恩替卡韦治疗失代偿期肝硬化疗效观察

目的观察恩替卡韦治疗失替偿期乙型肝炎肝硬化的疗效。方法对2006年3月至2007年6月18例来我院就诊乙型肝炎肝硬化失代偿期患者给予口服恩替卡韦治疗剂量0．5mg／次，1次／d，基本疗程1年。观察HBV-DNA定量，肝纤维化指标（HA、LN、POⅢ、Ⅳ—C），肝功能指标（ALT、AST、TBIL）变化情况。结果所有患者临床症状明显改善，肝功能指标、HBV—DNA定量、肝纤四项指标改善有非常显著差异（P〈0．01）。结论恩替卡韦治疗乙型肝炎失代偿期肝硬化可有效抑制病毒复制，改善肝功能，阻止肝纤维化进展，防止病情恶化。     

高校图书馆应如何对乙肝学生患者进行心理护理与健康教育

笔者与本馆研究组成员通过对本校2007级768名乙肝病毒学生患者进行问卷调查,并对造成他们心理负担的结果进行分析,最后总结出了对乙肝病毒学生患者如何进行心理护理和健康教育,目的是发挥高校图书馆教育优势,让学生能正确地认识乙肝疾病,增强自我保护意识,使学生能健康成长。     

瘦素在肝纤维化中的作用探讨

目的观察慢性乙型肝炎患者血清瘦素(Leptin)与Ⅲ型前胶原(PCEE)、透明质酸(HA)、层粘连蛋白(LN)和肝脏纤维组织增长的关系.方法采用放射免疫吸附实验(RIA)测定105例慢性乙型肝炎、肝硬化患者血清瘦素、HA,LN,PCⅢ含量做定量分析.结果各型乙肝患者血清瘦素水平明显高于对照组(P<0.01或P<0.05).瘦素与血清HA,LN,PCⅢ呈正相关(P<0.01或P<0.05).结论慢性乙型肝炎、肝硬化患者血清瘦素水平明显升高,并与HA,LN,PCⅢ含量呈正相关.瘦素在慢性乙型肝炎肝纤维化发病机制中起一定作用.     

乙肝免疫球蛋白联合乙肝疫苗阻断母婴传播136例疗效分析

孕妇乙型肝炎或表面抗原阳性者对胎儿的影响已得到公认,本文通过对乙型肝炎病毒表面抗原阳性的孕妇在妊娠期间应用乙肝免疫球蛋白(HBIG)进行母婴传播的阻断疗效观察,显示HBIG联合乙肝疫苗对治疗组的阻断成功率为97.1%,疫苗接种成功率为82.4%,而未接种母婴阻断的乙肝病毒感染为15.96%,疫苗接种成功率为57.1%,明显低于治疗组.     

HCV基因分型在丙肝诊断和治疗中的应用

目的 建立ＨＣＶ基因分型方法，研究ＨＣＶ基因型与肝病程度的关系，探讨ＨＣＶ基因型与ＩＦＮ－ａ２ｂ抗病毒疗效的关系。方法 ＨＣＶ基因组ＮＳ５区ＰＣＲ扩增产物酶切分型。结果 ７３例ＨＣＶ感染者中有ＨＣＶⅡ型４５例，ＨＣＶⅢ型２８例。Ⅱ型ＨＣＶ感性肝炎３１例，肝硬化１４例；Ⅲ型ＨＣＶ感染者中有慢性肝炎２６例，肝硬化２例。Ⅱ型ＨＣＶ感染者的肝硬化发生率显著高于Ⅲ型ＨＣＶ感染者（Ｐ〈０．０５）。所有病人均应     

Metabonomic analysis of hepatitis B virus-induced liver failure： identification of potential diagnostic biomarkers by fuzzy support vector machine

Hepatitis B virus （HBV）-induced liver failure is an emergent liver disease leading to high mortality. The severity of liver failure may be reflected by the profile of some metabolites. This study assessed the potential of using metabolites as biomarkers for liver failure by identifying metabolites with good discriminative performance for its phenotype. The serum samples from 24 HBV-indueed liver failure patients and 23 healthy volunteers were collected and analyzed by gas chromatography-mass spectrometry （GC-MS） to generate metabolite profiles. The 24 patients were further grouped into two classes according to the severity of liver failure. Twenty-five eommensal peaks in all metabolite profiles were extracted, and the relative area values of these peaks were used as features for each sample. Three algorithms, F-test, k-nearest neighbor （KNN） and fuzzy support vector machine （FSVM） combined with exhaustive search （ES）, were employed to identify a subset of metabolites （biomarkers） that best predict liver failure. Based on the achieved experimental dataset, 93.62% predictive accuracy by 6 features was selected with FSVM-ES and three key metabolites, glyeerie acid, cis-aeonitie acid and citric acid, are identified as potential diagnostic biomarkers.     

定量微板核酸杂交检测乙型肝炎患者血清中HBVDNA及其临床意义

采用定量微板核酸杂交技术检测448例肝病患者血清中HBVDNA含量.结果显示:其阳性率和病毒含量HBsAg(+)、HBeAg(+)、抗-HBc(+)组>HBsAg(+)、抗-HBe(+)、抗-HBc(+)组>抗-HBs(+)、抗-HBe(+)、抗-HBc(+)组(P<0.05,P<0.01).血清HBVDNA含量与黄疸程度及转氨酶的高低无关.血清HBVDNA含量高低,阳性率大小与临床型的严重程度呈一定的相关性,从而指导临床诊断和治疗.     

原发性肝癌的腹腔镜分型(60例报告)(英文)

原发性肝癌的发病率在亚非洲远高于欧美,同样反映于国内外腹腔镜文献中,对其腹腔镜检查的介绍皆少而简略。本文就武汉市四个医院内科自1960年12月至6月经腹腔镜检查而最后确诊为原发性肝癌者60例进行了分析。按照腹腔镜下所观察到的肝脏形态试分作6型,大块型9例,多结节型21例,单结节型5例,(氵弥)漫小结节型(或肝硬化型)16例,非结节型(或肝炎型)3例,大网膜包果型6例。与经典的病理学分型相比较,这一分型对诊断、鉴别、处理与预后似有一定价值。有癌肿的肝叶与未发现癌肿的肝叶在同时并存的病理改变有显著较大且有不一致,对于原发性肝癌以肝硬变或病毒性肝炎作为前驱病的学说提出了疑问,本组病例未能说明日本位血吸虫病为原发性肝癌的病因。认为原发性肝癌患者肝脏的结节及肝炎等改变可能为癌肿的后果而不一定为原因。腹腔镜检查对于原发性肝癌的价值在于诊断符合率高,免除许多病例不必要的剖腹;直视下肝穿刺阳性率高,对于手术可能性的决定似有相当价值,比剖腹探查经济,住院日短而较安全。     

丙型肝炎病毒抗体快速诊断试剂的方法学研究

通过将抗原片段用点膜仪固相在硝酸纤维素膜上,依次加入标本、生物素标记的IgG、链霉亲和素-碱性磷酸酶,最后加底物显色,建立一种快速、敏感、实用的丙型肝炎病毒抗体(抗-HCV)检测方法.结果表明,整个检测过程仅需15～25 min,操作简便,已通过"第3代ELISA抗-HCV诊断试剂国家参考品".该方法简便、快速,结果易判断,既有ELISA的特异性和灵敏性,又有金标记法的检测速度;既适合输血筛查实验,又适合临床常规检查.     

RNA interference-mediated inhibition of Hepatitis B Virus replication

Persistent and recurrent infection of hepatitis B virus (HBV) represents one of the most common and severe viral infections of humans, and has caused a formidable health problem in the affected countries. Currently used antiviral drugs have a very limited success on controlling HBV replication and infection. RNA interference (RNAi), a process by which double-stranded RNA (dsRNA) directs sequence-specific degradation of target mRNA in mammalian and plant cells, has recently been used to knockdown gene expression in various species. In this study, we sought to determine whether RNAi-mediated silencing of HBV viral gene expression could lead to the effective inhibition of HBV replication. We first developed RNAi vectors that expressed small interfering RNA (siRNA) and targeted the HBV core or surface gene sequence. Our results demonstrated that these specific siRNAs efficiently reduced the levels of corresponding viral RNAs and proteins, and thus suppressed viral replication. Treatment with siRNA gave the greatest reduction in the levels of HBsAg (92%) and in HBeAg (85%) respectively in the cultured cell medium. Our findings further demonstrated that the RNAi-mediated antiviral effect was sequence-specific and dose-dependent. Therefore, our findings strongly suggest that RNAi-mediated silencing of HBV viral genes could effectively inhibit the replication of HBV, hence RNAi-based strategy should be further explored as a more efficacious antiviral therapy of HBV infection.