Insulin-dependent diabetes mellitus as a possible sequelae of treatment of viral hepatitis with interferon-alpha]

Treatment of chronic hepatitis with interferon-alpha is an increasingly used successful therapeutic procedure. In the literature in recent years data accumulated on side-effects of interferon therapy, among which relatively frequently insulin dependent diabetes is mentioned. Interferon-alpha enhances the expression of molecules of the histocompatible complex I which may cause in genetically predisposed subjects the clinical manifestation of diabetes. It is therefore recommended to monitor before the onset of treatment and during interferon treatment the auto-antibody formation against islet cells and against insulin which signalizes changes in the pancreas before the clinical disease proper.     

212例慢性病毒性肝炎患者抑郁症状发生的现状分析

目的 了解慢性病毒性肝炎患者抑郁症状发生的现状.方法 以慢性乙型、丙型肝炎患者作为研究对象,采用问卷调查的方法,用自制的慢性病毒性肝炎问卷调查表、抑郁症状自评量表(SDS)、艾森克人格问卷等对慢性病毒性肝炎患者抑郁症状情况及相关因素进行调查.应用SPSS 13.0软件进行统计分析.结果 212例慢性病毒性肝炎患者抑郁症状的检出率为54.7%,SDS评分为39.08±11.16.不同年龄、职业、文化程度抑郁症状的检出率不同,差异有统计学意义(χ~2=32.24,P<0.000;~2=22.59,P<0.000;χ~2=23.304,P<0.000);病毒性肝炎分度、感染时间、确诊时间、肝炎复发次数、抗病毒治疗时间不同,抑郁症状的检出率不同,差异有统计学意义(χ~2=15.136,P=0.001;χ~2=32.737,P<0.000;χ~2=9.401,P=0.009;χ~2=10.734,P=0.005;χ~2=30.353,P<0.000);患者对治疗的信心、对周围态度满意程度不同抑郁症状检出率不同,差异有统计学意义(χ~2=12.715,P<0.01;χ~2=9.456,P<0.01).SDS总分与社会支持总分、客观支持维度分值、主观支持维度分值之间呈负相关关系,差异有统计学意义(r=-0.262,P=0.000;r=-0.228,P=0.001;r=-0.270,P=0.000).SDS总分与艾森克人格评分内外向维度分值之间呈显著负相关,差异有统计学意义(r=-0.330,P=0.000),与情绪稳定性分值维度之间呈显著正相关,差异有统计学意义(r=0.309,P=0.000).结论 (1)慢性病毒性肝炎患者抑郁症状的检出率为54.7%.(2)是否出现抑郁症状可因患者年龄、职业、文化程度、肝炎分度、感染时间、诊断时间、复发次数、抗病毒治疗时间、收入、支付方式、及对治疗信心和对周围态度的满意程度的不同而不同.(3)患者获得的支持度越低,SDS总分越高,抑郁程度越重;个性越倾向内向,SDS总分越高,抑郁程度越重;情绪越不稳定,SDS总分越高,抑郁程度越重.     

Polyunsaturated fatty acids levels and initial presentation of somatic symptoms induced by interferon-alpha therapy in patients with chronic hepatitis C viral infection

Objectives: Somatic symptoms are common in depressive disorder and are similar to sickness behaviors due to inflammatory activation after cytokine administration. Omega-3 polyunsaturated fatty acids (PUFAs) are natural anti-inflammatory agents and may reduce inflammation-induced behavioral changes. The aim of this study was to investigate the role of PUFAs on the development of somatic symptoms and depression in patients of hepatitis C virus infection (HCV) receiving interferon-alpha therapy (IFN-α) in a prospective manner.

Methods: In this 24-week, prospective cohort study, 43 patients with chronic HCV ongoing IFN-α therapy were assessed with the mini-international neuropsychiatric interview for major depressive episodes and neurotoxicity rating scale (NRS) for somatic symptoms.

Results: One-third later developed IFN-α-induced depression (depression (DEP) group). As compared to subjects without depression, DEP group had higher NRS scores (P?P?=?0.038) at week 2. Somatic symptoms, regardless of painful/non-painful characteristics, had positive association with arachidonic acid (P?P?Conclusion: This study implies that early intervention with omega-3 PUFAs might be a promising strategy to prevent depression and somatic symptoms in patients receiving cytokine therapy.     

乙醇性肝炎合并病毒感染患者的病原学检测分析

目的 探讨乙醇性肝炎合并病毒感染的病原学分布特征,为肝炎的预防治疗工作提供指导依据.方法 回顾性分析1472例乙醇性肝炎的临床资料,采用酶联免疫吸附法进行病原学检查.结果 1472例乙醇性肝炎患者中188例感染各类型病毒,感染率为12.77％;男性126例,占67.02％,女性62例,占32.98％;单一感染149例,占79.26％,混合感染22例,占11.70％,未分型17例,占9.04％;单一感染中以乙型肝炎病毒(HBV)和甲型肝炎病毒(HAV)为主,分别占52.13％和14.36％;混合感染包括双重感染17例,三重感染4例,四重感染1例,分别占77.27％、18.18％和4.55％;混合感染中以HAV+ HBV和HBV+丁型肝炎病毒(HDV)最常见,分别占22.73％和18.18％.结论 乙醇性肝炎合并病毒感染的比例较高,其病原学仍然以HBV为主,但混合感染严重,临床应重点筛查乙型肝炎,并加强对未定型肝炎的检测.     

α2b干扰素治疗慢性丙肝患者的临床研究

目的：探讨α2b干扰素对慢性丙肝患外周血单个核细胞（PBMC）内HCV的治疗效果。方法：采用国产α2b干扰素（300MU／d）治疗，3个月为一疗程，共2个疗程，并设常规治疗组（VitC、门冬氨酸）为对照。于疗程结束后分别检测患PBMC内HCV－RNA和血清内HCV－RNA、抗－HCV。结果：α2b干扰素治疗组2个疗程后慢性丙肝患PBMC、血清内HCV－RNA和抗－HCV转阴率分别为42．31％（11／26）、57．69％（15／26）、65．38％（17／26），常规治疗组慢性丙肝患PBMC、血清内HCV－RNA和抗－HCV转阴率分别为13．64％（3／22）、22．73％（5／22）、27．27％（6／22），两组相比，差异有显性（P＜0．05）。结论：α2b干扰对PBMC内HCV－RNA具有肯定的治疗作用，其疗效优于常规治疗组。     

病毒性肝炎住院患者葡萄球菌属感染与耐药性研究

目的探讨病毒性肝炎住院患者葡萄球菌属感染与耐药性,为合理使用抗菌药物提供依据。方法选取2013年11月-2014年12月住院治疗的病毒性肝炎合并葡萄球菌属感染患者80例,留取患者感染标本送检,采用法国生物梅里埃公司VITEK-AMS6全自动细菌鉴定系统进行葡萄球菌属鉴定,并使用纸片扩散法(K-B)进行药敏试验,分析葡萄球菌属的耐药性。结果 80例病毒性肝炎合并葡萄球菌属感染患者送检标本检出108株葡萄球菌属,金黄色葡萄球菌28株占25.93%,凝固酶阴性葡萄球菌80株占74.07%,金黄色葡萄球菌及凝固酶阴性葡萄球菌在标本中检出均以痰液为主,分别占64.29%及43.75%,其次均为血液、尿液、腹水,分别占17.86%及25.00%、10.71%及18.52%、7.14%及9.26%;耐甲氧西林金黄色葡萄球菌检出率为28.57%,耐甲氧西林凝固酶阴性葡萄球菌检出率为11.25%,耐甲氧西林金黄色葡萄球菌和耐甲氧西林凝固酶阴性葡萄球菌耐药性均较严重,对青霉素、苯唑西林耐药率均达100.00%,仅对万古霉素耐药率为0。结论病毒性肝炎住院患者葡萄球菌属的组成、来源、耐药性各有其特点,需要动态监测并根据结果正确选择抗菌药物治疗,以减少感染的发生率。     

十堰市市民对病毒性肝炎患者的态度

目的 了解社会各界人士对病毒性肝炎(以下简称肝炎)患者的态度,为肝炎[主要是乙型肝炎(乙肝)]的预防控制及宣传工作提供参考性意见.方法 采用自编社会对肝炎患者态度的调查问卷,对十堰市市民、十堰市人力资源局、东风商用车市场销售总部、十堰泽昌汽车销售有限公司等单位进行问卷调查.结果 81.58％的人关心肝炎(乙肝)患者或态度中立,但同时也存在着较严重的对肝炎(乙肝)患者的歧视情况,如拒绝乙肝病毒携带者入学(49.04％),拒绝录用乙肝病毒携带员工(44.77％),这种歧视是因为对肝炎(乙肝)的不了解.结论 建议有关部们应加大肝炎(乙肝)的宣传力度.     

Chronic hepatitis B antigenaemia in bilharzial patients treated with Praziquantel

One hundred and fifty two bilharzial patients together with one hundred and eighty four individuals as free controls were tested for HBsAg using ELISA technique. 6.6% of the former were carriers compared to only 2.2% in the later. It was found that past history of antibilharzial therapy, jaundice and presence of hepatosplenomegaly increased the risk of contracting HB virus infection. Praziquantel therapy showed 60% parasitological cure rate and 90 reduction in the mean egg count of bilharzial carriers of HBV infection. It improved both simple and early hepato-intestinal schistosomiasis as 5 out of 10 HBV carriers became free either from schistosoma ova or HBsAg after 6 months of treatment. In this work all chronic bilharzial carriers (5) had hepatosplenomegaly, 1 patient showed parasitological cure after treatment and the other four patients had a reduction in the mean egg count denoting the failure of praziquantel in improving their immunologic status and thus still HBsAg carriers.     

Sexual dysfunctions in patients with neurodermatitis and psoriasis

We investigated sexual dysfunction and accompanying depression in patients with neurodermatitis and psoriasis. Patients with neurodermatitis (n = 31) and psoriasis (n = 24) were compared to control cases (n = 33) with Beck depression scale (BDS) and Arizona Sexual Experience Scale (ASEX). Beck Depression Scale and ASEX scores varied between three groups. In two group comparisons, the neurodermatitis group had more sexual problems than the psoriasis group and the control group. Patients with neurodermatitis and psoriasis have sexual dysfunction and depression in the course of these chronic diseases and the higher frequency of sexual problems was seen in patients with neurodermatitis.     

肿瘤坏死因子在病毒性肝炎中的临床研究

近年来,细胞因子在病毒性肝炎发病机制中的作用越来越受到人们的重视.笔者对213例各型病毒性肝炎患者进行了血清肿瘤坏死因子(TNF-α)水平检验,以探讨其在病毒性肝炎中的作用.     

大剂量静脉用丙种球蛋白治疗病毒性脑炎130例分析

目的观察应用大剂量静脉用丙种球蛋白(IV IG),对病毒性脑膜炎的治疗效果。方法将收治的269例病毒性脑膜炎患儿,随机分为治疗组130例和对照组139例,对照组给予降颅压、对症支持治疗和病毒唑、干扰素等常规治疗,治疗组则在此基础上静脉注射IV IG 200～400 mg/(kg.d)3 d,比较2组7、10、15 d治愈率及症状的恢复时间。结果治疗组71、0 d治愈率分别为48.5%、91.5%,显著高于对照组(P<0.05);治疗组15 d治愈率为98.5%,与对照组比较差异无统计学意义。结论大剂量静脉注射IV IG治疗病毒性脑膜炎效果明显。     

湖北省散发性戊型病毒性肝炎167例临床分析

目的探讨湖北省散发性戊型病毒性肝炎(hepatitis E,HE)的临床特征。方法选取167例HE患者进行回顾性分析,并将患者划分为:1组(单纯HEV感染,61例),2组(慢性乙肝重叠感染HEV,49例),3组(慢性血吸虫病重叠感染HEV,45例)和4组(其他重叠感染及合并症类型,12例);另外根据患者年龄将其分为老年组(年龄≥60岁,72例)和非老年组(年龄<60岁,95例)。对患者的总胆红素(TBil)峰值、平均住院日、重肝发生率和死亡率进行统计学分析。结果上述4个指标在3组和1组间比较差异均无显著性(P>0.05);在2组和1组间比较差异均有显著性(P<0.05);在老年组和非老年组间比较差异均有显著性(P<0.05)。结论慢性乙肝患者重叠感染HEV后肝病明显加重,重型肝炎的发生率高,死亡率高。慢性血吸虫病患者重叠感染HEV后,重型肝炎发生率低,愈后尚好。老年戊肝患者易导致重型肝炎的发生,死亡率高。