Platelet aggregation ratio (PAR) was assessed in 35 patients with severe viral hepatitis (SVH) with Born's method.The PAR of normal individuals,patients with acute icteric hepatitis,and those with chronic active hepatitis were also studied to serve as controls.It was found that PAR decreased markedly in SVH patients,which was marked in the early stage of SVH,more marked in the intermediate stage,and most marked in the late stage.The changes of PAR were in negative correlation with those of serum total bilirubin,and in positive correlation with those of prothrombin activity.The reduction of PAR in SVH patients might be ascribed to the defect of platelets themselves as revealed by cross-over experiments.The results of this study indicate that PAR may be useful in judging the severity of SVH patients since the degree of PAR reduction parallels closely with the severity of liver damage.Finally the conditions of platelets in vivo and in vitro in SVH were discussed.

In this paper, we report Kinetic method was used to assess the concentration of human serum creatinine with MONARH 661 auto-centrifugal Analyzer. This method required small sample volumes and it was, rapid, convenient and reliable enough to be useful for routine de- termination. The standard curve of serum creatinine concentration was below 1768.0?mol/L. The recovery rate was 96.9-102%, within-run coefficient of variation was 2.86% and between-run was 4.22%. The major advanta ge of the method is that it can effectively avoid the negative interference from glucose, protein and bilirubin, etc. The reagent compares favorably with I Lco. reagent(X), Y = 0.99X-0.45,r=0.9995.

Severe liver diseases have various etiology.Hepatitis B and hepatitis C are commonly seen in China.However,alcoholic liver disease, autoimmune liver disease (ALD) and other non-viral severe liver diseases have shown an upward trend in recent years.There are no special therapeutical methods for severe alcoholic liver disease so far, glucocorticoids and pentoxifylline are mainly used for etiological treatment.The autoimmune liver disease is still one of the remarkable problems in the filed of liver diseases;at present, immunosuppressive agents and corticosteroids are routinely used for this liver disease, study on transduction pathway of biological agents interfering signals is expected to be a new therapy for ALD.The Wilson's disease is treated by administrating in a staggered manner or alternate manner to avoid the overlap of adverse reactions, while cell transplantation therapy and gene therapy will be the direction of future research.In conclusion, effective therapy should be given with reference to detailed condition, so as to improve survival rate in patients with severe liver diseases.

Currently, Lemology in PLA is facing two challenges: i) the threat of emerging infectious diseases (EID), bioterrorism and biological warfare (BW); ii) professional staffs are concerned over their development while the armed forces are undergoing re-organization. Whereas military lemology meets several opportunities such as: Ⅰ) the discipline occupies\ a\ prominent portion in military medicine; Ⅱ) an outbreak of EID and the threat of bioterrorism are closely related to military medicine; Ⅲ) infectious diseases are still common diseases prevalent in both servicemen and civilians; Ⅳ) the present status of lemological study in PLA is in the leading position in the whole nation; Ⅴ) once there should be another outbreak of SARS epidemic such as occurred in 2003 in Beijing, the most expeditions and effective approach is still to deploy the specialists in PLA organizing a medical team to enter the epidemic area. The development strategy of this discipline in PLA is proposed as follows: i) expanding the scope of the discipline; ii) further the construction of the team; ii) perfecting the system for prevention and treatment of EID. Finally, the presumption for the 21st century of the subject is following suggestions are the contemplation for the development of this discipline in the 21st century: i) further emphasize the study of this discipline is beneficial for both military and civilian; ii) to simplify the scope of the discipline is not against its enhancement; iii) the interchanges and collaboration among different disciplines should be encouraged and strengthened.

Objective To investigate the efficacy and safety of adefovir dipivoxil(ADV)for chronic hepatitis B(CHB)patients with lamivudine(LMD)resistance.MethodsA total of 247 LMDresistant CHB patients were included in this multi-center,randomized(1:1),double-blinded and LMDcontrolled clinical trial.All subjects were swithed to open-labelled ADV treatment after 12-week doubleblinded stage.Serum HBV DNA and ALT levels were monitored and safety assessments were conducted at 12th and 48th week during the treatment.Results At 12th week.mean reduction of ALT in trial group was 35.9 U/L,and the reduction of HBV DNA was 3.01 log10 copies/mL.The reductions of HBV DNA in 61.8%(76/123)subjects were more than 2 log10 copies/mL.While in the control group,ALT raised 2.8 U/L in average,and the reduction of HBV DNA was 0.78 log10 copies/mL.The reductions of HBV DNA in 17.7%(22/124)subjects were more than 2 log10 copies/mL.At 48th week,mean reduction of ALT in trial group was 59.7 U/L,and the reduction of HBV DNA was 4.70 log10 copies/mL.The reductions of HBV DNA in 87.0%(107/123)subjects were more than 2 log10 copies/mL.While in the control group,mean reduclion of ALT was 56.6 U/L,and the reduction of HBV DNA was 4.43 log10 eopies/mL.The reductions of HBV DNA in 85.5%(106/124)subjects were more than 2 log10 copies/mL.No severe adverse effect related to the investigational product was observed in both groups.Conclusion ADV is safe and effective in the treatment of LMD-resistant CHB patients with virological and biochemical improvements.

The quasispecies nature of hepatitis B and C virus (HBV, HCV) plays an important role in the pathogenesis, immune escape and drug resistance during chronic infection. Although there is still a lack of effective treatment for hepatitis C, a series of nucleoside analogs (NA) have been developed for the treatment of hepatitis B. NA resistant HBV mutants can accumulate during prolonged therapy and lead to the failure of anti-HBV therapy. Switching to other sensitive NAs can inhibit the emerged resistant mutants. Therefore, understanding the evolution of viral quasispecies under drug pressure is crucial for the establishment of antiviral strategy and the monitoring of antiviral process. Immune response and escape are complicated process, during which both host and virus factors may play their roles. Further understanding of the interaction and interrelationship between host and these viruses may lead to optimized prevention, diagnosis and treatment for chronic hepatitis.

Objective　To study the role of the structural gene variation of hepatitis C virus(HCV) in the chronicity of HCV infection. Methods　Serum samples from four HCV infection acquired during six-month follow up and four patients with chronic hepatitis C type were obtained. A 1-kb fragment containing the 3' half of core ，completed E1 and 5' half of E2/NS1 was amplified by nested reverse transcription polymerase chain reaction (RT-PCR). For each，30 cloned cDNAs were examined by a method that combined heteroduplex analysis (HAD) and a single-stranded conformational polymorphisim (SSCP)assay to optimize selection of clones with unique gel shift patterns (clonotypes )as a measure of the quasispecies complexity. Results　There was obvious difference between the SSCP bands of cloned cDNAs representing core-E1 and E2 region，but more distinct difference between heteroduplex and the homoduplex of clones spanning E2 region which accurately reflected the degree of heterogeneity. Quasispecies complexity was higher in those with persistent viremia than those with acute viremia. Conclusion　HCV persistence is associated with complex quasispecies in viral structural region.

Objective To disclose the variant rule of HIV-1 vertical transmission by studying the differences of genotypes and quasispecies in the individuals with HIV-1 vertical transmission. Methods RNA was extracted from the plasma of the individuals of vertical transmission and C2-V5 DNA segment of HIV-1 env gene was acquired by RT-PCR. Purified DNA segment was inserted into T vector and transformed into Top10 Escherichia coli. Positive clones were acquired by blue-white screening and used as models in PCR. PCR products were analyzed by conformation sensitive gel electrophoresis (CSGE). The clones of major and minor quasispecies were sequenced. Results HIV-1 quasispecies in the mother of the first group were less complex than her child, and their quasispecies nucleotide sequences were highly homologous and of HIV-1 of C subtype. HIV-1 quasispecies in the mother of the second group were more complex than her child, and their quasispecies nucleotide sequences were highly homologous and of HIV-1 of AE subtype. Conclusion HIV-1 genetic subtypes are generally not changed in vertical transmission, but HIV-1 quasispecies could be selected in vertical transmission and screened by the new environment of the new host which may both induce the changes of dominative and minor quasispecies. We also find that complexity of HIV-1 quasispecies is associated with immune status of host.