The effects of vitamin C on vitamin K-related clotting factors

The aim of this study was to assess the effects of vitamin C on vitamin K-related clotting factors II, VII, IX and X. Sixty female Wistar rats with a mean weight of 180 ± 20 g were selected, and after a 5-day adaptation period, control blood samples were taken under anaesthesia. The animals were randomly separated into two equal groups: one group received only warfarin for 30 days while the other group received both warfarin and vitamin C. Blood samples were taken at days 15 and 30 to measure vitamin K-related clotting factors, prothrombin time (PT) and activated partial thromboplastin time (APTT). The results showed that the combined administration of vitamin C and warfarin leads to increased coagulation factors II, VII, IX and X and decreased PT and APTT.     

慢性丙型肝炎患者凝血功能与血清HCV—RNA含量的关系探讨

目的探讨慢性丙型肝炎患者凝血功能与血清HCV-RNA含量之间的关系及其意义。方法收集广州市第八人民医院慢性丙型肝炎患者182例。健康人群20例作为正常对照组。慢性丙型肝炎患者根据HCV—RNA含量分为A组（HCV-RNA含量：〈10^5IU／ml）、B组（HCV．RNA含量：105IU／ml）、C组（HCV-RNA含量：106NIU／ml）、D组（HCV-RNA含量：10^7IU／ml）。分别检测其血浆凝血酶原时间（PT）、活化部分凝血酶原时间（APTT）、凝血酶时间（TT）、血浆纤维蛋白原（FIB）四项凝血功能指标及血清HCV．RNA含量。分析PT、AFIT、TT、FIB指标在不同血清HCV．RNA含量组中的变化及其意义。结果除FIB值外,不同HCV—RNA含量组之间胛、APTT、TT比较差异均有统计学意义（X2PT=32．91,X2APTT=25．78,X^2 TT=43．14,P均=0．000）。各组PT、APTT、TT值与正常对照组比较,差异均有统计学意义（P〈0．05）,特别是病毒含量≥10^5 IU／ml时,与正常对照组比较差异有显著统计学意义（P〈0．01）。对于FIB值,除了病毒含量≥10^7 IU／ml≥106～〈10^7 IU／ml组外,其余两组与正常对照组比较差异均有统计学意义（P〈0．05）。结论慢性丙型肝炎患者凝血功能随着病人体内HCV-RNA含量的增加有逐渐降低的趋势,特别是对于HCV-RNA含量≥10^6 IU／ml的病人。应随时监测病人的凝血功能,以防出现严重的出血。     

Removal of hepatitis B virus from a concentrate of coagulation factors II,VII, IX and X by hydrophobic interaction chromatography

Deliberately added hepatitis B surface antigen (HBsAg) and hepatitis B virus (HBV) could be removed by hydrophobic interaction chromatography from a concentrate of coagulation factors II, VII, IX and X. Chromatography in high concentrations of salt, preferably on octanoic acid hydrazide-Sepharose 4B, resulted in a 10⁴–10⁵-fold reduction of HBsAg. The binding properties of HBsAg and HBV to the hydrophobic gels were similar and the Chromatographie method seems particularly useful in removing low concentrations of virus-related material from protein solutions. The yield of protein from the coagulation factor concentrate was about 85% and the material showed the same stability and biological activities as before the chromatography.     

Parenteral antischistosomal therapy: a potential risk factor for hepatitis B infection

To study the association between hepatitis B and schistosomiasis, 1,234 Egyptian males, ages 18 to 24, were interviewed, examined, and tested for Schistosoma mansoni infection and HBsAg. Sera from 91 (7.4%) of the study subjects were positive for HBsAg, and S. mansoni was found in the stools of 26.3%. There was no correlation between S. mansoni infection, with or without hepatosplenomegaly, or a history of schistosomiasis, and HBsAg. An association was found between HBsAg positivity and a previous history of parenteral antischistosomal therapy (P less than 0.01). The results of the study indicate that parenteral therapy for schistosomiasis may be a risk factor for hepatitis B antigenemia. Further studies are indicated to determine the importance of parenteral therapy in the transmission of hepatitis B.     

Coagulation parameters of captive mountain gazelle (Gazella gazella Pallas, 1766; Bovidae: Antilopinae) and Nubian ibex (Capra ibex nubiana Cuvier, 1825; Bovidae: Caprinae)

The coagulation profiles of 36 mountain gazelles (Gazella gazella) aged 2–6?years, and 17 Nubian ibexes (Capra ibex nubiana), aged 1–4?years, were evaluated and compared. The following parameters were determined in both species: prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen concentration (FIB), and clotting factors VII, VIII:C, IX, X, and XI. Thrombin clotting time (TCT) was also determined in mountain gazelles. The results indicated significant interspecies differences in most parameters, with lower PT, aPTT, and factors VII, IX, and XI and higher factor XIII:C activities in the Nubian ibex than the mountain gazelle. Gender seemed to have a limited influence on these parameters within each species. Both species had higher plasma FIB and factor VIII:C activity relative to humans. This study is the first record of coagulation variables in these two species of wild Arabian desert ruminants.     

Effects of membrane plasma exchange on the hemostatic system and on thyroid hormones in critically ill patients

The present study examined the effects of repeated plasma exchanges with membrane filtration (Plasmaflux P2 membrane, 4.3 I human albumin solution) on the hemostatic system and on thyroid hormones in critically ill patients. Clotting factors V, VII, VIII, IX, X, XI, XII, XIII, fibrinogen, antithrombin III (ATIII), prothrombin time (PT), activated partial thromboplastin time (PTT), total (TT3) and free tri-iodothyronine (FT3), total (TT4) and free thyroxine (FT4), and thyroxine binding globulin (TBG) were determined before, immediately after, 1, 3, 6 and 24 h after plasma exchange in 6 patients (3 with glomerulonephritis, 2 with IgG myeloma, 1 with chronic polyneuritis) during 18 plasma exchanges. After plasma exchange levels of clotting factors and ATIII were markedly lowered but except for fibrinogen and factor XIII, they were not reduced by repeated exchange procedures. Thyroid hormones and TBG were reconstituted after 24 h. Pre-exchange levels, except for TT4 and TBG, were not lowered by repeated exchange procedures. Risk of bleeding or thrombosis is small and there is no appreciable risk of loss of thyroid hormones during repeated plasma exchanges.     

Clinical significance of TT virus infection in patients with chronic liver disease and volunteer blood donors in Egypt

Clinical significance of TT virus (TTV) infection was investigated in Egyptian patients with chronic liver disease and volunteer blood donors by a cross sectional analysis. TTV DNA in serum was assessed by a semi-nested polymerase chain reaction. The prevalence of TTV DNA did not differ among patients with chronic hepatitis B (11/24, 46%), chronic hepatitis C (22/72, 31%), or schistosomal liver disease (14/39, 36%). No difference in prevalence was found between blood donors (32/109, 29%) and each of the patient groups. Clinical background including mean age, sex distribution, history of blood transfusion, and mean level of alanine aminotransferase did not differ between TTV DNA-positive and -negative individuals in any of the study groups. Ultrasonographic evidence of liver cirrhosis was similar between TTV-positive and -negative patients in each of the chronic liver disease groups. TTV infection was not associated with hepatitis B or C virus infection in blood donors. The only significant difference observed was the lower concentration of serum HCV RNA in TTV DNA positive compared with negative patients with chronic hepatitis C (3.0 +/- 1.4 vs. 4.0 +/- 0.9 log copies/ml, P <. 001). In conclusion, TTV infection was not associated with either past history of blood exposure or infection with bloodborne hepatitis viruses in Egypt. No clinical significance of TTV was found in the present study. However, a reciprocal interaction was suggested between TTV and HCV replication.     

Präprothrombin bei akuter Virushepatitis B

Summary In vitamin K deficiency or treatment with vitamin K antagonists, a precoagulant of prothrombin (Factor II) called preprothrombin has been established. We measured preprothrombin with Clarke-Freeman electrophoresis in 26 patients with acute viral hepatitis (21 HB_s-AG positive) who did not suffer from vitamin K deficiency. Prothrombin and the vitamin-K dependent Factors VII, IX, and X were determined by standard coagulometric methods. Prothrombin was additionally estimated by immunoelectrophoresis according to Laurell. Three patients with acute HB_s-AG positive hepatitis showed preprothrombin in their plasma. The activity of Factors II, VII, IX, and X was slightly below normal with normal concentration of Factor II in the immunoelectrophoresis. Liver parenchymal damage and cholestasis were slight; the pseudocholinesterase showed subnormal levels in all three patients. Possible causes for the appearance of preprothrombin in the peripheral blood in acute viral hepatitis and the possible connections with liver cell damage are discussed.

     

肝病患者血浆凝血因子检测的临床研究

血 浆中凝血因子 ,除组织因子 (ＴＦ)、Ⅳ因子(Ｃａ2 +)、Ⅵ因子 (激活的Ⅴ因子 )、因子Ⅷ和因子Ⅷａ链以外的其它凝血因子 ,都是在肝脏中合成。肝病患者常伴有各种凝血因子的异常 ,临床上一般进行凝血酶原时间 (ＰＴ)、活化部分凝血活酶时间 (ＡＰＴＴ)、纤维蛋白原 (Ｆｉｂ)等常规测定 ,而各种凝血因子水平的检测并不多见。本文对 10 8例肝病患者进行ＰＴ、ＡＰＴＴ、Ｆｉｂ检测的同时 ,还进行了凝血因子Ⅱ、Ⅴ、Ⅶ、Ⅷ、Ⅸ、Ⅹ活性测定和分析。1　资料和方法1.1　研究对象正常对照组 ,30名健康人 ,男女各 15人 ,年龄18～ 5 5岁 ,平均 37.…     

Interleukin-28B Polymorphisms and Response of Chronic Hepatitis C Patients from Indonesia to Pegylated Interferon/Ribavirin Treatment

This study demonstrated that Indonesian patients with chronic hepatitis C (mostly ethnic Java people) mostly were infected with hepatitis C virus (HCV) genotype 1; however, they carried mainly the major genotypes of interleukin 28B (IL-28B) single nucleotide polymorphisms (SNPs) (rs12979860 CC, rs11881222 TT, rs8103142 AA, and rs8099917 TT), and they mostly achieved sustained virological responses to pegylated interferon/ribavirin treatment.     

Factors predisposing to the occurrence of cryoglobulinemia in two cohorts of Egyptian and Japanese patients with chronic hepatitis C infection: ethnic and genotypic influence

The association between cryoglobulinemia and hepatitis C virus (HCV) infection has been reported. However, the factors underlying its wide variation of occurrence have not yet been well identified. To investigate this, cryoglobulinemia was studied in four cohorts of Egyptian and Japanese patients. Fifty Egyptian patients with chronic hepatitis C, infected with genotype 4 (the predominant HCV genotype in Egypt), were compared with 50 age- and sex-matched Japanese patients, infected with HCV genotype 1b (the predominant HCV genotype in Japan). Thirty-two Egyptian and 30 age- and sex-matched Japanese patients with chronic hepatitis B were included as controls. All patients were noncirrhotic. Antinuclear antibody (ANA), immunoglobulins (Ig), and cryoglubulins were assessed. Results showed a significantly higher prevalence of cryoglobulinemia in chronic hepatitis C Japanese genotype 1b (40%) as compared with Egyptian genotype 4 (14%), P = 0.003, while no difference was found between Japanese (17%) and Egyptian chronic hepatitis B controls (13%). Symptomatic cryoglobulinemia was more prevalent in the Japanese than in the Egyptian chronic hepatitis C group (10% vs. 4%), but the difference was not statistically significant. Univariate analysis showed no association between cryoglobulinemia and either age, sex, alanine aminotransferase level, or HCV viral load in Japanese or Egyptian patients, while the mean IgM level was significantly higher in the cryoglobulin-positive than in the cryoglobulin-negative chronic hepatitis C patients in each group (P = 0.003 and 0.017, respectively). Cryoglobulinemia was found to be significantly associated with both high IgG level (P = 0.020), and positive ANA (P < 0.001) in Japanese patients with chronic hepatitis C, genotype 1b but not in Egyptians with genotype 4. Multivariate analysis showed that the only factors predisposing to cryoglobulinemia were Japanese ethnicity with HCV genotype1b (P = 0.002, OR = 2.56), high IgM level of >245 mg/dl (P = 0.018, OR = 2.05) and female gender (P = 0.040, OR = 1/0.66). In conclusion, cryoglobulinemia is prevalent in Japanese patients with chronic hepatitis C infected with genotype 1b, but cryoglobulinemia is not common in Egyptians with HCV genotype 4. Although it was not possible to evaluate ethnicity and HCV genotype separately in this study, HCV genotype 1b appears to predispose more to cryoglobulinemia than does genotype 4. Female gender and high serum IgM level were also related.     

TT virus infection in patients with chronic hepatitis B or C: influence on clinical, histological and virological features

Concomitant infection with TT virus and hepatitis B virus (HBV) or hepatitis C virus (HCV) is common. However, the effect of TTV infection on chronic hepatitis B or C is unknown. The prevalence of TTV infection, the effect of TTV infection on the clinical, histological and virological features of patients with chronic hepatitis B or C, and the influence of TTV infection on the HCV response to interferon alfa therapy were studied. A total of 100 asymptomatic hepatitis B surface antigen carriers, 220 patients with HBV-related chronic liver diseases, and 110 patients with chronic hepatitis C treated with interferon alfa (3 million units subcutaneously three times a week for 24 weeks) were enrolled. Serum HCV RNA and serum TTV DNA were detected by the polymerase chain reaction (PCR). Serum HBV DNA and serum HCV RNA level were quantified by branched DNA assays. Infection with TTV was detected in 21.5% of HBV carriers and 37% of HCV carriers. TTV infection had little effect on the clinicopathological course of chronic HBV infection. In chronic hepatitis C, clinical features, histological severity, serum HCV RNA levels, and the response to interferon alfa therapy did not differ between those with and without TTV infection. The loss of serum TTV DNA did not correlate with the biochemical response as did in the loss of serum HCV RNA. In conclusion, TTV infection is found frequently in patients with chronic hepatitis B or C in Taiwan; however, coinfection with TTV does not affect the clinicopathological course of chronic hepatitis B or C and the response to interferon alfa therapy.     

Precore mutant of hepatitis B virus prevails in acute and chronic infections in an area in which hepatitis B is endemic.

By using an amplification-created restriction site method, the precore TAG mutant of hepatitis B virus was detected in 6 (75%) of 8 acute fulminant hepatitis B patients, 7 (58%) of 12 acute self-limiting hepatitis B patients, 35 (81%) of 43 hepatitis B virus surface antigen carriers with fulminant hepatitis, and 42 (70%) of 60 hepatitis B virus surface antigen carriers with chronic hepatitis. The precore TAG mutant prevails in acute and chronic hepatitis B of various severity in this area where hepatitis B is endemic.     

Long-term follow-up of hepatitis B virus and hepatitis C virus replicative levels in chronic hepatitis patients coinfected with both viruses

Dual infection with hepatitis B and C viruses is often encountered in endemic areas of both viruses. However, understanding of the clinical and virological implications is limited. The aim of this study was to investigate the role of each virus in liver injury and the interaction between the two viruses in dual infection with hepatitis B and C viruses. Three patients who had chronic infection with both hepatitis B and C viruses were examined, and a longitudinal study of both serum hepatitis B virus DNA and hepatitis C virus RNA levels over 4 years was undertaken. The results were correlated with serum alanine aminotransferase levels. Serum alanine aminotransferase values showed a relationship with hepatitis B virus replicative levels, but not with hepatitis C virus replicative levels in all 3 patients. Serial changes of replicative levels of both viruses were studied, and it was found that hepatitis C virus replicative levels were enhanced after the decline of hepatitis B virus replication in 1 of the 3 patients. In the remaining 2 patients, a transient rise of hepatitis C virus replicative levels in association with a decrease of hepatitis B virus replication was also observed during part of the follow-up period. These findings indicate that hepatitis B virus may play a dominant etiological role in liver injury, and that a suppressive action between hepatitis B and C viruses may occur in dual infection with both viruses. © 1995 Wiley-Liss, Inc.     

机采血小板联合冷沉淀输注对颅脑外伤大出血患者凝血功能的影响

目的 探讨机采血小板联合冷沉淀输注对颅脑外伤大出血患者凝血功能的影响。方法 选取2017年1月~2018年10月我院收治的90例重型颅脑外伤患者，随机分为A、B、C三组，各30例。A组输注血小板治疗，B组输注冷沉淀治疗，C组输注血小板和冷沉淀治疗。比较三组输注血制品前后的凝血功能变化。结果 输注前1 h三组血小板（Plt）、纤维蛋白原（FIB）、凝血酶时间（TT）、活化部分凝血酶原时间（APTT）、凝血酶原时间（PT）比较，差异无统计学意义（P＞0.05）；输注24 h后三组Plt、FIB均高于输注前1 h，TT、APTT、PT均低于输注前1 h，且C组PLT、TT、APTT、PT优于A组、B组，差异均有统计学意义（P＜0.05）。结论 对于颅脑外伤大出血患者，联合输注血小板和冷沉淀对其凝血功能的改善优于单独输注血小板和冷沉淀。     

Acute Babesia bigemina infection: Changes in coagulation and kallikrein parameters

Summary Plasma from splenectomized calves infected with B. bigemina were assayed for disturbances in the coagulation system. Changes were observed in the WBCT, PTT, PT, TT and RT as well as in fibrinogen, calcium and thrombocyte levels. These changes were most marked during days 6–7 when parasite numbers were greatest. Massive intramuscular haemolysis coincided with these changes. The plasma kallikrein level fell progressively from days 6–11 and the level of activated kallikrein rose slightly.Parasite doubling time was calculated at 8.13 h. The similarities and differences between this disease and B. argentina infections of cattle are discussed.     

Severe hepatosplenic schistosomiasis: clinicopathologic study of 102 cases undergoing splenectomy

We present the preoperative findings of 102 patients who underwent successful splenectomy for advanced schistosomiasis japonica. All patients were symptomatic for schistosomiasis and had splenomegaly greater than or equal to II according to the Hackett criteria. Before surgery, all patients underwent clinical examination including full blood count; fibrinogen and serum protein levels; liver function tests; and serology for hepatitis B, C, and D. Ultrasound examination of the liver and spleen and liver histology for evidence of pathology were also undertaken. Ninety patients had a treatment history for schistosomiasis. Fifty-six patients were seropositive for hepatitis B virus antibody, and 6 patients were seropositive for hepatitis C virus antibody. Immunohistochemical testing of the liver samples confirmed that 45 patients were positive for hepatitis B virus surface antigen, thereby indicating active infection. A total of 66.7% of patients had fibrosis stages II to III by ultrasound; and 76.5% of patients had portal vein inner diameter greater than 12 mm, indicating portal vein hypertension. A total of 83.2% of patients showed various stages of esophageal varicosis via x-ray, and 81.4% had fibrotic stages III to IV by liver biopsy. Coinfection with hepatitis B virus accelerated the development of liver fibrosis. There was moderate concordance between the fibrosis assessed by ultrasonography and histopathology, indicating that ultrasound underestimates the true pathology. Combined assessment is needed to improve the diagnosis of clinical hepatic fibrosis.     

Current status in hepatitis virus research]

Seroconversion from eAg to anti-e is frequently seen in the course of chronic hepatitis B infection. This phenomenon is closely related to mutation of the precore region; a G-to-A substitution of nucleotide position 1986 replaces tryptophan to translational stop codon. This mutant is responsible for the fulminant hepatitis or acute exacerbation of chronic hepatitis B. The hepatitis C virus shows a high rate of genome variations, especially at the envelope (E and NS1) region, where a neutralizing epitope is believed to exist. According to the sequence identity, the hepatitis C virus is divided into four subtypes. The virus appears to evolve separately in geographically different areas and the subtyping may have some clinical implications, such as in interferon treatment. Hepatitis E virus has three open reading frames and share the high nucleotide identity among strains isolated from Myanmar and China. Hepatitis E is endemic in the developing world and is not present in industrialized countries.     

Delta hepatitis: molecular biology and clinical and epidemiological features.

Hepatitis delta virus, discovered in 1977, requires the help of hepatitis B virus to replicate in hepatocytes and is an important cause of acute, fulminant, and chronic liver disease in many regions of the world. Because of the helper function of hepatitis delta virus, infection with it occurs either as a coinfection with hepatitis B or as a superinfection of a carrier of hepatitis B surface antigen. Although the mechanisms of transmission are similar to those of hepatitis B virus, the patterns of transmission of delta virus vary widely around the world. In regions of the world in which hepatitis delta virus infection is not endemic, the disease is confined to groups at high risk of acquiring hepatitis B infection and high-risk hepatitis B carriers. Because of the propensity of this viral infection to cause fulminant as well as chronic liver disease, continued incursion of hepatitis delta virus into areas of the world where persistent hepatitis B infection is endemic will have serious implications. Prevention depends on the widespread use of hepatitis B vaccine. This review focuses on the molecular biology and the clinical and epidemiologic features of this important viral infection.     

Low prevalence of hepatitis C virus antibodies in chronic liver disease in northwest China

To evaluate the prevalence of hepatitis C virus infection in northwest China, 179 chronic liver disease patients in this area were examined for antibody to hepatitis C virus core protein (anti-HCVcore). This antibody was found in only 5 (14 percent) of 37 chronic non-A, non-B liver disease patients, in 11 (16%) of 67 asymptomatic hepatitis B virus carriers, and in 20 (27%) of 75 chronic hepatitis B patients. High titers of anti-HCVcore (cut off index >2) were observed in 3 (60%), 5 (45%), and 9 (45%) of the anti-HCVcore-positive cases of these groups, respectively. We further investigated the seroprevalence of antibodies to hepatitis B virus in the 37 chronic non-A, non-B liver disease patients. All 5 anti-HCVcore-positive cases were positive for a hepatitis B virus marker, with only 44% (14/32) of the anti-HCVcore-negative patients (P < 0.05). Based on these findings, it is concluded that the prevalence of hepatitis C virus infection in chronic non-A, non-B liver disease is unexpectedly low in northwest China and that hepatitis B and C viruses seem to have a similar mode of infection in that area.