The clinical analysis of serum HBsAg and HBsAb double positive in hepatitis B patients / 实用医学杂志

Objective Study of the rare hepatitis B virus patients model cases which both the hepatitis B surface antigen (HBsAg) and hepatitis B surface antibody (HBsAb) were positive, and discussion of its cause and the clinical value. Methods serum markers of hepatitis B virus (HBV-M) was detected by microparticle enzyme immunoassay chemiluminescence (MEIA); HBV-DNA was detected by fluores--cence quantitative PCR method, alanine aminotransferase and aspartate aminotransferase were detected by colorimetric, and all the data were combined with the clinical features of patients for comprehensive analysis. Results 1) HBsAg and HBsAb double positive detection rate was 2.3％ in 15600 cases of hepatitis B patients, there was no significant difference in the positive rate of different sex groups and different age groups (P> 0.05); 2) HBsAg, HBsAb, HBeAb, HBcAb positive mode accounted for the highest proportion in all HBsAg and HBsAb double positive cases, the percentage was 57.9％; 3) the positive rate of HBV DNA in hepatitis B patients with HBeAg positive rate were higher than HBeAg negative group in all HBsAg and HBsAb double positive cases; and the incident rate of double variation nt 1762 A-T/nt 1764 G-A in HBeAg negative group was higher than that in HBeAg positive group. There were significant differences between two groups (P < 0.05); 4) the detection rate of HBsAg and HBsAb double positive in patients with chronic hepatitis B were higher than those of asymptomatic carriers, liver cirrhosis, hepatitis B and hepatitis B hepatocellular carcinoma (P < 0.05). Conclusion The phenomenon of both positive HBsAg and HBsAb does not indicate the elimination of the hepatitis B virus infection, but it is likely suggested the mutation of the virus. It is necessary to prompt clinical detection of serum HBV DNA, so as to determine whether the virus in patients is in the replication status, and it also provide some help for clinical individualized treatment of HBsAg and HBsAb double positive patients.

Treatment of patients with different degree of acute respiratory distress syndrome caused by inhalation of white smoke / 中华烧伤杂志

Objective@#To summarize the treatment experience of patients with different degree of acute respiratory distress syndrome (ARDS) caused by inhalation of white smoke from burning smoke bomb.@*Methods@#A batch of 13 patients with different degree of ARDS caused by inhalation of white smoke from burning smoke bomb, including 2 patients complicated by pulmonary fibrosis at the late stage, were admitted to our unit in February 2016. Patients were divided into mild (9 cases), moderate (2 cases), and serious (2 cases) degree according to the ARDS Berlin diagnostic criteria. Patients with mild and moderate ARDS were conventionally treated with glucocorticoid. Patients with severe ARDS were sequentially treated with glucocorticoid and pirfenidone, and ventilator-assisted breathing, etc. were applied. The vital signs, arterial oxygenation index, changes of lung imaging, pulmonary ventilation function, general condition, and the other important organs/systems function were timely monitored according to the condition of patients. The above indexes were also monitored during the follow-up time of 10-15 months post injury. Data were processed with SPSS 18.0 statistical software.@*Results@#(1) The symptoms of respiratory system of patients with mild and moderate ARDS almost disappeared after 3 days′ treatment. Their arterial oxygenation index was decreased from post injury day 1 to 4, which almost recovered on post injury day 7 and completely recovered one month post injury. The symptoms of respiratory system of patients with severe ARDS almost disappeared at tranquillization condition 1-3 month (s) post injury. Their arterial oxygenation index was decreased from post injury day 3 to 21, which gradually recovered 1-3 month (s) post injury and was normal 15 months post injury. (2) Within 24 hours post injury, there was no obvious abnormality or only a little texture enlargement of lung in image of chest CT or X-rays of patients with mild and moderate ARDS. One patient with moderate ARDS had diffuse patchy and ground-glass like increased density shadow (pulmonary exudation for short) at post injury hour 96. Chest iconography of all patients with mild and moderate ARDS showed no abnormalities 10 months post injury. Both lungs of each of the two patients with severe ARDS showed obvious pulmonary exudation at post injury hours 45 and 75, respectively. One patient with severe ARDS showed no abnormality in chest image 10 months post injury, but there was still a small mesh-like increased density shadow in double lobes with slight adhesion of pleura in the other patient with severe ARDS 15 months post injury. (3) All patients showed severe restrictive hypoventilation when admitted to hospital. Pulmonary ventilation function of patients with mild and moderate ARDS recovered to normal one month post injury, and they could do exercises like running, etc. Pulmonary ventilation function of one patient with severe ARDS recovered to normal 6 months post injury, and the patient could do exercises like running, etc. The other patient with severe ARDS showed mild restrictive hypoventilation 15 months post injury and could do exercises like rapid walking, etc. (4) The condition of all mild and one moderate ARDS patients was better on post injury day 3, and they were transferred to the local hospital for subsequent treatment and left hospital on post injury day 21. One patient with moderate ARDS healed and left hospital on post injury day 29. Patients with severe ARDS healed and left hospital on post injury day 81. During the follow-up time of 10-15 months post injury, the other important organs/systems of all patients showed no abnormality, and there was no adverse reaction of glucocorticoid like osteoporosis, femoral head necrosis, or metabolic disorder. Two patients with severe ARDS did not have any adverse reaction of pirfenidone like liver function damage, photosensitivity, anorexia, or lethargy.@*Conclusions@#Early enough and uninterrupted application of glucocorticoid can significantly reduce the ARDS of patients caused by inhalation of white smoke from burning smoke bomb. Sequential application of glucocorticoid and pirfenidone can effectively treat pulmonary fibrosis at the late stage.

Study on Bushen Jianpi Recipe in treating bone marrow hematopoietic suppression mouse model caused by cyclophosphamide / 国际检验医学杂志

Objective To verify the effects of Bushen Jianpi Recipe(BSJP) on bone marrow hematopoietic suppression mouse model caused by cyclophosphamide .Methods The experimental C57BL/6 mice were divided into the normal control group ,bone marrow hematopoietic suppression group and BSJP treatment group ,and the bone marrow hematopoietic suppression group and BSJP treatment group were peritoneally injected with cyclophosphamide for 3 d .The BSJP group began to be given with BSJP by gavage from 4 d ,and the other two groups received water as gavage control .After 14 d treatment ,peripheral venous blood cells count ,bone marrow hematopoiesis stem cells (HSCs) count and bone marrow mononuclear cell proliferation ability were detected by using the blood cells analyzer and flow cytometry .Results Compared with the control group ,the white blood cells(WBCs) count , HSCs number and bone marrow mononuclear cell proliferation ability in the hematopoietic suppression group were decreased significantly(P＜0 .01);the platelet count ,HSCs count and bone marrow mononuclear cells proliferation ability after BSJP treatment in the BSJP treatment group were significantly higher than those in the hematopoietic suppression group (P＜0 .01) .Conclusion BSJP can alleviate the side effect of cyclophosphamide chemotherapy and increase the anti-tumor effect of chemotherapeutic drugs .

Evaluation of HCV-IgG,HCV-cAg and HCV-RNA in the diagnosis of Hepatitis C / 国际检验医学杂志

Objective To evaluate the diagnostic value of hepatitis C virus core antigen(HCV-cAg),hepatitis C virus(HCV-IgG) and hepatitis C virus(HCV-RNA) in the laboratory diagnosis of Hepatitis C.Methods HCV-cAg and HCV-IgG were detected by enzyme-linked immunosorbent assay(ELISA),HCV-RNA was detected by real-time fluorescent quantitative polymerase chain reaction(RT-PCR) in 84 suspected HCV patients and 87 healthy control subjects.Results In 84 suspected HCV patients,the HCV-IgG positive rate was 84.5%,HCV-cAg positive rate was 13.1%,HCV-RNA positive rate was 52.4%.Among 71 cases of HCV-IgG positive patients,there were 35 cases with negative HCV-RNA,the false positive rate was 49.3%.In 11 cases of HCV-cAg positive patients,there were 5 cases with negative HCV-RNA,the false positive rate was 45.5%.In 44 cases of HCV-RNA positive diagnosis of hepatitis C patients,HCV-IgG false negative rate was 18.2%,HCV-cAg false negative rate was 86.4%.The false negative rate of combined detection of HCV-cAg and HCV-IgG was 13.6%,and the true positive rate was 100.0%.Conclusion HCV-cAg and HCV-IgG have certain false negative and false positive in laboratory diagnosis of HCV,combine these two methods,or joint with HCV-RNA detection,could reduce the rate of missed diagnosis.

Effect of siRNA on hepatitis B virus X gene to HepG2.2.15 cells / 实用医学杂志

Objective Using chemically synthesized small interfering RNA (siRNA) transfected HepG2.2.15 cells to construct a cell model in interfering hepatitis B virus (HBV) X gene, studying the inhibi-tion of HBV replication and antigen expression in vitro. Methods After transfection of HepG2.2.15 cell for 24 h, 48 h, 72 h, detecting the cell supernatant of HBsAg and HBeAg by chemiluminescence immunoassay, the cell supernatant HBxAg protein by ELISA , the HBx mRNA relative expression of transfected cell was detected by fluorescence quantitative polymerase chain reaction (PCR), the ability of cell proliferation was detected by CCK-8 assay. Results After HBx-siRNA transfected HepG2.2.15 cells, cell proliferation ability was inhibited. The cell of HBx mRNA and the cell supernatant of HBxAg expression decreased (P < 0.05); at the same time it in-hibited the expression of HBsAg and HBeAg. The suppressed peak and the inhibition rate were 66% and 58%respectively at 72 h. The fluorescence quantitative PCR confirmed that expression of HBV DNA in the super-natant was decreased. Conclusion The HepG2.2.15 cell interference model of HBV X gene has been success-fully constructed, which has an effect of inhibiting proliferation of HepG2.2.15 cells and replication and expres-sion of HBV gene in vitro.

Significance of HP detection in patients of chronic urticaria / 中国免疫学杂志

Objective:To study the correlation between chronic urticaria and Helicobacter pylori infection,and to explore the significance of HP detection in the diagnosis and treatment of chronic urticaria. Methods: Totally 420 cases of chronic urticaria,who were treated in outpatient department from April 2014 to July 2015,and 450 cases of healthy physical people were selected randomly as healthy control group in the same period,then the serum HP unease antibody was detected by colloidal gold method,the positive rate of two groups patients with HP was analysed. Meanwhile 162 chronic urticaria patients with positive HP were divided into experimental group with 88 cases and control group with 74 cases. The patients in the control group were treated with conventional treatment,while the experimental group were treated with triple therapy based on the treatment of control group,and the clinical efficacy of different ther-apeutic methods was analysed in the chronic urticaria patients with positive HP. Results: The positive rate of HP in chronic urticaria group was 38. 6%, and the positive rate of HP in healthy control group was 14. 4%, the difference was statistically significant ( P<0. 05). The effective rate of clinical efficacy in the experimental group was significantly higher than the control group(P<0. 05). Con-clusion:There is close correlation between chronic urticaria and HP infection,HP detection has important clinical significance for the diagnosis and treatment of chronic urticaria.