ABSTRACT
Objective To investigate the effect of entecavir in the treatment of chronic severe hepatitis B and the influence on peripheral blood T cell subsets and liver function.Methods 100 patients with chronic severe hepati-tis B were selected as research subjects,who met the inclusion criteria.The patients were randomly divided into the observation group(50 cases)and control group(50 cases),then the clinical effects were assessed after treatment. Results The CD +4 ,CD +4 /CD +8 of the observation group and control group after treatment were (40.65 ±5.06)%and (35.32 ±5.18)%,(1.83 ±0.35)% and (1.30 ±0.26)%,which were significantly higher than before treat-ment,the differences were statistically significant(t =7.762 and 5.192,6.319 and 3.392,all P <0.05),the CD +8 levels were (22.13 ±4.85)% and (27.24 ±4.66)%,which were significantly lower than before treatment,the differences were significant(t =8.553,3.667,all P <0.05).The CD +4 ,CD +4 /CD +8 of the observation group were significantly higher than the control group,the differences were statistically significant(t =3.479,5.413,all P <0.05),the CD +8 was significantly lower than the control group,the difference was significant(t =3.551,P <0.05). The ALT,AST,HBV-DNA of the observation group and control group after treatment were (45 ±17)U /L and (90 ± 22)U /L,(55 ±20)U /L and (86 ±25 )U /L,(2.71 ±0.50)copy/mL and (4.62 ±0.53)copy/mL,which were significantly lower than before treatment,the differences were statistically significant(t =10.568 and 6.773,9.935 and 7.035,6.339 and 3.448,all P <0.05).The ALT,AST,HBV-DNA of the observation group were significantly lower than the control group,the differences were statistically significant(t =3.662,3.514,3.604,all P <0.05). Conclusion Entecavir can effectively suppress viral replication,enhance immune function and improve liver func-tion,and has better security in the treatment of 50 patients with chronic severe hepatitis B,which is worthy of clinical use.
ABSTRACT
BACKGROUND: Procalcitonin (PCT), C-reactive protein (CRP), and white blood cells (WBCs) are inflammatory markers used to diagnose severe bacterial infections. We evaluated the diagnostic role of these markers and compared their accuracy for spontaneous bacterial peritonitis (SBP) associated with chronic severe hepatitis B (CSHB). METHODS: PCT and CRP concentrations, WBC count, and other hematological parameters were measured in serum from 84 well-characterized patients with CSHB, of whom 42 had SBP. Receiver operating characteristics (ROC) curve analysis was performed to assess the diagnostic accuracy. RESULTS: PCT and CRP concentrations were significantly higher in the CSHB patients with SBP (n=42) than CSHB patients without SBP (n=42). PCT and CRP concentrations were more accurate than WBC count for the diagnosis of CSHB-associated SBP. The optimal cutoff value of PCT was 0.48 ng/mL. The PCT concentration was significantly correlated with the CRP concentration and WBC count. CONCLUSIONS: Serum PCT and CRP seems to be better markers than WBC for the diagnosis of CSHB patients with SBP.
Subject(s)
Female , Humans , Male , Middle Aged , Age Factors , Area Under Curve , Bacterial Infections/complications , Biomarkers/blood , C-Reactive Protein/analysis , Calcitonin/blood , Hepatitis B, Chronic/complications , Leukocyte Count , Leukocytes/cytology , Peritonitis/complications , Protein Precursors/blood , ROC Curve , Sex Factors , TemperatureABSTRACT
ObjectiveTo analyze the expression of osteopontin (OPN) and interleukin-17 (IL-17)and study the roles in the pathogenesis of chronic severe hepatitis B.MethodsTwenty patients of acute on chronic liver failure were collected from the infection disease in-patients department of the First Affiliated Hospital of Medical College,Zhejiang University from 2009 to 2010,and 40 health controls were from medical examination center during the same period.Meanwhile,Balb/C mice were used for ConA injection to induce fulminant hepatitis and the plasma,serum and liver tissue of mice were collected.OPN and IL-17concentrations were measured using ELISA kits.PBMC were separated and cultured with anti-TNF-α or TNF-α.Supernatants were collected for analysis of OPN and IL-17.Differences between groups were evaluated by using a Student's t test and the relationship between IL-17 and OPN were evaluated by Pearson correlation.ResultsIn chronic severe hepatitis B group,levels of OPN and IL-17 were markedly higher than those of healthy control,respectively.(42.4 ± 12.9 vs 10.6 ±4.8 pg/ml; 1460.1 ±523.1 vs 472.8 ±67.5 ng/ml) ( t =2.387,3.570,P ＜ 0.05).The level of OPN in blood and liver reached peak at 6 hours at 12 hours after ConA injection,respectively.The level of IL-17 in blood and liver was significantly increased after ConA injection.IL-17 were positive correlated with OPN levels (R2 =0.582,P =0.026).TNF-α can increase the level of OPN secreted by lymphocytes.ConclusionsOPN and IL-17 levels in peripheral blood of hepatitis B patients are closely related to the hepatitis B degree.TNF-α can increase the level of OPN secreted by lymphocytes.
ABSTRACT
OBJECTIVE To investigate and control the risk factors about hospital infection in patients with chronic severe hepatitis B. METHODS Totally 466 hospitalized patients with chronic severe hepatitis B in our hospital from Jan 2001 to Dec 2007 were studied retrospectively. RESULTS The total incidence of hospital infection was 20.1% for inpatients with chronic severe hepatitis B,the infection located as follows:56 patients were in lower respiratory tract (59.6%);17 patients in upper respiratory tract (18.1%);7 patients with bacteremia (7.4%);3 patients in urinary tract (3.2%);7 patients in gastrointestinal tract (7.4%);and 1 patients was in cutis tissue (1.1%). CONCLUSIONS The knowledge about the on infection risk factors liver disease must be strengthened by hospital medical staff of the use of antibiotics must be strict controlled in principle,operation must be aseptic,the concept of prevention standards must be enhanced,and the primary disease must be actively treated,all these can effectively reduce infection in hospital.
ABSTRACT
OBJECTIVE To analyze the characteristics of nosocomial infections,risk factors and prevention measures in patients with chronic severe hepatitis B.METHODS A retrospective review of the medical records of 354 patients with chronic severe hepatitis B admitted between Jan 2006 and Dec 2006 was performed.RESULTS The incidence of nosocomial infection in patients with chronic severe hepatitis B was 16.67% and mainly infection sites consisted of abdominal cavity(40.32%),and upper respiratory tract(22.58%).The most common infection(47.46%) was occurred during the period of hospitalization 15-30 days after and the most commonly pathogens were Gram-negative bacilli(68.75%).The infection risk factors were associated with invasive operation,hypoalbuminemia,endotoxemia,advanced age,antibiotics application and decrease in cell immune function.CONCLUSIONS It is important for the patients with chronic severe hepatitis B to strengthen management on related risk factors in order to prevent nosocomial infection effectively.
ABSTRACT
Objective To explore the relationship between chronic severe hepatitis and cryptosporidium infection to provide evidences for scientific prevention and treatment of chronic severe hepatitis. Methods Fecal samples of 218 patients with chronic severe hepatitis B (CSHB) and 140 children with diarrhea were collected, and were examined for cryptosporidium oocytes by using auramine-phenol staining method (AA-p) and modified acid-fast staining method (MAF), and for cryptosporidium DNA by PCR and restriction digestion analysis. The factors affecting cryptosporidium infection of patients with CSHB were preliminarily analyzed. Results The positive rates of cryptosporidium infection detected by AA-p, MAF and PCR in the patients with CSHB and children with diarrhea were 4.1%, 3.2%, 6.0% and 0.7%, 0.7%, 1.4%, respectively. The positive rate of cryptosporidium infection detected by PCR in patients with CSHB was higher than that in children with diarrhea (P
ABSTRACT
Objective:In order to explore the AICD happening in PBMC and the situation of peripheral blood lymphocyte subsets in chronic/ chronic severe hepatitis B Methods:The peripheral blood mononuclear cells of patients with chronic /chronic severe hepatitis B were cultured with PHA P for 72 h Then the apoptosis of PBMC was assayed by flow cytometry The peripheral blood lymphocyte subsets of patients with chronic /chronic severe hepatitis B were assayed by flow cytometry and automatic blood analyzer Results:The percentage of apoptotic PBMC in chronic hepatitis B group was higher than that in chronic severe hepatitis B group(P