Objective To explore the application of central venous catheter(CVT) in hemodialysis.Methods The clinical data of 2 206 cases of CVT patients were analyzed retrospectively,and the catheter puncture site,the catheter indwelling time,4 weeks of blood flow rate and the incidence of catheter related infections,and so on were observed.Results Internal jugular vein in 2 033 cases,the femoral vein in 173 cases.Internal jugular vein indwelling catheter time was (40.6 ±32.7) d,the femoral vein catheter indwelling time was (22.4 ± 16.3) d,and the difference was statistically significant (P＜ 0.05).Blood flow patency rate in four weeks was of 96.4％ (1 959/2 033) indwelling catheter in internal jugular vein,which was significantly higher than that of the femoral vein in 83.2％ (144/173),and the difference was statistically significant (P ＜ 0.05).Femoral vein catheter related infection rate was 11.0％ (19/173),significantly higher than that of internal jugular vein in 3.6％ (73/2 033),the difference was statistically significant (P ＜ 0.05).Conclusion Application of CVT for hemodialysis is convenient and reliable,with low infection rate,fewer complications,operation technology level is the key to success.

OBJECTIVETo observe the effect of hepatitis virus B on the detection rate of core antigen of hepatitis virus C in sera of chronic hepatitis C patients.

METHODHCVcAg and HCV RNA in sera were detected in 88 patients with chronic hepatitis C and 62 patients co-infected with HCV and HBV. At the same time, HBV DNA and HBeAg in sera were detected in 62 patients infected with HCV and HBV. Then we analyzed the correlation between HCVcAg and HBeAg/HBV DNA. The detection rates of HCVcAg in 88 patients with chronic hepatitis C and 62 patients co-infected with HCV and HBV were 72.7% (64/88) and 38.7% (24/62), respectively (x2 = 17.358, P less than 0.01).

RESULTSThe detection rates of HCV RNA in 88 patients with chronic hepatitis C and 62 patients co-infected with HCV and HBV was 81.8% (72/88) and 53.2% (33/62)respectively (x2=20.110, P less than 0.01). In 62 patients infected with HCV and HBV, the detection rate of HCVcAg in HBeAg positive patients and HBeAg negative patients were 28.6% (12/42) and 60% (12/20), respectively (x2 = 7.547, P = 0.011). Moreover, the positive rates of HBV DNA in HBeAg positive patients and HBeAg negative patients were 42.9% (18/42) and 80% (16/20), respectively (P more than 0.05). The detection rates of HCVcAg in HBV DNA positive patients and HBV DNA negative patients were 39.1% (18/46) and 37.5% (6/16), respectively (x2 = 0.013, P = 0.908). Compared with the detection rates of HCVcAg in patients only infected with HCV, the detection rate of HCVcAg in HBeAg or HBV DNA negative patients infected with HCV and HBV were 60% (12/20) (x2 = 1.266, P = 0.261) and 37.5% (6/16) (x2 =7.635, P less than 0.01), respectively.

CONCLUSIONThe detection rate of HCVcAg in patients infected with HCV and HBV is relatively low. The reason is possibly that HBeAg inhibits duplication of HCV and decreases the expression of HCVcAg.

Coinfection ; immunology ; virology ; DNA, Viral ; Hepacivirus ; immunology ; Hepatitis B ; immunology ; virology ; Hepatitis B virus ; Hepatitis C Antigens ; blood ; Hepatitis C, Chronic ; immunology ; virology ; Humans

OBJECTIVETo evaluate the relationship of the expression of bone morphogenefic protein-7 (BMP-7) in the liver and the liver fibrosis and inflammation in patients with chronic hepatitis B virus (HBV) infection, to explore the role of BMP-7 in the fibrogenesis of chronic hepatitis B.

METHODS81 patients chronically infected with HBV were enrolled. Liver biopsy were performed in all these patients. The hematoxylin staining and reticular fiber staining were performed for the grading of inflammation and staging of fibrosis, respectively. The patients were divided into different groups by the inflammatory grade or fibrosis stage (8, 14, 19, 22, 18 patients with inflammatory grade of G0, G1, G2, G3, G4, respectively; 8, 16, 21, 24, 12 patients with fibrosis stage of S0, S1, S2, S3, S4, respectively ). Then the immunohistochemical staining by BMP-7 were performed. The expression of BMP-7 in the liver was evaluated by digital image quantitative analysis system. We compared the expression of BMP-7 in the liver with different inflammatory grade and fibrosis stage.

RESULTSThe expression of BMP-7 in the liver tissue increased with the increase of hepatic inflammatory grade and fibrosis. When liver biopsy showed a severe intrahepatic inflammation, the expression of BMP-7 significantly increased, regardless the intrahepatic fibrosis stage. Similarly, when liver biopsy showed a severe intrahepatic fibrosis, the expression of BMP-7 also significantly increased, regardless the intrahepatic inflammatory grade.

CONCLUSIONBMP-7 may play an important role as anti-inflammatory and anti-fibrogenic effect in the fibrogenesis of chronic hepatitis B.

Bone Morphogenetic Protein 7 ; genetics ; metabolism ; Female ; Hepatitis B, Chronic ; genetics ; metabolism ; Humans ; Immunohistochemistry ; Liver ; immunology ; metabolism ; pathology ; Liver Cirrhosis ; genetics ; metabolism ; Male ; Reverse Transcriptase Polymerase Chain Reaction

OBJECTIVETo provide reliable evidence for acupuncture treatment of vascular dementia (VD).

METHODSMulti-central randomized controlled trial method was adopted and 270 cases enrolled were randomly assigned to an acupuncture-medicine group, an electroacupuncture group and a medication group. The acupuncture-medicine group were treated by scalp electroacupuncture on Sishencong (EX-HN 1), Baihui (GV 20), Shenting (GV 24), Fengchi (GB 20) and oral administration of Nimodipine; the electroacupuncture group were treated with scalp electroacupuncture; the medication group were treated with simple oral administration of Nimodipine. They were treated for 6 weeks. Mini-mental state scale (MMSE), ability of daily life-rating scale (ADL-R) and P300 were detected before and after treatment.

RESULTSThe total effective rate for cognition improvement was 86.59% in the acupuncture-medicine group, 82.05% in the electroacupuncture group and 43.21% in the medication group, the electroacupuncture group and the acupuncture-medicine group being better than the medication group; and their total effective rates for improvement of ability of daily life were 59.76%, 65.38% and 32.10%, respectively, the electroacupuncture group and the acupuncture-medicine group being better than the medication group. Scores for MMSE and ADL-R and P300 examination indicated that there were significant differences as the acupuncture-medicine group and the electroacupuncture group compared with the medication group (P < 0.01).

CONCLUSIONScalp electroacupuncture or scalp electroacupuncture combined with oral administration of Nimodipine has a better therapeutic effect in improvement of recognition function and the ability of life activity than simple oral administration of Nimodipine with a higher safety.

Acupuncture Points ; Aged ; Dementia, Vascular ; drug therapy ; physiopathology ; therapy ; Electroacupuncture ; Female ; Humans ; Male ; Middle Aged ; Nimodipine ; therapeutic use

OBJECTIVETo investigate the levels of HBsAg in predicting the efficacy of peglated interferon-alpha 2a combined with adefovir dipivoxil (ADV), in HBeAg-positive chronic hepatitis B patients.

METHODSThis trial enrolled 62 HBeAg-positive chronic hepatitis B patients with detectable HBsAg for at least 6 months prior to screening, serum HBV DNA levels of at least 100 000 IU/ml. The efficacy assessment: viral suppression below 100 IU/ml. The patients with HBV DNA < or = 100 IU/ml after 24 weeks therapy were divided into group A, in which monotherapy continued; While the rest were divided into group B, in which ADV was combined until week 48. In group B, at the end-of-treatment, the patients with HBV DNA < or = 100 IU/ml were divided into group B1, the rest were divided into group B2.

RESULTSThere was no significant difference on the baseline characteristics of patients between B1 and B2. There was significant difference on the levels of HBsAg at 12-week and 24-week between B1 and B2; while there was no significant difference on the levels of HBeAg.

CONCLUSIONSThe levels of HBsAg at 12-week and 24-week would be predictors to evaluate the efficacy of combined therapy in HBeAg-positive chronic hepatitis B patients.

Adenine ; adverse effects ; analogs & derivatives ; therapeutic use ; Adult ; Antiviral Agents ; therapeutic use ; Drug Therapy, Combination ; adverse effects ; Female ; Hepatitis B Surface Antigens ; blood ; Hepatitis B e Antigens ; blood ; Hepatitis B virus ; drug effects ; genetics ; isolation & purification ; Hepatitis B, Chronic ; blood ; drug therapy ; virology ; Humans ; Interferon-alpha ; adverse effects ; therapeutic use ; Male ; Organophosphonates ; adverse effects ; therapeutic use ; Recombinant Proteins ; Treatment Outcome

OBJECTIVETo indentify the relation between hepatic cells apoptosis and the lesion of liver tissue in acute toxic lethal hepatitis.

METHODS60 Wistar mice were randomly divided into normal control, model group and treatment group. Normal control and model group were pretreated by portal vein injection of normal saline, the treatment group was pretreated by portal vein injection of BCL-X1 adenoviruses. The mice of model group and treatment group were received an injection of D-galn and LPS to establish fulminant hepatic failure models 7 days after pretrement. To observe BCL-X1 expression, serum ALT, AST, hepatocyte apoptosis rate, and mortality rate of the three groups.

RESULTSThe BCL-X1 expression was higher in treatment group than in model group; 6 hours after fulminant hepatic failure models were established,the serum ALT, AST level of treatment group was lower than model group;The hepatocyte apoptosis rate of treatment group was lower than model group. The death rate of treatment group was lower than model group.

CONCLUSIONIn fulminant mice hepatic failure models, the hepatocyte apoptosis rate has a positive correlation with death rate, the overexpression of BCL-X1 can decrease the hepatocyte apoptosis rate and the death rate.

Adenoviridae ; genetics ; metabolism ; Animals ; Apoptosis ; Disease Models, Animal ; Female ; Gene Expression ; Genetic Therapy ; Genetic Vectors ; genetics ; metabolism ; Humans ; Liver ; cytology ; metabolism ; Liver Failure, Acute ; genetics ; physiopathology ; prevention & control ; therapy ; Rats ; Rats, Wistar ; bcl-X Protein ; genetics ; metabolism ; therapeutic use

OBJECTIVETo observe the efficacy and safety on the efficacy of HBeAg-positive chronic Hepatitis B patients treated with adefovir dipivoxil for 4 years.

METHODSNinety-five patients with HBeAg-positive chronic hepatitis B were treated with adefovir dipivoxil 10 mg per day orally. The patients were observed before and after treatment for their serum levels of ALT and HBV DNA, the new increasing rates of serum ALT normalization, HBV DNA clearances, HBeAg loss, HBeAg seroconversion and adverse drug events.

RESULTSAt 4 years on study, the rates of ALT normalization, HBV DNA clearances, HBeAg loss, HBeAg seroconversion and HBV DNA rebound were 89.5%, 63.2%, 47.4%, 41.1% and 8.0%, respectively. No drug related to renal function impairment was found during the treatment, eight patients had adverse drug events but all were mild.

CONCLUSIONAdefovir dipivoxil could effectively inhibit HBV replication, normalize ALT and enhance transformation from HBeAg to HBeAb for cases with naive and treated-first patients. The efficacy were increased with prolongation of the treatment period. It is safe and has a good tolerance.

Adenine ; administration & dosage ; adverse effects ; analogs & derivatives ; Adult ; Antiviral Agents ; administration & dosage ; Female ; Hepatitis B e Antigens ; blood ; Hepatitis B virus ; drug effects ; physiology ; Hepatitis B, Chronic ; blood ; drug therapy ; virology ; Humans ; Male ; Middle Aged ; Organophosphonates ; administration & dosage ; adverse effects ; Virus Replication ; drug effects

OBJECTIVETo study the status of detection of hepatitis C core antigen in intravenous drug addictions, and discuss the foreground of the hepatitis C core antigen ELISA test system.

METHODSHCV core antigen, HCV RNA quantity, anti HCV-IgG, HBsAg were analysis in all the plasma samples taken from 93 cases of intravenous drug users.

RESULTSThe specialty and sensitivity of HCV core antigen in intravenous drug addictions 100% -54% separately. When HBsAg were positive, the sensitivity of HCV core antigen was 38%, while HBsAg negative, the sensitivity of HCV core antigen was 69% (P < 0.01).

CONCLUSIONThe detections of HCV core antigen showed high specialty but low sensitivity in intravenous drug addictions. The positive rate has positive relation with HCV RNA virus logarithm quantity. Coinfection with HBV are the interfere factor of HCV core antigen detection. In screening experimentations, the detection of HCV core antigen in plasma may be applied as supplement method for anti-HCV-IgG. It can also be used to monitor viremia in HCV infection.

Adolescent ; Adult ; Enzyme-Linked Immunosorbent Assay ; methods ; Female ; Hepacivirus ; genetics ; immunology ; isolation & purification ; Hepatitis C ; diagnosis ; virology ; Hepatitis C Antigens ; blood ; genetics ; immunology ; Humans ; Male ; Middle Aged ; Substance Abuse, Intravenous ; virology ; Young Adult

OBJECTIVETo investigate the relationship of the serum chemokine RANTES level in patients with chronic hepatitis B among different clinical severity and to explore its possible reasons.

METHODS144 patients with chronic hepatitis B were divided into mild-moderate (46), serious (51) or severe group (47) according to the different clinical severity and 18 normal cases were taken as normal control. The serum level of chemokine RANTES was detected with an ABC-ELISA assay. Statistical analysis was performed on the software of SPSS 13.0.

RESULTSThe serum chemokine RANTES levels in patients with chronic hepatitis B (2227.06 +/- 790.80, 5878.49 +/- 3334.58, 3482.77 +/- 2315.62 ng/L in mild-moderate, serious and severe group respectively) were significantly higher than that in the normal control (329.46 +/- 152.00 ng/L). The differences between each two hepatitis groups were also statistically significant (P < 0.05) and serum chemokine RANTES level in serious group was highest among them.

CONCLUSIONSerum chemokine RANTES level in patients with chronic hepatitis B elevates significantly and it might play an important role in the pathogenesis of chronic hepatitis B.

Adolescent ; Adult ; Aged ; Case-Control Studies ; Chemokine CCL5 ; blood ; Female ; Hepatitis B, Chronic ; blood ; immunology ; Humans ; Male ; Middle Aged ; Young Adult

OBJECTIVETo investigate the effects of cAMP-response element binding protein-1 (CREB-1) on transforming growth factor-b3 (TGF b3) mRNA expression and promoter activity in hepatic stellate cells (HSCs).

METHODSFreshly isolated HSCs from rats were divided into six groups: CREB-1 expression plasmid transfected group (C), siRNA-CREB-1 plasmid transfected group (S), negative control group (N), forskolin treated group (F), H-89 treated group (H), and blank group (B). Rats in each group were further sub-divided according to whether (+) or not (-) they were exposed to exogenous TGF b3. TGF b3 mRNA expression was measured by real time quantitative PCR. HSCs of the C, S, N, F, H and B groups were transfected with the TGF b3 promoter luciferase reporter plasmid (PGL3-TGF b3-P; W group), the TGF b3 promoter luciferase reporter plasmid with CRE mutation (PGL3-basic-TGF b3P-mCRE; M group) and the renilla luciferase control plasmid (pRL-SV40; control group). TGF b3 promoter activity was assessed by luciferase reporter assays.

RESULTSCompared to N(-), the TGF b3 mRNA expression was reduced to 0.69+/-0.15 in S(-) (P less than 0.05) and increased to 4.68+/-2.76 in C(-) (P more than 0.05). Compared to B(-), the TGF b3 mRNA expression was reduced to 0.57+/-0.08 in H(-) (P less than 0.05). The differences between N(+) and N(-), S(+) and S(-), B(+) and B(-), and H(+) and H(-) were all significant (P less than 0.05). The values of TGF b3 promoter activity in S(W), N(W), and C(W) were 0.062+/-0.013, 0.122+/-0.011, and 0.165+/-0.016 (P less than 0.05), but the changes of TGF b3 promoter activity in S(M), N(M), and C(M) were not significant (P more than 0.05). The values of TGF b3 promoter activity in H(W), B(W), and F(W) were 0.154+/-0.010, 0.188+/-0.016, and 0.276+/-0.031 (P less than 0.05), but the changes of TGF b3 promoter activity in H(M), B(M), and F(M) were not significant (P more than 0.05).

CONCLUSIONIncreased levels of CREB-1 mRNA or p-CREB-1 up-regulate the TGF b3 mRNA expression and promoter activity in rat HSCs. The CRE site in the TGF b3 promoter is critical for this effect, and the gene's activity becomes significantly decreased when the site is missing. Exogenous TGF b3 enhances expression of endogenous TGF b3 in rat HSCs.

Animals ; Cells, Cultured ; Cyclic AMP Response Element-Binding Protein ; metabolism ; Hepatic Stellate Cells ; metabolism ; Promoter Regions, Genetic ; RNA, Messenger ; genetics ; Rats ; Transforming Growth Factor beta3 ; genetics