Study on the etiology of acute hepatitis hospitalized patients in Beijing Ditan Hospital from 2002 to 2011 / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To explore the etiology of acute hepatitis hospitalized patients in Beijing Ditan Hospital from 2002 to 2011.</p><p><b>METHODS</b>We summed up the changes in the characteristics of the etiology of acute hepatitis of patients mentioned above, and preliminarily analyze the causes.</p><p><b>RESULTS</b>From 2002 to 2011, 6235 patients with acute hepatitis were admitted to Ditan Hospital, aged between 12 and 78 years old, Of which 4309 were male and 1926 female. Acute viral hepatitis accounted for 70.44%-85.07%, while CMV, EBV, drug-induced liver injury accounted less than 5%, and acute hepatitis D and acute hepatitis C less than 1.10%. From year to year, the incidence and constitution of acute hepatitis changed significantly. The proportion of patients with acute hepatitis in total hospitalized patients was from 20. 38% to 2.05%. In 10 years, the percentage of acute hepatitis A decreased most obviously, about 99.11%, while 45.07% decline in incidence of acute hepatitis B and 62. 28% of acute hepatitis E. The constituent ratio of acute hepatitis also changed significantly. The proportion of acute hepatitis A declined from 31.31% in 2002, to less than 1% in 2011. The proportion of acute hepatitis B increased from 26.47% in 2002 to 45.88% in 2011, an increase of about 2 folds in 10 years. The proportion of acute hepatitis E increased from 26.73% in 2002 to 32.05% in 2010, a rise of 1.20 times in 10 years.</p><p><b>CONCLUSIONS</b>The proportion of patients with acute hepatitis in total hospitalized patients decreased from 20. 38% in 2002 to 2. 05% in 2011 in Beijing Ditan Hospital. The constituent ratio of acute hepatitis changed, too.</p>

Characteristics of patients and their medical cost on 14 398 hospitalized patients suffered form hepatitis B,from a hospital of infectious diseases located in Beijing / 中华流行病学杂志

Objective This article was to focus on the study of patient's profile,type and distribution of the disease and the related factors contributing to medical cost on 14398 cases of hospitalized patients with hepatitis B from a hospital of infectious diseases located in Beijing,in order to provide basic information on optimizing the prevention and treatment strategies.Methods Information on hospital admission of patients、with hepatitis B was collected and SPSS 16.0 statistics software package was used to analyze the profile,disease patterns distribution,structure of medical costs and main contributors related to medical costs.Results Through analysis,we found that the proportion of male patients was much bigger than that of female patients,with ratio as 2.9.The average age of patients with hepatitis B was 45.2 years old.The treatment process was time consuming,and the mortality rate was hiigh.Our data showed that the mortality of hospitalized patients was up to 7%and the average age of death was 55 years old.Hepatitis B infection was easy to develop into chronic,cirrhosis and even liver cancer,Fortreatment cost,the largest cost share was the drugs being used which accounted for 62.4%.In terms of health care costs,it was high and the total cost of hospitalization was related to the following factors:days of hospitalization;complexity of the disease condition and the factors as the severity of the disease complications as surgery,frequencies of rescue,type of disease etc;basic information of the patients as age,occupation,origin.Conclusion Compared with other diseases,the proportion of male patients with hepatitis B was much higher than that of the famale.Hepatitis B had a longer duration and difficult,treatment high cost of medical care,poor prognosis,high mortality rate;Cost control,Call not simply fixcd by single disease,but by complexity of the disease and patient characteristics.

High rates of HBsAg loss and seroconversion result from prolonged course of pegasys treatment / 中华肝脏病杂志

<p><b>OBJECTIVE</b>HBsAg loss and seroconversion in patients with chronic hepatitis B leads to long-lasting good clinical outcomes. The aim of this paper was to investigate to improve the rate of HBsAg loss and seroconversion in chronic hepatitis B patients by prolonged treatment of PEG-IFNa-2a. 217 cases of HBeAg-positive or negative patients were collected from inpatient and outpatient in Beijing Ditan Hospital from May 2005 to October 2009 and subcutaneous injection of 135 ug or 180 ug PEGASYS were given once a week according to body weights. The drug doses were adjusted according to the neutrophilic granulocyte and platelet counts during treatment course. Quantitative HBV DNA test was conducted using a commercially available real-time fluorescence quantitative PCR kit. The serum HBsAg/anti-HBs and HBeAg/anti-HBe were quantitatively detected by Abbott i 2000 chemiluminescent kit before and during treatment every three months. Patients with HBsAg steadily decreased and reached serum HBsAg level below 200 IU/ml after 48 weeks of treatment would receive prolonged treatment. Patients with more than 12 weeks of treatment entered into analysis. Main efficacy of prolonged treatment was evaluated by the incidences of HBsAg loss and seroconversion.</p><p><b>RESULTS</b>The treatment courses of the 217 patients ranged from 12.0 to 197.6 weeks with an average of 53.1+/-33.4 weeks, 118 cases took more than 48 weeks and another 89 cases less than 48 weeks. 13.4% (29/217) of patients achieved HBsAg loss or HBsAg seroconversion with treatment courses from 17.6 to 197.6 weeks (average 75.4+/-42.8 weeks). Among these 29 patients 24 (82.8%) received more than 48 weeks of treatment, but the treatment courses of HBV DNA reached undetectable level were 20.8+/-8.9 weeks. In this study, 9.5% (14/148) of HBeAg-positive patients achieved HBsAg loss or seroconversion, all of them treated more than 48 weeks, from 48 to 194 weeks, average 81.32+/-39.36 weeks. 21.7% (15/69) of HBeAg-negative patients achieved HBsAg loss or seroconversion, significantly higher than that of HBeAg-positive patients (9.5%) (x2 = 6.129, P = 0.013). The average treatment course for HBeAg-negative patients with HBsAg loss was 70.2+/-48.0 weeks, shorter than that of HBeAg-positive patients with HBsAg loss (81.3+/-39.4 weeks), but no significant difference (t = -0.522, P = 0.602) found between.</p><p><b>CONCLUSION</b>Higher rate of HBsAg loss and seroconversion could be obtained by individual extended treatment courses in patients with rapid HBV DNA and HBsAg response to PEG-IFNa-2a treatment and the HBeAg-negative patients could got higher rate of HBsAg loss than HBeAg-positive patients.</p>

Predictive study of HBsAg in different stages of neonatal venous blood on failure of blocking HBV mother to infant transmission / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>In this study, we discuss the predictive value of different content of HBsAg in different stages of neotal venous blood on failure of blocking mother to infant transmission of HBV.</p><p><b>METHODS</b>150 infants born of chronically HBV infected mothers who were positive of both HBsAg and HBeAg and who also had a HBV DNA virus load above 10(5) copies/ml were enrolled. These infants were given hepatitis B virus immune globin (HBIG) 200 IU immediately after birth and were given hepatitis B vaccine 10 or 20 microg at brith, 1 month and 6 months after birth. HBV serological index of these infants were test at birth, 1 month and 7 months after birth respectively. Different content of HBsAg in different stages of neonatal venus blood were analyzed to predict the failure of blocking mother to infant transmission of HBV.</p><p><b>RESULTS</b>11 infants failed in blocking of HBV mother to infant transmission. The positive rate of HBsAg at birth, 1 month and 7 months after birth were 41.26%, 10.49% and 7.69% respectively, and were 97.90%, 65.73% and 13.29% of HBeAg. The positive predictive value of HBsAg > or = 0.05 and HBsAg > or = 1 IU/ml at birth were 18.64% and 70% respectively, and were 73.33% and 100% one month after birth.</p><p><b>CONCLUSIONS</b>Infants with HBsAg > or = 1 IU/ml at birth should be suspicious of failure on blocking HBV mother-to-infant transmission and it should be more credible if the infant has HBsAg > or = 1 IU/ml one month after birth. How to improve the blocking rate of neonates who were positive of HBsAg at birth and one month after birth should be the focus of our future research.</p>

Study on the association of clinical characteristic, CD4+ and level of HIV viral load among 690 initial HIV-infection / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand the correlation between CD4+ cell count, HIV viral load (VL) and clinical characteristics among patients when HIV-1 was tested positive and initial AIDS diagnosis was made.</p><p><b>METHODS</b>690 HIV-infected cases from Beijing Di-Tan Hospital were included and under a cross sectional study while SPSS statistical method was used.</p><p><b>RESULTS</b>The 690 HIV-infected cases would include 458 males and 232 females with age range from 2-72 years (mean age as 35.3). The modes of transmission showed that: homosexual contact taking up 17.5% while heterosexual was 16.7%. Most of the homosexual-infected ones lived in Beijing and most of them had bachelor or master's degrees. 19.4% of the transmission happened between heterosexual/bisexual couples, suggesting that HIV was transmitted through the "bridge population" while the rest were infected by contaminated blood/plasma. Many of the cases were identified when they lately visited the pre-operation surveillance point in the hospital. Serious immunodeficiency symptoms or signs were discovered as: CD4+ count < 50 cell/microl, serious opportunistic infections including pneumocystosis pulmonary, cerebral toxoplasmosis and cryptococcal meningitis. Higher frequencies of diseases seen were dermotosis, pneumonia, upper respiratory tract infection, hepatitis and digestive tract moniliasis.</p><p><b>CONCLUSION</b>Because of the late identification of the disease, serious immuo-suppression situation often appeared, suggesting that there was an urgent need to improve STD/AIDS knowledge on those HIV (+) people so they might have an early access to accept medical care.</p>

Changes of trace elements in regional lymph nodes of gastric carcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the relationship between the changes of trace elements and lymphatic metastasis in gastric carcinoma.</p><p><b>METHODS</b>Trace elements including Fe, Mg, Mn, Ca, Cu, Zn, Se were measured in primary gastric carcinoma and regional lymph nodes from 40 patients with gastric carcinoma, and compared among the primary tumor, metastatic, and non-metastatic nodes.</p><p><b>RESULTS</b>There were no significant differences in the contents of Fe, Mg, Mn and Ca among primary gastric tumors, regional lymph nodes with or without metastasis (P=0.372 - 0.741, P > 005), and no significant differences in the contents of all 7 trace elements between primary tumors and metastatic lymph nodes (P=0.15 - 0.59, P > 005). Compared with metastatic lymph nodes, the contents of Zn, Se significantly decreased, while Cu and Cu/Zn significantly increased (P=0.001 - 0.009, P< 0.01) in non-metastatic lymph nodes. The content of Zn in N2 positive lymph nodes was significant lower than that in N1 positive nodes (P=0.027). There were no significant difference in the contents of all 7 elements between intestinal type and diffuse type (P=0.149 - 0.758, P > 0.05).</p><p><b>CONCLUSIONS</b>Lymphatic metastasis of gastric cancer is concomitant with the changes of trace elements, and the changes of Zn, Cu, Se may be related with lymphatic metastasis.</p>

Clinical evaluation of masticatory function of implant supported dentures in partially edentulous patients / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the masticatory efficiency of implant supported dentures in partially edentulous patients and the patients' satisfaction on masticatory function.</p><p><b>METHODS</b>The masticatory efficiency of implant supported dentures of 22 patients were tested. The questionnaire of the patients' satisfaction about masticatory function had also been collected. The correlativity of the masticatory efficiency of implant supported dentures and the scores evaluated by patients on masticatory function were analyzed.</p><p><b>RESULTS</b>There were no differences in masticatory efficiency between implant supported denture and non-implant supported denture (natural teeth and porcelain-fused-to-metal fixed bridges). The patients gave high scores to the satisfaction about masticatory function in the questionnaire. But the test results of masticatory efficiency were not related with the scores evaluated by patients.</p><p><b>CONCLUSION</b>The implant supported denture could meet the requirement of normal masticatory function. The patients were satisfactory with the masticatory function of implant supported dentures, but the patients' subjective evaluation about masticatory function was probably influenced by varied factors.</p>

Difference and significance of T-lymphocyte subsets in differential diagnosis between severe acute respiratory syndrome and common atypical pneumonia / 中华实验和临床病毒学杂志

<p><b>BACKGROUND</b>To clarify the difference and significance of T-lymphocyte subsets in differential diagnosis between severe acute respiratory syndrome SARS) and common atypical pneumonia.</p><p><b>METHODS</b>Totally 100 patients hospitalized in Beijing Ditan Hospital since March to June 2003 with clinical diagnosis of SARS were involved in this study. These patients courses of disease were over 3 weeks. These patients were divided into two groups, SARS group and common atypical pneumonia group (non-SARS group). The counts of CD3+, CD4+ and CD8+ T-lymphocyte of two groups were systematically recorded and analyzed.</p><p><b>RESULTS</b>Sixty-five of the patients were confirmed to have common type of SARS, including 26 males and 39 females, 50 cases received methylprednisolone treatment. Thirty-five cases had common atypical pneumonia (non-SARS), 21 were males while 14 were females, 20 cases received methylprednisolone treatment. All the cases of two groups were cured in the end. The SARS patients T-lymphocyte counts decreased first and then increased. Before 15 days of disease course, mean CD3+, CD4+, CD8+ T-lymphocyte counts of SARS patients were decreased apparently (694+/-568/microl, 441+/-356/microl, 309+/-462/microl). After 15th day of disease course, the counts gradually returned to normal CD3+, CD4+, CD8+ T-lymphocyte counts of non-SARS patients were normal. Compared with patients of the same group who were not treated with glucocorticoids, T-lymphocyte counts of non-SARS patients treated with glucocorticoids had no obvious difference. But glucocorticoids had some effect on SARS patients recovery of cellular immune function, i.e., it delayed the recovery by about 6 days.</p><p><b>CONCLUSION</b>With or without treatment with glucocorticoids,the lowered CD3+, CD4+, CD8+ T-lymphocyte counts in the early stage are of very important significance in differential diagnosis between severe acute respiratory syndrome and common atypical pneumonia.</p>

Clinical experience from treatment of seven SARS patients / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To summarize the clinical experience from treatment of patients with severe acute respiratory syndrome (SARS).</p><p><b>METHODS</b>Retrospective analysis of seven patients with SARS in Ditan hospital treated since April 22 in 2004 was performed.</p><p><b>RESULTS</b>In the 7 patients, 2 were male, 5 were female, and the average age was (35.3 plus/minus 11.3) years. The main clinical manifestations were fever, cough, minor or serious dyspnea, nausea, signs of injury to other organs, and so on. The treatment regiments included oxygen, small dosage and short period of methylprednisolone (1 to 2 mg/kg), use of ventilator, psychological intervention, and treatment of underlying diseases, after which, all the 7 patients recovered.</p><p><b>CONCLUSION</b>Rational use of methylprednisolone and timely use of ventilator were the key steps of treatment.</p>

Diagnosis and treatment of primary ureterai cancer(report of 24 cases) / 中华泌尿外科杂志

Objective To improve the diagnosis and treatment of ureteral cancer. Methods A retrospective analysis of 24 cases of primary ureteral cancer treated from January 1990 to March 2005 was performed.The diagnostic value of ultrasound,IVU,CT,MRU and the patients' outcomes were reviewed. There were 19 males and 5 females aged 38-72 years(mean,59 years).The tumors were on the left side in 16 cases and on the right in 8.Of the 24 cases,17(71%)had gross hematuria and 7(29%)had micro- scopic hematuria.Urine cytology was performed in 16 cases with a positive rate of 6.3%.B-ultrasonic exami- nation showed hydronephrosis in 19 cases(79%)and low-echo space-occupying disease of middle-inferior ureter in 3(12%).IVU demonstrated hydronephrosis in 20 cases(83%)and filling defect of the diseased ureter in 3(12%).Retrograde pyelography showed filling defect of the diseased ureter in 16(76%)of 21 cases(5 cases had failure of intubation).CT scan was performed in 20 cases,indicating thickening of the ureteral wall and infiltration of the cancer in 14(70%).In 3 cases who had undergone spiral CT thin layer scan and 1 of 3 cases who had undergone MRU,the definite diagnosis was made.Results All the 24 pa- tients underwent surgical treatment.Among them,nephroureterectomy and bladder cuff or partial resection were performed in 18 cases,and nephrectomy and partial ureterectomy in 6 cases.Postoperative pathology showed transitional cell carcinoma in 23 cases,and adenoma in 1.Of the 14 cases during 1990-1999 peri- od,1,5,3,2,2 and 1 cases had survival time of 1,2,3,4,5 and 6 years,respectively.Of the 10 cases during 2000-2005 period,3 were lost to follow-up;2 survived for 3 years and 2,for 1 year;the other 3 who have survived near 5 years have been followed till now.Conclusions IVU and retrograde urography are the most common diagnostic measures for primary ureteral cancer.They can be used in combination with other imaging study to reduce missed diagnosis rate.The 5-year survival rate was lower because of late pathologic stage of the tumors in the patients of this series.