Objective To understand the clinical features of hepatitis B virus(HBV)/hepatitis C virus(HCV)coinfected patients with different virological profiles.Methods The clinical data of 186 patients with HBV/HCV coinfection from May 1999 to May 2010 in the Third Affiliated Hospital of Sun Yat-Sen University were analyzed retrospectively.The demographic data,epidemiological data,laboratory results and pathological index were analyzed.The statistical analysis was done using t test and chi square test.Results A total of 186 patients were divided into 4 groups:66(35.5%)in HBV DNA(-)/HCV RNA(-)group,8(4.3%)in HBV DNA(+)/HCV RNA(+)group,68(36.6%)in HBV DNA(+)/HCV RNA(-)group and 44(23.7%)in HBV DNA(-)/HCV RNA(+) group.The gender composition,complication incidence,transmission among drug users,alanine aminotransferase(ALT)level,total bilirubin(TBil)level,prothrombin activity(PTA)and hapatitis B e antigen(HBeAg)negative rate were all significantly different among four groups(F or x2=11.578,8.451,11.738,2.669,5.102,4.254 and 18.413,respectively;all P<0.05).In groups of HCV RNA(-)and HCV RNA(+),the proportions of patients infected through drug abuse were 49.3%and 23.1%,respectively(x2=9.987,P:0.002)and blood transfusion transmission were 29.9%and 46.2%,respectively(x2=4.412,P=0.036).When HBV DNA was negative,the median ALT levels in HCV RNA(-)and HCV RNA(+)patients were 177 U/L and 62 U/L,respectively(t=2.200,P<0.05),median TBil levels were 133 μmol/L and 20μmol/L,respectively (t=3.608,P<0.05)and PTA were 70.6%±27.7%and 83.3%±27.8%,respectively(t=-1.982,P<0.05).The HBeAg negative rate was not affected by HCV RNA levels(t=0.707,P>0.05).The HBeAg negative rate in HBV DNA(-)patients was 85.5%,which was higher than that in HBV DNA(+)patients(59.2%)(x2=16.393,P<0.05).Conclusions HBV DNA(+/-)/HCV RNA(-)profile were major components in HBV/HCV confection.HBV DNA level is related to disease progression and prognosis,but not relate to disease severity.Liver function damage and disease severity are aggravated with HCV RNA level decreases.HBV DNA level is related to HBeAg negative rate,while HCV RNA level is not related to HBeAg seroconversion rate.

Objective To investigate short-term efficacy and security of transplantation of human umbilical cord mesenchymal stem cells (HUCMSCs)in the course of treatment of decompensated cirrhosis.Methods Ninety-six Hepatitis B patients with decompensated cirrhosis were enrolled,among which 50 were sbject to transplantation of HUCMSCs in addition to routine therapy (the treatment group) and the rest patients were underwent routine therapy(the control group).We observed the efficacy and security at 2,4,6 and 12 week of the treatment course.Results The symptoms of atigue,anorexia,bloating and edema were greatly relieved in both groups after 4 weeks,and sustained remission after 4-12 weeks.The overall survival rate was 96％ after 12 weeks of the treatment group,2 patients were died after 8 and 12 weeks of the HUCMSCs transplantation due to hepatic encephalopathy repecticely.Compared to the baseline,ALT,AST,TBil and ALB(albumin) were improved after 2,4,6 and 12 weeks in both groups(P ＜ 0.05),and the averages of ALB(albumin) of treatment group were higher than the control group.PT(prothrombin time) and PTA(prothrombin time activity) were improved after 4,6,12 weeks in the treatment group (P ＜ 0.05),however,there were no differences in the control group during the 4,6 and 12 weeks(P ＞0.05).During the course of HUCMSCs tranplantation,the security was satisfied and no special side effects were observed.Conclusion The transplantation of HUCMSCs for therapy of Hepatitis B patients with decompensated cirrhosis is a safety and effective therapy,and can improved ALB,PT,PTA,liver function and clinical symptoms within a short period,which is an alternative method of treatment recommended.

Objective To investigate short-term efficacy and security of telbivudine as a sequential therapy in the HBeAg positive chronic hepatitis B (CHB) patients with pegylated IFNα-2a treatment failure.Methods 27 CHB patients with HBeAg positive and HBV DNA detectable after a 48-week pegylated IFNα-2a therapy were enrolled into this study,and were assigned to group A,with telbivudine as a sequential therapy.54 CHB patients with HBeAg positive were assigned to group B,with telbivudine as a naive treatment.To assessment the efficacy and security of telbivudine at week 48.Results At week 12,the rates of aminotransferases normalization,HBeAg seroconversion and HBV DNA undetectable (＜ 100 IU/ ml) among the two groups were 59.3％,14.8％,66.7％ vs 75.9％,5.6％,46.3％ respectively.At week 24,the rates among the two groups were 92.6％,25.9％,70.3％ vs 92.6％,7.4％,85.2％,respectively.At week 48,the rates among the two groups were 88.9％,29.6％,81.5％ vs 98.1％,28.0％,83.3％ respectively.All these were not statistically significant.But the rate of HBeAg seroconversion in group A is higher than that in group B.The virological breakthrough rate of group B at week 48 is 14.8％,no virological breakthrough was observed in group A.During the treatment,38.3％ of patients had creatine kinase(CK) elevation,but there was no case stopping treatment for severe adverse effect.Conclusion CHB patients with HBeAg positive after a 48-week pegylated IFNα-2a treatment failure can also achieve the same efficacy and security as the na(i)ve treatment,after receiving telbivudine as a sequential therapy.

Objective To investigate the efficacy of Telbivudine as sequential therapy for HBeAg positive CHB patients with pegylated IFNα-2a (PEG-IFNα-2a)treatment failure.Methods After a 48-week pegylated IFNα-2a therapy,102 HBeAg positive CHB patients,whose HBeAg expression was positive and HBV DNA load was Detectable,were enrolled.These patients were randomly divided into two groups.Group A,included 52 patients,were treated with Telbivudine as a sequential therapy after a 3 months or longer wash-out period.Group B,included 49 patients,were treated with Telbivudine as a sequential therapy without wash-out period.The rate of ALT normalization,HBeAg seroconversion,the negative rate of HBV DNA and the level of creatine kinase in the two groups were observed and compared,respectively.Results HBeAg seroconversion of Group A at 3,6,12 months was 7.69％,15.3％,21.1％,respectively.HBeAg seroconversion undetectable of Group B at 3,6,12 months was 22.4％,32.6％,38.8％,respectively.Furthermore,there was statistically significant difference in HBeAg seroconversion between the two groups (P ＜ 0.05).However,there were not statistical difference in the rate of ALT normalization,the negative rate of HBV DNA and the level of creatine kinase between the two groups at 3,6,12 months.Conclusion Telbivudine,which was used as a sequential therapy without wash-out period for HBeAg positive CHB patients after PEG-IFNα-2a treatment failure,was secure.Moreover,HBeAg seroconversion of patients treated with Telbivudine as a sequential therapy without wash-out period was higher than those with wash-out period.

Objectives:To explore the influencing factors of inter-arm systolic blood pressure difference(sIAD)in young hypertensive population. Methods:A total of 12 895 young Kailuan employees aged≤40 years,who participated in the physical examination from 2010 to 2020,were enrolled in this study.All of them underwent blood pressure measurements of four limbs in supine position.Young hypertensive group(n=3 584)and young non-hypertensive group(n=3 584)were 1∶1 matched by sex and age(±1 year),and participants were further divided into sIAD＜10 mmHg(1 mmHg=0.133 kPa)and sIAD≥10 mmHg subgroups.A stepwise multivariate logistic regression model was established to analyze the determinants of sIAD≥10 mmHg. Results:The detection rate of sIAD≥10 mmHg was significantly higher in the young hypertensive group than in the young non-hypertensive group(31.72%vs.27.76%,P＜0.001).Stepwise multivariate logistic regression analysis showed that in young hypertensive population,ankle-brachial index(ABI)＜0.9,male,obesity,overweight,elevated low density lipoprotein cholesterol(LDL-C)level,and systolic blood pressure were positively associated with sIAD≥10 mmHg,while college education or above,physical exercise were negatively correlated with sIAD≥10 mmHg(all P＜0.05).In the young non-hypertensive population,ABI＜0.9,systolic blood pressure were positively correlated with sIAD≥10 mmHg,while age was negatively associated with sIAD≥10 mmHg(all P＜0.05). Conclusions:The detection rate of sIAD≥10 mmHg is higher in young hypertensive population than in young non-hypertensive population.Decreased ABI,male sex,obesity,overweight,increased LDL-C level,systolic blood pressure,college education and above,and physical exercise are the influencing factors of sIAD≥10 mmHg in young hypertensive population.