Relationship between B virus hepatitis genotypes and therapeutic efficacy in early treatment for chronic hepatitis B by using lamivudine / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the relationship between hepatitis B virus (HBV) genotype and therapeutic efficacy during the early phase of lamivudine treatment.</p><p><b>METHODS</b>Totally 595 patients with chronic hepatitis B were treated with lamivudine 100 mg/day for 12 months. HBV genotypes, contents of HBV DNA, HBeAg/anti-HBe and YMDD mutation after lamivudine treatment for 12 months were determined. The data were analyzed with SPSS software.</p><p><b>RESULTS</b>In 595 patients, 8 (1.4%) were genotype A; 53 (8.9%) genotype B; 360 (60.5%) genotype C; 112 (18.8%) were coinfection of genotype B and C; 14 (2.4%) of A and C; 15 (2.5%) A and B; 6 (1.0%) of A, B, and C, and remaining 27 (4.5%) were unspecified. Patients were treated with lamivudine 100 mg/day for 12 months. Genotype B with HBV DNA levels turned to be negative (HBV DNA < 0.1 ng/L) was 87.2%, genotype C was 89.51%, coinfection of genotype B and C was 93.04% (P > 0.05). HBeAg seroconversion of genotype B was 11.65%, of genotype C was 20.64%, and of coinfection of genotype B and C was 18.57% (P > 0.05). All 69 strains of YMDD mutation were detected after lamivudine treatment for 12 months, in which genotype B was in 16.98%, genotype C in 15.38%, and coinfection of genotype B and C was in 13.86% (P > 0.05).</p><p><b>CONCLUSION</b>There was no difference in HBV genotypes and the rate of development of YMDD mutations, HBeAg seroconversion, descending of HBV DNA level in Chinese patients with chronic hepatitis B.</p>

Dynamics of peripheral blood lymphocytes and their subpopulations in patients with severe acute respiratory syndrome / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study on the dynamics of peripheral blood lymphocytes and their subpopulations in patients with severe acute respiratory syndrome.</p><p><b>METHODS</b>Using flow cytometry, the absolute numbers of peripheral blood lymphocytes and their subpopulations in 240 SARS patients (696 specimens) and 51 individuals as controls, were counted and compared.</p><p><b>RESULTS</b>The absolute numbers of peripheral blood lymphocytes and their subpopulations (CD45, CD3, CD4, CD8) were 1298 +/- 785, 897 +/- 606, 510 +/- 372, 362 +/- 263/mm(3), respectively, significantly lower in SARS patients as compared to the normal controls (2024 +/- 423, 1391 +/- 289, 795 +/- 129, 551 +/- 183/mm(3)). Of SARS patients, severe group (1095 +/- 740, 740 +/- 562, 419 +/- 346, 304 +/- 244/mm(3)) had lower counts than that of mild group (1404 +/- 788, 991 +/- 612, 564 +/- 378, 396 +/- 267/mm(3)), and in group with deaths (587 +/- 493, 369 +/- 371, 204 +/- 191, 150 +/- 130/mm(3)) was lower than that of recovery group (1355 +/- 776, 948 +/- 603, 539 +/- 375, 382 +/- 263/mm(3)). There were significant differences (P < 0.01) for CD45, CD3, CD4, CD8, but with no significant difference (P > 0.05) for CD4/CD8 ratio between severe and mild, recovery and death groups. The lymphocytes and their subpopulations (CD45, CD3, CD4, CD8) declined in the 1st week and to the lowest level (977 +/- 579, 641 +/- 466, 360 +/- 275, 270 +/- 216/mm(3)) in the 2nd week. Then the lymphocytes and their subpopulations gradually increased during the recovery of the disease.</p><p><b>CONCLUSION</b>The absolute numbers of peripheral blood lymphocytes and their subpopulations in SARS patients might be used as one of the methods for diagnosis on the severity and prognosis of the disease.</p>

Detection for severe acute respiratory syndrome (SARS) coronavirus RNA in stool of SARS patients / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate excretion of severe acute respiratory syndrome coronavirus RNA (SARS-CoV) in stool of SARS patients.</p><p><b>METHODS</b>SARS-CoV RNA was detected in stool specimens with fluorescent quantitative polymerase chain reactions (FQ-PCR) in 101 SARS patients on the 10 to 55 days after onset, 27 non-SARS patients and 400 individuals with health check-up.</p><p><b>RESULTS</b>SARS-CoV RNA was positive in stool specimens by FQ-PCR in 58 of 101 SARS patients (57.4%), and all negative in 27 non-SARS patients and 400 healthy individuals. Positive rate of SARS-CoV RNA was 100% (8/8), 67.7% (21/31), 47.4% (27/57) and 40.0% (2/5) on the 10 - 19, 20 - 29, 30 - 39 and 40 - 55 days after onset of fever, respectively, with values of logarithm of SARS-CoV RNA load of 6.06 +/- 2.05, 4.51 +/- 1.23, 3.82 +/- 1.44 and 3.57 +/- 1.25, respectively.</p><p><b>CONCLUSION</b>Positive rate and load of SARS-CoV RNA in stool of SARS patients was the highest at their acute phase, and decreased with the extension of its course.</p>

Dynamics of peripheral blood B lymphocytes and natural killer cells in patients with severe acute respiratory syndrome / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the dynamics of peripheral blood B lymphocytes and natural killer (NK) cells in patients with severe acute respiratory syndrome (SARS).</p><p><b>METHODS</b>The absolute numbers of peripheral blood B lymphocytes and NK cells in 602 serial samples from 240 patients with SARS were counted, using flow cytometry, and compared with that of normal population.</p><p><b>RESULTS</b>The absolute numbers of peripheral blood B lymphocytes and NK cells in SARS patients were significantly lower than that of the normal population (P < 0.001) and were much lower in SARS patients with severe or extremely severe types, as compared with that of moderate or mild type cases (P < 0.001). The amount of B lymphocytes in recovery SARS patients increased at the 2nd week after onset, and gradually becoming normal at the 5th week of the disease onset. The number of NK cells was in the low level at onset, and keep decreasing at the 2nd week. However, it was increasing with the recovery of the disease, but did not reach to normal level at the 5th week after onset.</p><p><b>CONCLUSION</b>The absolute numbers of peripheral blood B lymphocytes and NK cells were associated with the severity of the disease, and detection of these two kinds of cells was useful for predicting the prognosis of SARS.</p>

Detection of SEN virus in sera of patients with chronic hepatitis B and general population in 5 cities of China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the prevalence of SEN virus (SENV) infection in CHB patients in five cities of China.</p><p><b>METHODS</b>A nest-polymerase chain reaction (nPCR) was used for detection of SENV-D and SENV-H in sera of 595 CHB patients from 5 cities of China and 96 normal individuals from Beijing. A total of 7 SENV strains were analyzed by direct sequencing.</p><p><b>RESULTS</b>The prevalence rates of SENV in CHB patients and normal individuals were 61.3% and 62.5%, respectively (chi(2) = 0.047, P = 0.829). The prevalence rates of CHB patients between 5 cities were different. Nucleotide sequence analysis showed that the homology between 4 SENV-D strains was 91% - 98% and 95% - 98% between 3 SENV-H strains isolated from 5 cities in China.</p><p><b>CONCLUSION</b>SENV-D/H were prevalent in CHB patients of China and their prevalence rates were similar to that in normal individuals.</p>

Predictors associated with clinical deterioration in SARS patients / 中华实验和临床病毒学杂志

<p><b>BACKGROUND</b>To study the predictive factors associated with clinical deterioration in SARS patients.</p><p><b>METHODS</b>The clinical data of 60 SARS patients were analyzed by logistic regression and Cox's proportional hazards analysis.</p><p><b>RESULTS</b>In logistic regression models, both older age (P=0.009) and severe lymphopenia (P=0.004) were significant predictors of clinical deterioration. In Cox's proportional hazard models, severe lymphopenia was significant predictor associated with prolongation of stay in hospital.</p><p><b>CONCLUSION</b>Older age and severe lymphopenia seem to be statistically significant for predicting the clinical deterioration in SARS patients.</p>

The treatment of molecular adsorbents recirculating system artificial liver in severe liver failure patients with multiple organ dysfunction syndrome / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To evaluate the effectiveness and mechanisms of molecular adsorbents recirculating system (MARS) treatment in severe liver failure patients with multiple organ dysfunction syndrome (MODS).</p><p><b>METHODS</b>60 single MARS treatments were performed for 6 - 24 hours on 24 severe liver failure patients with MODS.</p><p><b>RESULTS</b>MARS therapy was associated with marked reduction of albumin bound toxins and water soluble toxins, together with a significant removal of NO and certain cytokines, such as TNF-alpha, IL-6, IL-8, and INF-gamma. These were associated with a improvement of the patients' clinical conditions including hepatic encephalopathy, deranged hemodynamic situation, as well as renal and respiratory function, thus resulted into marked decrease of sequential organ failure assessment (SOFA) score (from 9.72+-1.89 to 6.98+-2.34), and improving outcome: 9 patients were able to be discharged from the hospital or bridged to successful liver transplantation. The overall survival rate of 24 patients was 37.5%.</p><p><b>CONCLUSIONS</b>There is positive therapeutic impact and safety to use MARS on liver failure patients with MODS. The effectiveness of MARS is correlated with reducing the levels of NO and cytokines, except for completely removing of accumulated toxins in liver failure patients.</p>

Rapid detection of genotypes of TT virus using a heteroduplex mobility assay / 中华流行病学杂志

<p><b>OBJECTIVE</b>To establish a simple, sensitive, specific and less-costly method for detecting genotypes of TT virus (TTV).</p><p><b>METHODS</b>TTV DNA was tested by nested polymerase chain reaction (nPCR) in sera from 180 patients with different types of viral hepatitis and 96 normal individuals in Beijing. TTV genotypes were determined in 40 sera collected from TTV DNA positive patients by heteroduplex mobility assay (HMA) and through sequencing.</p><p><b>RESULTS</b>The positive rates of TTV DNA in viral hepatitis patients and normal individuals were 22.2% (40/180) and 19.8% (19/96), respectively (chi(2) = 0.220, P = 0.639). TTV DNA positive rates of patients with hepatitis A, B, C, E and non-A to E were 20.0% (6/30), 16.7% (5/30), 23.3% (7/30), 36.7% (11/30) and 18.3% (11/60), respectively. Of 40 TTV DNA positive patients, 20 (50.0%) were TTV G1, 7 (17.5%) TTV G2, 10 (25.0%) coinfected with different genotypes of TTV, and 3 untyped by HMA. Twenty G1 and 7 G2 detected by HMA were confirmed by sequence analysis. Of 10 patients coinfected with different genotypes of TTV, 5 were G1 and G2, 2 G1 and G3, 1 G1 and G4, 1 G1 and G3, and 1 with G1, G2 and G3 coinfections.</p><p><b>CONCLUSION</b>HMA was recognized as simple, sensitive, specific and less-costly, thus could be used for genotyping of TTV.</p>