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A Severe Case of Reye’s Syndrome with Multiorgan Dysfunction after Epstein-Barr Virus Infection
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作者 刘秉楠 齐莹 《Chinese Medical Sciences Journal》 CAS CSCD 2019年第4期297-299,共3页
A 20-month-old male infant with multiorgan dysfunction after Epstein-Barr virus(EBV)infection developed Reye’s syndrome.He also suffered from acute liver failure,life-threatening cerebral edema,severe disseminated in... A 20-month-old male infant with multiorgan dysfunction after Epstein-Barr virus(EBV)infection developed Reye’s syndrome.He also suffered from acute liver failure,life-threatening cerebral edema,severe disseminated intravascular coagulation(DIC),and myocardial involvement.EBV infection aggravated the progress of Reye’s syndrome,leading to death despite full supportive and symptomatic therapy.This critical case suggested that pediatricians should pay attention to multiorgan involvement of severe EBV infection. 展开更多
关键词 epstein-barr virus Reye’s syndrome multiorgan dysfunction
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Chronic hepatitis B-associated liver disease in the context of human immunodeficiency virus co-infection and underlying metabolic syndrome 被引量:2
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作者 Edina Amponsah-Dacosta Cynthia Tamandjou Tchuem Motswedi Anderson 《World Journal of Virology》 2020年第5期54-66,共13页
Globally,a shift in the epidemiology of chronic liver disease has been observed.This has been mainly driven by a marked decline in the prevalence of chronic hepatitis B virus infection(CHB),with the greatest burden re... Globally,a shift in the epidemiology of chronic liver disease has been observed.This has been mainly driven by a marked decline in the prevalence of chronic hepatitis B virus infection(CHB),with the greatest burden restricted to the Western Pacific and sub-Saharan African regions.Amidst this is a growing burden of metabolic syndrome(MetS)worldwide.A disproportionate co-burden of human immunodeficiency virus(HIV)infection is also reported in sub-Saharan Africa,which poses a further risk of liver-related morbidity and mortality in the region.We reviewed the existing evidence base to improve current understanding of the effect of underlying MetS on the development and progression of chronic liver disease during CHB and HIV co-infection.While the mechanistic association between CHB and MetS remains poorly resolved,the evidence suggests that MetS may have an additive effect on the liver damage caused by CHB.Among HIV infected individuals,MetS-associated liver disease is emerging as an important cause of non-AIDS related morbidity and mortality despite antiretroviral therapy(ART).It is plausible that underlying MetS may lead to adverse outcomes among those with concomitant CHB and HIV co-infection.However,this remains to be explored through rigorous longitudinal studies,especially in sub-Saharan Africa.Ultimately,there is a need for a comprehensive package of care that integrates ART programs with routine screening for MetS and promotion of lifestyle modification to ensure an improved quality of life among CHB and HIV coinfected individuals. 展开更多
关键词 Hepatitis B virus Human immunodeficiency virus Metabolic syndrome Fatty liver disease chronic liver disease Sub-Sharan Africa
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One Hemophagocytic Syndrome Relating to Adult Epstein-Barr Virus Infection and a Literature Review
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作者 Xiaolong Liu Yamin Zhang +2 位作者 Zilin Cui Qing Tian Dongming Duan 《Case Reports in Clinical Medicine》 2016年第12期511-517,共7页
Background: Adult hemophagocytic syndrome is a critical condition that is often difficult to diagnose and results in a bad prognosis because of the lack of effective and unified treatment. Aim: To investigate the clin... Background: Adult hemophagocytic syndrome is a critical condition that is often difficult to diagnose and results in a bad prognosis because of the lack of effective and unified treatment. Aim: To investigate the clinical, diagnosis and treatment of hemophagocytic syndrome. Case Presentation: A 22-year-old female patient received a splenectomy, and the spleen was sent to the King Med Center of Medical Inspection. The results confirmed the diagnosis of hemophagocytic syndrome related to EB (Epstein-Barr) virus infection. Conclusion: Early diagnosis and early intervention are important factors for affecting the progression of the disease and improving its prognosis. 展开更多
关键词 Hemophagocytic syndrome epstein-barr viru DIAGNOSIS TREATMENT
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Epstein-Barr virus:Silent companion or causative agent of chronic liver disease? 被引量:10
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作者 Mihaela Petrova Victor Kamburov 《World Journal of Gastroenterology》 SCIE CAS CSCD 2010年第33期4130-4134,共5页
The Epstein-Barr virus(EBV)has an important and multifaceted role in liver pathology.As a member of the herpes virus family,EBV establishes a persistent infection in more than 90%of adults.Besides acute hepatitis duri... The Epstein-Barr virus(EBV)has an important and multifaceted role in liver pathology.As a member of the herpes virus family,EBV establishes a persistent infection in more than 90%of adults.Besides acute hepatitis during primary infection,many clinical syndromes of interest for the hepatologist are associated with EBV infection.The role of EBV in the evolution of chronic hepatitis from hepatotropic viruses is considered.Chronic EBVassociated hepatitis is suspected in immunocompetent adults with compatible serology,suggestive histology and detection of the viral genome in the liver and/or increase of specific circulating cytotoxic T-lymphocytes.EBV is the main cause of post-transplant lymphoproliferative disorders which occur in up to 30%of cases.EBV-driven lymphoproliferative diseases are also recognized in non-immunocompromised patients and liver is involved in up to a third of the cases.Directly implicated in the pathogenesis of different tumors,EBV has a disputable role in hepatocellular carcinoma carcinogenesis.Further research is required in order to establish or reject the role of EBV in human liver cancer.This paper attempts to discuss the range of EBV-associated chronic liver diseases in immunocompetent patients,from mild,self-limiting mononuclear hepatitis to liver cancer. 展开更多
关键词 epstein-barr virus chronic hepatitis Liver disease chronic active epstein-barr virus Post-transplant lymphoproliferative disorder Infectious mononucleosis
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Chronic active Epstein-Barr virus infection treated with PEGaspargase: A case report 被引量:1
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作者 De-Li Song Jing-Shi Wang +1 位作者 Lei-Lei Chen Zhao Wang 《World Journal of Clinical Cases》 SCIE 2021年第26期7845-7849,共5页
BACKGROUND Chronic active Epstein-Barr virus infection(EBV)is a systemic EBV-positive lymphoproliferative disease,which may lead to fatal illness.There is currently no standard treatment regimen for chronic active EBV... BACKGROUND Chronic active Epstein-Barr virus infection(EBV)is a systemic EBV-positive lymphoproliferative disease,which may lead to fatal illness.There is currently no standard treatment regimen for chronic active EBV(CAEBV),and hematopoietic stem cell transplantation is the only effective treatment.We here report a CAEBV patient treated with PEG-aspargase,who achieved negative EBV-DNA.CASE SUMMARY A 33-year-old female Chinese patient who had fever for approximately 3 mo was admitted to our hospital in December 2017.EBV-DNA was positive with a high copy number.She was diagnosed with chronic active EB virus infection.PEGaspargase was administered at a dose of 1500 U/m2 at a 14-d interval,resulting in eradication of EBV for more than 6 mo.The effect of PEG-aspargase in this patient was excellent.CONCLUSION A chemotherapy regimen containing PEG-aspargase for CAEBV may be further considered. 展开更多
关键词 chronic active epstein-barr virus infection PEG-aspargase CHEMOTHERAPY L-ASPARAGINASE Case report
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Natural killer/T-cell lymphoma with intracranial infiltration and Epstein-Barr virus infection: A case report
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作者 Nan Li Yi-Zhuo Wang +3 位作者 Yi Zhang Wei-Ling Zhang Yan Zhou Dong-Sheng Huang 《World Journal of Clinical Cases》 SCIE 2020年第15期3284-3290,共7页
BACKGROUND Because of atypical clinical symptoms,lymphoma is easily confused with infectious diseases.Extranodal nasal-type natural killer/T-cell lymphoma(NKTL)is more common,and there are few cases of eyelid site ons... BACKGROUND Because of atypical clinical symptoms,lymphoma is easily confused with infectious diseases.Extranodal nasal-type natural killer/T-cell lymphoma(NKTL)is more common,and there are few cases of eyelid site onset and intracranial infiltration,which increases the difficulty of diagnosis.This disease usually has a very poor prognosis and there are few reports of recovery.CASE SUMMARY A 3-year-old boy was admitted to our hospital due to an initial misdiagnosis of"eyelid cellulitis"and failed antibiotic treatment.He was characterized by fever,right eyeball bulging,convulsions,and abnormal liver function.His blood Epstein-Barr virus(EBV)DNA was positive(8.798×10^4 copies/mL),and remained positive for about half a year.The cranial imaging examination suggested a space-occupying lesion in the right eyelid,with the right temporal lobe and meninges involved.The boy underwent ocular mass resection.The pathological diagnosis was NKTL.He was diagnosed as having NKTL with intracranial infiltration,combined with chronic active EBV infection(CAEBV).Then he underwent systemic chemotherapy and intrathecal injection.The boy suffered from abnormal blood coagulation,oral mucositis,diarrhea,liver damage,and severe bone marrow suppression but survived.Finally,the tumor was completely relieved and his blood EBV-DNA level turned negative.The current follow-up has been more than 2 years and his condition is stable.CONCLUSION This case suggests that chemotherapy combined with intrathecal injection may have a good effect on intracranial infiltrating lymphoma and CAEBV,which deserves further study and discussion. 展开更多
关键词 Natural killer/T-cell lymphoma Intracranial infiltration chronic active epstein-barr virus infection Eyelid cellulitis CHEMOTHERAPY Case report
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Natural killer/T-cell lymphoma with concomitant syndrome of inappropriate antidiuretic hormone secretion: A case report and review of literature
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作者 Quan-Bo Liu Rui Zheng 《World Journal of Clinical Cases》 SCIE 2018年第13期694-702,共9页
We report a case of natural killer(NK)/T-cell lymphoma with concomitant syndrome of inappropriate antidiuretic hormone secretion(SIADH).The patient was a 64-yearold woman with a history of nasopharyngeal carcinoma of ... We report a case of natural killer(NK)/T-cell lymphoma with concomitant syndrome of inappropriate antidiuretic hormone secretion(SIADH).The patient was a 64-yearold woman with a history of nasopharyngeal carcinoma of over 30 years.She was admitted with a chief complaint of intermittent fever for 2 mo.Palpation after admission indicated a swollen lymph node below the left jaw.Multiple imaging examinations on admission indicated multiple enlarged lymph nodes throughout the body.We performed a left submandibular lymph node biopsy,and the results revealed NK/T-cell lymphoma.A biochemical examination indicated Epstein-Barr virus positivity.At the same time,the patient developed hyponatremia.Based on her laboratory examination and clinical manifestation,decreased plasma osmolality,urine osmolality greater than plasma osmolality,lack of skin swelling,normal blood pressure,normal renal function,no adrenal function detected on serology,and no abnormalities in imaging examination of the adrenal glands,the likelihood of SIADH in the patient was high.After fluid restriction and administration of sodium chloride,the patient’s blood sodium level gradually increased.Subsequently,the immune function of the patient declined,there were severe symptoms of infection,and she died of respiratory failure.NK/T-cell lymphoma associated with SIADH has not,to our knowledge,been previously reported in PubMed.This case emphasizes the importance of monitoring serum ion levels,especially serum sodium,in patients with NK/T-cell lymphoma. 展开更多
关键词 epstein-barr virus Case report Literature review syndrome of inappropriate antidiuretic HORMONE SECRETION Natural killer/T-cell lymphoma
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Drug associated vanishing bile duct syndrome combined with hemophagocytic lymphohistiocytosis
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作者 Hui Li Xin Li +5 位作者 Xiao-Xing Liao Hong Zhan et al. Yan Xiong Chun-Lin Hu Hong-Yan Wei Xiao-Li Jing 《World Journal of Gastrointestinal Endoscopy》 2012年第8期376-378,共3页
A 28-year-old woman with untreated autoimmune disorder, demonstrated skin rash and fever after taking Amoxicillin-clavulanate and developed progressive jaundice. A bone marrow aspiration indicated an increased number ... A 28-year-old woman with untreated autoimmune disorder, demonstrated skin rash and fever after taking Amoxicillin-clavulanate and developed progressive jaundice. A bone marrow aspiration indicated an increased number of macrophages with hemophagocytosis and liver biopsy showed pure centrilobular cholestasis with necrosis and some absence of portal bile ducts. Furthermore, a serological test for Epstein-Barr virus was positive. Under treatment by liver dialysis and administration of steroids led to rapidly defervescence and clinical improvement. However, liver enzymes were still markedly elevated with persistent anemia, even after immunosuppressive treatment. The patient is currently waiting for liver transplantation. This is the ?rst description of vanishing bile duct syndrome combined with hemophagocytic lymphohistiocytosis, with underlying causes including infection, drug-induced factors and untreated autoimmune disorder. 展开更多
关键词 Vanishing bile duct syndrome Hemophagocytic lymphohistiocytosis epstein-barr virus Amoxicillin-clavulanate
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Epstein-Barr virus associated secondary hemophagocytic lymphohistiocytosis with an unusual presentation of abdominal compartment syndrome
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作者 Li Lei Camilla J.Cobb +1 位作者 Jeffrey Cao Anwar S.Raza 《Hepatoma Research》 2016年第1期287-292,共6页
Hemophagocytic lymphohistiocytosis(HLH)is a cytokine storm syndrome caused by an overactive but ineffective immune reaction.Without prompt diagnosis and treatment,HLH is life-threatening.However,presenting symptoms ar... Hemophagocytic lymphohistiocytosis(HLH)is a cytokine storm syndrome caused by an overactive but ineffective immune reaction.Without prompt diagnosis and treatment,HLH is life-threatening.However,presenting symptoms are often nonspecific,with fatigue and fever being the most common.A high index of suspicion is therefore critical for early diagnosis and timely management.A previously healthy,65-year-old female who initially presented with fever and abdominal pain developed abdominal compartment syndrome(ACS)requiring decompressive laparotomy on hospital day 6.Intraoperative frozen sections of biopsied liver showed intense portal lymphohistiocytic infiltrates.Epstein-Barr virus DNA copy numbers escalated from 600 copies/mL after admission to 134,000 copies/mL before death.The diagnostic criteria of HLH-2004 were met.Patient expired on hospital day 12.It is important to raise awareness of ACS being an unusual presentation of HLH.Recent changes in diagnostic criteria tailored to adult HLH cases are reviewed. 展开更多
关键词 Hemophagocytic lymphohistiocytosis abdominal compartment syndrome liver biopsy epstein-barr virus
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聚肌胞苷酸复合游泳诱导的慢性疲劳综合征模型小鼠行为学中品系及性别差异研究
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作者 田骄 苏芮 +2 位作者 王婷婷 裴海鸾 王晶 《中国比较医学杂志》 CAS 北大核心 2024年第9期24-33,共10页
目的比较ICR和C57BL/6J两个品系小鼠建立的慢性疲劳综合征模型行为学中品系及性别的差异,为慢性疲劳综合征模型动物的选择提供实验依据。方法ICR和C57BL/6J小鼠,雌雄各半,通过每隔3 d腹腔注射聚肌胞苷酸(polyinosinic-polycytidylic aci... 目的比较ICR和C57BL/6J两个品系小鼠建立的慢性疲劳综合征模型行为学中品系及性别的差异,为慢性疲劳综合征模型动物的选择提供实验依据。方法ICR和C57BL/6J小鼠,雌雄各半,通过每隔3 d腹腔注射聚肌胞苷酸(polyinosinic-polycytidylic acid,Poly I:C)复合每天游泳,连续造模15 d,造模期间测定小鼠体重、进食量并进行疲劳量表评分,造模结束后进行行为学测定,包括力竭游泳、悬尾、机械痛阈和高架十字迷宫。结果与对照组相比,两种品系模型组小鼠力竭游泳时间均显著缩短(P<0.05、P<0.01),悬尾不动时间显著延长(P<0.05、P<0.01),机械痛阈值显著降低(P<0.05、P<0.01),两品系雄性模型鼠高架十字迷宫进入开放臂时间及次数显著降低(P<0.05、P<0.01),C57BL/6J雄性模型鼠体重显著降低(P<0.05、P<0.01),ICR雌性模型鼠体重显著降低(P<0.05)后有所升高。C57BL/6J对照组小鼠力竭游泳时间显著低于ICR对照组小鼠(P<0.01)。C57BL/6J模型组小鼠悬尾不动时间显著高于ICR模型组小鼠(P<0.01)。结论两品系小鼠在体重、疲劳程度及抑郁程度方面均有差异;同品系小鼠的雌性与雄性之间存在差异,雄性鼠焦虑程度重于雌性鼠。 展开更多
关键词 慢性疲劳综合征 聚肌胞苷酸 病毒感染 品系差异
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菖蒲郁金汤加减对HBV相关慢加急性肝衰竭肝功能、炎症因子及血清内毒素的影响
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作者 秦小洁 刘明 +1 位作者 于飞 曲效磊 《中国中医急症》 2024年第9期1586-1590,共5页
目的评价菖蒲郁金汤加减治疗HBV相关慢加急性肝衰竭(HBV-ACLF)毒热蕴结证的临床疗效及对炎症因子及血清内毒素(ET)的影响。方法将64例HBV-ACLF患者随机分为对照组和观察组各32例。对照组给予西医综合治疗措施;观察组在对照组治疗的基础... 目的评价菖蒲郁金汤加减治疗HBV相关慢加急性肝衰竭(HBV-ACLF)毒热蕴结证的临床疗效及对炎症因子及血清内毒素(ET)的影响。方法将64例HBV-ACLF患者随机分为对照组和观察组各32例。对照组给予西医综合治疗措施;观察组在对照组治疗的基础上口服菖蒲郁金汤加减方。疗程为4周。检测治疗前后血清总胆红素(TBil)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、白蛋白(Alb)、凝血酶原活动度(PTA)、纤维蛋白原(FIB)、凝血酶原时间(PT)和血小板计数(PLT)等肝功能和凝血功能指标;比较治疗前后慢性肝衰竭联盟-慢加急性肝衰竭预后(CLIF-CACLF)评分和毒热蕴结证评分;检测治疗前后白细胞介素-2(IL-2)、白细胞介素-17(IL-17)、干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)和ET水平。结果治疗后,两组TBil、ALT、AST、PT、INR水平下降,Alb、PTA、FIB和PLT水平升高(P<0.05),且治疗后观察组TBil、ALT、AST、PT、INR低于对照组(P<0.05),Alb、PTA、FIB和PLT水平高于对照组(P<0.05);治疗后,两组CLIF-CACLF评分和ET水平下降(P<0.05),且观察组低于对照组(P<0.05);治疗后,两组IL-2、IL-17、IFN-γ和TNF-α水平下降(P<0.05),且观察组低于对照组(P<0.05);治疗后,两组主要症状评分和总积分均下降(P<0.05),且观察组低于对照组(P<0.05);治疗后,观察组临床疗效总有效率为90.62%,高于对照组的68.75%(P<0.05)。结论菖蒲郁金汤加减内服治疗HBV-ACLF毒热蕴结证患者,可抑制炎症因子和内毒素血症,减轻损伤程度,促进肝功能恢复,改善凝血功能障碍,减轻临床症状,临床疗效优于单纯西医治疗,值得进一步研究与使用。 展开更多
关键词 慢加急性肝衰竭 乙型肝炎病毒 毒热蕴结证 菖蒲郁金汤 炎症因子 内毒素
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基于靶向氨基酸代谢组学探讨乙型病毒性肝炎相关慢加急性肝衰竭瘀黄证亚型的生物学基础
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作者 周超 唐巧 +7 位作者 何召云 张宁 张瑾 张晶晶 付双楠 刘鹏程 张田义 宫嫚 《中西医结合肝病杂志》 CAS 2024年第6期484-489,共6页
目的:从氨基酸代谢角度探讨乙型肝炎病毒相关慢加急性肝衰竭(HBV-ACLF)湿热瘀黄证和气虚瘀黄证的生物学基础。方法:采用靶向氨基酸代谢组学分析HBV-ACLF湿热瘀黄证组(20例)与气虚瘀黄证组(20例)患者的血清氨基酸代谢谱,寻找两种证型的... 目的:从氨基酸代谢角度探讨乙型肝炎病毒相关慢加急性肝衰竭(HBV-ACLF)湿热瘀黄证和气虚瘀黄证的生物学基础。方法:采用靶向氨基酸代谢组学分析HBV-ACLF湿热瘀黄证组(20例)与气虚瘀黄证组(20例)患者的血清氨基酸代谢谱,寻找两种证型的氨基酸代谢差异特征,分析不同证型中氨基酸代谢与炎症细胞因子表达的相关性。结果:湿热瘀黄证患者体内异亮氨酸表达水平显著高于气虚瘀黄证[(10.36±4.47)μg/ml vs(7.76±4.08)μg/ml,P=0.016],但色氨酸则表达相反[(10.26±4.95)μg/ml vs(14.51±7.32)μg/ml,P=0.014];湿热瘀黄证患者白细胞介素(IL)-6显著高于气虚瘀黄证[10.15(3.88,24.42)pg/ml vs 7.73(3.93,18.83)pg/ml,P=0.017],而IL-2、IL-10显著低于气虚瘀黄证[4.40(2.88,8.55)pg/ml vs 6.60(2.80,15.50)pg/ml,P=0.033;7.19(4.52,15.04)pg/ml vs 8.21(2.19,14.64)pg/ml,P=0.015];多种氨基酸代谢与两种证型的炎症细胞因子表达密切相关,尤其是色氨酸代谢与支链氨基酸代谢;湿热瘀黄证中氨基酸代谢主要与促炎细胞因子IL-2、IL-6相关,按照相关系数大小依次为天冬氨酸、谷氨酸、异亮氨酸、亮氨酸、蛋氨酸、酪氨酸、丝氨酸、赖氨酸、谷氨酰胺、色氨酸、苯丙氨酸;气虚瘀黄证中氨基酸代谢与肿瘤坏死因子α(TNF-α)、IL-2、IL-6、IL-10相关,按照相关系数大小依次为天冬氨酸、甘氨酸、丙氨酸、苏氨酸、色氨酸、丝氨酸。异亮氨酸及色氨酸代谢不仅在两种证型间差异有统计学意义,且差异性关联炎症细胞因子的表达。结论:HBV-ACLF湿热瘀黄证和气虚瘀黄证患者在氨基酸代谢及炎症反应中均具有异质性,且两者之间相互关联。色氨酸以及支链氨基酸代谢可能对HBV-ACLF的免疫炎症反应具有重要调节作用,与湿热瘀黄证和气虚瘀黄证的生物学基础密切相关。 展开更多
关键词 慢加急性肝衰竭 乙型病毒性肝炎 湿热瘀黄证 气虚瘀黄证 代谢组学
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Reactivation of Epstein-Barr virus in SFTSV infected patients
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作者 Li-Zhu Fang Yu-Hong Dong +3 位作者 Zhi-Jian Yan Chuan-Min Zhou Xue-Jie Yu Xiang-Rong Qin 《Infectious Medicine》 2023年第3期195-201,共7页
Background:Severe fever with thrombocytopenia syndrome(SFTS)is an emerging hemorrhagic fever caused by a tick-borne bunyavirus SFTSV with case fatality up to 30%.The reactivation of Epstein-Barr virus(EBV)has been pro... Background:Severe fever with thrombocytopenia syndrome(SFTS)is an emerging hemorrhagic fever caused by a tick-borne bunyavirus SFTSV with case fatality up to 30%.The reactivation of Epstein-Barr virus(EBV)has been proven to occur in individuals with various immune suppression conditions.Methods:Here,we diagnosed 22 SFTSV infected patients with PCR in a hospital in Shandong Province,China in 2020.To understand the consequences of SFTSV infection leading to EBV reactivation,we examined EBV reactivation in SFTSV-infected patients with PCR and RT-PCR.Results:We found that EBV was reactivated in 18.2%(4/22)of SFTS patients,suggesting that EBV reactivation is common in SFTS patients.Compared with SFTS patients without EBV reactivation,SFTS patients with EBV-reactivation had a significantly lower median level of serum albumin(32.45 g/L vs.26.95 g/L,p=0.03)and a significantly higher median number of urine red blood cells(0 cells/μL vs.9 cells/μL,p=0.04).Conclusion:SFTS infection can reactivate EBV in patients,which may make the clinical condition of patients worsen. 展开更多
关键词 Severe fever with thrombocytopenia syndrome virus epstein-barr virus REACTIVATION Glomerular injury
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Clinical analysis and follow-up study of chronic active Epstein-Barr virus infection in 53 pediatric cases 被引量:36
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作者 LU Gen XIE Zheng-de +6 位作者 ZHAO Shun-ying YE Ling-jun WU Run-hui LIU Chun-yan YANG Shuang JIN Ying-kang SHEN Kun-ling 《Chinese Medical Journal》 SCIE CAS CSCD 2009年第3期262-266,共5页
Background Chronic active Epstein-Barr virus infection (CAEBV) has been previously reported to be sometimes associated with an aggressive clinical course. The characteristics of CAEBV in Mainland Chinese pediatric p... Background Chronic active Epstein-Barr virus infection (CAEBV) has been previously reported to be sometimes associated with an aggressive clinical course. The characteristics of CAEBV in Mainland Chinese pediatric patients are largely unreported. The main aims of this survey were to recognize the clinical features of CAEBV in children and to explore its diagnostic criteria and risk factors. Methods A retrospective study was performed on 53 pediatric patients (36 boys and 17 girls) with CAEBV who were admitted to Beijing Children's Hospital between 2003 and 2007. All their medical records were reviewed and analyzed. For each patient, demographic, clinical, laboratory data and outcome were collected. Independent-samples t test was used for statistical analysis. Results The age at onset of CAEBV was from 2 months to 14.6 years (mean (5.3_+3.3) years). At the time of onset, 43.4% patients had an infectious mononucleosis-like symptom. Most patients exhibited intermittent fever (92.5%, 49/53), hepatomegaly (81.1%, 43/53) and splenomegaly (77.4%, 41/53). Life-threatening complications including hemophagocytic syndrome (24.5%,13/53), interstitial pneumonia (24.5%, 13/53), hepatic failure (15.1%, 8/53) and malignant lymphoma (11.3%, 6/53) were also observed. The serum EBV DNA level in 23 patients with CAEBV was in the range of 5.05×10^2-4.60×10^6 copies/ml with a mean value of 103.7 copies/ml. Many patients with CAEBV generally had continuous symptoms during the observational period. Eleven out of 42 patients (26.2%) died 7 months to 3 years after onset. Deceased patients were more likely to have had lower platelet counts and albumin levels than the living patients (P 〈0.05 for all comparisons). Conclusions The study reveals that CAEBV in Chinese pediatric patients has a severe clinical course and prognosis is poor. Thrombocytopenia and decreases in albumin might potentially be risk factors for a poor prognosis. EBV loads should be measured and tissue should be stained on hybridization probes for EBV-encoded small RNA (EBER) if a patient presents with the known symptoms of CAEBV. 展开更多
关键词 chronic active epstein-barr virus infection clinical features risk factors
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Haploidentical hematopoietic stem cell transplantation for pediatric patients with chronic active Epstein-Barr virus infection:a retrospective analysis of a single center 被引量:4
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作者 Yan-Hui Luo Jun Yang +10 位作者 Ang Wei© Guang-Hua Zhu Bin Wang Rui Zhang Chen-Guang Jia Yan Yan Kai Wang Sidan Li Xuan Zhou Mao-Quan Qin Tian-You Wang 《World Journal of Pediatrics》 SCIE CAS CSCD 2021年第6期626-636,共11页
Background This study aimed to evaluate the feasibility and clinical effect of haploidentical hematopoietic stem cell transplantation(haplo-HSCT)for the treatment of pediatric patients with chronic active Epstein-Barr... Background This study aimed to evaluate the feasibility and clinical effect of haploidentical hematopoietic stem cell transplantation(haplo-HSCT)for the treatment of pediatric patients with chronic active Epstein-Barr virus infection(CAEBV).Methods Children with CAEBV who did not have matched donors and underwent haplo-HSCT in Beijing Children's Hospital,Capital Medical University,from October 2016 to June 2020 were analyzed retrospectively.Data relating to the clinical manifestations,engraftment,and prognosis of the children were extracted from medical records.Results Twenty-five patients,including 16 males and 9 females,with an onset age of 5.0±2.6 years and a transplantation age of 6.9±2.9 years,were enrolled irnhis study.The mean time from diagnosis to transplantation was 3.8(2.0-40.2)months.The mean observation time was 19.0±12.0 months.Three patients received the reduced intensity conditioning regimen,and the remaining patients all received the modified myeloablative conditioning regimen.By the end of the follow-up,23 patients were characterized by disease-free survival(DFS),22 were characterized by event-free survival(EFS).and two died.One of the patients died of thrombotic microangiopathy(TMA),and another died of graft versus host disease(GVHD);this patient discontinued the treatment for economic reasons.The 3-year overall survival(OS)rate was estimated to be 92.0%±5.4%,and the 3-year EFS rate was estimated to be 87.4%±6.8%.All active patients survived after HSCT event-free.Acute GVHD degrees 1-3 were observed in ten patients(40.0%),and degree IV was observed in six(24.0%),who were all cured except for one patient.Chronic GVHD was observed in nine(36.0%),and most of these cases were mild.The incidence of TMA and veno-occlusive disease(VOD)was 28.0%and 4.0%.Conclusions Haploidentical hematopoietic stem cell transplantation is safe and effective in the treatment of pediatric CAEBV and can be used as an alternative therapy without matched donors or emergency transplantation.Patients with active disease before HSCT also benefited from haplo-HSCT.Haplo-HSCT requires careful monitoring for complications,such as GVHD and TMA.Early detection of TMA and timely treatment can reduce mortality and can improve the survival rate. 展开更多
关键词 chronic active epstein-barr virus infection Haploidentical hematopoietic stem cell transplantation PROGNOSIS Graft versus host diseases Thrombotic microangiopathy
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对新型冠状病毒感染后疲劳症状的相关研究 被引量:1
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作者 蔚昊燃 于瑶 蔚液光 《中医临床研究》 2023年第8期52-60,共9页
新型冠状病毒感染(Corona Virus Disease 2019,COVID-19)除了影响肺部,产生肺纤维化,以及使血液发生血栓事件外,还有约46%的人受到长期影响,这被称为COVID-19后综合征(Post-COVID-19 Syndrome,PCS)。疲劳、呼吸困难和认知障碍是最典型的... 新型冠状病毒感染(Corona Virus Disease 2019,COVID-19)除了影响肺部,产生肺纤维化,以及使血液发生血栓事件外,还有约46%的人受到长期影响,这被称为COVID-19后综合征(Post-COVID-19 Syndrome,PCS)。疲劳、呼吸困难和认知障碍是最典型的PCS症状。目前,COVID-19的确切病因仍然不明晰。COVID-19流行期间,各国统计数据显示,约有70%的COVID-19患者出现不同程度的疲劳、肌肉无力、工作能力下降等PCS症状。目前已有几种假说来解释PCS的病理生理学。文章从西医和中医两个方面综述PCS的病因及病理变化,并总结临床上的常用治法。由于缺乏大量的临床试验,目前仍没有相关的证据表明其治疗的可靠性。 展开更多
关键词 新型冠状病毒感染 慢性疲劳综合征 治疗
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Allogeneic hematopoietic stem cell transplantation with the modified myeloablative conditioning regimen for children with chronic active Epstein–Barr virus infection 被引量:1
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作者 Yanhui Luo Ang Wei +8 位作者 Bin Wang Guanghua Zhu Rui Zhang Chenguang Jia Yan Yan Xuan Zhou Jun Yang Maoquan Qin Tianyou Wang 《Pediatric Investigation》 CAS CSCD 2022年第4期250-259,共10页
Importance:Allogeneic hematopoietic stem cell transplantation(alloHSCT)is considered the only effective treatment for chronic active Epstein–Barr virus infection(CAEBV).The clinical efficacy and safety of allo-HSCT w... Importance:Allogeneic hematopoietic stem cell transplantation(alloHSCT)is considered the only effective treatment for chronic active Epstein–Barr virus infection(CAEBV).The clinical efficacy and safety of allo-HSCT with different conditioning regimens in children with CAEBV remain unclear.Objective:To evaluate the effectiveness and safety of allo-HSCT with the modified myeloablative conditioning(MAC)regimen for children with CAEBV and also the factors affecting the outcomes.Methods:We retrospectively analyzed children with CAEBV who underwent allo-HSCT with the modified MAC regimen at Beijing Children’s Hospital,Capital Medical University from October 2016 to June 2021.Data related to the clinical manifestations,engraftment,and outcome were extracted from the medical records.Results:The cohort comprised 41 patients(24 males,17 females)with a median transplantation age of 92.6(60.4,120.7)months and a median follow-up time of 28.2(15.3,40.2)months.Four patients(9.8%)died,among which three died from primary disease relapse,and one died from grade IV acute graft-versus-host diseases(aGVHD)after stopping treatment.The 3-year overall survival(OS)and 3-year event-free survival(EFS)rates were 88.8%±5.4%and 85.0%±5.7%,respectively.The 3-year OS and EFS did not significantly differ between the patients with hemophagocytic lymphohistiocytosis(HLH)and the patient without HLH(87.7%±6.8%vs.91.7%±8.0%,P=0.790;85.0%±6.9%vs.84.6%±10.0%,P=0.921),or among the patients with complete remission,partial remission,and activity disease before HSCT(all P>0.05).Multivariate analysis showed that grade III–IV aGVHD was a risk factor for mortality(Hazards ratio:11.65,95%confidence interval:1.00,136.06;P=0.050).Interpretation:Allo-HSCT with the modified MAC regimen is safe and effective for pediatric CAEBV.This treatment benefits patients with HLH or active disease.Patients with Grade III–IV aGVHD may be associated with worse outcomes. 展开更多
关键词 Myeloablative conditioning chronic active epstein-barr virus infection Hematopoietic stem cell transplantation CHILDREN
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乙肝辨证分型与病毒复制关系的初步研究 被引量:39
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作者 邢练军 季光 +6 位作者 王育群 张玮 李月信 王奕 王雨侬 程红 张广业 《辽宁中医杂志》 CAS 2001年第12期710-711,共2页
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 ,... 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。 展开更多
关键词 乙型慢性病毒性肝炎 辨证分型 病毒复制 中医学
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500例不同年龄段慢性乙型肝炎病毒携带者中医证候调查 被引量:15
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作者 李知玉 杨大国 +6 位作者 邓欣 何清 敖飞健 钟旬华 文彬 段钢 吴其恺 《中医药信息》 2010年第3期1-4,共4页
目的:观察不同年龄段慢性乙型肝炎病毒携带者的证候规律。方法:选择500例慢性乙肝携带者,分为7~14岁组、15~20岁组、21~30岁组、31~40岁组、41~65岁5组。5组患者分别填写证候调查表,进行辨证。结果:7~30岁患者以HBeAg阳性为主(68%... 目的:观察不同年龄段慢性乙型肝炎病毒携带者的证候规律。方法:选择500例慢性乙肝携带者,分为7~14岁组、15~20岁组、21~30岁组、31~40岁组、41~65岁5组。5组患者分别填写证候调查表,进行辨证。结果:7~30岁患者以HBeAg阳性为主(68%),30~65岁以HbeAg阴性为主(83.4%)。7~14岁,证型以不典型证为最常见,脾虚次之;15~20岁,以脾气虚证型为最常见,湿热或中阻次之;21~30岁,以脾气虚证型为最常见,肝气郁结及肝胆湿热次之;31~40岁及41~65岁均以肾阴虚较常见,血瘀阻络次之。HBeAg阳性患者以脾虚证型最常见,肝胆湿热及湿热中阻次之;HBeAg阴性患者的证型以血瘀阻络最常见,肾阴虚次之。结论:30岁以上HBeAg阴性的慢性乙肝病毒携带人群可能存在一定程度的肝纤维化,需进行积极干预。 展开更多
关键词 慢性乙型肝炎 病毒携带者 中医证候
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慢性乙型肝炎中医证型与免疫功能的相关性研究 被引量:22
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作者 王见义 韩向晖 +1 位作者 王灵台 竺丽明 《上海中医药杂志》 北大核心 2007年第9期35-36,共2页
目的观察乙型肝炎患者机体免疫功能与中医证型的关系,为临床辨证论治提供依据。方法收集初次治疗的慢性乙型肝炎患者515例,分为湿热中阻型、肝郁脾虚型、肝肾阴虚型、脾肾阳虚型和瘀血阻络型,并检测各患者血CD3+、CD4+、CD8+和血IgM、Ig... 目的观察乙型肝炎患者机体免疫功能与中医证型的关系,为临床辨证论治提供依据。方法收集初次治疗的慢性乙型肝炎患者515例,分为湿热中阻型、肝郁脾虚型、肝肾阴虚型、脾肾阳虚型和瘀血阻络型,并检测各患者血CD3+、CD4+、CD8+和血IgM、IgG、IgA。结果CD4+水平在湿热中阻证中最高,与肝肾阴虚、脾肾阳虚证相比有显著性差异(P<0.05);CD8+水平在脾肾阳虚证中最高,与湿热中阻、瘀血阻络证相比差异显著(P<0.05);血IgM、IgG水平在湿热中阻证中最高,与脾肾阳虚证相比有显著性差异(P<0.05)。结论慢性乙型肝炎患者的中医辨证分型与机体免疫功能之间存在相关性,相关免疫指标对辨证分型有参考价值。 展开更多
关键词 慢性乙型肝炎 免疫功能 辨证分型
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