Research progress on cirrhosis reversal and recompensation / 中华肝脏病杂志

Previously, liver lesions in cirrhosis were considered irreversible, especially because the condition aggravated gradually after entering the decompensated phase, thus making it difficult to return to the compensated phase. At present, more and more evidence shows that some patients with decompensated liver cirrhosis can be recompensated after the cause is controlled and complications are managed. This article explores the research progress related to LC reversal and recompensation from three aspects: liver histopathology, liver function, and clinical complications.

Three cases of occupational acute trimethyltin chloride poisoning / 中华劳动卫生职业病杂志

Trimethyltin chloride is a highly toxic substance, which is absorbed through respiratory tract, skin and digestive tract, with central nervous system injury as the main clinical manifestations, and can be accompanied by damage to various organs. In this paper, the treatment process of 3 patients with acute trimethyltin chloride poisoning was reviewed, and their clinical manifestations, auxiliary examination, diagnosis and treatment were analyzed. Three patients were misdiagnosed as mental abnormality, encephalitis, and hepatic encephalopathy in different hospitals in the early stage of medical treatment, suggesting that clinicians should pay attention to the occupational contact history of poisoned patients and conduct toxicant detection in time to avoid misdiagnosis and mistreatment.

Expression and clinical significance of runt-related transcription factor 3 in children with bronchiolitis / 中国当代儿科杂志

OBJECTIVE@#To study the mRNA level of runt-related transcription factor 3 (RUNX3) in children with bronchiolitis and its clinical significance in bronchiolitis.@*METHODS@#A total of 54 young children with bronchiolitis were enrolled as the bronchiolitis group, among whom 28 with atopic constitution were enrolled in the atopic bronchiolitis group and 26 with non-atopic constitution were enrolled in the non-atopic bronchiolitis group. A total of 48 healthy young children were enrolled as the healthy control group, among whom 24 with atopic constitution were enrolled in the atopic healthy control group and 24 with non-atopic constitution were enrolled in the non-atopic healthy control group. Quantitative real-time PCR was used to measure the mRNA level of RUNX3 in peripheral blood mononuclear cells. ELISA was used to measure the serum levels of interleukin-4 (IL-4) and interferon gamma (IFN-γ).@*RESULTS@#The bronchiolitis group had a significantly lower mRNA level of RUNX3 than the healthy control group, and the atopic bronchiolitis group had a significantly lower mRNA level of RUNX3 than the non-atopic bronchiolitis, atopic healthy control, and non-atopic healthy control groups (P<0.05). The bronchiolitis group had a significantly higher serum level of IL-4 than the healthy control group, and the atopic bronchiolitis group had a significantly higher serum level of IL-4 than the non-atopic healthy control group (P<0.05). The bronchiolitis group had a significantly lower serum level of IFN-γ than the healthy control group, and the atopic bronchiolitis group had a significantly lower serum level of IFN-γ than the non-atopic bronchiolitis, atopic healthy control, and non-atopic healthy control groups (P<0.05). The correlation analysis showed that the mRNA level of RUNX3 was negatively correlated with the serum level of IL-4 and was positively correlated with the serum level of IFN-γ (P<0.05).@*CONCLUSIONS@#Measurement of RUNX3 gene expression in peripheral blood mononuclear cells has a certain value in identifying children with atopic constitution at high risk of asthma among children with bronchiolitis.

Clinical analysis of 31 cases with rectal prolapse undergoing modified Gant-Miwa procedure and anal encircling / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy of modified Gant-Miwa procedure with anal encircling for adults with rectal prolapse.</p><p><b>METHODS</b>Clinical and follow-up data of 31 adult patients with rectal prolapse undergoing modified Gant-Miwa procedure with anal encircling procedure between September 2005 and January 2012 were retrospectively analyzed.</p><p><b>RESULTS</b>Operations were successfully performed in these 31 cases. The mean operation time was 75 (range 50-165) minutes. The mean estimated blood loss during operation was 50 (range 20-80) ml. There were no postoperative complications, such as hemorrhage, perianal abscess, anal fistula, intra-abdominal infection, or urogenital dysfunction, while only 7 patients developed urinary retention postoperatively. Rate of postoperative constipation improvement was 61.5% (8/13) and defecation difficulty improvement was 69.6% (16/23). Twenty-eight patients received anal manometry 2 months after operation and the result showed that rectal sensation threshold and rectal maximal tolerance decreased significantly, while anal resting pressure and anal squeeze pressure did not change significantly as compared to preoperative values. Six months after operation, anal function was Kirwan grade I in 22 cases and grade II in 8 cases. During a mean postoperative follow-up of 2.5 years (3 months-6.3 years), 2 of 26 patients developed recurrent prolapse.</p><p><b>CONCLUSIONS</b>Modified Gant-Miwa procedure with anal encircling for adults of rectal prolapse is a simple and safe procedure with low recurrence rate, minimal invasion, no serious complication and mortality, especially suitable for the elderly patients, accompanied with underlying diseases or reluctant to undergo transabdominal operation.</p>

Analysis of a randomized, double-blind, double-dummy, controlled, multicenter study confirmed the similar therapeutic efficacies of entecavir maleate and entecavir for treatment of HBeAg-positive chronic hepatitis B / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of entecavir maleate (ETV) versus ETV in Chinese patients with hepatitis B e antigen(HBeAg)-positive chronic hepatitis B(CHB).</p><p><b>METHODS</b>The patient population of this previously published randomized, double-blind, double-dummy, controlled, multicenter study was expanded by patients in the 0.5 mg/day ETV maleate group (total n = 110) and patients in the 0.5 mg/day ETV group (total n = 108). At treatment weeks 12, 24 and 48, hepatitis B virus (HBV) DNA levels were measured by the Roche Cobas Ampliprep/Cobas Taqman PCR assay. Adverse events (AE) were recorded.</p><p><b>RESULTS</b>As in the original analysis, the two treatment groups showed similar characteristics at baseline. In addition, the results for the all therapeutic effects showed identical trends to the results obtained in the original analysis, including the statistically similar effects of ETV and ETV maleate treatment-induced decreases in mean HBV DNA level at weeks 12, 24, and 48 (ETV: by 4.28, 5.00, and 5.53 log10 IU/ml vs. ETV maleate: by 4.46, 4.99, and 5.51 log10 IU/ml, respectively; all vs. baseline P more than 0.05), achievement of undetectable levels of serum HBV DNA ( less than 20 IU/ml) at week 48 (ETV: 38.18% vs. ETV maleate: 35.19%; P more than 0.05), HBeAg loss rates at week 48 (ETV: 10.91% vs. ETV maleate: 12.96%; P more than 0.05), HBeAg seroconversion rates at week 48 (ETV: 7.77% vs. ETV maleate: 10.38%; P more than 0.05), normalization of alanine aminotransferase at week 48 (ETV: 75.47% vs. ETV maleate: 82.86%; P more than 0.05), and overall incidence of AE (ETV: 18.02% vs. ETV maleate: 17.43%; P more than 0.05).</p><p><b>CONCLUSION</b>Performing analysis of the therapeutic efficacies of entecavir maleate versus entecavir with a larger study population confirmed our original findings of similar efficacy and safety profiles for these two drugs in patients with HBeAg-positive CHB.</p>

Protective performance and subjective evaluation of N95 filtering-facepiece respirators / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To evaluate the protective performance of N95 filtering-facepiece respirators (FFRs) used widely in China and to investigate participants' subjective evaluation about them.</p><p><b>METHODS</b>Four models (A1, A2, B1, B2) of N95 FFRs from two manufactures were chosen to measure the filter penetration and inhalation resistance. Inward leakage was measured by Condensation Nuclei Counting method (CNC) in 50 participants selected using the Chinese respirator fit test panel. Each participant was asked subjective feelings after wearing a respirator by questionnaire survey.</p><p><b>RESULTS</b>The filter penetration and inhalation resistance of four FFRs complied with national standard (GB 2626-2006). The geometric mean fit factors (GMFFs) for four models were 20.9, 14.6, 74.0, 49.1 and there passing rates were 4%, 4%, 42%, 10%. All of four models had bad seal performance, especially the passing rate of A1 and A2 were lower than 10%. The self-feelings about the resistance for FFRs had no significant difference (P > 0.05). The results indicated that B (B1 and B2) has a better fit than A (A1 and A2) according to participants' subject evaluation (P < 0.05). The folding style respirator (B2) was significant more comfortable than the cup style respirator (B1). The subjective feeling of respirators leakage by participant was poor consistent with objective inward leakage test. The kappa index was 0.067 (95%CI: -0.029∼0.163, P = 0.18) and the consistent rate was 50%.</p><p><b>CONCLUSION</b>The poor seal performance was the biggest problem of N95 FFRs in Chinese market. Respirators should be resigned or improved rely on Chinese facial features. Dust workers should choice a fit respirator according to the result of objective leakage test rather than subjective feeling of leakage.</p>

The prevalence and influencing factors of eye diseases for IT industry video operation workers / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the situation of video-contact and eye diseases for IT industry video operation workers, and to analyze the influencing factors, providing scientific evidence for the make of health-strategy for IT industry video operation workers.</p><p><b>METHODS</b>We take the random cluster sampling method to choose 190 IT industry video operation workers in a city of Jiangsu province, analyzing the relations between video contact and eye diseases.</p><p><b>RESULTS</b>The daily video contact time of IT industry video operation workers is 6.0-16.0 hours, whose mean value is (I 0.1 ± 1.8) hours. 79.5% of workers in this survey wear myopic lens, 35.8% of workers have a rest during their working, and 14.2% of IT workers use protective products when they feel unwell of their eyes. Following the BUT experiment, 54.7% of IT workers have the normal examine results of hinoculus, while 45.3% have the abnormal results of at least one eye. Simultaneously, 54.7% workers have the normal examine results of hinoculus in the SIT experiment, however, 42.1% workers are abnormal. According to the broad linear model, there are six influencing factors (daily mean time to video, distance between eye and displayer, the frequency of rest, whether to use protective products when they feel unwell of their eyes, the type of dis player and daily time watching TV.) have significant influence on vision, having statistical significance. At the same time, there are also six influencing factors (whether have a rest regularly,sex, the situation of diaphaneity for cornea, the shape of pupil, family history and whether to use protective products when they feel unwell of their eyes.) have significant influence on the results of BUT experiment,having statistical significance. However, there are seven influencing factors (the type of computer, sex, the shape of pupil, the situation of diaphaneity for cornea, the angle between displayer and workers' sight, the type of displayer and the height of operating floor.) have significant influence on the results of SIT experiment,having statistical significance.</p><p><b>CONCLUSIONS</b>The health-situation of IT industry video operation workers' eye is not optimistic, most of workers are lack of protection awareness; we need to strengthen propaganda and education according to its influencing factors and to improve the level of medical control and prevention for eye diseases in relevant industries.</p>

The effect of retrovirus-mediated HO-1 gene on chronic myeloid leukemia resistance cell K562/A02 apoptosis induced by nilotinib / 中华血液学杂志

<p><b>OBJECTIVE</b>To investigate the effect of retrovirus mediated heme oxygenase (HO)-1 gene on chronic myeloid leukemia (CML) resistance cell apoptosis induced by nilotinib (AMN107).</p><p><b>METHODS</b>High titer viral particles of pQCXIP-EGFP-HO-1 were prepared, and K562/A02 cells stably transfected with HO-1 gene was established. The expression of HO-1 in K562/A02 cells was detected by RT-PCR. After treated with AMN107 for 24 h, HO-1 mRNA and protein expression by RT-PCR and Western blot, respectively; Cell proliferation by MTT assay; bcr-abl fusion gene by RQ-PCR, and the apoptosis and cell cycle by flow cytometry.</p><p><b>RESULTS</b>Recombinant retrovirus vector was constructed successfully and K562/A02/HO-1 cells were successfully set up. The expression of HO-1 in K562/A02 cells was expressed clearly. After three groups cells treated with AMN107 for 24 h, the expression of HO-1 mRNA and protein was significantly higher in gene-transfected group than in either empty vector or no-transfected group. The difference was statistically significant (P < 0.05). The cell proliferation ofs was inhibited, but the cell viability was significantly higher in gene-transfected group than in other two groups. The difference was statistically significant(P < 0.05); After treated with 10 µmol/L AMN107 for 24 h, the CT values of bcr-abl fusion gene were (18.15 ± 0.18) in K562/A02/HO-1 group, being significantly higher than that in K562/A02/LXSN (20.32 ± 0.20) and K562/A02 (20.51 ± 0.21) group, the difference was statistically significant (P < 0.05); the apoptosis rate were (17.26 ± 0.23)%, (39.47 ± 0.17)%, and (41.84 ± 0.09)%, respectively in three groups, and were (3.74 ± 0.03)%, (5.91 ± 0.08)% in K563/A02/HO-1 untreated with drug and K562/A02 untreated with drug group. The number of G(0)/G(1) phase and S phase cells markedly decreased. The cells were arrested in G(2)/M phase. But cell cycle in gene-transfected group did not change significantly.</p><p><b>CONCLUSION</b>AMN107 inhibits proliferation of CML resistance cells and induces cell apoptosis. HO-1 gene can protect CML resistance cells to apoptosis. There was a relationship between HO-1 gene and the growth of CML resistance cells.</p>

Fit test and improvement of self-inhalation air-purifying dust respirator / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the fit of self-inhalation air-purifying dust respirator for Chinese workers, to improve the respirators according to Chinese facial features and to evaluate the protective effects of improved respirators.</p><p><b>METHODS</b>Two types of self-inhalation air-purifying dust respirators (cup respirators A1 and folding respirators B1) were tested by Condensation Nuclei Counting method (CNC) in 25 representative subjects (15 males and 10 females). According to the Chinese facial features and fit factors, A1 and B1 respirators were improved. The fit tests were performed for the improved A1 and B1 respirators.</p><p><b>RESULTS</b>The fit factors ≥ 100 served as the qualified standard of self-inhalation air-purifying dust respirators. The qualified rate for cup respirator A1 was 0.0%. Its geometric mean fit factor was 20.7 (6.9 ∼ 46.9). The qualified rate for cup respirator B1 was 4.0%. Its geometric mean fit factor was 26.0 (6.8 ∼ 154.9). After improvement, the qualified rates and fit factors significantly increased. The qualified rate for cup respirator A2 was 72.0% and geometric mean fit factor was 223.5 (2.2 ∼ 5932.7). There were significantly differences between respirator A1 and A2 (χ(2) = 25.09, P < 0.05). The qualified rate for cup respirator B2 was 88.0 % and geometric mean fit factor was 429.8 (41.5 ∼ 3692.9). The significant differences (χ(2) = 32.21, P < 0.05) between B1 and B2 were found.</p><p><b>CONCLUSION</b>To ensure the protective effects, the self-inhalation air-purifying dust respirators were designed according to Chinese facial features. The respirator fit test must be conducted when workers choose respirators.</p>

The relationship between fit characteristics of two kinds of self-inhalation air-purifying dust respirators and head-face dimensions of subjects / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the fitness characteristics of self-inhalation air-purifying dust respirators for representative subjects and to explore the influencing factors on fitness characteristics of respirators.</p><p><b>METHODS</b>According to the Chinese new bivariate fit test panel, 50 representative subjects were studied for using 2 kinds of self-inhalation air-purifying dust respirators. The N95 Companion from TSI was used to test the Fit factor (FF), and five representative facial dimensions (face width, bigonial breadth, nasal root breadth, face length and nose protrusion) were measured. Then chi-square test was used to compare the qualified rates of 2 kinds of respirators. The t-test was utilized to analyze the differences of facial dimensions between qualified samples and unqualified samples. Multiple linear regression models were also established to analyze the effects of facial dimensions on FF.</p><p><b>RESULTS</b>The qualified rate (86%) of folding respirators was significantly higher than that (68%) of cup respirators (P < 0.05). There were no significant differences of facial dimensions between qualified subjects and unqualified subjects for folding respirators. However, the face width, bigonial breadth and face length of qualified subjects were significantly larger than those of unqualified subjects for cup respirators (P < 0.01). The regression coefficient (0.31846) demonstrated that the positive effects of face length on mean log-transformed fit factor (MLFF) for all subjects with cup respirators (P < 0.05).</p><p><b>CONCLUSION</b>There were significant effects of respirator styles and head-face dimensions on the respirator fitness. There was a significant correlation between the respirator fitness and the facial dimensions for cup respirators.</p>

CML cell apoptosis induced by AMN107 combined with heme oxygenase-1 inhibitor / 中国实验血液学杂志

This study was aimed to investigate the effect of AMN107 (nilotinib) combined with heme oxygenase-1 (HO-1) inhibitor zinc protoporphyrin IX (ZnPPIX) on chronic myeloid leukemia (CML) cells and its mechanism. Proliferative rate of cells treated with AMN107 (10 µmol/L) and ZnPPIX (10 µmol/L) alone or both for different time was observed by MTT and trypan blue methods; the expression of HO-1 in the control group, ZnPPIX (10 µmol/L) group, AMN107 (10 µmol/L) group, AMN107 (10 µmol/L) combined with ZnPPIX (10 µmol/L) group was evaluated by semi-quantitative RT-PCR and Western blot at 48 h. Cell apoptosis was detected by flow cytometry with Annexin V/PI double staining at 48 h. The results showed that the strongest inhibition of cell proliferation was detected in combined group, and in a time-dependent manner; the expression level of HO-1 was lowest in combined group; the cell apoptosis rates were (11.38 ± 0.02)%, (17.44 ± 0.08)%, (39.81 ± 0.07)% and (56.46 ± 0.19)% in the control group, ZnPPIX group, AMN107 group, AMN107 combined with ZnPPIX group at 48 h respectively. It is concluded that the second-generation tyrosine kinase inhibitor AMN107 can induce the apoptosis in CML cells. Inhibition of HO-1 expression can enhance the killing effect of AMN107 on CML cells, which provides experimental evidence to further improve the clinical efficacy of CML treatment.

A randomized, double-blind, double-dummy, controlled, multicenter study of entecavir maleate versus entecavir for treatment of HBeAg-negative chronic hepatitis B: results at week 48 / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of entecavir (ETV) maleate versus ETV in Chinese patients with hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHB).</p><p><b>METHODS</b>This was a randomized, double-blind, double-dummy, controlled, multicenter study. Patients were randomly assigned to receive 48 weeks of treatment with 0.5 mg/day ETV (group A; n = 26) or 0.5 mg/day ETV maleate (n = 31). Hepatitis B virus (HBV) DNA levels were measured at weeks 12, 24, and 48 by the Roche Cobas Ampliprep/Taqman PCR assay. Adverse events (AE) were recorded.</p><p><b>RESULTS</b>Baseline characteristics were similar between the two groups. At weeks 12, 24, and 48, the mean HBV DNA level had similarly decreased from baseline in both groups (A: by 4.24, 4.61 and 4.88 log10 IU/mL vs. B: 4.01, 4.50 and 4.99 log10 IU/mL, respectively; all P more than 0.05). Patients who achieved undetectable levels of serum HBV DNA (less than 20 IU/mL) at week 48 were similar in the two groups (A: 69.23% vs. B: 80.65%; P more than 0.05). Both groups achieved similar normalization of ALT at week 48 (A: 96.00% vs. B: 83.87%; P more than 0.05). The overall AE incidence was similar for the two groups (A: 22.22% vs. B: 9.38%; P more than 0.05).</p><p><b>CONCLUSION</b>Entecavir maleate and entecavir showed similar efficacy and safety in patients with HBeAg-negative CHB.</p>

Percutaneous permeation characteristic of podophyllotoxin ethosomes in vitro / 中草药

Objective To study the percutaneous permeability characteristic of podophyllotoxin (POD) ethosomes in vitro. Methods Excised SD-rat abdomen skin was used as penetration barrier. The steady penetration rate and the skin residual amount were calculated to evaluate the percutaneous permeability of POD from ethosomes, tinctures, liposome, 30% hydro-ethanolic suspension, mixture of drug and blank ethosomes, respectively. Results The skin residual amount of POD in the ethosomes group was 8.17 ug/cm2 in 12 h, higher than those in the other groups. In addition, the steady penetration rate of POD in the ethosomes group decreased significantly compared with those in the liposome group with POD loading being 0.5%, and the hydro-ethanolic suspension group (P < 0.05), while no obvious difference was seen among the ethosomes group and the other groups. Conclusion Higher skin residual amount and lower steady penetration rate are observed in the ethosomes group.

Campylobacter enteritis in adult patients with acute diarrhea from 2005 to 2009 in Beijing, China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>There has been a marked global increase in the incidence of human Campylobacter enteritis in recent years. This study investigated the epidemiological and clinical features of Campylobacter enteritis in adult patients suffering from acute diarrhea.</p><p><b>METHODS</b>This was a retrospective review of Campylobacter enteritis in adult patients with acute diarrhea presenting at Beijing University First Hospital, Beijing, China, in the summer and autumn (April to October) of 2005 to 2009. The data collected included the species of campylobacter identified, and the age, gender, clinical manifestations and results of laboratory test on stool samples collected from the patients. Campylobacter sensitivity tests to various antimicrobial agents were conducted on 80 specimens. Chi-square tests were applied using SPSS13.0 software and a two-sided P value of < 0.05 was considered statistically significant.</p><p><b>RESULTS</b>Campylobacter spp. isolated from the stool specimens of 142 patients with diarrhea represented 14.9% of all the cases examined. C. jejuni was identified in 127 patients (89.4%) and C. coli in 15 others (10.6%). The infection incidence was highest in the age range of 21 - 30 years which comprised 21.7% of the total cases examined. Most cases of diarrhea (46 patients) occurred in June. Watery diarrhea (97.2%), abdominal pain (72.5%) and fever (64.8%) were the most common manifestations of enteric campylobacteriosis. Only four patients (2.8%) had bloody diarrhea. The antimicrobial resistance rates were: cefoperazone (100%), levofloxacin (61.3%), gentamicin (12.5%), erythromycin (6.3%), and azithromycin (2.5%).</p><p><b>CONCLUSIONS</b>Campylobacter was prevalent among adults with acute diarrhea from 2005 to 2009 in Beijing, China. The large number of those afflicted by the disease warrants the commission of a large multicenter study to determine the extent of enteric campylobacteriosis in this region.</p>

Effects of antiviral agents on intrahepatic ccc DNA in HBeAg-positive chronic hepatitis B patients / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To evaluate the effects of antiviral agents on intrahepatic HBV covalently closed circular DNA (cccDNA) in HBeAg-positive chronic hepatitis B patients.</p><p><b>METHODS</b>Seventy-one HBeAg positive chronic hepatitis B patients were enrolled in this study. Lamivudine was administered to 35 patients for 48 weeks, sequential therapy with lamivudine-IFN alpha-2b to 24 of the 71 patients for 48 weeks, and interferon alpha (IFN alpha-2b) was administered to 12 for 24 weeks. All subjects were followed-up for 24 weeks. Serum HBV DNA, intrahepatic HBV DNA and cccDNA were measured quantitatively by PCR. HBV genotypes were analyzed by PCR-RFLP.</p><p><b>RESULTS</b>Forty-eight weeks of sequential lamivudine-IFN alpha-therapy and lamivudine monotherapy and 24 weeks of IFN alpha monotherapy reduced the intrahepatic HBV DNA to (4.7+/-1.1) log10, (4.6+/-1.5) log10 and (5.6+/-1.5) log10, and cccDNA to (3.4+/-1.3) log10, (3.8+/-1.1) log10 and (5.0+/-1.5) log10, significantly lower than therapy (P < 0.05). Seventeen of the 71 patients developed HBeAg seroconversion, and the reduction of cccDNA in the HBeAg seroconverted patients was significantly more than that of the HBeAg positive patients (P < 0.05). After 24 weeks of antiviral therapy withdrawal, 18 patients achieved sustained virological response, and the baseline intrahepatic cccDNA in the patients with sustained virological response was significantly lower than that of patients with virological rebound (P < 0.05). The change in intrahepatic cccDNA correlated positively with the reduction in intrahepatic HBV DNA (P < 0.05). The cccDNA levels correlated with the serum HBeAg titers at the end of the treatment (P < 0.01). Of the total 71 cases, HBV genotype C accounted for 85.9% (n = 61), and genotype B for 14.1% (n = 10). There was no significant difference in the changes of intrahepatic HBV DNA and cccDNA levels between HBV genotypes C and B (P >0.05).</p><p><b>CONCLUSIONS</b>Both 48 weeks of sequential lamivudine-IFN alpha and lamivudine monotherapy strongly reduced intrahepatic HBV DNA and cccDNA more than 24 weeks of IFN alpha monotherapy. Low baseline intrahepatic cccDNA levels might predict a good long-term efficacy of antiviral treatment. The reduction of intrahepatic cccDNA correlated positively with the changes of intrahepatic HBV DNA, and intrahepatic cccDNA levels correlated with serum HBeAg titers. HBV genotypes had no obvious influence on intrahepatic HBV DNA load or cccDNA load.</p>

An analysis of clinical characteristics and risk factors of cirrhosis-related hepatocellular carcinomas in patients with hepatitis C virus infection / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To study the epidemiological and clinical characteristics and risk factors of cirrhosis-related hepatocellular carcinomas (HCC) in patients with hepatitis C virus (HCV) infection.</p><p><b>METHODS</b>Eighty-nine compensated and decompensated HCV cirrhosis patients were analyzed and followed-up. The main clinical and laboratory variables were analyzed as incidence factors of HCC with univariate analysis and multivariate analysis regression models.</p><p><b>RESULTS</b>The patients were followed-up for 86 months. Thirty-five of the 89 patients had HCC during the 86 months follow-up. Their five and ten-year cumulative incidences were 16.9% and 40.4% respectively. Of the 35 HCC patients, 4 had a family history of hepatitis C, 12 had a familial history of HCC, and 7 had a history of alcohol ingestion. Five and ten-year cumulative incidences of HCC in patients with hepatic steatosis were 24.6% and 51.0% respectively. Five-year and ten-year cumulative incidences of HCC in patients with non-hepatic steatosis were 8.7% and 26.2% respectively, and the difference in the cumulative incidences between them was significant (P < 0.05). Hepatic steatosis severity was associated with the severity of the cirrhosis. ALT and TBil levels were higher in the HCC group than in the non-HCC group, ALB was lower in the HCC group than in the non-HCC group, and the differences between them were significant (P < 0.05). Child-Pugh score and the severity of the hepatic steatosis during follow-up were independently correlated with HCC.</p><p><b>CONCLUSION</b>HCC is the most important and frequent outcome of chronic hepatitis C cirrhosis. Child-Pugh score and the severity of the hepatic steatosis are related to the risk factors. History of alcohol ingestion and family history of hepatitis C are also related to liver cancer.</p>

Efficacy of antiviral treatment on intrahepatic HBV DNA and histology in HBeAg -positive chronic hepatitis B patients / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To evaluate the effect of antiviral agents on intrahepatic HBV DNA and histology in HBeAg-positive chronic hepatitis B patients.</p><p><b>METHODS</b>Thirty-five patients were treated with lamivudine, 16 with interferon alfa (INF-alpha), 24 with sequential Lamivudine and INF-alpha. The total duration of therapy was 12 months. Intrahepatic HBV DNA was measured quantitatively by real-time polymerase chain reaction.</p><p><b>RESULTS</b>There was significant change in all parameters of the groups of patients at the end of treatment (P < 0.05). The patients treated with sequential treatment had slightly higher HBeAg seroconversion rate (38.1%) than that of the other patients (P=0.1352). The baseline levels of intrahepatic HBV DNA in the patients with HBeAg seroconversion or undetectable serum HBV DNA were significantly lower than that of the other patients (P < 0.05).</p><p><b>CONCLUSION</b>Antiviral agents could effectively inhibit intrahepatic HBV DNA and improve hepatic histology. The patients with low baseline intrahepatic HBV DNA level may achieve better antiviral efficacy. Sequential treatment might produce high HBeAg seroconversion rate.</p>

An analysis of the pathohistology of liver tissues, clinical features and prognostic factors of chronic hepatitis B virus carriers / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To study the correlations between clinical features and liver pathohistological changes of chronic hepatitis B virus (HBV) carriers and to discuss the factors which may influence the prognosis.</p><p><b>METHODS</b>Ninety HBV carriers who had liver biopsies were enrolled in this study.</p><p><b>RESULTS</b>(1) The mean follow-up period of the patients was 118 weeks. (2) Fifty-four patients (60.0%) had G1 hepatitis and 21 (23.3%) had G2 hepatitis. The fibrosis stages were graded as S1(42) and S2(21). (3) There were significant age differences among S0, S1 and S2. (4) There were significant differences in aminotransferase levels between patients who had a normal liver histology and those who had mild hepatitis. (5) The grades of liver inflammation were not correlated with the titers of HBeAg and HBV DNA in sera. The stages of liver fibrosis were not correlated with the titers of HBVDNA in sera. Most of the HBeAg negative patients progressed to S2. (6) There were significant differences in spleen dimensions measured by ultrasonography between S0, S1 and S2 patients. (7) During the follow-up period serum aminotransferase (ALT) levels remained normal in 60 patients (group A); 22 patients had transient elevations (group B), and 8 patients had persistent increases (group C). There were significant differences of the ratios of S0 and S2 cases among patients in groups A, B and C. (8) Age and fibrosis stages were predictive factors of liver cirrhosis.</p><p><b>CONCLUSIONS</b>Most chronic HBV carriers had mild inflammatory histological changes in their livers and also had different degrees of liver fibrosis. This follow-up study shows that some of those carriers should have had antiviral therapy.</p>

Establishment and application of a real-time PCR method to detect hepatitis B virus cccDNA quantitatively / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To establish a new method to detect HBV cccDNA quantitatively and to apply it to detect cccDNA in liver needle biopsy specimens of chronic hepatitis B patients.</p><p><b>METHODS</b>The sequences of HBV DNA genotypes A through G were analyzed. According to the different sequence structure of cccDNA and rcDNA, primes and probe were designed in highly conservative region outside the nick of cccDNA in order to amplify cccDNA but not rcDNA. The best conditions of this method were found after testing experiments. Also we checked its specificity and sensitivity and reproducibility. The products of PCR were sequenced in order to ascertain if it was the right region expected. To amplify with standard plasmid ranged from 10(2) to 10(10) copies/ml to measure the sensitivity and amplify in parallel with standard plasmid of 10(6) copies/ml for 30 replicates so as to measure its reproducibility. DNA was extracted from 32 needle liver biopsy specimens of chronic hepatitis B patients. The cccDNA was quantitatively detected with this method. The data of cccDNA obtained before and after therapy and their relationship with total HBV DNA were analyzed. RESULTS Results of sequencing showed that the PCR product was from the right region. The sensitivity was 10(3)-10(10) copies/ml. The Ct value was 29.69+/-0.31 and the coefficient of variability was 1.04 percent calculated from the data of 30 PCR reactions with standard plasmid. The percentage of decrease in serum HBV DNA, total HBV DNA in liver and cccDNA in liver were 0.49+/-0.17, 0.22+/-0.18 and 0.16+/-0.28 respectively. There is 47 percent-98 percent cccDNA in total HBV DNA in liver and the mean is 81.5 percent.</p><p><b>CONCLUSION</b>The method is good because of the simple and convenient operation, the high specificity, the wide linear detection range and the fine reproducibility. Therefore it can be used for both scientific research and clinical purpose. Lamividine can significantly inhibit serum HBV DNA by, but its inhibitory effect on cccDNA in liver was rather weak.</p>

Clinical characteristies and distribution of hepatitis B virus genotype and sub-genotype / 中华流行病学杂志

<p><b>OBJECTIVE</b>To determine the distribution and virologic characteristics of HBV genotypes, sub-type and possible association with the severity of liver disease.</p><p><b>METHODS</b>884 patients infected with HBV were enrolled from 8 provinces in China. HBV genotype and sub-type was determined, using PCR-RFLP method.</p><p><b>RESULTS</b>The most common HBV genotypes were B (20.77% ) and C (78.22 % ) but only 1 patient showed genotypes D. We found sub-type Ba in patients with genotype B, C1 and C2 sub-type in patients with genotype C. Genotype C (83.62%) and sub-type C2 (90.32%) were predominant in northern China. Patients with genotype B were much younger than those with genotype C. There was no significant difference between patients with sub-type C1 and C2. There was no significant difference in liver function and serum HBV-DNA load between patients with genotype B and C,or between patients with sub type C1 and C2. However, hepatic inflammation and fibrosis score in patients with genotype B were significantly lower than those with genotype C.</p><p><b>CONCLUSION</b>There were no significantly differences in liver function and HBV-DNA load between patients with genotype B and C, or between patients with sub-type C1 and C2. Hepatic inflammation and fibrosis score in patients with genotype B were significantly lower than those with genotype C. Genotype C/sub-type C2 were preponderance in northern China.</p>