慢性乙型肝炎患者配偶乙型肝炎病毒感染状况调查和分析

Objective To evaluate the influence of daily contact on HBV infection between hepatitis B virus carriers and their spouses by investigating the infection situation after marriage. Methods Premarital HBV carriers of serum HBV DNA positive were enrolled, family history, the histoty of blood donation, blood transfusion, drug abuse,physical examination, premarriage medical check, extramarital sex and hepatitis B vaccine were investigated in their spouses. Couples who were infected before marriage or vaccined with HBV vaccine were excluded. 68 couples were enrolled with an average marriage time of 12.5 years (0.5-35 years), their HBV serum markers and quantitative were performed. Results In the 68 couples, 54(79.4%) spouses were serum HBV marker positive, of the 54 spouses, 4 were HBV DNA positive. The chronic rate of HBV infection in the spouses was 7.4%, and was similar to the rate in general population(5%-10%). 48(88.9%) spouses were anti-HBs positive, the positive rate was similar to the rate in vaccinated population (85%-90%). Male spouses with at least one HBV marker positive were 22 cases (22/24), occupied 91.7% , female spouses were 32(32/44), occupied 72.7%, there was no difference between the male and female spouses(χ2 = 2.681, P > 0.05). Conclusions Whether HBV carriers' spouse infected with HBV is not correlated with marriage time, gender and HBV DNA level of carriers. HBV infection rate of the healthy people increases after marriage with HBV carriers, but the rate of chronic HBV infection is not increased obviouly.     

不同剂量国产重组酵母乙型肝炎疫苗成年人免疫效果及影响因素研究

Objective To evaluate the immuno-effect and related influencing factors on 10 μg and 20 μg Chinese hamster ovary (CHO) cell hepatitis B vaccine, using the randomized double-blind controlled trials in adult population. Methods A total of 642 adults aged 18-45 years old, non-vaccinated against hepatitis B, and negative on five blood indicators for hepatitis B, were selected as the study objects from four districts in Beijing. The study objects were randomly divided into two groups, and then accepted 10 tg and 20 μg recombinant CHO hepatitis B vaccination by 0-1-6 month schedule. Influencing factors were investigated by means of questionnaire. Blood samples were collected one month after the third dose of vaccination. Anti-HBs level was detected by Abott chemiluminescence detection method. For the anti-HBs negative person, fluorescent quantitative PCR method was used to find out if the person had been infected with HBV. Logistic regression analysis was used to find out the influencing factors of anti-HBs seroconversion on every studied subject. Results The anti-HBs seroconversion rates on 10 μg and 20 μg dose groups were 88.8%(95%CI: 85.4%-92.2%) and 95.3%(95%CI: 93.0%-97.6%)respectively. Taking the anti-HBs level＜100 mIU/ml as the low/non-response standard, the low response and non-response rates were 34.3% and 17.4% respectively. The geometric mean titers(GMT)of anti-HBs were 173.42 mIU/ml for the 10 μg dose group and 588.51 mIU/ml for the 20 μg dose group. Data from the Multivariate analysis showed that: diabetes, spouses infected with hepatitis B virus and old age were unfavorable factors for anti-HBs Seroconversion. 20 μg dose of the vaccine was conducive to seroconversion.Conclusion 20 μg CHO hepatitis B vaccine seemed better than 10 μg CHO hepatitis B vaccine while many factors need to be taken into account for evaluation on hepatitis B vaccines.     

不同剂量国产重组酵母乙型肝炎疫苗成年人免疫效果及影响因素研究

Objective To evaluate the immuno-effect and related influencing factors on 10 μg and 20 μg Chinese hamster ovary (CHO) cell hepatitis B vaccine, using the randomized double-blind controlled trials in adult population. Methods A total of 642 adults aged 18-45 years old, non-vaccinated against hepatitis B, and negative on five blood indicators for hepatitis B, were selected as the study objects from four districts in Beijing. The study objects were randomly divided into two groups, and then accepted 10 tg and 20 μg recombinant CHO hepatitis B vaccination by 0-1-6 month schedule. Influencing factors were investigated by means of questionnaire. Blood samples were collected one month after the third dose of vaccination. Anti-HBs level was detected by Abott chemiluminescence detection method. For the anti-HBs negative person, fluorescent quantitative PCR method was used to find out if the person had been infected with HBV. Logistic regression analysis was used to find out the influencing factors of anti-HBs seroconversion on every studied subject. Results The anti-HBs seroconversion rates on 10 μg and 20 μg dose groups were 88.8%(95%CI: 85.4%-92.2%) and 95.3%(95%CI: 93.0%-97.6%)respectively. Taking the anti-HBs level＜100 mIU/ml as the low/non-response standard, the low response and non-response rates were 34.3% and 17.4% respectively. The geometric mean titers(GMT)of anti-HBs were 173.42 mIU/ml for the 10 μg dose group and 588.51 mIU/ml for the 20 μg dose group. Data from the Multivariate analysis showed that: diabetes, spouses infected with hepatitis B virus and old age were unfavorable factors for anti-HBs Seroconversion. 20 μg dose of the vaccine was conducive to seroconversion.Conclusion 20 μg CHO hepatitis B vaccine seemed better than 10 μg CHO hepatitis B vaccine while many factors need to be taken into account for evaluation on hepatitis B vaccines.     

Clinical study of the efficacy of interferon-α therapy for HBeAg-negative chronic hepatitis B patients

Objective To investigate the effect of IFN-α therapy for HBeAg-negative ehronie hepatitis B(CHB). Methods 50 cases of HBeAg-negative CHB patients were selected as treated group, while 52 cases of HBeAg-positive CHB as control group. Both groups received injection of IFN-α at dose of 6 MU every other day for 48 weeks. Levels of alanine aminotransferase, viral markers levels of HBeAg, HBV DNA and the four serum fibrosis markers were analysed before and after treatment and 24 weeks after the course. Results There were 36 cases in treated group and 26 cases in control group who had got obvious therapeutic effects at the end of 24 weeks after treatment. And the rates of efficacy were 72% and 50% separately. The rate of treated group was higher than that of control group(X2 = 5.43, P <0.05). The four serum fibrosis markers of the both groups were clearly dropped after treatment (t = 2.365, P < 0.05). Conclusions The theraputie effects of IFN-α at dose of 6 MU for HBeAg-negative CHB is prior to HBeAg-positive CHB. And IFN-α also have an evident funtion on preventing or delaying hepatic fibrosis in patients with CHB.     

Clinical study of the efficacy of interferon-α therapy for HBeAg-negative chronic hepatitis B patients

Objective To investigate the effect of IFN-α therapy for HBeAg-negative ehronie hepatitis B(CHB). Methods 50 cases of HBeAg-negative CHB patients were selected as treated group, while 52 cases of HBeAg-positive CHB as control group. Both groups received injection of IFN-α at dose of 6 MU every other day for 48 weeks. Levels of alanine aminotransferase, viral markers levels of HBeAg, HBV DNA and the four serum fibrosis markers were analysed before and after treatment and 24 weeks after the course. Results There were 36 cases in treated group and 26 cases in control group who had got obvious therapeutic effects at the end of 24 weeks after treatment. And the rates of efficacy were 72% and 50% separately. The rate of treated group was higher than that of control group(X2 = 5.43, P <0.05). The four serum fibrosis markers of the both groups were clearly dropped after treatment (t = 2.365, P < 0.05). Conclusions The theraputie effects of IFN-α at dose of 6 MU for HBeAg-negative CHB is prior to HBeAg-positive CHB. And IFN-α also have an evident funtion on preventing or delaying hepatic fibrosis in patients with CHB.     

Clinical study of the efficacy of interferon-α therapy for HBeAg-negative chronic hepatitis B patients

Objective To investigate the effect of IFN-α therapy for HBeAg-negative ehronie hepatitis B(CHB). Methods 50 cases of HBeAg-negative CHB patients were selected as treated group, while 52 cases of HBeAg-positive CHB as control group. Both groups received injection of IFN-α at dose of 6 MU every other day for 48 weeks. Levels of alanine aminotransferase, viral markers levels of HBeAg, HBV DNA and the four serum fibrosis markers were analysed before and after treatment and 24 weeks after the course. Results There were 36 cases in treated group and 26 cases in control group who had got obvious therapeutic effects at the end of 24 weeks after treatment. And the rates of efficacy were 72% and 50% separately. The rate of treated group was higher than that of control group(X2 = 5.43, P <0.05). The four serum fibrosis markers of the both groups were clearly dropped after treatment (t = 2.365, P < 0.05). Conclusions The theraputie effects of IFN-α at dose of 6 MU for HBeAg-negative CHB is prior to HBeAg-positive CHB. And IFN-α also have an evident funtion on preventing or delaying hepatic fibrosis in patients with CHB.     

Clinical study of the efficacy of interferon-α therapy for HBeAg-negative chronic hepatitis B patients

Objective To investigate the effect of IFN-α therapy for HBeAg-negative ehronie hepatitis B(CHB). Methods 50 cases of HBeAg-negative CHB patients were selected as treated group, while 52 cases of HBeAg-positive CHB as control group. Both groups received injection of IFN-α at dose of 6 MU every other day for 48 weeks. Levels of alanine aminotransferase, viral markers levels of HBeAg, HBV DNA and the four serum fibrosis markers were analysed before and after treatment and 24 weeks after the course. Results There were 36 cases in treated group and 26 cases in control group who had got obvious therapeutic effects at the end of 24 weeks after treatment. And the rates of efficacy were 72% and 50% separately. The rate of treated group was higher than that of control group(X2 = 5.43, P <0.05). The four serum fibrosis markers of the both groups were clearly dropped after treatment (t = 2.365, P < 0.05). Conclusions The theraputie effects of IFN-α at dose of 6 MU for HBeAg-negative CHB is prior to HBeAg-positive CHB. And IFN-α also have an evident funtion on preventing or delaying hepatic fibrosis in patients with CHB.     

Clinical study of the efficacy of interferon-α therapy for HBeAg-negative chronic hepatitis B patients

Objective To investigate the effect of IFN-α therapy for HBeAg-negative ehronie hepatitis B(CHB). Methods 50 cases of HBeAg-negative CHB patients were selected as treated group, while 52 cases of HBeAg-positive CHB as control group. Both groups received injection of IFN-α at dose of 6 MU every other day for 48 weeks. Levels of alanine aminotransferase, viral markers levels of HBeAg, HBV DNA and the four serum fibrosis markers were analysed before and after treatment and 24 weeks after the course. Results There were 36 cases in treated group and 26 cases in control group who had got obvious therapeutic effects at the end of 24 weeks after treatment. And the rates of efficacy were 72% and 50% separately. The rate of treated group was higher than that of control group(X2 = 5.43, P <0.05). The four serum fibrosis markers of the both groups were clearly dropped after treatment (t = 2.365, P < 0.05). Conclusions The theraputie effects of IFN-α at dose of 6 MU for HBeAg-negative CHB is prior to HBeAg-positive CHB. And IFN-α also have an evident funtion on preventing or delaying hepatic fibrosis in patients with CHB.     

Clinical study of the efficacy of interferon-α therapy for HBeAg-negative chronic hepatitis B patients

Objective To investigate the effect of IFN-α therapy for HBeAg-negative ehronie hepatitis B(CHB). Methods 50 cases of HBeAg-negative CHB patients were selected as treated group, while 52 cases of HBeAg-positive CHB as control group. Both groups received injection of IFN-α at dose of 6 MU every other day for 48 weeks. Levels of alanine aminotransferase, viral markers levels of HBeAg, HBV DNA and the four serum fibrosis markers were analysed before and after treatment and 24 weeks after the course. Results There were 36 cases in treated group and 26 cases in control group who had got obvious therapeutic effects at the end of 24 weeks after treatment. And the rates of efficacy were 72% and 50% separately. The rate of treated group was higher than that of control group(X2 = 5.43, P <0.05). The four serum fibrosis markers of the both groups were clearly dropped after treatment (t = 2.365, P < 0.05). Conclusions The theraputie effects of IFN-α at dose of 6 MU for HBeAg-negative CHB is prior to HBeAg-positive CHB. And IFN-α also have an evident funtion on preventing or delaying hepatic fibrosis in patients with CHB.     

Clinical study of the efficacy of interferon-α therapy for HBeAg-negative chronic hepatitis B patients

Objective To investigate the effect of IFN-α therapy for HBeAg-negative ehronie hepatitis B(CHB). Methods 50 cases of HBeAg-negative CHB patients were selected as treated group, while 52 cases of HBeAg-positive CHB as control group. Both groups received injection of IFN-α at dose of 6 MU every other day for 48 weeks. Levels of alanine aminotransferase, viral markers levels of HBeAg, HBV DNA and the four serum fibrosis markers were analysed before and after treatment and 24 weeks after the course. Results There were 36 cases in treated group and 26 cases in control group who had got obvious therapeutic effects at the end of 24 weeks after treatment. And the rates of efficacy were 72% and 50% separately. The rate of treated group was higher than that of control group(X2 = 5.43, P <0.05). The four serum fibrosis markers of the both groups were clearly dropped after treatment (t = 2.365, P < 0.05). Conclusions The theraputie effects of IFN-α at dose of 6 MU for HBeAg-negative CHB is prior to HBeAg-positive CHB. And IFN-α also have an evident funtion on preventing or delaying hepatic fibrosis in patients with CHB.     

Clinical study of the efficacy of interferon-α therapy for HBeAg-negative chronic hepatitis B patients

Objective To investigate the effect of IFN-α therapy for HBeAg-negative ehronie hepatitis B(CHB). Methods 50 cases of HBeAg-negative CHB patients were selected as treated group, while 52 cases of HBeAg-positive CHB as control group. Both groups received injection of IFN-α at dose of 6 MU every other day for 48 weeks. Levels of alanine aminotransferase, viral markers levels of HBeAg, HBV DNA and the four serum fibrosis markers were analysed before and after treatment and 24 weeks after the course. Results There were 36 cases in treated group and 26 cases in control group who had got obvious therapeutic effects at the end of 24 weeks after treatment. And the rates of efficacy were 72% and 50% separately. The rate of treated group was higher than that of control group(X2 = 5.43, P <0.05). The four serum fibrosis markers of the both groups were clearly dropped after treatment (t = 2.365, P < 0.05). Conclusions The theraputie effects of IFN-α at dose of 6 MU for HBeAg-negative CHB is prior to HBeAg-positive CHB. And IFN-α also have an evident funtion on preventing or delaying hepatic fibrosis in patients with CHB.     

Clinical study of the efficacy of interferon-α therapy for HBeAg-negative chronic hepatitis B patients

Objective To investigate the effect of IFN-α therapy for HBeAg-negative ehronie hepatitis B(CHB). Methods 50 cases of HBeAg-negative CHB patients were selected as treated group, while 52 cases of HBeAg-positive CHB as control group. Both groups received injection of IFN-α at dose of 6 MU every other day for 48 weeks. Levels of alanine aminotransferase, viral markers levels of HBeAg, HBV DNA and the four serum fibrosis markers were analysed before and after treatment and 24 weeks after the course. Results There were 36 cases in treated group and 26 cases in control group who had got obvious therapeutic effects at the end of 24 weeks after treatment. And the rates of efficacy were 72% and 50% separately. The rate of treated group was higher than that of control group(X2 = 5.43, P <0.05). The four serum fibrosis markers of the both groups were clearly dropped after treatment (t = 2.365, P < 0.05). Conclusions The theraputie effects of IFN-α at dose of 6 MU for HBeAg-negative CHB is prior to HBeAg-positive CHB. And IFN-α also have an evident funtion on preventing or delaying hepatic fibrosis in patients with CHB.     

2789例10岁以上儿童重组乙型肝炎疫苗加强免疫效果评价

目的 比较不同重组乙型肝炎(乙肝)疫苗加强免疫效果.方法 选择1周岁内完成血源乙肝疫苗基础免疫的10岁以上儿童2789例,分别接种4种国内常用的不同重组乙肝疫苗,分为A、B、C、D4组,采集血清,使用化学发光法检测HBsAg、抗-HBs、抗-HBc,仅抗-HBs阳性者接种1剂次、抗-HBs阴性者接种3剂次相应疫苗,免疫1个月后采血检测抗-HBs.结果 加强免疫前、免疫1剂次及3剂次后A、B、C、D 4组抗-HBs阳性率分别为36.43%、37.59%、42.91%、46.46%;89.20%、91.52%、90.96%、85.45%;99.12%、99.47%、98.87%、98.85%;加强免疫前、免疫1剂次及3剂次后两两之间抗-HBs阳性率差异均有统计学意义(P值均＜0.05).抗-HBs阴性者加强免疫1剂次、3剂次后,抗-HBs阳转率分别为83.01%、86.41%、84.16%、72.82%;98.62%、99.16%、98.03%、97.84%;与抗-HBs阳性者加强免疫1剂次相比,4组抗-HBs阳转率差异均有统计学意义(P＜0.05).抗-HBs阳性者加强免疫1剂次后几何平均滴度(GMT)分别为2853.21、6254.23、3581.40、3021.32 mIU/ml.抗-HBs阴性者加强免疫1剂次、3剂次后4组GMT分别为273.08、648.52、387.87、245.36 mIU/ml;632.30、2341.14、563.97、394.08 mIU/ml.结论 采用上述4种重组乙肝疫苗对抗-HBs阳性的10岁以上儿童加强免疫1剂次、对抗-HBs阴性的10岁以上儿童加强免疫3剂次,免疫效果良好.

Abstract：

Objective To study the efficiency of booster immunization with different recombinant hepatitis B vaccines.Methods 2789 children aged over 10 years who had completed the basic immunization of hepatitis B vaccine under 1 year old were selected.All the sampled children were classified into four groups (A,B,C and D) and immunized with different hepatitis B vaccines produced by different campanies respectively.Before booster immunization,their blood plasma specimens were detected for hepatitis B virus (HBV) surface antigen (HBsAg),antibodies to HBV surface antigen (anti-HBs) and antibodies to HBV core antigen (anti-HBc) by chemiluminescence.In each group,the anti-HBs positive children were immunized with one dosage and anti-HBs negative children were immunized three dosages of the same vaccine.Their blood specimens were collected again after 1 month,and detected for anti-HBs.Results The anti-HBs positive rates of A,B,C and D group were 36.43%,37.59%,42.91% and 46.46% respectively before immunization while 89.20%,91.52%,90.96% and 85.45% respectively after immunization with one dosage,99.12%,99.47%,98.87% and 98.85% respectively after immunization with three dosages.The differences of anti-HBs positive rates in the four respective groups showed statistical significances between any two rates of pre-immunization,post-immunization with one dosage and post- immunization with three dosages (all P＜0.05).The anti-HBs positive conversion rates of four groups were 83.01%,86.41%,84.16% and 72.82% respectively after immunization with one dosage.The anti-HBs positive conversion rate of four groups were 98.62%,99.16%,98.03% and 97.84% respectively after immunization with three dosages and the difference of positive conversion rates in each group showed statistical significances between booster immunization with one dosage and booster immunization with three dosages.The average GMTs in anti-HBs positive children in the four groups were 2853.21,6254.23,3581.40 and 3021.32 mIU/ml respectively after immunization with one dosage.The average GMTs of anti-HBs negative children in the four groups were 273.08,648.52,387.87 and 245.36 mIU/ml respectively after immunization with one dosage,and were 632.30,2341.14,563.97 and 394.08 mIU/ml respectively after immunization with three dosages.Conclusion Our data showed that it would be suitable to anyone to use the four vaccines for anti-HBs positive children aged over 10 years with one dosage and for anti-HBs negative children aged over 10 years with three dosage booster immunization.     

拉米夫定联合阿德福韦酯治疗乙型肝炎失代偿期肝硬化的临床疗效及安全性分析

目的 研究拉米夫定联合阿德福韦酯治疗乙型肝炎失代偿期肝硬化的临床疗效及并发症.方法 将86例乙型肝炎失代偿期肝硬化患者采用随机数字表法分为对照组和观察组,每组43例,对照组在常规治疗的基础上加服拉米夫定,观察组在对照组的基础上加服阿德福韦酯,治疗12个月后对其临床疗效进行评价.结果 两组患者治疗前后丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TBil)、白蛋白(ALB)及Child-Pugh评分比较差异均有统计学意义(P<0.05),观察组治疗后ALT、AST与对照组比较差异有统计学意义(P<0.05);观察组HBeAg/HBeAb血清转换率和HBV DNA转阴率高于对照组[86.05%(37/43)比65.12%(28/43),79.07%(34/43)比55.81%(24/43)],两组比较差异有统计学意义(P<0.05);对照组共发生7例次并发症,观察组共发生8例次并发症,两组比较差异无统计学意义(P>0.05).结论 拉米夫定联合阿德福韦酯治疗乙型肝炎失代偿期肝硬化安全、有效,且临床疗效优于单纯应用拉米夫定.

Abstract：

Objective To study the clinical effect and complication of the combination treatment of lamivudine and adeforvir dipivoxil in decompeasated hepatitis B cirrhosis. Methods Eighty-six cases of decompensated hepatitis B cirrhosis were divided into the observation group and the control group with 43 eases each by random digits table. The control group was treated with routine treatment and lamivudine, and the observation group was added with adefovir dipivoxil on the base of the treatment in the control group. The clinical effect after 12 months' treatment was evaluated. Results After 12 months'treatment, the level of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), albumin ( ALB ) and Child-Pugh grade had significant improvement than that before the treatment in two groups(P < 0.05 ), and in the observation group they improved more obvious (P <0.05). The frequence of seroconversion of HBeAg/HBeAb and HBV DNA in the observation group was higher than that in the control group [86.05%(37/43) vs. 65.12%(28/43),79.07% (34/43) vs. 55.81%(24/43)], and the difference between the two groups was significant (P < 0.05 ). Seven cases of times complications happened in the control group and 8 cases of times complications happened in the observation group and the difference between the two groups was not significant (P > 0.05 ). Conclusion The effect of lamivudine and adefovir dipivoxil in the treatment of decompensated hepatitis B cirrhosis is superior to the only lamivudine.     

地塞米松在预防新生儿湿肺中的应用价值

目的 探讨足月选择性剖宫产中地塞米松对新生儿湿肺的预防效果.方法 按照随机数字表法将孕周＜39周足月选择性剖宫产孕妇200例分为试验组和对照组各100例,试验组产前予地塞米松24h至7 d,每次6mg肌肉注射,每12 h 1次,共4次.对照组予0.9%氯化钠肌肉注射,方法同上.采集两组孕妇的一般临床资料、新生儿湿肺的发生情况.结果 新生儿湿肺发生率:试验组1%(1/100),对照组9%(9/100);重症新生儿湿肺发生率:试验组1%(1/100),对照组2%(2/100);并发症:试验组0例,对照组1例.试验组新生儿湿肺发生率和重症新生儿湿肺发生率明显低于对照组(P=0.009、0.049),同时并发症少.结论 产前地塞米松干预足月选择性剖宫产孕妇,能减少新生儿湿肺的发生率,降低重症新生儿湿肺及并发症的发生率.

Abstract：

Objective To explore the effect of the prenatal dexamethasone treatment on the preventionof wet lung syndrome in the newborn of elective caesarean section at term. Methods Two hundred cases of elective caesarean section at term (the gestation age was less than 39 weeks) were divided into observation group and control group,with 100 cases in each by random digits table. Observation group was treated with four intramuscular injections of 6 mg dexamethasone in the 24 hours to 7 days before delivery, and control group was treated with 0.9% sodium chloride injection with the same method. The clinical data and the incidence of the wet lung syndrome of the newborn were collected. Results The incidence of the wet lung syndrome of the newborn was 1%(1/100) in observation group and 9%(9/100) in control group,and the incidence of the severity of the wet lung syndrome of the newborn was 1% ( 1/100) in observation group and 2%(2/100) in control group. There were no complication in observation group and 1 case in control group.The incidence and the severity of the wet lung syndrome of the newborn in observation group were less than that in control group significantly (P = 0.009,0.049). Conclusion Prenatal dexamethasone treatment can reduce the incidence of the wet lung syndrome of the newborn and decrease the incidence of the severity and complication of elective caesarean section at term.     

补充维生素A对婴幼儿乙肝疫苗再免疫效果的促进作用

目的 观察补充维生素A(VA)对婴幼儿乙型病毒性肝炎(简称乙肝)疫苗再免疫效果的影响.方法 于2008年10月至2009年3月间,招募山东临沂某农村地区所有按国家计划免疫常规全程接种过乙肝疫苗的7～36月龄婴幼儿,检测其血清乙肝表面抗体(抗-HBs)浓度,对其中100名血清抗-HBs水平较低的婴幼儿进行随机(随机数字表法)、双盲、安慰剂对照的VA干预实验.干预组(50名)采用市售浓缩鱼肝油作为VA补充剂,补充期3个月,每15天补充1次,每次0.5 g浓缩鱼肝油[含25 000 IU VA和2500 IU维生素D2(VD2)],共补充6次;对照组(50名)给予等体积玉米油.在干预实验开始后第30和第60天,给婴幼儿进行乙肝疫苗再免疫接种,第90天采集婴幼儿血清样本.用高效液相色谱法(HPLC)测定干预实验前后婴幼儿血清视黄醇浓度.用电化学发光免疫分析法(ECLIA)测定血清抗-HBs水平.结果 共有74名婴幼儿完成干预实验,实验组和对照组各37名.干预后,干预组和对照组儿童的血清视黄醇浓度分别为(404.1±123.1)、(240.8±92.8)μg/L(t=6.441,P＜0.01);两组儿童的血清抗-HBs水平分别为(2737.2±2492.6)和(1199.7±2141.6)U/L(t=2.846,P＜0.01).干预组无乙肝疫苗弱、无应答情况(0/37),对照组乙肝疫苗弱、无应答率为10.81%(4/37)(x2=4.229,P=0.040).结论 补充VA可提高儿童乙肝疫苗再免疫后血清抗-HBs水平.

Abstract：

Objective The objective of this study was to observe the interventional effect of cod liver oil supplementation on re-vaccination to hepatitis B virus (HBV) among infants and young children. Methods All 7 -36 months old infants and young children, who had been vaccinated with obligatory HBV vaccines routinely by the national technical and administrative procedures for HBV vaccination on children of China, were convened among villages in Linyi, Shandong province, from October 2008 to March 2009. After detection of serum anti-HBV, one hundred children with lower serum anti-HBV were picked out for the randomized, double blinded, placebo controlled vitamin A supplementation study. The children in the intervention group (50 subjects) took 0. 5 g condensed cod liver oil ( containing 25 000 IU vitamin A and 2500 IU vitamin D2 ) every 15 days for six times. The children in the control group (50 subjects) were given corn oil with same volume. All children were re-vaccinated at the 30th and the 60th day of the experiment. The serum samples were collected from each child at the 90th day of the experiment. Retinol concentration in serum samples was analyzed with HPLC method before and after the intervention. The levels of serum anti-HBs were detected by the electro-chemi-luminescence immunoassay (ECLIA) .Results Total 74 children finished the supplemental experiment and blood collection,37 subjects in each group, respectively. After intervention, the serum retinol level in the experimental and control group were ( 404. 1 ± 123. 1 ) and ( 240. 8 ± 92. 8 ) μg/L ( t = 6. 441, P ＜ 0. 01 ), respectively. The serum anti-HBs levels in the experimental and control group were( 2737.2 ± 2492.6 )and( 1199. 7 ± 2141.6 )U/L ( t =2. 846, P ＜ 0. 01 ), respectively. The rate of weak or no-answer case in experimental and control groups was 0. 00% ( 0/37 ) and 10. 81% ( 4/37 ) ( x2 = 4. 229, P = 0. 040), respectively. Conclusion The results showed that vitamin A supplementation might enhance the re-vaccination reaction against HB vaccine in infants and young children.     

降钙素对大白兔糖尿病骨质疏松模型假体骨密度及生物力学的影响

Objective To investigate the influence of calcitonin on bone mineral density and biomechanics around the artificial pros-thesis in ovariectomized diabetic rabbit model. Methods Fourteen femina New Zealand white rabbits at the age of 5 months old were select-ed, which weight 2.24 -2.65kg, averaging 2.26kg. First, the model of rabbit with diabetic osteoporosis was successfully established by the compound method of ovariectomy plus streptozotocin. Osteotomy in the middle part of femur was performed in both groups, fixation of artifi-cial prosthesis was done with 3.0 kirschner wire. After that, Rabbit models with diabetic osteoporosis were randomly divided into experimen-tal group and control group. Rabbits in the experimental group were treated with calcitonin 6U intramuscular injection once every other day. In control group, intramuscular injection of normal saline solution 1.5ml once every three days. Rabbit models of two groups were sacrificed in the 24th week. The BMD of the region of interest (ROI) around the prosthesis were detected before experiment and 8, 16 and 24 weeks after injection. After rabbits were killed, experimental femurs in both groups were complete removal and soft tissues were rejected. Determi-nation of the pull-out and torsion bone biomechanics experiments of prosthesis was done in both groups respectively. Results The BMD of ROI in the experimental group before operation was (0.1863±0.004)g/cm2 and (0.1753±0.005)g/cm2 in 24 weeks after operation, in control group before operation was (0.1865±0.002)g/cm2 and (0.1638±0.005)g/cm2 in 24 weeks after operation. There were significant difference between the two groups(P < 0.05). Biomechanical show that the pull-out strength in the experimental group was (312.68±8.73 )N/cm2 and (205.43±12.45 ) N/cm2 in control group. There were significant difference between the two groups(P < 0.05). The tor-sion strength in experimental group was (80.47±2.51) N/cm2 and (38.52±0.64) N/cm2 in control group. There were significant differ-ence between the two groups(P < 0.05). Conclusion Salmon calcitonin can reduce the bone turnover rate around prosthesis and decrease bone absorption in the rabbit of diabetic osteoporosis models, accelerate the bone formation around prosthesis, and increase the BMD. It can ameliorate the quality of bone around prosthesis, improve its biomechanics property, and increase the holding power between prosthesis and body mass. It is of clinical significance for the prevention and treatment of aseptic loosening artificial prosthesis.     

封闭式负压引流术在毁损性手外伤临床治疗中的应用

Objective To evaluate the effect of vacuum sealing drainage(VSD)ON the destroyed hand injuries.Methods From January 2006 to December 2008,forty pafients with destroyed hand injuries (surface of wound)were randomly divided into VSD group(20 cases)and control group(chlorhexidine wet compress)(20 cases)after debridement. The outcomes were retrospectively analysed by pain score,swelling score,bacterial positive rate and necrotic tissue.Results Three days after treatment,the pain score of VSD group was(2.62±1.54)degree,and that of control group was(3.39±1.64)degree.There wag significant difference between the two groups(P＜0.01).The swelling score of VSD group was(1.51±0.25)degree which was different from control group(2.29±1.26)degree(P＜0.05).The bacterial positive rate of control group was 20%(4/20),but that of VSD group was 5%(1/20).There was significant difference between the two groups(P＜0.05).The VSD group had no necrotic tissue occurrence,but the control group had 2 cases,one of which had serious necrosis and had escapology.Conclusion VSD Can inhibit bacterial infection,ease pain,exempt changing dressings and stimulate growing of granulation tissue also can maintain a good environment for tissue transplantation later.So VSD combining with tissue transplantation is an ideal therapy in destroyed hand injuries.     

实验性糖尿病大鼠肺组织晚期糖基化终末产物、肺表面活性物质蛋白质A免疫组织化学分析

Objective To approach the changes of advanced glycosylated end products (AGEs),surfactant proteins A (SP-A) in the lung of experimental diabetic rats and their relationship. Methods 48 male SD rats were divided into diabetes mellitus (DM) group and control group, each group with 24 rats.The DM rat model was made by injecting streptozocin (60mg/kg) into caudal vein. The rats were killed and the lung was individually taken out at the end of 4, 12 and 20 weeks after the models were established. The changes of AGEs, SP-A in rats lung were observed with immunohistochemical assay and the images were analyzed( black is minimum of gray, white is maximum of gray ). Results We observed a great quantity of AGEs positive cells in the alveolar epithelial cells, bronchial mucosal epithelium, angio-endothelial cell and smooth muscle cells of the DM rats. The average gray (AG) was inferior to that of the controls(4weeks 93.92 ± 7.92 vs 104. 75 ± 8. 20; 12 weeks 76. 25 ± 6. 76 vs 93.50 ± 7.56; 20 weeks 47.63 ± 7.96 vs 142. 38 ± 19. 76; P ＜0. 05) and decreased with the DM course. In the 4 weeks DM rats, there were a few SP-A positive cells in the type Ⅱ alveolar epithelial cells, Clara cells and alveolar macrophage cells. In the 12 and 20 weeks DM rats, there were a great many CTGF and TGF-β1 positive cells. The AG was inferior to that of the controls( 12 weeks 75.63 ± 6. 70 vs 110. 50 ± 13.20;20 weeks 47.38 ± 4. 84 vs 97. 25 ± 9. 87; P ＜ 0. 01 ). Conclusion With the progress of diabetes, DM rats' pulmonary alveolar type Ⅱ cells injury appeared, that might be related with the deposition of AGEs.     

实验性糖尿病大鼠肺组织晚期糖基化终末产物、肺表面活性物质蛋白质A免疫组织化学分析

Objective To approach the changes of advanced glycosylated end products (AGEs),surfactant proteins A (SP-A) in the lung of experimental diabetic rats and their relationship. Methods 48 male SD rats were divided into diabetes mellitus (DM) group and control group, each group with 24 rats.The DM rat model was made by injecting streptozocin (60mg/kg) into caudal vein. The rats were killed and the lung was individually taken out at the end of 4, 12 and 20 weeks after the models were established. The changes of AGEs, SP-A in rats lung were observed with immunohistochemical assay and the images were analyzed( black is minimum of gray, white is maximum of gray ). Results We observed a great quantity of AGEs positive cells in the alveolar epithelial cells, bronchial mucosal epithelium, angio-endothelial cell and smooth muscle cells of the DM rats. The average gray (AG) was inferior to that of the controls(4weeks 93.92 ± 7.92 vs 104. 75 ± 8. 20; 12 weeks 76. 25 ± 6. 76 vs 93.50 ± 7.56; 20 weeks 47.63 ± 7.96 vs 142. 38 ± 19. 76; P ＜0. 05) and decreased with the DM course. In the 4 weeks DM rats, there were a few SP-A positive cells in the type Ⅱ alveolar epithelial cells, Clara cells and alveolar macrophage cells. In the 12 and 20 weeks DM rats, there were a great many CTGF and TGF-β1 positive cells. The AG was inferior to that of the controls( 12 weeks 75.63 ± 6. 70 vs 110. 50 ± 13.20;20 weeks 47.38 ± 4. 84 vs 97. 25 ± 9. 87; P ＜ 0. 01 ). Conclusion With the progress of diabetes, DM rats' pulmonary alveolar type Ⅱ cells injury appeared, that might be related with the deposition of AGEs.