OBJECTIVETo study the relationship between genotype of HBV DNA and Chinese medicine (CM) syndrome pattern in patients with chronic hepatitis B (CHB).

METHODSWith an open parallel-controlled method adopted, CM syndrome types of 117 CHB patients were differentiated and their genotypes of HBV DNA in peripheral blood were determined to observe the relationship with syndrome pattern and diagnostic degree of hepatitis.

RESULTS(1) The HBV DNA genotype distribution in CHB patients was: type B in 17.51% (31 cases) of the 117 patients, type C in 131 (74.01%), type B/C in 11 (6.21%) and type D in 1 (0.56%), while the genotype in 3 cases was unable be determined. The proportion of patients with HBV DNA of type C was obviously higher than that with other types (P < 0.01). (2) Distribution of CM syndrome pattern was: 98 patients (55.37%) were differentiated as Gan-stagnation Pi-deficiency pattern (I), 6 (3.39%) as Gan-Shen yin-deficiency pattern (II), 2 (1.13%) as Pi-Shen yang-deficiency pattern (III), 12 (6.78%) as damp-heat blocking pattern (IV) and 59 (33.33%) as blood-stasis obstruction pattern (V). Sixteen out of the 32 severe CHB patients were differentiated as pattern V, accounting for 50.00%, but showed no statistical difference in comparing with that in patients of other patterns. However, the HBeAg negative rates in patients of pattern V was 62.71% (37/59), significantly higher than that in patients of other patterns (P = 0.00), suggesting that the inflammatory injury of liver was rather severer, and the virus were eliminated partially in the inflammatory reaction. (3) 42.37% (25/59) in patients of pattern V had family history of CHB, the percentage was significantly higher than that in patients of pattern I (P < 0.05).

CONCLUSIONSHCV DNA of type C is predominant in CHB patients in China. Liver injury in CHB patients of CM syndrome pattern V is severer than that in patients of other patterns. HBV genotype shows no obvious correlativity with CM syndrome pattern of patients, but the cases with family CHB infection history of pattern V take a higher proportion.

Adolescent ; Adult ; Aged ; DNA, Viral ; genetics ; Diagnosis, Differential ; Female ; Genotype ; Hepatitis B virus ; genetics ; Hepatitis B, Chronic ; virology ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Young Adult

Background and Objectives: Prior studies have shown that stroke patients treated with percutaneous left atrial appendage occlusion (LAAO) for non-valvular atrial fibrillation (NVAF) experience better outcomes than similar patients treated with warfarin. We investigated the impact of percutaneous left atrial appendage closure on post-stroke neurological outcomes in NVAF patients, compared with non-vitamin K antagonist oral anticoagulant (NOAC) therapy. Methods: Medical records for 1,427 patients in multiple registries and for 1,792 consecutive patients at 6 Korean hospitals were reviewed with respect to LAAO or NOAC treatment.Stroke severity in patients who experienced ischemic stroke or transient ischemic attack after either treatment was assessed with modified Rankin Scale (mRS) scoring at hospital discharge and at 3 and 12 months post-stroke. Results: mRS scores were significantly lower in LAAO patients at 3 (p<0.01) and 12 months (p<0.01) post-stroke, despite no significant differences in scores before the ischemic cerebrovascular event (p=0.22). The occurrences of disabling ischemic stroke in the LAAO and NOAC groups were 36.7% and 44.2% at discharge (p=0.47), 23.3% and 44.2% at 3 months post-stroke (p=0.04), and 13.3% and 43.0% at 12 months post-stroke (p=0.01), respectively.Recovery rates for disabling ischemic stroke at discharge to 12 months post-stroke were significantly higher for LAAO patients (50.0%) than for NOAC patients (5.6%) (p<0.01). Conclusions Percutaneous LAAO was associated with more favorable neurological outcomes after ischemic cerebrovascular event than NOAC treatment.

Background and Objectives: Prior studies have shown that stroke patients treated with percutaneous left atrial appendage occlusion (LAAO) for non-valvular atrial fibrillation (NVAF) experience better outcomes than similar patients treated with warfarin. We investigated the impact of percutaneous left atrial appendage closure on post-stroke neurological outcomes in NVAF patients, compared with non-vitamin K antagonist oral anticoagulant (NOAC) therapy. Methods: Medical records for 1,427 patients in multiple registries and for 1,792 consecutive patients at 6 Korean hospitals were reviewed with respect to LAAO or NOAC treatment.Stroke severity in patients who experienced ischemic stroke or transient ischemic attack after either treatment was assessed with modified Rankin Scale (mRS) scoring at hospital discharge and at 3 and 12 months post-stroke. Results: mRS scores were significantly lower in LAAO patients at 3 (p<0.01) and 12 months (p<0.01) post-stroke, despite no significant differences in scores before the ischemic cerebrovascular event (p=0.22). The occurrences of disabling ischemic stroke in the LAAO and NOAC groups were 36.7% and 44.2% at discharge (p=0.47), 23.3% and 44.2% at 3 months post-stroke (p=0.04), and 13.3% and 43.0% at 12 months post-stroke (p=0.01), respectively.Recovery rates for disabling ischemic stroke at discharge to 12 months post-stroke were significantly higher for LAAO patients (50.0%) than for NOAC patients (5.6%) (p<0.01). Conclusions Percutaneous LAAO was associated with more favorable neurological outcomes after ischemic cerebrovascular event than NOAC treatment.