Research Progress in Diagnostic Reference Levels in Interventional Radiology / 中国医学科学院学报

During interventional procedures,subjects are exposed to direct and scattered X-rays.Establishing diagnostic reference levels is an ideal way to optimize the radiation dose and reduce radiation hazard.In recent years,diagnostic reference levels in interventional radiology have been established in different countries.However,because of the too many indicators for characterizing the radiation dose,the indicators used to establish diagnostic reference levels vary in different countries.The research achievements in this field remain to be reviewed.We carried out a retrospective analysis of the definition,establishment method,application,and main factors influencing the dose difference of the diagnostic reference level,aiming to provide a basis for establishing the diagnostic reference level for interventional procedures in China.

Ursolic Acid Prevents Retinoic Acid-Induced Bone Loss in Rats / 中国结合医学杂志

OBJECTIVE@#To examine the effects of ursolic acid (UA) on mitigating retinoic acid (RA)-induced osteoporosis in rats.@*METHODS@#Fifty female Sprague-Dawley rats were randomly divided into the control group (n=10) and the osteoporosis group (n=40). The 40 osteoporosis rats were induced by 75 mg/(kg•d) RA once daily for 2 weeks, and then were randomly assigned to vehicle control (model), low-, middle-, and high-dose UA [(UA-L, UA-M, UA-H; 30, 60, 120 mg/(kg•d), respectively] groups (10 rats each). UA were administered once daily to the rats from the 3rd weeks for up to 4 weeks by gavage. Bone turnover markers [serum alkaline phosphatase (ALP), osteocalcin (OCN), urine deoxypyridinoline (DPD)] and other parameters, including serum calcium (S-Ca), serum phosphorus (S-P), urine calcium (U-Ca), urine phosphorus (U-P), and bone mineral density (BMD) of the femur, 4th lumbar vertebra and tibia, bone biomechanical properties and trabecular microarchitecture, were measured.@*RESULTS@#The osteoporosis in rats was successfully induced by RA. Compared with the model group, UA-M and UA-H significantly reversed the RA-induced changes in S-P, U-Ca, U-P, ALP, OCN and urine DPD ratio and markedly enhanced the BMD of right femur, 4th lumbar vertebra and tibia (Plt;0.05 or Plt;0.01). Further, biomechanical test and microcomputed tomography evaluation also showed that UA-H drastically improved biomechanical properties and trabecular microarchitecture (Plt;0.05 or Plt;0.01).@*CONCLUSION@#UA could promote bone formation, increase osteoblastic activity and reduce osteoclastic activity in rats, indicating that UA might be a potential therapeutic of RA-induced acute osteoporosis.

Effects of CeA lesions on the initiation and expression of sodium appetite in sodium-deficient rats / 中国应用生理学杂志

OBJECTIVE@#To investigate the effects of central nucleus of amygdala (CeA) lesion on the initiation and expression of sodium appetite in sodium-deficient rats.@*METHODS@#Three groups of SD rats (n=6 in each group) were treated with bilateral CeA lesion, sham lesion or no lesion. After the recovery, the rats were fed with low-sodium diets for 14 days to establish a sodium-deficient rat model. The double-bottle selection in single cage test was used to observe the intake of 0.3 mol/L NaCl and DW in 5 timepoint with 24 hours in sodium-deficient rats. Immunofluorescence staining of aldosterone-sensitive neurons in the nucleus tractus solitarii (NTS)was used to investigate the effect of CeA lesion or not on the activity of aldosterone-sensitive neurons in rats with or without sodium deficiency.@*RESULTS@#After fed with low-sodium diet for14 days, the volume and preference rate of 0.3 mol/L NaCl intake of the rats within 24 h were significantly increased compared with those before low-sodium diet (P＜0.01). The intake volume and the preference rate of 0.3 mol/L NaCl in CeA lesion rats were significantly decreased than those in CeA sham lesion rats and normal rats in the sodium-deficient condition (P＜0.01). The CeA lesion had no effects on the activity of aldosterone-sensitive neurons in NTS in rats with low-sodium diet.@*CONCLUSION@#Low-sodium diet induces an increase in the expression of sodium appetite in rats. CeA lesions inhibit the behavioral expression of sodium appetite in sodium-deficient rats but have no effects on the initiation of sodium appetite in rats with sodium-deficient rats.

Dynamics of routine blood tests in BALB/c mice with Babesia microti infec-tion / 中国血吸虫病防治杂志

Objective To understand the changes in body weight,spleen weight and complete blood cells in BALB/c mice infected with Babesia microti.Methods For the infection group,six weeks old BALB/c mice were injected intraperitoneally with a dose of 100μL of B.microti infected blood(20％RBC infection rate,each mouse).For the determination of the progres-sion of B.microti infection up to 28 days of the infection,the microscopic visualization of thin blood smears of tail blood stained with Giemsa staining was performed in the infection group.The experiment was carried out at different intervals on days 0,7,14,21,and 28 after the infection,respectively.The mice were sacrificed,and spleens were collected and weighed,and the body weight of the mice was also determined.The blood cells of the mice were analyzed by using Mindray BC-5300 Vet animal automatic hematology analyzer.Results On the first day after the infection,B.microti was visualized in RBC of the infection group.The significantly highest infection rate(55％)appeared on the seventh day of the infection,and then steadily decreased;the mice attained the latent infection phase on the 28th day post-infection,when the parasite could not be visualized in the pe-ripheral blood.The mice in the infected group acquired a significantly lowest body weight on the 7th day of the infection,and then gradually returned to normal.The weight of the spleen was the significantly highest on the 14th day of the infection,and then consistently decreased.On the 28th day of infection,the spleen weight was still higher than that of the control group.There were no significant changes in the number of white blood cells(WBC),lymphocytes,and eosinophils in the infected mice;and altered levels were all within the normal mouse reference range.The number of red blood cells,hemoglobin,and platelet count in the infected mice were decreased to the lowest level when the B.microti infection rate achieved to the highest,and then gradu-ally returned to the normal levels.Conclusions B.microti infection can cause body weight loss,splenic weight gain,and re-duction in the number of erythrocytes and platelets in whole blood of the mice.Besides,the whole blood cell analyzer has a diag-nostic significance in the identification of babesiosis.

Kinematic analysis of a posterior-stabilized knee prosthesis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The goal of total knee arthroplasty (TKA) is to restore knee kinematics. Knee prosthesis design plays a very important role in successful restoration. Here, kinematics models of normal and prosthetic knees were created and validated using previously published data.</p><p><b>METHODS</b>Computed tomography and magnetic resonance imaging scans of a healthy, anticorrosive female cadaver were used to establish a model of the entire lower limbs, including the femur, tibia, patella, fibula, distal femur cartilage, and medial and lateral menisci, as well as the anterior cruciate, posterior cruciate, medial collateral, and lateral collateral ligaments. The data from the three-dimensional models of the normal knee joint and a posterior-stabilized (PS) knee prosthesis were imported into finite element analysis software to create the final kinematic model of the TKA prosthesis, which was then validated by comparison with a previous study. The displacement of the medial/lateral femur and the internal rotation angle of the tibia were analyzed during 0-135° flexion.</p><p><b>RESULTS</b>Both the output data trends and the measured values derived from the normal knee's kinematics model were very close to the results reported in a previous in vivo study, suggesting that this model can be used for further analyses. The PS knee prosthesis underwent an abnormal forward displacement compared with the normal knee and has insufficient, or insufficiently aggressive, "rollback" compared with the lateral femur of the normal knee. In addition, a certain degree of reverse rotation occurs during flexion of the PS knee prosthesis.</p><p><b>CONCLUSIONS</b>There were still several differences between the kinematics of the PS knee prosthesis and a normal knee, suggesting room for improving the design of the PS knee prosthesis. The abnormal kinematics during early flexion shows that the design of the articular surface played a vital role in improving the kinematics of the PS knee prosthesis.</p>

Genetic polymorphisms of IL-28B are associated with sustained virologic response in patients with chronic hepatitis C / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To explore the relationship between polymorphism in the interleukin (IL)-28B gene and sustained virologic response (SVR) in chronic hepatitis C (CHC) patients.</p><p><b>METHODS</b>A total of 220 patients with CHC were prospectively treated with pegylated-interferon (peg-IFN) in combination with ribavirin (RBV) for 48 weeks, and followed-up for an additional 24 weeks. All patients were genotyped for the rs8099917 polymorphism and correlations with antiviral efficacy were determined by statistical analysis.</p><p><b>RESULTS</b>One-hundred-and-eighty-two (82.7%) of the patients achieved end-of-treatment virological response (ETVR). Significantly more patients in the ETVR group carried the rs8099917 genotypes of TT (93.5%) and GT+GG (68.8%), compared to the patients who did not achieve ETVR (X2=23.287, P less than 0.01). In addition, the patients who achieved SVR also represented significantly higher rates of both genotypes (TT: 86.2% and GT+GG: 60.6%; X2=15.531, P less than 0.01). In the SVR group: TT vs. GT+GG: odds ratio (OR)=4.063, 95% confidence interval (CI): 1.972-8.369; X2=15.531, P less than 0.01. In the RP group: TT vs. GT+GG: OR=0.246, 95% CI: 0.119-0.507; X2=15.531, P less than 0.01).</p><p><b>CONCLUSION</b>The IL-28B rs8099917 genotype is closely related to antiviral response of patients with chronic hepatitis C. Compared to carriers of the GT and GG genotypes, carriers of the TT genotype have higher SVR rates and lower RP rates. The TT genotype may be an important predictor of antiviral efficacy.</p>

Relationship between the genetic variation in interleukin 28B and response to antiviral therapy in patients with chronic hepatitis C / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Genetic variations at the interleukin 28B (IL-28B) locus are important in predicting outcome following therapy for chronic hepatitis C virus (HCV) infection. The aim of this research was to evaluate the role of IL-28B single nucleotide polymorphism (SNP) variations in Chinese patients undergoing pegylated interferon-α plus ribavirin (PEG-IFN-α/RBV) treatment.</p><p><b>METHODS</b>To determine the effect of IL-28B variation on the response to HCV therapy, these variants were genotyped in a cohort of 220 patients who were chronically infected with HCV and received combined PEG-IFN-α/RBV therapy.</p><p><b>RESULTS</b>The proportions of rs12979860 CC, CT, and TT genotypes were 71.4%, 25.0%, and 3.6% respectively, in the sustained virological response (SVR) group; 15.8%, 60.5%, and 23.7% respectively, in the null virological response (NVR) group; and 38.1%, 52.4%, and 9.5% respectively, in the relapse (Rel) group (P < 0.05). Logistic regression analysis showed that, compared to those having the CC genotype, CT heterozygotes had an increased risk of NVR and Rel (OR = 10.95, 95%CI = 4.12-29.11, P = 1.5×10(-7) and OR = 3.93, 95%CI = 1.86-8.32, P = 2.1×10(-4) respectively). The RNA quantification assay showed that patients with genotype CC exhibited much higher levels of IL-28 expression than those with genotype CT or TT (P < 0.001).</p><p><b>CONCLUSIONS</b>The IL-28B SNP rs12979860 genotype was related to the effectiveness of HCV therapy: patients with the CC rs12979860 genotype had higher rates of SVR than those with the CT or TT genotype, and the CC genotype revealed a significantly higher level of IL-28 mRNA expression.</p>

A five-year follow-up of one hundred and thirty-six patients of hepatitis C / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the clinical outcome and effect of interferon treatment on patients with chronic hepatitis C.</p><p><b>METHODS</b>136 cases of patients with chronic hepatitis C were followed up by methods of retrospective survey combined with prospective study. SPSS16. 0 was used to perform chi-square test and multiple logistic regression.</p><p><b>RESULTS</b>136 cases of patients were infected with HCV virus mainly through blood and blood products transfusion. They were diagnosed mainly between 2000 and 2005. 98 cases of them had anti-viral treatment with interferon and ribavirin, while the rest did not; 12 new cases developed HCV-related cirrhosis or liver carcinoma in five years, which accounted for 8.8% of the total. Among 76 cases once treated with interferon, 46 cases (60.5%) relapsed in five years. For patients with age < 40, the rates of cirrhosis and liver cancer were 0, and patients with age ≥ 40 but < 60 years, the rates of cirrhosis and liver cancer were 12.5% (7/56 cases), while for those ≥ 60 years old the rates were 35.7% (10/28 cases). The difference was significant ( B = 0.111, Wald = 4.324, P = 0.038) as analysed by logistic regression. The rates of cirrhosis and liver cancer were zero for those with normal or within twice the upper normal AST limit in five years, 43.5% (10/23 cases) for those with AST ranging from 2 to 4 fold the upper normal limit, and 58.3% (7/12 cases) for those with AST higher than four times the upper normal limit. The difference was also significant ( B = 2.184, Wald = 5.443, P = 0.02) by logistic regression analysis. The rate of relapse was 29.7% (11/37 cases) for those using pegylated interferon and 89.7% (35/39 cases) for those using interferon. The difference was significant ( Result of logistic regression showed-B = -2.077, Wald = 4.352, P = 0.037). The rate of relapse was 100% (15/15 cases) for those with treatment less than 24 weeks, 76.2% (16/21 cases) for those with treatment more than 24 weeks but less than 48 weeks, and 37.5% (14/40 cases) for those with treatment more than 48 weeks. The difference was significant (Result of logistic regression showed-B = -1.632, Wald = 6.651, P = 0.01). 42 cases of the relapsed (91.3%) were administrated with interferon once again with ideal effect.</p><p><b>CONCLUSION</b>Hepatitis C virus infection increases the risk of liver cirrhosis and liver cancer. Interferon combined with ribavirin therapy could effectively control the virus and improve outcomes. We can reduce the incidence of relapse by choosing the treatment of pegylated interferon instead of interferon and by completing the full treatment.</p>

Quality of life in patients with chronic hepatitis C after PEG-Interferon a-2a therapy / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To evaluate the quality of life (QOL) in the patients with chronic hepatitis C (CHC) after PEG-Interferon a-2a therapy.</p><p><b>METHODS</b>A study based on 102 CHC patients (group A, before PEG- Interferon a-2a therapy, T0) and 44 healthy persons (group B) was carried out using the general quality of life inventory (GQOLI-74) questionnaire, and QOL were compared between the two groups. Patients in group A were divided into subgroup A1 (72 patients ) which was given PEG-Interferon a-2a plus Ribavirin for one year and subgroup A2 (30 patients) without any antivirus therapy. QOL of patients in these two subgroups was investigated using GQOLI-74 questionnaire on the end of PEG-Interferon a-2a plus Ribavirin therapy (T1) and half one year after the end of PEG-Interferon a-2a plus Ribavirin therapy (T2). QOL of CHC patients (group A1 and A2) were compared at T0, T1 and T2, respectively.</p><p><b>RESULTS</b>Compared with group B, patients in group A had lower QOL (P < 0.05) on other scales and total scores of the GQOLI-74 questionnaire except psychological function(P > 0.05). Both on T1 and T2, patients in subgroup A1 had higher QOL on physical function, psychological function, social function and total scores than patients in subgroup A2 at the same time (P < 0.05). Patients in subgroup A1 at T1 had higher QOL on physical function, psychological function, social function and total scores than at T0 (P < 0.05). Patients in subgroup A1 at T2 had higher QOL on social function than that at T1 (P < 0.05).</p><p><b>CONCLUSIONS</b>QOL of CHC patients is more impaired than healthy persons. PEG-Interferon a-2a therapy will improve the QOL.</p>

The effects of diethylene glycol on liver function / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the hepatotoxic effects of accidental intravenous diethylene glycol (DEG.) poisoning in patients with liver disease.</p><p><b>METHODS</b>Clinical data and liver function results were obtained from 64 patients with liver diseases who had been accidentally treated with diethyl glycol-contaminated agent and 45 cases with hepatorenal failure. The hepatotoxic effects of diethylene glycol DEG on the patients with liver diseases were assessed by multivariable logistical regression analysis.</p><p><b>RESULTS</b>Of the 64 cases with liver diseases, 15 cases (23.4%) developed toxic presentations following the accidental administration of DEG. All affected cases were male. Twelve of the 15 poisoned patients (80%), died within 7 days of exposure to DEG. The most common clinical manifestations included kidney damage, renal failure, metabolic acidosis, and nerve system disturbances. The intravenous administration of DEG resulted in only mild liver function impairment. In terms of risk factors, both gender (r = 4.266, P less than 0.05) and the severity of jaundice prior to DEG administration were related to the occurrence of toxin-induced renal failure (r = 7.640, P less than 0.01).</p><p><b>CONCLUSIONS</b>DEG may worsen liver damage in patients with liver diseases.</p>

MiR-196a-2 gene polymorphism and the antiviral therapy of chronic hepatitis C / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To investigate the relationship between the SNP rs11614913 on miR196a-2 gene and the treatment effects of Peg-IFN-a plus Ribavirin on chronic hepatitis C patients.</p><p><b>METHODS</b>The total 139 patients of chronic hepatitis C infection who received the treatment of Peg-IFN-alpha-2a or Peg-IFN-alpha-2b plus Ribavirin were enrolled in this study. The patients were divided into two groups: sustained virological response (SVR) (n = 82) group and non virological response (NVR) or recurrence (n = 57) group. Blood samples were collected and chromosomal DNA was extracted. The miR-196a-2 polymorphism was determined with the method of polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP).</p><p><b>RESULTS</b>In our study, there was statistically association between miR-196a-2 polymorphism and the antiviral therapy efficacy of hepatitis C patients. There was statistically significance in the CT genotype and the TT genotype of miR-196a-2 between the two groups [P = 0.009, A = 2.924 (1.285 -6.652)]. There was statistically significance in the CC genotype and the TT genotype between the two groups [P = 0.036, A = 3.091(1.052 -9.078)]. There was statistically significance in the C allele and the T allele between the two groups [P = 0.036, A = 3.091 (1.052 - 9.078)].</p><p><b>CONCLUSION</b>These findings suggested that the rs11614913 SNP in miR - 196a-2 be associated with the antiviral therapy efficacy of hepatitis C patients, and the TT genotype or T alleles be associated with the SVR while the CC genotype or C allele could be related to the NVR or recurrence.</p>

A pilot study of peginterferon alfa-2a combined with short-term lamivudine therapy in HBeAg-positive chronic hepatitis B patients / 中华肝脏病杂志

<p><b>OBJECTIVES</b>To investigate the efficacy of by combining a 12-week course of lamivudine in those HBeAg-positive hepatitis B patients receiving peginterferon alfa-2a (peg-IFN alpha-2a) therapy.</p><p><b>METHODS</b>A total of 58 patients initiated a 52-week course of peginterferon alfa-2a were enrolled and divided into 3 groups. The patients with HBV DNA undetectable or HBeAg negative at week 12 were divided into group A, in this group treatment continued to week 52 with peg-IFN alpha-2a alone; The rest patients were divided into group B1 and B2, in group B1, lamivudine was combined at a course of 12 weeks, while in group B2 treatment continued to week 52 with peg-IFN alpha-2a alone. Clinical responses were assessed at week 52.</p><p><b>RESULTS</b>8 out of 58 patients achieved undetectable HBV DNA or HBeAg loss at week 12 and divide into group A. In this group the HBV DNA loss rate, HBeAg seroconversion rate, HBsAg loss rate and ALT normalization rate were 100% (8/8), 75% (6/8), 0% (0/8) and 100% (8/8) respectively at the end of treatment. In this group the HBV DNA loss rate, HBeAg seroconversion rate, HBsAg loss rate and ALT normalization rate were 100% (8/8), 75% (6/8), 0% (0/8) and 100%(8/8) respectively at the end of treatment. The rest 50 patients without early response to peg-IFN alpha-2a at week 12 were divided into group B1 (24 patients enrolled) and B2 (26 patients). At the end of treatment, the HBV DNA loss rate, HBeAg seroconversion rate, HBsAg loss rate and ALT normalization rate in Group B1 were 50% (12/24), 38% (9/24), 4% (1/24) and 63% (15/24) respectively, and 31% (8/26), 27% (7/26), 0% (0/26) and 35% (9/26) respectively in group B2.</p><p><b>CONCLUSION</b>Those patients with early responses to peg-IFN alpha-2a therapy can achieve high clinical responses at the end of 52-week treatment. The combining therapy of lamivudine for a course of 12-weeks can improve the clinical responses for the patients without early responses to peg-IFN alpha-2a.</p>

Association between the serum HBV DNA loads normalized to hepatic parenchyma cell volume and the liver histopathologic inflammation gradings in the immune clearance phase / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the relationship between the serum HBV DNA loads normalized to hepatic parenchyma cell volume and the liver histopathologic inflammation gradings in the immune clearance phase during the natural history of hepatitis B.</p><p><b>METHODS</b>Serum HBV DNA loads were detected by fluorescence polymerase chain reaction and normalized to hepatic parenchyma cell volume. The association between normalized HBV DNA loads and liver inflammation histopathologic grade were analyzed.</p><p><b>RESULTS</b>The serum HBV DNA loads in patients with liver inflammation histopathologic grading 1, 2, 3 and 4 were 8.20*10(5)+/-9.11*10, 1.36*10(6)+/-5.96*10, 8.12*10(5)+/-8.01*10 and 2.08*10(6)+/-3.69*10 copies/ml, respectively (P more than 0.05). But the serum HBV DNA loads normalized to hepatic parenchyma cell volume in their located fibrosis stage were 9.24*10(8)+/-935, 5.33*10(9)+/-756, 1.06*10(10)+/-1770 and 3.31*10(11)+/-518 copies/ml, respectively (P less than 0.05).</p><p><b>CONCLUSION</b>The serum HBV DNA load normalized to hepatic parenchyma cell volume in patients with different fibrosis stages is associated with liver histopathologic inflammation gradings.</p>

Venous diethylene glycol poisoning in patients with preexisting severe liver disease:a clinical analysis / 中华传染病杂志

Objective To describe the clinical features of venous diethylene glycol poisoning and to identify factors correlating with such kind of poisoning.Methods Retrospective chart review was performed to analyze the epidemiology,clinical presentation,hepatorenal functions,bemodynam- ics and pathological characteristics of 64 patients with severe liver diseases who received intravenous diethylene glycol.Comparative analyses of correlating factors and causes of poisoning were based on the presence or absence of poisoning.Results Fifteen cases of poisoning were reported.After a 5 day incubation period,all poisoned patients displayed acute renal failure and 11 cases with digestive tract symptoms and(or) symptom exacerbations were noted.Neurological system impairment was observed in 10 cases after 2 weeks.Metabolic acidosis developed in 13 cases.Poisoned patients exhibited signif- icantly lower red blood celI(RBC)[(2.32?0.76)?10~(12)/L],hemoglobin(Hb) [(79.5?23.6)g/L] value and higher white blood cell(WBC)[(9.78?3.75)?10~9/L] count.Renal biopsy of poisoned patients revealed acute tubular necrosis and interstitial nephritis.Twelve poisoned patients died.Sig nifieant differences were found between groups regarding preexisting severe hepatitis,ascites,renal disease and diuretic therapy.Prior to diethylene glycol injections,mean values of neutrophil,blood urea nitrogen(BUN),creatinine(Cr) and calcium and phosphorousions differed significantly between groups.Conclusions Features of venous diethylene glycol poisoning include oliguric acute renal fail- ure,metabolic acidosis,digestive symptoms,nervous system impairment and a high probability of anemia and WBC proliferation.Mortality is high.Correlative factors include preexisting severe liver disease,renal disease and infection.

The clinical features and natural history of post-transfusion hepatitis C / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To study the clinical features and natural history of post-transfusion hepatitis C (PTHC).</p><p><b>METHODS</b>Ninety-nine post-transfusion hepatitis C patients were analyzed using retrospective and prospective study and follow-up.</p><p><b>RESULTS</b>(1) Ninety-nine post-transfusion HCV patients were infected during 1989-1994, mostly between 1990-1992. (2) Ninety patients were diagnosed as chronic hepatitis C, and 9 as hepatic cirrhosis (period of compensation). (3) The intervals between their transfusions and their initial diagnoses of PTHC were 7.4+/-6.6 years in all 99 patients, and the intervals in 9 cirrhosis patients were 12.7+/-5.8 years. (4) Among 63 male patients, 59 cases were chronic hepatitis C and 4 were cirrhosis while among 36 female patients, 31 were chronic hepatitis C and 5 were cirrhosis. There was no significant difference of the ratio for hepatitis C and cirrhosis between the male and female patients (P>0.05). (5) Repeat abnormal liver function occurred accompanied with a fluctuation of ALT elevation in those patients with cirrhosis. (6) No patient developed hepatic carcinoma during the study period.</p><p><b>CONCLUSIONS</b>(1) The possibility of HCV infection by transfusion has declined greatly since 1995 in Guangzhou. (2) Nine of the 99 (9.1%) chronic HCV-infected patients developed a compensated cirrhosis after 12.7+/-5.8 years. (3) For those PTHC patients with repeat abnormal liver functions, interferon combined with ribavirin is recommended to prevent the development of cirrhosis.</p>

Therapy effect of lamivudine combination with alpha interferon on patients with chronic hepatitis B / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To evaluate the short-term therapeutic efficacy and safety of lamivudine (LAM) combining with alpha interferon (IFNalpha) on patients with chronic hepatitis B.</p><p><b>METHODS</b>90 chronic hepatitis B patients with HBV DNA and HBeAg positive were subdivided by 1:1:1 proportion into three groups: (1) LAM+IFN group: 6 months therapy of IFNalpha plus lamivudine followed by 6 months of lamivudine; (2) LAM group: lamivudine alone for 12 months; (3)IFN group: IFNalpha alone for 6 months.</p><p><b>RESULTS</b>At the end of treatment, the HBV DNA undetectable rate in LAM+IFN group (90.0%) was much higher than that in LAM group (80.0%) and IFN group (46.7%) (chi2 = 13.017, P < 0.001). ALT normalization occurred 90.0%, 80.0%, and 53.3% in LAM+IFN group, LAM group, and IFN group, respectively (chi2 = 9.932, P = 0.002). HBeAg/anti-HBe seroconversion rates achieved 46.7%, 13.3%, and 33.3% in LAM+IFN group, LAM group, and IFN group, respectively (chi2 = 7.937, P = 0.005). YMDD mutation was not detected in serum samples from LAM+IFN group patients.</p><p><b>CONCLUSIONS</b>LAM+IFN therapy for chronic hepatitis B is tolerated and more effective than IFN monotherapy in inhibiting viral replication and getting ALT normalization. The HBeAg/anti-HBe seroconversion rate with LAM+IFN therapy is higher than that with lamivudine monotherapy. LAM+IFN combination therapy seems to inhibit or postpone YMDD variants appearing in patients with chronic hepatitis B.</p>

Pathological changes of the livers from 39 patients with hepatic failure / 中华传染病杂志

Objective To explore the pathological changes of the livers from hepatic failure (HF)patients and its association with clinical disease stages.Methods Thirty-nine patients with liver failure caused by HBV infections were investigated,and none accompanied with hepatocellular carci- noma.The sections of tissue were taken from the liver after liver transplantation and stained with he- matoxylin eosin(H&E)or RT(reticular fiber)staining.The pathological features were analyzed and compared between the clinical and pathological diagnosis.Results 1.The range and the grade of the pathological changes were all well-proportioned in the whole liver but quite asymmetrical in the same spicemen.2.4 cases with clinical diagnosis of cirrhosis(active stage)were in accordance with the pathological diagnosis.Only 17 in 35cases can be pathologically diagnosed as chronic severe hepatitis (SH),while the other 18 cases were pathologically diagnosed as cirrhosis(active stage).Conclu- sion There were a great inconsistency between the clinical and pathological diagnosis.