血清皮质醇水平与重型肝炎预后的相关性

目的探讨重型肝炎患者血清皮质醇水平与预后的关系,为临床判断预后及探讨治疗提供理论依据。方法对临床诊断的重型肝炎患者进行血清皮质醇、TNFα含量检测;比较重型肝炎、急性肝炎和慢性肝炎患者血清皮质醇水平的差异以及重型肝炎患者中死亡组和存活组的差异;检测血清皮质醇含量与TNFα含量的相关性。结果重型肝炎患者血清皮质醇水平明显低于急、慢性肝炎患者,尤以死亡组患者更为明显;血清皮质醇水平与TNFα含量呈显著负相关。结论重型肝炎患者存在肾上腺皮质功能不全,且与患者预后密切相关。     

甲胎蛋白与慢性乙型重型肝炎预后的关系分析

临床工作中曾发现甲胎蛋白的升高与慢性重型肝炎的预后有一定的关系 ,现选取 1995年以来所治疗的慢性重型肝炎患者进行分析。病人总数 55例 ,死亡 30例 ,其中 2 3例有血清甲胎蛋白升高 ,7例血清检测不到甲胎蛋白 ;存活 2 5例 ,全部都有不同程度的血清甲胎蛋白升高 ,死亡组甲胎蛋白平均值 2 38ｎｇ/ｍＬ ,存活组甲胎蛋白平均值 2 94ｎｇ/ｍＬ ,两者无显著差异 (ｔ检验 ,Ｐ =0 .15)。病程早期有血清甲胎蛋白升高的慢性重型肝炎患者预后较好 ,没有甲胎蛋白升高的患者预后较差。为了进一步明确甲胎蛋白在慢性重型肝炎预后判断中的作用 ,选取了有…     

重型肝炎患者血清血管内皮细胞生长因子的含量及其临床意义

目的 :研究重型肝炎患者血清血管内皮细胞生长因子 (VEGF)的含量与重型肝炎预后的关系。方法 :采用ELISA定量检测55例重型肝炎患者 (其中急性重型肝炎 2例 ,亚急性重型肝炎 9例 ,慢性重型肝炎 44例 )及健康体检者血清VEGF含量。结果 :正常对照组、重型肝炎患者存活组、死亡组血清VEGF含量分别为 :44.73± 1 4 .71pg/ml,80 .48± 1 0 .47pg/ml,37.99± 1 2 .70pg/ml。提示重型肝炎患者存活组血清VEGF水平与正常对照组相比显著升高 (P <0 .0 5) ,死亡组略降低但无统计学意义 (P >0 .0 5)。结论 :(1 )VEGF与肝细胞再生密切相关 ;(2 )动态检测血清VEGF水平变化可以预测重型肝炎患者的预后     

HBV相关肝病总胆汁酸测定及其临床意义

目的探讨HBV感染患者血清总胆汁酸(TBA)水平的变化。方法常规检测血清总胆汁酸水平。结果慢性乙型重型肝炎、急性乙型肝炎患者血清TBA水平显著升高,差异非常显著(P0.01);在慢性乙型重型肝炎患者,存活组TBA水平明显低于死亡组,差异非常显著(P0.01);慢性乙型重型肝炎患者TBA水平与ALT、ALB、CHE呈明显的相关性(P均0.01)。结论血清TBA水平是反映肝损伤的程度,对乙型重型肝炎患者的病情及预后判断有重要意义。     

血管内皮细胞生长因子检测在重型肝炎患者中的应用

目的：探讨检测血管内皮细胞生长因子（VEGF）水平在重型肝炎患者中的临床应用，为其预后提供早期诊断依据。方法：采用双抗体夹心法定量检测80例重型肝炎患者血清VEGF水平。结果：急、慢性重型肝炎患者VEGF检出率分别为39．09％和81．36％。慢性期恢复率升高差异有显著性意义（P〈0．01），存活组和死亡组检出率分别高于正常组，存活组恢复期检出率达81．96％（P〈0．01），而死亡组恢复期检出率明显下降达21．05％（P〈0．05）。血清VEGF检测灵敏度为15pg／ml，特异性强，重复性好，板内板间变异系数均〈9．5％。结论：血清VEGF水平检测具有较好的特异性和敏感性，可反映重型肝炎患者肝细胞再生程度，是临床观察重型肝炎患者预后具有特征性的疗效指标。     

影响重型肝炎患者预后的危险因素研究

目的 研究影响重型肝炎患者预后的危险因素。方法收集75例重型肝炎患者（存活组39例，死亡组36例）28项临床指标，采用Cox比例风险模型研究影响重型肝炎患者生存的危险因素与生存状态及生存时间的综合性量化关系。结果白细胞、血小板、总胆红素、碱性磷酸酶、胆固醇、凝血酶原活动度、透明质酸、肝性脑病、肝肾综合征、电解质紊乱、腹水、感染在存活组和死亡组之间差异有统计学意义（P〈0．05）。Cox模型分析显示，凝血酶原活动度、肝性脑病、感染是影响重型肝炎患者预后的主要危险因素（相对危险度分别为0．963、4．107、0．258，P〈0．05）。结论重型肝炎预后影响因素众多，凝血酶原活动度、肝性脑病和感染为主要危险因素，可望用于重型肝炎的预后判断。     

乙型肝炎甲胎蛋白检测与重型肝炎预后指数评估的意义

给慢性活动肝炎患者输注人胎肝细胞悬液引起血清甲胎蛋白增高反应的初浓度为２０２±３８．３μｇ／Ｌ，其半衰期为１．７天；分布池为６．９一１０．２升。重型肝炎生存组血清甲胎蛋白显著高于死亡组，生存组甲胎蛋白与血清总胆红素呈非常显著相关，而死亡组两者无相关性。重型肝炎患者输注胎肝悬液后其血清甲胎蛋白进一步升高者，预后较好。取重型肝炎预后指数０．１为重型肝炎生死的截断点，判断预后的灵敏度、特异度、准确度和阳性预告值分别为７９．５％、８９．６％、８４．８％和８７．５％。重型肝炎预后指数的计算可作为判断预后与新疗法疗效的指标。     

检测肝炎患者胆碱脂酶活性的临床价值分析

目的 评估血清胆碱脂酶（CHE）活性变化在判定肝病病程和预后方面的价值。方法 采用全自动生化分析仪检测各种肝炎患者血清CHE的活性。结果 慢性肝炎组、重型肝炎组CHE活性均显著低于正常对照组（P〈0.01）。重型肝炎组（n=68）中存活组（n=40）和死亡组（n=28）CHE分别为3．49±1．23ku／L。和2．88±1．11ku／L，两组比较差异有统计学意义（P＜0.05）。结论 CHE活性检测有助于判定肝病患者的预后。     

慢性重型肝炎患者促甲状腺激素水平与肝功能以及预后的相关性分析

目的:探讨慢性重型肝炎患者促甲状腺激素(thyroid stimulating hormone, TSH)水平与肝功能以及预后的相关性。方法:选取2020年1月—2022年4月就诊的慢性重型肝炎患者为研究对象，所有患者出院后均随访6个月，以随访6个月内患者生存状态分为存活组(52例)和死亡组(45例),比较两组患者的临床资料以及血清TSH表达水平，Cox回归分析获得影响慢性重型肝炎患者随访6个月死亡的独立预测因素，绘制TSH预测慢性重型肝炎患者随访6个月死亡的ROC曲线，以TSH的最佳诊断截点将所有患者分为两组，Kaplan-Meier生存分析比较两组患者随访6个月的总生存率，并基于TSH和其他独立预测因素绘制相关Cox死亡风险得分图，Pearson相关性分析探讨TSH与肝功能的相关性。结果:死亡组患者肝性脑病、肝肾综合征所占比例、总胆红素以及终末期肝病模型(model for end-stage liver disease, MELD)评分明显高于存活组，凝血酶原活动度(prothrombin activity, PTA)和TSH明显低于存活组(P<0.05)。多因素Cox回归...     

重型肝炎

重型肝炎患者血糖变化的临床意义；重型肝炎并发症与存活率关系的探讨；重型肝炎预后相关的低相对分子质量蛋白质谱分析；慢性重型肝炎患者低氧血症42例动态观察；胸腺肽α1治疗重型肝炎的疗效观察；应用终末期肝病模型对慢性重型肝炎患者的预后评估；大黄煎剂超微配方颗粒与汤剂保留灌肠治疗终末期肝病内毒素血症的比较研究。     

A Call to Action to Enhance Filovirus Disease Outbreak Preparedness and Response

The frequency and magnitude of recognized and declared filovirus-disease outbreaks have increased in recent years, while pathogenic filoviruses are potentially ubiquitous throughout sub-Saharan Africa. Meanwhile, the efficiency and effectiveness of filovirus-disease outbreak preparedness and response efforts are currently limited by inherent challenges and persistent shortcomings. This paper delineates some of these challenges and shortcomings and provides a proposal for enhancing future filovirus-disease outbreak preparedness and response. The proposal serves as a call for prompt action by the organizations that comprise filovirus-disease outbreak response teams, namely, Ministries of Health of outbreak-prone countries, the World Health Organization, Médecins Sans Frontières, the Centers for Disease Control and Prevention—Atlanta, and others.     

Control of intraabdominal hemorrhage and shock: a comparison of fluid resuscitation, MAST, and balloon occlusion

Our study examined the efficacy of four treatment modalities in controlling hemorrhage and achieving hemodynamic stabilization in hemorrhagic shock: intravenous fluid replacement (IV); military antishock trousers used concomitantly with fluids (MAST); balloon occlusion at the level of the diaphragm with concomitant fluid replacement (balloon); and a combination of MAST inflation, balloon occlusion, and fluid resuscitation (MAST and balloon). Twenty-eight mongrel dogs were anesthetized, and the spleen was exposed and completely crushed. The abdomen was closed, and treatment was initiated and continued for four hours or until the dog died. For all conditions the hematocrit dropped during the course of the experiment; balloon occlusion was effective at slowing this drop (P less than .0001), but MAST had no statistically significant effect. Animals with balloons bled more slowly into the abdominal cavity than did animals in the other two groups (P less than .0001). MAST also were effective at slowing the bleeding (P less than .05). Of the balloon and the MAST and balloon dogs, all except one survived the entire four hours; this difference between balloon and nonballoon dogs is significant (P = .002). MAST did not have a statistically significant effect on survival. Perfusion pressure (PP) declined during the course of the experiment, and the balloon was effective at slowing this decline (P less than .0001); none of the other comparisons was statistically significant.     

Interplay between interferon-mediated innate immunity and porcine reproductive and respiratory syndrome virus

Innate immunity is the first line of defense against viral infection, and in turn, viruses have evolved to evade host immune surveillance. As a result, viruses may persist in host and develop chronic infections. Type I interferons (IFN-α/β) are among the most potent antiviral cytokines triggered by viral infections. Porcine reproductive and respiratory syndrome (PRRS) is a disease of pigs that is characterized by negligible induction of type I IFNs and viral persistence for an extended period. For IFN production, RIG-I/MDA5 and JAK-STAT pathways are two major signaling pathways, and recent studies indicate that PRRS virus is armed to modulate type I IFN responses during infection. This review describes the viral strategies for modulation of type I IFN responses. At least three non-structural proteins (Nsp1, Nsp2, and Nsp11) and a structural protein (N nucleocapsid protein) have been identified and characterized to play roles in the IFN suppression and NF-κB pathways. Nsp's are early proteins while N is a late protein, suggesting that additional signaling pathways may be involved in addition to the IFN pathway. The understanding of molecular bases for virus-mediated modulation of host innate immune signaling will help us design new generation vaccines and control PRRS.     

Disease Pandemics and Major Epidemics Arising From New Encounters between Indigenous Viruses and Introduced Crops

Virus disease pandemics and epidemics that occur in the world’s staple food crops pose a major threat to global food security, especially in developing countries with tropical or subtropical climates. Moreover, this threat is escalating rapidly due to increasing difficulties in controlling virus diseases as climate change accelerates and the need to feed the burgeoning global population escalates. One of the main causes of these pandemics and epidemics is the introduction to a new continent of food crops domesticated elsewhere, and their subsequent invasion by damaging virus diseases they never encountered before. This review focusses on providing historical and up-to-date information about pandemics and major epidemics initiated by spillover of indigenous viruses from infected alternative hosts into introduced crops. This spillover requires new encounters at the managed and natural vegetation interface. The principal virus disease pandemic examples described are two (cassava mosaic, cassava brown streak) that threaten food security in sub-Saharan Africa (SSA), and one (tomato yellow leaf curl) doing so globally. A further example describes a virus disease pandemic threatening a major plantation crop producing a vital food export for West Africa (cacao swollen shoot). Also described are two examples of major virus disease epidemics that threaten SSA’s food security (rice yellow mottle, groundnut rosette). In addition, brief accounts are provided of two major maize virus disease epidemics (maize streak in SSA, maize rough dwarf in Mediterranean and Middle Eastern regions), a major rice disease epidemic (rice hoja blanca in the Americas), and damaging tomato tospovirus and begomovirus disease epidemics of tomato that impair food security in different world regions. For each pandemic or major epidemic, the factors involved in driving its initial emergence, and its subsequent increase in importance and geographical distribution, are explained. Finally, clarification is provided over what needs to be done globally to achieve effective management of severe virus disease pandemics and epidemics initiated by spillover events.     

岳阳市城区小学生血吸虫病防治健康教育现状调查

目的 调查湖南省岳阳市城区小学生血吸虫病防治知识、行为现状及健康教育需求情况,为制定科学有效的小学生血吸虫病健康教育方案提供参考依据。方法 采用分层整群抽样方法,抽取岳阳市城区洞庭湖湖畔学校和中心城区学校各2所,每所再从五、六年级分别抽取2个班的学生,通过调查问卷了解小学生血吸虫病相关知识、预防行为及健康教育需求,并进行统计分析。结果 共调查湖畔小学353人、中心城区小学363人,两组学校小学生年龄、性别、年级构成差异无统计学意义（t=-0.494,χ²_性别=1.615,χ²_年级=2.152;P均>0.05）。学生血吸虫病防治知识总知晓率为42.60%（305/716）,其中,湖畔学校小学生血防知识知晓率（52.97%）高于中心城区（32.51%）,差异有统计学意义（χ²=30.661,P<0.05）;学生行为正确率为76.68%（549/716）,血防知识知晓组行为正确率（81.31%）高于不知晓组（71.24%）,差异有统计学意义（χ²=6.384,P<0.05）。学生血防知识主要来源于老师（47.49%）;91.90%的学生愿意了解更多的血防知识,最喜欢的血防知识学习方式是参加课外活动（50.42%）。结论 岳阳市城区小学生的血防知识知晓率及行为正确率偏低,对血吸虫病防治健康教育需求较高。建议针对学生开展形式多样的血防健康教育,以增强学生的血吸虫病防护意识,提高自我防护能力。     

Barrett's Esophagus: Where Do We Stand?

Barrett''s esophagus (BE) is a precursor for esophageal adenocarcinoma, which has an increased incidence rate over the last few decades. Its importance stems from the poor five-year survival of esophageal adenocarcinoma and current data that suggest a survival benefit when surveillance programs are implemented. In this review, we will cover the pathophysiology and natural history of BE and the different endoscopic findings. The prevalence of BE in different geographic areas and the incidence of high-grade dysplasia and adenocarcinoma in this patient population is reviewed. Recent recommendation for screening and surveillance of BE has been covered in this review as well as the efficacy of nonconventional imaging modalities and endoscopic ablation therapies.