Objective To study the relationship of hepatitis and pregnan cy .Methods 49 cases with viral hepatitis of pregnancy were analyze d and compared with viral hepatitis of non-pregnant cases.Results Most of the hepatitis following pregnancy were HBV,with the increment of preg nant weeks,the incidence and mortality rates of hepatitis were increased.PT was remarkably prolonged and ALB lowered in 49 cases.Complications of hepatic enceph alopathy and hepto-renal syndrome were more,the incidence and fatality rates of severe hepatitis were higher than that in healthy group (P

Objective To evaluate the long-term efficacy and safety profile of alpha-1-thymosin (T?_1) combined with Lamivudine(LAM) in the patients with chronic hepatitis B. Methods Eighty patients with chronic hepatitis B were randomly assigned by 1∶1 proportion to be given 100 mg LAM orally alone (LAM group) or T?_1 1.6 mg subcutaneous injection, combined with LAM(LAM+T?_1 group). Results 51.4 percent (18/35) of the patients achieved HBeAg seroconversion in combination group, while 5.4%(2/37) of the patients in LAM group achieved HBeAg seroconversion at 52 week, P

Objective To investigate HBV genotypes and gene mutations in chrenic hepatitis B (CHB) patients with liver failure after lamivudine withdrawal. Methods Twenty four patients with relapsing CHB after lamivudine withdrawal were divided into liver failure group ( n = 12 ) and chronic hepatitis group ( n = 12 ). HBV DNA from these patients was amplified by PCR. The PCR products were cloned into PGEM-T vector and HBV DNA sequences were analyzed. Results In liver failure group, there were 6 sequences detected, in which 3 were of genotype B and 3 were of genotype C. In chronic hepatitis group, there were 9 sequences detected, in which 2 were of genotype B and 7 were of genotype C. Compared with the wild type HBV sequences, there were multiples mutations in S, P, C, X regions. Gene mutations in high conservative sequences of BCP and P regions were detected in liver failure patients after lamivudine withdrawal. Conclusions In HBV patients with liver failure after lamivudine withdrawal, half of them were of genotype B and the others were of genotype C. Some mutations in high conservative sequences of BCP and P regions may be related to the liver failure in these patients.

Objective:To determine the effect of IL-12 on the cellular immune response of PBMC from patients with chronic hepatitis B virus infection, and provide basic scientific information for clinic therapy of this disease.Methods:PBMCS were prepared from peripheral blood of individuals with chronic HBV infection and cultured in the presence or absence of HBsAg and HBcAg with or without IL-12.The level of IFN-?in culture supernatants, the frequency of IFN-?-producing cells, and the subpopulation of IFN-?-producing cells were detected by either ELISA,ELISPOT or FACS.Results:Less than 30% patients and very low level of IFN-? were observed when PBMCs were stimulated with HBsAg or HBcAg alone. Addition of IL-12 to the cultures resulted in significant increase in IFN-?production and IFN-?-producing cells. In addition, IL-12 induced expression of IFN-? not only by CD8~+T cells, but also by non-T cell populations.Conclusion:IL-12 can promote the cellular immune response to the chronic hepatitis B virus by the enhancement of IFN-?production.

Objective To evaluate the effects of nucleoside/nucleotide analogue treatment on immunoglobulin and complement in patients with chronic hepatitis B (CHB).MethodsA total of 157 CHB patients were recruited and divided into CHB group,liver cirrhosis (LC) group and severe hepatitis B (SHB) group.There were 50 patients who received oral antiviral treatment (lamivudine 100 mg/d,or entecavir 0.5 mg/d,or telbivudine 600 mg/d).Serum levels of complement 3 and 4 (C3,C4),C-reaction protein (CRP),hemolytic complement (CH50),immunoglobulin G,M,A (IgG,IgM,IgA),hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) were detected by enzyme-linked immunosorbent assay (ELISA) or immunoturbidimetry.Hepatitis B virus (HBV) DNA was quantified by real-time polymerase chain reaction (RT-PCR) before and 1,2,3 and 4 weeks after nucleoside antiviral therapy.Comparison of means was done by t test and Mann-Whitney test.The correlation was analyzed by Pearson correlation coefficient test.ResultsSerum IgA and IgM levels of SHB and LC patients were significantly higher than those of CHB patients (P＜0.01).Levels of C3,C4,CH50 and CRP were significantly different among three groups.Levels of C3,IgM,IgG and HBV DNA in HBeAg positive patients were significantly different from those in HBeAg negative patients.There was a statistically significant difference of IgA,IgM,C3 and CH50 levels between patients with high HBV DNA level and low HBV DNA level in HBeAg-positive patients.While in the HBeAg-negative patients,only the IgA level was significantly different with HBV DNA levels.After anti-viral treatment,immunoglobulin and HBV DNA levels were all decreased in three groups,while the serum complement level was increased compared to baseline,and the differences became significant at week 4 of treatment. HBV DNA level was negatively correlated with C3 (r=-0.78,P=0.021) and HBeAg titer was positively correlated with C3 (r=0.87,P=0.015).ConclusionsThe immunoglobulin,CRP,C3,C4,and C H50 could reflect the inflammatory activity in liver.The changes of C3 level can predict the efficacy of antiviral therapy.

Objective To evaluate the therapeutic efficacy and its related factors of entecavir treatment for patients with acute on chronic hepatitis B liver failure (ACHBLF).Methods One hundred and eight patients with ACHBLF were enrolled and divided into entecavir group (n=53) and control group (n=55).HBV DNA level, liver function and 48-week survival rate were observed, and C ox regression model was established to identify the factors which may affect the efficacy of entecavir treatment.Results Totally 70 patients died in the study and 66 died within 12 weeks.The statistical difference on cumulative survival rate between two groups was observed from the third week on (χ2=5.357, P ＜ 0.05).The 48-weekcumulative survival rate in entecavir group was 47.2% (25/53), while that in the control group was 23.6%(13/55) (χ2=7.432, P ＜ 0.01).In entecavir group, for patients aged ＜ 40 with serum bilirubin level ＜513 μnol/L and international normalized ratio (INR) ＜ 2.5, the fatality rates decreased 74.9%, 75.3%and 76.0%, respectively.Conclusions Entecavir may improve the survival rate of patients with ACHBLF.Age, serum bilirubin level and INR are major factors related to the therapeutic efficacy.

Objective To analyze clinical features of patients with chikungunya fever and provide future reference for prevention and control of the disease. Methods Forty-six confirmed chikungunya fever inpatients were included. Their clinical symptoms, signs, blood count, key biochemical indicators and treatments were analyzed. The comparison between groups were done by ttest. Results The percentages of total cases presenting with fever, rash and joint pain were 100. 0% (46/46), 91. 3% (42/46) and 89. 1% (41/46), respectively. Fifteen (32.6%) cases displayed leucopenia. Increases in lactose dehydrogenase (LDH) and creatine kinase (CK) were observed in 45. 5%(20/44) and 28. 9%(13/45) of the cases, respectively. Three cases displayed an increase of alanine aminotransferase (ALT). Administration of ribavarin extend febrile time compared to symptom-relieving treatments (t=2. 588, P = 0. 013). Conclusions Clinical features of chikungunya fever include fever, rash and joint pain. Good prognosis can be resulted from symptom-relieving treatment. Antiviral treatment may not be beneficial to reducing course of disease.

Objective To investigate the balance of Th1/Th2 cytokines and its relationship with prognosis of severe chronic hepatitis B ( CHB ). Methods Peripheral blood samples were collected from 112 severe CHB patients, 30 CHB patients and 30 healthy controls. IL-4, IFN-γ levels and HBV DNA loads were measured by ELISA and fluorescent PCR, respectively. The levels of cytokines in different stages, and their correlations with HBV DNA loads and short-term prognosis were analyzed. Results Higher levels of IL-4, IFN-γ and Th1/Th2 ratios in peripheral blood were detected in patients with severe CHB than those with CHB and the healthy controls (Z = 8.968, 10. 004 and 26. 067, P =0. 009, 0. 007 and 0. 000). IL4 levels in patients with end-stage server CHB were markedly higher than those in other stages ( Z = 3. 672 and 3. 158, P= 0.000 and 0.002), while their Thl/Th2 ratios were lower (Z=3. 161 and 2. 166, P=0.002 and 0. 030). No significant differences on levels of IL-4, IFN-γ and Th1/Th2 ratios were observed in severe CHB patients with different HBV DNA levels (Z =4.431, 2.626 and 0. 140, P =0.219, 0.403 and 0. 987). Elevated IL-4 was closely correlated with the high case-fatality rate within 12 weeks. Conclusions The balance between Th1 and Th2 cytokines is- disturbed in patients with severe CHB. Thl/Th2 ratio decreases with the aggravation of diseases, which may indicate unfavorable short-term prognosis.

Objective To apply the model for end-stage liver disease(MELD)and the ChildTurcotte-Pugh(CTP)in predicting short-term prognosis of patients with severe chronic hepatitis B,and to evaluate their clinical value.Methods Data of 115 patients with severe chronic hepatitis B were retrospectively analyzed and all patients were divided into survival gnmp and fatal group by survival status at 3rd month of the treatment.The scores of MELD and CTP were obtained.The accuracies of MELD and CTP were evaluated by the receiver operating characteristic(ROC)curve.The difference between two systems was analyzed by Kaplan-Meier survival curve.Results MELD and CTP scores in fatal group were significantly higher than those in the survival group(t=4.891 and 3.949,P＜0.05),and two systems were significantly correlated(γ=0.500,P=0.000).MELD and CTP scores were good for predicting the fatality rate of patients with severe chronic hepatitis B within 3 months(C-statistic:0.765 and 0.834,respectively),and there was no significant difference between the two systems(Z=1.516,P＞0.05).Patients with CTP＜10.5 or MELD＜27.5 had longer survival time(Z:17.88 and 25.28,P=0.000)and higher survival rates(χ2=16.88 and 31.59.P=0.000)than those with CTP＞10.5 or MELD＞27.5.Conclusion MELD and CTP scores have similar predictive valHe for short-term prognosis of patients with severe chronic hepatitis B.and clinical data should be contained to better predict the short-term prognosis.

Objective To investigate the susceptibility of bone marrow mesenchymal stem cell (BMSC) to hepatitis B virus (HBV) infection during induction toward hepatocyte and the role of asialoglycoprotein receptor (ASGPR) in BMSC HBV infection. Methods BMSC obtained from hepatitis B patients were tested for HBV infection and then cultured with HBV infectious serum in vitro and induced to differentiate into hepatocyte through exposure to hepatocyte growth factor (HGF), fibroblast growth factor-4(FGF-4), and epidermal growth factor(EGF). Subsequently these cells were determined for the presence of hepatitis B virus e antigen( HBeAg), hepatitis B virus surface antigen(HBsAg) and ASGPR. All experiments were repeated for 3 times in 5 different samples. The results were analyzed by non-parametric test. Results After 6 days of exposure, BMSC-derived hepatocyte-like cells expressed hepatic special genes and proteins, including alpha fetoprotein(AFP),cytokeratin18 (CK18), albumin (Alb), and manifested hepatocyte functions, including glycogen synthesis, urea secretion and albumin synthesis. Expressions of CK18 and Alb were increased, and AFP was decreased with time of induction. The BMSC were resistant to HBV infection both in vitro and in vivo or after induction toward hepatocyte. ASGPR expression level was low in BMSC, which was increased in the induced BMSC but still lower than that of the control HepG2 cells. Conclusions BMSC are resistant to HBV infection both in vitro and in vivo. The low level expression of ASGPR may be a reason for this.