ObjectiveTo systematically review the diagnostic value of HBV Pre-S1Ag tested by enzyme-linked immunosorbent assay (ELISA) in patients with hepatitis B virus replication. MethodsSuch databases as PubMed, EMbase, The Cochrane Library (Issue 3, 2014), CBM, CNKI, VIP and WanFang Data were electronically and comprehensively searched for relevant studies on the diagnostic value of HBV Pre-S1Ag tested by ELISA in patients with hepatitis B virus replication from inception to May 1st, 2014. Relevant journals were also manually retrieved. Two reviewers independently screened literature according to inclusion and exclusion criteria, extracted data, and assessed methodological quality of included studies. Meta-analysis was then conducted using Meta-Disc 1.4 software. ResultsFinally, fifteen studies were included, involving 1 994 patients with hepatitis B diagnosed by the gold standard and 526 patients with non-hepatitis B diseases. The results of meta-analysis showed (Sen=0.76, 95%CI 0.74 to 0.78; Spe=0.90, 95%CI 0.88 to 0.91; +LR=8.54, 95%CI 4.25 to 17.15;-LR=0.17, 95%CI 0.10 to 0.27; DOR=65.12, 95%CI 24.91 to 170.28; AUC=0.943 0, SE=0.018 1; Q*=0.881 3, SE=0.023 4). ConclusionHBV Pre-S1Ag tested by ELISA has certain value in the diagnosis of patients with hepatitis B virus replication. Due to poor methodological quality of the included studies, the above conclusion should be verified by conducting high quality diagnostic tests.
The infection of Hepatitis B virus (HBV) can result in severe consequences, including chronic hepatitis, liver fibrosis, cirrhosis, and even liver cancer. Effective antiviral treatment has the potential to slow down the progression of the disease. HBV serum biomarkers play a crucial role in the dynamic management of chronic hepatitis B (CHB) patients. However, the conventional hepatitis B virus markers, such as hepatitis B serologic testing and HBV DNA, are insufficient to meet the clinical requirements. This review provided a comprehensive overview of the current research on the quantification of HBsAg and anti-HBc, HBV RNA and HBV core-associated antigen, which summarized the crucial role these markers play in the administration of antiviral medications, predicting the efficacy of treatment and anticipating the likelihood of virologic rebound following drug cessation, as well as assessing disease progression in CHB patients.
Objective To understand the molecular mechanism of HBx in the carcinogenesis of hepatitis B virus (HBV) related hepatocellular carcinoma (HCC).Methods The literatures published in the past 5 years which are mainly about HBx and hepatocellular carcinoma were reviewed. Results HBx had many functions, such as cell malignant transformation, inhibiting DNA repair, trans-activation, inhibiting p53 and apoptosis. These functions together with its Fas/Fas-L interfering and caspase-3 inhibiting could contribute to the carcinogenesis and development of HBV relatde HCC. Conclusion HBx has broad spectrum of biological functions, which contribute to the carcinogenesis and development of HBV related HCC.
【摘要】 目的 分析慢性乙肝患者血清生化、血常規、血清病毒載量及乙型肝炎標志物與肝組織炎癥分級、纖維化分期的相關性,以找到有較好相關性的臨床指標；通過肝活檢證實臨床診斷與病理診斷的符合情況,探討肝活檢的重要性及價值。方法 對2007年6月—2009年8月在傳染科行肝穿刺活檢的359例慢性乙型肝炎患者的血清丙氨酸氨基轉移酶(ALT)、門冬氨酸氨基轉移酶(AST)、總膽紅素(TB)、白蛋白(ALB)、球蛋白(GLB)等指標,白細胞(WBC)、血小板(PLT)等指標,凝血酶原時間(PT),血清HBV DNA定量及乙肝標志物的不同狀態與肝穿病理分級、分期的相關性進行分析；統計慢性乙肝患者臨床診斷與病理診斷的符合情況。結果 肝組織炎癥分級及纖維化分期之間有一定相關性(Plt;0.05)；血清ALT、AST、ALB、GLB、PT有助于判斷肝組織炎癥程度(Plt;0.05)；ALB、GLB、WBC、PLT、PT對肝組織纖維化程度的評估有意義(Plt;0.05)；HBV DNA復制水平與肝組織炎癥及纖維化無關(Pgt;0.05),但存在負相關的趨勢；纖維化程度高的患者HBeAg陰性組較HBeAg陽性組更多(Plt;0.05)。慢性乙型肝炎患者臨床與病理診斷總符合率為56.3％。結論 動態監測慢性乙肝患者肝功能、血常規、凝血常規在一定程度上有助于判斷疾病的程度,但要確診肝組織炎癥分級及纖維化分期,肝組織病理活檢是必需的。
目的探索乙型肝炎DNA陽性的終末期肝病患者肝移植前快速轉陰及肝移植術后復發的防治。方法4例乙型肝炎兩對半小三陽、HBVDNA(-)的患者術前開始聯合口服拉米夫定(lamivudine) 及泛昔洛韋, 術后3個月內治療同前, 3個月后僅口服拉米夫定維持至今； 2例乙型肝炎兩對半大三陽、HBVDNA(+)的患者, 術前除口服拉米夫定及泛昔洛韋外, 同時肌注乙肝免疫球蛋白共14 d,肝移植術中無肝期快速靜脈滴注15 000 u靜脈用乙肝免疫球蛋白，術后3個月內聯合口服拉米夫定及泛昔洛韋, 術后3個月內治療同前, 3個月后僅口服拉米夫定維持至今。結果1例患者術后第19天死于肺部霉菌感染,1例患者第49天死于肝動脈及門靜脈栓塞; 4例患者長期存活, 生存時間最長的患者已接近3年,術后全部患者均未發現有乙型肝炎復發。結論拉米夫定、乙肝免疫球蛋白及泛昔洛韋聯合使用可使乙型肝炎DNA陽性的終末期肝病患者在肝移植前快速轉陰，并能預防乙肝復發。
Background Hepatitis B is one of the major infectious diseases of mankind, and up to now, there is no effective way to handle it. Recent clinical trials have shown the potential advantages of Kurorinone an extract of Chinese herb, in treament of chronic HBV infection. Objectives Systermically review the safety and efficacy of Kurorinone in treatment of chronic HBV infection. Search strategy With the searching terms including Kurorinone, its products’ name, hepatitis B and chronic carrier status, the trials registers of the Cochrane Hepato- Biliary Group, the Cochrane Complementary Medicine Field, and the central database of the Cochrane Library as well as MEDILINE, EMBASE and Chinese Biomedical CD Database were searched from their date of inception onward. 20 Chinese medical journals and relevant academic conference proceedings have been searched by hand. The reference lists of identified documents were checked as the complementary search. Inclusion Criteria All RCTs that tested Kurorinone for chronic HBV infection were included in this review. Method of the review According the demand of Cochrane systematic review, selection of trial for inclusion, assessment of methodological quality, data extraction and data syntheses would be conducted for each included trial.
To challenge the 15% enhancement of 5-year survival of cancer for the plan of “Health-China 2030”, we must strive the following measurements to complete the 15% enhancement of 5-year survival of liver cancer: conduct conversion therapy and conversion to resectability for the 70% of unresectable intermediate-to-advanced stage liver cancer so as to prolong survival; try our best to identify and treat the people of HBV and HCV infection, and to screen the risk people so as to reduce the incidence of liver cancer and the proportion for intermediate-to-advanced stage liver cancer; continue to try our best in the full course management of liver cancer under the frame of MDT.
ObjectiveTo observe intervention effect of Shenlingcao oral liquid on asymptomatic chronic hepatitis B virus carriers (AsC). MethodsA self control before-after trial was conducted in the First Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine and the Ninth People's Hospital of Nanchang City from November 2011 to May 2012. A total of 64 AsCs were treated by Shenlingcao oral liquid (1 bottle/d, 200 mL, once daily for 6 months). Serum HBV viral load, six specific serum markers of HBV and 11 liver function index were tested and recorded before and at the 1th, 3th, 6th months of the treatment. Analysis of variance of repeated data was conducted. ResultsAfter one month of the treatment, 35/57 (61.40%) AsCs' serum HBV-DNA loads decreased, 1 log decrease was observed in 15 cases, 2 log decrease was observed in 4 cases, and decrease under the detection limit was observed in 12 cases. 41/57 (71.93%) AsCs' serum HBV-DNA loads decreased after 3 months of treatment, 1 log decrease was observed in 21 cases, 2 log decrease was observed in 5 cases, and decrease under the detection limit was observed in 15 cases. 31/49 (63.26%) AsCs' serum HBV-DNA loads decreased after 6 months of the treatment, 1 log decrease was observed in 19 cases, decrease more than 2 log was observed in 7 cases, and decrease under the detection limit was observed in 12 cases. The serum HBV viral loads at different time points of the treatment were significantly different (P<0.001). As medication time went, AsCs' serum HBV viral loads presented a decrease trend after taking Shenlingcao oral liquid, especially obvious at the 3th month. ConclusionShenlingcao oral liquid could help promote AsCs' ability of clearing virus and controlling serum HBVDNA loads.