冬虫夏草菌丝对乙型慢性病毒性肝炎免疫功能的影响

乙型慢性病毒性肝炎存在着不同程度的免疫功能失调,尤其是细胞免疫功能失调的情况,经临床观察发现具有培本补虚作用的冬虫夏草能升高CD4+、NK细胞,提高CD4+/CD8+比值。同时还能降低IgM水平。说明冬虫夏草不仅具有良好的调整细胞免疫功能的作用,而且对体液免疫功能也有一定的调节作用。

自拟健脾疏肝汤对慢性乙型肝炎的治疗作用

目的:观察凯西莱合健脾疏肝汤治疗慢性乙型病毒性肝炎的疗效。方法:将100例患者,随机分成2组各50例,均先常规应用凯西莱静脉滴注,后改口服,治疗组加用中药健脾疏肝汤,每日1剂,分2次服。疗程均3个月,随访3个月。结果:治疗组症状及体征消失率优于对照组(P<0.05);肝功能变化,ALT、AST、γ-GT下降优于对照组(P<0.01或<0.05);有效率也优于对照组(P<0.05)。结论:健脾疏肝汤对慢性乙型病毒性肝炎有较好的治疗作用,可明显改善临床症状,提高肝功能复常率。

阿德福韦、恩替卡韦对慢性病毒性(乙型)肝炎治疗效果及影响比较

针对慢性病毒性(乙型)肝炎临床治疗过程中选择阿德福韦以及恩替卡韦的具体效果以及影响分析。方法:筛选2019年1月~2021年1月在我院收治48例慢性病毒性(乙型)肝炎的患者来进行此次课题研究。依据电脑随机将其分为参照组、实验组,每组患者24例。参照组选择阿德福韦开展治疗,实验组选择恩替卡韦开展治疗。观察比较两组病情改善情况,以及治疗效果、不良反应的发生情况。结果:治疗后,所有患者AST、ALT以及TBIL等肝功能相关指标均出现较明显变化,并且实验组指标均优于参照组,比较意义显著(P<0.05);参照组治疗效果低于实验组,比较意义显著(P<0.05);参照组发生不良反应的概率高于实验组,比较意义显著(P<0.05)。结论:与阿德福韦相比,恩替卡韦治疗慢性病毒性(乙型)肝炎的疗效更加理想,既能显著改善患者的相应指标,又能积极提升患者的肝功能,推荐在临床中予以广泛应用。

乙肝辨证分型与病毒复制关系的初步研究

通过大样本的临床调查研究 ,初步探讨乙型慢性病毒性肝炎患者辨证分型与病毒复制程度之间的关系。采用临床流行病学———回顾性研究的方法。结果 ,本次调查资料经数据完整性、诊断规范化、辨证标准化初步筛选。 2 82例乙型慢肝患者 ,各证型的分布为肝郁脾虚 >肝胆湿热 >瘀血阻络 >肝肾阴虚 >脾肾阳虚 ,其中以肝郁脾虚证和肝胆湿热证为其常见证型 ,占所调查对象的 84 75 % ;肝郁脾虚证患者以HBsAg(+)、HBeAb(+)为主 ,病毒处于低复制阶段 (R1=0 938,P <0 0 1) ;而肝胆湿热证多见两种表型(R2 =0 799,P <0 0 1) ,即HBsAg(+)、HBeAg(+)、HBcAb(+)、HBV DNA(+)或HBsAg(+)、HBcAb(+)、HBV DNA(+) ,提示病毒复制高度活跃。肝胆湿热证与病毒高复制状态具有显著相关性。

乙肝清热解毒合养阴活血冲剂治疗乙肝的临床及实验研究

对乙肝清热解毒冲剂合乙肝养阴活血冲剂治疗乙型慢性病毒性肝炎进行临床及实验研究。临床研究表明 ,对改善患者症状、体征和肝功能有明显的疗效 ,对病毒指标的阴转亦有疗效 ,HBeAg、HBV DNA的转阴率分别为 32 14%和 37 5 0 % (P <0 0 5 )。实验研究表明 ,能有效抑制鸭乙肝病毒 (DHBV DNA)复制 ,治疗前后比较有显著性差异 (P <0 0 5 ) 。

Development of Novel Therapeutics for Chronic Hepatitis B

Chronic infection of hepatitis B virus (HBV) presents one of the serious public health challenges worldwide. Current treatment of chronic hepatitis B (CHB) is limited, and is composed of interferon and nucleoside/nucleotide reverse transcriptase inhibitors (NRTI). Interferon is poorly tolerated and is only responsive in a small fraction of CHB patients and NRTIs often face the problem of emergence of drug resistance during long-term treatment. The current treatment of CHB can be improved in several ways including genotyping mutations associated with drug resistance before treatment to guide the choice of NRTIs and suitable combinations among NRTIs and interferon. It is important to continue research in the identification of novel therapeutic targets in the life cycle of HBV or in the host immune system to stimulate the development of new antiviral agents and immunotherapies. Several antiviral agents targeting HBV entry, cccDNA, capsid formation, viral morphogenesis and virion secretion, as well as two therapeutic vaccines are currently being evaluated in preclinical studies or in clinical trials to assess their anti-HBV efficacy.

Serum concentration of sFas and sFasL in healthy HBsAg carriers,chronic viral hepatitis B and C patients

AIM:To estimate the amount of apoptosis among healthy HBsAg carriers,patients with chronic HBV infection treated wibh lamivudine and patients with chronic HCV infection treated with interferon alpha and ribavirin.Activity of apoptosis was evaluated by serum sFas/sFasL concentration measurement. Moreover dependence between apoptosis and HBV-DNA or HCV-RNA levels was studied. METHODS:Eighty-six persons were included into study:34 healthy HBsAg carders,33 patients with chronic HBV infecl^on and 19 patients with chronic HCV infection.Serum levels of sFas/sFasL were measured by ELISA assay.HBV-DNA and HCV-RNA were measured by RT-PCR assay.Levels of sFas/sFasL were determined before and 2 and 12 wk after therapy in patients with chronic hepatitis B and C infection. HBV-DNA or HCV-RNA was detected before treatment and 6 mo after treatment. RESULTS:Twenty-four (71%) healthy HBsAg carders showed HBV-DNA over 10~5/mL,which was comparable to the patients with chronic hepatitis B.independently from HBV-DNA levels, the concentration of sFas among healthy HBsAg carders was comparable to healthy persons.Among patients with chronic hepatitis B and C,the concentration of sFas was significantly higher in comparison to healthy HBsAg carriers and healthy persons.In chronic hepatitis B patients the concentration of sFas was decreased during lamivudine treatment.Among chronic hepatitis C patients the concentration of sFas was increased during IFN alpha and ribavirin treatment,sFasL was not detected in control group.Furbhermore sFasL occurred more frequently in chronic hepatitis C patients in comparison to chronic hepatitis B patients. CONCLUSION:There are no correlations between apoptosis and HBV-DNA levels.However ther is an association between apoptosis and activity of inflammation in patients with chronic HBV infection.Apoptosis can be increased in patients with chronic hepatitis C by effective treatment which may be a result of apoptosis stimulation by IFN-α.

HBeAg negative serological status and low viral replication levels characterize chronic hepatitis B virus-infected women at reproductive age in Greece: A one-year prospective single center study

AIM： To evaluate the seroprevalence of hepatitis B surface antigen （HBsAg） in 13 581 women at reproductive age and the hepatitis B e antigen （HBeAg）/anti-HBe status as well as serum hepatitis B virus （HBV）-DNA levels in a subgroup of HBsAg（＋） pregnant women at labor in Greece. METHODS： Serological markers were detected using enzyme immunoassays. Serum HBV-DNA was determined by a sensitive quantitative PCR assay. Statistical analysis of data was based on parametric methodology. RESULTS： Overall, 1.156% of women were HBsAg（＋） and the majority of them （71.3%） were Albanian. The prevalence of HBsAg was 5.1% in Albanian women, 4.2% in Asian women and 1.14% in women from Eastern European countries. The prevalence of HBsAg in African （0.36%） and Greek women （0.29%） was very low. Only 4.45% of HBsAg （＋） women were also HBeAg（＋） whereas the vast majority of them were HBeAg（-）/anti-HBe（＋）. Undetectable levels of viremia （〈200 copies/mL） were observed in 32.26% of pregnant women at labor and 29.03% exhibited extremely low levels of viral replication （〈400 copies/mL）. Only two pregnant women exhibited extremely high serum HBV- DNA levels （〉10 000 000 copies/mL）, whereas 32.26% exhibited HBV-DNA levels between 1 500 and 40 000 copies/mL. CONCLUSION： The overall prevalence of HBsAg is relatively low among women at reproductive age in Greece but is higher enough among specific populations. The HBeAg（-）/anti-HBe（＋） serological status and the extremely low or even undetectable viral replicative status in the majority/of HBsAg（＋） women of our study population, suggestthat only a small proportion of HBsAg（＋） women in Greece exhibit a high risk for vertical transmission of the infection.