OBJECTIVETo analyse the proportion of hepatitis associated aplastic anemia (HAAA) in severe aplastic anemia (SAA) and its clinical features of HAAA.

METHODSAll newly diagnosed SAA cases in our department in the recent 5 years were analyzed. A case-control study was undertaken to investigate the differences of clinical and laboratory features between HAAA and non-hepatitis associated SAA (non-HASAA) patients.

RESULTSThe proportion of HAAA in SAA was 3.3%. There was no significant difference in PB cell counts, bone marrow hematopoiesis status and the amount of blood transfusion between HAAA and non-HASAA patients. Sera from 13 patients with HAAA were tested for antibodies to hepatitis viruses A, B, and C and hepatitis B surface antigen. Twelve (92.3%) of them had negative serologic results for the tests and only one (7.7%) had a positive result for HBsAg and HBeAg. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were decreased prior to the diagnosis in twelve (92.3%) of the 13 HAAA patients. The percentage of CD4(+) cells in HAAA patients was significantly lower than that in non-HASAA patients (P < 0.05). HAAA patients had higher percentages of CD8(+) cells (P < 0.05) and lower ratios of CD4(+)/CD8(+) (P < 0.05). The early infection rate of the HAAA patients was significantly higher than that of non-HASAA patients (84.6% vs 42.3%, P < 0.05), with different mortalities (61.5% vs 15.4%, P < 0.05). The 2-year survival rate of HAAA patients was significantly lower than that of non-HASAA patients (16.6% vs 83.2%, P < 0.01).

CONCLUSIONThe proportion of HAAA in SAA was 3.3%. Most of HAAA were associated with non-A, non-B and non-C hepatitis virus. Compared with that of non-HASAA, the abnormality of T cell immunity of HAAA was more severe, with a higher frequency of early infection and a higher mortality rate.

Adolescent ; Adult ; Anemia, Aplastic ; blood ; complications ; pathology ; Case-Control Studies ; Female ; Follow-Up Studies ; Hepacivirus ; immunology ; Hepatitis A Antibodies ; blood ; Hepatitis A virus ; immunology ; Hepatitis B Antibodies ; blood ; Hepatitis B virus ; immunology ; Hepatitis C Antibodies ; blood ; Hepatitis, Viral, Human ; blood ; complications ; virology ; Humans ; Male

OBJECTIVETo study the clinical effect under highly active anti-retroviral therapy (HAART) in AIDS patients and for improving the curative effect and prognosis.

METHODSEpidemiological method was used from five aspects to describe the post-treatment clinical symptoms of 181 AIDS patients in Suizhou, and to evaluate the change of virus load and immune function of 79 AIDS patients. Data was doubly recorded by Epi Data and database was set up by SPSS 13.0 for analysis.

RESULTSThe effective powers of anomal-fever, cough, diarrhoea, lymphadenectasis, weight drop, erythra, mycotic infection were 81.39%, 85.00%, 84.62%, 81.89%, 82.86%, 66.07% and 45.45% respectively. CD4+ T lymphocyte count rose obviously after treatment, with an averag of 276 x 10(6) cells/ml (65 x 10(6)-824 x 10(6) cells/ml), an 129 x 10(6) cells/ml increase in three months and was 294 x 10(6) cells/ml (102 x 10(6)-750 x 10(6) cells/ml) in six months. The count change of CD4+ T lymphocyte between 3 months and 6 months did not show sigificant difference. The number of deaths among drug withdrawals was 14, with a case fatality rate as 29.79%; while the number of deaths among non-drug withdrawals was 3, with the case fatality rate as 2.24%.

CONCLUSIONResults through this study showed that HAART could obviously improve the clinical symptom of AIDS patients, and to increase the number of virus load. Improving the compliance could also reduce the case fatality rate.

Acquired Immunodeficiency Syndrome ; drug therapy ; immunology ; pathology ; virology ; Adult ; Antiretroviral Therapy, Highly Active ; methods ; CD4-Positive T-Lymphocytes ; drug effects ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Surveys and Questionnaires ; Treatment Outcome

OBJECTIVETo investigate the clinical characteristics and curative effect in 61 adult patients with acute lymphoblastic leukemia (ALL).

METHODSThe clinical data of 61 patients (≥15 years old) with ALL enrolled from January 2010 to December 2014 were studied retrospectively. The relationship between clinical characteristics and curative effect was analyzed. The univariate and multivariate analyses related with the overall survival (OS) and disease free survival (DFS) were conducted by using the method of COX regression analysis.

RESULTSForty-four patients obtained complete remission (CR) in all 61 cases. The total CR rate was 72.13%. Age of onset, WBC count at first visit, CNS involvement or not, status of myeloid antigen expression and Ph chromosome condition were the important factors affecting the CR rate (P<0.05). The 2 years OS rate of all the 61 cases was 28.13%, the median OS time was 11 months (95% CI 9.58-12.42). The 2 years OS rate and DFS rate of the 44 patients in CR were 39.57% and 34.29% respectively. As showed by univariate analysis, the age of onset, WBC count at first visit, whether achieved CR or not after induction chemotherapy, and whether accepted consolidation therapy or allo-HSCT therapy after CR were factors affecting the prognosis of adult ALL patients. The result of multivariate analysis showed that the older age (P=0.001), induction chemotherapy did not achieve CR (P=0.018) and patients did not received consolidation after CR(P=0.005) , all these were independent risk factors for DFS.

CONCLUSIONThe CR rate after induction chemotherapy is high in adult ALL patients, but the OS rate is low. To achieve CR and to maintain consolidation treatment after CR may be helpful to improve the long-term survival.

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, is a major public health issue. The epidemic is unlikely to be contained until the global launch of safe and effective vaccines that could prevent serious illnesses and provide herd immunity. Although most patients have mild flu-like symptoms, some develop severe illnesses accompanied by multiple organ dysfunction. The identification of pathophysiology and early warning biomarkers of a severe type of COVID-19 contribute to the treatment and prevention of serious complications. Here, we review the pathophysiology, early warning indicators, and effective treatment of Chinese and Western Medicine for patients with a severe type of COVID-19.
COVID-19 ; Humans ; SARS-CoV-2

BACKGROUNDPlasmacytoid dendritic cells (pDCs) and cytokines play an important role in occurrence and recovery of hepatitis B virus (HBV) infection. The aim of this study was to explore the frequency and function of pDC and serum cytokine network profiles in patients with acute or chronic HBV infection.

METHODSThe healthy individuals (HI group), hepatitis B envelope antigen (HBeAg)-positive chronic HBV patients in immune tolerance (IT) phase (IT group), HBeAg-positive chronic HBV patients (CHB group), and acute HBV patients (AHB group) were enrolled in this study. The frequency of cluster of differentiation antigen 86 (CD86) + pDC and the counts of CD86 molecular expressed on surface of pDC were tested by flow cytometer. The quantitative determinations of cytokines, including Fms-like tyrosine kinase 3 ligand (Flt-3L), interferon (IFN)-α2, IFN-γ, interleukin (IL)-17A, IL-6, IL-10, transforming growth factor (TGF)-β1 and TGF-β2, were performed using Luminex multiplex technology.

RESULTSIn this study, there were 13 patients in HI group, 30 in IT group, 50 in CHB group, and 32 in AHB group. Compared with HI group, HBV infected group (including all patients in IT, CHB and AHB groups) had significantly higher counts of CD86 molecular expressed on the surface of pDC (4596.5 ± 896.5 vs. 7097.7 ± 3124.6; P < 0.001). The counts of CD86 molecular expressed on the surface of pDC in CHB group (7739.2 ± 4125.4) was significantly higher than that of IT group (6393.4 ± 1653.6, P = 0.043). Compared with IT group, the profile of cytokines of Flt-3L, IFN-γ, and IL-17A was decreased, IFN-α2 was significantly increased (P = 0.012) in CHB group. The contents of IL-10, TGF-β1, and TGF-β2 in AHB group were significantly increased compared with IT and CHB groups (all P < 0.05).

CONCLUSIONSThis study demonstrated that the function of pDC was unaffected in HBV infection. The enhanced function of pDC and IFN-α2 might involve triggering the immune response from IT to hepatitis active phase in HBV infection. Acute patients mainly presented as down-regulation of the immune response by enhanced IL-10 and TGF-β.

Background: Cytokines play an important role in occurrence and recovery of hepatitis B virus (HBV) infection. The aim of this study was to investigate the changes of cytokines concentration and its correlation to alanine aminotransferase (ALT), HBV deoxyribonucleic acid (HBV-DNA), hepatitis B envelope antigen (HBeAg), and HBV surface antigen (HBsAg) in the development of chronic hepatitis B (CHB). Methods: Thirteen healthy individuals (HI), 30 chronic HBV-infected patients in immune tolerant (IT) phase, and 55 CHB patients were enrolled between August 2015 and May 2017. The peripheral blood samples were collected from all individuals. The levels of interferon (IFN)-α2, interleukin (IL)-10, transforming growth factor (TGF)-β1, HBV-DNA, HBsAg, and HBeAg and liver function were measured. The quantitative determinations of cytokines levels, including IFN-α2, IL-10, and TGF-β1 were performed using Luminex multiplex technology. The correlation of cytokines to ALT, HBV-DNA, HBsAg, and HBeAg was analyzed by linear regression analysis. Results: IFN-α2 levels were similar between HI and IT groups (15.35 [5.70, 67.65] pg/ml vs. 15.24 [4.07, 30.73] pg/ml, Z = -0.610, P = 0.542), while it elevated significantly in CHB group (35.29 [15.94, 70.15] pg/ml vs. 15.24 [4.07, 30.73] pg/ml; Z = -2.522, P = 0.012). Compared with HI group (3.73 [2.98, 11.92] pg/ml), IL-10 concentrations in IT group (5.02 [2.98, 10.11] pg/ml), and CHB group (7.48 [3.10, 18.00] pg/ml) slightly increased (χ = 2.015, P = 0.365), and there was no significant difference between IT and CHB group (Z = -1.419, P = 0.156). The TGF-β1 levels among HI (3.59 ± 0.20 pg/ml), IT (3.62 ± 0.55 pg/ml), and CHB groups (3.64 ± 0.30 pg/ml) were similar (χ = 2.739, P = 0.254). In all chronic HBV-infected patients (including patients in IT and CHB groups), the elevation of IFN-α2 level was significantly associated with ALT level (β= 0.389, t = 2.423, P = 0.018), and was also negatively correlated to HBV-DNA load (β = -0.358, t = -2.308, P = 0.024), HBsAg (β = -0.359, t = -2.288, P = 0.025), and HBeAg contents (β = -0.355, t = -2.258, P = 0.027). However, when both ALT level and cytokines were included as independent variable, HBV-DNA load, HBsAg, and HBeAg contents were only correlated to ALT level (β = -0.459, t = -4.225, P = 0.000; β = -0.616, t = -6.334, P = 0.000; and β = -0.290, t = -2.433, P = 0.018; respectively). Conclusions IFN-α2 elevation was associated with ALT level in patients with chronic HBV infection. However, in CHB patients, only ALT level was correlated to HBV-DNA, HBsAg and HBeAg contents.
Adult ; Alanine Transaminase ; blood ; Antigens, Surface ; Case-Control Studies ; Cytokines ; blood ; DNA, Viral ; Female ; Hepatitis B ; Hepatitis B Surface Antigens ; analysis ; Hepatitis B e Antigens ; Hepatitis B virus ; Hepatitis B, Chronic ; blood ; immunology ; Humans ; Male ; Young Adult