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 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 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

Objective To investigate the relationship of the serum chemokine RANTES level in patients with chronic hepatitis B among different clinical severity and to explore its passible reasons. Methods 144 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.Results The 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. Conclusion Serum 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.

Objective The aim of this study was to investigate the relationship between liver function test,serum HBeAg,HBV DNA level and liver pathological changes in patients with chronic hepatitis B.Methods 233 patients with chronic hepatitis B accept liver functure biopsy,liver function test,HBeAg detection and HBV DNA fluorescent quantitation PCR detection. Comparisons of liver function test,HBeAg and HBV DNA level were conducted among different liver pathological changes including inflammation grading and fibrosis staging. Results In different inflammation grading groups,ALT was highest in group G3 and lowest in group G0-1 ( P = 0.016) ;TBil was highest in group G4 and lowest in group G0-1 (P = 0.000);HBV DNA level was highest in group G4 and lowest in group G0-1 ,but not statistically significant among groups ( P = 0.463). in different fibrosis staging groups,ALT was highest in group S3 and lowest in group S0-1 ,but not statistically significant among groups (P = 0.562) ;TBil was highest in group S4 and lowest in group S2 ( P = 0.039) ; HBV DNA level was highest in group S3 and lowest in group S0-1 ,but not statistically significant among groups ( P = 0.395). In HBeAg positive group,the proportion of G3-4 in inflammation grading or S3-4 in fibrosis staging was lower than that in HBeAg negative group (46% vs 52%,P = 0.438;38 % vs 53 %,P = 0.025 ;respectively). Conclusion HBV DNA level can not indicate the severity of liver inflammation or fibrosis in chronic HBV infection. Patients with HBeAg negative often are complicated with more severity of liver fibrosis. In routine liver function test,TBil level eorrelates with hver inflammation grading or fibrosis staging; ALT level also correlates with liver inflammation grading but not with fibrosis staging.

Objective To investigate the clinical features and the short-term efficacy of ETV treatment of the HBeAg negative acute-on-chronic hepatitis B liver failure. Methods 132 HBeAg negative and 51 HBeAg positive patients with acute-on-chronic liver failure were rolled.84 patients were treated with ETV (0.5 nag daily) and routine supportive therapy. 99 patients in the control group received supportive therapy only. The clinical features and the short-term (180 days) efficacy of ETV were compared between the HBeAg negative and HBeAg positive groups. Results The age of HBeAg negative patients was significantly higher ( P=0.001 ). The viral load was significantly higher in the HBeAg positive group ( P=0.001 ). There was no significant difference in the severity and the mortality in control group between the different HBeAg groups. In the antiviral treatment groupa,20/ 25 HBeAg positive patients survived and 32/59 HBeAg negative patients survived (P = 0.004) .The mortality of HBeAg negative patients in control group was higher than that in treatment group ( P = 0.032). In HBeAg negative patients with the HBV DNA < 5 log copies/ml and HBV DNA 3 log copies/ml,10/18 patients in treatment group survived and 6/30 patients in control group survived ( P = 0.011 ). Conclusions There was no significant difference in the mortality between different HBeAg patients in routine treatment group. Antiviral therapy with ETV significantly improve survival rate in HBeAg negative patients. In patients with the HBeAg negative and HBV DNA < 5 log copies/ml and 3 log copies/ml,antiviral therapy with ETV can improve the survival rate.

Objective To study the pathological features of liver tissues from patients clinically diagnosed with mild chronic hepatitis B based on current guideline and emphasize the important significance of liver puncture and biopsy for these patients. Methods Totally 156 patients clinically diagnosed with mild chronic hepatitis B based on current guideline received liver puncture under the real-time Doppler ultrasonographic guiding. Pathological diagnosis was made after microscopic examinations of the liver tissue specimens stained with hematoxylin-eosin (HE) and reticular fiber staining. The differences between clinical and pathological diagnosis for these patients were analyzed. Results Finally, 105 (67.3%) patients were pathologically diagnosed with mild chroniehepatitis B; 28 (18.0%), 3 (1.9%) and 20 (12.8%) patients were pathologically diagnosed as moderate, severe chronic hepatitis B and cirrhosis, respectively. Forty-eight (30.8%) and 39 (25.0%) patients of non-mild chronic hepatitis B were found to have G3-4 inflammation and S3-4 fibrosis, respectively. Differences in serum alanine aminotransferase, aspartate aminotransferase, total bilirubin or albumin between mild and non-mild chronic hepatitis B based on pathological diagnosis were not statistically significant (t-test, P > 0.05 ). Comclusions Accurate pathological diagnosis is helpful to guiding an antiviral therapy.

Objective To investigate the level of the serum chemokine RANTES and its correlation with serum biochemical indices of liver function test, HBeAg and HBV DNA load in patients with chronic hepatitis B.Methods 144 patients with chronic hepatitis B (observed group) and 18 normal cases (control group) were enrolled in this study. The serum level of chemokine RANTES was detected with an ABC-ELISA assay. Statistical analysis was performed on the software of SPSS13.0. Results The serum chemokine RANTES level in the observed group (3930.12 ng/ml±2856.96) ng/ml was significantly higher than that in the control group (329.46 ng/ml±152.23) ng/ml. The results from the observed group indicated the positive correlation of serum RANTES level with indices of liver function test, including ALT (r=0. 197, P=0.018), AST(r=0.239, P=0.004) and TBil (r=0.316, P=0.001), but did not with PTA (r=-0.078, P=0.357). Neither difference of serum chemokine RANTES level between HBeAg-positive group and HBeAg-negative group nor that between high HBV DNA load group (≥105 copies/ml) and low HBV DNA load group (< 105 copies/ml) were statistically significant (P=0.407 and 0.185, respectively). Conclusions Serum chemokine RANTES level in patients with chronic hepatitis B elevates significantly and is not affected by HBeAg or HBV DNA load. Its positive correlation with indices of liver function test indicates that RANTES might play an important rule in the pathogenesis of chronic hepatitis B.

Objective To analyze different clinical features from patients with chronic hepatitis B between HBeAg negative and positive. Methods 354 patients with chronic hepatitis B (124 cases with HBeAg positive and 230 cases with HBeAg negative) were enrolled into this retrospective investigation. Comparisons were conducted according to their demographic, liver biochemical, virological characters and clinical diagnosis types.chronic hepatitis occupied a lower proportion (P=0.007and 0.014). But fulminant hepatitis had a higher HBeAg positive group,but TBil in HBeAg negative group was higher; AST had no statistical significance between than HBeAg positive group(37.4% vs 55.6%, P=0.1301). Conclusion HBeAg-negative patients compared with HBeAg-positive patients had older age, lower serum HBV DNA level and other characteristics; HBeAg-negative patients maybe had serious disease.