Research Progress of in Vitro Experiment of Allergic Transfusion Reaction for Plasma Transfusion and Its Relative Mechanism---Review / 中国实验血液学杂志

Allergic transfusion reaction (ATR) caused by plasma transfusion is one of the main adverse transfusion reactions, and severe allergic reactions may even endanger the patient's life. Currently, ATR is mainly prevented and controlled by drug prevention and symptomatic treatment, and there still lack of preventive measures such as in vitro experiments. It has been shown that mast cells and basophils are the main effector cells of allergic reactions, and histamine is one of the main mediators of IgE-mediated allergic reactions. Some experiments can be used to identify patients with allergies or plasma components containing allergens, such as detection of serum-specific IgE, IgA, anti-IgA antibody, tryptase and histamine, mast cell degranulation test, basophil activation test, and so on. The basophil activation test can also be used for functional matching of plasma in vitro. Research of in vitro experiment of ATR is good for directing the precise infusion of plasma, reducing waste of resources, and avoiding the risk of blood transfusion. As a pre-transfusion laboratory test for clinical use, in vitro experiment of functional matching provides a new way to prevent ATR.

Macrophage-NLRP3 Inflammasome Activation Exacerbates Cardiac Dysfunction after Ischemic Stroke in a Mouse Model of Diabetes / 神经科学通报·英文版

Ischemic stroke is one of the leading causes of death worldwide. In the post-stroke stage, cardiac dysfunction is common and is known as the brain-heart interaction. Diabetes mellitus worsens the post-stroke outcome. Stroke-induced systemic inflammation is the major causative factor for the sequential complications, but the mechanism underlying the brain-heart interaction in diabetes has not been clarified. The NLRP3 (NLR pyrin domain-containing 3) inflammasome, an important component of the inflammation after stroke, is mainly activated in M1-polarized macrophages. In this study, we found that the cardiac dysfunction induced by ischemic stroke is more severe in a mouse model of type 2 diabetes. Meanwhile, M1-polarized macrophage infiltration and NLRP3 inflammasome activation increased in the cardiac ventricle after diabetic stroke. Importantly, the NLRP3 inflammasome inhibitor CY-09 restored cardiac function, indicating that the M1-polarized macrophage-NLRP3 inflammasome activation is a pathway underlying the brain-heart interaction after diabetic stroke.

Macrophage-NLRP3 Inflammasome Activation Exacerbates Cardiac Dysfunction after Ischemic Stroke in a Mouse Model of Diabetes / 神经科学通报·英文版

Ischemic stroke is one of the leading causes of death worldwide. In the post-stroke stage, cardiac dysfunction is common and is known as the brain-heart interaction. Diabetes mellitus worsens the post-stroke outcome. Stroke-induced systemic inflammation is the major causative factor for the sequential complications, but the mechanism underlying the brain-heart interaction in diabetes has not been clarified. The NLRP3 (NLR pyrin domain-containing 3) inflammasome, an important component of the inflammation after stroke, is mainly activated in M1-polarized macrophages. In this study, we found that the cardiac dysfunction induced by ischemic stroke is more severe in a mouse model of type 2 diabetes. Meanwhile, M1-polarized macrophage infiltration and NLRP3 inflammasome activation increased in the cardiac ventricle after diabetic stroke. Importantly, the NLRP3 inflammasome inhibitor CY-09 restored cardiac function, indicating that the M1-polarized macrophage-NLRP3 inflammasome activation is a pathway underlying the brain-heart interaction after diabetic stroke.

TXNDC5 mediates serum starvation-induced proliferation inhibition of HeLa cell / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the role of TXNDC5 in serum starvation-induced proliferation inhibition of HeLa cell.</p><p><b>METHODS</b>TXNDC5 was either over-expressed or knocked down by small interfering RNA (siRNA) in HeLa cells which were then cultured in conventional medium or serum starvation medium. The protein level of TXNDC5 was evaluated by Western blot analysis. The mRNA level of TXNDC5 was measured by quantitative real-time PCR. Cell growth rate was determined by cell proliferation assay kit (MTS method). Cell cycle distribution and apoptosis were detected by flow cytometry.</p><p><b>RESULTS</b>Serum starvation mildly reduced the mRNA level of TXNDC5 (P<0.05), but dramatically increased the protein level of TXNDC5 in HeLa cells. The stability of TXNDC5 mRNA remained unchanged. Cycloheximide abolished the serum starvation-induced up-regulation of TXNDC5 protein. Over-expression of TXNDC5 had no effect on cell proliferation. However, suppression of TXNDC5 attenuated the proliferation inhibition of HeLa cell induced by serum starvation (P<0.05), increased the proportion of cells in S phase (P<0.05), but had no effect on cell apoptosis.</p><p><b>CONCLUSION</b>TXNDC5 mediates serum starvation-induced proliferation inhibition of HeLa cell.</p>

Flavonoids from leaves of Epimedium pubescens / 中国中药杂志

Eleven compounds were isolated from the leaves of Epimedium pubescens by means of various chromatographic techniques such as silica gel, MCI, Sephadex LH-20 and preparative HPLC. Their structures were identified as anhydroicaritin (1), icariside II (2), 2'''-O-rhamonosyl-icariside II (3), desmethylanhydroicaritin (4), baohuosaide II (5), epimedokoreanin B (6), acuminatin (7), tricin(8), kaempferol (9), daidzein (10) and 4-hydroxy ethyl benzoate (11) on the basis of physicochemical properties and spectroscopic data analysis. Among them, compound 11 was isolated from Epimedium species for the first time, and other compounds were obtained from this plant for the first time.

A clinical study on leucogen tablets therapy efficacy during PEG-alpha interferon and alpha-interferon in chronic hepatitis B / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To discuss the efficacy of Leucogen tablets treatment lessen the hematological reaction and raise the efficacy therapy of interferon in chronic hepatitis B treated with PEG-alpha interferon and alpha interferon.</p><p><b>METHODS</b>A total of 395 patients with HBeAg-positive chronic hepatitis B (CHB) inpatients from January 2002 to February 2011. Group: All the patients were assigned to A or B according as during the treatment added Leucogen tablets or not.</p><p><b>RESULTS</b>(1) All of 35.9% patients had neutrophil counts decrease under 1 x 10(9)/L, A group had 29.6%, B had 42.8% patients, P = 0.01; neutrophil counts < or = 0.75 x 10(9)/L A group had 12.6% ,B group had 26.4%, P = 0.02; neutrophil counts < or = 0. 5 x 10(9)/L A group had 4.8%, B group had 16.4%, P = 0.04. (2) A group had 8.2% patients interferon-alpha dose decreased, all the patient finished the period of therapy. B group had 23.3% patients interferon-alpha dose decreased, 2.1% of patients had paused. A group had 40.3% of patients interferon-alpha beyond conventional dose, B group had only 5.2%. (3) All of 9.8% patients had hematoblast decrease under 100 x 10(9)/L, A group had 8.7%, B had 11.1% patients; hematoblast < or = 80 x 10(9)/L A group had 5.3%, B group had 7.9%; hematoblast < or = 50 x 10(9)/L A group had 1.0%, B group had 2.6%. A group had the trend of reducing hematoblast decrease. (4) At the end of therapy A group had 67.4% patients HBVDNA < 100IU/ml, 54.3% e antigen negative, 40.7% e antigen conversed; B group had 53.9%, 41.2%, 26.9%, P was respectively 0.02, 0.01, 0.01.</p><p><b>CONCLUSION</b>Leucogen tablets treatment and prevention interferon-alpha-related neutrophil counts hematological reaction in CHB treated with alpha-interferon, and had the trend of reducing interferon-alpha-related hematoblast decrease, farther improved the efficacy of alpha-interferon treatment CHB.</p>

Efficacy and safety of ademetionine for treatment of drug-induced liver disease in children / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To investigate the efficacy and safety of ademetionine for treatment of cholestatic or mixed-type drug-induced liver disease (DILD) in children.</p><p><b>METHODS</b>The children with DILD were divided into the treated group and control group. Yinzhihuang Granule was orally administered and Compound Glycyrrhizin Injection intravenously given in patients of both groups. Those patients in the treated group were additionally treated with intravenous infusion of 250-1000 mg ademetionine for 28 d. The incidence of pruritus and adverse effects as well as biochemical parameters in all the patients and compared between the 2 groups. For statistical analysis, Chi2 test was used for between-group comparison and t test for processing the data.</p><p><b>RESULTS</b>1) Before treatment, severe pruritus was found in 17 and 16 children in the treated and control group, respectively. Two weeks after the treatment, the symptom was significantly relieved in 14 and 3 patients in the treated and control group, respectively (Chi2 = 4.52, P < 0.05). 2) As for comparisons between the 2 groups, a P value of 0.0014 for AST level was found 4 weeks, 0.045 and 0.007 for disappearance and recovery rate of jaundice, 0.0014 and 0.0006 for decrease in TBA level and 0.0003 for gammaGT level 2 and 4 weeks after the treatment.</p><p><b>CONCLUSION</b>Intravenous administration of ademetionine is safe in children with DILD and it can effectively alleviate pruritus, promote the recovery of various biochemical parameters and fasten liver functional recovery in these children. Therefore, ademetionine can be widely used for treatment of intrahepatic cholestasis in children.</p>

Accuracy of perioperative cardiac preload monitoring by global end-diastolic volume and intrathoracic blood volume in orthotopic liver transplantation / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the clinical value of global end-diastolic volume (GEDV) and intrathoracic blood volume (ITBV) in perioperative monitoring of the cardiac preload in patients undergoing orthotopic liver transplantations (OLT).</p><p><b>METHODS</b>Eight ASA III or IV patients aged 42-50 years undergoing OLT without venovenous bypass under general anesthesia were enrolled in this study. Before the induction, a thermodilution femoral artery catheter was inserted into the femoral artery under local anesthesia and connected to a PiCCOplus system to monitor ITBV and GEDV. A CCO catheter was inserted into the right internal jugular vein to monitor the pulmonary artery obstruction pressure (PAOP), central venous press (CVP) and stroke volume (SVPAC). Anesthesia was induced with a combination of midazolam (0.1 mg/kg), propofol (1 mg/kg) and fentanyl (3 microg/kg). Pipecuronium (0.1 mg/kg) was given to facilitate naso-endotracheal intubation. Before anesthesia (T0) and at 10 min before the anhepatic phase (T1), 10 min after anhepatic phase (T2), 10 min after neohepatic phase (T3) and at the end of surgery (T4), all the TPTD and CCO parameters were measured by injecting 10 ml cold saline solution (below 8 degrees celsius;) via the distal port of the central venous catheter.</p><p><b>RESULTS</b>ITBV and GEDV at T2 were significantly lower than those at T0, T1, T3 and T4 (P<0.05). SVPAC at T2 was dramatically decreased compared with that at T0 and T1 (P<0.05). The changes in the pressure preload parameters of the pulmonary artery catheter (PAOP and CVP) did not correlate to the changes in SVPAC, whereas the changes in the volume preload parameters (ITBV and GEDV) of the TPTD was significantly correlated to the changes in SVPAC (P<0.01). PAOP and CVP did not correlate to the changes in ITBV and GEDV.</p><p><b>CONCLUSION</b>ITBV and GEDV are more reliable than PAOP and CVP in perioperative monitoring of the cardiac preload in patients undergoing OLT.</p>

Peripheral NK and NKT cell in pediatric subjects with chronic HBV infection / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To investigate the characteristic of NK cells and NKT cells in HBV infected pediatric subjects for evaluation of their clinical implication.</p><p><b>METHODS</b>Fresh peripheral blood samples were obtained from 42 HBV-infected pediatric cases and 15 healthy counterparts. NK cells and NKT cells were analyzed by flow cytometry assay. The clinical data such as serum ALT level and HBV viral load was simultaneously recorded from each HBV carrier.</p><p><b>RESULTS</b>HBV-infected children had an obviously increasing percentage of NK cells 12.071% +/- 7.100%, there were significant differences between the children with chronic B hepatitis and the healthy children (P <0.05). As far as percentage of NKT 3.048% +/- 1.937% was concerned, there were not differences. Furthermore the association was not found between serum HBV viral load level and the NK lymphocyte.</p><p><b>CONCLUSION</b>Our data may provide valuable information of NK and NKT lymphocyte for evaluation of disease progression of HBV infected children NKI cells.</p>

The level of TNF-alpha secretion of PBMC in patients with chronic hepatitis C and nonalcoholic fatty liver / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To study the roles of TNF-alpha secretion of PBMC in patients with chronic hepatitis C and Nonalcoholic fatty liver.</p><p><b>METHODS</b>The level of TNF-alpha secretion of PBMC in patients with chronic hepatitis C and Nonalcoholic fatty liver was detected by ELISA after culturing for 72 hours in vitro, as well as patients with chronic hepatitis C and the normal control.</p><p><b>RESULTS</b>(1) Compared with the normal control, the level of TNF-alpha in group with chronic hepatitis C and in group with chronic hepatitis C and Nonalcoholic fatty liver notably increased. (2) Compared with the group with chronic hepatitis C, the level of TNF-alpha in group with chronic hepatitis C and Nonalcoholic fatty liver also notably increased.</p><p><b>CONCLUSION</b>It suggested TNF-alpha takes important roles in the infection course of chronic hepatitis C with Nonalcoholic fatty liver.</p>

Relation of viral genotypes to clinical features in children with chronic hepatitis B / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To investigate the relation of HBV genotypes to clincal features in children with chronic hepatitis B.</p><p><b>METHODS</b>The genotypes of serum HBV DNA from 404 children with chronic hepatitis B were determined by PCR using type-specific primers.</p><p><b>RESULTS</b>For the 404 children, genotype B in 99 (24.5%), genotype C in 285 (70.5%). For the 75 children from south part of China, 29 were of genotype B (38.7%) and 44 of genotype C (58.7%). For the 329 children from north part of China, 70 were of genotype B (21.3%) and 241 of genotype C (73.3%). There were significant differences between the children from south part and those from north part of China in genotype B and C (P = 0.002). Genotype B and C were not significantly correlated to gender, age and mother-to-fetus transmission. There was no marked difference in liver injury severity (P = 0.4796), serum HBeAg positivity, HBVDNA level, inflammatory degree of liver tissue (P = 0.209) and liver fibrosis( P = 0.177) between the children with genotype B and those with genotype C.</p><p><b>CONCLUSION</b>In children with HBV infection, genotype C accounts for 70.5% and genotype B for 24.5%. The genotypes are of regional difference in children with HBV infeciton. There are replication and liver pathological change between genotype B and genotype C.</p>

Level of the cytokine secreted by periferal blood mononuclear cells in patients with chronic hepatitis C before antiviral therapy / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To study the immune state of patients with chronic hepatitis C before antiviral therapy by detecting the levels of the cytokines interleukin (IL)-2, IL-4, IL-10, IL-12, interferon (IFN)-gamma, and tumor necrosis factor (TNF)-alpha secretion by periferal blood mononuclear cells (PBMC).</p><p><b>METHODS</b>The level of the cytokine secreted by PBMC in patients with chronic hepatitis C after culturing for 72 hours in vitro was detected by ELISA.</p><p><b>RESULTS</b>(1) Compared with the cytokine level of normal controls, the level of IFN-gamma, TNF-alpha, and IL-10 of patients with chronic hepatitis C significantly increased (P < 0.05) while IL-2, IL-4, and IL-12 were not detected in the culture supernatant of PBMC from both normal control and patients with chronic hepatitis C. (2) There was no statistically significant difference in secretion of the cytokines among patients with different severity of the disease.</p><p><b>CONCLUSION</b>PMBCs from patients with chronic hepatitis C tend to secret Th2 type cytokines. Restoring the imbalance of TH1/TH2 may help to clear the hepatitis C virus.</p>

Clinical study on adverse reactions of peginterferon alfa-2a in treatment of chronic hepatitis in adults and children / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To investigate the scope and degree of short-term adverse reactions of peginterferon alfa-2a in treatment of chronic hepatitis in adults and children to provide basis for anti-viral treatment in clinical practice.</p><p><b>METHODS</b>A prospective study was conducted in adults and children with chronic hepatitis treated with peginterferon alfa-2a. Meanwhile, the reactions in the patients were recorded with a table designed by ourselves and statistically analyzed.</p><p><b>RESULTS</b>The short-term adverse reactions included increase in body temperature and aching pain in joints and muscles. The increase in body temperature was the major reaction and accounted for 54.11%. The increase in body temperature began to appear in 47.6% of the patients. The body temperature was 37.3 degrees C-38.9 degrees C in most of the patients and mediate and low increase was found in 85.4% of the patients, which was decreased to 70% in the 4th week. However, the percentage of patients with high temperature was increased from 14.5% in the 1st week to 30% in the 4th week. The increase of body temperature began to appear in 9-12 h and 3-5 h after injection of peginterferon alfa-2a in the 1st and later, respectively. The duration of fever was 3-4 h in most of the patients. It appeared once in 1 week after the rejection in most of the patients. For management of fever, cooling with medication was conducted in 45.5 % of the patients.</p><p><b>CONCLUSION</b>The short-term adverse reactions in patients with chronic hepatitis treated with peginterferon alfa-2a include the increase in body temperature etc. The severity of the adverse reactions gradually reduces with continuation of the treatment. Of the adverse reactions, the increase in body temperature is the major (47.6%) and others only account for 1%-16.9%. The increase in body temperature is mainly transient and no management is needed in 50% of the patients. Since the "ladder-type" dose-adding method is used for administration of peginterferon alfa-2a in this group of patients, the adverse reactions are low in number and mild in degree.</p>

Simultaneous determination of four components in Hedyotis diffusa oral solution by reversed-phase HPLC / 中国中药杂志

<p><b>OBJECTIVE</b>A new method for simultaneous determination of four methyl-3, 4-dihydroxybenzoate ( I ), P-coumaric acid (II), ferulaic acid (III) and E-6-O-P-coumaroyl scandoside methyl ester (IV) in Hedyotis diffusa oral solution by reversed-phase HPLC was developed.</p><p><b>METHOD</b>The separation was performed on a Diamonsil C18 column (4.6 mm x 250 mm, 5 microm) with gradient elution. A-acetonitrile, B-methonal-water-glacial acetic acid (5: 95: 0.25), 0-20 min, 1% -16% A; 2042 min, 16% A; 42-46 min, 16%-20%A; 46-65 min, 20% A. The UV detection was set at 265 nm; flow rate 1.0 mL x min(-1).</p><p><b>RESULT</b>There was good linearity between the peak area and concentration at the ranges of 2.1-105 (r = 0.999 8), 3.5-175 (r = 0.999 8), 1.72-86 (r = 0.999 9), 4.0-200 mg x L(-1) (r = 1.000 0) for I, II, III and IV respectively. The average recoveries of I, II, III and IV were 99.9%, 97.9%, 98.6% and 98.1%.</p><p><b>CONCLUSION</b>The method is rapid, simple and accurate, and it can be used for the evaluation of H. diffusa oral solution.</p>

Peripheral blood T cell subsets and TH1/TH2 cytokines secretion in children with chronic hepatitis C virus infection / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To determine the cellular immunological abnormalities in children with chronic hepatitis C virus infection.</p><p><b>METHODS</b>(1) The quantity of the peripheral blood T cell subsets in 16 children with chronic hepatitis C virus infection and 10 healthy blood donors was detected by FACS. (2) The levels of the TH1/TH2 cytokines secretion of PBMC in patients and healthy blood donors were detected by ELISA.</p><p><b>RESULTS</b>(1) Compared with normal controls, there was no significant difference in the percentage of CD4+ cells. The percentage of CD8+ cells was significantly higher than that of controls (P < 0.05). The percentage of CD3+ cells was higher and the ratio of CD4+/CD8+ cells was lower, but the difference was not significant (P > 0.05). (2) Compared with the cytokine level of normal control, the levels of IFN-gamma, IL-10 and TNF-alpha notably increased (P < 0.01) while IL-2, IL-4, and IL-12 were not detected in the culture supernatant of PBMCs from both normal control and patients.</p><p><b>CONCLUSION</b>There is an imbalance in peripheral blood T cell subsets and disturbance in cellular immunity in children with chronic hepatitis C virus infection, which may be associated with HCV persistent infection.</p>

Effects of carvedilol on neurohormone and magnesium metabolism in patients with chronic heart failure / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the effects of carvedilol on neurohormone and magnesium metabolism in patients with chronic heart failure (CHF).</p><p><b>METHODS</b>Fifty-seven patients with CHF were divided into two groups randomly: received conventional treatment alone or combined with carvedilol for 8 weeks, respectively. Urine magnesium excretion (UME), plasma levels of magnesium (PMC), norepinephrine (NE), angiotensin-II (Ang-II), aldosterone (ALD), plasma renin activity (PRA) and peripheral monocyte magnesium content (MMC) were measured before and after treatments. Twenty-six health persons were selected as normal subjects.</p><p><b>RESULTS</b>There was a significant increase in UME and plasma concentrations of NE, ALD, Ang-II and PRA, and a significant decrease in MMC in patients with CHF, compared with the control group (P < 0.01). UME was positively correlated with ALD, Ang-II, PRA r = 0.41, 0.42, 0.38, respectively (P < 0.01). These parameters significantly improved after carvedilol (P < 0.05).</p><p><b>CONCLUSION</b>Carvedilol decreases significantly plasma concentrations of neurohormone and urine magnesium excretion, and increases cell magnesium content in patients with CHF.</p>

An open-label pilot study evaluating the efficacy and safety of peginterferon alfa-2a combined with ribavirin in children with chronic hepatitis C / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of peginterferon alfa-2a plus ribavirin in the treatment of children with chronic hepatitis C (CHC) in China.</p><p><b>METHODS</b>Totally 54 children with CHC were treated with peginterferon alfa-2a plus ribavirin from July 2003 to July 2004. The dose of peginterferon alfa-2a was 104 microg.(m2)-1 per week. An inductive treatment with interferon 1-3 MIU q.o.d for a week was given before peginterferon for the reduction of possible side effects. Initially 1/3 to 1/2 dose of ribavirin was given and then the was gradually increased to an ideal level of 15-20 mg.kg(-1).d(-1).</p><p><b>RESULTS</b>The mean age of the patients was 11.3 years. Twenty three patients (42.6%) had received interferon plus ribavirin but the disease relapsed or did not respond to the treatment. The HCV of 70.8 percent of patients was genotype 1 and 14.8 percent of patients had a high viral load (>/=10(-6)/L). After 3-month treatment, 87.5% (42/48) and 8.3% (4/48) of the patients became HCV RNA negative or the viral load reduced by >/= 2 log, respectively, and only 8.3% (4/48) of the patients failed to respond. After 6-month treatment, 87.9% (29/33) and 6.1% (2/33) of the patients became HCV RNA negative or had a >/= 2 log reduction of HCV RNA, respectively, and only 6.1% (2/33) failed to respond. The adverse events were the typical of those reported in the treatment with interferon and ribavirin. Pyrexia occurred in 48.1% of patients, fatigue in 46.3%, decreased appetite in 9.3%, and skin rash in 3.7%. The absolute neutrophil counts of 51 patients (94.4%) were reduced to </= 2.0 x 10(-9)/L, and in 35.2% of them to < 1.0 x 10(-9)/L. Hemoglobin were reduced in only 2 patients (in one case to < 100 g/L, and in the other to < 110 g/L).</p><p><b>CONCLUSION</b>The regimen consisted of peginterferon alfa-2a and ribavirin achieved a high virologic response in Chinese children patients with chronic hepatitis C. No severe adverse events occurred and most of the patients well tolerated the treatment.</p>

Analysis on prognostic factors of liver failure in children / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To analyze the prognostic factors of liver failure in children.</p><p><b>METHODS</b>The clinical data of 105 children with liver failure treated in the No. 302 Hospital in the past 17 years were retrospectively analyzed. The related factors were analysed by EXCELL 2000 and STATA 7.0, multivariate statistical analysis was performed by Logistic regression.</p><p><b>RESULTS</b>(1) A total of 72 children died and the mortality was 68.6%. (2) Univariate statistical analysis showed that the factors significantly correlated with death were age, clinical type and stage of liver failure, decrease in prothrombin activity (PTA) and albumin (AIB) level, increase in serum level of total bilirubin (TBIL), appearance of deviation of TBIL and ALT, complications and hepatic encephalopathy. There was no significant difference between boys and girls. (3) There was no significant difference among etiological diagnoses such as HBV infection, Wilson's disease, and unknown pathogeny. (4) Multivariate statistical analysis showed that PTA (P = 0.000) and TBIL (P = 0.029) were independent risk factors of mortality of the children.</p><p><b>CONCLUSION</b>The prognosis of liver failure in children is poor and mortality is high. PTA and TBIL might be useful for indicating prompt diagnosis and treatment to improve survival rate of the children with liver failure.</p>

Study on treatment effectiveness and safety in children with chronic hepatitis B or C using bicyclo tablets / 中华实验和临床病毒学杂志

<p><b>BACKGROUND</b>To evaluate treatment effectiveness and safety of bicyclo tablets in children with chronic hepatitis B or C.</p><p><b>METHODS</b>A randomized controlled trial was conducted in 148 children with chronic hepatitis B or C for evaluating safety, tolerability, and efficacy of treatment with bicyclo tablets or Hugan tablets. Children in therapy group were treated with bicyclo tablets and control group treated with Hugan tablets.</p><p><b>RESULTS</b>(1) ALT and AST level decreased more prominently in therapy group than in control group (P<0.01). (2) Bicyclo was more effective than Hugan tablets (P<0.01). (3) Symptoms were ameliorated more prominently in bicyclo group than in control group (P<0.01). (4) Both groups had no significant adverse events.</p><p><b>CONCLUSION</b>Satisfactory therapeutic effect and safety were obtained with bicyclo tablets in children with chronic hepatitis B or C.</p>

Clinical features of liver failure in children / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To analyze the etiology, clinical and laboratory characteristics of hepatic failure in 105 children.</p><p><b>METHODS</b>The clinical data of 105 children with hepatic failure treated in our hospital from January 1986 to June 2003 were retrospectively analyzed by EXCELL 2000 and t test.</p><p><b>RESULTS</b>(1)Of the 105 children with hepatic failure, 9 were cases with fulminant hepatic failure, 38 with subacute hepatic failure and 58 with chronic hepatic failure. (2)Morbidity was the highest in 7-12 years old children (43/105, 41.0%) followed by infants (30/105, 28.6%). (3)CMV infection could be confirmed in 9 infants (30.0%), etiological diagnosis was not possible in 13 infants (43.3%). Etiological diagnosis could be confirmed in children over 1 year of age, which included hepatitis B (n=22, 29.3%), Wilson's disease (n=15, 20.0%), hepatitis A (n=10,13.3%). Etiology in 21 cases (28.0%) could not be confirmed. (4)Seventy-one cases (67.6%) had ascites, 34 of them (47.9%) had spontaneous peritonitis. Thirty-five cases were complicated with other infections. The commonest complication was pulmonary infection and sepsis was the next. Fifty-one cases (48.6%) had hydroelectrolyte imbalance. Forty-eight cases (46.2%) had hepatic encephalopathy, which may be subclinical in children under three years of age. (5)The incidence of hypoglycemia was 77.2%(71/92).</p><p><b>CONCLUSION</b>The etiology of liver failure was related to age. CMV infection was the commonest in infants. HBV, HAV infection was the commonest in children over 1 year of age and Wilson?s disease was the next. It is necessary to prevent and manage the associated complications as early as possible such as spontaneous peritonitis, hepatic encephalopathy, hydroelectrolyte imbalance and hypoglycemia etc.</p>