Objective The objective of this study was to explore the relations of quantitatively measurment of serum alphafetoprotein(AFP)and prognosis in severe viral hepatitis.Methods To retrospectively analyse the different level of quantitatively measurment of serum alphafetoprotein(AFP) and distribution of AFP in 213 patients with severe viral hepatitis.Results The abnormity rate of AFP was 68.1%,the abnormity rate of AFP in acute severe hepatitis patients was significantly less than that in subacute severe hepatitis and chronic severe hepatitis(P＜0.01),the death rate of patients with AFP＜20 μg/L,AFP 20～400 μg/Land AFP＞400 μg/L was 86.8%,58.8% and 20.9% respectively,the survival severe hepatitis parients were 85 cases with AFP(248.0±72.5)μg/L in 213 cases,128 cases with AFP(97.6±50.4)μg/L died(P＜0.01).Conclusion The mortality of severe decreases and the survival rates of severe increases gradually along with the higher level of AFP,and it reveals the higher level of AFP in severe hepatitis has a better prognosis,it is the important reference index of prognostic judgement.

OBJECTIVE:To investigate the therapeutic effect of Lipo-prostaglandin E 1 (Lipo PGE 1 )on chronic severe type B hepatitis by MELD(Model for end-stage live disease)prognosis analysis.METHODS:Of a total of115cases with chronic severe type B hepatitis,57were randomly assigned to receive a common combined therapy and58to receive a common combined therapy plus Lipo PGE 1 for4weeks,the MELD score and prognosis of diseases of the2groups were assessed.RE-SULTS:The MELD score in the treatment group(20.12?8.97)was lower than that of the control group(24.76?10.41)after4weeks’treatment(P

Objective To explore the value of CD+4T lymphocyte count in laboratory diagnosis of AIDS complicated with pulmonary tuberculosis.Methods Forty-three patients with acute tuberculosis were selected as the subjects.Among them,14 patients had typical tuberculosis(X-ray or chest CT),29 cases were atypical tuberculosis(X-ray or chest CT).43 patients were examined by CD+4T lymphocyte count,sputum smear tuberculosis acid-fast bacilli test and T-SPOT.TB(interferon-γ release test),and the results of various methods were compared.Results The The number of CD+4T lymphocytes in patients with typical pulmonary tuberculosis was (151.26±59.47)/μL,and that in atypical pulmonary tuberculosis was (69.11±19.65)/μL,the difference was statistically significant(t=5.124,P<0.05);and with the reduction of CD+4T lymphocytes,AIDS patients showed more atypical pulmonary tuberculosis.The positive detection rates of CD+4T lymphocyte count,T-SPOT.TB and sputum smear were 86.05%,16.28% and 51.16% respectively.The positive rate of combined detection of three methods(90.70%) was significantly higher,the differences were statistically significant(x2=5.123,6.023,7.125,all P<0.05).Conclusion CD+4T lymphocyte count is of great value in the laboratory diagnosis of AIDS complicated with tuberculosis,and it is worthy to be widely carried out in clinical practice.

OBJECTIVE:To explore the effects of entecavir combined with chemotherapy on positive HBV in tumor patients with normal liver function. METHODS:106 patients were selected and divided into observation group (44 cases) and control group (62 cases) according to therapy plan. Control group received routine chemotherapy according to tumor condition;observa-tion group was given Entecavir tablets orally 0.5 mg,qd,before 1 week of chemotherapy,for consecutive 1 week. HBV reactiva-tion rate,recurrence rate of severe hepatitis,mortality rate,serum level of ALT before and after treatment and the incidence of ADR were compared between 2 groups. RESULTS:4 patients of observation group and 2 of control group withdrew from the study. HBV reactivation rate,recurrence rate of severe hepatitis and mortality were 7.5%,0,0 in observation group and 56.7%, 50.0%,13.3% in control group,with statistical significance between 2 groups(P<0.05). Before chemotherapy,there was no sta-tistical significance in serum levels of ALT between 2 groups(P>0.05);after chemotherapy,the serum levels of ALT in 2 groups were increased significantly,and the control group was significantly higher than the observation group,with statistical significance (P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Entecavir can effectively prevent HBV reactivation and decrease the recurrence rate of severe hepatitis and mortality rate in tumor patients dur-ing chemotherapy, and doesn’t increase the risk of ADR.

Objective To study the correlation between the level of serum ferritin(SF) and the degree of liver damagement with severe hepatitis B,and the clinical significance of SF changes in judging the prognosis.Methods The level of SF was detected by radioimmunoassay(RIA) from 62 cases with severe hepatitis B,the level of SF from acute hepatitis B,chronic hepatitis B,liver cirrhosis and normal men were served as contrast study.Results The level of SF from severe hepatitis B was significantly higher than those from acute hepatitis B,chronic hepatitis B,liver cirrhosis and normal men;the level of SF was positively correlated with total bilirubin(TB),prothrombin time(PT),total bile acid(TBA) and negatively with Alb,ALT,AST,CHE.The levels of SF of those who died were significantly higher than those of suvivals;the level of SF decreased as the disease controlled and increased as the disease deterio-rated.Conclusions There is a parallel correlationship between the level of SF and the degree of liver damagement with severe hepatitis B,the severer the hepatocyte damage was,the higher the ferritin was.It is helpful to judge the degree of damagement and prognosis of severe hepatitis by detecting the level of serum ferritin.

Objective To investigate the relationship between pancreatic beta cell function and liver function in hepatitis B cirrhosis with different glucose metabolism status.Methods A total of 247 patients with hepatitis B cirrhosis were included and divided into 3 groups according to measurement of fasting blood glucose (FBG),and 2h blood glucose in 75g oral glucose tolerance test(2hPG),normal glucose metabolic status group(group A,n =47),glucose tolerance impairment group(group B,n =103) and diabetes mellitus group(group C,n =97).Data of fasting and 2h postprandial blood glucose,C-peptide,insulin and glycosylated hemoglobin (HbA1c),pancreatic beta cell function index(HBCI),insulin sensitivity index (ISI),hepatitis B virus load were collected and analyzed.Results Abnormal glucose metabolism was observed in 81％ patients with hepatitis B cirrhosis,while hepatogenic diabetes accounted for 39.3％.2 hPG[(6.29 ± 3.78) mmol/L,(10.56 ± 4.26) mmol/L,(17.34 ± 5.9) mmol/L],FBG [(4.72 ±2.15)mmot/L,(5.68 ±2.81) mmol/L,(9.82 ±5.1) mmol/L],HbA1c [(4.5 ± 1.2)％ (10.56 ±4.26) ％ (9.5 ± 3.0) ％],HBV-DNA [(3.78 ± 0.52),(4.82 ± 0.61),(6.02 ± 0.63)] were compared in group A,group B and C.2hPG,FBG,HbA1c and HBV viral loads in group A were significantly lower than group B and group C (F =93.23,41.35,84.93,237.2,P ＜ 0.05).Fasting insulin [(15.65 ± 4.17) mU/L,(26.53 ± 7.22) mU/L,(30.18 ± 3.23) mU/L],postprandial insulin [(45.28 ± 10.22) mU/L,(106.8 ± 20.74) mU/L,(141.68 ±20.25) mU/L],postprandial C peptide [(5.96 ± 4.82) mU/L,(9.86 ± 5.46) mU/L,(9.54 ± 6.42) mU/L] and ISI [(-5.96 ± 0.61),(-4.92 ± 0.42),(-5.03 ± 0.51)] were compared in group C,group B and A,those values in group C were lower than group A and B,the defferences were stastistically significant (P ＜ 0.05).HBCI in three groups were (5.66 ± 0.64),(5.32 ± 1.01),(4.30 ± 1.53),respectively,the defferences were stastistically significant(F =27.55,P ＜0.05).Patients in group C with Child-Pugh C score was much more than group A and B,the defference was stastistically significant (x2 =48.6,P ＜ 0.01).Conclusion Hyperinsulinemia,increased insulin resistance and decreased insulin secretion exist in hepatitis B cirrhosis patients,and they are closely related to liver function.