RESUMEN
Objective:To explore the effects of Rougan Huaxian Granules combined with nucleoside antiviral drugs on liver and kidney function, portal hemodynamics, vascular activity, antiviral indexes and aspartate transaminase-platelet ratio index in patients with hepatitis B decompensated cirrhosis.Methods:A case-control study was conducted on 150 patients with hepatitis B decompensated cirrhosis who were hospitalized in Tangshan Infectious Disease Institute and Affiliated Hospital of North China University of Science and Technology from June 2017 to December 2019 were enrolled. The patients were divided into control group and observation group by computer random random number method, with 75 cases in each group. The control group was given routine liver protection and antiviral treatment; the observation group was given Rougan Huaxian granules on the basis of the control group treatment. Observe the changes of liver and kidney function, portal vein system hemodynamics, vascular activity, antiviral index and aspartate transaminase-platelet ratio index in the two groups. Independent sample T test was used to compare the measurement data between the two groups, paired T test was used for comparison between the same groups before and after treatment, and χ2 test was used for counting data. Results:There were no significant differences in gender, age, course of cirrhosis, Child grade of liver function and baseline data of indexes before treatment between 2 groups (ALL P>0.05). After treatment, alanine aminotransferase (ALT), aspartate aminotransferase (AST), urea nitrogen, creatinine,diameter of portal vein (Dpv), diameter of splenic vein (Dsv), endothelin-1, nitric oxide, glucagon (GLA), APRI,were all lower than before treatment. Comparison between groups, observation group ALT (51.60±15.97) U/L, AST (62.65±26.28) U/L, urea nitrogen (10.25±1.65) mmol/L, creatinine (78.54±14.09) μmol/L, Dpv (10.20±1.10) mm, Dsv (8.08±0.68) mm, endothelin-1 (31.93±6.35) ng/L, nitric oxide (41.38±8.06) μg/L, GLA (69.54±12.14) mg/L, APRI (3.14±1.35), were significantly lower than those of control group ((97.49±30.87) U/L, (96.03±25.63) U/L, (17.49±2.55) mmol/L, (116.43±22.77) μmol/L, (13.42±1.26) mm, (10.44±0.83) mm, (44.34+11.88) ng/L, (63.47±15.50) μg/L, (107.11+25.29) mg/L, (5.91±1.93)), the differences were statistically significant ( t values were respectively 11.43, 7.87, 20.64, 12.26, 16.62, 18.99, 7.98, 10.96, 11.60, 10.23, all P<0.05). After treatment, albumin, portal vein velocity (Vpv), and velocity of splenic vein blood flow (Vsv) were all higher in the two groups than before treatment. However, there was no significant difference in Vsv of the control group before and after treatment ( t=0.51, P=0.613). Comparison between groups, albumin (39.42±7.35) g/L, Vpv ((25.72±4.06) cm/s), Vsv ((24.22±6.15) cm/s) in the observation group were significantly higher than those in the control group (34.66±7.95) g/L, (19.38±3.46) cm/s, (19.54±5.88) cm/s ( t values were 3.81, 10.28, 4.76, all P<0.05). After treatment, the total effective rate (96.00%(72/75) vs. 86.67%(65/75), χ2=4.13, P=0.042), HBV DNA negative conversion rate (76.00%(57/75) vs. 58.67%(44/75), χ2=5.12, P=0.024), HBeAg negative conversion rate (50.67%(38/75) vs. 30.67%(23/75), χ2=6.22, P=0.013) and serum HBeAg/HBeAb conversion (28.00%(21/75) vs. 13.33%(10/75), χ2=4.92, P=0.027) in observation group were higher than those in control group, and the differences were statistically significant ( P<0.05). HBsAg negative rate (8.00%(6/75) vs. 5.33%(4/75), χ2=0.43, P=0.513) was higher than that of control group, but the difference was not statistically significant ( P>0.05). Conclusion:Rougan Huaxian Granules combined with nucleoside antiviral drugs has significant effect on patients with decompensated liver cirrhosis of hepatitis B, improve liver and kidney function, liver fibrosis and hemodynamics of the portal vein system, increase vascular activity function, and reduce hepatitis B virus (HBV) DNA load, HBV replication, aspartate transaminase-platelet ratio index, APRI, Toll-like receptor (TLR-4) and transforming growth factor β1 (TGF-β1) levels and improves the body′s immune status.
RESUMEN
Objective To explore the risk factom of hepatitis B virus infection and alcoholic liver disease in patients with decompensated cirrhosis complicated with liver failure.Methods One hundred and fifty-eight cases hepatitis B virus infection and alcoholic liver disease in patients with decompensated cirrhosis were selected.According to whether complicated with liver failure,the patients were divided into observation group with 62 cases (complicated with liver failure group) and control group with 96 cases (without liver failure group).The clinical data and results of 2 groups were analyzed to screen the risk factors of liver failure.Results Compared with control group,observation group in alanine aminotransferase,aspartate aminotransferase,cholinesterase,total bilirubin,and prothrombin time,activated partial thrombin time live enzymes,thrombin time,fibrinogen,serum creatinine,the differences were not statistically significant (P ＞ 0.05);in albumin ((28.02±7.36) g/L vs.(23.26±6.54) g/L,t =4.421,P =0.002),serum urea nitrogen ((8.84±4.71) mmol/L vs.(9.33±5.24) mmol/L,t =3.656,P=0.007),upper gastrointestinal bleeding(x2 =7.534,P=0.006),ascites (x2 =8.615,P =0.003),infection (x2 =10.321,P =0.001),hepatic encephalopathy (x2 =6.561,P =0.010),hepatorenal syndrome(x2 =4.952,P=0.026),the difference were statistically significant.(2)The results of logistic regression analysis showed that upper gastrointestinal bleeding (OR =1.020,95％ CI:1.003-1.036),hepatorenal syndrome(OR=2.872,95％CI:0.385-21.423) were risk factor of hepatitis B virus infection and alcoholic liver disease in patients with decompensated cirrhosis complicated with liver failure.Conclusion Upper gastrointestinal bleeding,hepatorenal syndrome are independent risk factors of hepatitis B virus infection and alcoholic liver disease in patients with decompensated cirrhosis complicated with liver failure.
RESUMEN
OBJECTIVE The short-term efficacy of endoscopic adenoid hypothermic plasma ablation and its effect on Eustachian tube function. METHODS 75 patients with obstructive sleep apnea hypopnea syndrome who were treated in our hospital from March 2013 to March 2015 were divided into two groups according to the different operative methods: nasal power cutting group(30 cases) and low temperature plasma ablation group(45 cases), comparison of the two groups of patients with surgery time, intraoperative blood loss and follow-up after 6 months of clinical efficacy and Eustachian tube function. RESULTS The time of resection, operation time and intraoperative blood loss were significantly better in the low-temperature plasma ablation group than that in the rhinectomy group, the difference was statistically significant(P0.05). CONCLUSION The clinical efficacy of low-temperature plasma ablation is close to nasal dynamic cutting, but low-temperature plasma ablation surgery in the amount of bleeding was significantly less than the nasal excision. This surgical approach is minimally invasive and safe, but its postoperative secondary infection and secondary bleeding is high, so this need for further study.
RESUMEN
Objective To explore the influence factors of cirrhosis complicated with upper gastrointestinal bleeding,and to guide the clinical treatment of patients with cirrhosis and prevent upper gastrointestinal bleeding.Methods One hundred and seventy-five cases patients with cirrhosis and upper gastrointestinal bleeding were treated in the Infectious Disease Hospital of Tangshan and the Affiliated Hospital of North China University of Science and Technology from July 2013 to July 2015 as the case group.One hundred and eighty-two patients with cirrhosis and no upper gastrointestinal bleeding at the same period in hospital as the control group.A face to face questionnaire was used to fill in the questionnaire.Results Multifactor conditional Logistic regression analysis showed that onset season (OR =4.185,95％ CI:1.874-8.354),non steroidal drugs (OR =6.215,95％ CI:2.681-15.532),drinking (OR =5.481,95％ CI:3.205-11.225),portal vein highpressure gastropathy(OR =7.658,95％ CI:3.227-14.714),diameter of portal vein (OR =8.901,95％ CI:1.218-9.026),liver function classification (OR =13.124,95 ％ CI:2.107-15.228) and esophageal varices (OR =11.021,95％ CI:2.181-13.487) were related with patients with liver cirrhosis complicated with upper digestive tract hemorrhage.Conclusion The onset season,nonsteroidal anti-inflammatory drugs,drinking,portal hypertensive gastropathy,portal vein diameter,liver function classification and esophageal varices are the risk fators of liver cirrhosis complicated with upper digestive tract hemorrhage factors.
RESUMEN
Objective To investigate the influence factors of chronic hepatitis B virus(HBV) infection complicated with chronic liver failure.Methods One hundred and eighty-six chronic HBV infection patients with chronic liver failure were selected as our subjects,who were hospitalized in the Affiliated Hospital of Hebei United University from Jul.2008 to Dec.2013 and they served as case group.Meanwhile,186 patients with chronic HBV infection were selected and served as control group,who were hospitalized during the same period.A self-mad questionnaire was used to collect the information.The influence factors related to HBV infection complicated with acute on chronic liver failure were recorded.Results Multivariate conditional Logistic regression analysis showed that 8 variables were risk factors in terms of chronic HBV infection complicated with acute on chronic liver failure and they were virus overlap infection (OR =6.523,95％ CI:2.034 -10.030),drug application (OR =9.012,95％ CI:3.018-13.241),alcohol (OR =7.2520,95％ CI:1.985 -11.247),bacterial infection(OR =4.378,95％ CI:2.032-5.648),surgical operation (OR =8.514,95％ CI:2.114-17.253),emotional stress and fatigue (OR =2.217,95％ CI:1.729-5.648),genetic (OR =11.124,95％ CI:2.168-13.429),high PCR-HBVDNA quantity (OR =1.628,95％ CI:1.504-3.282).And one protective factorwas the usage of antiviral drug(OR=0.163,95％CI:0.085-0.417).Conclusion The risk factors include virus over infection,application of hepatotoxic drugs,disease before drinking,bacterial infection,surgical operation,emotional stress and fatigue,the genetic parents and high PCR-HBVDNA quantification;and antiviral drugs application is the protective factor in terms of Chronic HBV infection complicated with acute-on-chronic liver failure.
RESUMEN
This study was aimed to investigate the antitussive, expectorant and antiasthmatic effects of aqueous extracts and the chemical split fractions ofMori Cortex. Cough mice models induced by ammonia water were used to observe the effect on arresting cough. The phenol red expectoration method in mice was used to observe the effect on expelling phlegm. Histamine and acetylcholine mixture induced asthma model was used to observe the effect on relieving asthma. Isolated trachea model was used to observe the effect on relieving spasm. Compared with the control group, the low, medium and high doses of aqueous extracts ofM. Cortex can obviously decrease the frequency of cough, increase phenol red output of trachea in mice, prolong the latent period of asthma in guinea pigs, and increase the antispasmodic rate. The medium dose had the best effect. The comparison between different chemical split fractions ofM. Cortex and the control group showed that the 30% and 50% ethanol fraction ofM. Cortex can obviously decrease the frequency of cough and prolong the latent period of cough induced by ammonia water in mice, increase phenol red output of trachea in mice (P<0.05 orP<0.01); and 30% ethanol fraction and fatty oil fraction can prolong the latent period of asthma in guinea pigs (P< 0.05 orP<0.01). In addition, 30% ethanol fraction can obviously reduce the degree of tracheal contraction. It had certain effect of relieving spasm. It was concluded that aqueous extracts ofM. Cortex had better effects on relieving cough, expectorant and antiasthma. The effective part was the 30% ethanol fraction, which was the dose equivalent of 1/3 of the medium dose. It had significant effect on relieving cough, expectorant and antiasthma. The effect was equivalent to the medium dose of aqueous extracts of M. Cortex.
RESUMEN
Objective To analyze the efficacy and prognosis of different antiviral agents on compensated hepatitis B cirrhosis.Methods Eight hundred and sixty-five cases of Hepatitis B patients with compensated cirrhosis were randomly divided into five groups:A group(n =143,subcutaneous injection interferon 3 million U every other day for 48 weeks),B group(n =171,orally treatment with lamivudine 100 mg/d for 48weeks),C group(n =137,orally treatment with adefovir 10 mg/d for 48 weeks),D group(n =83,oral treatment with entecavir O.5 mg/d,for 48 weeks) and E group(n =331,treated with general hepatoprotective drugs).Clinical symptoms and signs,changes in liver function were observed and prothrombin time activity degrees (PTA),quantitative HBV-DNA,HBeAg seroconversion and HBeAg/HBeAb conversion situation were detected.Results There were significant differences on HBeAg seroconversion between A group and other four groups after treated for48 weeks(31.5％ vs 13.5％,22.6％,18.1％,5.7％,x2 =58.56,P ＜0.01) and at the end of follow up (33.1％ vs 14.2％,23.3 ％,23.6％,6.4％,x2 =52.87,P ＜ 0.01).Patients' condition in A,B,C,D groups progressed slowly,and their incidence rates of decompensate cirrhosis were significantly lower than that in group E(x2 =122.41,P ＜ 0.01).The incidence rate of liver cancer in group A was significantly lower than that in B,C,D,E groups (x2 =19.61,P ＜ 0.01).Conclusion Antiviral therapy of interferon and nucleoside drugs can slow the progression of compensated Hepatitis B cirrhosis and reduce the incidence rates of decompensate cirrhosis.And interferon can significantly reduce the incidence rate of liver cancer.
RESUMEN
Objective To investigate the efficacy and safety of Fuzheng huayu capsule in combination With anti-viral drugs in the treatment of hepatitis B-mediated liver cirrhosis.Methods One hundred and twentysix patients with liver cirrhosis resulting from hepatitis B were randomized into group A (38 cases receiving conventional therapy),group B (41 cases receiving conventional therapy + entecavir)and group C (47 cases receiving conventional therapy + entecavir and anti-fibrosis treatment ).The Fuzheng Huayu capsule was administrated for 24 weeks and all the patients were observed for 48 weeks.Results The liver cirrhosis-related parameters in Group C were more remarkably improved than that of Group A and Group B:HA( [ 152.3 ± 72.3 ]μg/L vs.[212.3 ± 86.9] μg/L,[325.6 ± 153.1 ] μg/L,F =30.18,P ＜ 0.01 ),LN( [ 104.7 ± 23.9 ] μg/L vs.[ 139.9 ±28.9] μg/L,[ 127.7 ±76.0] μg/L,F =36.99,P ＜0.01 ),Pc Ⅲ ( [ 167.8 ±61.4] μg/L vs.[207.5 ±78.1 ] μg/L,[ 263.1 ± 113.2 ] μg/L,F =30.34,P ＜ 0.01 ) and Child-Pugh scale ( [ 6.94 ± 1.31 ] vs.[ 7.53 ±1.24 ],[ 8.77 ± 1.36 ],F =14.45,P ＜ 0.01 ).The liver function-related parameters in Group C were significantly different from that of Group A and Group B:ALT( [58 ±41 ] U/L vs.[ 147 ±96] U/L,[75 ± 19]U/L,F =16.82,P ＜0.01 ),ALB( [38.1 ± 1.7]g/L vs.[26.5 ±3.5 ] g/L,[35.4 ± 1.8 ] g/L,F =4.69,P ＜0.01),TBil ([31.9 ± 12.7] μmol/L vs.[85.2 ±58.3] μmol/L,[46.1 ± 17.8] μmol/L,F.=15.10,P ＜0.01)and PTA improvement ([76 ±24]％ vs.[57 ± 12]％,[73 ± 18]％,F =79.26,P ＜0.01).Conclusion Entecavir can rapidly and effectively inhibit the replication of HBV in patients with decompensated hepatitis Bmediated cirrhosis and improve the liver function.When combined with fuzheng huayu capsule,entecavir will effectively improve the cirrhosis and elevate the serum albumin level.
RESUMEN
Objective To investigate the changes of serum concentration of amylase(AMY) and pathological of pancreas in severe acute pancreatitis of SD-rats treated with Ulinastatin combined with qingyitang and to provide the basis for clinical application.Methods Ninty male SD-rats with average weight of(271.59±11.13) g were conventional feeding for a week.Twelve hours before experiment,they were forbidden to take food.They were randomly divided into five groups(with 18 in every group):sham operation group,severe acute pancreatitis group,Ulinastatin treated group,qingyitang treated group,Ulinastatin combined with qingyitang treated group.Then eighteen rats in every group were divided randomly into 6 h,12 h and 24 h groups with six rats in each group.Severe acute pancreatitis model was created by retrograde injection of 5％ sodium taurocholate (0.1 ml/100 g) through pancreatic duct,in sham operation group,only pancreas were flipped.The three treated groups were treated with vein injection of Ulinastatin(20 000 U/kg)or qingyitang perfusion(1 ml/100 g)or Ulinastatin combined with qingyitangat 0 h,5 h and 11 h after severe acute pancreatitis model successfully created.AMY and patholigical changes of pancreas were measured.Results There was significant difference on AMY level at 6 h,12 h and 24.h between severe acute pancreatitis group and sham operation group[6 h:(16 518±327)U/L vs(1671±175)U/L,F =3296.24,P ＜0.01;12 h:(16 796±338) U/L vs(1751±223)U/L,F =3802.44,P ＜0.01;24 h:(1554±373) U/L vs(1724±187) U/L,F =2382.54,P ＜0.01].Compared with severe acute pancreatitis group,the AMY level and pathologic score both decreased significantly in Ulinastatin treated group,qingyitang treated group and Ulinastatin combined with qingyitang treated group(P ＜0.05 or P ＜ 0.01).At the same time,the AMY level and pathologic score both decreased more in Ulinastatin combined with qingyitang treated group than Ulinastatin treated group and qingyitang treated group(P ＜0.05 or P ＜ 0.01).Conclusion Combination of Ulinastatin with qingyitang in treatment of severe acute pancreatitis of rats is superior to treatment with single medicine.
RESUMEN
Objective To evaluate the anti-fatigue effect by taurine in mice.Methods Mice were randomly divided into three groups,two groups were given taurine at dose of 10.0 g/L and 2.5 g/L respectively,and the control group was given physiological Saline.After 30 days of intervention,the swimming test was carried out,the liver glycogen,serum BUN and Lactic acid were also measured.Results Both high taurine and low taurine prolonged the swimming time significantly comparing with the control group ([380.9 ± 65.5 ] s vs [226.0 ± 44.8 ] s vs [175.7 ± 24.4 ] s,P ＜ 0.05 ).Liver glycogen also increased significantly,they were ( 21.85 ± 4.21 ),( 13.26 ± 2.16 ) ( 7.13 ± 1.34 ) mg/g in high,low taurine and control group respectively.The level of BUN and LAC were decreased significantly in taurine groups ( P ＜ 0.05 ).Conclusion Taurine may has the anti-fatigue effect to some extent.
RESUMEN
Objective To compare the curative effect of magnesium isoglycyrrhizinate and compound ammonium glycyrrhetate in patients with liver cirrhosis of decompensated.Methods Eighty-six patients with liver cirrhosis of decompensated were enrolled into the study and randomly divided into two groups: the treatment group(n=43) were given magnesium isoglycyrrhizinate once a day in addition to routine treatment;the control group(n=43) were given compound ammonium glycyrrhetate once a day in addition to routine treatment.The clinical manifestation,including symptoms,signs and hepatic function were observed.The clinical lab data,including blood routine examination,urine routine test and kidney function of all patients from two groups were collected before and after the treatments.The adverse drug reactions were monitored throughout the whole therapy.Results ALT and AST turned to normal in 97.7%(42/43) and 90.7%(39/43) of patients respectively in the treatment group,which were significantly higher than those of 72.1%(31/43) and 74.4%(32/43) respectively in the control group( x2=9.86 and 4.73,respectively,Ps＜0.05). Time to turning to normal in ALT and AST were(21.6±9.1)d and(23.1±10.6)d in the treatment group,which were significantly lower than those of(37.5±17.8)d,and(46.7±19.4)d respectively in the control group(t=5.23 and 7.01,respectively,Ps＜0.01).Conclusion The results suggested that magnesium isoglycyrrhizinate had better effect on alleviating symptoms and decreasing enzyme in treatment of liver cirrhosis of decompensated stage.
RESUMEN
0.05) were seen among the cases given autohemotransfusion including hemodilution and the use of retrieved blood comparing with the allogeneic transfusion. Therefore, hemodilution and retrieving blood for retransfusion are safe and reliable ways to be adopted in orthopaedic surgery.