A multi-center clinical study of N-acetylcysteine on chronic hepatitis B / 中华肝脏病杂志

<p><b>OBJECTIVES</b>To evaluate the effectiveness and safety of N-acetylcysteine (NAC) in treating chronic hepatitis B patients.</p><p><b>METHODS</b>144 patients with chronic hepatitis B (total bilirubin, TBil>170 mmol/L) from several centers were chosen for a randomized and double blind clinical trial. The patients were divided into a NAC group and a placebo group and all of them were treated with an injection containing the same standardized therapeutic drugs. A daily dose of 8 microgram NAC was added to the injection of the NAC group. The trial lasted 45 days. Hepatic function and other biochemistry parameters were checked at the experimental day 0 and days 15, 30, 45.</p><p><b>RESULTS</b>Each group consisted of 72 patients of similar demology and disease characteristics. During the trial, 28 cases of the 144 patients dropped out. In the NAC group, at day 0 and day 30, the TBil were 401.7 vs. 149.2 and 160.1+/-160.6. In the placebo group, the TBil on the corresponding days were 384.1+/-134.0 and 216.3+/-199.9. Its decrease in the NAC group was 62% and 42% in the placebo group. At day 0 and day 45 of treatment, the effective PTa increase rate was 72% in the NAC group and 54% in the placebo group. The total effective rate (TBil + PTa) was 90% in the NAC group and 69% in the placebo group. The parameters of the two groups showed a remarkable difference. The rate of side effects was 14% in the NAC and 5% in the placebo groups.</p><p><b>CONCLUSION</b>NAC can decrease the level of serum TBil, increase the PTa and reduce the time of hospitalization. NAC showed no serious adverse effects during the period of our treatment. We find that NCA is effective and secure in treating chronic hepatitis B patients.</p>

The difference between the positive rate of anti-HCV in the patients with severe viral hepatitis detected by the first generation or second generation enzyme linked-immunosorbent assay / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To compare the positive rate of antibody to hepatitis C virus (anti-HCV) in sera of patients with severe viral hepatitis between 1984-1990 year and 1997-2003 year.</p><p><b>METHODS</b>Serum anti-HCV was detected by enzyme linked-immunosorbent assay (ELISA). It was detected by the first generation (1st) ELISA (Ortho Co. USA) in 79 cases of severe viral hepatitis during 1984-1990 year, and it was detected by the second generation (2nd) ELISA (Xiamen Xingchuang Co. China) in 251 cases of severe viral hepatitis during 1997-2003 year.</p><p><b>RESULTS</b>The positive rate of serum anti-HCV was 51.9% detected by the 1st ELISA in 79 cases of severe viral hepatitis during 1984-1990 year, and it was 1.2% detected by the 2nd ELISA in 251 cases of severe hepatitis during 1997-2003 year (chi2 = 133.68, P </= 0.001).</p><p><b>CONCLUSION</b>To compare with the positive rate of serum antibody to hepatitis C virus in severe viral hepatitis detected by the 1st ELISA, it was lower that detected by the 2nd ELISA</p>

Diagnosis and therapy of 186 spontaneous bacterial peritonitis patients with end-stage liver disease / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To improve the diagnosis and treatment level of spontaneous bacterial peritonitis (SBP) in the patients with advanced liver disease, get better curative effect and prognosis.</p><p><b>METHODS</b>Registered the body temperature, symptoms and signs in the abdomen, and blood routine test, the polymorphonuclear (PMN) cell count, and ascites culture in the patients with cirrhosis and fulminant hepatitis. These patients were given supporting therapies including use plasma and albumin as well as antibiotics treatment according to drug sensitivity or empiric. Changes of the body temperature, symptoms and signs were used to evaluate the effect of therapy.</p><p><b>RESULTS</b>186 of 275 inward patients with end-stage liver disease during this period were considered as SBP by ascites culture or clinical experience with various degree symptoms and signs such as pain, distention, higher tension and touch pain in the abdomen. Infective rate was 67.6%. Among them 138 patients had abnormal body temperature more than 37.4 degrees C. 106 patients with leukocyte count in the peripheral blood more than 10 x 10(9)/L; 137 patients with PMN more than 80% in differential cell count; 103 patients with PMN more than 250/mm(3) in ascites. Only 29 patients were culture positive. 82 patients were cured, 17 patients with improvement, 18 patients with inefficacy or deterioration. 42 patients died of hepatic-renal failure and 27 patients died because of upper alimentary tract bleeding, respectively.</p><p><b>CONCLUSION</b>Signs and symptoms of SBP were atypical in the patients with end-stage liver disease. Ascites culture positive rate was not high. Early diagnosis and proper use antibiotics according to culture and empirics were important to increase effect and improve prognosis</p>

Etiology and clinical characters of hepatitis caused by non-hepatotropic virus / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To explore the etiology and clinical characters of hepatitis caused by non-hepatotropic virus.</p><p><b>METHODS</b>68 non-hepatotrophic viral hepatitis patients with negative anti-HAV-anti-HEV were diagnosed by detecting antibodies of anti-HSV IgM, anti-EBV IgM, anti-CMV IgM, anti-CSV IgM and anti-ANA, anti-mitochondrion antibody. Their clinical symptoms and signs were compared with that of acute viral hepatitis patients at the same time.</p><p><b>RESULTS</b>Among the 68 patients, 9 were infected by HSV, 12 by EBV, 8 by CMV, 14 by CSV, and the other 13 patients and 12 patients were positive for anti-ANA and anti-mitochondrion antibody, respectively. 35 of 43 non-hepatotrophic viral hepatitis patients were infected in winter and spring season. Their clinical symptoms and signs were milder than that of acute viral hepatitis patients.</p><p><b>CONCLUSION</b>Liver damage and dysfunction may be the prominent phenomenon during HSV, EBV, CMV and CSV infection, just like that of acute viral hepatitis but with milder clinical symptom and signs.</p>

The efficacy of two type of membrane plasma separator on the treatment of patients with chronic severe hepatitis B / 中华肝脏病杂志

<p><b>OBJECTIVE</b>In order to compare the efficacy of two kinds of membrane plasma separator on the treatment of patients with severe hepatitis B.</p><p><b>METHODS</b>63 cases suffering from chronic severe hepatitis B were divided into two groups, 25 cases were treated with plasma exchange using Evacure-4A membrane plasma separator (A group) or 38 cases were using PS-06 membrane plasma separator (B group). Both of them also were treated with similar basic medical treatment. The level of serum total bilirubin, non-conjugated bilirubin, prothrombin time and albumin were tested at baseline and the end of the treatment with PE.</p><p><b>RESULTS</b>Evacure-4A and PS-06 membrane plasma separators can effientively remove bilirubin, the levels of serum total bilirubin, non-conjugated bilirubin of all patients were significantly decreased after treated with PE. In A group, the level of serum total bilirubin, non-conjugated bilirubin decreased from (464.2+/-193.8)micromol/L to (279.4+/-158.7)micromol/L, (293.5+/-129.1)micromol/L to (175.5+/-106.7)micromol/L (t=5.45, 10.36, P<0.01) respectively. In B group, the level of serum total bilirubin, non-conjugated bilirubin decreased from (493.2+/-126.9)micromol/L to (299.7+/-96.5)micromol/L, (300.2+/-74.3)micromol/L to (171.5+/-53.1)micromol/L (t=5.17, 12.04, P<0.01) respectively. The level of serum albumin increased after treated with PE in A and B groups, to contrast with PS-06, the increasing percentage of albumin was higher when the patients were treated with PE using Evacure-4A membrane plasma separator [(8.3+/-0.7) % vs. (3.4+/-9.3) %, t = 2.76, P<0.01].</p><p><b>CONCLUSION</b>Evacure-4A membrane plasma separator may be better than PS-06 membrane plasma separator on the treatment of patients with chronic severe hepatitis B.</p>

Effects of exhaustive exercise on biochemical indexes of endurance-trained mice / 中国应用生理学杂志

<p><b>AIM</b>To observe possible mechanism that endurance training can enhance anti-fatigue capability, and that blood redistribution by analyzing some biochemical indexes of endurance-trained mice after exhaustive exercise.</p><p><b>METHODS</b>The model was set up by exhaustive exercise. The indexes include the activity of SOD, CAT and POD and the MDA content in serum and the NO content in liver, muscle, heart and serum.</p><p><b>RESULTS</b>After exhaustive exercise, the SOD activity in serum and the NO content in liver significantly decrease (P < 0.05 - 0.01), and the activity of POD and CAT, the NO content in serum and muscle significantly increase (P < 0.05 - 0.01), but the rest insignificantly change in non-endurance (P > 0.05). In endurance group, the CAT activity in serum are significantly higher than in non-endurance (P < 0.05), and the NO content in serum is significantly lower than in non-endurance (P < 0.01), but the rest are insignificantly different between two groups (P > 0.05). After 24h restoration, in non-endurance group, the CAT activity and the MDA content in serum and the NO content in liver significantly rise (P < 0.05-0.01), and the NO content in muscle and serum significantly decrease (P < 0.05), but the rest insignificantly change (P > 0.05). In endurance group, the SOD activity in serum and the NO content in liver, serum and heart significantly rise (P < 0.05), and the CAT activity in serum significantly decreases (P < 0.05), but the rest insignificantly change (P > 0.05). In endurance group, the CAT activity and the MDA content in serum are significantly lower than in non-endurance (P < 0.05), but the NO content in heart is higher than in non-endurance (P < 0.05). The rest are insignificantly different between two groups (P > 0.05).</p><p><b>CONCLUSION</b>The possible mechanism, which endurance training can enhance anti-fatigue capability, is relative to enhance the capability to resume balance. Blood redistribution are possibly relative to change to the NO content.</p>

One year and half treatment with lamivudine in active cirrhosis resulting from chronic hepatitis B / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To study the therapy effect of long term lamivudine treatment on active cirrhosis following chronic hepatitis B, and explore the methods for abnormalities resulting from lamivudine withdrawing.</p><p><b>METHODS</b>58 patients received lamivudine 100 mg orally everyday for 18 months. The changes were observed and wrote down, including clinical symptoms and signs, aminotransferase, virology indexes, and the abnormalities after lamivudine withdrawing, then further to find out plans for the latter.</p><p><b>RESULTS</b>(1) After lamivudine treatment, there were 35 patients whose situation stabilized, life quality improved, child-pugh score declined, and liver function turned better. (2) The level of HBV DNA decreased at least 10(3) copies/ml. HBeAg of 33.3% patients (13/39) became negative. (3) Among the 10 patients who stopped lamivudine of their own accord, and came again after 3 - 6 months because of hepatitis B recurring, two were treated with interferon for one month, then turning to liver-protecting methods for deteriorating, the other eight only received liver-protecting and immune-regulating treatment, whose liver function improved.</p><p><b>CONCLUSIONS</b>Long term treatment with lamivudine for active cirrhosis following chronic hepatitis B can improve liver function and life quality, prevent exacerbation. And it is not advisable to use interferon for hepatitis B relapsing after lamivudine withdrawing.</p>

Long-term health-related quality of life in chronic hepatitis B patients / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To evaluate their long-term outcome and the efficacy and economic significance of antiviral drugs by investigating the long-term health-related quality of life (HQL) in chronic hepatitis B (CHB) patients.</p><p><b>METHODS</b>The HQL of 101 CHB patients with biopsy-proven 6 to 18 years ago and 105 persons of general population as control was studied with revised SF-36 questionnaire.</p><p><b>RESULTS</b>The HQL in CHB patients was lower than that in general population in physical functioning, role physical, general health, mental health, and specific symptoms (mu > or = 2.10, P<0.05).</p><p><b>CONCLUSIONS</b>The long-term HQL in chronic hepatitis B patients is poor.</p>