ABSTRACT
Nucleos(t)ide analogues (NAs), which are widely used as the first-line anti-hepatitis B virus (HBV) drugs in clinical practice, can effectively inhibit the replication of HBV DNA, significantly slow down disease progression in chronic hepatitis B (CHB) patients, and reduce the development of end-stage liver diseases such as liver failure and liver cancer. However, for some CHB patients receiving first-line NAs for 48 weeks or longer, serum HBV DNA is still persistently or intermittently higher than the lower detection of limit of sensitive nucleic acid detection reagents. After discussion by the authors, low-level viremia (LLV) is defined as follows: persistent LLV refers to the condition in which CHB patients, who receive entecavir, tenofovir disoproxil fumarate, or tenofovir alafenamide fumarate for ≥48 weeks, test positive for HBV DNA by two consecutive detections with sensitive quantitative PCR, with an interval of 3-6 months, but have an HBV DNA level of ＜2000 IU/ml; intermittent LLV refers to the condition in which patients test positive for HBV DNA intermittently by at least three consecutive detections with sensitive quantitative PCR, with an interval of 3-6 months, but have an HBV DNA level of ＜2000 IU/ml. For the diagnosis of LLV, the issues of poor compliance and drug-resistant mutations should be excluded. LLV might be associated with the increased risk of progression to liver fibrosis or hepatocellular carcinoma in patients with liver cirrhosis under NA treatment, but there are still controversies over whether the original treatment regimen with NAs should be changed after the onset of LLV. This article summarizes the incidence rate of LLV under NA treatment and the influence of LLV on prognosis and analyzes the possible mechanisms of the osnet of LLV, so as to provide a reference for the management of LLV in patients treated with NAs.
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Sepsis is now defined as life-threatening organ dysfunction due to a dysregulated host response to infection.The identification of pathogen is usually time-consuming.Besides, it has a low positivity rate in diagnosis of sepsis.Thus, it’s crucial to find suitable biomarkers for early diagnosis , prognosis and evaluation of treatment effect of sepsis.This article reviews the diagnostic value of pro-inflammatory cytokines, anti-inflammatory cytokines,surface receptors of immune cells in nature immunity in sepsis.
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Objective To explore the influence of fixed-foot stance Yunshou combined with raising handclasp of Bobath on the recovery of upper extremity in post- stroke patients with hemiplegia. Methods Meeting the criteria 59 cases of stroke patients with hemiplegia were randomly divided into experimental group (29 cases) and control group(30 cases) according to random number table.All the patients in both groups were received routine therapy and nursing,besides,the patients in the control group were given raising handclasp of Bobath,while the patients in experimental group were treated with fixed-foot stance Yunshou combined with raising handclasp of Bobath.The intervention were once a day,five days a week,lasting eight weeks.The Fugl-Meyer Assessment of Upper Extremity(FMA-UE)and Modified Barthel Index(MBI) as well as Simple Test for Evaluating Hand Function(STEF) were used to assess the patients′condition before,8 weeks after treatment respectively. Results After 8weeks intervention,the scores of FMA-UE,MBI,STEF were 40.69±8.67,76.89±1.79,59.31±7.89 and before intervention were 24.17 ± 11.98,57.14 ± 13.93,31.83 ± 5.41, the difference between the experimental group before and after intervention was statistically significant(t=13.222,8.755,18.311,P<0.01).At 8 weeks,the scores of FMA-UE, MBI, STEF in the control group were 35.47 ± 9.68,73.17 ± 2.82,49.47 ± 8.78, and were17.38 ± 4.10,37.38 ± 4.30, 74.62 ± 11.22 respectively before intervention,all the measures in control groups had significantly improved than those before training (t=-4.797, 7.372, 17.139, P<0.01).Score of FMA-UE and STEF in the experimental group were higher than those in the control group,and the difference was statistically significant (t=2.180, 4.525, P<0.05 or 0.01), while the MBI had no statistically difference between two groups (P>0.05). Conclusion Compared with training on raising handclasp of Bobath alone,fixed-foot stance Yunshou combined with raising handclasp of Bobath is more effective On the recovery of upper limb function in stroke patients with hemiplegia.
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In recent years,antiviral therapy for chronic hepatitis B infected patients has achieved great development along with the invention of nucleos (t) ide,nucleos (t) ide analogues,interferon α and pegylated interferon α.The development of antiviral medicine also proposes new demands for the clinical diagnosis and therefore promotes the development of laboratory diagnostic techniques in the detection of chronic hepatitis B.In this review,we focused on the clinical application in the quantitive detection of HBV DNA,and its significance on clinical evaluation,treatment options,follow-up and prognosis in antiviral therapy.
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Objective To develop a HPLC-UV method for the determination of [6]-gingerol in the rat plasma.Methods [6]-Gingerol was extracted from the rat plasma by using liquid-liquid extraction,then was separated on a Hypersil C18 column(250 mm?4.6 mm,5 ?m).The mobile phase was acetonitrile and water(45:55,v/v) with a flow-rate of 1.0 mL/min.The eluate from the HPLC column was monitored by the spectrophotometric detector at 280 nm.The injection volume was 20 ?L.[6]-Gingerol was identified based on its retention time compared with the reference standard.Results The linear calibration curve was obtained in the concentration range of 0.25～5.0 ?g/mL.The low quantitative limit was 0.1 ?g /mL.The RSD of inter-day was
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Objective To extract and separate crude gingerols and to determine the content of [6]-gingerol in crude gingerols.Methods Crude gingerols were separated from the ginger supercritical-CO2 extracts by silica gel dry column chromatography with solvent system of diethyl ether-n-hexane(7:3).The content of [6]-gingerol in crude gingerols was determined by HPLC.Results [6]-gingerol content in the prepared crude gingerols by silica gel dry column chromatography arrived 52.87 %(m/m).[6]-gingerol had a good linearity in the range of 0.512～ 3.075 ? g,r=0.999 9,and the average recovery was 99.19 %,RSD=1.58 % .Conclusion Silica gel dry column chromatography can be used to quickly,effectively prepare crude gingerols,in which [6]-gingerol content is high,and can supply enough material for further research.The liquid chromatographic analysis of [6]-gingerol is simple,reliable,reproducible and can be used for the quality control of crude gingerols.