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Objective@#To investigate the curative effect of antiviral therapy and related factors influencing the curative affect in children with immune-tolerant phase chronic hepatitis B.@*Methods@#From May 2014 to April 2015, 46 children with chronic hepatitis B, aged 1 to 16 years with immune-tolerant phase were enrolled as the treatment group. All cases in the treated group either received interferon alpha (3-5 MIU/m2, once daily) in lamivudine combination (if HBV DNA decreased < 2 log10) or repeatedly received interferon-alpha alone (if HBV DNA decreased >2 log10) for 12 weeks. Interferon was discontinued at 72 weeks and followed-up period was continued with lamivudine for 24 weeks. At the same time, data of 23 cases of untreated children with immune-tolerant phase chronic hepatitis B were collected as the control group. The treatment group and the control group were divided into two age groups: 1-7 years old and 7-15 years old. Data measurements were compared using t-test, analysis of variance and single factor analysis methods, and the count data were analyzed by χ 2 test. Multiple logistic regression analysis was used to analyze the effects of different factors on response.@*Results@#(1) There were 22 cases aged 1-7 years in the treatment group (47.8%) and 12 cases aged 1-7 years in the control group (52.2%). The cases of mother-to-child transmission (MTCT) in treatment and control group were 34 (73.9%) and 17 (73.9%), while children with normal baseline ALT in the treatment and control group were 18 (39.1%) and 10 (43.5%). (2) At the end of follow-up, 15 cases in the treatment group (32.6%) had HBeAg serological conversion. Among them, nine (19.6%) cases had HBsAg clearance or HB-Ag seroconversion with anti-HBs, and one (2.2%) case had HBsAg clearance, but both HBeAg and anti-HBe were positive. In the control group, one case had HBV DNA lower than the lower limit of detection level, and one case had HBeAg seroconversion without HBsAg clearance. (3) At the end of follow-up, the seroconversion rates of HBeAg in patients aged 1 to 7 years and patients aged 7 to 15 years were 45.5% and 20.8%, respectively (P = 0.078) and the clearance rates of HBsAg were 36.4% and 8.3% (P = 0.023). The serum conversion rates of normal and abnormal baseline alanine aminotransferase levels were 5.6% and 50.0% (P = 0.005), and the clearance rates of HBsAg were 5.6% and 32.1% (P = 0.077), respectively. There was no statistically significant difference in gender, mother-to-child transmission, HBV DNA genotyping and baseline HBsAg level in antiviral efficacy among children (P > 0.05). (4) HBsAg and HBeAg clearance occurred in 100% of patients at the end of follow-up who had HBsAg < 3 000 IU/ml at 24 weeks of treatment. (5) Multivariate logistic regression analysis showed that serum HBeAg conversion rate had relation with non-MTCT transmission and abnormal baseline alanine aminotransferase. Furthermore, HBsAg clearance rate was associated with the age of children.@*Conclusion@#Sequential combination of interferon and lamivudine with a prolonged course can improve the HBV DNA negative conversion rate, HBeAg seroconversion rate, HBsAg loss rate and mild ALT abnormalities at baseline in children under the age of 7 years with immune-tolerant phase chronic hepatitis B.
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Objective Retrospectively study of the effects of interferon-α therapy on height and weight of children with chronic hepatitis B (CHB).Methods Total of 116 hospitalized cases of CHB children in Adolescent Liver Centre, 302 Military Hospital of China from January 2010 to December 2011 were respectively studied.Heights and weights of all the subjects at baseline, 24 weeks, 48 weeks, 72 weeks and 96 weeks of treatment, and 24 weeks, 48 weeks and 96 weeks of follow-up were measured.The weight Z score (WAZ), height Z score (HAZ) and body mass index (BMI) Z score of subjects with hepatic fibrosis (S) 0.05).At 48 weeks of treatment, the median HAZ was 0.50, and the median WAZ was 0.20;after a follow-up period of 24 weeks, the median HAZ was-0.32, and the median WAZ was-0.18;after a follow-up period of 48 weeks, the median HAZ was 0.09 and the median WAZ was 0.06.All the above median values of HAZ and WAZ were significantly different from those at baseline (all P<0.05).The difference of HAZ at baseline and 96 weeks of treatment in group aged 6-16 years was significantly different from that in group aged 1-6 years (-0.74±0.69 vs-0.53±0.35, t=1.85, P<0.05).Also, the difference of WAZ at baseline and 96 weeks of treatment in group aged 6-16 years was significantly different from that in group aged 1-6 years (-0.69±0.41 vs-0.17±0.75, t=3.74, P<0.05).The difference of HAZ at baseline and 96 weeks after treatment in group aged 6-16 years was significantly different from that in groups aged 1-6 years (-1.12±0.81 vs-0.05±0.69, t=2.06, P=0.022).Conclusions Interferon-α treatment for children with chronic hepatitis B does have influence on their height and weight, which restores to some degree after the treatment finished.Physicians should pay more attention to the influence of interferon-α treatment on height and weight in children aged 6-16 years.
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<p><b>OBJECTIVE</b>To explore the pathological and clinical characteristics of children with liver diseases by retrospective study on clinical and liver biopsy pathological data of children with liver diseases.</p><p><b>METHOD</b>This retrospective analysis was performed at Beijing No. 302 Hospital among 3 932 children with liver diseases who visited the hospital from January 2001 to December 2012. The kinds of diseases were compared with the results of 1983-2000.</p><p><b>RESULT</b>(1) Liver biopsy was successful in 99.72% (3 932/3 943) of cases of 2001-2012 group, complications occurred in 31 children only. (2) Of the 3 932 cases, 2 647 (67.32%) had hepatitis , non-hepatotropic viral hepatitis and non viral liver disease were seen in 365 cases (9.28%), and 920 cases (23.4%), respectively. Among 2 647 cases with viral hepatitis, 2 115 were hepatitis B (79.90%), 521 hepatitis C (19.69%), 7 were hepatitis A (0.26%) and 4 hepatitis E (0.15%), respectively. (3) In 2001-2012 group, the degrees of inflammatory activity (>G2) of liver were seen in 9.57% (202/2 111) patients with hepatitis B, while 23.57% (132/560) in 1983-2000 group. There was significant difference between the two groups (χ(2)=80.36, P=0.00 ). (4) Significant difference was observed in the rate of non viral liver disease between 2001-2012 group (23.40%, 920/3 932) and 1983-2000 group (9.61%, 98/1 020) (χ(2)=93.46, P=0.00). In 2001-2012 group, including 46 kinds of diseases, which were significantly higher than those of 1983-2000 group (18 kinds). In 2000-2012, the main causes of diseases were liver degeneration (18.26%, 168/920), drug-induced liver injury (13.59%, 125/920), fatty liver (8.80%, 81/920) and liver glycogen accumulation disease (8.70%, 80/920). While in 1983-2000 group, the main causes were liver degeneration (20.41%, 20/98), fatty liver (16.33%, 16/98), glycogen storage disease (10.20%, 10/98) and myopathy (9.18%, 9/98).</p><p><b>CONCLUSION</b>Liver biopsy in children is safe and feasible. Hepatitis B virus was ranked first in children with liver diseases in 2001-2012 group. The kinds of non viral hepatic disorders had changed and extended.</p>
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Biopsy, Needle , Hepatitis B , Pathology , Hepatitis, Viral, Human , Pathology , Hepatolenticular Degeneration , Epidemiology , Pathology , Liver , Pathology , Liver Diseases , Pathology , Liver Function Tests , Retrospective StudiesABSTRACT
Objective To study the effects of matrine on proliferation, cell cycle and apoptosis of human hepatocarcinoma cell line HepG2 and probe into the mechanisms of its anti-hepatocarcinoma effects.Methods The HepG2 cells were treated with different concentration of matrine (0.0125, 0.02, 0.05, 0.1, 0.2,0.4, 0.8, 1.6 g/L) for different time (24, 48, 72 h), then investigate the effects of matrine on cell proliferation by MTT, and the effects on cell cycle and apoptosis by flow cytometry. Results Matrine can inhibit the HepG2 cells proliferation at the concentration of 0.1 g/L and above in a concentration-dependent and timedependent manner(P ＜0.01). The result of FCM showed that the cell cycle of HepG2 was retarded at G1 phase treated with matrine for 48 h at the concentration of 0.8 g/L [(75.3±6.5)% vs (64.1±6.3)%, P ＜0.05], whereas was retarded at G2 phase treated with matrine for 48 h at the concentration of 1.6 g/L [(29.1 ±9.1)% vs (11.6±2.1)%, P ＜0.01]. The apoptosis of HepG2 cells can be induced by matrine for 12, 24 h or 48 h at the concentration of 0.4, 0.8, 1.6 g/L. Conclusion Matrine can inhibit cell proliferation, interfere cell cycle and inducing apoptosis of hepatocarcinoma cells, which may be involved in the mechanisms of matrine's antihepatocarcinoma effects.
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Objective To study the embryotoxicity and teratogenicity of monocrotophos in mice.Methods Sixty pregnant Kunming mice were randomly divided into four groups,15 in each:three groups were exposed to the monocrotophos at the doses of 0.05,0.10 and 0.20 mg/kg,10 ml/kg through gavage,during the period of organ formation(from 7th day to 16th day),once a day and the control group to distilled water.The pregnant mice were weighted in day of 0,6,12,18,and 20,and were sacrificed on 20th day of pregnancy.The numbers of living,dead and absorbed fetus were counted,and the uterus and placenta were weighted.The deformity examination was conducted.Results The maternal body weight of exposure groups were lower than those of control group in 12,18 and 20 day of pregnancy.With the increased doses of monocrotophos,the weights of pregnant mice showed a downward trend.Compared with the control group,the rates of dead fetus and absorbed fetus increased significantly,and the rates of living fetus,the fetal body weight and body length,tail length and placental weight decreased significantly(P