Estudio descriptivo de pacientes con cirrosis hepática de etiología viral, en la provincia de Matanzas / Descriptive study of patients with viral-etiology liver cirrhosis in the province of Matanzas

RESUMEN Introducción: la cirrosis hepática de etiología viral representa un impactante problema de salud a nivel mundial, no solo por su elevada tasa de prevalencia, sino por los costos generados en la atención médica. Objetivos: determinar el comportamiento de los pacientes cirróticos, de etiología viral, en la provincia de Matanzas. Materiales y métodos: se realizó un estudio descriptivo-retrospectivo en 47 pacientes con cirrosis hepática de etiología viral, atendidos en el Servicio de Gastroenterología del Hospital Universitario Clínico Quirúrgico Comandante Faustino Pérez Hernández, de Matanzas, de enero de 2016 a enero de 2018. Los resultados de las variables analizadas se expusieron en tablas de doble entrada. Resultados: el 68,1 % de los pacientes correspondió a cirrosis por virus C. Predominaron los mayores de 50 años, con carga viral entre 4-6,9 log10, y atendidos en régimen ambulatorio. En el 57,4 % se detectaron signos endoscópicos de hipertensión portal, que se corroboraron en el doppler hepático. La ascitis asociada a diferentes sepsis fueron las complicaciones más registradas. El 55,4 % fue clasificado como Child-Pugh A, y el 76,6 % en etapa clínica compensada. Conclusiones: el diagnóstico y seguimiento de la cirrosis hepática viral sigue siendo un verdadero reto para la comunidad médica. De ahí los esfuerzos que han de realizarse para su control desde las fases compensadas, para retardar la aparición de complicaciones (AU).

ABSTRACT Introduction: viral etiology liver cirrhosis is an impacting health problem around the world, not only because of its high prevalence rate but also because of the costs generated by its medical care. Objective: to determine the behavior of the patients with viral etiology liver cirrhosis in the province of Matanzas. Materials and methods: a descriptive-retrospective study was carried out in 47 patients with viral etiology liver cirrhosis treated in the service of Gastroenterology of the Hospital "Comandante Faustino Perez" of Matanzas, from January 2016 to January 2018. The results of the analyzed variables were shown in double-entry tables. Results: 68.1% of the patients presented cirrhosis caused by C virus, Patients elder 50 years old predominated, with 4-6.9 log10, treated in ambulatory regimen. Endoscopic signs of portal hypertension were found in 57.4%. It was corroborated with liver Doppler. Ascites associated to different sepsis were the most frequently registered complications. 55.4% were classified as Child-Pugh A, and 76.6% were in compensated clinical stage. Conclusions: viral liver cirrhosis diagnosis and follow-up is still a true challenge for the medical community, and hence the efforts that should be made to control it from the compensated stages to delay the appearance of complications (AU).

Role of autophagy in the pathogenesis of myocarditis / 国际儿科学杂志

Myocarditis refers to diffuse or focal inflammatory cell infiltration of the myocardial interstitium and necrosis or degeneration of adjacent myocardial fiber caused by infection or other causes,which is one of the common diseases that cause the death of infants and adolescents.Viral infection is the main pathogenic factor,but the pathogenesis of myocarditis has not yet been fully elucidated.Autophagy is a highly conservative process of self-digestion,which can provide amino acids,ATP and other substances for cells in the state of inflammation or starvation to help cells survive the energy crisis under excessive stimulation.However,excessive autophagy can promote the replication of viruses,which leads to autophagic death.In recent years,some researchers found that autophagy is closely related to the process of viral myocarditis associated with Coxsackie virus B3.The role of autophagy in the pathogenesis of myocarditis is reviewed in this article.

Expression of the VP1 protein and establishment of indirect ELISA detection method of Coxsackievirus B4 / 中华实验和临床病毒学杂志

Objective@#To detect antibodies to Coxsackievirus B4 (CV-B4), the indirect enzyme-linked immunosorbent assay (ELISA) method was established and optimized using the recombinant VP1 protein expressed in the prokaryote system as the envelope antigen.@*Methods@#The VP1 gene of CV-B4 was amplified using reverse transcriptase-polymerase chain reaction (RT-PCR). It was ligated into the expression vector pET32a(+ ) to obtain the recombinant plasmid pET32(+ )-VP1 and was then transformed into E. coli expression strain Rosetta (DE3). The recombinant VP1 protein was induced by IPTG, which was verified using SDS-PAGE electrophoresis and mass spectrometry. The establishment and optimization of the indirect ELISA reaction system was based on the purified recombinant protein mentioned above as the coating antigen.@*Results@#The CV-B4 VP1 gene was stably expressed in E. coli in the form of inclusion body. The optimal coating concentration of antigen was 7.5 μg per well and the optimal serum dilution was 1∶100. The threshold for determining the negative and positive result of the serum samples was the optical density value of ≥ 0.376 at 450 nm. The purified recombinant protein could be specifically recognized by CV-B4 positive serum without cross-reaction with Coxsackievirus (CV)-A, CV-B1 and CV-B5, indicating that it has good immunogenicity. However, it can cross-react with CV-B3 serum samples.@*Conclusions@#The indirect ELISA detection method based on the CV-B4 VP1 protein could be used in the detection of serum antibody to CV-B4 infection with good sensitivity, specificity and repeatability.

Effects of particulates in four different air pollution sources and coxsackie virus B3 on autophagy and apoptosis of cardiac myocytes in rats / 中华实验和临床病毒学杂志

Objective@#To observe the changes of LC3, lc3-Ⅱ/lc3-Ⅰ ratio, Nrf2 and Bcl2 in myocarditis induced by coxsackievirus group B type 3 (CV-B3) infection and myocardial damage in SD rats caused by particulate matter of four different pollution sources, and to further explore the mechanism of autophagy and apoptosis of myocardial cells and myocardial damage.@*Methods@#Adult SD rats were randomly divided into CV-B3 infection group (20 rats), automobile exhaust group (20 rats), coal smoke group (20 rats), burning straw group (20 rats), atmosphere group (20 rats) and control group (20 rats). The expressions of LC3, Bcl2 and Nrf2 in rats were detected by Western blot at 12 hours, 48 hours, 5 days and 10 days.@*Results@#In the first three groups of rats expression of LC3, Bcl2 and Nrf2 was upregulated, this was seen early in CV-B3 group, the peak was high, and recovery was fast; while in automobile exhaust group the above changes appeared later, the amplitude was low; in the coal smoke group rats the above changes appeared even later, but the amplitude of change was higher than that in automobile exhaust group, but lower than that of CV-B3 group. In automobile exhaust and coal smoke groups Bcl2 and Nrf2 expression was still slightly increased at day 10. After 48 hours, the above measurements in rats in the atmosphere group were temporarily up-regulated, and returned to normal on day 5. The above measurements of rats in the straw smoke and the control group did not show significant change.@*Conclusions@#In the SD rats with acute viral myocarditis induced by CV-B3 and myocardial damage induced by automobile exhaust, coal smoke and atmospheric particulate matter, the whole process of metabolism, renewal, repair and anti-damage activity of myocardial cells can be accomplished through autophagy activation, apoptosis inhibition and antioxidant mechanism.

Serología del virus de la hepatitis B: para múltiples escenarios, múltiples exámenes / Serology of hepatitis B virus: multiple scenarios and multiple exams

Resumen El virus de la hepatitis B (VHB) tiene un gran impacto mundial. No obstante la disponibilidad de la vacuna, 2000 millones de personas se han infectado agudamente y, de ellos, 240 millones persisten crónicamente infectados. La infección tiene diferentes formas de presentación tales como infección aguda, infección crónica, infección oculta y reactivación cuando hay inmunosupresión. Así mismo, hay marcadores muy sensibles como el anticore, cuya positividad puede tener diversos significados. El recientemente descrito antígeno relacionado con el antígeno core es un marcador emergente que podría reemplazar al ácido desoxirribonucleico (ADN) viral. En la presente revisión se discuten los exámenes de laboratorio necesarios para el diagnóstico de los diferentes escenarios de la infección.

Abstract Hepatitis B virus (HBV) has an enormous global impact. Despite the availability of a vaccine, two billion people have been acutely infected. Of these, 240 million remain chronically infected. The infection has different forms of presentation including acute infections, chronic infections, hidden infections, and reactivation when there is immunosuppression. Similarly, there are very sensitive markers such as anti-core, but a positive test can have different meanings. This recently described antigen which is related to the core antigen is an emerging marker that could replace viral DNA. In this review we discuss the laboratory tests necessary for diagnosing the various scenarios of the infection.

Liver transplantation from donor liver of organ donation after citizen's death: a single center experience / 器官移植

Objective To evaluate the application value of donor liver from organ donation after citizen's death (organ donation) in clinical liver transplantation. Methods Clinical data of 75 pairs of donors and recipients undergoing liver transplantation from organ donation in the First People's Hospital of Foshan from October 2011 to December 2016 were retrospectively analyzed. The conditions of the donors were strictly evaluated. Clinical prognosis and the incidence of postoperative complications of the recipients were summarized. Results The 1-year and 3-year accumulated survival rates of 75 liver transplantation recipients were 88% and 78%. Four recipients died from the recurrence and metastasis of liver cancer, 1 case from graft-versus-host disease, 1 case from severe pulmonary infection, 1 case from recurrence of virus B hepatitis (hepatitis B) and liver failure, 1 case from postoperative multiple organ failure and 1 case from massive hemorrhage of the upper digestive tract. Thirteen recipients suffered from biliary tract stenosis. One case was mitigated spontaneously and 1 recipient was healed after percutaneous transhepatic biliary drainage (PTBD). Eleven cases were treated with endoscopic retrograde cholangiopancreatography (ERCP). Among them, 5 cases were healed,2 recipients were switched to choledochojejunostomy and 4 cases were still monitored in clinical practice. Conclusions Liver transplantation from organ donation yields high clinical efficacy. Strict evaluation of donor conditions, standard perioperative management of the recipients, maintenance immunosuppressive therapy without adrenocortical hormone,timely and effective treatment of complications, regular postoperative follow-up are pivotal measures to guarantee the success of liver transplantation from organ donation and long-term survival of the recipients.

In Silico Identification of MicroRNAs with B/CYDV Gene Silencing Potential

ABSTRACT Computational investigation of a set of publicly available plant microRNAs revealed 19 barley- and other plants-encoded miRNAs and their near-complement reverse sequences (miRNA*) that have potential to bind all B/CYDV open reading frames (ORFs) except ORF0 and ORF6. These miRNAs/miRNAs*, their binding positions and targets are discussed in the context of biological protection of cereals against B/CYDV, based on antiviral silencing.

Effects of Shufengjiedu Capsule on model of viral myocarditis in mice / 中草药

Objective: To investigate the effect of Shufengjiedu Capsule on the modality of myocardial tissue and levels of serum TNF-α and SAA in mice with viral myocarditis. Methods: BALB/C mice were randomly divided into normal control group, virus group, Shufengjiedu Capsule 0.1, 0.2, 0.5 g/kg/d groups, and ribavirin 0.1 g/kg/d group. The mouse model of viral myocarditis was established by ip injection of CVB3, and after 2 h of modeling, the animals were continuously admistered for 7 d. Half of the mice were killed on days 4 and 8, the myocardium tissue was HE stained to observe the pathological changes and blood samples were taken for measurement of serum TNF-α and SAA contents. Results: Compared with the control group, the pathological changes of myocardium were significantly decreased in high-dose Shufengjiedu Capsule group, and the serum TNF-α and SAA contents were significantly decreased (P < 0.05). Conclusion: Shufengjiedu Capsule has antiviral effect and could alleviate the inflammation on mice with viral myocarditis.

Effects of Liver Function in Patients with Liver Cirrhosis and Virus B Hepatitis on Drug Half-life and An-algesic Effect of Target Controlled Infusion of Remifentanil / 中国药房

OBJECTIVE:To explore the safety and effects of liver function in patients with liver cirrhosis following virus B hepatitis(called“hepatitis B”for short)on drug half-life and analgesic effect of target controlled infusion of remifentanil. METH-ODS:100 patients with liver cirrhosis following hepatitis B underwent liver and gallbladder surgery under selective general anesthe-sia were collected from our hospital and divided into group A(mild abnormal liver function)and group B(severe abnormal liver function,3 cases withdrew from the test and 47 cases completed the test),with 50 cases in each group,according to Child-Pugh grading of liver function. Both group were given phenobarbital sodium 0.1 g+scopolamine 0.3 mg intramuscularly 0.5 h before oper-ation;midazolam 0.04 mg/kg+propofol 1.5 mg/kg+atracurium 0.6 mg/kg intravenously;target controlled infusion of Remifentanil hydrochloride for injection during operation with 0.125-0.250 μg/(kg·min). The distribution half-life and the elimination half-life of remifentanil were determined, and temperature pain perception threshold (tPDT) and electrical pain perception threshold (ePDT) were measured immediately after the operation;the occurrence of ADR was observed. RESULTS:The distribution and elimination half-life of remifentanil were (4.52 ± 1.25)min and(24.64 ± 1.30)min in group A and (4.68 ± 1.31)min and(25.45 ± 2.08)min in group B respectively,there was no statistical significance between 2 groups(P>0.05). tPDT and ePDT of group A were(8.88± 1.66)mA and(1.54±0.09)mA respectively,and those of group B were(9.16±1.58)mA and(1.34±0.15)mA,there was no sta-tistical significance between 2 groups (P>0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:The abnormal liver function of patients with liver cirrhosis following hepatitis B have no significant effect on drug half-life and analgesic effect of remi-fentanil with good safety.

Prolonged remission in a child with chronic myeloid leukemia following Parvo virus B19 (B19V) infection.

Parvovirus B19 (B19V) has been associated with a wide spectrum of clinico‑pathological disorders in human beings depending upon the host immunity. The present report describes a child with chronic myeloid leukemia (CML) on hydroxyurea in haematological remission, who developed profound erythroid suppression following B19V infection requiring multiple transfusions and withdrawal of hydroxyurea. Despite being off-therapy the child remained in complete clinical and haematological remission till anti B19V antibodies appeared. This case illustrates the ability of B19V infection in suppressing neoplastic myeloid clone, a phenomenon not described earlier.

Protective effect of GYY4137 on rat myocardial cells infected by Coxsackie virus B3 / 中华实用儿科临床杂志

Objective To study the protective effect of GYY4137 on rat myocardial cells infected by Coxsackie virus B3 (CVB3) and its signal transduction mechanism.Methods Cardiomyocytes were treated with different concentrations of GYY4137(10,50,100 μmol/L) for 24 hours before addition of 100 TCID50 CVB3 for 2 hours before serum-free conditions.After treatment,the cell viability was ascertained with Cell Counting Kit-8 (CCK-8) assay.At the same time,the levels of tumor necrosis factor-α (TNF-α),interleukin-1β (IL-1β),interleukin-6 (IL-6) in the supernatants were analyzed by enzyme-linked immunosorbent assay (ELISA).Western blot was used to study the expression of nuclear factor kappa-B (NF-κB) protein and the inhibitory subunit of (IκBα) in myocardial cells.Results After exposure of cardiomyocytes to GYY4137 with different concentration (10,50,100 μmol/L)for 24 hours cell viability had no change.The NF-κB expression and the levels of TNF-α,IL-1β,IL-6 [(175.80 ± 5.05) ng/L,(25.80 ± 1.97) ng/L,(65.33 ± 3.51) ng/L] in the GYY4137-treated CVB3 infection group were significantly reduced when compared with untreated CVB3 infection group (P ＜ 0.01),respectively.Compared with the normal group,the GYY4137 concentration-dependently restrained the CVB3-mediated IκBα degradation(P ＜ 0.01).Conclusions GYY4137 exerts anti-inflammatory effects in CVB3-infected cardiomyocytes.This anti-inflammatory mechanism may be associated with suppression of the activation of the NF-κB.

Application of the 4℃refrigerator in the isolation of influenza B virus / 中国基层医药

Objective To explore the effect of cryopreserved canine kidney cells (MDCK)single -layer on the isolation and proliferation of influenza virus B.Methods Revived P17 MDCK cells were passage for 2 -4 gener-ations,and subsequently preserved in 4℃ refrigerator for 3,6 and 9 days,respectively.Under same experimental con-ditions,the 4℃ refigerater preserved cells were co -incubated with influenza -like illness(ILI)throat swab speci-mens.Cytopathic effect (CPE)was observed,and the proliferation of virus was determined using real -time PCR and the hemagglutinin titers were determined by serological test.Results (1)CPE:The CPE of the MDCK cells pre-served in 4℃ refrigerator for 3 or 6 days had no significant differences compared with that in the control group,while the cell preserved in 4℃ refrigerator for 9 days showed CPE fastly and maintained for a short time.(2)Real -time PCR:the proliferation of influenza virus B in the MDCK cells preserved with 4℃refrigerator for 3 or 6 days (25.86 × 105 -30.25 ×106 ,26.31 ×105 -30.54 ×106 )had on difference compared with that of the control group (24.82 × 105 -29.86 ×106 ),with the proliferation rate of 105 to 106 times,while the proliferation cell with 4℃ cryopreserved for 9 days(19.72 ×104 -28.34 ×105 )the proliferation in cells preserved for 9 days was sharply decreased,with pro-liferation rate of 104 to 105 times.(3)The HA titer:The virus strains with hemagglutination titer above or equal to 116 (P >0.05)isolated with MDCK cells preserved in 4℃ refrigerator 3 or 6 days were not significantly different from that of the control group (10.92 ±0.79).And the cells with 4℃ cryopreserved for 9 days were significantly dicreased (P <0.01).Conclusion No significant effects on the isolation and proliferation of influenza virus B using MDCK cell preserved in 4℃ frigerator for near one week were observed in the present study.

Glucosylated caffeoylquinic acid derivatives from the flower buds of Lonicera japonica

Three new glucosylated caffeoylquinic acid isomers (1-3), along with six known compounds, have been isolated from an aqueous extract of the flower buds of Lonicera japonica. Structures of the new compounds were determined by spectroscopic and chemical methods as (-)-4-O-(4-O-β-d-glucopyranosylcaffeoyl)quinic acid (1), (-)-3-O-(4-O-β-d-glucopyranosylcaffeoyl)quinic acid (2), and (-)-5-O-(4-O-β-d-glucopyranosylcaffeoyl)quinic acid (3), respectively. In the preliminary in vitro assays, two known compounds methyl caffeate and 2'-O-methyladenosine showed inhibitory activity against Coxsackie virus B3 with IC50 values of 3.70 μmol/L and 6.41 μmol/L and SI values of 7.8 and 12.1, respectively.

Correlation of Serum Lipoxin A4 with Clinical Grading of Chronic Hepatitis B Patients / 昆明医科大学学报

Objective To explore the correlation between serum Lipoxin A4 and clinical grading of chronic hepatitis B patients. Method The serum Lipoxin A4 was detected by Enzyme-Linked Immunosorbent Assay in 94 chronic hepatitis B patients. Results It was found that the level of serum Lipoxin A4 of severe hepatitis patients were significantly lower than mild hepatitis patients and moderate hepatitis patients ( =0.04 and =0.03) . The serum Lipoxin A4 levels were correlated negatively with the ALT and AST levels,respectively =-0.41, =0.019 and R=-0.37,P=0.034. Conclusion These findings support the fact that the serum Lipoxin A4 may contribute to clinical grading of chronic hepatitis B patients.

HBV-specific T lymphocyte responses during different stages of hepatitis B virus infection / 中华微生物学和免疫学杂志

Objective To analyze hepatitis B virus ( HBV)-specific T lymphocyte responses dur-ing different stages of HBV infection.Methods Eighty-four patients with HBV infection were recruited in this study.They were divided into four groups including acute HBV infection group (8 cases), chronic HBV infection group (39 cases), hepatocirrhosis group (17 cases) and hepatocellular carcinoma group (20 ca-ses) .HBV-specific T cell responses were detected by using ELISPOT assay in combination with magnetic beads sorting assay.Results (1)The magnitudes of HBV-specific T cell responses in patients with acute HBV infection ,chronic HBV infection , hepatocirrhosis and hepatocellular carcinoma were respectively (2067.00±1029.00) SFU/106 PBMCs, (288.50±57.69) SFU/106 PBMCs, (96.25±31.06) SFU/106 PBMCs and (71.47±14.26) SFU/106 PBMCs.The differences with the magnitudes of HBV-specific T cell responses among patients from the four groups were significant (P<0.01).(2)HBV Core (HBV C) protein induced the strongest T cell responses[ (323.90±130.30) SFU/106 PBMCs] in patients with acute HBV infection in comparison with HBV-surface ( HBV S ) protein, HBV P protein and HBV X protein ( P=0.0037).The strongest T cell responses in patients with chronic HBV infection were induced by using HBV P protein [(127.20±54.42) SFU/106 PBMCs], followed by using HBV S protein, HBV C protein and HBV X protein (P=0.0159).(3)The magnitudes of IFN-γreleasing induced by HBV X protein, HBV P protein, HBV S protein and HBV C protein showed no significant differences in patients with either hepato-cirrhosis or hepatocellular carcinoma, but were lower than those induced in patients with chronic HBV infec-tion.Conclusion HBV-specific T cell responses were gradually reduced along the progression of HBV in-fection from acute HBV infection to chronic HBV infection, liver cirrhosis and hepatocellular carcinoma.The HBV-specific T cell responses induced by viral proteins might play different roles in different stages of HBV infection.

Epidemiología y factores de riesgo / Epidemiology and risk factors

La distribución geográfica del carcinoma hepatocelular (CHC) depende de la incidencia y prevalencia de sus agentes etiológicos en los diferentes lugares. Esto ha llevado a la realización de un mapa que muchas veces puede coincidir con las características de dichas entidades causales; las más importantes son la hepatitis B, la hepatitis C e incluso el alcohol en algunas regiones del mundo. Las estadísticas informadas en cuanto a raza, edad y sexo también dependen mucho de estas causas, y por eso en algunos casos los datos pueden ser similares, pero bien vale la pena recordarlos.

The geographical distribution of hepatocellular carcinoma (HCC) depends on the incidence and prevalence of related etiological agents in different places. This has led to the creation of a map upon which the characteristics of these causal entities can often be matched. The most important are hepatitis B, hepatitis C and even alcohol in some regions. The statistics are also reported in terms of race, age and sex and are heavily relied upon in these cases as well. In some cases the data may be similar which is well worth remembering.

Effect of HeLa cells infected with Coxsackie virus B3 on mTOR and p70S6K mRNA expression under different nutritional conditions / 中华实用儿科临床杂志

Objective To explore the effect of HeLa cells infected with Coxsackie virus B3 (CVB3) on the changes of mTOR signal pathway under different nutritional conditions.Methods The HeLa cells were cultured under conventional culture and serum starvation culture.(1) For the conventional method,the medium with 10 g/L fetal bovine serum was added for 24 h after the Hela cells were fused into 40％ to 50％,and the medium was changed on the next day,then the virus group was infected with CVB3 of 50％ tissue culture infective dose (TCID50).However,the control group was cultured by 2 g/L fetal bovine serum.(2) For the serum starvation method,HeLa cells were cultured with the medium without fetal bovine serum for 24 h.Then the virus group was infected with CVB3 of TCID50.The cells in control group were cultured by 2 g/L fetal bovine serum.Cell morphology changes were observed by inverted microscope,and the expressions of the mTOR,p70S6K mRNA were detected with Real-time PCR at 3 h,6 h,9 h,12 h,24 h respectively in both conventional culture and serum starvation groups.Results The expressions of mTOR and p70S6K mRNA were lower in the virus group than those in control group at 12 h and the 24 h (all P ＜0.05) in the conventional culture group.And the expressions of mTOR and p70S6K mRNA in the virus group were lower than those in the control group at every time points (all P ＜ 0.05) in serum starvation group.The expressions of mTOR and p70S6K mRNA in group with serum starvation virus and the control groups were higher than those in conventional culture group in all time points,but only the expressions of mTOR mRNA were significantly different between the 2 groups (all P ＜0.05),however,the expressions of p70S6K mRNA had no significant difference between the 2 groups (all P ＞ 0.05).Conclusion CVB3 may be able to down-regulate the expressions of mTOR and p70S6K mRNA.

Transfusión intrauterina en hidrops fetal por Parvovirus B19: a propósito de un caso clínico / Intrauterine transfusion for hydrops fetalis by parvovirus B19 infection: a case report

Hidrops fetal no inmunológico diagnosticado a las 22 semanas de gestación, secundario a infección por Parvovirus B19, tratado exitosamente con cinco transfusiones intrauterinas. Parto vaginal con recién nacido de término sin estigmas de enfermedad. Enfatizamos la importancia de sospechar el diagnóstico, el manejo basado en Vmax de ACM y la capacidad actual de tratamiento exitoso a través de transfusiones intrauterinas.

Non immunologic hydrops fetalis diagnosed at 22 weeks of gestation, secondary to infection by Parvovirus B19, successfully treated with five intrauterine transfusions. Vaginal delivery at 37 weeks without stigmata of disease. We emphasize the importance of suspecting the diagnosis, management based on Vmax of ACM and the current capacity of successful treatment by intrauterine transfusion.

Influence of hepatitis B virus factors and antiviral therapy on recurrence after liver resection and transplantation for patients with hepatocellular carcinoma / 中华肝胆外科杂志

At present,hepatectomy are recognized as the firsttreatment option for hepatocellular carcinoma (HCC).However,the patients have high frequency of recurrence after operation.In China,Most of the patients with HCC are related to chronic hepatitis B infection.The hepatitis B virus(HBV) factors such as:genotype,status of hepatitis B e antigen,HBV DNA level in serum and HBV DNA level in liver tissue influence the recurrence of tumors.Antiviral therapy,especially interferon therapy may be the effective method to prevent recurrence.HBV status also can influence the recurrence rate after transplant.

Identification and phylogenetic analysis of Coxsackie-virus B5 that caused an outbreak of viral encephalitis in Henan area / 中华微生物学和免疫学杂志

Objective To identify the pathogen that caused an outbreak of viral encephalitis in Henan area in 2011.Phylogenic analysis was carried out on Coxsackie-virus B5 (CVB5) which was isolated during this outbreak.Methods Five throat swab,21 stool and 14 cerebrospinal fluid (CSF) specimens were collected from 29 inpatients during this outbreak.Viral isolation and real time RT-PCR were then performed for all specimens.Viral nucleic acid of enterovirus 71 (EV71),coxsackievirus A 16 (CA16) and pan-enterovirus (PE)were detected by real time RT-PCR.Phylogenetic tree based on entire VP1 sequences was constructed among CVB5 isolates from 2 stool and 3 CSF specimens of 5 inpatients and others published data retrieved from GenBank.Results The real time RT-PCR results showed that the PE nucleic acid positive rates of throat swab,stool and CSF specimens were 60.0％ (3/5),61.9％ (13/21) and 85.7％ (12/14) respectively.All of these specimens were negative for EV71 and CA16.The isolation rates of throat swab,stool and CSF specimens were 20.0％ (1/5),25.0％ (5/21) and 29.0％ (4/14),respectively.BLAST with both VP1 and 5′-UTR sequences and molecular typing indicated that CVB5 was the main pathogen.Analysis among the 5 positve isolates based on the complete VP1 sequences showed 97.9％-99.5％ homology.Data from homologous comparisons indicated that these isolates had the highest nucleotide acid identity with the Changchun CVB5 CC10/10/Changchun strain (97.1％-98.1％) which caused hand,foot,and mouth disease (HFMD) outbreak in Changchun in 2010,and lower identity (89.0％-89.6％ and 91.8％-92.5％) with the COXB5/Henan/2010 and 03001N strain isolated from Pingdingshan,Henan in 2010 and 2012,respectively.Phylogenetic tree in VP1 region showed that isolates of this outbreak belonged to genotype D,the same clade with Changchun strain.Conclusion CVB5 was the major etiological agent correlated with this outbreak.The shift of predominant genotype might serve as one of the causes that associated with this outbreaks.