A family associated outbreak of Mycoplasma pneumoniae infection in a hospital ward / 中华流行病学杂志

Objective To describe the epidemiological and serological features on a family associated outbreak caused by Mycoplasma pneumoniae (MP) infection occurred in Beijing in August 2007.Methods Mutual exposure of the family members was investigated and retrospective medical record was reviewed for the hospitalized patients.Serum antibodies to MP were measured and chest X-rays were taken for all the family members.Results This family consisted of 5 members,with fixed members as the boy (13 years old ),his father (43 years old) and mother (44 years old),grandmother (64 years old) and uncle (32 years old ) who was involved in taking care of the sick boy and his father.During 23 days of the event,four of all the five family members were ill.Three (boy,father and uncle) had radiographic pneumonia,whose paired sera all showed a ≥ fourfold increase in antibody titer,and two of them were confnrmed by chest X-ray on day 2 after onset of fever.The grandmother suffered from bronchitis,with positive(PA) serum antibody to MR Serum MP-IgG from the father and uncle was positive,3 days and 2 days after the onset of fever.The chances of contact between grandmother with the boy and uncle with the father were both only in the hospital wards.Only the mother remained asymptomatic,with her serum MP-IgM (-)and MP-IgG ( + )for which the blood sample was collected 37 days after close contact with the boy.The longest time of exposure to the patients was between mother and the boy but only the mother did not increase her total workload or feeling for fatigue.Conclusion Results of MP-IgG from post-infection did not completely defend against the repeated MP infection.Combined risk factors as index patients with severe cough,prolonged close contact,poorly ventilation of the environment,and family members with excessive fatigue might work as the causes of this family MP outbreak.

An analysis of clinical characteristics and risk factors of cirrhosis-related hepatocellular carcinomas in patients with hepatitis C virus infection / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To study the epidemiological and clinical characteristics and risk factors of cirrhosis-related hepatocellular carcinomas (HCC) in patients with hepatitis C virus (HCV) infection.</p><p><b>METHODS</b>Eighty-nine compensated and decompensated HCV cirrhosis patients were analyzed and followed-up. The main clinical and laboratory variables were analyzed as incidence factors of HCC with univariate analysis and multivariate analysis regression models.</p><p><b>RESULTS</b>The patients were followed-up for 86 months. Thirty-five of the 89 patients had HCC during the 86 months follow-up. Their five and ten-year cumulative incidences were 16.9% and 40.4% respectively. Of the 35 HCC patients, 4 had a family history of hepatitis C, 12 had a familial history of HCC, and 7 had a history of alcohol ingestion. Five and ten-year cumulative incidences of HCC in patients with hepatic steatosis were 24.6% and 51.0% respectively. Five-year and ten-year cumulative incidences of HCC in patients with non-hepatic steatosis were 8.7% and 26.2% respectively, and the difference in the cumulative incidences between them was significant (P < 0.05). Hepatic steatosis severity was associated with the severity of the cirrhosis. ALT and TBil levels were higher in the HCC group than in the non-HCC group, ALB was lower in the HCC group than in the non-HCC group, and the differences between them were significant (P < 0.05). Child-Pugh score and the severity of the hepatic steatosis during follow-up were independently correlated with HCC.</p><p><b>CONCLUSION</b>HCC is the most important and frequent outcome of chronic hepatitis C cirrhosis. Child-Pugh score and the severity of the hepatic steatosis are related to the risk factors. History of alcohol ingestion and family history of hepatitis C are also related to liver cancer.</p>

An analysis of the pathohistology of liver tissues, clinical features and prognostic factors of chronic hepatitis B virus carriers / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To study the correlations between clinical features and liver pathohistological changes of chronic hepatitis B virus (HBV) carriers and to discuss the factors which may influence the prognosis.</p><p><b>METHODS</b>Ninety HBV carriers who had liver biopsies were enrolled in this study.</p><p><b>RESULTS</b>(1) The mean follow-up period of the patients was 118 weeks. (2) Fifty-four patients (60.0%) had G1 hepatitis and 21 (23.3%) had G2 hepatitis. The fibrosis stages were graded as S1(42) and S2(21). (3) There were significant age differences among S0, S1 and S2. (4) There were significant differences in aminotransferase levels between patients who had a normal liver histology and those who had mild hepatitis. (5) The grades of liver inflammation were not correlated with the titers of HBeAg and HBV DNA in sera. The stages of liver fibrosis were not correlated with the titers of HBVDNA in sera. Most of the HBeAg negative patients progressed to S2. (6) There were significant differences in spleen dimensions measured by ultrasonography between S0, S1 and S2 patients. (7) During the follow-up period serum aminotransferase (ALT) levels remained normal in 60 patients (group A); 22 patients had transient elevations (group B), and 8 patients had persistent increases (group C). There were significant differences of the ratios of S0 and S2 cases among patients in groups A, B and C. (8) Age and fibrosis stages were predictive factors of liver cirrhosis.</p><p><b>CONCLUSIONS</b>Most chronic HBV carriers had mild inflammatory histological changes in their livers and also had different degrees of liver fibrosis. This follow-up study shows that some of those carriers should have had antiviral therapy.</p>

Significance of serum carnitine in patients with liver diseases / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To determine serum carnitine levels in patients with liver diseases and to investigate their significance.</p><p><b>METHODS</b>25 patients with acute viral hepatitis, 34 with chronic viral hepatitis, 22 with post hepatitis cirrhosis with normal renal function, 9 with post hepatitis cirrhosis but with renal disfunction, and 40 healthy subjects (serving as controls) were enrolled in this study. An enzymatic cycling method was used to determine the serum free carnitine levels.</p><p><b>RESULTS</b>The serum free carnitine level was (48.3+/-10.2)micromol/L in the healthy control group. It was (35.2+/-13.2)micromol/L in the acute viral hepatitis group, (36.5+/-9.9)micromol/L in the chronic viral hepatitis group, (45.0+/-11.0)micromol/L in the post hepatitis cirrhosis with normal renal function group, and (83.6+/-50.4)micromol/L in the post hepatitis cirrhosis with renal dysfunction group. Serum free carnitine levels in the acute viral hepatitis and chronic viral hepatitis groups were significantly lower than those in the healthy controls. There were no significant differences in serum free carnitine levels of the post hepatitis cirrhosis group and the normal control group.</p><p><b>CONCLUSIONS</b>Patients with liver diseases can have carnitine metabolism errors. One of the secondary carnitine lack causes is liver disease.</p>

Significance of blood HCV RNA screening in the prevention of post-transfusion hepatitis C / 中华实验和临床病毒学杂志

<p><b>BACKGROUND</b>To investigate the significance of blood HCV RNA screening in the prevention of post-transfusion hepatitis C.</p><p><b>METHODS</b>Totally 56,400 anti-HCV negative blood samples collected from Jan. 2000 to Dec. 2003 were tested for HCV RNA by RT-PCR, and the patients who received the HCV RNA negative blood were followed up.</p><p><b>RESULTS</b>The HCV RNA positive rate was 2.5 per thousand (146/56,000) and none of the patients followed up suffered from HCV infection.</p><p><b>CONCLUSION</b>HCV RNA screening for the anti-HCV negative blood samples is very effective and feasible for prevention of post-transfusion hepatitis C.</p>

Serum HBV-DNA level can predict treatment effectiveness in patients with chronic hepatitis B using interferon-alpha-2a / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To evaluate the correlation between the efficacy of interferon-alpha-2a and the kinetics of viral load in serum.</p><p><b>METHODS</b>The authors conducted a trial including 58 patients with chronic hepatitis B. Patients were treated with interferon-alpha-2a three times a week for 6 months. Viral kinetics were assessed by serial quantitive measurements of HBV-DNA.</p><p><b>RESULTS</b>A significant decline of serum HBV-DNA was seen after interferon-alpha-2a administration for 1 month, the decreases were (2.50 +/- 0.44) log10, (1.62 +/- 1.12) log10 and (1.05 +/- 1.35) log10 for complete responders, partial responders and no-responders, respectively. After 1 month of treatment, HBV-DNA level was (3.99 +/- 0.91) log10 for complete responders versus (5.63 +/- 1.31) log10 for partial responders, and (6.69 +/- 1.42) log10 for no-responders (P < 0.05). Multivariate analysis suggested that undetectable serum HBV-DNA after 1 month of interferon-alpha-2a treatment was associated with better efficacy; higher baseline ALT or/and no family history were also correlated with better treatment outcomes.</p><p><b>CONCLUSION</b>Kinetics of HBV-DNA level under interferon-alpha-2a treatment are highly predictive of therapeutic response.</p>

Differential clinical diagnostic parameters of acute hepatitis B and flare of chronic HBV infection / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To evaluate useful clinical diagnostic parameters for differentiating acute hepatitis B and flare of chronic HBV infection.</p><p><b>METHODS</b>Using PCR method to detect viral level in the patient's serum, HBV marker was detected by ELISA kit. Liver function was also detected.</p><p><b>RESULTS</b>The patient can be diagnosed as acute hepatitis B if a patient has one of the following parameters: (1)HBV-DNA negative on admission. (2) When the patient's ALT was lower than 400 IU/L, HBV-DNA was negative or HBsAg became negative or HBeAg/HBeAb seroconverted.</p><p><b>CONCLUSION</b>The viral DNA level, HBV marker and ALT can help differentiate acute hepatitis B and flare of chronic HBV infection.</p>

Therapeutic effect of levamisole plus HBV vaccine and dipyridamole on patients chronically infected by HBV with precore mutation / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To evaluate the incidence of precore mutation in HBeAg negative HBV infected patients and the therapeutic effect of the immune therapy (levamisole + HBV vaccine + dipyridamole) on patients chronically infected by HBV with precore mutation.</p><p><b>METHODS</b>The precore region of HBV from the HBeAg (-) chronic hepatitis patients was sequenced and the patients suffered from HBV with precore mutation were treated with immune therapy.</p><p><b>RESULTS</b>The precore mutation rate was 10/12. The therapeutic effect of the immune therapy on the precore mutation patients (5/7) was better than that on the HBsAg(+), HBeAg(+) patients (2/11), P less than 0.05.</p><p><b>CONCLUSION</b>The precore mutation rate was quite high in the HBsAg(+), HBeAg(-) patients we studied. The immune-therapy has some therapeutic effects on the patients with precore mutation. But the number of cases was too small, further study is needed.</p>

Dynamics of HBV-DNA level in acute hepatitis B / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To verify the mechanism of the hepatitis B viral clearance using clinical data.</p><p><b>METHODS</b>Viral level and HBV marker in serum were analyzed in 12 patients with acute hepatitis B.</p><p><b>RESULTS</b>The clearance of hepatitis B virus occurred before the patients were hospitalized in 66.7% of patients. The viral level and the A value of HBsAg;HBeAg declined gradually during hospitalization.</p><p><b>CONCLUSIONS</b>In most of patients with acute hepatitis B in the study, the virus was cleared without destruction of infected cells.</p>