Numerical Procedure for Fractional HBV Infection with Impact of Antibody Immune

The current investigations are presented to solve the fractional order HBV differential infection system(FO-HBV-DIS)with the response of antibody immune using the optimization based stochastic schemes of the Levenberg-Marquardt backpropagation(LMB)neural networks(NNs),i.e.,LMBNNs.The FO-HBV-DIS with the response of antibody immune is categorized into five dynamics,healthy hepatocytes(H),capsids(D),infected hepatocytes(I),free virus(V)and antibodies(W).The investigations for three different FO variants have been tested numerically to solve the nonlinear FO-HBV-DIS.The data magnitudes are implemented 75%for training,10%for certification and 15%for testing to solve the FO-HBV-DIS with the response of antibody immune.The numerical observations are achieved using the stochastic LMBNNs procedures for soling the FO-HBV-DIS with the response of antibody immune and comparison of the results is presented through the database Adams-Bashforth-Moulton approach.To authenticate the validity,competence,consistency,capability and exactness of the LMBNNs,the numerical presentations using the mean square error(MSE),error histograms(EHs),state transitions(STs),correlation and regression are accomplished.

Establishment and validation of a nomogram for predicting the risk of liver inflammation in chronic HBV infection

Objective:To establish a non-invasive quantitative and visual predictive model for assessing the occurrence of significant inflammation in chronic HBV infection,and to present nomogram to validate the efficacy.Methods:A total of 180 patients with chronic HBV infection that were admitted to the Department of Infectious Liver Diseases of the First Affiliated Hospital of Hainan Medical College from January 2019 to December 2021 with informed consent and underwent liver biopsy puncture were selected,and to prevent overfitting of the model,131 patients and 49 patients were randomly divided into a model group and a validation group according to randomization,to collect the clinic information,serological examination,liver elastography and liver histopathology results.The patients were divided into non-significant inflammation and significant inflammation groups in the modeling group.The R 4.1.1 package and the rms package were used to build the column line graph model,while the Bootstrap method was applied to repeat the sampling 1000 times for internal and external validation,and the H-L goodness of fit test and ROC curve were used to assess the calibration and discrimination of the column line graph model respectively.Results:A total of 180 patients with chronic HBV infection were included,and 92 patients(51.1%)had significant inflammation.In the modeling set,67 patients(51.1%)had significant inflammation.In the modeled group,comparison of HBV DNA,PLT,ALT,AST,ALP,GGT,PAB,H.A,PⅢP,CⅣ,L.N,IL-6,LSM and HBeAg for non-significant inflammation and significant inflammation showed statistically significant differences(P<0.05).Nomogram were obtained using stepwise regression analysis to establish a predictive model for the risk of significant inflammation following chronic HBV infection.The χ^(2) values of the H-L goodness-of-fit test for the modelling and validation groups were 0.279 and 2.098,respectively,corresponding to P values of 0.87 and 0.35,suggesting that the nomogram has good predictive accuracy;the area under the ROC curve of the column line plot predicting the occurrence of significant inflammation after HBV infection for the modelling and validation groups was 0.895[95%CI(0.843-0.948)]and 0.760[95%CI(0.622-0.897)],suggesting that the column line plot model has good discrimination.Conclusion:After stepwise regression analysis,it was established that PLT,Ln(HBV-DNA),AST,C桇and LSM were more closely associated with the occurrence of significant inflammation after HBV infection,and a visualization of the occurrence of significant inflammation nomogram was established by comprehensive assessment,and the effectiveness was good.

HBV C基因型有关的HBsAg阴性HBV DNA阳性患者S区突变对HBsAg的影响

目的通过构建HBV C基因型突变质粒研究HBsAg阴性HBV DNA阳性患者HBV S区突变对HBsAg水平的影响。方法收集2022年8月至2023年4月首都医科大学附属北京佑安医院107例HBsAg-/HBV DNA+患者血液样本,对成功提取扩增的HBV DNA S区进行测序,通过构建HBV C基因型突变质粒对HBV S区突变位点进行细胞功能验证,探讨OBI可能发生的分子机制。结果对成功提取扩增的68例患者进行测序,发现HBV S区存在大量突变,包括免疫逃逸突变(如sG145R、sK122R、sS114T、sT131P等)和跨膜结构域(transmembrane domain,TMD)突变(如sT5A、sG10D、sF20S等)。通过构建HBV C基因型突变质粒,进行细胞转染和细胞免疫荧光实验发现sG145R突变会明显降低HBsAg的表达,但是sK122R、sI26N、sQ29N、sR169H、sS114T、sT131P这6个突变位点并未影响细胞内外HBsAg的表达。结论通过测序发现HBsAg-/HBV DNA+患者HBV S区存在大量突变位点,通过构建sG145R、sK122R、sI26N、sQ29N、sS114T和ST131P等突变质粒发现sG145R突变会明显降低细胞内外HBsAg的表达,但是sK122R、sI26N、sQ29N、sR169H、sS114T、sT131P并未明显降低细胞内外HBsAg的表达。

Exosomes in viral infection:Effects for pathogenesis and treatment strategies

Exosomes are small vesicles that carry molecules from one cell to another.They have many features that make them interesting for research,such as their stability,low immunogenicity,size of the nanoscale,toxicity,and selective delivery.Exosomes can also interact with viruses in diverse ways.Emerging research highlights the significant role of exosomes in viral infections,particularly in the context of diseases like COVID-19,HIV,HBV and HCV.Understanding the intricate interplay between exosomes and the human immune system holds great promise for the development of effective antiviral therapies.An important aspect is gaining clarity on how exosomes influence the immune system and enhance viral infectivity through their inherent characteristics.By leveraging the innate properties of exosomes,viruses exploit the machinery involved in exosome biogenesis to set replication,facilitate the spread of infection,and eliminate immune responses.They can either help or hinder viral infection by modulating the immune system.This review summarizes the recent findings on how exosomes mediate viral infection and how they can be used for diagnosis or therapy.This could lead to new clinical applications of exosomes in disease management.

基于血清抗-HBc定量建立慢性HBV感染者显著肝组织病理学改变的无创诊断模型

目的建立慢性HBV感染者显著肝组织病理学改变的诊断模型,并评估模型的诊断价值。方法选取2011年12月—2017年12月在上海市公共卫生临床中心肝胆内科住院并进行肝活检且未经抗病毒治疗的457例慢性HBV感染者,收集患者的肝活检病理结果及常规实验室指标,并进行抗-HBc定量检测。依据Scheuer方法进行炎症分级(G)及纤维化分期(S),分为显著与非显著肝坏死性炎症、肝纤维化和肝损伤组。根据单因素分析和多因素logistic回归分析构建预测显著肝坏死性炎症、显著肝纤维化和显著肝损伤的数学模型,并与FIB-4、GPR、APRI、RPR利用ROC曲线分析评估模型的预测性能,根据ROC曲线下面积(AUC)比较诊断价值。结果457例患者中显著肝坏死性炎症(G≥2)178例,非显著肝坏死性炎症(G<2)279例,显著肝纤维化(S≥2)248例,非显著肝纤维化(S<2)209例,显著肝损伤(G≥2或/和S≥2)264例,非显著肝坏死性炎症(G<2和S<2)193例。根据单因素分析和多因素logistic回归分析结果,分别建立由抗-HBc、AST、PLT、TTR等指标组成的预测显著肝坏死性炎症的数学模型M-SHN,由抗-HBc、PLT、ChE、TTR、性别等指标组成的预测显著肝纤维化的数学模型M-SHF,及由抗-HBc、PLT、TTR、性别等指标组成的预测显著肝损伤的数学模型M-SHI,并通过ROC曲线分析各模型的预测价值,M-SHN模型的AUC为0.826(95%CI:0.788~0.860),M-SHF模型的AUC为0.776(95%CI:0.735~0.814),M-SHI模型的AUC为0.789(95%CI:0.748~0.825)。结论基于患者常规实验室指标及血清抗-HBc定量,建立了M-SHN、M-SHF、M-SHI模型,对于显著肝坏死性炎症、显著肝纤维化、显著肝损伤有较为可靠的预测价值,可帮助临床评估患者是否需要进行抗病毒治疗。

Prevalence of occult HBV infection in haemodialysis patients with chronic HCV

瞄准：与长期的 HCV 在血液透析病人学习流行和秘密 HBV 感染的临床的效果。方法：有否定 HbsAg 的五十个长期的牙齿过敏细胞溶解病人，和积极 anti-HCV 在学习被包括。这些病人被划分成二个组：积极的 HCV-RNA 和 HCV-RNA negative，基于 HCV-RNA PCR 的结果。HBV-DNA 在两个组用 PCR 方法被学习。结果：任何一个都没由 PCR 方法在浆液 22 个 HCV-RNA 积极病人和 28 个 HCV-RNA 否定病人揭示 HBV-DNA。平均年龄是 47.2 +/- 17.0 在 HCV-RNA 积极的组和 39.6 +/- ， 15.6 在 HCV-RNA negative 组织。结论：秘密 HBV 感染的流行不在有在我们的区域的长期的 HCV 的血液透析病人高。我们的学习的这结果不得不在我们的区域在在 HBsAg 确实(8%-10%) 和 HBV 异种的频率之间的相互作用的考虑被评估。

DYNAMICAL BEHAVIOR OF A STOCHASTIC HBV INFECTION MODEL WITH LOGISTIC HEPATOCYTE GROWTH

This paper is concerned with a stochastic HBV infection model with logistic growth. First, by constructing suitable stochastic Lyapunov functions, we establish sufficient conditions for the existence of ergodic stationary distribution of the solution to the HBVinfection model. Then we obtain sufficient conditions for extinction of the disease. The stationary distribution shows that the disease can become persistent in vivo.

Efficiency and safety of lamivudine therapy in patients with chronic HBV infection, dialysis or after kidney transplantation

AIM: To analyze the effectiveness and safety of lamivudine treatment in patients with chronic HBV infection undergoing hemodialysis or after kidney transplantation, and to study the frequency of tyrosine - methionine - aspartate - aspartate (YMDD) mutation occurrence after lamivudine treatment.METHODS: We analyzed 91 patients with chronic hepatitis B, among whom, 16 patients underwent hemodialysis, 7patients had kidney transplantation and 68 patients had normal function of kidney. The hemodialysis patients were treated by lamivudine 300 mg/wk. Patients after kidney transplantation and patients with normal function of kidney were treated with lamivudine 100 mg/d. Therapy lasted for 12 mo. HBV-DNA, HBsAg, HBeAg and anti-HBe, and antiHCV antibodies were assessed in sera of patients. The analysis was performed before and 6 mo after the end of lamivudine treatment. Before, during and after the lamivudine therapy,the number of erythrocytes, leukocytes, platelets and hemoglobin concentration, ALT and AST activity, as well as bilirubin, urea and creatinine concentrations were analyzed in sera from patients.RESULTS: After the 12-mo lamivudine treatment, elimination of HBV - DNA was observed in 56% patients undergoing hemodialysis and in 53% patients with normal kidney function. Only 1 from 7 (14%) kidney-transplanted patients eliminated HBV-DNA. Furthermore, HBeAg elimination was observed in 36% hemodialysis patients, in 51% patients with normal function of kidneys and in 43% kidneytransplanted patients. Among the patients undergoing dialysis, no YMDD mutation was found after 12 mo of therapy, while it was detected in 9 patients (13%) with normal function of kidney and in 2 kidney-transplanted patients (29%, P＜0.006). We did not observe significant side effects of lamivudine treatment in studied patients.CONCLUSION: Effectiveness of lamivudine therapy in dialysis patients is comparable with that in patients withnormal function of kidney. Lamivudine treatment is well tolerated and safe in patients with renal insufficiency undergoing hemodialysis and kidney-transplantation.However, in the latter group, high incidence of YMDD mutation after lamivudine treatment was observed.

合并MAFLD的慢性HBV感染者显著肝纤维化的无创模型建立与验证

目的 探究合并代谢相关性脂肪性肝病(metabolic associated fatty liver disease,MAFLD)的慢性HBV感染患者发生显著肝纤维化的危险因素,构建并验证预测肝组织显著肝纤维化的无创模型,为临床启动抗纤维化治疗提供思路。方法 回顾性收集2015年1月至2020年12月就诊于广东省中医院肝病科收治的合并MAFLD的慢性HBV感染患者445例,根据入院时间分为训练队列(n=274)和验证队列(n=171)。训练队列中根据病理结果分为无/轻微肝纤维化组(<S_(2)期,n=106)和显著肝纤维化组(≥S_(2)期,n=168),比较两组患者临床指标,多因素Logistic回归方法筛选显著肝纤维化的危险因素,ROC曲线评价无创模型的预测效能,并在验证队列中验证。结果 445例患者中,肝组织显著纤维化287例(63.08%),其中训练队列168例(61.31%)、验证队列119例(69.59%)。训练队列中,≥S_(2)期组患者的年龄、ALT、AST、ALP、GGT、PT、HBsAg、HBV DNA、LSM均高于<S_(2)组,WBC、RBC、PLT、TG、Urea均低于<S_(2)组(P<0.05)。多因素分析显示,年龄、GGT、HBV DNA、LSM均是显著肝纤维化的独立危险因素(P<0.05),Urea是保护因素(P<0.05)。根据年龄、GGT、Urea、HBV DNA和LSM建立无创模型Y=0.063×年龄(岁)+0.016×GGT(U/L)+0.246×HBV DNA(lg IU/L)+0.245×LSM(kPa)-0.484×Urea(mmol/L)-3.578,在训练队列中预测肝组织显著纤维化预测效能均高于APRI、FIB-4(P<0.05),取敏感度与特异度最大时的点的临界值Y=0.70,此时预测敏感度为62.5%,特异度为92.5%;在验证队列中,预测效能均高于APRI、FIB-4(P<0.05)。结论 年龄、GGT、Urea、HBV DNA和LSM是合并MAFLD的慢性HBV感染患者发生显著肝纤维化的危险因素,由这些参数建立的无创模型对预测该人群发生显著肝纤维化有一定准确性。

GLOBAL ASYMPTOTICAL PROPERTIES FOR A DIFFUSED HBV INFECTION MODEL WITH CTL IMMUNE RESPONSE AND NONLINEAR INCIDENCE

This article proposes a diffused hepatitis B virus (HBV) model with CTL immune response and nonlinear incidence for the control of viral infections. By means of different Lyapunov functions, the global asymptotical properties of the viral-free equilibrium and immune-free equilibrium of the model are obtained. Global stability of the positive equilibrium of the model is also considered. The results show that the free diffusion of the virus has no effect on the global stability of such HBV infection problem with Neumann homogeneous boundary conditions.

Significant increase in HBV, HCV, HIV and syphilis infections among blood donors in West Bengal, Eastern India 2004-2005: Exploratory screening reveals high frequency of occult HBV infection

AIM: To evaluate the prevalence of markers of hepatitis B virus (HBV) and hepatitis C virus (HCV) and human immunodeficiency virus (HIV) among blood donors in Kolkata, Eastern India for two consecutive years and to conduct a pilot study to explore the presence of HBV DNA among hepatitis B surface antigen (HBsAg) negative but anti-HBc positive blood donors. METHODS: Seroprevalence of HBsAg, anti-HCV and anti-HIV was studied among 113 051 and 106 695 voluntary blood donors screened in 2004 and 2005, respectively. Moreover, a pilot study on 1027 HBsAg negative donors was carried out for evaluating the presence of HBV DNA by PCR on HBsAg negative/anti- HBc positive donors. RESULTS: A statistically significant increase in the prevalence of HBV (1448 vs 1768, P < 0.001), HIV (262 vs 374, P < 0.001), HCV (314 vs 372, P = 0.003) and syphilis (772 vs 853, P = 0.001) infections was noted among blood donors of Kolkata West Bengal in 2005 as compared to 2004. Moreover, the exploratory study on 1027 HBsAg negative donors revealed that 188 (18.3%)of them were anti-HBc positive out of which 21% were positive for HBV DNA. CONCLUSION: The findings of this study underscore the significantly increasing endemicity of hepatitis viruses, syphilis and HIV among the voluntary blood donors of our community. The pilot study indicates a high rate of prevalence of HBV DNA among HBsAg negative/anti-HBc positive donors and thus emphasizes the need for a more sensitive and stringent screening algorithm for blood donations.

Prevention of de novo HBV infection by the presence of anti-HBs in transplanted patients receiving core antibody-positive livers

瞄准：分析在肝的 anti-HBs 的存在是否移植接受者在阻止 HBV 感染是有效的。方法：23 个病人收到 anti-HBc 积极的肝被学习。九个接受者是由于以前的 HBV 感染积极的 anti-HBc。他们，一个人也收到了在肝前移植时期期间疫苗的 HBV。十四个接受者是由于在预先移植经期期间管理的 HBV 疫苗积极的 anti-HBs。肝活体检视在 10/14 anti-HBc negative/anti-HBs 被获得积极接受者并且在 4/9 anti-HBc 积极接受者。结果：在 46 个月的一个吝啬的后续时期以后，有保护的浆液 anti-HBs 层次的 1 个接受者作为有免疫力的逃跑 HBV 异种的后果得了 de novo HBV 感染。在 14 之中种牛痘的 anti-HBc negative/anti-HBs 积极接受者，有可得到的肝活体检视(10%) 的 1/10 病人在 13 瞬间有肝 HBV-DNA 没有浆液的肝以后的移植病毒的标记并且没得 de novo HBV 感染。种牛痘的 anti-HBc 没有 HBV 疫苗的反应的积极接受者是在浆液和肝积极的 HBV-DNA，病毒的 DNA 在下列测试是连续地否定的，自发的 seroconversion 因此被诊断。结论：由于 HBV 疫苗或过去的 HBV 感染的 anti-HBs 的存在似乎在保护从 anti-HBc 收到肝的病人有效积极施主。然而，有免疫力的逃跑 HBV 异种的出现，能躲避 anti-HBs 保护，应该被看作 HBV 感染的风险。

双重血浆分子吸附系统序贯血浆置换治疗HBV感染相关慢加急性肝衰竭疗效及对患者血清内毒素和炎症因子水平的影响

目的:分析双重血浆分子吸附系统(DPMAS)序贯血浆置换(PE)治疗乙型肝炎病毒感染相关慢加急性肝衰竭(HBV-ACLF)疗效及对患者血清内毒素和炎症因子水平的影响。方法:将92例HBV-ACLF患者根据非随机同期对照研究及患者自愿原则分为DPMAS序贯PE组(n=45例)和PE组(n=47例)。PE组接受单纯PE治疗,DPMAS序贯PE组接受DPMAS序贯PE治疗。比较两组患者治疗4周及12周时的好转率及存活率;比较两组治疗前、治疗4周及12周时的血清炎性因子、内毒素水平(ET)及终末期肝病模型(MELD)评分;比较两组并发症发生情况。结果:两组治疗4周好转率比较有统计学差异(P<0.05),治疗12周好转率比较无统计学差异(P>0.05);两组治疗4周及12周存活率比较无统计学差异(均P>0.05);治疗4周及12周时,DPMAS序贯PE组血清C反应蛋白(CRP)、白细胞介素6(IL-6)、中性粒细胞/淋巴细胞比值(NLR)及ET水平低于PE组(均P<0.05);DPMAS序贯PE组治疗4周时的MELD评分低于PE组(P<0.05);两组治疗期间肺部感染、电解质紊乱、肝肾综合征等并发症发生率比较无统计学差异(均P>0.05)。结论:DPMAS序贯PE治疗HBV-ACLF患者,可有效降低血清炎症因子及内毒素水平,应用效果良好。

Synergistic Action of Clonorchiasis,HBV Infection and Alcohol Consumption on Primary Hepatocellular Carcinoma

OBJECTIVE It has been recognized that HBV infection andalcohol consumption are two important risk factors for primaryhepatocellular carcinoma (HCC). Recently, the role of clonorchiasisas a risk factor for HCC is controversial. We aimed to investigatewhether these factors increase the risk of HCC in Guangxi, China.METHODS A hospital-based, case-control study of HCCwas conducted from July 2005 to July 2007. We enrolled 500consecutive patients with HCC as an experimental group and 500patients without tumor in liver as a control group. The risk factorsthat the patients were exposed to were assessed.RESULTS Comparing the risks of developing the HCC, wefound out the following results. The risk of developing HCC forthe patients with clonorchiasis was 5 folds of that for the patientswithout clonorchiasis (OR = 5.0; 95% CI: 3.1-8.1), and the risk forthe patients with alcohol consumption was 3 folds of that for thepatients without drinking alcohol (OR = 3.4; 95% CI: 2.3-4.9), andsimilarly, the risk for the patients with HBV infection was 21 timesof that for the patients without HBV infection (OR = 20.6; 95% CI:14.3-29.7). According to crossover analysis, there was significantinteraction among clonorchiasis, HBV infection and alcoholconsumption, with synergistic indices greater than 1. The etiologicfractions attributed to these interactions [EF (A x B)] are 0.7465,0.5789 and 0.5506, respectively.CONCLUSION Clonorchiasis, HBV infection and heavy alcoholconsumption are independent risk factors for developing HCC inour population in Guangxi, and as they can interact synergistically,the risk of developing HCC is increased. Data from this study mayindicate new prevention strategies of developing HCC in high-riskindividuals.

Risk factors from HBV infection among blood donors:A systematic review

Objective:To perform a systematic review of the scientific literature to identify risk factors associated with hepatitis B viruses(HBV) infection among blood donors.Methods:The literature search was carried out on Pub Med and Scopus databases using the keywords "risk factors" "HBV infection" and "blood donors".No date or language restrictions were applied to the search.This literature review was completed in March2014.The selection process and the reporting of the review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement.The Newcastle Ottawa scale was using to evaluate the quality of each single primary study.Results:Out of 172 records resulted in the search,5 papers were included in the final analysis because they are within acceptance criteria.Two of the selected studies were cross-sectional and three of them were case-control studies.Significant association resulted with some demographic and behavioral risk factors,such as marital status,dental treatment/procedure history,no stable relationship or multiple partners and family history of HBV infection.Conclusions:The systematic review performed encourages to conduct further research among blood donors in order to fully understand risk factors among donors in more extensive thus to provide valuable information about surveillance.

A study on the Appearance of HBV DNA in the Liver and Serum of Patients with HDV/HBV Infection

The appearance of HBV DNA in the liver and serum of 15 patients with hepatitisB conifected with HDV was observed and compared with that of 13 HDV-negative cases.Itwas found that HBsAg titer was lower than or equal to 1:4 in 8 HDV-positive patients,inwhom it was temporally negative in 5,and negative during the,two-day hospitalization in 1.No similar result could be observed in the HDV-negative cases.The detection rate of HBVDNA in both the HDV positive and negative groups was 20.0％ (3/15) and 25％ (3.12) in se-rum,and 46.7％ (7/15) and 61.5％ (8/13) in the liver rcspectively.There was no signif-icant statistical difference between the 2 groups.The HBV DNA grains detected with in situ hybridization,with biotinylated HBV DNAprobe were demonstrated in the sparse type of distribution in 3 cases and lightly stained in 2.Itis believed that HBV DNA replication activity might be suppressed by HDV.However activeHRV DNA replication was also present in some HDV-positive patients and HBV DNA was posi-tive in both the liver and serum in 3 such patients.It was concluded that the difference of the detection rate of HBV DNA in HDV-positivepatients might be related to the different stages of HDV infection.

Post-Exposure Prophylaxis against HBV and HIV Infection in Health Care Workers

Healthcare Workers (HCWs) are constantly at risk of exposure to viral infections such as hepatitis B virus (HBV), human immune deficiency virus (HIV) and hepatitis C virus (HCV). We aim at demonstrating the results of a three-year period of a surveillance program in Iran with the prospective follow-up of HCWs exposed to blood-borne viruses. HCWs who had experienced an occupational exposure to HBV, HCV or HIV from September 2005 to 2008 were enrolled in the study. Age, gender, route of exposure, type of fluid, type of virus, job, department, working shift, work experience, wearing gloves when exposed, history of HBV vaccination and the serum level of anti HBs antibody were recorded for all participants through an individual interview. Serum samples were taken from both HCWs and the sources of exposure and were tested by enzyme linked immunosorbent assay (ELISA). The data were gathered through questionnaires completed by a nurse under the supervision of a specialist of infectious diseases. In this study, 100 HCWs who were occupationally exposed to HIV, HCV or HBV were included. Most exposures had occurred among nurses (35%), followed by residents (29%), interns (18%), housekeepers (7%), the lab staff (6%), and specialists (5%). Most of the exposures had occurred in emergency (21%) and surgical (20%) wards. The most common route of exposure was percutaneous injuries (77%) and the most common cases had contacted with needles and angiocaths (71.1%) during injection or opening vein routes (21%). Establishing a surveillance system for registering the occurrence of occupational hazardous exposures, performing prophylactic measures and following up the exposed is a necessity in hospitals so that the number of exposures and occupational diseases among the HCWs can be decreased.

Hepatitis B Virus (HBV) Infection in Pregnancy: Knowledge and Practice of Care Providers in Nigeria

Purpose: To determine the practice of obstetric care providers regarding routine screening for hepatitis B virus infection, and to assess their knowledge of the management of the positive pregnant women. Methods: A cross sectional descriptive study of obstetric care providers in southwestern Nigeria. Mean and standard deviation was used to summarize continuous variables while frequency and percentage was used for categorical variables. Categorical variables were compared with chi-square test and Fisher’s exact tests as appropriate;while continuous variables were compared using the t-test. The level of statistical significance was set at P ≤ 0.05. Scoring of the outcome variables for knowledge was done, and the score categorized into good and poor knowledge, depending on if the respondent scored above or below the mean score. Results: Three hundred and eighty-one (67.4%) of the care givers routinely screen pregnant women for the serum marker (HBSAg) of HBV infection. Two hundred and seventy-four (48.5%) of the respondents had good knowledge score of the management of HBV infection in pregnancy. Routine screening for HBV infection was significantly associated with age (p = 0.002), years of practice (p < 0.001), specialty (p = 0.001) and professional cadre (p < 0.001), while knowledge was significantly associated with age (p = 0.012), years of practice (p = 0.003), specialty (p = 0.047) and types of practice (p = 0.014). Conclusion: Screening for HBV infection in pregnant women is not universal in southwestern Nigeria, and the care providers have poor knowledge of the management of the positive mothers.

HBV and HCV infection and pancreatic ductal adenocarcinoma

Introduction Pancreatic ductal adenocarcinoma(PDAC)is a highly lethal malignancy,with a poor overall fiveyear survival.Its dismal prognosis,even after curative resection,depends on its advanced stage at diagnosis,early metastatic spread,aggressive biological behavior and inefficacy of available systemic therapies.[1]To date,epidemiological studies have identified some risk factors for this cancer,including cigarette smoking habit,family history as well as high dietary fat consumption,alcohol abuse,diabetes mellitus,metabolic syndrome and chronic pancreatitis history.[1]

Establishment and Validation of a nomogram for Predicting the Risk of Liver Fibrosis in Chronic HBV Infection

Objective:To establish a non-invasive quantitative and visual predictive model for assessing the occurrence of significant fibrosis in chronic HBV infection,and to present nomogram to validate the efficacy.Methods:A total of 180 patients with chronic HBV infection that were admitted to the Department of Infectious Liver Diseases of the First Affiliated Hospital of Hainan Medical University from January 2019 to December 2021 with informed consent and underwent liver biopsy puncture were selected.131 patients and 49 patients were randomly divided into a model group and a validation group according to randomization.The patients were divided into non-significant fibrosis and significant fibrosis groups in the modeling group.To collect the clinic information,serological examination,liver elastography and liver histopathology results and to establish a rosette model to predict the risk of chronic HBV infection with significant fibrosis.Results:A total of 180 patients with chronic HBV infection were included,and 113 patients(62.7%)had significant fibrosis.In the modeling set,84 patients(64.1%)had significant fibrosis.In the modeled group,comparison of HBV DNA,PLT,ALT,AST,ALP,ALB,PAB,IL-6,HA,PⅢP,CIV,L.N and LSM for non-significant fibrosis and significant fibrosis showed statistically significant differences.The χ^(2) values of the H-L goodness-of-fit test for the modelling and validation groups were 4.988 and 0.527,respectively,corresponding to P values of 0.08 and 0.77,suggesting that the nomogram has good predictive accuracy;the area under the ROC curve of the column line plot predicting the occurrence of significant fibrosis after HBV infection for the modelling and validation groups was 0.843[95%CI(0.775-0.910)]and 0.776[95%CI(0.714-0.838)],suggesting that the column line plot model has good discrimination.Conclusion:After stepwise regression analysis,it was established that ALB,HA,PⅢP,LSM and IL-6 were more closely associated with the occurrence of significant fibrosis after HBV infection,and a visualization of the occurrence of significant fibrosis column line graph model was established by comprehensive assessment,and validation was given that all were superior to the traditional models FIB-4 and APRI.