Post-partum reactivation of chronic hepatitis B virus infection among hepatitis B e-antigen-negative women

AIM: To investigate the frequency and timing of post-partum chronic hepatitis B virus(HBV) reactivation and identify its pre-partum predictors. METHODS: Forty-one hepatitis B e antigen(HBe Ag)-negative chronic HBV infected pregnant women were prospectively evaluated between the 28 th and the 32 nd week of gestation. Subjects were re-evaluated at 3-mo intervals during the first post-partum year and every 6 mo during the following years. HBV DNA was determined using real-time reverse transcription polymerase chain reaction(Cobas Taq Man HBV Test) with a lower detection limit of 8 IU/m L. Post-partum reactivation(PPR) was defined as abnormal alanine aminotransaminase(ALT) levels and HBV DNA above 2000 IU/m L. RESULTS: Fourteen out of 41 women(34.1%) had prepartum HBV DNA levels > 2000 IU/m L, 18(43.9%) had levels < 2000 IU/m L and 9(21.9%) had undetectable levels. Fourteen women were lost to follow-up(failure to return). PPR occurred in 8 of the 27(29.6%) women evaluated, all within the first 6 mo after delivery(5 at month 3; 3 at month 6). Five of the 6(83.3%) women with pre-partum HBV DNA > 10000 IU/m L exhibited PPR compared with 3 of the 21(14.3%) women with HBV DNA < 10000 IU/m L(two with HBV DNA > 2000 and the third with HBV DNA of 1850IU/m L), P = 0.004. An HBV DNA level ≥ 10000 IU/m L independently predicted post-partum HBV infection reactivation(OR = 57.02, P = 0.033). Mean pre-partum ALT levels presented a non-significant increase in PPR cases(47.3 IU/L vs 22.2 IU/L, respectively, P = 0.094).CONCLUSION: In the present study, PPR occurred in approximately 30% of HBe Ag-negative pregnant women; all events were observed during the first semester after delivery. Pre-partum HBV DNA level > 10000 IU/m L predicted PPR.

Neural differentiation of human Wharton＇s jelly-derived mesenchymal stem cells improves the recovery of neurological function after transplantation in ischemic stroke rats

Human Wharton＇s jelly-derived mesenchymal stem cells（h WJ-MSCs）have excellent proliferative ability,differentiation ability,low immunogenicity,and can be easily obtained.However,there are few studies on their application in the treatment of ischemic stroke,therefore their therapeutic effect requires further verification.In this study,h WJ-MSCs were transplanted into an ischemic stroke rat model via the tail vein 48 hours after transient middle cerebral artery occlusion.After 4 weeks,neurological functions of the rats implanted with h WJ-MSCs were significantly recovered.Furthermore,many h WJ-MSCs homed to the ischemic frontal cortex whereby they differentiated into neuron-like cells at this region.These results confirm that h WJ-MSCs transplanted into the ischemic stroke rat can differentiate into neuron-like cells to improve rat neurological function and behavior.

SURGICAL TREATMENT OF GYNECOLOGIC MALIGNANCES IN PATIENTS 70 YEARS OF AGE AND OLDER

Objective.T o assess the viability of surgical procedures on gynecologic malignant patients o f70years age and older.Methods.Between September1,1983to June30,1 999,57gynecologic malignant patients aged70years and older were treated by surgical procedures.A retrospective study was perf ormed.All patients were analyzed for preexisting medical conditions,length of hospital stay,morbidi-ty,and mortality.Results.Thirty-four patients had a n extensive surgical procedure,while a local surgical procedure was done in23 patients.Forty-one patientshad one or more preexisting medical i llnesses.Minor surgical morbidity occurred in24patientsand majo r surgical morbidity occurred in6patients.There were no differen ces in the types of surgical procedures,mean hospital stay,preexisting medical illness and postoperative complications between the two groups of patients70 to75year older and over age75.The major postoperative complications all occ urred in the extensive surgical procedure group that were higher as compared wit h local operation and postoperative mean stay was also significant-ly length in former group.Conclusions.The extensive surgical procedure can be performed fo r elderly patients with gynecologic malignances.Careful preoperative evaluatio n,monitoring,and meticulous postoperative care are vital to the success.

Lymphocytes and perforin expression in endometrium during the menstrual cycle

Obejctive To study the lymphocytes, perforin protein and mRNA expression in endometrium of different phases in the menstrual cycle and to explore the regularity and role of the lymphocytes and perforin in the reproductive system Methods Immunohistochemical and in situ hybridization techniques were employed to demonstrate the population, phenotype and mediator (perforin) of lymphocytes in the proliferative and secretory endometrium Results In different phases of the endometrium, there were very few CD 3 + typical T lymphocytes, CD 4 + helper lymphocytes and CD 8 + suppressor/cytotoxic T lymphocytes, while CD 56 + lymphocyte (also named NK like cell) were abundant CD 56 + lymphocytes were absent in postmenopausal endometrium A double immunohistochemical labelling method demonstrated the co expression of perforin protein and CD 56 antigen of cells in different phases of the endometrium Quantitative analysis of CD 56 + lymphocytes and perforin positive cells increased in number from the proliferative to the secretory endometrium ( P <0 05) In situ hybridization analysis showed that perforin mRNA positive cells formed islands in proliferative endometrial stroma, but were scattered in secretory endometrium There was difference between perforin gene expression and protein expression in the proliferative endometrium Conclusions Lymphocytes and perforin expression in the endometrium at different phases of the menstrual cycle are specific and may play an important role in the reproductive system They may exert a positive influence on embryo implantation and be involved in endometrial stroma breakdown during menstruation