Recompensation of complications in patients with hepatitis B virus-related decompensated cirrhosis treated with entecavir antiviral therapy / 中华肝脏病杂志

Objective: To analyze the occurrence of recompensation conditions in patients with chronic hepatitis B virus-related decompensated cirrhosis after entecavir antiviral therapy. Methods: Patients with hepatitis B virus-related decompensated cirrhosis with ascites as the initial manifestation were prospectively enrolled. Patients who received entecavir treatment for 120 weeks and were followed up every 24 weeks (including clinical endpoint events, hematological and imaging indicators, and others) were calculated for recompensation rates according to the Baveno VII criteria. Measurement data were compared using the Student t-test or Mann-Whitney U test between groups. Categorical data were compared by the χ (2) test or Fisher's exact probability method between groups. Results: 283 of the 320 enrolled cases completed the 120-week follow-up, and 92.2% (261/283) achieved a virological response (HBV DNA 20 IU/ml). Child-Pugh and MELD scores were significantly improved after treatment (8.33 ± 1.90 vs. 5.77 ± 1.37, t = 12.70, P < 0.001; 13.37 ± 4.44 vs. 10.45 ± 4.58, t = 5.963, P < 0.001). During the 120-week follow-up period, 14 cases died, two received liver transplants, 19 developed hepatocellular cancer, 11 developed gastroesophageal variceal bleeding, and four developed hepatic encephalopathy. 60.4% (171/283) (no decompensation events occurred for 12 months) and 56.2% (159/283) (no decompensation events occurred for 12 months and improved liver function) of the patients had achieved clinical recompensation within 120 weeks. Patients with baseline MELD scores > 15 after active antiviral therapy achieved higher recompensation than patients with baseline MELD scores ≤15 [50/74 (67.6%) vs. 109/209 (52.2%), χ (2) = 5.275, P = 0.029]. Conclusion: Antiviral therapy can significantly improve the prognosis of patients with hepatitis B virus-related decompensated cirrhosis. The majority of patients (56.2%) had achieved recompensation. Patients with severe disease did not have a lower probability of recompensation at baseline than other patients.

Utilization strategies of Chinese medicinal solid waste by pyrolysis and gasification technology / 中国中药杂志

With the advantages of extensive sources, easy collection, renewability, high yield, carbon circulation, low pollution, and so on, Chinese medicinal solid waste can be converted into clean gas by pyrolysis and gasification, which is then able to serve for industrial production. This is of great practical significance in the context of energy shortage and for solid waste recycling in China. This paper reviews the research progress on biomass gasification principle, gasification medium, and reactor in gasification technology of Chinese medicinal solid waste in recent years. Meanwhile, based on the summary of related research, the defects and improvement measures regarding raw materials, gasification agents, by-products, and reactors were discussed, which provides direction for further development in the gasification technology of Chinese medicinal solid waste in the future.

Gait analysis on young male with collateral ligament injury of ankle joint / 医用生物力学

Objective To obtain kinematic and kinetic parameters of the ankle joint from young man with ankle lateral collateral ligament (LCL) injury during walking, and to investigate the biomechanical characteristics of gaits by these ankle-injured patients. Methods Qualysis MCU500 3D image capture system and Kistler 3D force platform were used to test synchronously the gait of 15 patients with LCL injury and 15 healthy young men. Results For patients with LCL injury, the vertical component of ground reaction force (GRF) changed smoothly, and the posterior anterior component of GRF and the medial-lateral component of GRF were larger than that of healthy young men during anterior-middle support phase and during 60% anterior support phase, respectively. The moment of ankle joint plantar flexion in patients with LCL injury and in healthy young men was similar. The largest ecstrophy and extorsion moment of the ankle joint was found at the injured side of patients with LCL injury, with the largest output power in the sound limb of them. Conclusions The stability of the ankle joint in patient with LCL injury was decreased, with abnormal gait appeared during walking. The sound limb had to compensate the injured limb to reduce the load on the injured limb by switching quickly to the phase of vertical support at the moment of heel-striking. This study provides theoretical references for both the prevention and treatment of ankle joint injury in clinic and rehabilitation training.

Research of the relationship of ubiquinone and beclin-1 and liver mitochondria / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To study whether CO-Q10 can protect liver injury caused by acute on chronic liver failure (ACLF) by autophagy.</p><p><b>METHODS</b>Rats were separated into three groups: control group, acute on chronic liver failure (ACLF) and intervenient group, liver tissues were observed by optical microscopy and electron microscopy. The levels of Beclin-1 expression were determined by real-time PCR. And Western Blot.</p><p><b>RESULTS</b>Areas of necrosis detected in intervenient group were alleviated than in ACLF significantly. Most mitochondrias had been degradated in ACLF group while alive in intervenient group. Real-time PCR and Western Blot revealed level of beclin-1 in ACLF was lower than control and intervenient group.</p><p><b>CONCLUSION</b>Intervenient group may ameliorate rat liver injury by promoting autophagy.</p>

Correlation research of isolated liver tissue pathology and clinical diagnosis in patients with chronic severe hepatitis B / 中华肝脏病杂志

To study the coincidence rate of clinical diagonisis with pathological diagnosis for chronic severe hepatitis, and to screen out clinical indicators consistent with pathological diagnosis. Fifty-one patients diagnosed as chronic severe hepatitis and underwent liver transplantation in Beijing You'an hospital from November 2004 to June 2009 participated in this study. The clinical data were selected as following: ALT, AST, urea nitrogen, creatinine, glucose, cholinesterase, total cholesterol, Glutamyl endopeptidase, alkaline phosphatase, serum potassium, serum sodium, prothrombin activity and blood ammonia level. The width of the portal vein and splenic vein thickness were measured by color Doppler ultrasound and were compared in different groups. Data were ananlyzed with independent sample t test and F test. The coincidence rate between clinical and pathological diagnoses in this study was 64.7%. ALT and AST levels for Chronic severe hepatitis and decompensated cirrhosis were 675.0+/-510.0 U/L, 67.00+/-45.0 U/L ( P is less than to 0.01) and 392.0 +/-370.0 U/L, 103.0+/-59.0 U/L (P is less than to 0.01) respectively, with statistically significant difference existed. The mean level of ALT in Chronic severe hepatitis group was significantly different in the situations of onset less than 30 days or more than 30 days (means were 761.0+/-743.0 U/L and 117.0+/-112.0 U/L, P is less than to 0.01). The rate of the phenomenon of enzyme isolated bile in the chronic severe hepatitis and decompensated cirrhosis group were 78.9% and 0 respectively. The coincidence rate of clinical with pathological diagnoses for Chronic Severe Hepatitis was low, increased ALT and AST levels would help improve the diagnostic accuracy.

Association between PCT levels and liver function in liver cirrhosis patients / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To explore the association between procalcitonin (PCT) levels and liver function in liver cirrhosis patients.</p><p><b>METHODS</b>Collect serum samples from 44 liver cirrhosis patients, detect the PCT levels by semi-quantitative solid immunoassay, and at the same time, detect the serum levels of ALT, AST, TBIL, ALB, CHE, CHOL, PTA etc, then rate the patients by Child-pugh scoring system into Child-pugh A, B, C.</p><p><b>RESULTS</b>set PCT > 0.5 microg/L as the positive threshold, significantly the PCT positive patients have higher ALT, TBIL but lower CHOL, PTA compared with the PCT negative patients. With the increasing of PCT levels, the ALT, AST, TBIL levels are gradually increased too, but PTA decreased. We find that the PCT positive patients are mainly Child-pugh B and C patients, and PCT negative patients are mainly Child-pugh C patients. PCT positive patient's lymphocyte count are lower than PCT negative patient's.</p><p><b>CONCLUSION</b>Liver injury increase the risk of infection in liver cirrhosis patients. As the severity of the injury, the patients are easier to progress into severe infection. Combined with monitoring the PCT levels, pay more attention to protect the liver function will be helpful in early detecting infections and controlling of infection in liver cirrhosis patients.</p>

The approaches for making acute-on-chronic liver failure in rat / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To study the approaches for making acute-on-chronic hepatic failure model in rat.</p><p><b>METHODS</b>SD rats were intraperitoneally injected with 50% CCl4 (Carbon tetrachloride) olive solution every three days for 6 or 10 weeks. Then they were divided into two groups randomly and injected with D-galactosamine (D-gal) at a dose of 2 g/kg, lipopolysaccharide (LPS) at a dose of 100 pg/kg and D-gal at a dose of 0.5 g/kg BW respectively. The levels of serum ALT, AST and TBil were detected,and histopathological changes were observed to evaluate these two models.</p><p><b>RESULTS</b>After injection of 50% CCl4 olive solution intraperitoneally for 6 weeks, liver fibrosis happened in SD rats, 10 weeks, cirrhosis happened. Pelleta necrosis and massive or submassive necrosis was seen administration of two reagents mentioned above.</p><p><b>CONCLUSION</b>By injecting of 50% CCl4 olive solution intraperitoneally, acute-on-chronic liver failure model could be induced by D-gal, LPS/D-gal in rats.</p>

Effect of glutamine on intestinal mucosal barrier function in rats with acute hepatic injury / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To explore the role of glutamine in LPS and D-Gal induced acute hepatic injury.</p><p><b>METHODS</b>A total of 61 Wistar rats were randomly divided into three groups: control group, model group and GLN pretreated group. The animal model was established by LPS and D-Gal intraperitoneal injection. GLN at dose of 1 g/kg was intragastrically administrated for 7 d before intraperitoneal injection. To evaluate the hepatic injury, the serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBiL) were detected by automatic biochemistry analysator. The liver and bowel tissue was observed by lightmicroscope and transmission electron microscope (TEM). The apoptosis of hepatocyte was detected by TUNEL. HPLC-PED was used in the study of intestinal permeability.</p><p><b>RESULTS</b>No significant differences were noted between ALT, AST, TBIL level, death rate and intestinal permeability (L/M) between model group and GLN pretreated group; In microscope, the confused structure of hepatic injury and inflammatory infiltration were similar between model group and GLN pretreated group. The injury of bowel was not obviously. Compared with the model group, there was better trend in liver and bowel in GLN pretreated group by transmission electron microscope (TEM). The apoptosis index in GLN pretreated group were lower than those in model group.</p><p><b>CONCLUSION</b>LPS can induce acute liver injury in D-Gal-sensitized rats.Glutamine has't the trend of protecting liver function and intestinal barrier function,decreasing death rates.</p>

Relationship between the level of serum TNF-alpha of patients with chronic hepatitis C and treatment with interferon-alpha and the influencing factors / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To assess the relationship between the level of serum TNF-alpha of chronic hepatitis C with severity of disease and curative effect of anti-virus therapy with interferon alpha.</p><p><b>METHODS</b>Thirty healthy controls and 102 patients with chronic hepatitis C were recruited into this study. The level of serum TNF-alpha was determined by ELISA in both groups. Then the 102 patients with chronic hepatitis C were evaluated after being classified into mild (44 cases), moderate (34 cases), and severe types (24 cases) based on the results of liver function tests. Liver functions, viral load and genotype of HCV RNA were measured.</p><p><b>RESULTS</b>Before anti-virus treatment, the level of fasting serum TNF-alpha in the patients with chronic hepatitis C (1) was higher than that of the normal controls; (2) in the cases with mild type was lower than that in the moderate and severe groups; (3) serum TNF-alpha was not associated with the HCV load; (4) serum TNF-alpha was not significantly different between HCV subtypes 1b and 2a; (5) serum TNF-alpha was not significantly different between the patients responsive and non-responsive to the anti-virus treatment; (6) serum TNF-alpha was positively correlated with the level of serum direct bilirubin, negatively correlated with cholinesterase (CHE).</p><p><b>CONCLUSIONS</b>The level of fasting serum TNF-alpha in the patients with chronic hepatitis was higher than that in the normal controls, and was positively correlated with the severity of the disease but not correlated with the therapeutic effect of interferon-alpha.</p>

Synthesis, solubility, lipids-lowering and liver-protection activities of sulfonated formononetin / 药学学报

A water-soluble compound, sodium formononetin-3'-sulfonate with good lipid-lowering and liver-protection activities was synthesized. It was synthesized by sulfonation reaction, and its structure was characterized by IR, NMR and elemental analyses. The solubility of sodium formononetin-3'-sulfonate in water and n-octanol/water partition coefficient were determined by UV spectrophotometry. The lipid-lowering and liver-protection activities of sodium formononetin-3'-sulfonate were tested by using rat's high fat model induce by feeding with high fat food. The results showed that sodium formononetin-3'-sulfonate not only had favorable water, solubility but also had good lipid-lowering and liver-protection activities.

Application of UV similarity in quality control of Chinese medical injection / 中国中药杂志

<p><b>OBJECTIVE</b>To propose an algorithm of the similarity between UV-spectra for controlling the quality of Chinese medical injection.</p><p><b>METHOD</b>The similarity is calculated base on the data of two UV-spectrum curves, thus the sample quality is evaluated according to the average value of the similarity of the UV-spectra between sample with each of standard samples; the proposed algorithm of the similarity is compared with cosine of vectorial angle and relative coefficient; the proposed method for quality evaluation of traditional Chinese injection is discussed with the method according to the chromatographic fingerprint similarity.</p><p><b>RESULT</b>The calculated similarity with the proposed method can be sensitive to show the difference between UV-spectra. This proposed method for quality evaluation was applied for assessing quality of 14 batches of Xiangdan injection and the results well coincident with sample quality.</p><p><b>CONCLUSION</b>The proposed method can be used to evaluate the quality of the Chinese medical injection according to the similarity of two UV-spectrum curves.</p>

Energy metabolism in patients with chronic viral hepatitis and posthepatitic cirrhosis / 中华全科医师杂志

Objective To evaluate the pattern of energy metabolism and nutrients intake in patients with chronic viral hepatitis and posthepatitic cirrhosis to effectively direct their nutrition therapy.Methods Resting energy expenditure (REE) was measured with open-circuit indirect Jorimetry in 60 patients with chronic viral hepatitis and 60 patients with posthepatitic cirrhosis.Their normal basal energy expenditure (BEE) was predicted by Harris-Benedict equation and energy intake (EI) was determined by diet recall. Correlation between REE and indicators for nutrition assessment was analyzed.Results REE was (77? 21) kJ?kg~(-1)?d~(-1) in 60 patients with pusthepatitic cirrhosis,significantly lower than BEE[(95?16) kJ? kg~(-1)?d~(-1)(P0.05,and their EI was (127?34) kJ?kg~(-1)?d~(-1),1.41?0.43 times as REE,in which PROI was (1.02?0.29) g?kg~(-1)?d~(-1),1.31?0.61 times as PROE (0.87?0.34) g?kg~(-1)?d~(-1),also indicating a negative nitrogen balance (-2.02?4.07).REE,EI and intake of three nutrients,serum level of albumin and prealbumin (PA) and body weight significantly decreased in patients with posthepatitic cirrhosis,as compared to those in patients with chronic viral hepatitis (P

Effect of shenfu injection on brain natriuretic polypeptide and aminoterminal peptide of precollagen type III in patients with acute myocardial infarction during intervention treatment / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the effect of Shenfu injection (SFI) on indexes of heart function and myocardial fibrosis in patients with acute myocardial infarction (AMI) treated by percutaneous coronary intervention (PCI).</p><p><b>METHODS</b>Ninety-three AMI patients treated by PCI were randomly divided into two groups, 47 in the treatment group (treated by PCI plus 40 ml SFI intravenous injection, once a day for 7 days) and 46 in the control group (treated by PCI only). Levels of brain natriuretic poly peptide (BNP) and aminoterminal peptide of precollagen type III (NP III) were measured at different time points, i.e. immediately after admission (T1), and at 24th hour (T2) and 7th day (T3) after AMI onset in the two groups.</p><p><b>RESULTS</b>The proportion of TIMI 3 grade of front blood flow in AMI related vessels after PCI was insignificantly different in the two groups. The concentration of BNP of T2 was significantly higher than that of T1 in the two groups (P < 0.01), and it was higher in the control group than that in the treatment group (P < 0.01), while at T3, it was insignificantly different in the treatment group to that of T1 (P > 0.05), but in the control group, it was still significantly higher than that in the treatment group and that of T1 (P < 0.01). The levels of NP III the two groups were similar at T1 and T2 (P > 0.05). At T3, it showed an increase in the treatment group, but with no significant difference (P > 0.05) as compared with that at T1, but in the control group did markedly increase and showed significant difference as compared with that of T1 and that in the treatment group at T3 (P < 0.05).</p><p><b>CONCLUSION</b>Early applying of SFI can protect myocardium from ischemia/reperfusion injury after AMI, ameliorate the degree of injury, improve heart function of patients and prevent myocardial fibrosis.</p>

Use of glucocorticoid in treatment of severe acute respiratory syndrome cases / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the effect of glucocorticoid in the treatment for severe acute respiratory syndrome (SARS).</p><p><b>METHODS</b>Clinical data of 70 patients with SARS admitted to Youan Hospital in Beijing during March to May, 2003 were analyzed.</p><p><b>RESULTS</b>(1) Sixty-three of 70 cases of SARS recovered and seven cases died, with a case-fatality ratio of 10%. (2) Average length of hospital stay was 16.9 days for the all 70 cases, and 16.8 days for the 11 cases without glucocorticoid treatment, without statistical significance (F = 1.018, P = 0.39). (3) The other 59 cases were administered with 40 mg to 640 mg of methylprednisolone daily. (4) Average hospital stay was 15 days for the 23 cases with lower dose of 40 mg to 80 mg methylprednisolone daily, 18.5 days for the 27 cases with medium dose of 120 mg to 240 mg daily, and 17.9 days for the nine cases with higher dose of 320 mg to 640 mg daily (F = 1.018, P = 0.39).</p><p><b>CONCLUSIONS</b>Earlier use of glucocorticoid therapy with suitable doses could alleviate their clinical symptoms, improve their clinical courses, and promote the absorbance of infiltration in their lungs on chest-X-ray films for the cases with SARS. However, current clinical data showed that glucocorticoid therapy could not shorten the length of hospitalization for the cases with SARS.</p>

Clinical features of severe acute respiratory syndrome in forty-one confirmed health care workers / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the clinical features of severe acute respiratory syndrome (SARS).</p><p><b>METHODS</b>Forty-one medical care workers (aged 23 - 55 years, with a average of 32 years; men/women = 8/32) who were admitted to our hospital and diagnosed with SARS during March and April, 2003 were retrospectively analyzed.</p><p><b>RESULTS</b>Thirteen of all the patients were physicians and the rest were nurses. The disease was mainly transmitted through air droplet in a short distance, and overwork induced tiredness was involved in disease stimulation. Seventy-three percent of the patients presented fever as their first symptom. Ten patients complained inertia and myalgia. One patient showed no clinical symptoms, and bilateral infiltrates was found in his chest X-ray. Among the 41 cases, 6 (15%) were diagnosed as severe type. At the first week, the counts of white blood cells (WBCs), lymphocyte and platelets were (4.4 +/- 1.5) x 10(9)/L, 0.22 +/- 0.12 and (143 +/- 37) x 10(9)/L, which were significantly lower when compared with those at the 2nd to 4th week. Abnormal liver function was found in 27 cases (mostly with elevated serum ALT), with 70% occurred at the 3rd or 4th week. In terms of CT, 30 patients (73%) showed pathological changes in lungs, and bilateral lung involvement was found in 35.59%. Of 36 cases treated with steroids, 86% received middle or low dosage (80 - 240 mg/d). Artificial ventilation was used for twenty-seven patients, and air pipe mechanical ventilation was used for 1 case. Mortality in this study was 5%.</p><p><b>CONCLUSIONS</b>Inertia and myalgia may be the earlier symptoms of health care workers with SARS include, which are parallel to CT manifestations. There is no objective index for the assessment of the severity of the disease at early stage. The medicine associated toxicities may be the main reason of liver lesions. damages. Middle or low dosage of steroid was reasonable to be used as early as possible.</p>