Effect of interferon and ribavirin combination therapy in sixty-two patients with chronic hepatitis C originating from a single blood donor / 中华肝脏病杂志

To investigate the efficacy of interferon alpha 2 b plus ribavirin combination therapy in sixty-two patients with chronic hepatitis c (CHC) infection originating from a single blood donor. The 62 patients who developed CHC following blood transfusion from a known single infected donor were treated with interferon and ribavirin combination therapy for 48 weeks and followed-up for 96 weeks. The therapy regimen consisted of subcutaneous administration of 3-500 MIU interferon alpha 2 b every other day and daily oral administration of 0.6-1.0 g of ribavirin. Patients were monitored during treatment and in follow-up for sustained virological response (SVR), early virology response (EVR), treatment end virology response (ETVR), biochemical response of withdrawals, and side effects. The SVR rate was 83.9% (52/62). The EVR rate was 95.2% (59/62). The ETVR rate was 87.1% (54/62). The biochemical response rate after withdrawal of treatment was 100.0%. Eight patients developed mildly abnormal thyroid function as a result of the interferon therapy, but all were able to complete the antiviral treatment regimen under the care of endocrinologists. Younger age, relatively short course of disease, low viral load, and better compliance, but not sex, were correlated to curative effect of the combination therapy. Interferon alpha 2 b plus ribavirin combination therapy had a significant curative effect on a group of 62 CHC patients originating from a single case, with 52 of the patients showing SVR out to 96 weeks after therapy. Antiviral treatment is recommended for hepatitis C virus-positive patients to eradicate the virus and prevent disease progression.

Eighty three cases of post transfusion HCV infection: a 10-year follow up / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To find out clinical characteristics and natural history of post transfusion HCV infection.</p><p><b>METHODS</b>83 subjects who have received the blood from a same blood donor from January 1998 to July 2002 were investigated by the method combining cross-sectional study with retrospective study. HCV-antibody, HCV RNA, liver function, abdomen B-ultrasound and Fibroscan were detected.</p><p><b>RESULTS</b>The HCV-antibody were all positive. The HCV RNA of 56 out of the 83 cases were positive. The chronicity rates of hepatis C were 76.3% (29/38) in male patients and 60.00% (27/45) in female patients respectively, without significant difference (X² = 2.99, P = 0.11). The average age of the HCV RNA positive patients was (36.54 ± 14.37) years old. The average age of the HCV RNA negative patients was (27.43 ± 12.51) years old. A significant difference (T = -2.41, P = 0.018) existed between. The HCV genotype was type1b. Among the HCV RNA positive patients,10 cases were with mild asthenia, anorexia and abdominal distention, 9 cases with increased serum ALT, 12 cases.with chronic hepatitis and 1 case was diagnosed with decompensated liver cirrhosis.</p><p><b>CONCLUSION</b>The clinical manifestations of HCV infection are occult and chronic. The chronicity rate is related to gender and the age when infection was caught.</p>

Bacterial infection distribution and drug sensitivity monitoring In patients with open extremity in-juries caused by Wenchuan earthquake / 中华创伤杂志

Objective To analyze results of bacterial infection distribution and drug sensitivity monitoring in 414 patients with open extremity injuries caused by Wenchuan earthquake so as to provide advices for guiding utility of antibiotics in treatment of patients injured in natural disasters. Methods Bacterial culture of wound secretion substance and drug sensitivity monitoring were done in 414 patients with open extremity injuries. Results There were 12 patients (2.9%) with G+ coccobacteria, 66 (15.9%) with G- bacillus, 2 (0.5%)with G+ bacillus, 6 (1.5%) with multiplicitas infection(5 with dual infection and I with triplication infection). Main pathogenic bacteria were as follows: (1)G+cocco- bacteria including Staphylococcus epidermidis, Staphylococcus aureus and anthropo-staphylococci ; (2) G- bacillus including Aerobacter cloacae, banmanii, escherichia co]i, aerugo pseudomonas, proteusvul- gaffs and Ewingella americana. (3)G+ bacillus including bacillus subtilis. The drugs with high sensi0tivi- ty to G+ coccobacteria included vancomycin, rifampin, levofloxacin and cidomycin, but those with low sensitivity to G+coccobacteria included penicillin, ampicillin and erythremycin. The drugs with high sen- sitivity to G- bacillus included imipenem, amikacin, levofloxaciu and tenebrimycin, but those with low sensitivity to G-bacillus included ampicillin and piperacillin. Conclusions Patients with open ex- tremity injuries caused by earthquake have rather high bacterial infection rate, involving many kinds of in- fection strains. Therefore, we should do bacterial culture and drug sensitivity monitoring of wound excre- tion substance as early as possible to guide rational use of antibiotics.

Clinical application of robotic tele-manipulation system in stereotactic surgery / 中华外科杂志

<p><b>OBJECTIVE</b>To assess the clinical usefulness, accuracy, and safety of tele-manipulation for frameless stereotactic surgery using the CAS-R-5 robot system.</p><p><b>METHODS</b>We prospectively evaluated 32 patients underwent tele-manipulation of frameless stereotactic operations from Sep. 2005 to Sep. 2006. Tele-manipulations were performed via a digital data network by a neurosurgeon in Beijing while the patients were located in Yan'an. The distance is 1300 kilometers away. The accuracy of location and improvement of symptom were observed after operation. The period of follow-up was from 3 to 14 months (the average was 12 months).</p><p><b>RESULTS</b>The surgical operations in 32 cases were successful. Remote fiducial registration was performed with a mean accuracy of 1. 50 mm and the standard difference were 0.32 mm between the planned and actual target. There were no complications.</p><p><b>CONCLUSIONS</b>Diagnosis and treatment for intracranial disease by tele-manipulation frameless stereotactic surgeries are reliable and safe.</p>

Investigation on virus genotype in patients infected with hepatitis B virus in four cities of Guizhou / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate the distribution of hepatitis B virus (HBV) genotype in Guizhou and to study the relationship between the genotype and the progression of liver disease.</p><p><b>METHODS</b>786 patients with chronic HBV infection, from 4 cities of Guizhou, including 346 asymptomatic carriers (ASC), 313 chronic hepatitis (CH), 77 liver cirrhosis (LC), 50 hepatocellular carcinoma (HCC) were examined. HBV genotype was determined by restriction fragment length polymorphism analysis and the subtypes were determined by direct sequencing of PCR product in 94 patients with HBV B genotype, the relationship between HBV genotype and the progression of liver disease was studied by multifactor analysis such as HBeAg positivity, HBV DNA load and ALT level.</p><p><b>RESULTS</b>Of the 786 patients, 7 (0.89%), 497 (63.23%), 275 (34.99%), and 7 (0.89%) belonged to genotype A, B, C, D, respectively. There was statistically significant difference in the distribution of genotype B among Kaili (96.04%), Zunyi (78.79%), Duyun (64.52%) and Guiyang (53.14%) (P< 0.01). Genotype C was more prevalent in Guiyang than in other three cities (P < 0.01, or P < 0.05). Out of 94 genotypes B, 93 (98.94%) belonged to subtype Ba, only one was subtype Bj. There were statistically significant difference in the distribution of genotype B and C among various stage of liver disease (P < 0.05 or P < 0.01). Genotype B showed a gradual decrease from ASC, CH, LC to the HCC group while in contrast, genotype C showed a gradual increase in the same order. The ALT levels and the mean age were significantly higher and older in patients with genotype C than those in genotype B (P < 0.01 or 0.05). The HBeAg positivity was significantly lower in genotype C than that in genotype B (P < 0.025).</p><p><b>CONCLUSION</b>Data showed that there were genotype A, B, C and D existing in Guizhou. Genotype B was the major one but genotype C was more commonly seen. In genotype B, subtype Ba appeared to be predominant. The geographic distribution of genotype B and C were different in some cities of Guizhou. Compared to genotype B, genotype C was associated with the development of more severe liver damage.</p>