新生儿重组酵母乙肝疫苗接种免疫的研究

目的：探讨重组酵母乙肝疫苗新生儿接种后抗体应答持续时间，强化复种的必要性。方法：常规对新生儿0d(出生后当天)、1月、6月接种重组酵母乙肝疫苗后检测抗体应答情况，再随机分两组，一组为强化组，一组为常规组，并随访其5年的抗体应答情况。结果：新生儿常规接种法，于12个月后有一明显抗体应答下降期(0d、1月、6月、12月)，强化组乙肝表面抗体形成率高，持续时间均高于常规接种法。结论：新生儿乙肝疫苗0d、1月、6月、12月接种法有较好的远期保护效果，对现有的0d、1月、6月新生儿乙肝疫苗常规接种法，有强化接种的必要。     

国内丙型肝炎病毒感染与肝细胞癌关系的19个病例对照研究的 Meta 分析

本文对国内１９个有关丙型肝炎病毒（ＨＣＶ）感染与肝细胞癌（ＨＣＣ）关系的病例对照研究进行Ｍｅｔａ分析。经齐性检验表明，１９个研究中有１７个研究结果是一致的。对此１７个研究结果加权合并，累积ＨＣＣ病例１５７７例，ＨＣＶ感染率为２３．０％，累积对照１９８０例，ＨＣＶ感染率为４．０％；合并ＯＲ值为６．７。结果表明，国内ＨＣＶ感染与ＨＣＣ关系密切，ＨＣＶ感染是ＨＣＣ发生的一个危险因素。     

人白细胞干扰素诱导慢性乙型肝炎病人DNA损伤修复的探讨

应用不同浓度人白细胞干扰素处理10例慢性乙型肝炎病人外周血淋巴细胞,观察病人姐妹染色单体互换(SCE)频率的动力学变化.结果表明,人白细胞干扰素处理组SCE平均频率明显低于对照组,差异高度显著(P<0.01);慢性迁延性肝炎和慢性活动性肝炎处理组之间SCE平均频率无显著性差异;但人白细胞干扰素处理低浓度组SCE平均频率低于高浓度组,差异不显著(P>0.05).提示人白细胞干扰素具有诱导HBV损伤人体DNA的修复作用;大剂量人白细胞干扰素对HBV损伤人体DNA的修复未必有益.     

Association between chronic hepatitis B virus infection and diabetes among Asian Americans and Pacific Islanders

BACKGROUND: Asians have a higher prevalence of both diabetes (diabetes mellitus) and chronic hepatitis B virus infection compared to Caucasians. The aim of this study was to investigate whether hepatitis B virus infection was associated with diabetes mellitus among Asian Americans and Pacific Islanders. METHODS: We reviewed the electronic medical records of 411 Asian and 424 Pacific Islanders seen at our medical centre over a 5-year period. Diabetes mellitus was defined by the presence of two or more random blood glucose levels > or =200mg/dL, an ICD-9 diagnostic code of diabetes mellitus, or use of medications for diabetes mellitus. Hepatitis B virus infection was defined by a positive HBsAg test. RESULTS: Diabetes mellitus was diagnosed in 223 of the 835 subjects (26.7%), whereas hepatitis B virus infection was diagnosed in 56 (13.8%) of the 407 subjects tested for HBsAg. Overall, the prevalence of diabetes mellitus was significantly higher in patients with hepatitis B virus than in those without hepatitis B virus (58.9% vs. 33.3%, P<0.001), and this remained significant after adjustment for potential confounding variables (OR=3.17; 95% CI, 1.58-6.35). When Asians and Pacific Islanders were analysed separately, the prevalence of diabetes mellitus in patients with hepatitis B virus was significantly higher than in those without hepatitis B virus among Asians (65.0% vs. 27.5%, P<0.001) but not in Pacific Islanders (43.8% vs. 37.1%, P=0.60). Among the 390 subjects who were tested for both hepatitis B virus and hepatitis C virus, the prevalence of diabetes mellitus was 29.4% in uninfected subjects, 44.4% in patients with hepatitis B virus monoinfection, 47.2% in patients with hepatitis C virus monoinfection and 85.0% in patients with hepatitis B virus and hepatitis C virus coinfection (P<0.001). CONCLUSIONS: Hepatitis B virus infection is strongly associated with diabetes mellitus among Asian Americans, but not in Pacific Islanders, whereas hepatitis C virus infection was associated with diabetes mellitus in both ethnic groups.     

丙型肝炎传播途径的病例对照研究

本文按１１病例对照设计研究了丙型肝炎的传播途径。结果显示：无论单因素还是多因素条件Ｌｏｇｉｓｔｉｃ回归分析，输血及血制品都是丙型肝炎传播的一条重要途径。多因素条件Ｌｏｇｉｓ－ｔｉｃ回归分析的ＯＲ＝４．４８０，Ｐ＝０．００１。另外，肝炎家族史和外科手术史也可能与丙型肝炎的感染有关。本研究未发现注射、有创性检查以及外出饮食习惯与ＨＣＶ感染的关系     

乙型肝炎患者可溶性白细胞介素2受体水平变化

本研究应用酶联免疫吸附试验(ELISA)检测了103例乙型肝炎各型患者及26倒乙肝病毒(HBV)携带者血清中可溶性白细胞介素2受体(sIL-2R)水平,并结合临床资料进行分析。结果发现:各型患者及HBV 携带者sIL-2R 水平均明显高于正常对照(P<0.01～0.001),其升高程度与病情轻重呈正比,在去除危重患者酶—胆分离时谷丙转氨酶(ALT)过低的影响后,sIL-2R 水平与ALT 有良好的正相关关系(r=0.38.p<0.05);作者认为sIL-2R 能够较好地反映疾病的活动状况,动态观察血清sIL-2R 水平的变化,对判断和评价HBV 感染后的病情演变及免疫失衡状态具有重要意义。     

Autoimmune hepatitis type 1 and primary biliary cirrhosis have distinct bone marrow cytokine production

We have recently reported differences in the hematopoiesis between autoimmune hepatitis type 1 (AIH-1) and primary biliary cirrhosis (PBC). In view of the notion that cytokines are regulators of hematopoiesis, we investigated in our tertiary center the cytokine production in the bone marrow (BM) of the same consecutive cohort of patients (13 AIH-1, 13 PBC, 10 healthy and 7 patients with cirrhosis due to chronic hepatitis B). Interferon-gamma (IFN-gamma), interleukin-4 (IL-4), interleukin-10 (IL-10), tumor necrosis factor-alpha (TNF-alpha) and transforming growth factor-beta (TGF-beta) were determined in the supernatants of long-term BM cultures by ELISAs. IL-4, TNF-alpha and TGF-beta were found significantly increased in the BM of PBC patients compared to AIH-1 and both control groups. AIH-1 patients had significantly higher BM IL-10 compared to PBC patients and higher IL-10, IL-4 and TNF-alpha compared to controls. BM IFN-gamma was significantly higher in PBC and AIH-1 patients compared to controls. In AIH-1 patients, IL-10 was positively correlated with CD34+, CD34+/CD38- and CD34+/CD38+ cell proportions. In conclusion, the BM cytokine microenvironment of PBC and AIH-1 patients differs significantly compared to that of healthy individuals and cirrhotic patients of non-autoimmune etiology. Differences were also found between patients with PBC and AH-1. The implication of BM in the pathogenesis of autoimmune liver diseases is possible and needs further investigation.     

临床诊断为非甲～戊型肝炎患者的病原学研究

目的探讨临床诊断为非甲-戊型肝炎患者的病原学。方法 采用巢式PCR（nPCR)检测HBV、TTV、B19、和SENV DNA；用逆转录巢式PCR（RT-nPCR)检测HGV和HCV RNA。结果 60例临床诊断为非甲-戊型肝炎患者中，单独HBVDNA阳性30例（阳性率为50.0%)，HBV和TTVDNA阳性10例（16.7%)，HBV和B19DNA阳性6例（10.0%)，HCVRNA、HBV和SENVDNA阳性1例（1.7%)，单独HCVRNA阳性1例（1.7%)，HCVRNA和B19DNA阳性1例（1.7%),HGVRNA无一例阳性，单独B19DNA阳性2例（3.3%)。单独TTVDNA阳性1例（1.7%)，另8例（13.3%)上述病毒核酸均为阴性。HBV合并感染TTV或B19对其血清学生化指标无影响。结论HBV是临床诊断为非甲-戊型肝炎的主要病原，HGV、TTV、B19和SENV与非甲-戊型肝炎无关。     

Hepatitis B surface antigen and hepatocellular carcinoma in Southern Africa

Summary Most series in Africa show a high percentage of hepatitis B surface Hepatitis antigen in hepatocellular carcinoma. Two groups of cases were investigated in this study. The one was derived from the autopsy material at Baragwanath hospital from subjects who had lived in Soweto, a large Black urban town. The second group consisted of male Black mineworkers generally originating from rural areas. A combination of the aldehydefuchsin stain and immunoperoxidase technique was used. The two groups showed totally different results. The Baragwanath series consisted of 24 hepatocellular carcinomas of which only 4 (17%) were HBsAg positive. Of the 24 cases, 14 had cirrhosis of which 9 were macronodular and 5 micronodular. Ten of these cases showed heavy iron overload. The series of male Black mineworkers comprised 22 cases of which 16 (72%) were HBsAg positive. Twelve of the 22 cases showed a macronodular cirrhosis and there were no micronodular cirrhoses. Only one case showed severe iron overload. These findings delineate two different populations of hepatocellular carcinoma in Southern Africa.