<b>OBJECTIVEb>To assess changes of liver function in HIV-positive children with/without HBV/ HCV co-infection after 1 year of highly active antiretroviral therapy (HARRT).

<b>METHODSb>Seventy-eight pediatric AIDS patients with HBV/HCV co-infection,19 pediatric AIDS patients with HBV co-infection and 44 pediatric AIDS patients without HBV/HCV co-infection who received HAART at least for 1 year were enrolled. HIV-1 viral load was quantitatively detected using a standardized reverse transcriptase-polymerase chain reaction assay, and blood cells were determined by three-color flow cytometry. Anti-HCV antibody and HBsAg was detected using an enzyme-linked immunosorbent technique, and ALT, AST and TBIL were detected by automatic biochemical analyzer.

<b>RESULTSb>After 1 year-HAART, the viral load was decreased to the lowest limit of detection in 90.34% patients (t=2.61, P<0.01), and CD4+ T cell counts were increased from 170.187±132.405/ μl to 796.014±158.491/ μl (t=3.17, P<0.01). The levels of ALT and AST were elevated (t=2.02, P<0.05), while the ALT and AST levels in patients receiving nevirapine (NVP) based HAART increased from 18.28±13.74 U/L and 24.23±8.09 U/L to 55.35±22.40 U/L and 69.97±26.72 U/L, respectively(t=3.80,t=4.11;Ps<0.01). The increment of ALT and AST in NVP based HAART were significantly higher than that in the efavirenz based HAART (ALT:46.28±13.35 U/L vs 37.70±15.25 U/L and AST:19.53±7.23 U/L vs 1.25±0.21 U/L, respectively; t=4.53, t=5.79; Ps<0.01), particularly in patients co-infected with HIV/HBV/HCV (ALT:54.32±22.85 U/L vs 16.89±14.42 U/L and AST:41.71±19.26 U/L vs -3.44±15.59 U/L, respectively; t=3.42, t=2.98, Ps<0.01).

<b>CONCLUSIONb>HARRT can repress HIV-1 replication effectively, but it also cause the damage of liver function, especially in patients with HBV and/or HCV co-infection.

Antiretroviral Therapy, Highly Active ; Child ; Coinfection ; drug therapy ; Female ; HIV Infections ; complications ; drug therapy ; physiopathology ; Hepatitis B ; complications ; Hepatitis C ; complications ; Humans ; Liver ; physiopathology ; Male

Chronic liver disease represents a major public health problem, accounting for significant morbidity and mortality worldwide. As prognosis and management depend mainly on the amount and progression of liver fibrosis, accurate quantification of liver fibrosis is essential for therapeutic decision-making and follow-up of chronic liver diseases. Even though liver biopsy is the gold standard for evaluation of liver fibrosis, non-invasive methods that could substitute for invasive procedures have been investigated during past decades. Transient elastography (TE, FibroScan(R)) is a novel non-invasive method for assessment of liver fibrosis with chronic liver disease. TE can be performed in the outpatient clinic with immediate results and excellent reproducibility. Its diagnostic accuracy for assessment of liver fibrosis has been demonstrated in patients with chronic viral hepatitis; as a result, unnecessary liver biopsy could be avoided in some patients. Moreover, due to its excellent patient acceptance, TE could be used for monitoring disease progression or predicting development of liver-related complications. This review aims at discussing the usefulness of TE in clinical practice.
Antiviral Agents/therapeutic use ; Carcinoma, Hepatocellular/epidemiology/physiopathology ; Chronic Disease ; *Elasticity Imaging Techniques ; Hepatitis B/drug therapy/physiopathology ; Hepatitis C/drug therapy/physiopathology ; Humans ; Liver Cirrhosis/*diagnosis/ultrasonography ; Liver Neoplasms/epidemiology/physiopathology ; Recurrence

<b>OBJECTIVEb>To investigate the apoptosis regulation on hepatoma cells by HBx between genotype B and C.

<b>METHODSb>Genotype B and C HBx gene fragments were amplified and inserted into green fluorescent protein (GFP) eukaryotic expression vector pEGFP-C1 to construct recombinant pGFP-XB and pGFP-XC. The pEGFP-C1, pGFP-XB and pGFP-XC were introduced into Bel-7402 cells by Fugene HD to obtain Bel-7402 cells expressing GFP. The transcription and expression of HBx gene were demonstrated by RT-PCR and Western Blot analysis. Bel-7402, Bel-7402/GFP, Bel-7402/GFP-XB, Bel-7402/GFP-XC cells were treated with adriamycin (2.5 microg/ml), and the apoptosis of the cells was determined by trypan blue exclusion, and flow cytometry analysis.

<b>RESULTSb>RT-PCR and Western Blot analysis showed that HBx genes of genotypes B and C were transcribed and expressed in Bel-7402/GFP-XB, Bel-7402/GFP-XC cells. Trypan blue exclusion showed adriamycin induced time-dependent cell death in Bel-7402, Bel-7402/GFP cells while no significant cell death was observed in Bel-7402/GFP-XB, Bel-7402/GFP-XC cells. Flow cytometry analysis indicated that no significant differences of apoptosis rates of Bel-7402/GFP-XB (3.87%) and of Bel7402/GFP-XC (4.01%) were observed (P > 0.05), moreover, no significant differences of Bel-7402/ GFP-XB (3.87%), Be17402/GFP-XC (4.01%) and of the untreated cells. Apoptosis rates in Bel-7402/GFP-XB (3.87%), Bel-7402/GFP-XC (4.01%) cells were significantly lower than those in Bel-7402 (27.05%) and Bel-7402/GFP (29.14%) cells at 48 hours after the adriamycin treatment (P < 0.01).

<b>CONCLUSIONSb>Bel-7402 cell lines expressing GFP, GFP-XB and GFP-XC fusion proteins were successfully established. HBV X protein blocks adriamycin-induced apoptosis of Bel-7402 cells. There is no difference between HBx of genotype B and C in inhibiting apoptosis induced by adriamycin.

Antiviral Agents ; pharmacology ; Apoptosis ; drug effects ; Cell Line ; Cell Line, Tumor ; Doxorubicin ; pharmacology ; Hepatitis B ; drug therapy ; physiopathology ; virology ; Hepatitis B virus ; classification ; drug effects ; genetics ; metabolism ; Humans ; Trans-Activators ; genetics ; metabolism

<b>OBJECTIVEb>To observe the influence of Fuzheng Huayu Tablet on mental state and social activity of patients with post-hepatitis B liver cirrhosis (LC-HB).

<b>METHODSb>Adopting grouped randomized double-blinded control method, 180 LC-HB patients in 3 research centers were distributed to 2 groups, the treated group and the control group, 90 in each group. Patients in the treated group were administered with FZHYT; while those in the control group treated with conventional therapy combined with placebo, the course for all patients were 6 months. Their mental state and social activity were evaluated before treatment, after 3 months' treatment and at terminal of the 6-month therapeutic course by estimating with Zung self-rating anxiety scale (SAS), self-rating depression scale (SDS) and social deficit screening scale (SDSS). Additionally, the basic demographic materials, liver function, cirrhosis index, hepatic and splenic images, blood coagulation function, etc. in the patients were tested and compared as well.

<b>RESULTSb>As compared with before treatment, the normal rate of SAS and SDS scores increased and the social deficit rate decreased in the treated group significantly after treatment, showing statistical significance (P<0.05 or P<0.01); while in the control group, change was only shown in the social deficit (P<0.01), inter-group comparisons after treatment showed significant differences in all the three indexes (P<0.05 or P<0.01). Additionally, after treatment, levels of liver function, cirrhosis, blood coagulation function and splenomegaly in the treated group were all improved significantly P<0.05 or P<0.01), and the improvements were better than those in the control group (P<0.01) in levels of total bilirubin (TBIL), albumin (ALB), type IV collagen (IV-C), prothrombin time (PT), prothrombin activity (PTA).

<b>CONCLUSIONb>Most patients of LC-HB have mental disturbance and social activity deficit, which could definitely be improved by intervention with Chinese FZHYT.

Blood Coagulation ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Hepatitis B ; complications ; drug therapy ; physiopathology ; Humans ; Liver Cirrhosis ; drug therapy ; etiology ; physiopathology ; psychology ; Liver Function Tests ; Patient Dropouts ; Social Behavior ; Tablets

<b>OBJECTIVEb>To assess the effect of Danqi Huogan Capsule in protecting the liver, promoting the circulation and removing blood clots in patients with chronic hepatitis B (CHB).

<b>METHODSb>A total of 104 CHB patients were randomized into two groups. Routine therapies for liver protection were given in the control group (n=50), and Danqi Huogan Capsule was administered in the therapeutic group (n=54) in addition to the routine therapies. The changes in the clinical symptoms, physical signs, liver functions, and hemorrheology were observed after the 3-month therapies.

<b>RESULTSb>Danqi Huogan Capsule treatment obvious improved the clinical symptoms, physical signs and liver functions of the patients (P<0.01), and significantly decreased the hematocrit, low-shear blood viscosity, plasma viscosity and index of red blood cell aggregation (P<0.05).

<b>CONCLUSIONb>Danqi Huogan Capsule is effective in protecting the liver, improving hemorrheology, promoting the blood circulation and removing clots in patients with chronic hepatitis B.

Adolescent ; Adult ; Aged ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Hemorheology ; Hepatitis B, Chronic ; blood ; drug therapy ; physiopathology ; Humans ; Liver Function Tests ; Male ; Middle Aged ; Phytotherapy ; Young Adult

<b>OBJECTIVEb>To assess the clinical efficacy of Xiaozhang Recipe (XR) in treatment of chronic viral hepatitis B patients with compensated liver cirrhosis.

<b>METHODSb>Based on the anti-viral effects of lamivudine, 84 chronic viral hepatitis B patients with compensated liver cirrhosis were randomly assigned to the treatment group and the control group. Patients in the treatment group were treated with XR (consisting of heterophylla falsestarwort root, large head atractylodes rhizome, tangerine peel, green tangerine peel, water-plantain tuber, bugleweed herb, turtle shell, oyster shell, chicken's gizzard-skin endothelium, areca peel, decocted, one dose daily, twice daily). Patients in the control group took Fuzheng Huayu Capsule (consisting of red sage root, walnut seed, gynostemma pentaphyllum, aweto, magnoliavine fruit; five pills each time, three times daily, 30 min before meals). The therapeutic course for all was 12 months. The changes of the Chinese medicine symptom scores, chronic liver disease questionnaire (CLDQ), the liver function, hepatitis B virus deoxyribonucleic acid (HBV DNA) were compared between before and after treatment in the two groups. Meanwhile, B ultrasound was performed on all patients. Changes of the inner diameter of the portal vein and the splenic vein, the length and the thickness of the spleen were recorded.

<b>RESULTSb>After treatment the Chinese medicine symptom scores and CLDQ obviously decreased in the two groups (P<0.01). Besides, the score in the treatment group decreased more obviously than that in the control group (P<0.05, P<0.01). The Child-Pugh scores obviously decreased in the two groups (P<0.01). However, the comparison between the two groups did not show any statistical significance (P>0.05). The liver function of of the two groups were improved when compared with before treatment (P<0.01), and the treatment group was superior to the control group (P<0.01). The B ultrasound results showed MPV, SPV, the length and the thickness of the spleen obviously decreased in the treatment group (P< 0.01). Only the thickness of the spleen obviously decreased in the control group (P<0.01). The HBV DNA obviously decreased in the two groups (P<0.01), more obviously shown in the treatment group (P<0.01).

<b>CONCLUSIONSb>XR in combination of lamivudine could improve the liver function of chronic viral hepatitis B patients with compensated liver cirrhosis and HBV DNA, lower their Chinese medicine symptom scores and CLDQ scores, improve their Child-Pugh classification to some extent. It showed favorable effects.

Adolescent ; Adult ; Aged ; Antiviral Agents ; therapeutic use ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Hepatitis B, Chronic ; drug therapy ; Humans ; Integrative Medicine ; Lamivudine ; therapeutic use ; Liver Cirrhosis ; drug therapy ; physiopathology ; Male ; Middle Aged ; Phytotherapy ; Prospective Studies ; Young Adult

We described two patients who were successfully resuscitated from out-of-hospital cardiac arrest. Their ECGs showed ST elevations in V1 and aVR, as well as diffuse ST depression. Their ST elevation in V1 was noted to be greater than in aVR. While one patient was found to have an occlusion of the right ventricular (RV) branch of the right coronary artery, the other was found to have an occlusion of a proximal non-dominant right coronary artery supplying the RV branch. Successful primary percutaneous coronary intervention was performed for each patient with angioplasty and implantation of a drug-eluting stent. Both patients made good physical and neurological recovery.
Adult ; Angioplasty ; Angioplasty, Balloon, Coronary ; Cardiopulmonary Resuscitation ; Coronary Vessels ; physiopathology ; Defibrillators ; Drug-Eluting Stents ; Electrocardiography ; Heart Ventricles ; physiopathology ; Hepatitis B ; complications ; Humans ; Male ; Myocardial Infarction ; diagnosis ; physiopathology ; Out-of-Hospital Cardiac Arrest ; therapy ; Percutaneous Coronary Intervention ; Resuscitation ; Singapore

<b>OBJECTIVEb>To evaluate the clinical efficacy and safety of Yinchen Zhufu Decoction (, YCZFD) in the treatment of acute-on-chronic liver failure caused by hepatitis B virus (HBV-ACLF) with cold pattern in Chinese medicine (CM).

<b>METHODSb>This is a multi-center randomized controlled trial of integrative treatment of CM and Western medicine (WM) for the management of HBV-ACLF patients. A total of 200 HBV-ACLF patients with cold pattern were equally randomly assigned to receive YCZFD and WM (integrative treatment) or WM conventional therapy alone respectively for 4 weeks. The primary end point was the mortality for HBV-ACLF patients. Secondary outcome measures included Model for End-Stage Liver disease (MELD) score, liver biochemical function, coagulation function and complications. Adverse events during treatment were reported.

<b>RESULTSb>The mortality was decreased 14.28% in the integrative treatment group compared with WM group (χ(2) =6.156, P=0.013). The integrative treatment was found to signifificantly improve the MELD score (t=2.353, P=0.020). There were statistically signifificant differences in aspartate transaminase, total bilirubin, indirect bilirubin, direct bilirubin and prothrombin time between the two groups (P<0.05 or P<0.01). The complications of ascites (χ(2)=9.033, P=0.003) and spontaneous bacteria peritonitis (χ(2)=4.194, P=0.041) were improved signifificantly in the integrative treatment group. No serious adverse event was reported.

<b>CONCLUSIONSb>The integrative treatment of CM and WM was effective and safe for HBV-ACLF patients with cold pattern in CM. The Chinese therapeutic principle "treating cold pattern with hot herbs" remains valuable to the clinical therapy. (Trial registration No. ChiCTR-TRC-10000766).

Acute-On-Chronic Liver Failure ; complications ; drug therapy ; mortality ; virology ; Adult ; Ascites ; complications ; Demography ; Drugs, Chinese Herbal ; adverse effects ; pharmacology ; therapeutic use ; Electrolytes ; Female ; Hepatitis B ; complications ; drug therapy ; mortality ; physiopathology ; Hepatitis B virus ; physiology ; Humans ; Integrative Medicine ; Liver ; drug effects ; pathology ; physiopathology ; virology ; Liver Function Tests ; Male ; Peritonitis ; complications ; Time Factors ; Treatment Outcome

<b>OBJECTIVEb>To investigate the relationship between the genetic polymorphisms of CYP3A5 and the clinical effectiveness of Bicyclol on patients with chronic hepatitis B to make individual medication possible.

<b>METHODSb>34 cases of chronic hepatitis B were treated by bicyclol tablets for 24 weeks. Liver function indexes (ALT and AST) were determined before and after treatment. Blood CYP3A5 genotyping of each patient was determined by the PCR-RFLP analysis.

<b>RESULTSb>All subjects were genotyped for the CYP3A5*3 gene and divided into different group. The groups comprised subjects with CYP3A5*3 carriers (n=18) and CYP3A5*1 carriers (n=16) which include CYP3A5*1/*1 (n=2) and CYP3A5*1/*3 (n=14). Compared with pre-treatment, the serum ALT and AST levels were decreased obviously in all patients. The mean percentage reduction of serum ALT and AST levels were significantly greater in subjects with CYP3A5*3 carriers (79.73% and 74.76%) than in those with CYP3A5*1 carriers (65.90% and 49.63%; P < 0.05) The recovery rates of ALT and AST were significantly highter in CYP3A5*3 carriers than those in CYP3A5*1 carriers (P < 0.05).

<b>CONCLUSIONb>CYP3A5 genotype has an impact on the therapeutic effects of Bicyclol. The subjects with CYP3A5*3 carriers is more effective than the subjects with CYP3A5*1 carriers. CYP3A5 genotyping may be helpful in predicting therapeutic effects of Bicyclol especially in the terms of decreasing ALT and AST.

Adolescent ; Adult ; Alanine Transaminase ; blood ; Biphenyl Compounds ; pharmacology ; therapeutic use ; Cytochrome P-450 CYP3A ; genetics ; Female ; Genotype ; Hepatitis B, Chronic ; blood ; drug therapy ; genetics ; physiopathology ; Humans ; Liver ; drug effects ; enzymology ; physiopathology ; Male ; Middle Aged ; Polymorphism, Genetic

<b>OBJECTIVEb>To investigate the treatment effect of autologous HBsAg-loaded dendritic cells (DCs) on patients with chronic hepatitis B (CHB).

<b>METHODSb>Monocytes were isolated from fresh peripheral blood of 19 CHB patients by Ficoll-Hypaque density gradient centrifugating and cultured with plastic -adherence method. DCs were induced and proliferated from the monocytes with granulocyte-macrophage clony stimulating factor (GM-CSF) and interleukin-4 (IL-4) for seven days. After being incubated with HBsAg for two hours, DCs were injected to patients subcutaneously twice at the interval of two weeks. HBV DNA level, alanine aminotransferase (ALT) level, and HBV markers in the serum of patients were tested every two months.

<b>RESULTSb>11 of the 19 (57.9%) patients responded to DC-treatment clinically. The rates of HBeAg clearance and HBeAg/anti-HBe seroconversion were 52.6% (10/19) and 26.3% (5/19) respectively, and the copies of HBV DNA decreased by 10(1.77 2.39) (t = 3.13, P < 0.01). Two patients who were treated in combination with lamivudine had complete clinical response. There was no difference in the trial effect between the DC treatment and the other two antiviral methods, and in the efficient rate between the patients whose ALT levels were high before treatment and those whose ALT levels were normal.

<b>CONCLUSIONb>The autologous HBsAg-loaded DCs can effectively suppress HBV replication, reduce virus load in serum, eliminate HBeAg and promote HBeAg/ anti-HBe seroconversion. The patients whose ALT levels are high or normal can response clinically to DCs treatment. DCs in combination with lamivudine can eliminate virus more effectively.

Adjuvants, Immunologic ; administration & dosage ; therapeutic use ; Adolescent ; Adult ; Antiviral Agents ; therapeutic use ; Cells, Cultured ; Dendritic Cells ; cytology ; immunology ; virology ; Female ; Granulocyte-Macrophage Colony-Stimulating Factor ; pharmacology ; Hepatitis B Surface Antigens ; immunology ; Hepatitis B Vaccines ; biosynthesis ; therapeutic use ; Hepatitis B, Chronic ; drug therapy ; physiopathology ; Humans ; Interleukin-4 ; pharmacology ; Lamivudine ; therapeutic use ; Male ; Middle Aged ; Virus Replication ; drug effects