Objective To investigate the proportion and the clinical significance of status of different hepatitis B virus(HBV) serological markers in HBV related chronic liver disease(CLD),including chronic hepatitis B(CHB),liver cirrhosis(LC) and hepatocellular carcinoma(HCC).Methods The related clinical data of 2 482 inpatients during the period of January 2006 to December 2007 were collected and analyzed statistically.Results In 1 226 patients with CHB,64.4% of them were hepatitis B e antigen(HBeAg)-positive,and 35.6% of them were HBeAg-negative.In 362 patients with LC,27.1% of them HBeAg-positive,66.0% HBeAg-negative,6.9% HBsAg-negative,and in 894 patients with HCC,16.4% were HBeAg-positive,75.1% HBeAg-negative and 8.5% HBsAg-negative.In every disease entity of CLD,the sex ratio for serological markers was similar,though the ratio of male-to-female in the patients with HCC(8.8∶1) was significantly higher than that of LC(4.5∶1) and CHB(4.4∶1),respectively.The age of HBeAg-negative patients with CHB was significantly older than that of HBeAg-positive patients with CHB.The average age of patients with different status of serological markers in LC or HCC was similar.No statistical difference was found in ALT levels between the HBeAg-positive and HBeAg-negative patients with CHB.However,the proportion of low ALT levels became higher in the patients with LC or with HCC when HBeAg positive turned to be HBeAg-negative then to HBsAg-negative.Conclusions The proportion and the clinical significance of changes in serological markers are different in three different entities of CLD.

Objective To explore the information on the clinical features of the severe acute respiratory syndrome (SARS) prevalent recently. Methods We collected and analyzed clinical date from the 85 inpatients suffered from SARS in Nanfang Hospital, Guangzhou. Results The patients ranged from 4 to 87 years old (mean age 38.2?16.7 years). The incubation period ranged form 2 to 16 days (mean periods 7.4? 3.8 days). The most common symptoms included fever (in 97.8 percent of the patients), cough (81.2%), malaise (74.1%), headache (63.5%), myalgia (41.2%). Peripheral vein blood test showed normal leukocytes and leukopenia in 82.4 percent of the patients. Other common findings were lymphopenia (in 27.1 percent of the patients), elevated alanine aminotransferase (44.7%), elevated aspartate aminotransferase (57.6%), elevated lactase dehydrogenase (49.4%) and elevated creatinine kinase (20.0%). Chest radiographs predominately showed air-space shadowing, such as ground-glass opacities, focal consolidation or patchy consolidation. The air-space shadowing was mostly in the lower lung zones (in 88.3 percent of the patients, bilateral and unilateral for 51.8% and 36.5% respectively). The mean period of complete resolution of the air-space shadowing was 20.3?8.4 days and 13.1?6.9 days after onset of illness and absent fever respectively. Empirical therapy most commonly included ribavirin, antibiotics. Conclusions SARS appears to be infectious. Fever followed by rapidly progressive respiratory compromise is the key complex of signs and symptoms from which the syndrome derives its name.

Objective: To learn the technical efficiency and influencing factors of hospital beds in China′s hospitals from 2010 to 2016. Methods: The two-stage Network DEA-Tobit model was used to analyze the technical efficiency and influencing factors of hospital beds at all levels in China. Results: There was a big difference in the utilization status of hospital beds at all levels. The bed burden of tertiary hospitals was heavier, and their average bed occupancy rate was 102%, while the potential of primary and secondary hospital beds was relatively large. The average technical efficiency of the hospitals in the primary, secondary and tertiary hospitals was 0.99, 0.37 and 0.82, respectively. Over-investment of resources for beds in hospitals at all levels was found with insufficient output, and the utilization of bed resources in primary and secondary hospitals was seriously insufficient. The nurse-bed ratio, per capita medical expenses of hospitalized patients, per-bed income and financial subsidy to the technical efficiency of the hospital bed were statistically significant. The correlation coefficient between the guard bed ratio and the technical efficiency of the hospital bed was 3.106 409. Conclusions It is necessary to further implement the hierarchical medical system and clarify the functional positioning of hospitals at all levels. It is recommended to control the scale of investment and improve the utilization efficiency of existing bed resources, and it is also imperative to improve the medical technology level and diagnosis rate of hospitals at all levels, and promote the maximization of bed utilization efficiency.

Objective To investigate the efficacy of individualized interferon (IFN)-alpha therapy in HBeAg-negative chronic hepatitis B patients. Methods Seventy- six Chinese HBeAg-negative chronic hepatitis B patients proven by liver biopsy were treated with 5 MU recombinant IFN-alpha 1b subcutaneously thrice every week. All the patients were followed up for at least 24 months the combined responses were defined as normalization of serum alanine transaminase (ALT) and HBV DNA＜3 log10 copy/mL. An intention-to-treat (ITT) analysis was used in this paper in which all 76 patients were included. Results Six patients were lost. Treatment duration was in the range 2-24 months with a median of 8.5 months, and combined responses were achieved at a median of 6.0 months (range 2-19 months) of treatment duration.Seventy-five-percentile of treatment duration to endpoints was 10.0 months. The combined response rate was 46.1% (35/76) at the end of treatment, 43.3% (33/76) at 12-month follow-up and 40.8% (31/76) at 24-month follow-up. The relapse rate was 20. 0% (7/35) and 25. 7% (9/35) at 12-month and 24-month follow-up, respectively. Higher necroinflammatory activity in liver biopsy predicted a good response, while gender, age, liver fibrosis, baseline ALT, aspartate aminotransferase levels and baseline HBV DNA levels were not impact factors of therapeutic effects by binary Logistic regression analysis.Conclusion Individualized prolonged IFN-alpha regimen lead to considerable sustained disease suppression in patients with HBeAg-negative chronic hepatitis B.

OBJECTIVETo establish a simple and practicable method to identify the different genotypes of hepatitis B virus (HBV).

METHODSBased on the alignment of 114 complete nucleotide sequence for HBV DNA of different genotypes, the specific sequence of each genotype was found. Six primer sets were designed for each of the six genotypes according to the genotype-specific sequence, and used separately for PCR. The genotype of HBV was identified according to the positive result of PCR. Three primer sets for B, C and D genotypes were added into a single tube for PCR reaction, and HBV was genotyped according to the length of the amplified DNA.

RESULTSThere was no difference in the genotyping result of PCR by single or multiplex primers, which was identical to the PCR-RFLP method.

CONCLUSIONSThis multiplex PCR method is simple, precise, sensitive, and easy to use.

DNA Primers ; Databases, Nucleic Acid ; Genotype ; Hepatitis B virus ; classification ; genetics ; Humans ; Polymerase Chain Reaction ; methods ; Sequence Alignment ; methods

OBJECTIVETo investigate the compositions of Th1/Th2/Th3 cells in chronic hepatitis B virus (HBV)-infected individuals by determining the expression of interleukin-4 (IL-4), inetrferon-gamma (IFN-gamma), and transform growth factor-beta (TGF-beta) in single CD4(+) T cells isolated from peripheral blood mononuclear cells (PBMCs) and the role of polarized Th cell populations in chronic HBV-infection was discussed.

METHODSPBMCs from chronically infected HBV individuals were isolated, stimulated by PMA/Ionomycin/Monensin, and IL-4, IFN-gamma and TGF-beta production by CD4(+) T cells was determined by using fluorescence activated cell sorter (FACS) analysis.

RESULTSThe percentage of IFN-gamma-producing T cells, IL-4-producing T cells and TGF-beta-producing T cells ranged from 2.3% - 18.6%, 1.1% - 8.7% and 0.7% - 7.1% respectively in CD4(+) T cells from non-infected individuals. Most of CD4(+) T cells from PBMCs in chronically infected HBV individuals were Th0 cells. The proportion of Th1 cells increased significantly with hepatic inflammatory activity, and in the active period of chronic hepatitis B infection were higher than those in the non-active period (P < 0.05). Th2 cell percentage in CD4(+) T cells from HBV-infected individuals did not differ significantly (P > 0.05), but were higher than that from controls (P < 0.05). Th3 cell percentage in CD4(+) T cells from asymptomatic carrier (AsC) group was higher than that in the chronic hepatitis B (CHB) and control groups (P < 0.05).

CONCLUSIONSTh1 phenotype cytokines were positively correlated with hepatic inflammatory activity in chronic hepatitis B and Th2 cells may be associated with the persistence of HBV infection. Th3 cells cooperating with Th2 cells can negatively regulate immune responses and may be associated with the immune tolerant state of chronic HBV infection.

CD4-Positive T-Lymphocytes ; immunology ; Hepatitis B, Chronic ; immunology ; metabolism ; pathology ; Humans ; Interferon-gamma ; biosynthesis ; Interleukin-4 ; biosynthesis ; T-Lymphocytes, Helper-Inducer ; immunology ; Th1 Cells ; immunology ; Th2 Cells ; immunology ; Transforming Growth Factor beta ; biosynthesis

OBJECTIVETo evaluate the changes in the renal function of patients with chronic hepatitis B (CHB) receiving adefovir dipivoxil (ADV) or telbivudine (L-DT) monotherapy.

METHODSThis retrospective analysis involved 101 patients with CHB and liver cirrhosis receiving either ADV or L-DT monotherapy for 52 weeks. Serum creatinine, estimates of glomerular filtration rate (eGFR), and the percentage of patients with eGFR≥90 ml·min(-1)·1.73 m(-2) at week 52 were compared with the baseline data between the two groups.

RESULTSThe mean changes of CR at week 52 from baseline were +0.05 mg/dl in ADV group and -0.12 mg/dl in L-DT group, showing a significant difference between the two groups (P=0.000). No patient was found to have an elevation of creatinine over 0.50 mg/dl. The median change of eGFR at week 52 from baseline differed significantly between ADV and L-DT groups (-4.09 vs+18.32 ml·min(-1)·1.73 m(-2), P=0.000). Ninety-two percent (12/13) of the patients with baseline eGFR<90 ml·min(-1)·1.73 m(-2) shifted to eGFR ≥90 ml·min(-1)·1.73 m(-2) after 52 weeks of L-DT treatment, as compared to 38% (3/8) in ADV group. The proportion of patients with eGFR≥90 ml·min(-1)·1.73 m(-2) in L-DT group increased from 76.36% (42/55) at baseline to 94.55% (52/55) at week 52, while that in ADV group decreased from 82.61% (38/46) at baseline to 78.26% (36/46). The constituent ratios of eGFR at different levels were similar at baseline (P=0.443) but significantly different at week 52 between the two groups (P=0.015).

CONCLUSIONL-DT treatment is associated with a renoprotective effect in patients with CHB, but the mechanism remains unclear.

Adenine ; analogs & derivatives ; therapeutic use ; Adolescent ; Adult ; Creatinine ; blood ; Female ; Glomerular Filtration Rate ; Hepatitis B, Chronic ; drug therapy ; physiopathology ; Humans ; Male ; Middle Aged ; Organophosphonates ; therapeutic use ; Retrospective Studies ; Thymidine ; analogs & derivatives ; therapeutic use ; Young Adult

OBJECTIVETo study the clinical and histological features of chronic hepatitis B (CHB) with negative hepatitis B e-antigen (HBeAg).

METHODSA total of 743 in-patients with chronic hepatitis B were recruited into the study and divided into two groups according to the HBeAg status. The correlation among alanine transaminase (ALT) levels, hepatitis B virus (HBV) DNA semiquantification, and the liver histopathological data were detected.

RESULTSOf the 743 successive in-patients, 267 (35.9%) were HBeAg-negative. The HBDAG-negative group had significantly lower serologic HBV DNA levels (63.0% of < 100 pg/ml) vs HBeAg-positive (42.6%, P < 0.001), while more sever inflammation (58.1% of inflammatory scores of histological activity index (HAIinf > or = 9) vs HBeAg-positive group (46.0%, P < 0.001) and severe fibrosis (45.3% of fibrosis scores of histological activity index (HAIfib > or = 3) vs HBeAg-positive group (27.9%, P < 0.001) of liver histology. In HBeAg-positive patients, increasing ALI levels were significantly associated with high inflammation and fibrosis scores and low HBV DNA levels. However, it was not the case in the HBeAg-negative cases. In HBeAg-positive patients, 91.3% of them had HAIinf > or = 9 and 65.7% had HAIfib > or = 3 with HBV DNA > 100 pg/ml, while 8.2% of them had HAIinf > or = 9 and 12.3% had HAIfib > or = 3 with HBV DNA < 20 pg/ml, indicating an obverse correlation between HBV DNA levels and histology scores.

CONCLUSIONSAs regards clinical and histological background, the chronic HBeAg-negative hepatitis B is a different subpopulation from the HBeAg-positive counterpart.

DNA, Viral ; Fibrosis ; pathology ; Hepatitis B ; immunology ; pathology ; Hepatitis B e Antigens ; analysis ; Hepatitis B virus ; genetics ; Hepatitis, Chronic ; Humans ; Liver ; pathology

Objective:To establish a colloidal gold technique assay for the rapid detection of immunoglobulin(Ig)M and IgG antibodies against 2019 novel coronavirus (2019-nCoV) and to evaluate its clinical performance.Methods:A total of 278 patients who were respectively treated at Wuhan Hankou Hospital and the People′s Hospital of Honghu from February 12, 2020 to February 20, 2020 were collected. According to the diagnostic criteria, 89 patients were confirmed with positive 2019-nCoV nucleic acid, and 189 were 2019-nCoV nucleic acid-negative suspected patients. A total of 273 medical examiners from Nanfang Hospital, Southern Medical University from 2015 to 2018 were selected as controls. The serum samples of patients were collected. 2019-nCoV nucleic proteins were obtained from prokaryotic expression vectors. Indirect IgM and IgG colloidal gold techniques were established by using recombinant nuclear protein. 2019-nCoV nucleic acid detection by reverse transcription-polymerase chain reaction (RT-PCR) was used as control. Serum specimens were tested for 2019-nCoV IgM and IgG. The specificity and sensitivity of colloidal gold assay were analyzed.Results:The positive rates of IgM and IgG with the colloidal gold detection in confirmed patients with positive 2019-nCoV nucleic acid were 78.7%(70/89) and 73.0%(65/89), respectively. The positive rates of IgM and IgG in medical examiners were 1.8%(5/273) and 0.7%(2/273), respectively. The sensitivity and specificity of IgM detection reagents were 78.7% and 98.2%, respectively, those of IgG detection reagents were 73.0% and 99.3%, respectively, and those of IgM combined with IgG detection were 87.6% and 98.2%, respectively. For suspected patients with negative 2019-nCoV nucleic acid, the positive rates of IgM and IgG were 59.8%(113/189) and 52.9%(100/189), respectively, and the positive rate of IgM combined with IgG detection was 66.1%(125/189).Conclusion:This reagent of 2019-nCoV antibodies detection (colloidal gold technique) fulfills the requirement for clinical application with high specificity and sensitivity, which can be served as a supplementary detection method for 2019-nCoV nucleic acid detection by RT-PCR.

Objective: To establish a colloidal gold technique assay for the rapid detection of immunoglobulin(Ig) M and IgG antibodies against 2019 novel coronavirus (2019-nCoV) and to evaluate its clinical performance. Methods: A total of 278 patients who were treated at Wuhan Hankou Hospital and the People's Hospital of Honghu from February 12, 2020 to February 20, 2020 were collected. According to the diagnostic criteria, 89 patients were confirmed with 2019-nCoV nucleic acid positive diagnosis, and 189 were 2019-nCoV nucleic acid-negative suspected patients. A total of 273 medical examiners from Nanfang Hospital, Southern Medical University from 2015 to 2018 were selected as controls. The serum samples of patients were collected. 2019-nCoV nucleic proteins were obtained from prokaryotic expression vectors. Indirect IgM and IgG colloidal gold techniques were established by using recombinant N protein. 2019-nCoV nucleic acid detection by reverse transcription-polymerase chain reaction (RT-PCR) was used as control. Serum specimens were tested for 2019-nCoV IgM and IgG. The specificity and sensitivity of colloidal gold assay were analyzed. Results: The sensitivity and specificity of IgM detection reagents were 78.7% and 98.2%, respectively, those of IgG detection reagents were 73.0% and 99.3%, respectively, and those of IgM combined with IgG detection were 87.6% and 98.2%, respectively. For suspected patients with negative 2019-nCoV nucleic acid, the positive rates of IgM and IgG were 59.8% (113/189) and 52.9% (100/189), respectively, and the positive rate of IgM combined with IgG detection was 66.1% (125/189). Conclusion This reagent of 2019-nCoV antibodies detection (colloidal gold technique) fulfills the requirement for clinical application with high specificity and sensitivity, which can be served as a supplementary detection method for 2019-nCoV nucleic acid detection by RT-PCR.