Objective To evaluate the efficacy and safety of autologous peripheral blood stem cell transplantation (APBSCT) in treatment of patients with decompensated hepatitis B cirrhosis.Methods Sixty two patients with decompensated hepatitis B cirrhosis admitted in Ningbo Second Hospital during January 2010 and December 2013 were enrolled in the study.Patients were randomly assigned in two groups: 50 patients in control group received comprehensive medical treatment only, and 12 patients in combination group received APBSCT on the basis of medical treatment.The levels of serum total bilirubin (TBil), albumin (Alb), alanine aminotransferase (ALT) and prothrombin time (PT) in two groups were mearsured at the 4th,12th,24th week.Overall survival (OS),progression-free survival (PFS) and complications were compared between two groups after 3 years follow-up.SPSS17.0 software was used to analyze the data.Results After APBSCT treatment, the level of Alb and PT at week 4,12 and 24 in combination group improved significantly(tAlb=-4.437,-5.210 and-6.915,tPT=12.083,11.251 and 10.640,all P<0.01),there were also significant differences between combination group and control group (tAlb=4.985, 5.565 and 6.260,tPT =-3.013、-3.727 and-3.983,all P<0.01).The 3-year OS and 3-year PFS of patients in combination group were higher than those of control group [(90.9±8.7)%vs.(60.7±7.4)%, (75.8±12.5)% vs.(47.9±7.3)%](χ2=6.887 and 5.565,P<0.05).Besides,APBSCT had more advantages than control group in reducing ascitic fluid and hepatic encephalopathy(χ2=7.992 and 4.681,P<0.05 or <0.01).Conclusion APBSCT combined with medical treatment can improve liver function and 3-year survival rate with mild adverse reaction in patients with decompensated hepatitis B cirrhosis.

Acute-On-Chronic Liver Failure ; diagnosis ; virology ; Antiviral Agents ; therapeutic use ; Hepatitis B, Chronic ; drug therapy ; Humans ; Nucleosides ; therapeutic use ; Nucleotides ; therapeutic use ; Prognosis

Objective To comparative analyze the influence factors of short-term (6 months) and long-term (10 years) prognosis in patients with HBV-related acute-on-chronic liver failure (ACLF),and to provide some reference values on clinic therapy and follow-up management.Methods The data of 524 hospitalized patients with ACLF from January 2001 to December 2009 were analyzed retrospectively.The follow-up termination time was December 2013.Patients were all given internal medical therapy,and were given antiviral therapy with nucleoside and nucleotide analogs (NAs) (yes/no) and plasma exchange in artificial liver support system (yes/no) according to the patient's informed choice.The method of Cox regression analysis was used to analyze the short-term prognostic factors and long-term prognosis factors of ACLF.Results The short-term prognosis factors in patients with ACLF were MELD scores,ages,percentage of neutrophils,hepatic encephalopathy,whether to apply NAs or not,HBV DNA levels,times of plasma exchange in artificial liver support system,cholinesterase levels and total bilirubin levels in turn (P ＜0.05).The long-term prognosis factors were ages,whether to apply NAs or not,MELD scores,cholinesterase levels,concomitant infection,white blood cell counts,gender and hepatic encephalopathy in turn (P ＜ 0.05),and antiviral therapy with NAs was a time-dependent independent prognostic factor.Conclusions There are some differences between the short-term prognosis factors and the long-term prognosis factors in patients with ACLF.We should give antiviral therapy with NAs,measures to improve liver function,preventions and treatments of infection and hepatic encephalopathy and other complications from early-stage to long-term follow-up managements.And in early-stage of ACLF we should also give the treatment with artificial liver support system.

This study aimed to establish human IFN-gamma (hIFN-gamma) in vitro release assay and to apply it in diagnosis of human tuberculosis. Human IFN-gamma gene was cloned and expressed in Escherichia coli. The recombinant hIFN-gamma was purified and used as immunogen to immunize mice and rabbits respectively. Monoclonal and polyclonal antibodies were respectively developed and a sandwich ELISA was established. The heparized whole blood from 111 active tuberculosis patients and 292 clinical healthy controls were collected. The blood was stimulated with tuberculosis specific fused antigen ESAT-6/CFP-10 and the plasma was collected for IFN-gamma detection. The sensitivity for tuberculosis diagnosis was 95.5%, whereas the positive detection rate for the healthy controls was 16.7%. There was a significant difference between the patients and healthy controls (P<0.01) indicating that this assay had a high sensitivity and specificity, and thus could be promising in tuberculosis diagnosis.
Animals ; Antibodies, Monoclonal ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Interferon-gamma ; immunology ; secretion ; Mice ; Mice, Inbred BALB C ; Mycobacterium tuberculosis ; immunology ; Rabbits ; T-Lymphocytes ; immunology ; Tuberculosis ; diagnosis ; immunology