恩替卡韦联合护肝药物治疗慢性乙肝肝硬化的价值分析

目的 探究恩替卡韦联合护肝药物治疗慢性乙肝肝硬化的临床效果及对肝功能的影响.方法 以2020年1月—2021年1月80例慢性乙肝肝硬化患者为研究对象,应用随机数字表法分组,对照组采用护肝药物治疗,试验组采用恩替卡韦与护肝药物联合治疗,分析两组治疗结果的差异性.结果 试验组总有效率为92.50％,高于对照组总有效率72....     

某人参产品对SD大鼠保肝功能的实验研究

目的了解某人参产品对动物酒精性肝损伤是否具有保护功能。方法取受试物连续30 d经口灌胃给予SD大鼠后,除阴性对照组外各组再经口灌胃给予50%乙醇,然后取血清检测极低密度脂蛋白（VLDL）和甘油三酯（TG）的含量,并对肝脏作组织病理学检查,同时观察对动物体重和肝重及肝体比的影响。结果在酒精性肝损伤模型成立的条件下,该受试物低、中剂量组的甘油三酯（TG）和极低密度脂蛋白（VLDL）含量明显低于模型对照组（P〈0.01、P〈0.01、P〈0.01、P〈0.01）;低、中剂量组的脂肪染色评分明显低于模型对照组（P〈0.01）。结论在本实验条件下,某人参产品对动物酒精性肝损伤具有辅助保护作用。     

Hepatoprotective effects of Rubus coreanus miquel concentrates on liver injuries induced by carbon tetrachloride in rats

As well-being foods pursuing healthy life are becoming popular, interest in Rubus coreanus Miquel (RCM) fruit, a type of Korean blackberry, is increasing due to its medicinal actions including protecting the liver, brightening the eyes, and alleviating diabetes. This study was carried out to evaluate the hepatoprotective effects of RCM concentrates on liver injuries induced by carbon tetrachloride (CCl₄) in rats. RCM, produced in June ~ July 2008 at Chunbook, Gochang (South Korea), was finely mashed. The seeds were removed and the juices were condensed. Thirty-two Sprague-Dawley rats were divided into four groups according to treatment: normal (eight rats), CCl₄, 1% RCM, and 2% RCM. Experimental diets were provided to the experimental animals for 4 weeks. We measure total cholesterol, high density lipoprotein-cholesterol (HDL-C), aspartate amino transferase (AST), alanine amino transferase (ALT), and alkaline phosphatase (ALP) levels. Part of the livers was isolated for histopathological evaluation, and analyzed for lipid peroxide (TBARS), superoxide dismutase (SOD) and liver proteins. The activities of serum AST, ALT, and ALP were elevated following CCl₄ administration. Levels of hepatic TBARS were also significantly increased in the CCl₄ groups. However, hepatic TBARS levels and the activities of serum enzymes were markedly reduced by supplementation with the RCM concentrates (P < 0.05). Hepatic SOD activity increased in the RCM concentrates group versus CCl₄ groups. Histopathological examination revealed massive necrosis in the centrilobular area and degenerative changes caused by CCl₄ were ameliorated by dietary supplementation with RCM concentrates. These results suggest that RCM concentrates have hepatoprotective effects and may improve the symptoms of liver injuries.     

4种国产重组乙肝疫苗接种不同人群的血清学效果观察

[目的]评价大年龄组儿童和成人接种国产重组乙肝疫苗的免疫效果,为制订和调整本地区乙肝疫苗免疫策略提供依据。[方法]2006～2007年,应用4种国产重组乙肝疫苗对烟台市部分HBsAg、抗-HBs和抗-HBc均为阴性的小学生、初中生、成人按照0、1、6的免疫程序进行接种,全程接种后1个月检测血清抗-HBs。[结果]抗-HBs阳转率,106名中小学生接种5μg／剂啤酒酵母乙肝疫苗（A疫苗）的为99．06％,127名接种10μg／剂啤酒酵母乙肝疫苗（B疫苗）的为95．28％,83名接种10μg／剂汉逊酵母乙肝疫苗（C疫苗）的为98．80％,118名接种10μg／剂重组中国仓鼠卵巢细胞乙肝疫苗（D疫苗）的为100．00％;211名成人接种D疫苗后阳转率为93．37％。接种后1个月,血清抗-HBs几何平均滴度,接种A疫苗、B疫苗、C疫苗、D疫苗的中小学生分别为1：472．59、1;773．24、1：575．87、1：613．71（P〉0．05）;成人为1：1358．24,高于接种同一疫苗的中小学生（P〈0．01）。[结论]中小学生和成人接种4不同国产乙肝疫苗后的抗体阳转率和几何平均滴度均很高,成人接种10μg／剂汉逊酵母乙肝疫苗免疫效果好于儿童。     

不同人群接种重组(酵母)乙型肝炎疫苗免疫效果分析

为观察重组 (酵母 )乙型肝炎 (乙肝 )疫苗在不同人群中的免疫效果 ,于 1997～ 2 0 0 2年随机抽取 1～ 5 9岁人群 ,进行乙肝病毒 (HBV)感染史和乙肝疫苗接种史调查。根据调查情况 ,将调查对象分为易感人群和非易感人群 ,对易感人群和非易感人群分别接种重组 (酵母 )乙肝疫苗 ,以观察重组 (酵母 )乙肝疫苗对不同人群的免疫效果。结果表明 :易感人群接种重组 (酵母 )乙肝疫苗 ,能显著提高人群抗乙肝病毒表面抗体 (抗 HBs)阳性率 ,降低乙肝病毒表面抗原 (HBsAg)、乙肝病毒核心抗体 (抗 HBc)阳性率。免疫起始年龄越小 ,免疫效果越好。 5年以内 ,抗 HBs阳性率维持在 77 6 %以上。不同HBV感染情况的非易感人群 ,接种重组 (酵母 )乙肝疫苗的免疫效果不同 ,抗 HBc单项阳性效果较好 ,接种后抗 HBs上升到 77 5 4 %。说明重组 (酵母 )乙肝疫苗用于易感人群和抗 HBc单项阳性的非易感人群免疫效果良好。     

食品和公共场所从业人员接种不同剂量国产重组酵母乙肝疫苗效果分析

[目的]评价饮食和公共场所从业人员接种2种不同剂量重组酵母乙肝疫苗的免疫效果。[方法]2004～2010年,应用2种国产重组乙肝疫苗对在某部常规体检的饮食和公共场所从业人员(Ⅰ组和Ⅱ组)按照0、1、6的免疫程序进行接种,全程接种后1个月、1年检测血清抗-HBs。[结果]合计调查5 886人,全程接种重组(酵母)乙肝疫苗1月后抗-HBs阳转率,Ⅰ组为86.07%、Ⅱ组为95.28%(P<0.01);全程接种重组(酵母)乙肝疫苗1年后,抗-HBs阳转率Ⅰ组为78.90%、Ⅱ组为89.67%(P<0.01)。接种1个月后,抗体滴度Ⅰ组为225±1.25mIU/ml、Ⅱ组为390±1.37mIU/ml(P<0.01);接种1年后,抗体滴度Ⅰ组为126±1.18mIU/ml、Ⅱ组为224±1.08mIU/ml(P<0.01)。[结论]对饮食和公共场所从业人员按0、1、6个月接种程序,每次分别接种20μg重组酵母乙肝疫苗可以取得较好的效果。     

新生儿重组酵母乙肝疫苗免疫后血清学调查

目的 了解重组酵母乙肝疫苗在新生儿广泛使用后的免疫效果及免疫持久性.方法 采用横断面调查和分层随机抽样的方法对2005-2011年出生的1-6岁儿童进行乙肝疫苗免疫后血清学调查,用微粒子化学发光分析法定量检测HBsAg和抗-HBs.结果 967名完成3剂初免者的抗-HBs水平随接种年限延长而下降,抗-HBs阳性率从0年的98.06％到6年后的57.50％ (P＜0.01),同期有效保护率从95.15％到37.50％ (P＜0.0l),几何平均滴度(GMT)从95.61 mIU/mL (95％CI:69.45～131.61 mIU/mL)到3.17 mIU/mL(95％ CI:1.20 ～ 8.36 mIU/mL)(P＜0.01).其中在免后的0～2年下降迅速,3～6年抗-HBs两两比较差异无统计学意义.3年以后抗-HBs GMT降至有效保护水平(10 mIU/mL)以下,其中25.15％的调查对象抗-HBs低于1 mIU/mL.初免后抗体虽逐年下降,但所有对象HBsAg阳性率仅为0.34％.1剂加免组的抗-HBs阳性率(P＜0.01)、有效保护率(P＜0.01)及GMT (P＜0.01)均明显高于同期初免组,GMT是初免组的9.93倍;加免后0～3年的抗-HBs阳性率(P＞0.05)、有效保护率(P＞0.05)随年限变化不明显.结论 重组酵母乙肝疫苗初免后6年的抗-HBs阻性率、有效保护率和GMT均已明显下降,但免疫记忆良好,6年内无需进行大规模的加强免疫.     

乙型肝炎病毒慢性感染基础对散发性戊型肝炎临床特点的影响

「目的」阐明乙型肝炎病毒慢性感染基础对散发性戊型肝炎临床表现、肝功能指标、血清学规律和预后的影响。「方法」比较分析１００例慢性乙型肝炎重叠散发性戊型肝炎患者和１４４例散发性戊型肝炎患者的发病年龄、住院时间；血清丙氨酸转氨酶（ＡＬＴ）、总胆红素（ＴＢ）、谷氨酰转肽酶（ＧＧＴ）、碱性磷酸酶（ＡＫＰ）和凝血酶原时间（ＰＴ）的水平；不同病周的抗－ＨＥＶ－ＩｇＭ、抗－ＨＥＶ－ＩｇＧ的阳性率；以及病死率。「结     

病毒性肝炎血浆凝血酶原活动度与肝组织病变程度的关系

目的　探讨病毒性肝炎血浆凝血酶原活动度 (PTA)与肝组织病变程度的一致性及其存在的问题。方法　对经临床和病理双重确诊的 2 3 4例慢性乙型病毒性肝炎 (慢性乙肝 )及 5 4例重型乙型病毒性肝炎 (重型肝炎 )肝活检组织进行分级、分期及分度 ,并与同期血浆PTA水平对比分析。结果　PTA与肝组织病变Ishak计分呈明显负相关 (P <0 0 0 1,r =-0 3 2 3 )。PTA下降程度与肝组织学分度符合率在重型肝炎组及轻、重度慢性乙肝组达 70 %以上 ,中度慢性乙肝组仅 3 9 3 %。重型肝炎死亡组PTA显著性低于存活组 (P <0 0 1) ,PTA低于 10 %者无一例存活 ;治疗 2周后 ,存活组PTA稳步回升 ,死亡组持续下降。结论　血浆PTA下降程度对重型肝炎及轻、重度慢性乙肝诊断符合率较高 ,对判断重型肝炎的预后和疗效有一定价值。应加强PTA检测的标准化     

A Comparative Study of the Hepatoprotective Effect of Centella asiatica Extract (CA-HE50) on Lipopolysaccharide/d-galactosamine-Induced Acute Liver Injury in C57BL/6 Mice

Acute liver failure (ALF) refers to the sudden loss of liver function and is accompanied by several complications. In a previous study, we revealed the protective effect of Centella asiatica 50% ethanol extract (CA-HE50) on acetaminophen-induced liver injury. In the present study, we investigate the hepatoprotective effect of CA-HE50 in a lipopolysaccharide/galactosamine (LPS-D-Gal)-induced ALF animal model and compare it to existing therapeutic silymarin, Lentinus edodes mycelia (LEM) extracts, ursodeoxycholic acid (UDCA) and dimethyl diphenyl bicarboxylate (DDB). Serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were decreased in the CA-HE50, silymarin, LEM, UDCA and DDB groups compared to the vehicle control group. In particular, AST and ALT levels of the 200 mg/kg CA-HE50 group were significantly decreased compared to positive control groups. Lactate dehydrogenase (LDH) levels were significantly decreased in the CA-HE50, silymarin, LEM, UDCA and DDB groups compared to the vehicle control group and LDH levels of the 200 mg/kg CA-HE50 group were similar to those of the positive control groups. Superoxide dismutase (SOD) activity was significantly increased in the 100 mg/kg CA-HE50, LEM and UDCA groups compared to the vehicle control group and, in particular, the 100 mg/kg CA-HE50 group increased significantly compared to positive control groups. In addition, the histopathological lesion score was significantly decreased in the CA-HE50 and positive control groups compared with the vehicle control group and the histopathological lesion score of the 200 mg/kg CA-HE50 group was similar to that of the positive control groups. These results show that CA-HE50 has antioxidant and hepatoprotective effects at a level similar to that of silymarin, LEM, UDCA and DDB, which are known to have hepatoprotective effects; further, CA-HE50 has potential as a prophylactic and therapeutic agent in ALF.     

苦参素胶囊治疗慢性乙型肝炎的疗效

目的探讨苦参素胶囊治疗慢性乙型肝炎（CHB）的疗效。方法选择CHB100例，随机分为治疗组和对照组各50例，治疗前后检测HBVM、HBVDNA。疗程均为26周。结果HBeAg阴转率及HBVDNA阴转率治疗组分别为42．0％、44．0％，显著高于对照组的4．0％、4．0％（P〈0．01）。结论苦参素有明显抗HBV作用。     

心理干预对干扰素-α治疗慢性乙型病毒性肝炎病人疗效及复发的影响

目的 分析心理干预对慢性乙型病毒性肝炎（CHB）病人重组干扰素-α 2b（rIFN-α 2b）疗效的影响.方法 CHB病人60例随机分为2组,观察组和对照组各30例,观察组除用rIFN-α 2b治疗外加心理干预治疗,对照组单用rIFN-α 2b治疗.rIFN-α 2b治疗前、结束时用症状自评量表（SCL-90）分别进行心理测试,并相互比较.结果 抗病毒前两组病人均存在严重的心身症状,差异无显著性（P＞0.05）;抗病毒结束时观察组阳性总分低于对照组（P＜0.05）;随访期末观察组完全应答率高于对照组（P＜0.05）,而复发率低于对照组（P＜0.05）.结论 CHB病人抗病毒前心理负担大,存在负性情绪;心理干预能减轻心理负担,且能提高干扰素-α治疗的远期疗效,降低复发率.     

Effect of Interferon-Free Regimens on Disparities in Hepatitis C Treatment of US Veterans

Objectives

To determine whether implementation of interferon-free treatment for hepatitis C virus (HCV) reached groups less likely to benefit from earlier therapies, including patients with genotype 1 virus or contraindications to interferon treatment, and groups that faced treatment disparities: African Americans, patients with HIV co-infection, and those with drug use disorder.

甲型肝炎减毒活疫苗（H2株）保护效果的研究

目的：观察国产甲型肝炎减毒活疫苗（H2株）在甲型肝炎流行情况下,其保护发病与保护感染效果。方法：在某乡甲肝流行情况下,采用病例对照研究方法,调查病例组与对照组甲肝疫苗免疫史,估计疫苗保护发病效果;选择该乡发病率较高的13个村小学学生,进行血清学及甲肝疫苗接种史调查,计算疫苗保护感染效果。结果：甲肝病毒活疫苗保护率为98．1％,95％可信限下限为83．5％。隐性感染率在接种组与未接种组分别为10．23％和11．59％,两者无统计学差异。结论：国产甲型肝炎减毒活疫苗（H2株）具有很好的保护发病效果,可以同国外灭活疫苗相媲美,其保护感染效果不及保持发病效果。     

乙肝免疫球蛋白与乙肝病毒疫苗联合应用阻断乙肝母婴传播的Meta分析

[目的]综合评价孕晚期注射乙肝免疫球蛋白联合新生儿注射乙肝免疫球蛋白及乙肝病毒疫苗阻断乙肝病毒母婴传播的有效性,为制定重点人群的乙肝免疫策略提供循证依据。[方法]应用计算机检索相关文献,实验组干预措施为孕晚期注射乙肝免疫球蛋白,新生儿注射乙肝免疫球蛋白和乙肝病毒疫苗;对照组干预措施仅为新生儿注射乙肝病毒疫苗。对符合纳入标准的8项随机对照研究,采用固定和随机效应模型进行Meta分析。[结果]各纳入文献的发表偏倚较小。Meta分析显示实验组母婴传播率（6.01%）低于对照组（16.37%）,χ^2=7.02,P〈0.001;合并RR为0.37,95%可信区间为0.28-0.48,敏感性分析提示模型稳定性较好。亚组分析显示无论对于单纯HBsAg阳性还是HBsAg和HBeAg双阳性的孕妇;或者不管是以新生儿出生24h内乙肝感染标志阳性或是以出生后12个月乙肝感染标志阳性为标准,实验组的母婴传播率均低于对照组（P〈0.05）。[结论]孕晚期注射乙肝免疫球蛋白联合新生儿注射乙肝免疫球蛋白及乙肝病毒疫苗能有效地阻断乙肝病毒的母婴传播。     

驻粤战士乙型肝炎表面抗体阳性率抽样调查与接种效果分析

目的了解驻粤战士乙型肝炎表面抗体(HBs Ab)水平,评估乙肝疫苗接种效果,为完善乙肝防治策略提供参考。方法采用分层整群抽样方法,随机抽取3个驻粤单位已接种乙肝疫苗战士1185名,采集被调查者血液以ELISA法检测血清HBs Ab,并与未接种疫苗的890名入伍新兵检测结果进行对比分析,评价疫苗接种效果。结果 1185名战士血清HBs Ab阳性率为81.8%(969/1185),抗体水平不达标为15.1%(179/1185)。2013年度未接种疫苗的890名新兵乙肝表面抗体阳性率为63.9%(569/890),抗体水平不达标为23.6%(210/890)。抽检战士HBs Ab阳性率和达标率(81.8%,66.7%)均明显高于未接种疫苗新兵(63.9%,40.3%)(P0.01;X2达标率=142.59,P0.01)。结论血清HBs Ab水平可用于乙肝疫苗接种效果评价和考核预防接种工作,应进一步开展相关研究。     

国产酵母重组和CHO重组乙肝疫苗阻断母婴传播的免疫效果比较

目的评价国产重组乙肝疫苗酵母和重组ＣＨＯ乙肝疫苗阻断母婴传播效果。方法应用两种乙肝疫苗,对母亲ＨＢｓＡｇ和ＨＢｅＡｇ双阳性的新生儿进行免疫,并以国产血源乙肝疫苗作对照。结果国产酵母重组和ＣＨＯ重组乙肝疫苗具有较好的安全性,免疫第９、１２个月,阻断母婴传播的近期保护效果分别为１０００％和９６４％。结论上述两种国产基因重组乙肝疫苗与３０ｕｇ血源乙肝疫苗＋ＨＢＩＧ效果（９５０％）相同。     

In Vitro Bioaccessibility,Human Gut Microbiota Metabolites and Hepatoprotective Potential of Chebulic Ellagitannins: A Case of Padma Hepaten? Formulation

Chebulic ellagitannins (ChET) are plant-derived polyphenols containing chebulic acid subunits, possessing a wide spectrum of biological activities that might contribute to health benefits in humans. The herbal formulation Padma Hepaten containing ChETs as the main phenolics, is used as a hepatoprotective remedy. In the present study, an in vitro dynamic model simulating gastrointestinal digestion, including dialysability, was applied to estimate the bioaccessibility of the main phenolics of Padma Hepaten. Results indicated that phenolic release was mainly achieved during the gastric phase (recovery 59.38%–97.04%), with a slight further release during intestinal digestion. Dialysis experiments showed that dialysable phenolics were 64.11% and 22.93%–26.05% of their native concentrations, respectively, for gallic acid/simple gallate esters and ellagitanins/ellagic acid, in contrast to 20.67% and 28.37%–55.35% for the same groups in the non-dialyzed part of the intestinal media. Investigation of human gut microbiota metabolites of Padma Hepaten and pure ChETs (chebulinic, chebulagic acids) established the formation of bioactive urolithins (A, B, C, D, M5). The fact of urolithin formation during microbial transformation from ChETs and ChET-containing plant material was revealed for the first time. Evaluation of the protective effect of ChETs colonic metabolites and urolithins on tert-butyl hydroperoxide (t-BHP)-induced oxidative injury in cultured rat primary hepatocytes demonstrated their significant reversion of the t-BHP-induced cell cytotoxicity, malonic dialdehyde production and lactate dehydrogenase leakage. The most potent compound was urolithin C with close values of hepatoprotection to gallic acid. The data obtained indicate that in the case of Padma Hepaten, we speculate that urolithins have the potential to play a role in the hepatic prevention against oxidative damage.     

乙型肝炎患者重叠感染丙型肝炎、庚型肝炎病毒的研究

[目的 ]了解乙型肝炎患者重叠感染丙型肝炎病毒 (HCV)、庚型肝炎病毒 (HGV)的情况。 [方法 ]应用 EL ISA法分别对 86 8例乙肝患者、5 17例乙肝病毒携带者检测血清抗 - HCV和抗 - HGV,应用逆转录聚合酶链反应法分别对HCV、HGV感染者进行血清 HCV- RNA、HGV- RNA检测 ,并与乙肝病毒携带者比较。 [结果 ]乙肝患者与乙肝病毒携带者 HCV感染率分别为 14.5 %、2 .3% ,HGV感染率分别为 15 .6 %、3.9% ,HCV和 HGV的重叠感染率分别为 2 .3%、0 .2 % ,两组间 HCV、HGV合并感染率均有非常显著性差异 (P<0 .0 1)。乙肝患者中 HCV感染者 HCV- RNA阳性率14.3% ,HGV感染者 HGV- RNA阳性率 11.9%。 [结论 ]乙型肝炎、丙型肝炎、庚型肝炎可以重叠感染。急慢性乙型肝炎患者的 HCV、HGV重叠感染率不同。     

马鞍山市16年乙型肝炎防治效果评价

目的了解马鞍山市乙型肝炎（下称乙肝）流行状况,评价防治效果,为制定或调整乙肝疫苗接种策略提供依据。方法按照两阶段抽样法,抽取8个行政村1～59岁常住人口2040人,采静脉血3—5ml,ELISA法检测HBV—M。结果HBsAg阳性70人,阳性率3．43％;HBV—M总感染率18．40％,HBsAg阳性率较1991年（13．41％）显著降低（χ^2=116．95,P=0．000）。1992年推广乙肝疫苗接种以来,其保护率达73．08％。2007年与1991年健康人群乙肝血清学各项指标分地区、城乡、性别、年龄比较,除HBsAb20岁以上年龄组外,差异均有统计学意义;职业分布发生变化,1991年学生HBsAg阳性构成比占59．32％,农民占12．43％;2007年学生HBsAg阳性构成比下降到11．27％,农民构成比上升到50．70％。结论该市乙肝防治效果非常显著,继续开展新生儿乙肝免费接种,推广成人接种,并将预防乙肝资源向农村地区倾斜.