Evolution of hepatitis B virus quasispecies during lamivudine-entecavir sequential therapy / 中华肝脏病杂志

<p><b>OBJECTIVES</b>To study the evolution of HBV quasispecies under the pressures of lamivudine (LAM) - entecavir (ETV) sequential therapy and its clinical significance.</p><p><b>METHODS</b>Consecutive serum samples from 2 patients underwent LAM-ETV sequential therapy were extensively studied for HBV quasispecies composition and evolution, using PCR-cloning-sequencing method. Maximum likelihood trees were built to analyze the genetic relationship between representative sequences. Correlation between HBV quasispecies evolution and serological/virological data was analyzed to determined the clinical significance of the evolution of HBV quasispecies during prolonged nucleotide analog therapy.</p><p><b>RESULTS</b>Virological breakthrough was observed in both patients. Patient I acquired sustained virological response after switching to ETV rescue therapy, whereas Patient II suffered from virological breakthrough after 72 weeks of ETV therapy. Each virological breakthrough was accompanied with the replacement of previous drug susceptible dominant quasispecies with a drug resistant variant, indicating a close correlation between quasispecies composition and drug susceptibility. The rtL180M+S202G+M204V triple mutant, which was most likely a descendant of the LAM resistant rtL180M+M204V variant, was closely correlated with ETV resistant in Patient II.</p><p><b>CONCLUSION</b>Quasispecies composition of HBV is closely correlated with nucleotide analog susceptibility. ETV resistant variant can emerge from a LAM resistant viral population. Dynamic monitoring of HBV quasispecies composition is of great importance during nucleotide analog therapy.</p>

Analysis of the correlation between the pre-S1 antigen, pre-S2 antigen and DNA of hepatitis B virus in the serum of chronic hepatitis B patients undergoing nucleoside analogue therapy / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the dynamic correlation between pre-S1 antigen, pre-S2 antigen and HBV DNA in the serum of chronic hepatitis B (CHB) patients undergoing nucleoside analogue therapy.</p><p><b>METHODS</b>12 CHB patients with transient virological response after lamivudine treatment, and 20 patients treated with adefovir for 5 years were recruited in this study. Serum samples were collected at four time points when HBV DNA fluctuated sharply during lamivudine treatment, and at 0, 8, 12, 28, 52, 104, 156, 208, 260 weeks following adefovir treatment. HBV DNA was quantified by real-time PCR, pre-S1 and pre-S2 antigens were detected by ELISA.</p><p><b>RESULTS</b>The titers of pre-S1 and pre-S2 antigens were not correlated with the HBV DNA level in the serum of lamivudine treated patients. Only in one case of the adfovir treated patients, the decrease of pre-S1 and pre-S2 antigens was in parallel with the decrease of HBV DNA. Linear regression analysis indicated that neither pre-S1 antigen nor pre-S2 antigen was correlated with HBV DNA in the serum of lamivudine or adfovir treated patients (P more than 0.05).</p><p><b>CONCLUSION</b>Our results indicate that the titers of pre-S1 and pre-S2 antigens are not correlated with the serum HBV DNA in CHB patients undergoing nucleoside analogue therapy. Neither pre-S1 nor pre-S2 is a good predictor for the outcome of nucleoside analogue treatment.</p>

Clinical Pathological Features of Mesenteric and Omental Inflammatory Myofibroblastic Tumor in 5 Children / 实用儿科临床杂志

Objective To study the clinical pathological features of mesenteric and omental inflammatory myofibroblastic tumor (IMT) in children.Method Clinical features,laboratory result,pathological evidence for diagnosis and treatment of 5 cases with mesenteric and omental IMT were analyzed and evaluated.Results Intra-abdominal mass was most frequently found in childhood mesenteric and omental IMT.Gastrointestinal obstruction was showed in 2 cases.Anemia,leucocytosis,thrombocytosis,polyclonal-hyperglobulinemia appeared in 5 cases.The histological pattern showed:4 cases were myxoid pattern IMT,1 case was compact spindle cells pattern IMT.Immunohistochemistry showed:the spindle cells were expressed vimentin,smooth muscle action(SMA) and desmin.Partial spindle cells were anaplastic lymphoma kinase(ALK) and cytokeratin(CK) positive,while S-100 protein,CD34 were negative.Complete surgical excision was performed on 5 cases.Follow-up studies ranged from 5 months to 3 years,and no patient developed recurrence.Conclusions Childhood mesenteric and omental IMT is a rare interstitial tumor.The diagnosis should be based on pathological and immunohistochemistry examinations.Most cases are benign,and complete surgical excision can avoid local recurrence.

Clinical and Pathological Analysis of 401 Cases by Mucosa Biopsy / 实用儿科临床杂志

Objective To explore the clinical and pathological feature of pediatric chronic gastritis and whether gastritics in children related to hericobacter pylori(Hp).Methods Retrospective analysis the result of 401 children with gastroendosopy and 100 species with Hp detected were performed.Results Superficial gastritis form mild to moderate was the mainly pathologic change in pediatric chronic gastritis,chronic inflammation was the mainly change in pediatric Hp infection,and the detected rate of chronic superficial gastritis from mo-(derate) to heavy was significantly higher than mild(?~2=7.61 P

Expression Levels of Interleukin-12 and Interleukin-12 mRNA in Gastritis Related Infection with Helicobacter Pylori in Children / 实用儿科临床杂志

Objective To determine the changes of interleukin-12(IL-12) and IL-12 mRNA in gastric mucosa of children with helicobacer pylori (Hp) infection,and to study the effects of Hp infection on the expression levels of IL-12 and IL-12 mRNA,and to evaluate its possible roles in the pathogenesis of gastric mucosal inflammation in Hp related gastroduodenal diseases.Methods Biopsy specimens were taken from the antral mucosa on endoscopy in patients with or without Hp infection, which were diagnosed by urease test and Giemsa staining. The expression levels of IL-12 and IL-12 mRNA in gastric mucosa were determined by ELISA and RT-PCR.Results Inflammation of gastric antral mucosa was more severe in Hp-positive mucosa .The expression levels of IL-12 and IL-12 mRNA in Hp-positive mucosa were (66.42?15.15) ng/g and (59.21?15.03)%,which were more than those in (Hp-negative )(22.22?8.79) ng/g and (17.94?7.39)%(P