Objective To investigate the pathogenesis of hepatogenic diabetes.Methods The fasting and 2-hour postprandial plasma glucose,fasting sertum insulin,glutamate decarboxylase antibody,insulin release index (IRI)and insulin sensitivity index(ISI)Was determined and analyzed in 135 liver cirrhosis patients.Results The incidence of hepatogenic diabetes wag 39.3%(53/135)in liver cirrhosis patients.The incidence of hepatogenic diabetes in post hepatitis C liver cirrhosis patients(53.3%.16/30)was muchh igher than that in post hepatitis B liver cirrhosis patients(37.1%,26/70)and alcohofic liver cirrhosis patients(31.4%.11/35)(P＜0.01).The fasting serum insulin,IRI and the positivity rate of glutamate decarboxylase antibody was much higher in hepatogenic diabetes than that in controls(P＜0.01),and ISl was much lower than that in controls(P＜0.01).Conclusions The development of hepatogenic diabetics is relsted with the etiological factor of liver cirrhosis.Besides impairment of the hepatocellular function and insulin resistance,viral infection and immunologic derangement and so on results in impairment of beta cell of islet function.Relative or absolute deficiency of insulin secretion is an important influential factor in the development of hepatogenic diabetics.

Objective To explore the pathogenesis of thrombocytopenia in chronic type B hepatitis. Methods The serum thrombopoietin (TPO) levels, bone marrow megakaryocyte (MK) count, platelet-associated immunoglobulin G (PAIgG), splenic index (SPI), prothrombin activity (PTA) were measured in 76 chronic type B hepatitis patients with thrombocytopenia. Results The regression analysis revealed that the platelet count was correlated with parameters including the serum TPO levels, bone MK count, SPI and PTA (r was 0.450, 0.521, -0.438, 0.428 respectively, P<0.05). The regression equation was Pt=36.38+0.23 TPO-0.57 SPI+0.69 MK, R<'2>=0.57, F=18.78, P<0.01. Conclusion It suggests that decline of thrombopoiedn, myelosuppression and hypersplenism may contribute to thrombocytopenia in chronic type B hepatitis patients.

ObjectiveTo verify the efficacy and safety of conversion from cyclosporine (CsA) to tacrolimus (Tac) in renal transplant recipients. MethodsThe clinical data of conversion from CsA to Tac in renal transplant recipients were retrospectively analyzed. In 97 patients undergoing kidney transplantation, there were 62 cases of chronic allograft nephropathy (CAN), 21 cases of refractory renal allograft rejection, 8 cases of hepatic impairment, and 6 cases of gingival overgrowth and hirsutism. The patients were followed up with renal function, hepatic function, blood fat, pressure,glucose,acute rejection incidence, patients/kidney survival rate,and adverse drug reaction for 3 years.ResultsThe renal function of patients with CAN and refractory acute rejection was greatly improved after conversion from CsA to Tac treatment at the first year (P＜0. 05) ,and steady at the 2nd or 3rd year. The conversion treatment could greatly improve the hepatic function of patients with dysfunction of liver, improve the gum hypertrophy and hypertrichosis results from CsA. The 1- and 3-year patients/kidney survival rate after conversion from CsA to Tac was 100 ％/97. 9 ％ and 100 ％/92. 8 ％, respectively. The conversion treatment showed a significantly lower degree of plasma cholesterol, low density lipoprotein, triglyceride, and blood pressure (P ＜ 0.05). Incidence of pathoglycemia, diarrhea or anepithymia,and tremor after conversion treatment was 13.4 ％ (13/97),2. 1％ (2/97) and 5. 2 ％ (5/97),respectively. There were no serious pulmonary infection and tumor during the observation period. ConclusionThe mid-long term effect of conversion from CsA to Tac in patients with kidney transplantation is safe and effective.

OBJECTIVETo investigate the efficacy of anti-hepatitis B virus (HBV) drugs for preventing vertical transmission of HBV and the safety of these drugs when given as treatment during pregnancy (to women) or insemination (to men).

METHODSCases of women and men who had taken anti-HBV drug therapy during pregnancy or insemination, respectively, were retrospectively selected for study from among 18 hospitals and 33 specialists in the Guangdong Province. Demographic, HBV infection and treatment data was collected for puerperal men or women and their newborns from the medical records.

RESULTSA total of 122 cases with detailed follow-up data were included in the study and including 74 women who were administered lamivudine (LAM) more than telbivudine (LdT) more than adefovir (ADV)more than entecavir (ETV) (hierarchy ranking by number of cases) and 48 men who were administered LAM more than ADV more than LdT more than ETV.None of the 122 newborns related to these cases showed HBV infection at 7 months of follow-up.None of the 74 puerperal women showed complications related to reproduction.There was one ease of a newborn being underweight at birth (2.1 kg), for which the mother had taken LdT during pregnancy. There was also one case of a newborn with a harelip and one case of a newborn with an inguinal hernia, for which both of the fathers had taken ADV during the time of insemination.

CONCLUSIONThis retrospective investigation carried out in Guangdong Province indicated that not only are anti-HBV drugs efficacious for blocking vertical transmission of HBV but also are safe for both mothers and infants when taken by fathers or mothers during the reproduction phases of insemination and pregnancy.

Adenine ; analogs & derivatives ; Antiviral Agents ; adverse effects ; therapeutic use ; Female ; Guanine ; analogs & derivatives ; Hepatitis B ; drug therapy ; Hepatitis B virus ; Humans ; Infant ; Infant, Newborn ; Infectious Disease Transmission, Vertical ; Lamivudine ; Male ; Mothers ; Organophosphonates ; Pregnancy ; Retrospective Studies ; Thymidine ; analogs & derivatives ; Time Factors