[Clinical efficiency of tanshinone IIA-sulfonate in treatment of liver fibrosis of advanced schistosomiasis].

OBJECTIVE: To evaluate the clinical efficiency of tanshinone IIA-sulfonate (STS) in the treatment of liver fibrosis of advanced schistosomiasis. METHODS: A total of 73 advanced schistosomiasis patients were selected into a treatment group and 55 cases of advanced schistosomiasis were selected into a control group, and dipstick dye immunoassay assay (DDIA) for schistosomiasis and HBsAg of all the patients were negative. The patients in the treatment group received STS for 14 days, and all the patients in both groups received the conventional liver-protecting treatment for 14 days. All the patients in both groups received the measurements of portal vein, 4 indicators of liver fibrosis (P III P, C IV, HA, LN), and 3 indicators of serum enzyme activities (ALT, AST, gamma-GT). RESULTS: After the treatments, the inside diameters of the portal vein and the degrees of the positive results of indicators of serum enzyme activities of all the patients of both groups decreased, but there were no statistically significant differences compared with those before the treatment. In the treatment group, the degrees of the positive results of indicators of liver fibrosis decreased somewhat, but there were no statistically significant differences compared with those before the treatment except C IV. In the control group, the degrees of the positive results of indicators of liver fibrosis fluctuated. In the treatment group, the indicator of liver fibrosis, CIV improved and the 2 indicators of liver fibrosis, PIIIP and HA improved significantly, but the indicators of serum enzyme activities did not improve. CONCLUSION: STS is effective in the treatment of liver fibrosis of advanced schistosomiasis.

The efficacy and safety of entecavir in patients with advanced schistosomiasis co-infected with hepatitis B virus.

OBJECTIVE: To evaluate the efficacy and safety of entecavir (ETV) in patients with advanced schistosomiasis and hepatitis B virus (HBV) co-infection. METHODS: Sixty-seven patients with advanced schistosomiasis and HBV co-infection were enrolled in this study. The patients were randomly divided into the ETV treatment group (n=35) and the control group (n=32). The patients in the control group adopted routine supportive therapy for 52 weeks, and those in the ETV treatment group received ETV at a dose of 0.5mg once daily on the basis of routine supportive therapy for 52 weeks. Hepatic fibrosis markers (hyaluronic acid, type III procollagen, type IV collagen, laminin, and fibronectin), Ishak fibrosis score, alanine transaminase (ALT), HBV DNA, and Child-Pugh score were compared between the two groups. The intention to treat (ITT) population was used for the analysis. The measurement data and count data were analyzed by t-test and Chi-square test, respectively. RESULTS: After 52 weeks of treatment, the hepatic fibrosis markers (hyaluronic acid, type III procollagen, type IV collagen, laminin, and fibronectin) were significantly improved in the ETV treatment group compared to the control group (all p<0.05). A ≥1-point improvement in the Ishak fibrosis score was found in 25.7% (9/35) of the ETV group, and the mean change from the baseline in the Ishak fibrosis score was a 0.3-point reduction. The control group showed disease progression in the Ishak fibrosis score. More patients in the ETV group than in the control group had undetectable serum HBV DNA levels (82.9% vs. 3.1%, p<0.05) and ALT normalization (68.6% vs. 18.3%, p<0.05). The ETV treatment group demonstrated an improvement in Child-Pugh score at week 52 (-3.7 vs. 0.3, p<0.05). In addition, no obvious adverse reactions were observed during ETV treatment. CONCLUSION: ETV is safe and effective in patients with advanced schistosomiasis and HBV co-infection.

[Therapeutic effect of dahuangzhechong pills on advanced schistosomiasis].

OBJECTIVE: To evaluate the therapeutic effect and safety of Dahuangzhechong pills on advanced schistosomiasis. METHODS: Sixty-two patients with advanced schistosomiasis were divided randomly into two groups, a treatment group and a control group, and treated with Dahuangzhechong pills and routine therapy, respectively. The course of treatment was 52 weeks in the two groups. Before and after the 52-week treatment, the indexes of liver function and hepatic fibrosis, prothrombin time (PT), Child-Pugh scores and changes of B-type ultrasonic images were detected for all the patients. RESULTS: There were significant differences in the levels of alanine aminotransferase (ALT) and total bilirubin (TBIL), the indexes of hepatic fibrosis, portal venous inside diameters and portal venous flow between the two groups after 52 weeks treatment (P < 0.05). In addition, there were no obvious adverse effects during the treatment in the patients of the Dahuangzhechong pill group. CONCLUSION: Dahuangzhechong pill treatment is a safe and effective therapy for the patients with advanced schistosomiasis.

[Clinical significance of Helicobacter pylori in pathogenesis of idiopathic thrombocytopenic purpura].

This study was purposed to investigate the infection incidence of Helicobacter pylori (HP) in patients with idiopathic thrombocytopenic purpura (ITP) and curative efficacy of glucocorticoids combined with anti-helicobacter. 100 ITP patients with positive HP were divided randomly into 3 groups: glucocorticoid group (treatment with glucocorticoids, n = 35), anti-HP treatment group (HP eradication, n = 30) and combined treatment group (glucocorticoid combined with HP eradication, n = 35). 100 healthy individuals were selected as control. The results showed that HP infection rate in ITP group was 70%, while HP infection rate in control group (persons received physical examination) was 56%, there was significant difference between two groups (p < 0.05). The HP of 31 cases in combined treatment group was eradicated that the platelet count in 23 out of 31 cases recovered to normal, and in 8 cases was higher than that before treatment, which mean count was (165 +/- 225) x 10(9)/L, this value had statistical significance as compared with that before treatment (p < 0.01). Total efficiency in this group reached to 89%, and relapse rate within 1 year was 8%. The HP infection of 2 cases in glucocorticoid group had been turned to negative naturally, and platelet count recovered to normal, while HP infection in remained 33 cases was still positive. The platelet count in 23 out of 33 cases of that group was not back to normal, but back to normal in 10 cases. The platelet mean count in that group was (78 +/- 26) x 10(9)/L with total efficiency rate of 68% and relapse rate within 1 year was 37%. In the anti-HP treatment group, HP infection in 25 cases was eradicated and platelet count in 9 out of 25 cases recovered to normal, that platelet count in 9 cases was higher than that before treatment, platelet mean count was (135 +/- 174) x 10(9)/L), there was significant difference (p < 0.01), as compared with value before treatment. Total efficiency rate in this group reached to 60%, and relapse rate within 1 year was 33%. It is concluded that the patients with ITP have higher HP infection incidence, and the eradication of HP is effective therapy for the ITP patients with HP infection, which can be used as initial treatment.