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ObjectiveTo investigate the change and potential role of Mindin protein in the treatment of chronic hepatitis B (CHB) with PEG-IFNα-2b. MethodsA total of 29 CHB patients who received the treatment with PEG-IFNα-2b in The Second Affiliated Hospital of Xi’an Jiaotong University from January 2018 to December 2019 were enrolled, and according to their clinical outcome, they were divided into cured group with 17 patients and uncured group with 12 patients. Peripheral blood samples were collected from both groups at baseline, 12 weeks, and 24 weeks to measure blood routine indices, liver function parameters, hepatitis B markers, and Mindin protein. HBsAg, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and Mindin protein at different time points were compared between the two groups. The independent-samples t test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; a Spearman correlation analysis was used to investigate correlation; a multiple linear regression analysis was used to investigate the influence of HBsAg and ALT on the content of Mindin protein. ResultsThe analysis of baseline data showed that there were significant differences in the levels of HBsAg, HBeAb, albumin, and albumin/globulin ratio between the cured group and the uncured group (all P<0.05). The cured group tended to have a gradual increase in the level of Mindin, and the level of Mindin at 24 weeks was significantly higher than that at baseline (P<0.05). The cured group had a significantly higher level of Mindin protein than the uncured group at 24 weeks (P=0.019). The cured group had a significantly lower level of HBsAg than the uncured group (P<0.05), with a significant change from baseline to each time point within the cured group (P<0.05). In addition, the levels of ALT and AST in the cured group tended to first increase and then decrease, and the expression levels at 12 weeks were significantly higher than those at baseline (P<0.05). At 12 weeks, there was a strong linear correlation between Mindin protein levels and ALT in the untreated group (r=0.760 8, P<0.05), and further multiple linear regression analysis also demonstrated a linear relationship between the two (b=1.571, P=0.019). ConclusionThere is a significant difference in the level of Mindin protein between the cured group and the non-cured group after 24 weeks of PEG-IFNα-2b antiviral treatment, and therefore, detecting the dynamic changes of Mindin protein can better predict the treatment outcome of CHB, which provides a reference for clinical practice.
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【Objective】 To study the expression levels of suppressor of cytokine signaling 1 (SOCS1) and its clinical significance in hepatitis B virus (HBV)-related liver diseases. 【Methods】 For this study we enrolled 25 patients with chronic hepatitis B (CHB), hepatitis B cirrhosis, or HBV-associated chronic acute liver failure (HBV-ACLF), and 25 healthy controls. The expression levels of SOCS1 mRNA in peripheral blood mononuclear cells (PBMCs) were determined using the RT-PCR method. The levels of SOCS1 and interleukin-6 (IL-6) in the plasma of patients with chronic liver diseases and healthy controls were measured using the ELISA method. The relative expression levels of SOCS1, SOCS1 mRNA, and other laboratory test indicators such as HBV-DNA, alanine aminotransferase (ALT), aspartate aminotransferase (AST), prothrombin activity (PTA) and total bilirubin (TBil) were compared among the groups. Additionally, the correlation between the expression levels of SOCS1 mRNA and the aforementioned laboratory indicators was assessed. 【Results】 The expression levels of SOCS1 mRNA and serum SOCS1 were highest in the HBV-ACLF group, followed by the cirrhosis group, and lowest in the healthy control group, with statistically significant differences (F=109.65, P<0.001). The relative expression of SOCS1 mRNA was positively correlated with TBil (r=0.89, P<0.001), ALT (r=0.89, P<0.001), AST (r=0.84, P<0.001) and IL-6 (r=0.93, P<0.001), but negatively correlated with PTA (r=-0.89, P<0.001) and was not significantly correlated with HBV-DNA (P=0.28). 【Conclusion】 The expression levels of SOCS1 in patients with HBV-related chronic liver diseases can reflect the severity of the disease and show a significant correlation with indicators used to assess the severity of liver diseases.
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Objective To investigate the efficacy and safety of the 12-week regimen with sofosbuvir and coblopasvir hydrochloride in the treatment of chronic hepatitis C (CHC) in northwest China. Methods This study enrolled 101 patients with CHC of any genotype who received sofosbuvir (400 mg) combined with coblopasvir hydrochloride (60 mg) for 12 weeks in The First Affiliated Hospital of Air Force Medical University, The Second Affiliated Hospital of Air Force Medical University, The Second Affiliated Hospital of Xi'an Jiaotong University, and Baoji Central Hospital from July 1 to December 31, 2021, among whom 13 had liver cirrhosis and 88 did not have live cirrhosis. Other antiviral drugs such as ribavirin were not added regardless of the presence or absence of liver cirrhosis or the genotype of CHC. Related clinical data ere extracted, including HCV RNA quantification and liver biochemical parameters at baseline, at week 12 of treatment, and at 12 weeks after drug withdrawal. The primary endpoints were sustained virologic response at 12 weeks after the end of treatment (SVR12) and safety at week 12 of treatment, and the secondary endpoint was the effect of the 12-week treatment on liver biochemical parameters. The non-normally distributed continuous data were expressed as M ( P 25 - P 75 ), and the Mann-Whitney U test was used for comparison between groups. Results A total of 101 patients were included in the analysis, among whom there were 55 male patients (54.5%) and 46 female patients, and the median age was 53 years. Among these patients, 12.8% had liver cirrhosis, 1.0% had liver cancer, 3.0% were treatment-experienced patients, and 3.0% had type 2 diabetes. As for genotype distribution, 8% had CHC genotype 1, 60% had CHC genotype 2, 19% had CHC genotype 3, and 6% had CHC genotype 6, and genotype was not tested for 7% of the patients. After 12 weeks of treatment, all 101 patients had a HCV RNA level of below the lower limit of detection and an SVR12 rate of 100%, with a significant reduction in the serum level of alanine aminotransferase (ALT) from baseline to week 12 of treatment ( P < 0.05). Among these patients, 22.7% had concomitant medications such as atorvastatin calcium, aspirin, metformin, nifedipine, bicyclol, and compound glycyrrhizin. The incidence rate of adverse events was 16.8%, and fatigue (12.9%) was the most common adverse event. Conclusion The 12-week treatment with sofosbuvir and coblopasvir hydrochloride can obtain high SVR12 in CHC patients in northwest China and has good antiviral safety, with a significant improvement in abnormal serum ALT at week 12 of treatment.
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Objective:To detect the expression levels of laboratory of genetics and physiology 2 (LGP2), retinoic acid inducible gene I (RIG-I) and melanoma differentiation associated gene 5 (MDA5) in children with hand, foot and mouth disease (HFMD), and to explore their possible clinical significance in HFMD.Methods:Fifty children with HFMD, who visited Second Affiliated Hospital of Xi′an Jiao Tong University, Xi ′an Children′s Hospital and Xi ′an Central Hospital from May 2020 to May 2021, were selected as the research subjects, and 20 children with physical examination at the same age during the same period were selected as the control group.Children with HFMD were divided into enterovirus 71 (EV-A71) type and coxsackievirus A6 (CV-A6) type according to the results of pathogen detection, and then divided into mild group and severe group according to the severity of the disease.The relative mRNA expression levels of LGP2, RIG-I and MDA5 in each group, and the correlation among the three proteins were compared and analyzed.Results:Among 50 cases of HFMD, 26 cases were EV-A71 type (16 cases were mild and 10 cases were severe) and 24 cases were CV-A6 type (17 cases were mild and 7 cases were severe). There was no significant difference in age and sex between HFMD group and control group ( P>0.05). The relative expression levels of LGP2 mRNA in EV-A71 and CV-A6 HFMD cases were 2.37(1.78, 3.25)% and 1.88 (1.35, 3.13)%, lower than that in control group [2.97(2.61, 3.55)%]. Only the difference between CV-A6 HFMD children and control group was statistically significant ( Z=-2.310, P=0.021). The relative expression levels of RIG-I mRNA in EV-A71 and CV-A6 HFMD cases were 9.95 (7.79, 14.62)% and 9.78(7.04, 15.83)%, lower than that in control group [18.47(13.00, 21.07)%]. The differences were all statistically significant ( P<0.05). The relative expression levels of MDA5 mRNA in EV-A71 and CV-A6 HFMD cases were 4.41(2.82, 5.99)% and 3.98 (2.18, 7.41)%, lower than that in control group [5.10(3.52, 7.71)%], but the differences were not statistically significant.There were no significant differences in the relative expression levels of the three indicators between the mild and severe groups of children with EV-A71 or CV-A6 HFMD.The expression levels of LGP2, RIG-I and MDA5 mRNA were highly correlated( P<0.001). Conclusion:The relative expression levels of LGP2, RIG-I and MDA5 mRNA in children with HFMD are decreased in different degrees than those in normal children.And there is a correlation among them.
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Objective:To investigate the effect of transcatheter arterial chemoembolization (TACE) combined with ultrasound-guided radiofrequency ablation (RFA) on the efficacy and immune function in patients with primary liver cancer.Methods:The clinical data of 152 patients with primary liver cancer from February 2019 to February 2021 in the Second Affiliated Hospital of Xi′an Jiaotong University were retrospectively analyzed. Among them, 76 patients were treated with TACE combined with RFA (combined group), and 76 patients were treated with TACE (control group). The efficacy was compared; the α-L fucosidase, T lymphocyte subsets (CD 3, CD 4, CD 8 and CD 4/CD 8), B lymphocyte subsets (CD 19) and tumor markers (alpha-fetoprotein, AFP; carcinoembryonic antigen, CEA; carbohydrate antigen 125, CA125) before treatment and 1 month after treatment were detected. Results:The total clinical effective rate in combined group was significantly higher than that in control group: 81.58% (62/76) vs. 52.63% (40/76), and there was statistical difference ( χ2 = 4.54, P<0.05). There were no statistical difference in all indexes before treatment between 2 groups ( P>0.05); the α-L fucosidase, AFP and CD 8 1 month after treatment in combined group were significantly lower than those in control group: (18.06 ± 5.33) U/L vs. (26.58 ± 7.75) U/L, (87.93 ± 22.55) μg/L vs. (146.83 ± 21.85) μg/L and 0.295 ± 0.052 vs. 0.367 ± 0.064, the CD 3, CD 4 and CD 4/CD 8 were significantly higher than those in control group (0.489 ± 0.054 vs. 0.462 ± 0.063, 0.363 ± 0.059 vs. 0.303 ± 0.075 and 1.43 ± 0.27 vs. 0.89 ± 0.14), and there were statistical differences ( P<0.01 or<0.05); there was no statistical difference in CEA, CA125 and CD 19 1 month after treatment between 2 groups ( P>0.05). Conclusions:TACE combined with RFA in the treatment of primary liver cancer patients can not only improve the total clinical effective rate, but also significantly improve the immune function, and help to reduce level of the liver tumor marker of AFP.
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【Objective】 To screen the differentially expressed immune genes between responders (Rs) and non-responders (NRs) in chronic hepatitis B patients receiving interferon alpha (IFN-α) treatment and to explore the molecular basis of IFN-α treatment failure. 【Methods】 The gene expression profile GSE27555 which contained 6 Rs and 7 NRs was obtained from the Gene Expression Omnibus (GEO) database; then differentially expressed genes between liver tissues of Rs and NRs were selected by the R software. The iconic immune gene set consisting of 1793 genes was downloaded from the immunology database and analysis portal (ImmPort). The immune genes were extracted from the differentially expressed genes to obtain the differentially expressed immune genes. Subsequently, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses of the differentially expressed immune genes were performed by the R software. Protein-protein interaction (PPI) network of the differentially expressed immune genes was constructed using the STRING online tool. The plugin CytoHubba of the Cytoscape software was applied to identify the top 10 genes by using Degree, MCC, MNC, and Closeness algorithms; then the intersection was taken to obtain the hub genes. 【Results】 A total of 88 differentially expressed immune genes, consisting of 13 upregulated and 75 downregulated genes, were identified between Rs and NRs. GO analysis showed that the differentially expressed immune genes were significantly enriched in T cell activation, cell chemotaxis, regulation of cell-cell adhesion, antigen processing and presentation. KEGG pathway analysis suggested that the differentially expressed immune genes were significantly enriched in cytokine-cytokine receptor interactions, Th cell differentiation, antigen processing and presentation, interactions between viral proteins and cytokines and cytokine receptors, chemokine signaling pathways, T cell receptor signaling pathway, IL-17 signaling pathway, natural killer cell-mediated cytotoxicity, Toll-like receptor signaling pathway, and other immune response signaling pathways. The top 7 hub genes, identified by the plugin cytoHubba of the Cytoscape software by using Degree, MCC, MNC and Closeness algorithms, were CD8A, IFNG, CCL2, CCL5, CXCL10, CCL4, and FCGR3A. 【Conclusion】 This study made a comprehensive analysis of the differentially expressed immune genes and signal pathways between Rs and NRs by bioinformatics, and identified 7 Hub genes related to the ineffectiveness of IFN-α treatment in CHB patients. These hub genes may serve as potential biomarkers for predicting the response of IFN-α treatment in CHB patients.
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Nucleos(t)ide analogues (NAs), which are widely used as the first-line anti-hepatitis B virus (HBV) drugs in clinical practice, can effectively inhibit the replication of HBV DNA, significantly slow down disease progression in chronic hepatitis B (CHB) patients, and reduce the development of end-stage liver diseases such as liver failure and liver cancer. However, for some CHB patients receiving first-line NAs for 48 weeks or longer, serum HBV DNA is still persistently or intermittently higher than the lower detection of limit of sensitive nucleic acid detection reagents. After discussion by the authors, low-level viremia (LLV) is defined as follows: persistent LLV refers to the condition in which CHB patients, who receive entecavir, tenofovir disoproxil fumarate, or tenofovir alafenamide fumarate for ≥48 weeks, test positive for HBV DNA by two consecutive detections with sensitive quantitative PCR, with an interval of 3-6 months, but have an HBV DNA level of <2000 IU/ml; intermittent LLV refers to the condition in which patients test positive for HBV DNA intermittently by at least three consecutive detections with sensitive quantitative PCR, with an interval of 3-6 months, but have an HBV DNA level of <2000 IU/ml. For the diagnosis of LLV, the issues of poor compliance and drug-resistant mutations should be excluded. LLV might be associated with the increased risk of progression to liver fibrosis or hepatocellular carcinoma in patients with liver cirrhosis under NA treatment, but there are still controversies over whether the original treatment regimen with NAs should be changed after the onset of LLV. This article summarizes the incidence rate of LLV under NA treatment and the influence of LLV on prognosis and analyzes the possible mechanisms of the osnet of LLV, so as to provide a reference for the management of LLV in patients treated with NAs.
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ObjectiveTo investigate the influencing factors for the short-term prognosis of patients with HBV-related acute-on-chronic liver failure (HBV-ACLF). MethodsClinical data were collected from 240 HBV-ACLF patients without liver transplantation who were admitted To The Second Affiliated Hospital of Xi’an Jiaotong University from January 2009 to December 2019, and the patients were divided into groups according to survival on days 28 and 90 after admission (28-day survival group with 164 patients and 28-day death group with 76 patients; 90-day survival group with 140 patients and 90-day death group with 100 patients). The data collected included predisposing factors, liver function parameters, Model for End-Stage Liver Disease (MELD) score, MELD combined with serum sodium concentration (MELD-Na) score, and complications. The Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. The receiver operating characteristic (ROC) curve was plotted to calculate the area under the ROC curve (AUC), and a multivariate logistic regression analysis was used to investigate the risk factors for the short-term prognosis of HBV-ACLF. ResultsThe main predisposing factors of HBV-ACLF included spontaneous activation of HBV (55.6%) and HBV activation caused by the withdrawal of or resistance to nucleoside analogues (25.2%). There were significant differences in age, prothrombin time activity (PTA), neutrophil-lymphocyte ratio (NLR), serum sodium, MELD score, MELD-Na score, and total bilirubin (TBil) at baseline between the 28-day survival group and the 28-day death group (Z=-2.400,-6.015, -5.070, -5.103, -5.044, -7.430, and -6.637, all P<0.05), and there were also significant differences in age, PTA, NLR, serum sodium, MELD score, MELD-Na, TBil, and cholesterol at baseline between the 90-day survival group and the 90-day death group (Z=-2.205, -7.728, -3.335, -4.015, -6.053, -7.908, -6.655, and -3.607, all P<0.05). The multivariate logistic regression analysis showed that TBil >260.20 mmol/L (odds ratio [OR]=4.572, 95% confidence interval [CI]: 1.321-15823, P<0.05), PTA <24.8% (OR=8.934, 95%CI: 3.026-26.374, P<0.05), NLR>5.63 (OR=2.632, 95%CI: 1.126-6.152, P<0.05), serum sodium <130.8 mmol/L (OR=27.467, 95%CI: 6.113-123.423, P<0.05), MELD score >17.84 (OR=4.303, 95%CI: 1.048-17.663, P<0.05), and MELD-Na score >25.1 (OR=3.453, 95%CI: 1.614-7.387, P<0.05) were independent risk factors for 28-day survival; TBil>260.20 mmol/L (OR=5.148, 95%CI: 1.918-13.822, P<0.05), PTA <25.5% (OR=15.718, 95%CI: 5.161-47.866, P<0.05), serum sodium <135.3 mmol/L (OR=10.080, 95%CI: 3.244-31.323, P<005), MELD score >17.84 (OR=11.157, 95%CI: 2.580-48.254, P<0.05), MELD-Na score >25.1 (OR=4.391, 95%CI: 2057-9.372, P<0.05) were independent risk factors for 90-day survival. Among the 240 patients, 160 (66.7%) experienced infection within 90 days, among whom 140 had bacterial infection, 12 had viral infection, and 8 had fungal infection. The 160 patients with infection had a significantly higher 90-day mortality rate than the patients without infection (46.3% vs 32.5%, χ2=6.720, P=0.010). Of all 240 patients, 176 had ascites, 44 had pleural effusion, 36 had acute renal injury, 60 had hepatic encephalopathy, and 12 had gastrointestinal bleeding within 28 days, and there were significant differences in the proportion of patients with acute renal injury, grade Ⅲ-Ⅳ hepatic encephalopathy, or gastrointestinal bleeding between the 28-day survival group and the 28-day death group (χ2=64.088,29811,7.797,all P<0.05). ConclusionTBil, PTA, serum sodium, MELD score, and MELD-Na score at baseline are independent risk factors for the 28- and 90-day prognosis of HBV-ACLF. Liver inflammation and necrosis caused by HBV activation may be the initiating factor for ACLF, and infection, acute renal injury, hepatic encephalopathy, and gastrointestinal bleeding are the main complications affecting the prognosis of patients.
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【Objective】 To construct and verify a model for predicting the prognosis of liver cancer patients with autophagy-related long non-coding RNA (LncRNA) expression. 【Methods】 LncRNA expression spectrum, mRNA expression spectrum and clinical characteristics of 374 patients with liver cancer were obtained from the Cancer Genome Atlas (TCGA) Database. The expression levels of autophagy-related genes (from the Human Autophagy Database) were extracted from the mRNA expression profile, and the LncRNA was screened to obtain the highly relevant autophagy-related genes by correlation analysis with the LncRNA expression profile. Differential expression analysis and single factor analysis were conducted between the expressions of the above established autophagy-related LncRNA in 374 cancer tissues and 50 normal tissues to screen autophagy LncRNAs which were differentially expressed and was associated with a significant liver cancer prognosis. The above screened LncRNA were included in the risk of Cox proportional model selection and the prognosis of patients with liver cancer prediction model was established. The risk index (risk score) was calculated according to the forecast model and patients could be divided into high-risk and low-risk groups. Kaplan-Meier survival analysis, Cox regression analysis and receiver operating characteristic curve (ROC) were conducted to evaluate the prognostic value of the model. Gene set enrichment analysis (GSEA) was carried out to analyze the signal pathway of gene enrichment in patients with a high or a low risk. 【Results】 We screened 582 autophagy LncRNAs (R≥0.6, P<0.001) to obtain 23 LncRNAs which were differentially expressed and associated with a significant liver cancer prognosis. A prognostic model consisting of 6 LncRNAs, namely, MKLN1-AS, AC012360.3, AC145207.5, AL513320.1, AC099850.3 and AL049840.2 were constructed. KM survival analysis showed that the survival time of the high-risk group was significantly lower than that of the low-risk group (median survival time: 6.937 years and 2.323 years, P<0.001). Cox regression analysis showed that the survival time of patients in the high-risk group was significantly lower than that in the low-risk group (HR=3.773, 95% CI: 2.252-6.322, P<0.001); the area under the time dependent ROC curve for 1, 2, 3, 4, 5 and 6-year overall survival was 0.760, 0.729, 0.731, 0.722, 0.696 and 0.685. GSEA analysis showed that the genes in the high-risk group were mainly concentrated in cell cycle, autophagy, tumor, ubiquitin-mediated proteolysis, and RNA degradation. 【Conclusion】 The prognostic model composed of MKLN1-AS, AC012360.3, AC145207.5, AL513320.1, AC099850.3 and AL049840.2 can be used to predict the prognosis of liver cancer patients, which is expected to guide clinical treatment.
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We plotted daily data on the frequencies of keywords related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from WeChat, a Chinese social media. Using "Feidian", Chinese abbreviation for SARS, may detect the SARS-CoV-2 outbreak in 2019 two weeks earlier. WeChat offered a new approach to early detect disease outbreaks.
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OBJECTIVE: We investigated the association between OAS1 gene polymorphism and susceptibility to central nervous system (CNS) involvement of enterovirus (EV)71 infection. METHODS: This case-control study was conducted among 180 children with EV71 infection, including 72 with mild infections without any complications and 108 with severe infections and CNS involvement; 201 children undergoing routine physical examination served as the healthy controls. For all the participants, the single nucleotide polymorphisms (SNPs) at OAS1 rs2660 and rs1131454 were analyzed using SNPscan multiple SNP typing methods. RESULTS: No significant differences were found between the case and control groups in genotype or allele distributions of rs2660 and rs1131454. OAS1 rs2660 polymorphism was significantly different between the children with CNS involvement and those with mild EV71 infection, and the genotype AG frequency was higher and the genotype GG frequency was lower in children with CNS involvement. No significant difference was found in the distribution of genotypes or alleles of rs1131454 between the children with CNS involvement and those with mild EV71 infection. CONCLUSIONS: OAS1 gene rs2660 and rs1131454 SNPs are not associated with the susceptibility to or CNS involvement of EV71 infection, but OAS1 rs2660 SNPs are significantly correlated with the susceptibility to CNS involvement in EV71 infection. Children carrying OAS1 rs2660 AG genotype are more likely to have CNS involvement after EV71 infection.
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2',5'-Oligoadenilato Sintetasa/genética , Enterovirus Humano A , Infecciones por Enterovirus , Estudios de Casos y Controles , Niño , Infecciones por Enterovirus/genética , Predisposición Genética a la Enfermedad , Genotipo , Humanos , Sistema Nervioso , Polimorfismo de Nucleótido SimpleRESUMEN
Objective@#To investigate the clinical effect and safety of entecavir capsules in the treatment of treatment-naïve HBeAg-positive patients with chronic hepatitis B (CHB).@*Methods@#A total of 158 HBeAg-positive CHB patients were given oral entecavir capsules at a dose of 0.5 mg/time once a day for 144 weeks. Clinical outcome and safety were evaluated at baseline and at 24, 48, 72, 96, 120, and 144 weeks of treatment respectively. The Fisher’s exact test was used for the analysis of categorical data.@*Results@#After 144 weeks of treatment, 90.91% of all patients achieved virologic response (< 69 IU/ml), the normalization rate of alanine aminotransferase was 88.18%, the clearance rate of HBeAg was 33.33%, and the seroconversion rate of HBeAg was 24.07%. Of all patients, 2 dropped out due to adverse events and 5 experienced serious adverse reactions.@*Conclusion@#Entecavir capsules can inhibit viral replication and have good safety in treatment-naïve HBeAg-positive CHB patients.
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Immune tolerance refers to the specific non-response or negative response of T and B lymphocytes to antigens.According to the period of formation,immune tolerance can be classified into central tolerance and peripheral tolerance.Immune tolerance to hepatitis B virus (HBV) after HBV infection is considered a major cause of chronic HBV infection.This article briefly reviews the roles of HBeAg,functional defects of dendritic cells,low response of cytotoxic T lymphocytes,T helper cells and cytokines,variations of HBV genotype and genome,and host gene polymorphisms in the development of immune tolerance in chronic HBV infection,as well as related research advances.
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Because of the specificity of infectious diseases , the the medical ethics education and concepts need to be paid more attention to .During the clinical teaching of infectious diseases , pay attention to teachers′medical ethics accomplishment level of ascension , teaching teachers should play the role of shape model , encourage interac-tion, eliminate the fear and discrimination interns and strengthen medical ethics consciousness and the combination of legal concepts , promote the medical students medical ethics consciousness of the form .
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<p><b>OBJECTIVE</b>To investigate the efficacy and safety of antiviral treatment in patients with hepatitis C virus (HCV) infection and decompensated cirrhosis and determine the effects of virological response on long-term prognosis.</p><p><b>METHODS</b>Sixty-six consecutive,interferon (IFN)-na(i)ve patients with HCV infection and decompensated cirrhosis were enrolled in this prospective study. All patients were given a 48-to 72-week course of IFN plus ribavirin (RBV) combined therapy,with a low accelerating dosage regimen using either:pegylated (PEG)-IFNa-2b at 1.0-1.5 mug/kg/week,PEG-IFNa-2a at 90-180 mug,or standard IFN-a-2b at 3MU,every other day.RBV was given at 800 to 1000 mg/day. All patients were routinely monitored for adverse drug reactions and virological response.Effects of treatments on patient survival were assessed by Kaplan-Meier analysis.</p><p><b>RESULTS</b>At the end of treatment,74.2% of patients were HCV RNA-negative,with 45.5% having achieved sustained virological response and 28.8% having relapsed;the remaining 25.7% of patients showed non-virological response (NVR). Among the patients with HCV genotype 1, 65.9% achieved end-of-treatment virological response (ETVR) and 34.1% achieved SVR;among the patients with HCV genotype 2,90.9% achieved ETVR and 68.2% achieved SVR. The positive and negative predictive values of early virological response (EVR) for ETVR were 95.7% and 75.0% respectively, and for SVR were 65.2% and 100% respectively. Compared with baseline,patients who achieved ETVR had better liver function,as evidenced by changes in levels of total bilirubin,alanine aminotransferase and albumin,as well as prothrombin activity and Child-Pugh score (t =4.564,11.486,2.303,2.699,3.694 respectively, all P less than 0.05).Compared with the NVR patients, the ETVR patients had lower risk of hepatic decompensation and hepatocellular carcinoma, and had improved survival (x2=18.756,6.992,7.580, respectively, all P less than 0.05).Twelve (18.2%) patients experienced serious adverse events,with 10 requiring premature treatment withdrawal and 2 dying.</p><p><b>CONCLUSION</b>Antiviral treatment for patients with HCV infection and decompensated cirrhosis using interferon in a low accelerating dosage regimen in combination with ribavirin is feasible.Patients who achieved ETVR had significantly improved long-term prognosis.</p>
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Humanos , Alanina Transaminasa , Antivirales , Usos Terapéuticos , Carcinoma Hepatocelular , Quimioterapia Combinada , Genotipo , Hepacivirus , Genética , Hepatitis C , Diagnóstico , Quimioterapia , Interferón-alfa , Usos Terapéuticos , Estimación de Kaplan-Meier , Cirrosis Hepática , Quimioterapia , Virología , Neoplasias Hepáticas , Polietilenglicoles , Usos Terapéuticos , Estudios Prospectivos , Proteínas Recombinantes , Usos Terapéuticos , Ribavirina , Usos Terapéuticos , Resultado del TratamientoRESUMEN
Objective To investigate the changes of interleukin-18 (IL-18), tumor necrosis factor-α(TNF-α) and interferon-γ (IFN-γ) levels of liver cirrhosis induced by the composite factors of carbon tetrachloride (CCl_4) in SD rats and their significance. Methods Totally 80 male SD rats of clean class were randomly divided into normal control group (20 rats) and model groups, the latter of which were further divided into three groups according to the length of administration time, namely, 2-week group (2 wk group), 4-week group (4 wk group) and 6-week group (6 wk group), with 20 rats in each. Six rats were killed after 2 wk, 4 wk and 6 wk administration time, respectively. The rat serum levels of IL-18, TNF-α and IFN-γ and the hepatic homogenate supernatant of IL-18 were detected by ELISA; pathological changes of liver tissues were observed by HE staining. Results ① Pathological observation revealed that in the model groups hepatic cells degenerated and swelled at week 2 while large amounts of fibrosis and pseudolobules of some liver tissues occurred at week 6. ② The serum levels of IL-18, TNF-α and IFN-γ were gradually increased with the modeling time, and they were significantly higher in 6-week group than in normal control group (P<0.01). ③ The levels of hepatic homogenate supernatant of IL-18 in the model groups were elevated with liver damage, and they were significantly higher in 6-week group than in normal control group (P<0.01). Conclusion During the formation of liver cirrhosis induced by composite factors of CCl_4 in rats, IL-18, TNF-α and IFN-γ levels gradually increase, suggesting that the three cytokines play a certain role during the occurrence of liver cirrhosis in rats.
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BACKGROUND: Emodin (1, 3, 8-trihvdroxy-6-methylanthraquinone) is derived from herbal medicines and proved to have a strong antimicrobial activity. However, its anti-virus effects are less known. The aim of the present study was to investigate the effects of emodin, interferon alpha (IFNalpha), and lamivudine (3TC) on hepatitis B virus (HBV) in vitro. MATERIAL/METHODS: The human hepatoma G2.2.15 cell line stably expresses hepatitis B virus particles in culture. The cells were exposed to different concentrations of emodin, IFNa, and lamivudine triphosphate, respectively. MTT (methyl thiazolyl tetrazolium) assay was used to evaluate the cytotoxicity of the drugs and real-time PCR was applied to quantify extracellular HBV DNA. HIBsAg and HBeAg were assessed by enzyme-linked immurnosorbent assay (ELISA). RESULTS: The results showed that exposure of HepG2.2.15 cells to emodin resulted in a time- and concentration-dependent inhibition of HBV DNA replication and HBsAg secretion. After exposed to three different concentrations of emodin for 3, 6, and 9 days, the inhibition rates of extracellular HBV DNA, HBsAg, and HBeAg of each concentration decreased significantly (P < 0.05). After 9 days of treatment, the inhibition rates of extracellular HBV DNA of the different concentrations differed greatly (P < 0.001). IFNalpha and 3TC had similar inhibition results to HBV DNA replication to those previously found. CONCLUSIONS: These findings suggest that mnodin may prove to be a new modality to treat hepatitis B infection.
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Antivirales/farmacología , Emodina/farmacología , Inhibidores Enzimáticos/farmacología , Virus de la Hepatitis B/efectos de los fármacos , Replicación Viral/efectos de los fármacos , Bioensayo , Citidina Trifosfato/análogos & derivados , Citidina Trifosfato/farmacología , Didesoxinucleótidos , Emodina/química , Inhibidores Enzimáticos/química , Antígenos de la Hepatitis B/análisis , Antígenos de la Hepatitis B/metabolismo , Humanos , Interferón-alfa/farmacología , Lamivudine/análogos & derivados , Lamivudine/farmacología , Células Tumorales CultivadasRESUMEN
OBJECTIVE:To observe the clinical outcome of lipid microspheres prostaglandin E 1 (Lipo-PGE 1 )injection in combination with diammonium glycyrrhizinate injection plus combined therapy in the treatment of chronic severe hepati-tis.METHODS:68patents with severe hepatitis B were assigned to receive lipid Lipo-PGE 1 injection in combination with di-ammonium glycyrrhizinate injection(treatment group)besides the necessary combined therapy as in the control group for4weeks,the clinical outcome and biochemical indicators were compared between2groups.RESULTS:As compared with the control group,the treatment group had a significantly alleviated clinical symptoms after treatment for2weeks and4weeks(P
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OBJECTIVE:To study the preventive effect of emodin and astragalus polysaccharides on experimental hepato-carcinoma in rats.METHODS:The experimental rats were randomly divided into the normal group,model group,emodin group,and emodin combined with astragalus polysaccharides group.hepatocarcinogenesis in rat models were induced by di-ethylnitrosamine,while at the same time all the groups were administered with pre-set drugs by stomach irrigation.Rat's we_ ight,serum indices of ALT,ALP,?-GT,?-L-fucoxidase were determined,and pathological examination was made before and after administration.RESULTS:The group administered with emodin and astragalus polysaccharides improved more than any other groups in terms of rat's weight,serum indices,onset time of hepatocarcinogenesis,and pathological grade.CONCLU_ SION:Emodin combined with astragalus polysaccharides have certain preventive effect on experimental hepatocarcinoma in rats.
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Objective To investigate transfusion transmitted virus (TTV) infection among population of different groups in Shaanxi Province. Methods A nested polymerase chain reaction (PCR) with primers from ORF1 of TTV genome was established to detect TTV-DNA in serum of the patients. ResultsTTV-DAN was detected in the sera of 3 of 50 cases of general population(6%), 2 of 30 cases of vocational blood donors(6.7%),21 of 97 cases with Type B hepatitis (21. 6%), 9 of 35 cases of Type C hepatitis (25. 7%),and 23 of 40 cases with non-A~ non-G hepatitis (57.5 % ). ConclusionThere is TTV infection among general population in Shaanxi Province. TTV may be an impor- tant agent to cause non-A~non-G hepatitis. And the patients with HBV or HCV can have overlapping TTV infection.