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1.
Zhonghua ganzangbing zazhi ; Zhonghua ganzangbing zazhi;(12): 489-494, 2023.
Artículo en Chino | WPRIM | ID: wpr-986158

RESUMEN

Objective: To explore the role of transient elastography technology in the assessment of disease staging and treatment in patients with chronic hepatitis B virus (HBV) infection. Methods: Patients who were clinically diagnosed with chronic HBV infection at Beijing Tsinghua Changgung Hospital from January 2018 to December 2021 was collected. Liver stiffness measurement (LSM) examination was performed more than once by transient elastography. The count data were expressed as cases (%) and the χ (2) test was made. Fisher's exact test was used with theoretical frequency less than 5. The measurement data between two groups was compared by t-test. Multiple groups were compared with an analysis of variance. Results: 1 055 patients were included in this study, including 669 (63.4%) males and 386 (36.6%) females. 757 (71.8%) patients were untreated. Among the untreated patients, the LSM value in the immune clearance (10.2 ± 3.8) kPa (187 cases, 40.4%), and the reactivation stages (9.1 ± 3.4) kPa (114 cases, 24.6%) was significantly higher than that in the immune tolerance (8.7 ± 3.6) kPa (78 cases, 16.8%) and immune control stages (8.4 ± 3.5) KPa (84 cases, 18.1%), and the difference between the four groups was statistically significant (F = 5.31 and P = 0.03). With ALT (male: 30 U/L, female: 19 U/L) as defined the normal value, the LSM value in the immune tolerance and the immune control stages were (5.8 ± 0.9) kPa and (7.1 ± 2.5) kPa, respectively, which were significantly lower than those of patients in the immune tolerance and immune control stages, and the difference was statistically significant (P < 0.01). There were 294 (38.8%) patients with uncertain period, excluding patients with fatty liver. Patients with uncertain periods were divided into four gray zone (GZ) groups: immune tolerance stage: LSM (5.1 ± 1.3) kPa was significantly lower than GZ-A (6.5 ± 2.4) kPa, t = 2.06, P = 0.03, and the difference was statistically significant; immune control stage: LSM was (5.6 ± 1.5) kPa, which was also lower than GZ-C (6.8 ± 1.3) kPa, t = 3.08, P = 0.02, and the difference was statistically significant; immune clearance stage: LSM > 8.0 kPa. LSM values showed a year-by-year reduction in patients with expanded indications who started antiviral treatment and were followed up for three years. Conclusion: The LSM value is significantly lower after the decrease of the defined high-normal ALT value in patients with the immune tolerance and immune control stages of chronic HBV infection. The LSM values of GZ-A and GZ-C in the uncertain periods of chronic HBV infection are higher than those of patients in the immune tolerance and immune control stages.


Asunto(s)
Humanos , Masculino , Femenino , Hepatitis B Crónica/tratamiento farmacológico , Cirrosis Hepática/patología , Diagnóstico por Imagen de Elasticidad , Antivirales/uso terapéutico , Hígado/patología
2.
Artículo en Chino | WPRIM | ID: wpr-707224

RESUMEN

Objective To analyze the change of intrahepatic regulatory T cells (Treg )/helper thymphorytes (Th)17 balance in patients with different phases of chronic hepatitis B virus (HBV ) infection ,and to explore the role of Treg/Th17 balance in maintaining immune tolerance and inducing immune clearance ,and its influence on disease progression .Methods Sixty-eight patients with chronic HBV infection who underwent liver biopsy in Tianjin Second People′s Hospital were included .The 68 patients included 20 cases in immune tolerant (IT) phase ,36 cases in immune clearance (IC) phase and 12 cases in inactive phase .Eight healthy liver transplant donors were collected as healthy controls .The intrahepatic Treg/Th17 levels were detected by immuno-histochemical method . The changes of Treg/Th17 balance in patients with different phases of chronic HBV infection ,and the relationship between Treg/Th17 balance and the decreases of hepatitis B surface antigen (HBsAg ) , hepatitis B antigen (HBeAg) and HBV DNA levels in the peripheral blood were analyzed in patients with IC phase at two weeks of admission .Results The intrahepatic Treg and Th17 levels in IC phase group were the highest , then and they were higher in inactive phase group were higher than those in IT phase group ,And they were the lowest in control group .The Treg level in IC phase group increased significantly compared with the other three groups (all P< 0 .01) ,and there were no significant differences among the other three groups (all P> 0 .05) .The Th17 level between IT phase group and inactive phase group was not significantly different (P> 0 .05) ,while the differences were not significant in other groups (all P>0 .05) .Treg/Th17 ratio of IT phase group was the highest ,then the ratio of control group was higher than that of inactive phase group ,and IC phase group was the lowest ratio .The differences between IC phase group ,control group and IT phase group were significant (all P< 0 .05) ,and the difference between inactive phase group and IT phase group was also significant (all P<0 .05);and there was no significant difference among other groups (all P>0 .05) .The decreases of HBsAg ,HBeAg and HBV DNA levels in the peripheral blood at two weeks admission were negatively correlated with the intrahepatic Treg cell level in patients in IC phase of chronic HBV infection ( r= -0 .941 ,-0 .869 ,and -0 .883 ,respectively ,both P<0 .01) .The Treg ,Th17 levels and their ratio in IC phase group with different degree of inflammation and fibrosis had significant differences :G4 group > G3 group > G2 group ,S3 group > S2 group > S1 group (all P<0 .05) .Conclusions There is no change of the Treg/Th17 balance in IT phase ,and Treg has no influence on maintaining immune tolerance in chronic HBV infection .T he imbalance of Treg/Th17 is observed in IC phase .Th17 may actively participate in the immune-mediated liver injury and the development of hepatic fibrosis in CHB patients .Treg may inhibit inflammation and reduce liver injury via the negative feedback regulation mechanism ,and may impede the eradication of HBV simultaneously .

3.
Artículo en Chino | WPRIM | ID: wpr-707247

RESUMEN

Objective To investigate the relationship between hepatic steatosis and virological markers in patients with chronic hepatitis B (CHB ) during immune clearance (IC ) phase.Methods Pathology proven CHB patients in IC phase were collected from the Liver Center of the First Affiliated Hospital of Fujian Medical University from January 2009 to October 2016 .Patients were divided into non-to mild fatty liver (F0 -F1) group and moderate to severe fatty liver (F2 -F4) group according to the liver steatosis degree .The relationship between liver steatosis and virological markers in serum was compared .The measurement data were analyzed using independent sample t test ,and the count data were analyzed by chi-square test .Results A total of 298 patients were included ,including 237 males (79 .5%) and 61(20 .5%) females ,and the average age was (32 .4 ± 10 .3) years old .The 23 .5%(70/298) of these patients had liver steatosis .A total of 273 (91 .6%) cases were in F0-F1 group ,and the remaining 25 (8 .4%) cases were in F2 -F4 group.The patients in F2 - F4 group had higher body mass index ([25.90 ± 2.70] vs [21 .68 ± 2.90] kg/m2) ,serum triglyceride ([1.52 ± 0.77] vs [1.11 ± 0.55] mmol/L) and cholesterol ([4 .88 ± 1 .15] vs [4 .33 ± 0 .92] mmol/L) than F0-F1 group ,and the differences were all statistically significant (t= -7 .007 ,-2 .667 ,and -2 .751 ,respectively ,all P<0 .05).In addition , the serum levels of HBsAg and HBV DNA in F2 -F4 group were also significantly higher than F0 -F1 group (t= -3 .291 and -2 .831 ,respectivelt ,both P<0 .01).According to the grading of inflammation and fibrosis ,the differences of HBsAg and HBV DNA levels between F0 -F1 group and F2 -F4 group were statistically significant only in patients with more severe inflammation (t= -2 .738 and -2 .135 , respectively ,both P<0 .05) or less severe fibrosis (t= -2 .258 and -2 .333 ,respectively ,both P<0 .05).Conclusion Among CHB patients experiencing immune clearance ,serum HBsAg and HBV DNA levels are positively correlated with the severity of hepatic steatosis ,and this phenomenon is closely related to the degree of liver inflammation.

4.
Artículo en Chino | WPRIM | ID: wpr-470511

RESUMEN

Objective To screen and analyze microRNA (miRNA) molecules associated with immune clearance in patients with chronic hepatitis B (CHB).Methods Twelve hospitalized CHB patients and 9 healthy individuals from Taizhou People's Hospital during June 2011 and August 2012 were enrolled.miRCURYTM chip was used to identify differential expression patterns of miRNA.The target genes of differentially expressed miRNA molecules were predicted by TargetScan,miRBase and miRanda databases,and their molecular pathways and functions were analyzed with bioinformatic methods.Results Compared with healthy individuals,52 differentially expressed miRNA molecules were identified in PBMCs of CHB patients,including 33 up-regulated and 19 down-regulated ones.With TargetScan,miRBase and miRanda databases,354 target genes were predicted in up-regulated miRNA molecules,and 1 935 target genes were predicted in down-regulated miRNA molecules.Gene ontology (GO) and Pathway analysis showed that several molecular pathways might be affected by up or down-regulated miRNA molecules.miRNA-mRNA network analysis showed that some target genes might be regulated by miRNA molecules like hsa-miR-520d-5p,hsa-miR-106a-Sp,hsa-miR-30a-5p and hsa-miR-29b-3p,and constituted a complex molecular network.Conclusion There are several miRNA molecules with abnormal expressions in CHB patients,which may be involved in immune clearance through the regulation of target genes and molecular pathways.

5.
Artículo en Chino | WPRIM | ID: wpr-439881

RESUMEN

This study was aimed to explore the antitumor effect of volatile oil of X ihuang pill and its immune mecha-nism in order to screen the antitumor active site of Xihuang pill. Among 70 female Wistar rats, 10 rats were random-ly selected as the blank control group; and the other 60 rats was used in the establishment of walker 256 breast can-cer cell tumor-bearing rat models. The model rats were randomly divided into the negative control group (model group), high-dose volatile oil group, middle-dose volatile oil group, low-dose volatile oil group, high-dose Xihuang pill group, and lentinan group (positive control group), with 10 rats in each group. The intragastric administration was given twice a day for 14 days. Blood was taken from the abdominal aorta. Tumor tissues was removed and weighed to calculate the tumor inhibitory rate. ELISA method was used to detect the level of IL-2, IL-6, IL-10, IFN-γ and TGF-β in peripheral blood. The flow cytometry was used to detect the content of CD3+ T cell, CD4+ T cell, CD8+ T cell, and B7-1 cell (CD80). The results showed that the tumor inhibitory rates of volatile oil of high-dose group and middle-dose group were 28.4% and 24.1%, respectively. Compared with the model group, the average level of IL-2 and IFN-γ of volatile oil of high-dose group and middle-dose group and CD3+ T cell, CD8+ T cell, B7-1 cell con-tent were obviously increased (P< 0.05). It was concluded that volatile oil of Xihuang pill had certain antitumor ef-fect, which was one of the antitumor active sites of Xihuang pill. The volatile oil of Xihuang pill upregulates the lev-els of IL-2 and IFN-γ, as well as the contents of CD3+ T cell, CD8+ T cell, B7-1 cell in order to increase the im-mune clearance function of tumor-bearing rats.

6.
Artículo en Chino | WPRIM | ID: wpr-446736

RESUMEN

Objective To investigate the expression of microRNA-548ah (miR-548ah) and microRNA-4804 (miR-4804) in peripheral blood mononuclear cells (PBMCs) of patients with chronic hepatitis B virus infection and their clinical significance.Methods PBMCs were collected from 29 patients with chronic hepatitis B (CHB),30 hepatitis B virus carriers (HBVC),26 inactive HBsAg carriers (IASC) and 28 healthy controls in Taizhou People's Hospital during September 2012 and August 2013.Expressions of miR-548ah and miR-4804 in PBMCs were detected by fluorescence real-time quantitative RT-PCR (qRT-PCR).Receiver operating characteristic (ROC) curve was used to evaluate the expression of miR-548ah and miR-4804 in distinguishing immune tolerance phase and clearance phase of HBV infection.Pearson correlation analysis was performed to assess the correlations of miRNAs expression with clinical markers alanine aminotrans ferase (ALT) and HBV DNA loads.Results There were significant differences in expressions of miR-548ah and miR-4804 in PBMCs between CHB,HBVC,IASC groups and control group (F =28.16 and 83.17,P < 0.01).Compared with control group,miR-548ah was up-regulated in CHB group(P < 0.01),and down-regulated in HBVC and IASC groups (P < 0.01) ; miR-4804 was up-regulated in CHB group (P < 0.01),down-regulated in HBVC group (P < 0.01),while there was no significant difference between IASC group and control group in miR-4804 expressions(P > 0.05).The areas under ROC curve (AUCs) of miR-548ah and miR4804 in differentiation of immune tolerance and immune clearance were 0.966 and 0.997,and the sensitivities and specificities were 89.7%,96.6% and 99.6%,100.0%,respectively.No significant correlation was found between the expression of miR-548ah,miR-4804 and ALT,HBV DNA loads (r=0.14,0.18,-0.20 and-0.19,P>0.05).Conclusion miR-548ah and miR-4804 may be involved in the immunopathogenesis of CHB,and their expression levels in PBMCs are helpful in differentiation of immune tolerance and immune clearance in HBV infection.

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