei (TSM group, n=93) and those without Talaromyces marneffei (non-TSM group, n=190). The diagnostic accuracy of the Mp1p enzyme immunoassay (EIA), galactomannan (GM) assay, and blood culture performed within 3 days of hospitalisation were evaluated, using talaromycosis confirmed by culture and/or pathology as the gold standard. The positivity rates in the Mp1p EIA, GM assay, and blood culture were 72%, 64.5%, and 81.7%, respectively, in the TSM group. The sensitivity, specificity, and positive and negative predictive values of the Mp1p EIA were 72.0% (67/93), 96.8% (184/190), 91.8% (67/73), and 87.6% (184/210), respectively. The Mp1p EIA showed a substantial agreement with the gold standard (kappa: 0.729) and superiority to the GM assay (kappa: 0.603); it also showed a superior diagnostic accuracy in the patients with CD4+ counts of <50 cells/µL compared to those with CD4+ counts ranged from 50–100 cells/µL. The Mp1p EIA has the advantage of assisting in the early diagnosis of talaromycosis in patients with AIDS, especially those with low CD4+ counts.

Talaromycosis is a life-threatening fungal disease commonly seen in patients with acquired immunodeficiency syndrome (AIDS), which is endemic in Southern China and Southeast countries. The diagnostic methods available for talaromycosis are relatively time-consuming and yield a high mortality. Therefore, early diagnosis of talaromycosis is extremely important. We aimed to determine a potential method for assisting in its early diagnosis. A total of 283 patients with AIDS admitted to our hospital because of opportunistic infections were prospectively included in this case-control study and divided into those with (TSM, n = 93) and without talaromycosis (non-TSM, n = 198). The diagnostic accuracy of the Mp1p assay with enzyme immunoassay, galactomannan (GM) assay, and blood culture performed within 3 days of hospitalisation was evaluated. Most patients were men (n = 243 [85.9%]), mainly young (52.3%), and middle-aged adults (33.9%). The positivity rates in the Mp1p assay, GM assay, and blood culture were 72%, 64.5%, and 81.7%, respectively, in the TSM group. The sensitivity, specificity, and positive and negative predictive values of the Mp1p assay were 72.0% (67/93), 96.8% (184/190), 91.8% (67/73), and 87.6% (184/210), respectively. The Mp1p assay showed a substantial agreement with the gold standard (kappa: 0.729) and superiority to the GM assay (kappa: 0.603); it also showed a superior diagnostic efficacy in the patients with CD4 + T cell counts of < 50 Nr/µL compared to those with CD4 + T cell counts of ≥ 50 Nr/µL. The Mp1p assay possesses a superior advantage in assisting in the early diagnosis of talaromycosis in patients with AIDS, especially those with low CD4 + T cell counts.

ObjectiveThe purpose of this study was to clarify whether hypo-fractionated radiation therapy combined with oxaliplatin can aggravate liver damage, in order to determine its safety for clinical application.MethodsEighty Wistar rats were randomly divided into four groups: the control group, the chemotherapy treatment group, the radiation treatment group, and the concurrent chemoradiotherapy group. The rats' liver tissues were then collected for histological evaluation at the first, second, fourth, sixth, and eight week after irradiation. The tissues were histologically evaluated using hematoxylin and eosin staining, and immunohistochemistry to analyze the expression of Bcl-2 and Bax.ResultsHistological examination revealed swollen hepatocellular cells in the experimental groups, with visible liver degeneration and necrosis. Alanine aminotransferase and aspartate aminotransferase levels were significantly different between the groups (F = 85.869 and 214.663; P < 0.001). The intra-group expressions of Bcl-2 and Bax were also significantly different between each time point (F = 6.047 and 43.344;P < 0.05). Bax expression was significantly different between each group (F = 8.122; P < 0.05), although no inter-group differences were observed for Bcl-2 expression (F = 0.808; P > 0.05).ConclusionChemoradiotherapy may aggravate liver injury, possible via overexpression of Bcl-2 and reduced expression of Bax. Therefore, this treatment should be used carefully in the clinic.