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Objective:To explore hepatitis B virus (HBV) infection rate of breast feeding to newborn babies of HBV carrying parturient women with hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) double positive.Methods:A prospective cohort study was conducted to include HBsAg and HBeAg double-positive HBV carrying parturient women and their babies born from February 2016 to May 2018 at the Women′s Hospital, Zhejiang University School of Medicine, and 323 parturient women and 323 babies were enrolled. The babies were divided into breast feeding group and artificial feeding group. Chemiluminescence immunoassay and polymerase chain reaction-fluorescent probe method were used to detect the positive rates of serum HBV markers and HBV DNA levels in the newborns <24 h and seven-month-old age, respectively. The statistical method was performed using χ2 test. Results:A total of 297 parturient women were finally included for the analysis, including 149 in the breast feeding group and 148 in the artificial feeding group. There were no significant differences in the positive rates of HBsAg, hepatitis B surface antibody (anti-HBs), HBeAg and HBV DNA>100 IU/mL between the two groups at birth <24 h and seven months of age (all P>0.05). The positive rate of anti-HBs in newborns in the breast feeding group at birth <24 h was 58.39%(87/149), which was lower than 95.97%(143/149) at seven months of age. The HBeAg-positive group was 65.10%(97/149) at birth <24 h in the breast feeding group, which was higher than 13.42%(20/149) at seven months of age. The differences were both statistically significant ( χ2=59.75 and 40.49, respectively, both P<0.01). The positive rates of HBsAg and HBV DNA>100 IU/mL in newborns in the breast feeding group were 2.01%(3/149) and 2.68%(4/149) at birth <24 h, respectively, and those at seven months were 2.68%(4/149) and 2.68%(4/149), respectively. There were no significant differences between the two time points (both P>0.05). In the artificial feeding group, the positive rate of anti-HBs in newborns was 47.97%(71/148) at birth <24 h, which was lower than 95.94% (142/148) at seven months of age. The positive rate of HBeAg in the artificial feeding group was 55.41%(82/148) in newborns at birth <24 h, which was higher than 19.59%(29/148) at seven months of age. The differences were statistically significant ( χ2=85.37 and 39.84, respectively, both P<0.01). The positive rates of HBsAg and HBV DNA>100 IU/mL in newborns in the artificial feeding group at birth <24 h were 4.73%(7/148) and 1.35%(2/148), respectively, and those at seven months were 1.35%(2/148) and 1.35%(2/148), respectively. There were no significant differences between the two time points (both P>0.05). Conclusions:Breast feeding is not a decisive factor for the risk of vertical transmission in HBsAg and HBeAg double-positive HBV carriers. It is recommended that such women could breastfeed under formal precautions.
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Objective@#To explore hepatitis B virus (HBV) infection rate of breast feeding to newborn babies of HBV carrying parturient women with hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) double positive.@*Methods@#A prospective cohort study was conducted to include HBsAg and HBeAg double-positive HBV carrying parturient women and their babies born from February 2016 to May 2018 at the Women′s Hospital, Zhejiang University School of Medicine, and 323 parturient women and 323 babies were enrolled. The babies were divided into breast feeding group and artificial feeding group. Chemiluminescence immunoassay and polymerase chain reaction-fluorescent probe method were used to detect the positive rates of serum HBV markers and HBV DNA levels in the newborns <24 h and seven-month-old age, respectively. The statistical method was performed using χ2 test.@*Results@#A total of 297 parturient women were finally included for the analysis, including 149 in the breast feeding group and 148 in the artificial feeding group. There were no significant differences in the positive rates of HBsAg, hepatitis B surface antibody (anti-HBs), HBeAg and HBV DNA>100 IU/mL between the two groups at birth <24 h and seven months of age (all P>0.05). The positive rate of anti-HBs in newborns in the breast feeding group at birth <24 h was 58.39%(87/149), which was lower than 95.97%(143/149) at seven months of age. The HBeAg-positive group was 65.10%(97/149) at birth <24 h in the breast feeding group, which was higher than 13.42%(20/149) at seven months of age. The differences were both statistically significant (χ2=59.75 and 40.49, respectively, both P<0.01). The positive rates of HBsAg and HBV DNA>100 IU/mL in newborns in the breast feeding group were 2.01%(3/149) and 2.68%(4/149) at birth <24 h, respectively, and those at seven months were 2.68%(4/149) and 2.68%(4/149), respectively. There were no significant differences between the two time points (both P>0.05). In the artificial feeding group, the positive rate of anti-HBs in newborns was 47.97%(71/148) at birth <24 h, which was lower than 95.94% (142/148) at seven months of age. The positive rate of HBeAg in the artificial feeding group was 55.41%(82/148) in newborns at birth <24 h, which was higher than 19.59%(29/148) at seven months of age. The differences were statistically significant (χ2=85.37 and 39.84, respectively, both P<0.01). The positive rates of HBsAg and HBV DNA>100 IU/mL in newborns in the artificial feeding group at birth <24 h were 4.73%(7/148) and 1.35%(2/148), respectively, and those at seven months were 1.35%(2/148) and 1.35%(2/148), respectively. There were no significant differences between the two time points (both P>0.05).@*Conclusions@#Breast feeding is not a decisive factor for the risk of vertical transmission in HBsAg and HBeAg double-positive HBV carriers. It is recommended that such women could breastfeed under formal precautions.
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Objective To study the effects of binary cardiac rehabilitation (CR) composed of hospital-based and home-based CR in patients after acute myocardial infarction (AMI) evaluated by six-minute walking distance (6MWD). Methods A total of 38 post-MI patients were divided into two groups, namely conventional CR group (n=20) and binary CR group (n=18). In the first seven days, CR training was carried out in all 38 patients in our hospital, and then 20 patients were kept at CR training in the hospital (hospital-based CR group), whereas the remaining 18 patients (binary CR group) got tele-monitored walking training at home for eight weeks (binary model). Before discharge from hospital based CR or after 8 weeks CR at home, all patients received Cardiopulmonary Exercise Testing and Six-minute Walk Test, and the data of patients' body mass index (BMI),thyroid function, serum lipid metabolism and echocardiography were collected before and after CR. Results After CR, BMI and low density lipoprotein (LDL) decrease in both groups compared with those before CR[hospital-based group: BMI, (25.99±3.36)kg/m2 vs. (23.04±3.72) kg/m2,P＜0.05; LDL, (3.40±1.38) mg/dl vs. (2.04±0.73)mg/ dl,P＜0.01; binary group: BMI, (24.84±2.70) kg/m2 vs. (22.88±2.56) kg/m2,P＜0.05; LDL, (3.40±1.01) mg/dl vs. (92.11±0.37) mg/dl,P＜0.01]. After 8 weeks CR at home or hospital based CR until discharge, the anaerobic threshold (AT), maximum rate of oxygen consumption (VO2max),metabolic equivalent (MET) and 6MWD improved significantly in both groups compared with those at 7 days after CR in hospital [Hospital-based group: AT, (12.37±1.53) mL/(kg. min) vs. (14.77±1.57) mL/(kg. min); VO2max (17.87± 1.66 mL/(kg. min) vs. (20.73±2.14) mL/(kg. min); MET (5.02±0.36) vs. (6.09±0.53); 6MWD (500±53.36) m vs. (582.5±57.6) m,P＜0.01; Binary group: AT, (12.56±1.11) mL/(kg·min) vs. (14.30±1.23) mL/(kg. min); V02max, (17.28±1.38) mL/(kg. min) vs. (20.02±1.37) mL/(kg. min); MET, (5.07±0.47)vs (5.94±0.46); 6MWD,(511.4±50.96) m vs. (590.3±56.1)m,P＜0.01]. There was no significant difference in CR effects observed between two groups (P＞0.05). Conclusions In post-MI patients,a binary model of CR training improved physical capacity and was a similarly effective form of CR as a entirely hospital-based approach. A home-based tele-monitored program facilitated patients' adherence to CR. The 6 minute walk experiment is economical and good evaluation on the CR effect of binary cardiac rehabilitation.
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Objective To investigate the diagnostic value of blood homocysteine,ankle -brachial index and brachial -ankle pulse wave velocity in elderly patients with coronary heart disease (CHD).Methods 97 patients with routine coronary angiography were classified into CHD group (65 cases)and non -CHD group (32 cases) according to the results of coronary angiography.There were 24 cases with single -vessel disease in 65 CHD cases, 21 cases with double -vessel disease and 20 patients with multivessel disease of CHD.Basic clinical parameters,age, gender,TC,TG,LDL -C,HDL -C,etc and blood HCY,ABI,baPWV levels were compared among groups.Results The age of double -vessel disease group,multivessel disease group was significantly higher than that in single -vessel disease group(t =3.721,3.927,all P 0.05),and the ABI of multi -vessel disease,double vessel disease group were significantly lower than that of non -CHD group (all P <0.01).HCY,baPWV of CHD group were significantly higher than non -CHD group(all P <0.01 ),double vessel disease,HCY multivessel disease group,ABI,baPWV average water with single -vessel disease group were signifi-cantly different(all P <0.01 ).With the increase of coronary lesions involved,the blood HCY,baPWV showed an increasing trend and ABI showed an decreasing trend.Conclusion Combined detection of HCY,baPWV and ABI has great value in early detection and early intervention of CHD in the elderly.