Application effect of pre-hospital information publicity and education management model in patients with gastrointestinal tumors / 中国实用护理杂志

Objective:To explore the application effect of pre-hospital information publicity and education management model in patients with gastrointestinal tumors.Methods:The inpatients with gastrointestinal tumors who made an appointment in the outpatient department of the Affiliated Hospital of Qingdao University were randomly divided into 225 cases in the control group and 226 cases in the experimental group. The control group was treated according to the routine process, the experimental group implemented pre hospital information education and management, and the patients were individually assessed and health education through the official account of WeChat, Heals mobile education system, telephone communication and WeChat group.Results:After the implementation of pre-hospital information management model, the anxiety and depression scores of patients in the experiment group were (55.89 ± 15.53) and (56.19 ± 17.87), which were significantly better than those in the control group, (60.84 ± 15.42) and (62.28 ± 19.67) ( t = 3.40, 3.43, both P<0.01). The awareness rate of admission related knowledge (74% to 93%) and satisfaction with pre-hospital publicity and education management in the experimental group were also higher than control group ( χ2 values were 5.84-20.28, all P<0.05). The hospitalization rate of patients in the experimental group was 91.15%(206/226), which was significantly higher than that in thecontrol group, 81.78%(184/225), the difference was significant ( χ2 = 8.47, P<0.01). The secondary hospitalization rate in the experimental group was 8.41%(19/226), which was significantly lower than that in the control group, 19.11% (43/225)( χ2 = 10.90, P<0.01). Conclusion:The pre-hospital information publicity and education management model can improve the awareness rate of patients′ admission related knowledge, improve patients′ satisfaction with pre hospital publicity and education management, reduce the secondary hospitalization rate and shorten the average preoperative hospital stay, which is worthy of further promotion and application in clinic.

Effect of Mobile Health for Standardized Management on Women with Gestational Diabetes Mellitus / 中国医学科学院学报

Objective To explore the performance of mobile health platform for standardized management of pregnant women with gestational diabetes mellitus(GDM). Methods A randomized controlled trial was conducted,in which 295 women with GDM were randomized into two groups(traditional management group and mobile health management group)by a computer-generated sequence.The traditional management group accepted standardized GDM management,and the mobile health management group was supplemented by mobile health management based on the standardized management.The glycemic control rate and the incidences of low birth weight,macrosomia,preterm birth,premature rupture of membranes,postpartum hemorrhage after cesarean section,neonatal asphyxia,malformation,and admission to the neonatal intensive care unit were compared between the two groups. Results The glycemic control rate in mobile health management group was significantly higher than that in the traditional management group [(67.22±22.76)%

Long-term follow-up of efficacy of insulin pump in the treatment of children with type 1 diabetes mellitus / 中国当代儿科杂志

OBJECTIVE@#To study the clinical effect of continuous subcutaneous insulin infusion (CSⅡ) versus multiple daily injection (MDI) on blood glucose control in children with type 1 diabetes mellitus (T1DM).@*METHODS@#A retrospective analysis was performed on the medical data of 91 children with T1DM who were treated with CSⅡ for more than 1 year and 75 children with T1DM who were treated with MDI. The two groups were compared in terms of glycosylated hemoglobin (HbA1C) and the recurrence of diabetic ketoacidosis (DKA) to evaluate the difference in the efficacy during the 3-year follow-up. A survey was conducted for the children in the CSⅡ group and their family members to investigate the degree of satisfaction with insulin pump.@*RESULTS@#There was no significant difference in age, sex, and course of diabetes between the CSⅡ and MDI groups at disease onset and in the first year, the second year, and the third year of follow-up (@*CONCLUSIONS@#Children with T1DM treated with CSⅡ have a better control of blood glucose than those treated with MDI, and children and their family members are satisfied with CSⅡ treatment. Therefore, it holds promise for clinical application.

Simultaneous Determination of Pyrrolidine Alkaloids and Their Nitrogen Oxides in Farfarae Flos by UPLC-MS/MS / 中国实验方剂学杂志

<b>Objective::To establish an ultra-high performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) for the simultaneous determination of 15 pyrrolidine alkaloids (PAs) and their nitrogen oxides, and determine the content of the 15 PAs in the 15 batches of Farfarae Flos samples obtained from different sources, in order to understand the distribution status of these 15 PAs in Farfarae Flos from different sources, and provide relevant references for the safe and rational use of this medicinal materials. <b>Method::The method was achieved by Agilent Eclipse Plus C₁₈ column (3.0 mm×150 mm, 1.8 μm) using a mobile phase made up of 0.05%formic acid and 2.5 mmol·L^-1 ammonium formate in water (A)-0.05%formic acid and 2.5 mmol·L^-1 ammonium formate in methanol(B). The flow rate and the injection volume were 0.4 mL·min^-1 and 2 μL, respectively. The column temperature was 40 ℃. The instrument was Agilent 1290-6470 QQQ ultra high performance liquid chromatography-triple quaternary bar mass spectrometer. The components were detected in multiple reaction monitoring mode by mass spectrometry with ionizationmode of ESI⁺. The content of the components measured in the samples was calculated by using the external standard method, and the difference between samples was analyzed based on RSD of different components. <b>Result::The established method had a high sensitivity and good separation degree. The results of methodological investigation met the requirements. The results showed that all of the 15 batches of Farfarae Flos contained PAs and their nitrogen oxides. These PAs had almost the same types of structure. There were significant differences in the content and distribution of PAs in Farfarae Flos obtained from different sources. <b>Conclusion::In general, Farfarae Flos contains pyrrolidine alkaloids and their nitrogen oxides. Senkirkine with a significant hepatotoxicity is the main compound. The content determination of PAs will provide scientific fundaments for the safe and effective use of Farfarae Flos.

Progress in research of clinical trials of herpes zoster vaccines / 中华疾病控制杂志

Herpes zoster (HZ) is more common in middle-aged and elderly people, and is caused by varicella-zoster virus (VZV) that is latent in sensory ganglia. In recent years, due to various reasons, especially the aging of China's population has become more serious, the incidence of HZ in China has risen sharply. Although HZ is self-limited, its complications will still reduce the quality of life of patients and increase the economic burden of patients' families and society. In order to reduce the incidence and improve the quality of life of the elderly in their later years, the development of safe and effective HZ vaccine may be an important and effective measure. This article aims to make a brief review of the progress in research for clinical trials of HZ vaccines, so as to provide a reference for the use of HZ vaccine and the prevention and control of HZ disease in China.

Study on the relationship between screen time and prediabetes in adolescents / 中国实用护理杂志

Objective@#To explore the relationship between screen time and prediabetes in adolescents.@*Methods@#A cross-section study. A total of 532 adolescents aged 12~18 years in Shandong Zibo Vocational Institute were selected by stratified sampling method. The screen time was investigated by questionnaire survey. Measuring fasting fingertip blood glucose, screening for who with potentially abnormal blood glucose, and measuring their fasting venous blood glucose, which is to determine whether it is prediabetes.@*Results@#With the increase of screen time, the risk of prediabetes increased continuously. Compared with adolescents with those who spend 0~119 minute per day screen time, the risk of prediabetes of adolescents with an average daily screen time of 120~239, 240~317, ≥318 minute increased by 0.37%, 2.63%, and 3.57%, respectively. After multi-factor adjustment, the risk of prediabetes with who take 240~317, ≥318 minute per day screen time is still higher than who with the average daily screen time of 0~119 minute, the adjusted OR was 2.502 (95% CI 1.279-4.897), 2.337(95% CI=1.189-4.594).@*Conclusion@#The results of this study show that the longer the screen time, the higher the risk of prediabetes in adolescents, and adolescents should be encouraged to reduce screen time.

Study on the relationship between screen time and prediabetes in adolescents / 中国实用护理杂志

Objective To explore the relationship between screen time and prediabetes in adolescents. Methods A cross-section study. A total of 532 adolescents aged 12～18 years in Shandong Zibo Vocational Institute were selected by stratified sampling method. The screen time was investigated by questionnaire survey. Measuring fasting fingertip blood glucose, screening for who with potentially abnormal blood glucose, and measuring their fasting venous blood glucose, which is to determine whether it is prediabetes. Results With the increase of screen time, the risk of prediabetes increased continuously. Compared with adolescents with those who spend 0～119 minute per day screen time, the risk of prediabetes of adolescents with an average daily screen time of 120～239, 240～317,≥318 minute increased by 0.37% , 2.63% , and 3.57% , respectively. After multi-factor adjustment, the risk of prediabetes with who take 240～317,≥318 minute per day screen time is still higher than who with the average daily screen time of 0～119 minute, the adjusted OR was 2.502 (95% CI 1.279-4.897), 2.337 (95% CI=1.189-4.594). Conclusion The results of this study show that the longer the screen time, the higher the risk of prediabetes in adolescents, and adolescents should be encouraged to reduce screen time.

Effects of germplasm and host tree trunk on endophytic fungal communities in epiphytic Dendrobium catenatum / 中国中药杂志

In order to investigate the effects of germplasm and host tree trunk on endophytic fungal communities in epiphytic Dendrobium catenatum, a total of 3 835 isolates were recovered from roots, stems and leaves of four D. catenatum germplasms attached to one kind of host tree trunk and one germplasm attached to four kinds of epiphyte-host tree trunks. A total of 152 taxa were identified and classified based on the fungal cultural characteristics and phylogenetic analyses of ITS sequences. The taxa were assigned to 60 genera, 35 families, 21 orders and 5 classes of 2 phyla. The results indicated that D. catenatum cultivated in stereo cultivation harbor variety of fungi. The dominant fungal groups were different between Lin'an and Yiwu. Moreover, several groups showed geographical specificity, such as Arthrinium, Coniochaeta, Fusarium, Neofusicoccum and Zopfiella only dominating in Panshan of Lin'an, while Alternaria, Bjerkandera, Cercophora, Nigrospora and Trichoderma only dominating in Shangxi of Yiwu. There was no significant difference in diversity or species richness of endophytic fungi neither among germplasm nor host tree trunk. However, the richness and diversity indices exhibited a strong dependence on tissue type (<0.05). The germplasm and host tree trunk impact the distribution patterns of endophytic fungi less than tissue type. Nevertheless, the relative frequencies of the dominant fungal groups were different among germplasms or host tree trunk types. Furthermore, there were some fungal species specific to certain germplasm or host tree trunk. This might be due to the distinctions in growth traits and chemical compositions of D. catenatum owning to the differences in D. catenatumgenetic background and microenvironment of host tree. Most of fungal taxa exhibit tissue specificity or preference. These results provide the basis for the study on the relationship between endophytic fungi and D. catenatum in stereo cultivation mode.

Validity and reliability of the knowledge-attitude-practice scale for prevention catheter associated urinary tract infection measurement / 中国实用护理杂志

Objective To develop a scale of catheter-associated urinary tract infection (CAUTI) knowledge-attitude-practice (KAP) and to test its psychometric properties, and to provide effective assessment tools for clinical evaluation of knowledge, attitude and practice of CAUTI prevention. Methods Based on KAP theory and CAUTI preventive current guideline,the scale was developed by using literature review,Delphi expert inquiry.A questionnaire survey was conducted among 300 medical workers in a third grade A hospital in Qingdao.Exploratory factor analysis and confirmatory factor analysis were both conducted to screen the items further.The psychometric properties of scale was tested. Results The finalized scale included 4 subscales and 45 items,amount to 63.21% of the variance contribution rate. The total Cronbach's alpha was 0.914,and the split half reliability was 0.812.The content validity of the scale was 0.895,while it ranged from 0.846-1.000 for each subscale.The correlation of item-to total was 0.711-0.862,and the correlation coefficient of item-to-item ranged from 0.425-0.564. Conclusions The scale of CAUTI KAP has good reliability and validity. It can be used to evaluate CAUTI related knowledge,attitude and practice level of medical workers.

Clinical Significance of Serum Level of Cyclopropaneoctanoic Acid 2-Hexyl in Patients with Hypertriglyceridemia-Related Disorders / 现代检验医学杂志

Objective To observe the serum level of cyclopropaneoctanoic acid 2-hexyl (CPOA2H) in patients with hypertrilyceridemia-related disorders,and investigate its clinical significance.Methods 53 obese patients (Obese group),62 obese patients after a 3 month low calorie diet (Obese patients after low calorie diet group),46 patients with chronic kidney disease (CKD group),and 60 healthy controls (Control group) were collected from Mar 2013 to Dec 2015 in Shaanxi Provincial People's Hospital.Gas chromatography-mass spectrometry (GC-MS) were used to detect the serum fatty acid and CPOA2H level in four groups.Results Ages,body mass index (BMI),C-reaction protein (CRP),total cholesterol (TC),triacylglycerols (TAG) among four groups had significant difference (F=6.85 ～ 25.36,P＜0.05).Most saturated fatty acid (14 ∶ 0,16 ∶ 0) and monounsaturated fatty acid (14 ∶ 1,16 ∶ 1,18 ∶ 1,20 ∶ 1) in obese group were higher than controls (F=3.251～7.351,P＜0.05).The polyunsaturated fatty acid (18 ∶ 2n-6,20 ∶ 4n-6) in CKD group were lower than controls (F=4.351 ～6.251,P＜0.05).There existed significant difference of serum levels of CPOA2H among four group (F=19.95,P=0.005).Serum level of CPOA2H in control (r=0.63,P=0.033) and CKD group (r=0.61,P=0.044) were positively related with TAG.Serum level of CPOA2H in obese group and obese patients after low calorie diet group were positively related with TC (r=0.70,P=0.011;r=0.48,P=0.021) and TAG (r=0.75,P=0.024;r=0.72,P=0.018).Conclusion Hypertrilyceridemia-related disorders,such as obesity and CKD,presented with elevated serum levels of CPOA2H,it suggested that serum level of CPOA2H is positively related to serum TAG concentration rather than BMI.

The preventive effects of warmer intravenous infusion combimed with local liquid dressing for phlebitis in PN patients / 肠外与肠内营养

Objective:To investigate the effect of warmer intravenous infusion combined with local liquid dressing skin daub methods in short-term PN infusion patients with peripheral venous indwelling needle.Methods:Using the single blind random control method,150 PN patients from October 2015 to August 2016 were included.The control group was given the liquid dressing skin daub with 75 cases,and the observation group was given warmer intravenous infusion jointing local liquid dressing skin daub with 75 cases.To observe the incidence of phlebitis and the pain of the infusion catheter site with the infusion limb and the average maintain time of peripheral venous indwelling needle.Results:The incidence of phlebitis was significantly lower in the observation group than that in the control group (P ＜ 0.01) in two groups.The degree of infusion catheter pain with infusion limb pain wasless painful in the observation group than that in the control group (P ＜ 0.005) in two groups.The degree of catheter site pain after pulling out peripheral venous indwelling needle was less painful in the observation group than that in the control group(P ＜ 0.01) in two groups To compare the average maintain time of peripheral venous indwelling needle was (P ＜ 0.001)in two groups.Conclusion:Warmer intravenous infusion combined with liquid dressing skin daub can effectively prevent the occurrence of phlebitis in patients with peripheral venous indwelling needle PN infusion and improve the comfort.

Feasibility study on monitoring blood pressure of the superficial temporal artery in neonates / 中华护理杂志

Objective To explore the feasibility of monitoring blood pressure via superficial temporal artery catheterization in neonates,which may provide more ways to monitor arterial blood pressure of neonates.Methods By lottery method,64 neonates from NICU who met inclusion criteria and needed arterial blood pressure monitoring were randomly divided into two groups.Thirty-two cases in the experimental group were treated with superficial temporal artery catheterization,while 32 cases in the control group were treated with radial artery catheterization.The success rate of one-time catheterization,indwelling time of catheter,blood pressure and the rate of complications were compared between two groups.Results There were no significant differences between two groups in the success rate of one-time catheterization,indwelling time of catheter,systolic blood pressure and the rate of complications (P＞0.05).Results showed there was significant difference in diastolic blood pressure between two groups(P＜ 0.05).Conclusion Compared with radial artery blood catheterization,neonatal superficial temporal artery catheterization showed equivalent effect,which made it more convenient for observing condition of neonates.

Characteristics of Surface Electromyography in Maximum Isometric Voluntary Contraction of Ankle Dorsiflexors and Plantarflexors in Healthy Middle to Old People / 中国康复理论与实践

@#Objective To establish normal reference range of surface electromyography (sEMG) in related myoelectric activity when maximum isometric voluntary contraction of ankle dorsiflexors and plantarflexors in healthy middle to old people. Methods From Septem-ber to December, 2015, a total of 110 healthy people aged 41 to 75 years were divided into 41 to 50 years group, 51 to 60 years group and>60 years group according to age. The integral electrical values were measured in each subject by sEMG technique and analysis system under maximum isometric voluntary contraction of ankle dorsiflexors and plantarflexors. Results and Conclusion Under ankle dorsiflexion and plantar flexion movement modes, no significant difference was found in the integral electrical values of tibialis anterior muscle, long perone-al muscle, short tibial muscle and gastrocnemius among different groups (F<4.545, P>0.05). No significant difference was found in the inte-gral electrical values of different sides and different genders (F<7.028, P>0.05). Normal reference range for integral electrical values was es-tablished under maximum isometric voluntary contraction of ankle dorsiflexors and plantarflexors in healthy people.

Feasibility study on monitoring blood pressure of the superficial temporal artery in neonates / 中华护理杂志

Objective To explore the feasibility of monitoring blood pressure via superficial temporal artery catheterization in neonates,which may provide more ways to monitor arterial blood pressure of neonates.Methods By lottery method,64 neonates from NICU who met inclusion criteria and needed arterial blood pressure monitoring were randomly divided into two groups.Thirty-two cases in the experimental group were treated with superficial temporal artery catheterization,while 32 cases in the control group were treated with radial artery catheterization.The success rate of one-time catheterization,indwelling time of catheter,blood pressure and the rate of complications were compared between two groups.Results There were no significant differences between two groups in the success rate of one-time catheterization,indwelling time of catheter,systolic blood pressure and the rate of complications (P＞0.05).Results showed there was significant difference in diastolic blood pressure between two groups(P＜ 0.05).Conclusion Compared with radial artery blood catheterization,neonatal superficial temporal artery catheterization showed equivalent effect,which made it more convenient for observing condition of neonates.

Characteristics of Surface Electromyography in Maximum Isometric Voluntary Contraction of Ankle Dorsiflexors and Plantarflexors in Healthy Middle to Old People / 中国康复理论与实践

@#Objective To establish normal reference range of surface electromyography (sEMG) in related myoelectric activity when maximum isometric voluntary contraction of ankle dorsiflexors and plantarflexors in healthy middle to old people. Methods From Septem-ber to December, 2015, a total of 110 healthy people aged 41 to 75 years were divided into 41 to 50 years group, 51 to 60 years group and>60 years group according to age. The integral electrical values were measured in each subject by sEMG technique and analysis system under maximum isometric voluntary contraction of ankle dorsiflexors and plantarflexors. Results and Conclusion Under ankle dorsiflexion and plantar flexion movement modes, no significant difference was found in the integral electrical values of tibialis anterior muscle, long perone-al muscle, short tibial muscle and gastrocnemius among different groups (F<4.545, P>0.05). No significant difference was found in the inte-gral electrical values of different sides and different genders (F<7.028, P>0.05). Normal reference range for integral electrical values was es-tablished under maximum isometric voluntary contraction of ankle dorsiflexors and plantarflexors in healthy people.

Dendrobium officinale stereoscopic cultivation method / 中国中药杂志

The study is aimed to make the most of available space of Dendrobium officinale cultivation facility, reveal the yield and functional components variation of stereoscopic cultivated D. officinale, and improve quality, yield and efficiency. The agronomic traits and yield variation of stereoscopic cultivated D. officinale were studied by operating field experiment. The content of polysaccharide and extractum were determined by using phenol-sulfuric acid method and 2010 edition of "Chinese Pharmacopoeia" Appendix X A. The results showed that the land utilization of stereoscopic cultivated D. officinale increased 2.74 times, the stems, leaves and their total fresh or dry weight in unit area of stereoscopic cultivated D. officinale were all heavier than those of the ground cultivated ones. There was no significant difference in polysaccharide content between stereoscopic cultivation and ground cultivation. But the extractum content and total content of polysaccharide and extractum were significantly higher than those of the ground cultivated ones. In additional, the polysaccharide content and total content of polysaccharide and extractum from the top two levels of stereoscopic culture matrix were significantly higher than that of the ones from the other levels and ground cultivation. Steroscopic cultivation can effectively improves the utilization of space and yield, while the total content of polysaccharides and extractum were significantly higher than that of the ground cultivated ones. The significant difference in Dendrobium polysaccharides among the plants from different height of stereo- scopic culture matrix may be associated with light factor.

Relationship between artesunate influence on the process of TGF-beta1 induced alveolar epithelial cells transform into mesenchymal cells and on idiopathic pulmonary fibrosis / 药学学报

This study is to investigate the effect of artesunate on transforming growth factor-beta1 (TGF-beta1) induced epithelial-mesenchymal transition (EMT) and its possible mechanism. After the in vitro cultured RLE-6TN cells were treated with TGF-beta1 then artesunate intervened on it, after 24 h, expression of the markers of mesenchymal cell was assayed using Western blotting and real-time PCR analysis. Western blotting was also used to detect the effect of TGF-beta1 on the Smad3 and Smad7 expressions of RLE-6TN cells. Morphological alterations were examined by phase-contrast microscope, and ultrastructure changes by electron microscope. Incubation of RLE-6TN cells with TGF-beta1 resulted in the up-regulation of the expression of the mesenchymal cell markers, after artesunate intervened on it, resulted in the down-regulation of the expression. Meanwhile, incubation with artesunate intervened on RLE-6TN cells could lead to the apparent down-regulation of the expression of Smad3 and up-regulation of Samd7 and the transition of RLE-6TN cells to mesenchymal-like by TGF-beta1 induction, after artesunate intervened on it, RLE-6TN cells to epithelial-like. TGF-beta1 induced epithelial-mesenchymal transition process; artesunate can inhibit TGF-beta1-induced epithelial-mesenchymal transition process, the possible mechanism is up-regulation of the expression of Smad7 and down-regulation of the expression of Smad3, meanwhile inhibits phosphorylation of Smad3.

Maternal-fetal outcomes of lamivudine treatment administered during late pregnancy to highly viremic mothers with HBeAg+ chronic hepatitis B / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To evaluate the therapeutic efficacy and safety of lamivudine treatment in late pregnancy by analyzing the maternal-fetal outcomes of chronic hepatitis B (CHB) mothers featuring hepatitis B e antigen (HBeAg)-positivity and highly viremic status.</p><p><b>METHODS</b>A total of 256 pregnant women in the second or third trimester with monoinfected CHB, HBeAg-positivity, and HBV DNA more than 6 log10 copies/mL were divided into two groups: lamivudine (lam) treatment (n=164) or no treatment (controls; n=92). All infants were treated with hepatitis B immune globin (HBIg; 200 IU) within 12 hrs of birth and 15 days later, and were given the recombinant HBV vaccine (20 mug) at 0, 1 and 6 months. All infants were followed-up to at least seven months and hepatitis B surface antigen (HBsAg) and HBV DNA levels were used to determine perinatal transmission (PT) rates. The mothers' data from routine blood analysis, tests of hepatic and renal function, detection of HBV markers and HBV DNA were retrospectively analyzed to determine changes associated with the lam treatment. Correlations of lam treatment with HBV PT rate, alanine aminotransferase (ALT) normalization, adverse reactions, pregnancy complications, congenital deformities, and infants' growth/development were determined by statistical analyses.</p><p><b>RESULTS</b>Prior to delivery, the lam-treated mothers had significantly lower HBV DNA levels (3.72+/-1.78 vs. controls: 7.83+/-0.67 log10 c/ml; t=-22.359, P less than 0.001). The rate of virological response in the lam-treated group was 97.56% (160/164). The lam-treated group had significantly higher ALT normalization rate (90.20% vs. controls: 55.88%; X2=13.349, P less than 0.001) and significantly lower HBeAg titer (957.73+/-458.42 vs. controls: 1296.35+/-383.14 S/CO; t=-5.410, P less than 0.001). At birth, the infants from lam-treated mothers had significantly lower HBsAg-positivity (15.24% (25/164) vs. controls: 30.43% (28/92); X2=8.284, P=0.004). By 7-12 months after birth, none of the infants born to lam-treated mothers tested positive for HBsAg, compared to 8.70% (8/92) of the infants born to mothers in the control group (X2=14.721, P less than 0.001). None of the lam-treated mothers required treatment discontinuation due to adverse events or lam-resistance. No congenital deformities were observed during the study and follow-up periods. There were no differences between the lam-treated and control groups for postpartum hemorrhage, gestational age, infants' height/weight or Apgar scores.</p><p><b>CONCLUSION</b>In highly viremic HBsAg+ mothers with CHB, lam treatment in the second or third trimester of pregnancy is safe and effective for reducing HBV maternal-neonatal transmission.</p>

Efficacy and safety of telbivudine in pregnant women to prevent perinatal transmission of hepatitis B virus / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of telbivudine use during the second and third trimester of pregnancy for reducing hepatitis B virus (HBV) transmission from highly viremic hepatitis B e antigen-positive (HBeAg+) mothers to their fetuses.</p><p><b>METHODS</b>Pregnant women, between weeks 20 to 32 of gestation, who were HBeAg+ and had HBV DNA more than 1.0*10(7) copies/mL were enrolled in our study. The women were offered inclusion into one of two treatment arms, based upon their personal preference: telbivudine or no telbivudine. The patients in the telbivudine treatment arm were administered 600 mg/d telbivudine at least until postpartum week 4. All delivered infants in both treatment arms were administered hepatitis B immune globulin (HBIG; 200 IU) within 12 hours of delivery and recombinant HBV vaccine (20 mug) at 0, 1 and 6 months. The HBV perinatal transmission rate was determined by measuring HBsAg and HBV DNA in infants at postpartum week 28.</p><p><b>RESULTS</b>A total of 220 pregnant women were enrolled in our study, 120 chose the telbivudine arm and 100 chose the control arm. All telbivudine treated subjects were registered in the Antiretroviral Pregnancy Registry. Telbivudine treatment was associated with a marked reduction in the mothers' serum HBV DNA, HBeAg and ALT levels before delivery. A striking decline of HBV DNA levels in treated mothers was observed at week 2 of treatment, which was followed by a gradual and steady decrease that continued until delivery. Thirty-seven (31%) of the telbivudine-treated mothers and none (0%) of the untreated controls had polymerase chain reaction-undetectable viremia at delivery. At week 28, 0% of the infants delivered from telbivudine-treated mothers were HBsAg+ or HBV DNA+, as compared to 8% HBsAg+ or HBV DNA+ in the untreated control arm (P = 0.002). No telbivudine discontinuations occurred from adverse events, and no congenital deformities were observed in the infants delivered to telbivudine-treated mothers. Eighty mothers discontinued telbivudine at week 4 postpartum, and there were no cases of severe hepatitis. There were no significant differences between the two treatment arms for postpartum hemorrhage, adverse events during pregnancy, cesarean section, gestational age, or infants' height/weight or Apgar scores.</p><p><b>CONCLUSIONS</b>Telbivudine use during the second and third trimester of pregnancy in HBeAg+ highly viremic mothers can safely reduce perinatal HBV transmission rates. Telbivudine was well-tolerated by our patient group. Furthermore, no safety concerns were observed in either the telbivudine-treated mothers or their delivered infants in short term follow-up.</p>

Abstract efficacy of combined vaccine for the prevention of HBV transmission in highly viremic HBeAg+ mothers and the HBV markers' dynamic change of babies in follow-up / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy of combined vaccination with 200IU dose of HBIG and 20 μg of anti-HBV vaccine for the prevention of HBV vertical transmission in babies delivered by HBeAg + and highly viremic mothers and the HBV markers' dynamic changes in babies during follow-up.</p><p><b>METHODS</b>HBeAg + mothers with HBV DNA ≥ to 1.0 × 6 log(10) copies/ml were enrolled and their babies were followed up until 12 months old. The infants received HBIG 200 IU IM in 24 hrs and on day 15, and 20 μg recombinant anti-HBV vaccine at 0, 1 and 6 months. The HBV markers and HBV DNA were tested at birth day, and 1, 7, 12 months after birth respectively. The vertical transmission rate at birth and intrauterine infection rate, the HBsAb positive rate and the HBV markers' dynamic changes during follow up were evaluated.</p><p><b>RESULTS</b>(1) 29 out of 127 infants with HBsAg (+) at birth, 11 of which were HBV DNA (+), HBV perinatal transmission rate was 22.83%. 2 infants' HBsAg were positive at month 1 and became negative at month 7 and 10 infants were still HBsAg (+) and HBV DNA (+). HBV intrauterine infection rate was 7.87%. (2) The positive rate of HBeAg and HBcAb in uninfected infants were 96.58% and 98.29% respectively, which declined gradually to undetectable level after immunization. No infants were HBeAb (+). (3) Infants uninfected produced effective HBsAb after vaccination. The level of HBsAb elevated gradually, and the level of HBeAg decreased quickly even to undetectable.</p><p><b>CONCLUSION</b>The combination vaccination of 200 IU HBIG with 20 μg recombinant anti-HBV vaccine in the Infants delivered by HBeAg (+) and highly viremic mothers reduced obviously the rate of perinatal transmission of HBV, enhanced largely the production of antibody against HBV surface antigen and dropped the maternal HBeAg and HBcAb in infants or even to negative.</p>