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@#Abstract: Objective To explore the threshold of ALT for initiating antiviral therapy in HBV infected patients, and to provide a basis for initiating antiviral therapy in chronic HBV-infected patients. Methods This retrospective cohort study recruited 707 consecutive treatment-naïve chronic hepatitis B (CHB) patients undergoing diagnostic liver biopsy in the department of infectious diseases of the Affiliated Hospital of Yan′an University from October 2013 to August 2018. Liver biopsy specimens were obtained under ultrasound guidance using Menghini 16G disposable needles. The METAVIR scoring system, which is commonly used internationally, was used to divide the patients into the group with mild liver tissue injury and the group with significant liver tissue injury, and the alanine aminotransferase (ALT) levels were measured separately. Receiver operating characteristic (ROC) curve and Mann-Whitney U test were used to evaluate the diagnostic value of ALT for significant liver tissue injury under different demographic characteristics. Results Of 707 patients, 292 (41.30%) had significant liver tissue injury confirmed by liver biopsy (METAVIR ≥A2 and/or F2). When the ULN of ALT was set to NICE criteria (30 U/L for males, 19 U/L for females), AASLD criteria (35 U/L for males, 25 U/L for females) and EASL or APASL criteria (40 U/L for males and females), CHB patients with <ULN accounted for 32.38%, 35.03% and 36.07% of significant liver tissue injury, respectively. And significant liver tissue injury in CHB patients with 1-2×ULN accounted for 41.99%, 41.85% and 50.30%, respectively. The optimal ALT critical values were 33 U/L for overall patients, 25 U/L for females, 45 U/L for males, 45 U/L for ≤30 years olds, 33 U/L for>30 years olds, 22 U/L for HBeAg negative and 31 U/L for HBeAg positive patients. Conclusions The threshold of ALT for initiating antiviral therapy in chronic HBV patients should be individualized, especially should be down-regulated for the females, olders and HBeAg-negative patients.
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Objective:To reevaluate the upper limit of normal (ULN) of serum alanine aminotransferase (ALT) by retrospectively analyzing the ALT levels in healthy people in Ningbo area.Methods:A total of 56 140 people who underwent health examination and detection of liver biochemical indexes in the Affiliated Hospital of Medical School of Ningbo University and Yinzhou Huamao Hospital of Ningbo from 2018 to 2020 were enrolled. After excluding relevant factors that may lead to liver injury, 11 411 people were included to compare the difference of serum ALT levels among different genders and age groups (20 to 29 years, 30 to 39 years, 40 to 49 years and 50 to 59 years) to determine the ALT ULN in different gender groups. Statistical methods were performed using two independent samples t test and analysis of variance. Results:The serum ALT of males was (19.20±7.90) U/L, which was higher than that of females ((13.75±6.17) U/L), with statistical significance ( t=41.16, P<0.001). The serum ALT ULN in males and in females were 35 U/L and 26 U/L, respectively. The serum ALT levels of 20 to 29, 30 to 39, 40 to 49 and 50 to 59 years old groups were (15.48±7.61) U/L, (16.21±7.40) U/L, (17.36±7.52) U/L and (18.77±7.57) U/L, respectively.The difference was statistically significant ( F=71.51, P<0.001). Serum ALT level in 50 to 59 years old group was higher than that in 20 to 29 years old group, and the difference was statistically significant ( t=13.11, P<0.01). In males, the ALT ULN of 20 to 29 years old was the lowest of 34.43 U/L, and highest of 35.29 U/L in 40 to 49 years old. In females, the ALT ULN in the 20 to 29 years old group was the lowest of 23.01 U/L, and the ALT ULN in the 50 to 59 years old group was the highest of 30.79 U/L. ALT ULN increased with age in females. The serum ALT of males was higher than that of females in all age groups ( t=29.55, 26.91, 13.43 and 4.62, respectively, all P<0.05). Conclusions:The serum ALT level is significantly correlated to gender and age. The serum ALT ULNs of healthy adult are 35 U/L in males and 26 U/L in females in Ningbo area.
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Objective To investigate the upper limit of plasma′s alanine aminotransferase (ALT ) donated by volunteers in Chongqing city ,utmost avoid blood discarding due to ALT unqualified and provide a scientific basis for the improvement measures . Methods Checking 115 530 blood donors′ALT by rate method ,the activity of ALT value was normal distribution ,deem x ± 1 .96s as the upper limit of ALT of blood donors ,the upper limit of ALT and the unqualified rate was analyzed according tomonth ,age , gender .Results 95% upper limit of blood donors′ ALT reference range to less than 47 .88 U/L .From June to September ,ALT value unqualified rate compared with other months of the year have significant difference (P0 .05) .There was obvious difference about unqualified rate and upper limit between different sex group ,there was statistical significance (P<0 .05) .Conclusion The quantitative blood agen‐cies should increase propagandist strength ,optimize ALT screening strategy ,gender‐specific blood donors screening measures should be taken ,re‐establish a more scientific ALT Elimination standard ,the maximum reduct blood ALT′s failure rate .To ensure the safety and clinical local blood supply at the same time ,the maximum to avoid waste of blood .
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The most useful for evidence of streptococcal infection of group A beta hemolytic serological response is the determination of antistreptolysin O (ASO). Strep throat is most common infection caused by these organisms, which can lead to non-suppurative complications such as acute rheumatic fever and glomerulonephritis.These complications can be prevented by proper diagnosis and treatment. For determination of ASO in Venezuela imported reagents are used whose reference values have been established in different populations and latitudes; so the aim of this study is to determine the reference values of ASO titlesin 203 students aged 10 to 15 years old enrolled in four institutions of the Municipality "Francisco Linares Alcántara", Aragua state, through an investigation of cross-sectional descriptive.Each student a sample of whole blood was collected for determination of ASO titles using neutralization tests and agglutination.The correlation between positive ASO titles were determined by both methods, the sensitivity, specificity and positive and negative predictive values of the agglutination test was calculated.The results refer to as reference value for the method of neutralization to 250 Todd Units/mL and for technical agglutination 400 International Units/mL. The concordance was weak between the two tests and obtained sensitivity, specificity, positive and negative predictive values of 100%, 60%, 24.2% and 100%, respectively. The disclosure in the health centers in the mentioned municipality of referential values of ASO found in this study is suggested.
La respuesta serológica más útil para evidenciar la infección por estreptococo beta hemolítico del grupo A,es la determinación de antiestreptolisina O (ASTO). La faringitis estreptocócica es la infección más frecuentemente causada por estos microorganismos, que puede conllevar a complicaciones no supurativas como la fiebre reumática aguda y la glomerulonefritis. Dichas complicaciones pueden prevenirse mediante un diagnóstico y tratamiento oportuno. Para la determinación de ASTO en Venezuela se emplean reactivos importados cuyos valores referenciales han sido establecidos en poblaciones y latitudes diferentes a la de nuestro país; por lo que el objetivo del presente estudio es determinar los valores referenciales de ASTO en 203 estudiantes de 10 a 15 años de edad inscritos en cuatro instituciones del Municipio "Francisco Linares Alcántara", estado Aragua, mediante una investigación de tipo descriptivo de corte transversal. De cada estudiante se recolectó una muestra de sangre total para la determinación de ASTO empleando pruebas de neutralización y aglutinación. Se determinó la concordancia entre los títulos positivos de ASTO por ambos métodos; se calculó la sensibilidad, especificidad y valores predictivos positivo y negativo de la prueba de aglutinación. Los resultados refieren como valor referencial para el método de neutralización hasta 250 Unidades Todd/mL y para la técnica aglutinación hasta 400 Unidades Internacionales/mL. La concordancia fue débil entre ambas pruebas y se obtuvo una sensibilidad, especificidad, valores predictivos positivo y negativo de 100%, 60%, 24,2% y 100%, respectivamente. Se sugiere la divulgación de los resultados de este estudio en los centros de salud del municipio mencionado.
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Aim: Many medicinal plants have been used traditionally in treating ailments in humans and animals. However, for most of herbal remedies, no scientific toxicity profiles exist in literature. In this study, the safety profile of an herbal extract mixture containing Entada leptostachya (EL) and Prosopis juliflora (PJ) was determined using acute oral toxicity tests using adult female Wistar albino rats. Place and Duration of Study: Laboratories in the departments of Chemistry, Zoology, Botany and Biochemistry of Jomo Kenyatta University of Agriculture and Technology (J.K.U.A.T.) between March 2012 and April 2012. Methodology: The OECD 425 guidelines (Up-and-Down procedure) were followed. Different dosages (control, 175, 550, 1750 and 5000 mg/kg body weight) were used in the experiment. Selective observations and analysis were made and recorded on mortality, signs of pain or distress and moribund animals, biochemical and macroscopic (pathological, organ and live body weights) analyses. Results: During the entire period of the study, no signs of pain or enduring distress were observed neither was there any mortality. Alanine aminotransferase (ALT) values were within range (for experimental rats) apart from the rat in control while Aspartate aminotransferase (AST) values were within range (for experimental rat) apart from two rats in the upper limit. Macroscopic organ observations did not show colour or texture consistent with drug-induced inflammation or lesions. The toxicity studies of the extract mixture showed that the median lethal dose (LD50) was above the upper limit of 5000mg/kg body weight. Conclusion: In conclusion, the LD50 of the extract mixture was found to be greater than 5000 mg/kg body weight and was, therefore, considered safe and has potential as a novel herbal preparation.
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Objective: To establish serum TSH reference values for a population of Brazilian elderly, and to compare them to those found in the adult population. Subjects and methods: Healthy volunteers aged 70 to 85 years, without known thyroid disease or risk factors for thyroid dysfunction, who did not use any medication that could potentially interfere with TSH, were selected. Subjects with goiter, palpable thyroid nodules, anti-thyroperoxidase antibodies, or altered free T4 were excluded. The sample consisted of 360 older adults (180 per sex). Results: TSH values corresponding to the 2.5th and 97.5th percentile of the sample were 0.2 and 4.62 mIU/L, respectively. TSH > 2.5 mIU/L was seen in 25.26% of the volunteers, > 3 mIU/L in 15.26%, and > 4 mIU/L in 6.1% of them. TSH values were slightly higher than those previously reported for adults (18-60 years). Conclusion: This study suggests an upper limit for normal TSH of approximately 4.6 mIU/L for the Brazilian elderly population. .
Objetivo: Estabelecer os valores de referência do TSH sérico em uma população idosa brasileira e compará-los ao encontrado na população adulta. Sujeitos e métodos: Foram selecionados voluntários saudáveis; com idade entre 70 e 85 anos; sem doença tireoidiana conhecida ou fatores de risco para disfunção tireoidiana; sem uso de medicamentos potencialmente interferentes no TSH. Indivíduos com bócio, nódulo tireoidiano palpável, anticorpos antitireoperoxidase ou T4 livre alterado foram excluídos. A amostra foi composta de 360 participantes (180 de cada sexo). Resultados: Os valores correspondentes aos percentis 2,5 e 97,5 da amostra foram 0,2 e 4,62 mIU/L, respectivamente. TSH > 2,5 mIU/L foi visto em 25,26% dos indivíduos, > 3 mIU/L em 15,26% e > 4 mIU/L em 6,1%. Os valores de TSH foram discretamente maiores que os encontrados previamente em indivíduos adultos (18-60 anos). Conclusão: Nosso estudo sugere para a população idosa brasileira o limite superior normal do TSH de aproximadamente 4,6 mIU/L. .
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Aged , Aged, 80 and over , Female , Humans , Male , Thyrotropin/blood , Age Factors , Brazil , Healthy Volunteers , Luminescent Measurements , Reference Values , Statistics, NonparametricABSTRACT
OBJECTIVES: This study evaluated the ototoxicity by mixed organic solvents on workers'hearing using the upper limit of hearing(ULH). METHODS: Seven hundred ninety-seven male workers in the ship building industry who were evaluated by interview with an upper limit of hearing from August 2000 to July 2002 were enrolled in the study. The subjects were divided into 3 groups according to exposure profile and job: officers, field supporters, and painters. To assess the ototoxicity of mixed organic solvent exposure on hearing, with regard to confounders, the general liner model was used. RESULTS: After controlling for the possible confounders, such as age, career, noise exposure level, tinnitus, alcohol intake, and smoking, the estimated mean for ULH of the painter group was higher than that of the officer and the field supporter groups. These differences of mean ULH were at the borderline of statistically significance(p=0.069). CONCLUSIONS: The results of this study suggest that a relatively lower level of mixed organic solvent chronically affected the hearing organ or auditory pathway. ULH seems to be a useful method for early detection of the ototoxicity of organic solvents.
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Humans , Male , Auditory Pathways , Construction Industry , Hearing , Noise , Ships , Smoke , Smoking , Solvents , TinnitusABSTRACT
We measured the concentration of serum PSA to define statistical upper limits for PSA in relation to age in 228 men without clinical evidence of prostatic cancer. We defined the cancer-free group as men with a PSA less than or equal to 2.5ng/ml(ELSA-PSA' monoclonal immunoradiometric assay) and nonsuspicious digital rectal examination and those with an abnormality in either parameter underwent transrectal ultrasound and pathologically excluded prostatic cancer from the group by transrectal prostatic biopsy or transurethral resection. A total 252 men between 40 and 79 years of age entered the protocol, of whom 228 men satisfied our cancer-free criteria. There was a significant correlation between natural logarithm transformed PSA(In PSA) and age by linear regression analysis(r=0.32, p=0.02) and age-specific upper limits of PSA=mean+2SD) were 2.62ng/ml in the 40 to 49-year group, 3.45ng/ml in the 50 to 59-year group, 5.09ng/ml in 60 to 69- year group and 7.07ng/ml in the 70 to 79-year group.
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Humans , Male , Biopsy , Digital Rectal Examination , Linear Models , Prostatic Neoplasms , UltrasonographyABSTRACT
The urine arsenic of 563 workers was determined;an investigation on labor hygien in the workshop and a physical examination of these 563 cases were made.The results indicate that the present suggested value of urine arsenic is rather high in the Yunnan area.In order to raise the reference value of determining urine arsenic in the diagnosis of arsenic poisoning,we suggest that the upper limit of the normal value of urine arsenic be 0.1mg/L and establish an area health standard throughout the country.