Rrelationship between liver volume atrophy rate,liver stiffness measurements and Child-Turcotte-Pugh value with Laennec histopathological classification in patients with hepatitis B cirrhosis / 重庆医学

Objective To explore the relationship between the liver volume atrophy rate,liver stiffness measurements(LSM) and Child-Turcotte-Pugh(CTP) value with the Laennec histopathological classification in the patients with hepatitis B cirrhosis and its value in the quantitative diagnosis of liver cirrhosis degree.Methods The clinicopathological data of liver biopsy tissue pathological slides,FibroScan,CT examination and hematological detection in 32 cases of hepatitis B cirrhosis were retrospectively analyzed.Liver cirrhosis was divided into mild,moderate and severe according to the Laennec liver cirrhosis histopathological classification.Then the relationship between the liver volume atrophy rate,LSM and CTP score with liver cirrhosis histopathological.Results Among 32 cases,9 cases(28.12％) were mild,12 cases(37.50％) were moderate and 11 cases(34.38％) were severe.The liver volume atrophy rates of mild,moderate and severe groups were (16.75±2.20)％,(23.11±6.67)％ and(35.55±5.70)％ respectively;LSM were(14.96±3.36),(20.21± 3.07),(37.03 ± 16.44) kPa respectively,the difference among 3 groups was statistically significant (P＜ 0.01).The CTP scores had no statistical difference among the 3 groups were(P＞0.05).The cirrhosis histopathological grade had the positive correlation with the liver volume atrophy rate and LSM(r=0.93,0.74,P＜0.01),however had no obvious correlation with the CTP scores(r=0.27,P＞0.05);the liver volume atrophy rate was positively correlated with LSM and CTP score(r=0.90,0.91,P＜0.01);while LSM had no obvious correlation with CTP score (r =0.15,P ＞ 0.05).Conclusion The more severe the cirrhosis histoathological grade,the bigger the liver volume atrophy rate and the higher the FibroScan detection value;the liver volume atrophy rate and LSM may serve as the quantitative diagnosis indicators of liver fibrosis histopathological severity.

Qualitative research of the psychological experience of the main caregivers of hepatocellular carcinoma with hepatitis B virus / 中国实用护理杂志

Objective@#To explore the psychological experience of the caregivers of Hepatocellular Carcinoma with Hepatitis B virus.@*Methods@#Semi-structured Interviews were performed in a total of 12 main caregivers of Hepatocellular Carcinoma with Hepatitis B in the Chinese Academy of Medical Sciences from October 2016 to March 2017, and the original data was analyzed according to the Colaizzi 7-step method.@*Results@#A total of five topics were extracted, including Awareness of relief stress when the diagnosis was informed, Indebtedness and self-blame, fear and sadness of possible loss of loved ones, stressful anxiety (stress of economy, loss of function, worrying about being infected), and joint stigma.@*Conclusions@#Many psychological experiences of main caregivers of patients with hepatocellular carcinoma combined with hepatitis B coexist in the course of care. Exploring and providing effective care support based on the psychological experience and needs of caregivers is one way to improve physical and mental health and the quality of care for patients.

The changes of autoantibodies in hepatitis B patients and its clinical significance / 中国基层医药

Objective To investigate the changes of autoantibodies in hepatitis B disease and its clinical sig-nificance.Methods 418 cases of hepatitis B patients were selected as hepatitis B group.At the same time,148 hos-pitalized patients in our hospital with autoimmune hepatitis( AIH) were chosen as AIH group.And 100 healthy people with physical examination were selected as control group at the same time .The antinuclear antibodies , anti -smooth muscle antibody( SMA) and anti-kidney microsomal antibodies and other autoantibodies of the three groups were detected and analyzed statistically.Results ANA-positive rate of hepatitis B group was 22.73%,ANA titer was mainly 1:100,only two cases of liver cirrhosis titers were 1:320,ANA karyotype was mainly homogenous,only four cases belonged speckled pattern;ANA positive rate of AIH patients was 60.14%,ANA titer was mainly 1:320,or even 1:1 000, primarily as a spot -type karyotype, nucleolar and centromere type.Differences between the two groups were statistically significant (P<0.05).The positive rates of hepatitis B,chronic hepatitis,severe hepatitis B and hepatitis B patients with cirrhosis ANA were significantly higher than in patients with acute hepatitis B,the differ-ences were statistically significant (χ2 =12.172,12.560,28.123,all P<0.05).Compared with AIH group,the posi-tive rate of SMA and LKM in patients with hepatitis decreased 51.98%,32.22%,respectively,the differences were statistically significant (χ2 =196.843,107.357,all P<0.05).The positive rate of hepatitis B level ANA ( +) patients of ALT and AST,HBV DNA was significantly higher than ANA (-) group.The level of hepatitis B patients ALT and AST,HBV DNA positive group were significantly higher than AIH.Differences were statistically significant (all P<0.05).Conclusion Autoantibody detection helps to study autoimmune etiology and pathogenesis of great importance for patients with hepatitis B and cirrhosis,but the reaction involved in the pathogenesis of autoimmune hepatitis level research still needs to be deeper.

Comparison of the influence of different HBV genotypes and subgenotypes to patients 'immune function / 中国基层医药

Objective To compare the influence of different genotypes of hepatitis B virus to the body's immune function.Methods 377 patients with chronic hepatitis B virus (serum HBV DNA are all positive)were selected.The serum specimens were collected.Nest PCR method was used to detect all entrants subtype HBV genotypes,ELISA method was used to detect serum levels of IL -10 and IL -17,fully automatic biochemical instrument was used to test all entrants liver function.Results Of 377 patients with chronic hepatitis B,C genotype in 323 cases,C2 type in 321 cases (85.1%),C1 type 2 cases (0.5%);Genotype B 41 cases (10.9%),were B2 subtype;B and C mixed 12 cases (3.2%);Type D in 1 case (0.3%).The sex,age,ALT,AST,TBIL of B2,C2 subtypes,BC mixed infection had no statistically significant differences.B2,C2 subtypes,BC mixed infection had no statistically significant difference in serum IL -17 level.And B2,C2 subtype infection had statistically significant difference in IL -10 level (F =0.444,P <0.05).Conclusion Different genotype HBV subtypes may have different effect to the body's immune function.

Expression and clinical significance of liver tissue HBVcccDNA and serum markers for chronic hepatitis B antiviral treatment / 中国基层医药

Objective To investigate the expression and clinical significance of liver tissue hepatitis B virus covalently closed circular DNA ( HBV cccDNA) and three serum markers ( including serum HBV DNA, HBsAg, HBeAg) for chronic hepatitis B antiviral treatment.Methods 80 patients with chronic hepatitis B were collected, they were treated with telbivudine tablets,and the liver tissue HBVcccDNA and serum HBV DNA expression were detected by fluorescence quantitative PCR( FQ-PCR) .Serum HBsAg,HBeAg expressions were detected by enzyme linked immunosorbent assay ( ELISA) before treatment,12 weeks,28 weeks,44 weeks,52 weeks after treatment. Then,the correlation of liver tissue HBVcccDNA with serum markers was analyzed.Results Liver tissue HBVcccD-NA,serum DNA HBV,serum HBsAg and serum HBeAg were significantly decreased with the time of treatment,the differences were statistically significant(F=3.786,4.785,3.806,3.452,P=0.034,0.009,0.031,0.042),and the liver tissue HBVcccDNA, serum DNA HBV and serum HBeAg before treatment compared with after treatment had statistically significant differences(all P<0.05).And the differences of serum HBsAg in the treatment of 44 and 52 weeks compared with before treatment were statistically significant(all P<0.05).The results of correlation analy-sis showed that the expression of HBVcccDNA was positively correlated with serum HBV DNA and HBeAg ( r =0.674,0.672,P=0.015,0.036),and had no significant correlation with serum HBsAg expression(r=0.125,P=0.142 ) .Conclusion The expressions of serum HBV DNA and HBeAg could reflect HBVcccDNA expression of liver tissue,and the detection method is simple and non-invasive,which is worthy of recommendation in clinical.

Effect of partial splenic embolization on the immune function of cirrhosis patients with hypersplenism

Objective To discover the effect of partial splenic embolization on the immune function of cirrhotic patients with hypersplenism. Methods Patients involved in the study were enrolled and divided into three groups, including control group, experimental group, and complication group. Numbers of CD3

Effect of partial splenic embolization on the immune function of cirrhosis patients with hypersplenism

OBJECTIVE@#To discover the effect of partial splenic embolization on the immune function of cirrhotic patients with hypersplenism.@*METHODS@#Patients involved in the study were enrolled and divided into three groups, including control group, experimental group, and complication group. Numbers of CD3(+), CD4(+) and CD8(+) T cells and CD4(+)CD25(+)CDl27(low/-) Treg cells in the peripheral blood of patients before surgery, 1 month, 6 months, 1 year, and 2 years after surgery were analyzed by fluorescence active cell sorting (FACS). Contents of immunoglobulins (IgA, IgG and IgM) were analyzed by auto immunoassay analyzer.@*RESULTS@#In the peripheral blood of patients from experimental group, numbers of CD3(+), CD4(+) and CD8(+) T cells initially declined, but afterwards increased to normal level; in the peripheral blood of patients from complication group, CD3(+) and CD8(+) T cells showed the same trend, but the number of CD4(+) T cells was below normal level at all detection times. Furthermore, CD3(+), CD4(+) and CD8(+) T cells in the peripheral blood of patients from complication group were initially less than those in experimental group, and afterwards were comparable between two groups. In patients from both experimental group and complication group, the number of CD4(+) CD25(+) CDl27(low/-)Treg cells increased 1 month and 6 months after surgery, and gradually restored to normal level. CD4(+)CD25(+)CDl27(low/-) Treg cell counts in patients from complication group were initially more than those in patients from experimental group 1 month and 6 months after surgery, but then they were comparable. Furthermore, contents of immunoglobulins (IgA, IgG and IgM) were comparable in three groups at all detection times.@*CONCLUSION@#Partial splenic embolization influenced the immune function of cirrhotic patients with hypersplenism in the short term but the immune function could afterwards gradually restore to normal. Our results implicated that measures that prevent infection and improve immune function were necessary in early stage after undergoing PSE in order to reduce complications.

Research of Treg and cytokines in patients with hepatitis B virus infection / 国际检验医学杂志

Objective To investigate the value and clinical significance of CD4+CD25+ regulatory T cells (Treg) ,inteleukin‐18 , interferon‐γand transforming growth factor‐βin patients with hepatitis B virus (HBV) infection .Methods A total of 175 patients with HBV infection were divided into chronic type B hepatitis (CHB) group and chronic asympotomatic HBV carrier (ASC) group , which were further divided into hepatitis B e antigen (HBeAg) positive and negative groups .CD4+ CD25+ Treg ,cytokines levels and liver function were measured .Healthy subjects were enrolled into control group .Results Proportion of CD4+CD25+ Treg were without significant difference among healthy controls ,HBeAg(+ ) and HBeAg(-) ASC groups ,and HBeAg(+ ) and HBeAg(-) CHB groups (P>0 .05) .Compared with control group ,cytokines levels were significant higer in CHB and ASC group (P<0 .05) . CD4+CD25+ Treg level was significant positive correlation to alanine aminotransferase and ratio of aspartate aminotransferase to plateles in HBeAg(+ )ASC group (P<0 .05) .Conclusion CD4+CD25 + Treg and related cytokines could play important roles in the course of CHB ,while CD4+CD25+ Treg expressing might be correlated with inflammatory degree of hepatitis .

The relationship between syndrome differentiation of TCM and clinical test results of 196 cases with chronic ;hepatitis B / 中国基层医药

Objective To establish the corresponding relationship between syndrome differentiation of TCM and clinical test results in chronic hepatitis B patients,and thus to provide objective evidence for TCM treatment. Methods 196 patients with chronic hepatitis B,according to the Chinese medicine dialectical typing results were divided into five groups(liver kidney yin deficiency syndrome type 35 cases,Shire Zhongzu syndrome type 24 cases, Yang deficiency of spleen and kidney syndrome type 26 cases,damp heat resistance type and blood stasis syndrome type 42 cases,liver stagnation and spleen deficiency syndrome type 69 cases).HBV -DNA,hepatitis B,TBIL,ALT, TTT were detected.Results In the HBV -DNA test,the majority of the five groups were positive,the overall compar-ison,the difference was not statistically significant (P =0.937).But in the second liver five,TBIL,ALT and TTT detection,the detection results were reflected in the corresponding relationship between TCMsyndrome differentiation. Such as in TTT detection,liver kidney yin deficiency syndrome type and liver stagnation and spleen deficiency syn-drome type group of patients,most patients with TTT detection results between 7 and 10,two groups sequentially com-pared with the other three groups,the differences were statistically significant (all P =0.000);damp heat resistance type and blood stasis type in the patients group,TTT detection results were generally less than 6,two groups in turn compared with the other three groups,the differences were statistically significant (all P =0.000);Yang deficiency of spleen and kidney in the patients group,TTT detection results were generally more than 10,and compared with the other four groups,the differences were statistically significant (all P =0.000).Conclusion TCMsyndrome differen-tiation of chronic hepatitis B patients has a certain correlation with the clinical test results.

Research on Developing Law of Pathogeny and Mechanism of Chronic Hepatitis Type B / 中国中医药信息杂志

Objective To discuss the developing law of pathogeny and mechanism of chronic hepatitis type B.Methods Patients of chronic hepatitis type B,early hepatocirrhosis and ascites caused by hepatocirrhosis was chosen as objects and clinical information was collected face to face.Patterns of Chinese medicine were confirmed and counted seperately according to efficiency,deficiency and efficiency-deficiency sydrome,harmed Zang-Fu organs and syndrome factors.Finally,the developing law of pathogeny and mechanism was analyzed.Results As the state of chronic hepatitis type Bevolving,simple efficiency and deficiency sydrome decrease with efficiency-deficiency sydrome increasing.Zang-Fu organs damaged by chronic hepatitis type B including mostly liver,gallblader,spleen,stomach,kidney,Trijiao and so on,among which spleen and liver are mainly damaged.As the state of chronic hepatitis type B evolving,the frequencies of damage to gallblader,spleen,stomach,kidney,Trijiao and so on increase.Most simple chronic hepatitis type B cases are due to Shi,Shi-Re,efficiency and stasis of Qi,while most of early hepatocirrhosis stem from Shi-Re,extravasated blood,efficiency and stasis of Qi,with that of ascites caused by hepatocirrhosis originating from Shi-Re,extravasated blood,Shui,efficiency of Qi and Yin. Conclusion There is developing law in the character,location and syndrome factors of chronic hepatitis type B.

Relationship between Hepatitis B Virus Variation and TCM Syndrome Types in HBeAg-Negative Patients of Chronic Hepatitis B / 中医杂志

Objective:To probe the relationship between hepatitis B virus(HBV) variation and TCM syndrome types in HBeAg-negative patient of chronic hepatitis B.Methods:Eighty-four cases of HBeAg-negative patient of chronic hepatitis B were divided into 5 syndrome types according to TCM differentiation.C gene promoter (BCP area) and pre-C gene termination variation in HBV were detected with gene chip for HBV mutation detection.Results:There was no significant correlativity between generation of HBV variation and TCM syndrome types in HBeAg-negative patient of hepatitis B as compared with HBeAg-positive patient;The variation rate of the BCP area and/or the pre-C area was 34.5% in prevailing excess syndrome group and 65.5% in the prevailing deficiency group,the former being higher than the latter.Conclusion:There is correlativity between variation of BCP area and/or pre-C area and TCM syndrome types,with the variation rate of the excess syndrome being lower than that of the deficiency syndrome.

Study on correlativity of development of illness state with changes of biochemical indexes in the cases of hepatitis B and E with overlapping infections of the liver and gallbladder dampness-heat type / 中医杂志

As the patient of hepatitis B and E overlapping infection of liver and gallbladder damp - heat type compared with the patient of simple hepatitis E of liver and gallbladder damp-heat type, attack was very rapid, jaundice exacerbated progressively and hepatic function damaged severely. Aftertreatment the state of illness restored more slowly and the duration of illness was obviously prolonged. At the same time, it was found that the biochemical indexes (hyaluronic acid, total bile acid) increased significantly at acute stage, and the indexes in the patient of overlapping infection in the time for recovering normality at restoration stage was longer than that in the patient of simple hepatitis E, with a significantly difference between the two groups. It is indicated that lesion of the liver in the patient of overlapping infection of hepatitis B and E was more severe than the simple hepatitis E, with no good prognosis.

On Basic Principles of Modern TCM Treatment of Hepatitis B / 中医杂志

In TCM treatment of hepatitis B,one of refractory diseases,must follow strictly the principles of learning the past, but not rigidly adhere to it,and opening up and innovation. The principles of anti-virus, playing attention to objective detection. clinically re-researching, unifying disease differentiation and syndrome differentiation, as well as attaching importance to medicine toxicity and carefully selecting medicines and so on mentioned in this paper are a preliminary opinion based on the above view point in combination with long-term clinical practice and thinking.