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ObjectiveTo investigate the correlation of serum angiopoietin-1 （Ang-1）， angiopoietin-2 （Ang-2）， and Ang-1/Ang-2 ratio with HBA DNA and alanine aminotransferase （ALT） in patients with chronic hepatitis B （CHB） or liver cirrhosis. MethodsClinical data and serum specimens were collected from 99 patients with CHB and 59 patients with liver cirrhosis who were admitted to Beijing YouAn Hospital， Capital Medical University， from March 2018 to October 2019， and 46 individuals who underwent physical examination were enrolled as control group. PCR was used to measure serum HBV DNA level， and ELISA was used to measure the serum levels of Ang-1 and Ang-2. The serum levels of Ang-1 and Ang-2 and Ang-1/Ang-2 ratio were compared between groups. The Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups， and the Bonferroni method was used for further comparison between two groups； the Spearman correlation analysis was used to investigate the correlation of Ang-1， Ang-2， and Ang-1/Ang-2 ratio with HBV DNA and ALT. ResultsCompared with the control group， the CHB group and the liver cirrhosis group had a significant reduction in the level of Ang-1 （479.0 pg/mL and 208.4 pg/mL vs 671.0 pg/mL， both P<0.05）， and compared with the CHB group， the liver cirrhosis group had a significant reduction in the level of Ang-1 （P<0.001）. Compared with the control group， the CHB group and the liver cirrhosis group had a significant increase in the level of Ang-2 （286.1 pg/mL and 438.4 pg/mL vs 198.0 pg/mL， both P<0.001）， and compared with the CHB group， the liver cirrhosis group had a significant increase in the level of Ang-2 （P<0.001）. Compared with the control group， the CHB group and the liver cirrhosis group had a significant reduction in Ang-1/Ang-2 ratio （1.6 and 0.5 vs 3.4， both P<0.001）， and compared with the CHB group， the liver cirrhosis group had a significant reduction in Ang-1/Ang-2 ratio （P<0.001）. The Spearman correlation analysis showed that in the CHB group， Ang-1 was negatively correlated with HBV DNA and ALT （r=-0.400 and -0.394， both P˂0.001）， Ang-2 was positively correlated with HBV DNA and ALT （r=0.365 and 0.351， both P<0.001）， and Ang-1/Ang-2 ratio was negatively correlated with HBV DNA and ALT （r=-0.463 and -0.473， both P<0.001）； in the liver cirrhosis group， Ang-1， Ang-2， and Ang-1/Ang-2 ratio had no correlation with HBV DNA or ALT （all P>0.05）. ConclusionThere are significant changes in the serum levels of Ang-1 and Ang-2 and Ang-1/Ang-2 ratio in patients with CHB or liver cirrhosis， and Ang-1， Ang-2， and Ang-1/Ang-2 ratio reflects the degree of liver injury in patients with CHB to a certain extent.
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Objective:To study the influence of different feeding patterns on mother-to-child transmission (MTCT) of hepatitis B virus (HBV) in pregnant women with high viral loads who received antiviral medication during pregnancy to the day of delivery.Methods:This prospective cohort study was conducted in Beijing You'an Hospital. From January 1, 2019, to March 31, 2020, and 574 pregnant women with positive hepatitis B surface antigen (HBsAg) and HBV DNA>2×10 5 IU/ml were enrolled. All participants received tenofovir, telbivudine, lamivudine, or propofol tenofovir from 24-28 weeks of gestation and discontinued on the day of delivery, and their neonates were postnatally given routine passive-active immunoprophylaxis. Based on the feeding patterns, the subjects were divided into three groups: breastfeeding ( n=257), bottle-feeding ( n=241) and mixed feeding groups ( n=76). The follow-up data were obtained from liver functions and HBV DNA level of the mothers at 6-8 weeks postpartum and HBV serological markers of infants at 7-12 months. One-way ANOVA, Student-Newman-Keuls, Chi-square test or Fisher exact test, and repeated measures ANOVA were used to analyze the data. Results:The average maternal HBV DNA levels before antiviral treatment did not differ significantly between the three groups [(7.90±0.67), (7.82±0.70), (7.83±0.70) log 10 IU/ml, F=0.912, P>0.05]. HBV DNA level before delivery in the mixed feeding group was slightly lower than that in the breastfeeding and bottle-feeding group [(3.87 ±1.08) vs (4.21±1.17) and (4.30±1.28) log 10 IU/ml, q= 3.052 and 3.831, both P<0.05], while the comparison between the latter two groups showed no significant differences ( P>0.05). After delivery, HBV DNA level in the bottle-feeding group was slightly lower than that in the breastfeeding group [(7.42±0.93) vs (7.69±0.90) log 10 IU/ml, q=4.583, P<0.05]. Among 580 infants (including six pairs of twins), only one bottle-fed infant (0.4%, 1/243) was infected with HBV through MTCT, and none in the breastfeeding or mixed feeding group ( P=0.553). Conclusions:For pregnant women with high viral loads of HBV who have received antiviral medication during pregnancy, although HBV DNA level will rebound after discontinuation upon delivery, breastfeeding is recommended considering it does not increase the risk of MTCT.
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Objective@#To investigate the genetic characteristics of Lamivudine-resistant mutation patterns and HBV S gene mutants in patients with chronic hepatitis disease of different disease progression.@*Methods@#Blood samples of LAM-resistant patients with chronic hepatitis disease were collected. HBV RT gene nucleotide sequences were obtained, and then differences in drug-resistant mutation patterns, drug susceptibility and HBV S gene mutants characteristics between the two groups were analyzed.@*Results@#Forty-seven chronic hepatitis B (CHB) patients and 16 HBV-related liver cirrhosis (LC)/HBV-related hepatocellular carcinoma (HCC) patients were included in this study. M204I single point mutation and L180M+ M204I/V were the most common pattern during patients with chronic hepatitis disease (35/63, 55.56%). The numbers of resistant to three nucleos(t)ide analogues in LC/HCC group was higher than CHB group’s (62.50% vs 34.04%, P=0.046). In HBV S gene, more immune associated HBsAg-escape mutations were detected in LC/HCC group than that in CHB group (62.50% vs 31.91%, P=0.031). I126T/V and G145A (for LCC/HCC group, 60%), I126S/T and S117T (for CHB group, 46.67%) were showed as the most common form for HBsAg escape mutations in the two groups. The two groups both detected RT mutations concomitantly with stop codon mutations in S gene (rtA181T/sW172* and rtM204I/sW196*).@*Conclusions@#Different characteristics in Lamivudine-resistant mutations and associated HBV S gene mutants were found in patients with chronic hepatitis disease of different disease progression, and LC/HCC patients exhibit more multi-drug resistant variants and immune associated HBsAg-escape mutants than CHB patients.
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Objective To investigate the surgical methods and effect of double-cut nasolabial muscle directional three-dimensional reconstruction on the secondary deformity of unilateral cleft lip repair.Methods We first increased a contralateral vermilion secondary incision based on the nasolabial muscle directional three-dimensional reconstruction, without damaging the contralateral white lip skin, via suturing both sides of nose wings bundle of nose outside corner under the columella muscle, and overlapping suturing both sides of the orbicularis muscle flap, and then rebuilt and took shape of the nest and the crest.Results All incisions healed well in 18 patients, all nasal deformities were corrected better than the traditional methods, with the nasal base plump, the nasal sill formed close to the contralateral side, and rebuild the philtrumdimple and philtrum crest, with clear appearance and symmetrical form.A good appearance was obtained on the both sides of nostril, nasal base and the nasal sill, and the effect of preoperative design achieved.Conclusions Both sides of the nostrils size, nasal sill and shape are almost perfectly symmetrical, and the double-cut nasolabial muscle directional three-dimensional reconstruction is suitable for repairing the secondary deformity after unilateral cleft lip repair.
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Objective To design a new vermilion musculomucosal flap to reconstruct the normal appearance of unilateral cleft lip,and to analyze the clinical effects.Methods All patients were repaired with Millard method,and vermilion musculomucosal flap was formed with fixed point method to repair vermilion.Normal function and morphology were recovered by reconstructing lip beads and forming a peak of cupid's bow.Results 78 cases were enrolled in this study.They were followed-up for 6 to 36 months after operation.Except for 6 cases of nasal deformity and 5 mild lift of vermilion of affected side,67 cases obtained satisfied nasolabial form and function,with full decline and symmetry of cupid's bow peak,and well form of nasolabial fold,and natural transition of vermilion,and significance of lip beads,and inconspicuous scars.Conclusions Appling vermilion musculomucosal flap for reconstructing vermilion of unilateral cleft lip has good effect,and it is simple and feasible.It can be a regular surgery method,and is worthy of clinical promotion.
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Objective To analyze hepatitis B virus ( HBV)-specific T lymphocyte responses dur-ing different stages of HBV infection.Methods Eighty-four patients with HBV infection were recruited in this study.They were divided into four groups including acute HBV infection group (8 cases), chronic HBV infection group (39 cases), hepatocirrhosis group (17 cases) and hepatocellular carcinoma group (20 ca-ses) .HBV-specific T cell responses were detected by using ELISPOT assay in combination with magnetic beads sorting assay.Results (1)The magnitudes of HBV-specific T cell responses in patients with acute HBV infection ,chronic HBV infection , hepatocirrhosis and hepatocellular carcinoma were respectively (2067.00±1029.00) SFU/106 PBMCs, (288.50±57.69) SFU/106 PBMCs, (96.25±31.06) SFU/106 PBMCs and (71.47±14.26) SFU/106 PBMCs.The differences with the magnitudes of HBV-specific T cell responses among patients from the four groups were significant (P<0.01).(2)HBV Core (HBV C) protein induced the strongest T cell responses[ (323.90±130.30) SFU/106 PBMCs] in patients with acute HBV infection in comparison with HBV-surface ( HBV S ) protein, HBV P protein and HBV X protein ( P=0.0037).The strongest T cell responses in patients with chronic HBV infection were induced by using HBV P protein [(127.20±54.42) SFU/106 PBMCs], followed by using HBV S protein, HBV C protein and HBV X protein (P=0.0159).(3)The magnitudes of IFN-γreleasing induced by HBV X protein, HBV P protein, HBV S protein and HBV C protein showed no significant differences in patients with either hepato-cirrhosis or hepatocellular carcinoma, but were lower than those induced in patients with chronic HBV infec-tion.Conclusion HBV-specific T cell responses were gradually reduced along the progression of HBV in-fection from acute HBV infection to chronic HBV infection, liver cirrhosis and hepatocellular carcinoma.The HBV-specific T cell responses induced by viral proteins might play different roles in different stages of HBV infection.