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Objective@#To observe the changes of liver function, virology and serology and the safety of drug withdrawal in pregnant women who are chronic hepatitis B virus (HBV) carriers.@*Methods@#A prospective clinical cohort was established to enroll pregnant women who are chronic HBV carriers and they were divided into the nucleoside/nucleotide analogs (NAs) intervention group and the non-NAs intervention group according to patients' wishes. Liver function, HBV DNA and HBV serological markers were detected at gestation, postpartum 6 weeks, 12 weeks, 24 weeks, 36 weeks and 48 weeks.@*Results@#351 patients were enrolled, 320 in the NAs intervention group and 31 in the non-NAs intervention group. The proportion of postpartum hepatitis flares in both groups was higher than that in pregnancy (39.4% vs 12.5%, P < 0.001; 38.7% vs 3.2%, P = 0.001). Six weeks postpartum was the peak period of hepatitis flares, and 96.0% (121/126) of the hepatitis flares occurred within 24 weeks postpartum. At 6 weeks postpartum, there were 6 cases of alanine aminotransferase (ALT) ≥ 10 times upper limit of normal (ULN) in the NAs intervention group. The rate of the hepatitis flare after drug withdrawal was 16.7% (34/203).@*Conclusion@#Regardless of the presence or absence of NAs intervention, pregnant women who are chronic HBV carriers have a certain proportion of hepatitis flares during pregnancy and postpartum, and the hepatitis flare even have a tendency to be severe. Therefore, drug withdrawal after delivery is not always safe, which requires close observation and classification. At 6 weeks postpartum, the incidence of hepatitis flares was high, and those who meet the treatment indications can get better therapeutic effects if given appropriate treatment. The vast majority (96%) of postpartum hepatitis flares occur within 24 weeks, so it is recommended to follow up to at least 24 weeks postpartum after discontinuation.
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Objective To evaluate the feasibility and safety profile of pegylated-interferonα-2a (Peg IFNα-2a) combined with adefovir dipivoxil (ADV) in inactive hepatitis B surface antigen (HBsAg) carriers (IHC).Methods This was a single center, prospective and open-label study.IHC were divided into therapeutic group (T, 112 subjects) and control group (C, 72 subjects) according to personal willingness.Patients with hepatitis B virus (HBV) DNA<20 IU/mL were treated with Peg IFNα-2a monotherapy, and those with HBV DNA ≥20-<2 000 IU/mL were treated with Peg IFNα-2a combined with ADV.Total therapy duration was 96 weeks.For patients who achieved HBsAg seroconversion and continued consolidation treatment for 24 weeks, the treatment duration could be less than 96 weeks.t test was used for continuous variable comparison between the two groups, while chi-square test or Fisher′s exact probability method was used for counting data analysis.The related factors affecting HBsAg clearance was analyzed by univariate or multivariate logistic regression analysis.Results A total of 194 patients were enrolled with 112 in therapeutic group and 72 in control group.The HBsAg clearance rate and seroconversion rate at week 48 in therapeutic group were 30.8% (32/104) and 26.0% (27/104), respectively.The rates at week 96 increased to 45.2% (47/104) and 38.5% (40/104), respectively.The HBsAg clearance rates at weeks 48 and 96 in control group were both 1.5% (1/68).HBsAg seroconversion was not achieved in control group.The HBsAg clearance rate in treatment group was significantly higher than that in control group (χ2=39.066, P<0.01).The quantitative HBsAg levels at baseline (OR=2.313, 95%CI: 1.258-4.251, P=0.007), week 12 (OR=3.159, 95%CI: 1.826-5.466, P<0.01) and week 24 (OR=3.347, 95%CI: 2.050-5.465, P<0.01), the decline of HBsAg at week 12 (OR=5.343, 95%CI: 2.085-13.689, P<0.01), and week 24 (OR=4.855, 95%CI: 2.380-9.902, P<0.01), and alanine transaminase (ALT) elevation at week 12 (OR=3.520, 95%CI: 1.369-9.052, P=0.009) were independent predictors for HBsAg clearance.Conclusions Peg IFNα-2a-based treatment for IHC could achieve higher HBsAg clearance rate and seroconversion rate, and has a safety profile.Decline of HBsAg at week 12 and week 24 with ALT elevation at week 12 could predict a higher HBsAg clearance rate.
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The purpose of this study is to evaluate the anti-aging effects and reveal the underlying mechanism of Scutellaria baicalensis Georgi ethanol extract (SBG) in D-galactose-induced rats. Fifty rats were randomly divided into five groups: vehicle control group, D-galactose group, and D-galactose combined with 50, 100, 200 mg x kg(-1) SBG. A rat aging model was induced by injecting subcutaneously D-galactose (100 mg x kg(-1)) for ten weeks. At the tenth week, the locomotor activity (in open-field test) and the learning and memory abilities (in Morris water maze test) were examined respectively. The urine was collected using metabolic cages and analyzed by high-resolution 1H NMR spectroscopy combined with multivariate statistical analyses. The SBG at doses of 50, 100 and 200 mg x kg(-1) treatments groups could significantly ameliorate aging process in rats' cognitive performance. The 50, 100, 200 mg x kg(-1) SBG regulated citrate, pyruvate, lactate, trimethylamine (TMA), pantothenate, β-hydroxybutyrate in urine favorably toward the control group. These biochemical changes are related to the disturbance in energy metabolism, glycometabolism and microbiome metabolism, which is helpful to further understanding the D-galactose induced aging rats and the therapeutic mechanism of SBG.
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ObjectiveTo investigate the correlation between the changes in routine blood test results and antiviral effect in patients with refractory chronic hepatitis C receiving standard treatment. MethodsA total of 63 previously untreated patients with refractory chronic hepatitis C who visited Beijing YouAn Hospital, Capital Medical University, from September 2011 to December 2012 were enrolled. The patients were treated with pegylated interferon-α-2a 180 μg/week and ribavirin (RBV) for 48 weeks. HCV RNA measurement and routine blood tests were performed at baseline and weeks 4, 12, and 24 of treatment to analyze the correlation between routine blood test results and antiviral effect. According to the status of sustained virologic response (SVR), the patients were divided into SVR group and nSVR group. The t-test was used for comparison of continuous data between groups, the chi-square test was used for comparison of categorical data between groups, and a simple linear correlation analysis was performed. ResultsOf the 63 patients, three were lost to follow-up, and the other 60 patients completed the antiviral therapy and 24-week follow-up; among the 60 patients, 46 achieved SVR, resulting in an SVR rate of 76.7%. Compared with the nSVR group, the SVR group showed lower absolute lymphocyte count (LYPH), white blood cell count (WBC), and absolute neutrophil count (NUET), and the three indicators were significantly different between the two groups at 12 weeks (t=3.398, 2.766, and 2.037, all P＜0.05); WBC and NUET still showed significant differences between the two groups at 24 weeks (t=2.559 and 2.151, both P＜0.05). In addition, at week 4 of treatment, the SVR group showed significantly greater reductions in these three indicators from baseline compared with the nSVR group, LYPH showed significant different between the two groups(t=226,P=003). At weeks 4 and 12 of treatment, LYPH, WBC, and NEUT were positively correlated with the reduction in HCV RNA (r=0.36, 045, 0.37, 0.47, 0.61, and 0.33, all P＜0.05). ConclusionThe reductions in LYPH, WBC, and NEUT can be used as predictive indicators for antiviral effect in patients with refractory chronic hepatitis C.
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Objective To investigate the efficacy and safety of combination of transcatheter arterial chemoembolization (TACE)and percutaneous radiofrequency ablation (RFA)in treatment of hepatocellular carcinoma (PHC).Methods 70 cases of PHC were divided into combined group (TACE +RFA,n =37) and control group (only TACE,n =33).Patients were followed up for1 to 2 years,and the therapeutic effects and side effects were compared between the two groups.Results The patients with tumor completely necrosis and AFP level lower than >50% in combined group were significantly more than those in control group (P <0.05);the half of year,one year and two years survival rate in combined group were greatly higher than those of control group;no severe side effect was observed in two groups.Conclusions TACE+RFA is effective and safe in treatment of PHC of more than 5 cm in diameter.
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AIM:To investigate the effect of cervical lymphatic blockage(CLB)on blood pressure(BP)in conscious unrestrained rats.METHODS:Sprague-Dawley(SD)rats were adopted and randomly divided into two groups as Sham operated group and CLB group.By means of monitoring hemodynamic change in conscious unrestrained rats,twenty-four-hour blood pressure(SBP,DBP and MAP),blood pressure variability(BPV),heart rate(HR)and heart rate variability(HRV)were respectively measured before sham and cervical lymphatic blockage operation as their baseline and at 1st,3rd,7th,11th,15th days after operation.Meanwhile,arterial baroreflex sensitivity(BRS)was measured before and at 1st,7th,15th days after operation.RESULTS:SBP,DBP,MAP and HR significantly decreased at 1st day after CLB operation and their lowest values appeared at 7th day.The tendency of their alternation was descending early and then ascending whereas reverse alterations of BPV and HRV were observed.BRS reduced in CLB rats with no apparent recovery from 7th day.CONCLUSION:CLB results in reduction of blood pressure and dysfunction of nervous regulation on cardiovascular system in conscious unrestrained rats.