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Objective To explore the relationship between the antiviral effect and peripheral blood mononuclear cell (PBMC) hepatitis B virus (HBV) DNA when the patients reach the standard of withdrawal of antiviral therapy in chronic hepatitis B (CHB).Methods Ninety CHB patients treated with interferon(n=44) or nucleot (s) ide(n=46) who reached the standard of withdrawal of antiviral therapy were recruited.HBV DNA levels in PBMCs were tested at the end of treatment,and its relationship with serum HBV DNA level before treatment in PBMC HBV DNA positive group and negative group were compared.The correlation between HBV DNA in PBMCs at the end of treatment and relapse were explored.Measurement data were analyzed by student t test and enumeration data were analyzed by X2 test.Results Among 90 patients,67(74.4%) were PBMC HBV DNA negative at the end of treatment,and 23(25.6%) were positive.The serum HBV DNA positive conversion rate in PBMC HBV DNA negative patients was 13.4%,which were significantly lower than that in positive group (73.9%) (X2=30. 4873, P<0.01 ). There were no significant differences of alanine aminotransferase (ALT) levels when hepatitis flare (t=0. 8729, P=0. 3913) and relapse time (t=1. 9222, P=0. 0665) between PBMC HBV DNA negative group and positive group after withdrawal of therapy, while the serum HBV DNA rebound was greater in positive group than that in negative group (t=2. 7493, P=0. 0112). There were five patients who achieved hepatitis B surface antigen (HBsAg) seroconversion, whose PBMC HBV DNA were all undetectable, and none relapsed during follow-up for 6-12 months. The pretreatment HBV DNA as level in PBMC HBV DNA positive was (7.2±1.1) lg copy/mL, which was much higher than that in negative group[(5.2±2.1) lg copy/mL] (t=4. 3557, P<0.01). Conclusions In patients who reach the standard of drug withdrawal,PBMC HBV DNA at the end of treatment is an important predictor for durability of antiviral therapy in CHB.
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Objective To investigate the prevalence of CKD in patients underging coronary angiography with suspected coronary heart disease(CHD). Methods A total of 1031patients with suspected CHD undergoing coronary angiography in Zhongda Hospital from December 2008 to October 2009 were enrolled in the study.The prevalence of CKD and associated risk factors were analyzed.GFR Wag estimated with MDRD equation.CKD was deftned as eGFR<60branches of coronary artery was considered as CHD. Results The mean age of patients were (64.37±11.02)years.There were 543 males and 488 females,including 551 patients with CHD and 134 patients with CKD(13%).Patients with CHD had a significantly higher prevalence of CKD compared with patients without CHD(18.33%vs 6.88%,P<0.01).With the increasing number of stenosis coronary vessels(n=0,1,2,3),eGFR was declined[(84.25±19.00),(81.61±23.92),increased(0.42%,0.82%,1.96%,3.25%,P=0.006),and the prevalence of CKD increased (6.88%,13.11%,21.57%,23.38%,P<0.01).Logistic regression analysis indicated that increasing age(OR 1.094,95%C/1.068 to 1.120),increasing number of stenosis coronary vessels(OR 1.288,95%CI 1.074 to 1.543).hypertension(OR 1.974,95%CI 1.082 to 3.603),cardiac systolic insufficiency(OR 3.183,95%CI 1.696 to 5.972),and hyperuricemia(OR 5.366,95%CI 3.224 to 8.9311 were risk factors for CKD. Conclusions The prevalence of CKD in patients with CHD diagnosed by coronary angiography is quite high.Aging,elevated number of stenosis coronary vessels,hypertension,cardiac systolic insufficiency and hyperuricemia are important risk factors for angiographic patients with CKD.
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Objective:To analyze the genotypes of HCV RNA in alcoholic and nonalcoholic HCV patients and contrast the distribution of the genotypes between those,identifying whether alcoholic patients have a higher susceptibility to certain genotype than nonalcoholic patients.Meanwhile,to detect the level of IFN-? and TNF-? for gaining the mechanism of hepatic lesion in alcoholic HCV patients.Method:114 HCV patients,according to the history of alcohol abuse,were divided into the alcohol group and nonalcohol group.The genotypes of HCV RNA in the two groups were performed by gene chip technique.Liver biopsy was practiced in 30 patients to diagnose.Ficoll gradient centrifugation and ELISA were used for extraction of PBMC and detection of IFN-?and TNF-?,respectively.Result:The genotype 1b was greater than other genotypes in the two groups,and there was no statistical significance(Alcohol group was 60% and nonalcohol group was 43.75%,P=0.22).The serum titers of HCV RNA of alcohol group were(1 1100?14 174.3)?103copies/ml and the nonalcohol group were(3 927.8?4 549.6)?103copies/ml,and there was statistical significance between the two groups(P=0.025).Among 18 alcoholic patients of 30 patients practiced liver biopsy,their liver inflammation was higher than nonalcoholic patients.The level of TNF-?of the alcohol was higher than that of nonalcohol,there was statistical significance between the two groups(P=0.048) and no statistical significance between those of IFN-?.Conclusion:Alcohol can promote the copies of HCV RNA in HCV patients and aggravate liver injury,but can't add susceptibility to certain genotypes of HCV RNA.The liver inflammation of alcoholic patients is higher than that of nonalcoholic patients.TNF-?,which builds an important effect in alcoholic HCV patients,is one of the important mechanisms in the liver injury.
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Objective To evaluate the effect of combination of growth hormone(GH),somatostatin(ST) with hypocaloric parenteral nutrition(HPN) on SAP patients with MOD. Methods forty one cases of SAP complicated with MOD were randomedly divided into control group (20 cases) and experiment group (21 cases). In experiment group ,total calories and nitrogen were given 62.9～83.9kJ/(kg?d) and 0.10～ 0.12g/(kg?d). lipid calorie was supplied in less than 40 percent of the total energy.GH was percutaneously injected for 7d and ST was intravenously injected for 7～14d. Control group was given TPN only.Serum albumin, pre albumin, transferring,CRP,total lymphocyte count(TLC), urea nitrogen, nitrogen balance and serum TNF ?, IL 1,IL 6 level were determined before treatment and on the day 7 after treatment. Results After treatment, serum albumin and pre albumin and transferring increased significantly (P