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 analyse the pathogeny of pregnancy with virus hepatitis,the change of index of hepatic function and the clinical pathogenetic characteristic,and to explore the relationship between pregnancy and hepatitis.Methods The clinical datas of 96 pregnant patients with virus hepatitis were retrospectively analyzed,and compared with non-pregnancy during the reprodective age in the corresponding period.The pathogeny,index of hepatic function and clinical pathogenetic characteristic were compared.Results Virus hepatitis in the pregnancy were mostly type B hepatits,the morbility of hepatitis increased gradually along with the progress of pregnant weeks,the prothrombin time(PT) significantly prolonged in pregnancy with virus hepatitis,and the albumin decreased significantly,the complications of hepatocerebral disease and hepatorenal syndrome were more than non-pregnancy with virus hepatits,the incidence rate of serious hepatiti was higher than non-pregnancy with virus hepatitis(P

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 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.

]. Conclusions The monoclonal-based ECLIA is a sensitive, specific, and rapid method and no radiocontamination. It can be used to detect hanum serum proinsulin in type 2 diabetes.

Objective:To investigate the effect of infliximab (IFX) on neurological function in mice after traumatic brain injury (TBI) and the role of nuclear factor-κB (NF-κB)/inducible nitric oxide lyase (iNOS) signaling in it.Methods:Seventy-two healthy adult male C57BL/6 mice were randomly divided into sham-operated group, TBI group, and TBI+IFX group ( n=24). The mouse TBI models were established by controlled cortical impact method. IFX (dissolved in normal saline at a concentration of 2.5 mg/mL and a dose of 10 μg/g) was administered intraperitoneally into the mice of TBI+IFX group 30 min after modeling once daily for 3 d; mice in the sham-operated group and TBI group were given the same amount of saline intraperitoneally at the same time points for 3 d. Neurological deficits (Garcia scores) were assessed one, 3 and 7 d after modeling; blood-brain barrier permeability was detected by Evans blue staining, and brain tissue water content was measured by dry and wet weight method; Nissl staining was used to detect the percentage of injured neurons in brain tissues; the percentage of apoptotic neurons was detected by Tunel staining; immunofluorescent double-labeling was used to detect the expressions of caspase-3 and neuronal nuclear antigen (NeuN) in neurons; immunohistochemical staining was used to detect the microglia marker ionized calcium binding adaptor molecule-1 (IBa-1) expression; ELISA was used to detect the expressions of inflammatory factors (tumor necrosis factor [TNF]-α, interleukin [IL]-1β, IL-6, interferon [IFN]-γ) and free radicals (oxygen free radicals [ROS], nitrogen free radicals [RNS]) in the brain tissues; and immunofluorescent staining and Western blotting were used to detect the expressions of nuclear factor (NF)-κB/inducible nitric oxide synthase (iNOS). Results:(1) One, 3 and 7 d after modeling, the Garcia scores showed significant differences among the three groups ( P<0.05); as compared with the TBI group, the TBI+IFX group had significantly increased Garcia scores 3 and 7 d after modeling ( P<0.05). (2) Three d after modeling, as compared with those in the TBI group, Evans blue leakage ([18.45±1.32] μg/g vs. [16.38±1.25] μg/g), brain water content ([81.56±0.96]% vs. [79.97±0.79]%), percentage of injured neurons ([79.50±5.85]% vs. [68.81±7.47]%), and percentage of apoptotic neurons ([41.93±7.49]% vs. [30.59±8.60]%) in mice of the TBI+IFX group were significantly deceased ( P<0.05). Three d after modeling, immunofluorescent double labeling showed that the relative caspase-3 expression in the TBI+IFX group (0.76±0.16) was significantly decreased as compared with the TBI group (1.11±0.23, P<0.05). Immunohistochemical staining and ELISA results showed that as compared with those in the TBI group, the Iba-1 staining scores, TNF-α, IL-1β, IL6 and IFN-γ levels, and ROS and RNS contents in TBI+IFX group were significantly decreased ( P<0.05). Immunofluorescent staining and Western blotting showed that as compared with the TBI group, the TBI+IFX group had significantly decreased expressions of NF-κB p65, iNOS and phosphorylated nuclear factor-κB inhibitor-α, and statistically inhibited nuclear translocation of NF-κB ( P<0.05). Conclusion:IFX can reduce inflammatory response and oxidative stress response, and play a neuroprotective role, which is related to its inhibition of downstream NF-κB/iNOS pathway activation.

Objective:To explore the clinical characteristics and establish a corresponding prognostic scoring model in patients with early-stage clinical features of hepatitis B-induced acute-on-chronic liver failure (HBV-ACLF).Methods:Clinical characteristics of 725 cases with hepatitis B-related acute-on-chronic hepatic dysfunction (HBV-ACHD) were retrospectively analyzed using Chinese group on the study of severe hepatitis B (COSSH). The independent risk factors associated with 90-day prognosis to establish a prognostic scoring model was analyzed by multivariate Cox regression, and was validated by 500 internal and 390 external HBV-ACHD patients.Results:Among 725 cases with HBV-ACHD, 76.8% were male, 96.8% had cirrhosis base,66.5% had complications of ascites, 4.1% had coagulation failure in respect to organ failure, and 9.2% had 90-day mortality rate. Multivariate Cox regression analysis showed that TBil, WBC and ALP were the best predictors of 90-day mortality rate in HBV-ACHD patients. The established scoring model was COSS-HACHADs = 0.75 × ln(WBC) + 0.57 × ln(TBil)-0.94 × ln(ALP) +10. The area under the receiver operating characteristic curve (AUROC) of subjects was significantly higher than MELD, MELD-Na, CTP and CLIF-C ADs( P < 0.05). An analysis of 500 and 390 cases of internal random selection group and external group had similar verified results. Conclusion:HBV-ACHD patients are a group of people with decompensated cirrhosis combined with small number of organ failure, and the 90-day mortality rate is 9.2%. COSSH-ACHDs have a higher predictive effect on HBV-ACHD patients' 90-day prognosis, and thus provide evidence-based medicine for early clinical diagnosis and treatment.