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Objective To analyze the efficacy of entecavir (ETV) combined with Peg IFNα-2b in chronic hepatitis B ( CHB) patients with low levels HBsAg following initial ETV treatment.Methods Sixty-nine CHB outpatients achieving serum HBsAg ＜2 000 IU/mL and HBV DNA＜100 IU/mL following initial ETV treatment in Pujiang People's Hospital and the First Affiliated Hospital of Zhejiang University School of Medicine from January 2014 to January 2016 were enrolled.Patients were randomly assigned in two groups: 39 patients in combination group received ETV (0.5 mg/d ) and Peg IFNα-2b (1.5 μg· kg－1· week －1, hypodermic injection), and 30 patients in ETV group received ETV (0.5 mg/d) alone.Serum HBsAg quantification, negative conversion rate of HBsAg and HBeAg , and levels of aminotransferase (ALT) were measured at baseline , 12th, 24th, 48th, 72th and 96th week after treatment.Results The levels of HBsAg in the combination group decreased gradually with the prolongation of therapy , which were lower than those in ETV group 24 week after treatment (Z＝－2.566,P＜0.05),and at 48th, 72th and 96th week (Z＝－3.499,－3.825 and －3.864,P＜0.01).Clearance of HBsAg appeared in the combination group at 24th week,the clearance rates were 7.70%(3/39) and 28.20%(11/39) at 24th and 96th week, respectively;while the clearance of HBsAg occurred in ETV group at 96th week, the clearance rate was only 3.30%(1/30).The negative conversion rates of HBsAg in combination group were higher than those in ETV group at 48th,72th and 96th week (P＜0.05 or＜0.01).In the combination group, there were 11 cases of clinical cure , 11 cases of clinical efficacy and 17 cases of clinical effectiveness , while there were 1, 1 and 28 cases in ETV group,respectively.The treatment effect of the combination group was better than that of ETV group(χ2＝18.496,P＜0.01).Serological conversion rates of HBeAg were 30.00%(6/20) and 65.00%(13/20) in combination group at 12th and 96th week, while those were 11.11%(2/18) and 22.22%(4/18) in ETV group at 48th and 96th week.There were significant differences in the HBeAg serological conversion rates at 12th, 24th, 72th and 96th week between two groups (P＜0.05 or ＜0.01). The levels of ALT in combination group increased at 12th and 24th week, which had significant difference compared with ETV group (Z＝－1.236 and －2.658,P＜0.05), and the ALT levels gradually declined 48 week after treatment in combination group and there were no statistical differences between two groups at other time points.The ETV combined with Peg IFNα-2b and low baseline HBeAg levels were associated with the clearance rate of HBsAg (both P＜0.01).Conclusions CHB patients with low HBsAg levels following initial ETV monotherapy can achieve high negative conversion rate of HBeAg and HBsAg with the combination treatment of ETV and Peg IFN α-2b.
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Objective To evaluate the clinical efficacy of Clostridium butyricum tablets in treatment of diarrhea in patients with hepatitis B-related liver cirrhosis.Methods Eighty-seven patients with hepatitis B-related liver cirrhosis and diarrhea were collected from Pujiang People' s Hospital in Zhejiang province during January 2011 and May 2013.According to random number table,patients were divided into Clostridium butyricum treated group (n =44) and control group (n =43).Both groups were given antiviral,liver support,jaundice-relieving and fluid infusion treatments,while patients in Clostridium butyricum group were given Clostridium butyricum tablets (2 tables per time,3 tables per day for 4 weeks) additionally.Diarrhea remission time,improvements in liver function and the complications were observed.Differences in measurement data were compared with t test,and enumeration data were compared with x2 test or rank-sum test.Results The total effective rate in Clostridium butyricum group was 95.45％ (42/44),while that in control group was 74.4％ (32/43) (Z =2.82,P ＜ 0.05).After 4 weeks of treatment,the improvements of alanine aminotransferase (ALT),aspartate transaminase (AST),total bilirubin (TBil),albumin (Alb) and Child-Pugh (CTP) score in Clostridium butyricum group were more marked than those in control group (t =2.13,2.57,4.83,5.93 and 3.30,P ＜ 0.01).Hepatic encephalopathy occurred in 2 patients in control group and none in Clostridium buayricum group.Conclusion Clostridium butyricum has significant curative effect on diarrhea in patients with hepatitis B-related liver cirrhosis,and it can also improve liver function and reduce the incidence of hepatic encephalopathy.
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Objective To explore the clinical effect of octreotide combined with propranlolum in the treatment of portal hypertension combined upper alimentary canal haemorrhage.Methods 63 cases with portal hypertension upper gastrointestinal hemorrhage were randomly divided into two groups,both of the two groups were given same basic medical care,while then one group was treated with octreotide combined with propranlolum,and the other group was given pituitrin.Results There was statistical difference in defecate occult blood disappear time,total effective rate between treatment group and control group (P ＜ 0.05).Conclusion Octreotide combined with propranlolum was more effective to the patients with portal hypertension upper gastrointestinal hemorrhage than pituitrin.
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Objective To investigate the transfer rate of alkaloids in extraction and purification process of Cortex Phellodendri Amurensis (CPA) and to ascertain the optimal purification technology.Methods We purified the alkaloids from Cortex Phellodendri Amurensis by AB-8 macroporous resin.With the contents of berberine hydrochloride and palmatine hydrochloride as the reference indexes,content determination of alcohol extract,sample solution and eluent from AB-8 macroporous resin were determined by HPLC.Results The optimal technology was as follows:using 8-fold 75 %(V/V) ethanol as extract,extracting for 3 times and lasting one hour for each time.The transfer rate of alkaloids was 83.75 %under the above condition.The transfer rate of alkaloids was about 80 %when the concentration of sample solution(pH value being 8 and centrifugation) was 0.1 g/mL,and the transfer rate of alkaloids in eluent was 75.14 %.Conclusion The optimum technology is stable and feasible,and the purification effect of alkaloids from Cortex Phellodendri Amurensis by AB-8 macroporus resin is good.