Oral anti-viral agents nucleos (t)ide analogues (NAs) are widely used in treatment of chronic hepatitis B (CHB) since they are well-tolerated in most patients.But clinical relapse occurs in a considerable part of patients after the cessation of NAs therapy.This paper reviews factors related to clinical relapse, including time for drug withdrawal, cccDNA level, age, baseline alanine aminotransferase (ALT) and HBV DNA levels, type of NAs, serum level of HBsAg and the immune status of patients.

OBJECTIVE: To summary the clinical characteristics and outcomes of nasal inverted papilloma treated by intranasal endoscopic approach. METHOD: Fourty-six patients with nasal inverted papilloma were treated with endoscopic surgery from 1995 to 2005. There were 34 males and 12 females, age ranged from 18 to 76 years old. The period of follow-up was 12-72 months. RESULT: Only 5 cases recurred within 24 months after the surgery. The other cases had no recurrence during the follow-up period. CONCLUSION The endoscopic endonasal approach is an effective treatment for an inverted papilloma in selected cases. A combination of Caldwell Luc procedure and transnasal endoscopic sinus surgery may be needed for those patients with inverted papilloma in stage III.
Adolescent ; Adult ; Aged ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Nose Neoplasms ; surgery ; Papilloma, Inverted ; surgery ; Young Adult

OBJECTIVE: To investigate the distribution of positive allergens in patients with allergic rhinitis in Changzhou. METHOD: A total of 4242 cases with allergic symptoms and signs underwent skin prick test with 16 kinds of standardized allergens. The common allergens were found out. The samples were stratified on seven age groups to analysis the distributive characteristics of allergens responsible for each group. The samples were also stratified on children group and adults group to analysis their response degree to dust mite. RESULT: 2638 cases (62.19%) had the positive reaction, including male 1380 (52.3%) cases, female 1258 (47.7%) cases. Dermatophagoides farinae and dermatophagoides pteronyssinus had the highest positive ratio (85.86%, 83.55%) in inhalation group, followed cockroach (11.49%) and Humulus L. (9.82%), fungus (2.92%) in the lower positive ratio. Shrimp (5.76%) was the most common allergen in food group. The distribution of common allergens in different age groups was variable. There was significantly higher sensitivity to dust mite between children group compared to adults group (P < 0.01). CONCLUSION The study shows that Dust mite was the mostly responsible common allergen in Changzhou district. The distribution of common allergens in children group and adults group was variable.
Adolescent ; Adult ; Aged ; Allergens ; analysis ; Animals ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Mites ; Rhinitis, Allergic ; Rhinitis, Allergic, Perennial ; diagnosis ; epidemiology ; Skin Tests ; Young Adult

Objective To study the correlation between interleukin(IL)-21 and the recurrence of chronic hepatitis B(CHB)in hepatitis B e antigen(HBeAg)-positive patients after discontinuation of entecavir(ETV).Methods A total of 112 HBeAg-positive CHB patients treated with ETV were enrolled.Serum levels of IL-21 at week 0,12,24 and 52 after ETV discontinuation were detected.The Cox regression model was used to analyze the correlation between IL-21 and the recurrence after ETV discontinuation.The receiver operating characteristic(ROC)curve was applied to determine the predictive value of IL-21 for CHB recurrence after ETV discontinuation.The expression differences of IL-21 were compared between sustained viral response(SVR)group and viral relapse(VR)group.The t test and Chi-square test were used for statistical analysis.Results The serum levels of IL-21 in SVR group at week 0,12,24 and 52 after ETV withdrawal were(60.0 ± 10.8),(60.2 ± 14.7),(60.6 ± 19.5)and (61.2 ± 15.4)ng/L,respectively,which were all significantly higher than those in VR group(47.5 ± 10.7),(47.3 ± 12.9),(46.9 ± 12.2)and(46.4 ± 12.8)ng/L,respectively(t=6.153,4.926,4.382 and 5.515,respectively,all P< 0.01).The area under curve(AUC)was 0.811(95% CI:0.728 ~0.893,P<0.01)and the best cut-off value of serum IL-21 level was 49.8 ng/L.The recurrence rates of patients with serum IL-21 level ≥49.8 ng/L and <49.8 ng/L at time of ETV withdrawal was 25.4%(16/63)and 77.6%(38/49),respectively.The difference was statistically significant(χ2=30.027,P<0.01).The serum IL-21 level at the time of drug withdrawal(P= 0.005),serum hepatitis B surface antigen(HBsAg)level at the time of HBeAg seroconversion(P= 0.008)and age(P= 0.016)were factors associated with CHB recurrence after ETV withdrawal by multivariate Cox model analysis.The serum levels of ALT,HBV DNA,HBeAg and HBsAg in SVR group were significantly lower than those of VR group at week 12,24 and 52 after ETV withdrawal(t= -5.968,-7.691,-8.093; -3.047,-9.477,-28.900;-2.872,-10.424,-18.330;-4.633,-4.030 and -5.032,respectively;all P<0.01).Serum level of IL-21 was negatively correlated with HBsAg in SVR group after ETV withdrawal (r= -0.241,P<0.01),while positively correlated with HBsAg in VR group(r=0.286,P<0.01). Conclusions The serum IL-21 level at the time of drug withdrawal is associated with the recurrence after ETV discontinuation.IL-2l may play an important role as an immunomodulatory factor in maintaining virological responses in HBeAg-positive CHB patients after ETV withdrawal.

Objective: To explore the characteristics underlying Th1/Th2/Th17 expression level after entecavir (ETV) discontinuation of chronic hepatitis B (CHB) patients who were HBeAg-positive and define the role of Th1/Th2/Th17 in maintaining virological response after ETV discontinuation. Methods: We selected 112 HBeAg positive CHB patients who met the withdrawal criteria according to the guideline of prevention and treatment of chronic hepatitis B (2010 version), and we also separated them into virology sustained response (SVR) group and virological relapse (VR) group according to the recurrence in 52 weeks. We detected serum level of Th1/Th2/h17 related cytokines during 0, 12, 24 and 52 weeks follow-up to further analyze their dynamic changes and expression differences. Results: The results of the study reveals that serum levels of IFN-γ in the group of SVR were at a higher level compared with VR group during follow-up (all P<0.05). While, the serum level of IL-10 decreased in SVR group and was lower than the paired IL-10 level in VR group with significance during follow-up. In VR group, the serum level of IFN-γ decreased during the first 24 weeks after ETV withdrawal, and after then, the level rose. The serum levels of IFN-γ (Th1) in SVR patients were significantly higher than those in VR patients in the different follow-up time points after ETV discontinuation (all P<0.05). And the serum levels of IL-10 (Th2) in SVR patients were significantly lower than that in VR patients (all P<0.05). The comparison of serum levels of IL-17A (Th17) between the two groups had no significant difference (all P>0.005). Conclusions The serum level of IFN-γ in SVR group maintained a high level is conducive to maintaining virological response after ETV withdrawal and high level of IL-10 may be related to virologic relapse.