Objective:To evaluate the diagnostic efficacy of chronic viral hepatitis B(CHB)with significant liver fibrosis(S2)in patients with nonalcoholic fatty liver disease(NAFLD)by using noninvasive diagnosis and their combin...Objective:To evaluate the diagnostic efficacy of chronic viral hepatitis B(CHB)with significant liver fibrosis(S2)in patients with nonalcoholic fatty liver disease(NAFLD)by using noninvasive diagnosis and their combined models,and to explore their clinical features.Methods:A total of 104 inpatients with CHB diagnosed and complicated with NAFLD(hepatic steatosis suggested by liver biopsy)were retrospectively collected from January 2018 to January 2023 in the Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University.Liver biopsy was performed in all patients.General data,laboratory test results,liver hardness(LSM),FIB-4,APRI,GGT/PLT,AST/PLT and other results of patients were collected and grouped according to different fibrosis stages(S)to explore the clinical and pathological characteristics of patients with<S2 and S2 stages.Receiver operating characteristic curve was used to evaluate the diagnostic value of LSM,FIB-4,APRI,GGT/PLT,AST/PLT and their combined models in patients with significant liver fibrosis in CHB patients with NAFLD.Results:Among the 104 patients,there were 55 patients had S1 fibrosis,32 patients had S2 fibrosis,11 patients had S3 fibrosis and 6 patients had S4 fibrosis.Patients had<S2 fibrosis,ALT 33.75±17.15 U/L,AST 24.00(19.77,29.00)U/L,inflammation above G2 stage accounted for 92.72%,GGT/PLT 0.07(0.10,0.15),AST/PLT 0.09(0.10,0.15),LSM 8.70(6.80,10.10)kPa,FIB-41.07±0.51,APRI 0.26(0.22,0.28).In patients S2 fibrosis,ALT 42.14±21.39 U/L,AST 29.04(24.00,40.32)U/L,inflammation above G2 stage accounted for 97.95%,GGT/PLT 0.15(0.10,0.28),AST/PLT 0.14(0.10,0.26),GGT/PLT 0.15(0.10,0.28),AST/PLT 0.14(0.10,0.26).LSM 11.80(8.50,16.65)kPa,FIB-41.39±0.72,APRI 0.35(0.26,0.66),the difference between the two groups was statistically significant(P<0.05).The area under the receiver operator characteristic curves of the subjects of LSM,FIB-4,APRI,GGT/PLT and AST/PLT were 0.716,0.623,0.669,0.644 and 0.669(P<0.05),respectively.In the combined model,the area under the receiver operator characteristic curves of LSM combined with FIB-4,LSM combined with APRI,LSM combined with GGT/PLT and LSM combined with AST/PLT were 0.712,0.719,0.715 and 0.719,respectively(P<0.05).Conclusion:Although the currently commonly used Noninvasive diagnosis of liver fibrosis has certain diagnostic efficacy for significant liver fibrosis in CHB complicated with NAFLD,it cannot replace liver biopsy.Noninvasive Diagnosis can be used as an auxiliary method for regular clinical evaluation of liver biopsy.展开更多
Sepsis is a common systemic disease characterized by various physiological and pathological disorders.It can result from infection by various pathogens,such as bacteria,viruses,and fungi.The rate of culture-negative s...Sepsis is a common systemic disease characterized by various physiological and pathological disorders.It can result from infection by various pathogens,such as bacteria,viruses,and fungi.The rate of culture-negative sepsis is almost 42%,indicating that most patients may have nonbacterial infections.With the outbreak of coronavirus disease 2019,viral sepsis has attracted growing attention because many critically ill patients develop sepsis.Viral sepsis can be caused by viral infections and combined with,or secondary to,bacterial infections.Understanding the common types of viral sepsis and the main characteristics of its pathogenesis will be helpful for effective diagnosis and treatment,thereby reducing mortality.Early identification of the causative agent of viral sepsis can help reduce the overuse of broad-spectrum antibiotics.In this article,we reviewed the common viruses of sepsis,their potential pathophysiology,targets of diagnosis,and remedies for viral sepsis.展开更多
In China, the estimated number of HIV infected cases is approaching one million. Although public education has been initiated for awareness and behavioral modification for this devastating infection, better diagnostic...In China, the estimated number of HIV infected cases is approaching one million. Although public education has been initiated for awareness and behavioral modification for this devastating infection, better diagnostic methods are needed to identify infected persons and manage infection. Simple and more accurate diagnostic tools have become available, particularly for early detection and to monitor treatment in those who receive anti-retroviral treatment. In this short review, we summarize some of the common and new methodologies that can be used in clinical laboratories, in the field, or in private laboratories. These range from simple antibody tests to more sophistical methods that are used to monitor disease progression and identify drug resistance. These tools can assist physicians, medical practitioners, and laboratory personnel to select suitable diagnostic tools for the diagnosis, blood screening, monitoring of disease progression, and for detection of drug resistance to anti-retroviral therapies.展开更多
Viral hepatitis can result in important morbidity and mortality,with its impact on health conditioned by the specific type of hepatitis,the geographical region of presentation and the development and access to new dru...Viral hepatitis can result in important morbidity and mortality,with its impact on health conditioned by the specific type of hepatitis,the geographical region of presentation and the development and access to new drugs,among other factors.Most acute presentation forms are self-limiting and may even go unnoticed,with just a small percentage of cases leading to acute liver failure that may necessitate transplantation or even cause the death of the patient.However,when they become chronic,as in the case of hepatitis B virus and C virus,unless they are diagnosed and treated adequately they may have severe consequences,like cirrhosis or hepatocarcinoma.Understanding of the mechanisms of transmission,the pathogenesis,the presence of vaccinations and the development over recent years of new highly-efficient,potent drugs have meant that we are now faced with a new scenario in the management of viral hepatitis,particularly hepatitis B virus and hepatitis C virus.The spectacular advances in hepatitis C virus treatment have led the World Health Organization to propose the objective of its eradication by 2030.The key aspect to achieving this goal is to ensure that these treatments reach all the more vulnerable population groups,in whom the different types of viral hepatitis have a high prevalence and constitute a niche that may perpetuate infection and hinder its eradication.Accordingly,microelimination programs assume special relevance at the present time.展开更多
目的研究分析肝炎肝硬化患者诊治中进行肝功能检验的临床价值。方法选取2020年1月—2022年12月丰县人民医院收治的肝炎肝硬化患者50例设为观察组,依据Child-Pugh分级划分为A级组(n=15)、B级组(n=16)、C级组(n=19),同时选取同期进行体检...目的研究分析肝炎肝硬化患者诊治中进行肝功能检验的临床价值。方法选取2020年1月—2022年12月丰县人民医院收治的肝炎肝硬化患者50例设为观察组,依据Child-Pugh分级划分为A级组(n=15)、B级组(n=16)、C级组(n=19),同时选取同期进行体检的健康者50例设为对照组。对两组间及不同程度肝炎肝硬化患者总胆红素(total bilirubin,TBIL)、白蛋白(albumin,ALB)、胆碱酯酶(cholinesterase,CHE)、总胆汁酸(total bile acid,TBA)等肝功能指标进行检验比较。结果观察组ALB、CHE水平分别为(30.69±4.54)g/L、(2276.37±271.36)IU/L,明显低于对照组,TBIL、TBA水平分别为(23.07±2.25)μmol/L、(48.74±6.24)μmol/L明显高于对照组,差异有统计学意义(t=14.181、88.262、45.004、47.026,P<0.05)。在ALB、CHE水平方面,A级组最高,B级组高于C级组,差异有统计学意义(P<0.05);在TBIL、TBA水平方面,A级组最低,B级组低于C级组,差异有统计学意义(P<0.05)。结论肝炎肝硬化患者诊治中进行肝功能检验的临床价值非常高,对判断病情程度有着十分积极的作用,能够为临床诊断提供指导依据。展开更多
基金Natural Science Foundation of Xinjiang Uygur Autonomous Region (No.2022D01C173)National Natural Science Foundation of China (No.81760832)。
文摘Objective:To evaluate the diagnostic efficacy of chronic viral hepatitis B(CHB)with significant liver fibrosis(S2)in patients with nonalcoholic fatty liver disease(NAFLD)by using noninvasive diagnosis and their combined models,and to explore their clinical features.Methods:A total of 104 inpatients with CHB diagnosed and complicated with NAFLD(hepatic steatosis suggested by liver biopsy)were retrospectively collected from January 2018 to January 2023 in the Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University.Liver biopsy was performed in all patients.General data,laboratory test results,liver hardness(LSM),FIB-4,APRI,GGT/PLT,AST/PLT and other results of patients were collected and grouped according to different fibrosis stages(S)to explore the clinical and pathological characteristics of patients with<S2 and S2 stages.Receiver operating characteristic curve was used to evaluate the diagnostic value of LSM,FIB-4,APRI,GGT/PLT,AST/PLT and their combined models in patients with significant liver fibrosis in CHB patients with NAFLD.Results:Among the 104 patients,there were 55 patients had S1 fibrosis,32 patients had S2 fibrosis,11 patients had S3 fibrosis and 6 patients had S4 fibrosis.Patients had<S2 fibrosis,ALT 33.75±17.15 U/L,AST 24.00(19.77,29.00)U/L,inflammation above G2 stage accounted for 92.72%,GGT/PLT 0.07(0.10,0.15),AST/PLT 0.09(0.10,0.15),LSM 8.70(6.80,10.10)kPa,FIB-41.07±0.51,APRI 0.26(0.22,0.28).In patients S2 fibrosis,ALT 42.14±21.39 U/L,AST 29.04(24.00,40.32)U/L,inflammation above G2 stage accounted for 97.95%,GGT/PLT 0.15(0.10,0.28),AST/PLT 0.14(0.10,0.26),GGT/PLT 0.15(0.10,0.28),AST/PLT 0.14(0.10,0.26).LSM 11.80(8.50,16.65)kPa,FIB-41.39±0.72,APRI 0.35(0.26,0.66),the difference between the two groups was statistically significant(P<0.05).The area under the receiver operator characteristic curves of the subjects of LSM,FIB-4,APRI,GGT/PLT and AST/PLT were 0.716,0.623,0.669,0.644 and 0.669(P<0.05),respectively.In the combined model,the area under the receiver operator characteristic curves of LSM combined with FIB-4,LSM combined with APRI,LSM combined with GGT/PLT and LSM combined with AST/PLT were 0.712,0.719,0.715 and 0.719,respectively(P<0.05).Conclusion:Although the currently commonly used Noninvasive diagnosis of liver fibrosis has certain diagnostic efficacy for significant liver fibrosis in CHB complicated with NAFLD,it cannot replace liver biopsy.Noninvasive Diagnosis can be used as an auxiliary method for regular clinical evaluation of liver biopsy.
文摘Sepsis is a common systemic disease characterized by various physiological and pathological disorders.It can result from infection by various pathogens,such as bacteria,viruses,and fungi.The rate of culture-negative sepsis is almost 42%,indicating that most patients may have nonbacterial infections.With the outbreak of coronavirus disease 2019,viral sepsis has attracted growing attention because many critically ill patients develop sepsis.Viral sepsis can be caused by viral infections and combined with,or secondary to,bacterial infections.Understanding the common types of viral sepsis and the main characteristics of its pathogenesis will be helpful for effective diagnosis and treatment,thereby reducing mortality.Early identification of the causative agent of viral sepsis can help reduce the overuse of broad-spectrum antibiotics.In this article,we reviewed the common viruses of sepsis,their potential pathophysiology,targets of diagnosis,and remedies for viral sepsis.
文摘In China, the estimated number of HIV infected cases is approaching one million. Although public education has been initiated for awareness and behavioral modification for this devastating infection, better diagnostic methods are needed to identify infected persons and manage infection. Simple and more accurate diagnostic tools have become available, particularly for early detection and to monitor treatment in those who receive anti-retroviral treatment. In this short review, we summarize some of the common and new methodologies that can be used in clinical laboratories, in the field, or in private laboratories. These range from simple antibody tests to more sophistical methods that are used to monitor disease progression and identify drug resistance. These tools can assist physicians, medical practitioners, and laboratory personnel to select suitable diagnostic tools for the diagnosis, blood screening, monitoring of disease progression, and for detection of drug resistance to anti-retroviral therapies.
文摘Viral hepatitis can result in important morbidity and mortality,with its impact on health conditioned by the specific type of hepatitis,the geographical region of presentation and the development and access to new drugs,among other factors.Most acute presentation forms are self-limiting and may even go unnoticed,with just a small percentage of cases leading to acute liver failure that may necessitate transplantation or even cause the death of the patient.However,when they become chronic,as in the case of hepatitis B virus and C virus,unless they are diagnosed and treated adequately they may have severe consequences,like cirrhosis or hepatocarcinoma.Understanding of the mechanisms of transmission,the pathogenesis,the presence of vaccinations and the development over recent years of new highly-efficient,potent drugs have meant that we are now faced with a new scenario in the management of viral hepatitis,particularly hepatitis B virus and hepatitis C virus.The spectacular advances in hepatitis C virus treatment have led the World Health Organization to propose the objective of its eradication by 2030.The key aspect to achieving this goal is to ensure that these treatments reach all the more vulnerable population groups,in whom the different types of viral hepatitis have a high prevalence and constitute a niche that may perpetuate infection and hinder its eradication.Accordingly,microelimination programs assume special relevance at the present time.
文摘目的研究分析肝炎肝硬化患者诊治中进行肝功能检验的临床价值。方法选取2020年1月—2022年12月丰县人民医院收治的肝炎肝硬化患者50例设为观察组,依据Child-Pugh分级划分为A级组(n=15)、B级组(n=16)、C级组(n=19),同时选取同期进行体检的健康者50例设为对照组。对两组间及不同程度肝炎肝硬化患者总胆红素(total bilirubin,TBIL)、白蛋白(albumin,ALB)、胆碱酯酶(cholinesterase,CHE)、总胆汁酸(total bile acid,TBA)等肝功能指标进行检验比较。结果观察组ALB、CHE水平分别为(30.69±4.54)g/L、(2276.37±271.36)IU/L,明显低于对照组,TBIL、TBA水平分别为(23.07±2.25)μmol/L、(48.74±6.24)μmol/L明显高于对照组,差异有统计学意义(t=14.181、88.262、45.004、47.026,P<0.05)。在ALB、CHE水平方面,A级组最高,B级组高于C级组,差异有统计学意义(P<0.05);在TBIL、TBA水平方面,A级组最低,B级组低于C级组,差异有统计学意义(P<0.05)。结论肝炎肝硬化患者诊治中进行肝功能检验的临床价值非常高,对判断病情程度有着十分积极的作用,能够为临床诊断提供指导依据。
