Lan-Fang Zhang

Peking University People's Hospital, Peping, Beijing, China

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Publications (4)3.32 Total impact

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    ABSTRACT: We aimed to assess liver fibrosis in biopsies from patients with chronic hepatitis C and relationship to different responses to interferon-beta-la. 21 patients with chronic hepatitis C were divided into two groups randomly and treated with recombinant human interferon-beta-la (IFN-B-1a) or IFN-beta-1a plus ribavirin (RBV) for 24 weeks, then followed up for another 24 weeks. 42 liver biopsies of 21 patients before and after treatment respectively were evaluated on conventional histological assessment. Then we studied 21 patients liver biopsies by immunohistochemical analysis of alpha-smooth muscle actin (alpha-SMA) and collagen type III. A significant improvement in HAI fibrosis staging was detected after therapy in all sustained viral responders (SVR) and non-responders (NR) patients. The percentages of cases with HAI scores and fibrosis staging decreased obviously were 100.0% and 71.4% in SVR patients and 50.0% and 42.9% in NR patients. The patients with combination therapy or normal ALT on 48w would more often receive the HAI and fibrosis staging decrease. The significantly lower alpha-SMA-positive HSCs and mean expression level of collagen type III were detected in the post-treatment biopsies. The HAI, alpha-SMA, collagen type III values were significantly correlated with the values of the semiquantitative indexes of fibrosis. IFN-beta-1a therapy is effective for patients with chronic hepatitis C on liver histology regardless of viral response. The alpha-SMA-positive HSCs and collagen type III expression are responsible for liver fibrosis.
    Hepato-gastroenterology 01/2009; 56(90):328-34. · 0.77 Impact Factor
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    ABSTRACT: To access the effect of pegylated interferon (PEGIFN) beta-1a on the reduction of liver fibrosis in chronic hepatitis C (HVC). Twenty-one patients with chronic HVC were divided into two groups randomly and treated with recombinant human PEGIHN-beta-1a (n = 13) or PEGIHN-beta-1a plus ribavirin (RBV) (n = 8) for 24 weeks, and then followed up for another 24 weeks. The clinical manifestations were observed and the clinical effects were evaluated. Biopsy was conducted before and after the treatment to analyze the histological activity index (HAI) and staging of fibrosis according the modified Knodell scoring system. Immunohistochemical analysis was used to examine the levels of alpha-smooth muscle actin (alpha-SMA), marker of activation of hepatic stellate cells (HSCs), and collagen type III in the HSCs. Sustained viral response (SVR) was achieved in 7 patients, and end-of-treatment virologic response (ETVR) was achieved in 9 patients. The HAI after treatment was 4.3 +/- 2.2, significantly lower than that before treatment (6.6 +/- 2.2, t = 4.77, P < 0.01). The fibrosis score after treatment was 1.1 +/- 1.1, significantly lower than that before treatment (1.7 +/- 1.2, t = 1.92, P < 0.05). The alpha-SMA score after treatment was 14 +/- 8, significantly lower than that before treatment (20 +/- 11, t = 2.15, P < 0.05). The integrated light density of collagen type III after treatment was 10 +/- 10, significantly lower than that before treatment (16 +/- 12, t = 1.83, P < 0.05). The improvement levels of fibrosis, alpha-SMA score, and integrated light density of collagen type III of the patients with SVR were all better than those of the patients without SVR; however, the differences were all not significant. The patients with combination therapy, female patients, and the patients with the HCV RNA < 2 x 10(6) copies/ml before treatment all showed higher levels in histology response. HAI, alpha-SMA level, and collagen type III values were all significantly correlated with the values of the semiquantitative indexes of fibrosis (all P < 0.01). Resisting hepatitis virus C and inhibiting and reversing the fibrotic progress, IFN-beta-1a therapy improves the liver histology of chronic HVC regardless of the viral response.
    Zhonghua yi xue za zhi 01/2008; 88(2):96-100.
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    ABSTRACT: To study the relationship between hepatitis B virus (HBV) DNA levels and liver histology in patients with chronic hepatitis B (CHB) and to determine the prevalence and characteristics of hepatitis B e antigen (HBeAg) negative patients. A total of 213 patients with CHB were studied, and serum HBV DNA levels were measured by the COBAS Amplicor HBV Monitor test. All patients were divided into two groups according to the HBeAg status. The correlation between serum HBV DNA levels and liver damage (liver histology and biochemistry) was explored. Of the 213 patients with serum HBV DNA levels higher than 10(5) copies/mL, 178 (83.6%) were HBeAg positive, 35 (16.4%) were HBeAg negative. The serum HBV DNA levels were not correlated to the age, history of CHB, histological grade and stage of liver disease in either HBeAg negative or HBeAg positive patients. There was no correlation between serum levels of HBV DNA and alanine aminotransferanse (ALT), aspartate aminotransferase (AST) in HBeAg positive patients. In HBeAg negative patients, there was no correlation between serum levels of HBV DNA and AST, while serum DNA levels correlated with ALT (r=0.351, P=0.042). The grade (G) of liver disease correlated with ALT and AST (P<0.05, r=0.205, 0.327 respectively) in HBeAg positive patients. In HBeAg negative patients, correlations were shown between ALT, AST and the G (P<0.01, and r=0.862, 0.802 respectively). HBeAg negative patients were older (35 +/- 9 years vs 30 +/- 9 years, P<0.05 ) and had a longer history of HBV infection (8 +/- 4 years vs 6 +/- 4 years, P<0.05) and a lower HBV DNA level than HBeAg positive patients (8.4 +/- 1.7 Log HBV DNA vs 9.8 +/- 1.3 Log HBV DNA, P<0.001). There were no significant differences in sex ratio, ALT and AST levels and liver histology between the two groups. Serum HBV DNA level is not correlated to histological grade or stage of liver disease in CHB patients with HBV DNA more than 10(5) copies/mL. Compared to HBeAg positive patients, HBeAg negative patients are older and have a lower HBV DNA level and a longer HBV infection history. There is no significant difference in sex ratio, ALT and AST levels and liver histology between the two groups.
    World Journal of Gastroenterology 04/2007; 13(14):2104-7. · 2.55 Impact Factor
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    ABSTRACT: To investigate the clinical outcomes and hepatic histology of patients with hepatitis C. Nine patients with hepatitis, 4 males and 5 females, aged 44 +/- 7, who were infected during transfusion or blood donation underwent follow-up for 13 approximately 14 years: liver histological examination by biopsy, ultrasonography, biochemical examination of alanine transaminase (ALT), apartate aminotransferase (AST), and total bilirubin (TBIL), serum anti-HCV by ELISA, and HCV RNA quantification by PCR. ALT were higher than the normal value at every time point and HCV RNA remained positive (3.57 x 10(8) approximately 7.21 x 10(9) copies/L) in all patients. Ultrasonography showed mild and moderate hepatitis (3 and 6 cases respectively). The modified histological activity indices (HAI) were 5.0 approximately 8.5 and the fibrosis scores were 1 approximately 4. The ALT value was higher in the moderate cases than in the mild cases, and higher in those with higher HAI. The viral load was higher in the patients infected by the virus of the genotype 1b than in the patients infected by the virus of the genotype 2. The clinical outcomes and hepatic histology of patients with hepatitis C seem not very severe.
    Zhonghua yi xue za zhi 06/2005; 85(17):1166-70.

Publication Stats

21 Citations
3.32 Total Impact Points

Institutions

  • 2008–2009
    • Peking University People's Hospital
      Peping, Beijing, China
  • 2005
    • Peking University
      Peping, Beijing, China