ObjectiveTo further explore the occurrence of occult hepatitis B virus (HBV)infection m patients with hepatitis B e antibody (anti-Hbe) positive alone and analyze the possible reasons of occult infection.MethodsSera of 61 patients carrying anti Hbe alone (absorbance≤0.1) were collected and real time polymerase chain reaction (PCR) was used to detect HBV DNA level.HBV markers were detected again by Abbott reagent,preS/S amplification products were obtained by PCR,and clonal sequencings were done in HBV DNA positive samples.ResultsTwo samples were HBV DNA positive in 61 samples with anti-Hbe positive alone,with the hepatitis B surface antigen (HBsAg) miss rate of 3.3％.Sequencing disclosed preS deletion mutations,preS2 initiatior codon mutations and co-existence of the different mutant types in one sample with anti-Hbe positive alone by repeated Abbott detection.No preS/S mutations were found in the other sample with HBsAg and hepatitis B core antibody (anti-HBc) weakly positive by repeated Abbott detection except for anti Hbe strongly positive. Conclusions Occult HBV infection and HBsAg serological test failure exist in patients with anti-Hbe positive alone.The failure of HBsAg detection may be due to preS/S gene mutations as well as low level of circulating HBsAg.

AIM: To explore the serum levels of visfatin (VF) and tumor necrosis factor-alpha (TNF-α) in the patients with pre-eclampsia (PE) and their correlation with insulin resistance (IR).METHODS: The severe PE pa-tients (n =30), mild PE patients (n =30) and normal pregnant women (n =40) were selected according to the classifica-tion standard of PE.The serum levels of VF and TNF-αwere measured by ELISA.Fasting plasma glucose (FPG) and fasting insulin (FIns) were detected by glucose oxidase method and radioimmunoassay, respectively.Triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol ( HDL-C) and low-density lipoprotein cholesterol ( LDL-C) were measured by an automatic biochemical analyzer.According to calculating the mean arterial pressure (MAP), body mass index (BMI) and homeostatic model assessment for insulin resistance index (HOMA-IR), the correlation between IR and the levels of serum VF as well as TNF-αwere analyzed.RESULTS: The levels of VF and TNF-αin severe PE group and mild PE group were significantly lower than those in normal pregnancy group (P <0.05).In addition, the levels of VF and TNF-αin severe PE group were lower than those in mild PE group (P <0.05).Linear correlation analysis showed that serum VF was positively correlated with TNF-αand HDL-C (P <0.05), and negatively with MAP and FIns (P <0.05). The serum TNF-αwas positively correlated with HDL-C (P <0.05), and negatively with BMI, TG, MAP and FIns (P <0.05).Multiple stepwise regression analysis showed that FBG, FIns and HOMA-IR were relative independent factors of se-
rum VF and TNF-α(P <0.05).CONCLUSION: Serum levels of VF and TNF-αare closely related to IR.