Recompensation of complications in patients with hepatitis B virus-related decompensated cirrhosis treated with entecavir antiviral therapy / 中华肝脏病杂志

Objective: To analyze the occurrence of recompensation conditions in patients with chronic hepatitis B virus-related decompensated cirrhosis after entecavir antiviral therapy. Methods: Patients with hepatitis B virus-related decompensated cirrhosis with ascites as the initial manifestation were prospectively enrolled. Patients who received entecavir treatment for 120 weeks and were followed up every 24 weeks (including clinical endpoint events, hematological and imaging indicators, and others) were calculated for recompensation rates according to the Baveno VII criteria. Measurement data were compared using the Student t-test or Mann-Whitney U test between groups. Categorical data were compared by the χ (2) test or Fisher's exact probability method between groups. Results: 283 of the 320 enrolled cases completed the 120-week follow-up, and 92.2% (261/283) achieved a virological response (HBV DNA 20 IU/ml). Child-Pugh and MELD scores were significantly improved after treatment (8.33 ± 1.90 vs. 5.77 ± 1.37, t = 12.70, P < 0.001; 13.37 ± 4.44 vs. 10.45 ± 4.58, t = 5.963, P < 0.001). During the 120-week follow-up period, 14 cases died, two received liver transplants, 19 developed hepatocellular cancer, 11 developed gastroesophageal variceal bleeding, and four developed hepatic encephalopathy. 60.4% (171/283) (no decompensation events occurred for 12 months) and 56.2% (159/283) (no decompensation events occurred for 12 months and improved liver function) of the patients had achieved clinical recompensation within 120 weeks. Patients with baseline MELD scores > 15 after active antiviral therapy achieved higher recompensation than patients with baseline MELD scores ≤15 [50/74 (67.6%) vs. 109/209 (52.2%), χ (2) = 5.275, P = 0.029]. Conclusion: Antiviral therapy can significantly improve the prognosis of patients with hepatitis B virus-related decompensated cirrhosis. The majority of patients (56.2%) had achieved recompensation. Patients with severe disease did not have a lower probability of recompensation at baseline than other patients.

Risk assessment of cirrhosis patients with esophageal and gastric variceal bleeding by three scoring systems / 中华消化内镜杂志

Objective:To compare the risk assessment capability of model for end-stage liver disease (MELD), glasgow-blatchford score (GBS), and the AIMS65 scoring system for liver cirrhosis patients with esophageal and gastric variceal bleeding (EGVB).Methods:A retrospective analysis was made on data of 182 cirrhosis patients with EGVB admitted to the Department of Gastroenterology, General Hospital of Tianjin Medical University from January 1, 2015 to March 1, 2018. According to the MELD, GBS and AIMS65 scoring system, the corresponding scores of each patient were calculated to evaluate the ability of the three scoring systems to correctly classify EGVB as a " high-risk patient" . The receiver operating characteristic curve was drawn to compare the predictive value of three scoring systems for different clinical outcomes (blood transfusion, rebleeding, and death). The area under curve (AUC)>0.7 was believed to have higher accuracy.Results:The clinical outcomes of 182 patients included blood transfusion in 113 (62.1%) cases, rebleeding in 31 (17.0%) cases, and death of 11 (6.0%) cases. The MELD score was 7-25, GBS was 3-16, and AIMS65 score was 0-3. There were 4 (2.2%) patients with MELD score < 9, 139 (76.4%) patients with AIMS65 score 0-1, including 68 patients with AIMS65 score of 0 and 71 patients with AIMS65 score of 1. The AUC of MELD, GBS and AIMS65 for predicting blood transfusion was 0.514 (95% CI: 0.439-0.589), 0.681 (95% CI: 0.608-0.748), and 0.669 (95% CI: 0.596-0.737), respectively. When predicting rebleeding, the AUC of MELD, GBS and AIMS65 was 0.525 (95% CI: 0.449-0.599), 0.528 (95% CI: 0.453-0.602) and 0.580 (95% CI: 0.505-0.652), respectively. When predicting in-hospital mortality, the AUC of MELD, GBS and AIMS65 was 0.642 (95% CI: 0.567-0.711), 0.581 (95% CI: 0.505-0.653) and 0.786 (95% CI: 0.719-0.843), respectively. AIMS65 was superior to MELD ( P=0.083 6) and GBS ( P=0.047 0). Conclusion:GBS can correctly classify cirrhosis patients with EGVB as " high-risk group" , and is better than AIMS65 and MELD scoring system. MELD, GBS and AIMS65 all have poor accuracy in predicting blood transfusion and rebleeding, AIMS65 has a higher predictive value for death.

Changes of Concentrations of Serum Interleukin-18 and Intercellular Adhesion Molecule-1 in Neonates with Hypoxic-Ischemic Encephalopathy / 实用儿科临床杂志

Objective To observe changes of serum concentrations of interleukin-18(IL-18) and intercellular adhesion molecule-1(ICAM-1) in neonates with hypoxic-ischemic encephalopathy(HIE) and to explore the correlation of the 2 indices and its effect on patients′condition.Methods Thirty newborn infants met the criteria for HIE.There were 16 cases in mild HIE group,14 cases in moderate and severe HIE group.Twenty normal newborn infants were used as control group.The serum concentrations of IL-18 and ICAM-1 of HIE group and control group were detected using ELISA on the third day and 7th day.Results 1.The IL-18 levels of the mild,moderate and severe HIE and control groups measured within 3 days of life were (120.1?12.7),(175.1?15.4),(100.3?12.5) ng/L,respectively.The concentrations of IL-18 in HIE groups were higher than that of control group(Pa

Expression of Toll-Like Receptor 2 in Newborn Infants with Septicemia and Its Correlation with C Reaction Protein / 实用儿科临床杂志

Objective To explore the value of Toll-like receptor 2(TLR2) on the diagnosis of neonatal septicemia especially for the early diagnosis.Methods Twenty-two newborns with septicemia were divided into 2 groups according to the time of onset:early-onset group(n=12) and late-onset group(n=10).Another 14 non-infectious newborns were collected as control group.The TLR2 mRNA in peripheral blood was detected by real-time polymerase chain reaction,and mononuclear cells were isolated by the density gradient centrifuga-tion;the C reaction protein(CRP) was detected,and the co-relationship of the indexes was analyzed by Pearson correlation analysis.Results 1.The level of CRP in early-onset group were(157.89?32.96) ng?L-1,and(89.78?16.24) ng?L-1 in late-onset group,and there was significant difference between both groups(P=0.001);(6.91?1.20) ng?L-1 in control group,which was significantly lower than that in early-onset group and late-onset group(P=0.000,0.001).2.The expression of TLR2 mRNA in early-onset group and late-onset group was(57.38?10.72)?1012 copies?L-1and(32.74?4.65) ?1012 copies?L-1,which was significantly higher than that in control group[(4.12?0.68) ?1012 copies?L-1].3.CRP is positively correlated with TLR2 mRNA(C=0.972,P=0.000).Conclusions TLR2 expression is proven to be related to both the level of CRP and the stage of onset and may play a key role in the pathogenesis of neonatal septicemia.Detection for TLR2 may assist the earlier diagnose of atypical neonatal septicemia.

RCT on the therapautical effect of mospride citrate in functional dyspe psia / 第三军医大学学报

Objective　To observe the curative effect and sid e effect of the gastrokinetic agent mosapride citrate by RCT. Methods　 42 cases of functional dyspepsia (FD) were divided into two groups rando mly, the group of mosapride(21 cases):orally administrated mosapride, 5mg, t.i.d for 4 weeks, and the control (21 cases):orally administrated domperidone, 5mg, t.i.d for 4 weeks. Symptoms and side effects were recorded before and at d 14, d 28 after administration of the medicines according to GCP and double blind pri ciple. Gastric empting test was also carried out in randomly selected patients. Results　Mosapride and domperidone were significantly effective on alleviating symptoms of the patient with FD. In mosapride treated group the half emptying time was shortened and the 120 min remain rate was reduced. No sid e effect was found. Conclusion　These results suggest that mosa pride 5 mg t.i.d. is effective and safe on alleviating symptoms of patients with FD and improving the ga stric empting time.

RCT on the therapautical effect of mospride citrate in functional dyspe psia / 第三军医大学学报

Objective　To observe the curative effect and sid e effect of the gastrokinetic agent mosapride citrate by RCT. Methods　 42 cases of functional dyspepsia (FD) were divided into two groups rando mly, the group of mosapride(21 cases):orally administrated mosapride, 5mg, t.i.d for 4 weeks, and the control (21 cases):orally administrated domperidone, 5mg, t.i.d for 4 weeks. Symptoms and side effects were recorded before and at d 14, d 28 after administration of the medicines according to GCP and double blind pri ciple. Gastric empting test was also carried out in randomly selected patients. Results　Mosapride and domperidone were significantly effective on alleviating symptoms of the patient with FD. In mosapride treated group the half emptying time was shortened and the 120 min remain rate was reduced. No sid e effect was found. Conclusion　These results suggest that mosa pride 5 mg t.i.d. is effective and safe on alleviating symptoms of patients with FD and improving the ga stric empting time.