A seroepidemiologic study of hepatitis B virus infection among barbers in Huangshi City, Hubei, China

Between March and August 1986 in Huangshi City, serum samples were collected from 316 apparently healthy barbers as a study group, as well as from 361 healthy employees of department stores as a control group. They were tested for hepatitis B surface antigen (HBsAg), antibody to HBsAg (anti-HBs) and antibody to hepatitis B core antigen (anti-HBc) by enzyme-linked immunoadsorbent assays. Barbers showed a prevalence higher than that in controls for HBsAg (16.8 vs. 9.2%, P less than 0.01), anti-HBs (67.1 vs. 45.9%, P less than 0.001), and anti-HBc (39.2 vs. 21.2%, P less than 0.001). The prevalence of at least one marker of hepatitis B virus (HBV) infection was significantly higher in barbers than in controls (86.1 vs. 61.7%, P less than 0.001). Although the socioeconomic status and education level did not correlate with the frequency of HBV markers, the prevalence of HBsAg increased in parallel with the duration of practice. Because of their high risk for HBV infection, barbers need to be screened for markers of HBV infection on a routine basis, and are prime candidates for immunoprophylaxis with hepatitis B vaccine.     

Non-secretion of ABO blood group antigens as a host susceptibility factor in the spondyloarthropathies.

Gram negative bacteria precipitate reactive arthritis and may be concerned in the pathogenesis of ankylosing spondylitis and other spondyloarthropathies. Susceptibility to many infectious agents is associated with ABO blood group or secretor state, or both. The distribution of the ABO blood group or secretor state, or both, was therefore determined in 87 patients with ankylosing spondylitis and 32 with other forms of spondyloarthropathy. The prevalence of non-secretors was significantly increased in the total patient group (54/114; 47%) and in the subgroup with ankylosing spondylitis (41/84; 49%) compared with local controls (89/334; 27%) (p less than 0.001). Other subgroups of patients showed a similarly increased prevalence of non-secretion (33-47%). The distribution of ABO blood groups did not differ between patients and controls. The association between non-secretor state and ankylosing spondylitis strengthens the hypothesis that ankylosing spondylitis is a form of reactive arthritis. It also suggests several pathogenic mechanisms which may be relevant to the initial hostparasite interaction in ankylosing spondylitis.     

Prediction of early death after therapeutic hepatic arterial embolisation.

A consecutive series of 14 patients with hepatic malignant disease treated by palliative hepatic arterial embolisation was reviewed. Twelve patients had hepatic pain from their tumour and two were suffering from the carcinoid syndrome. Six patients died within four weeks of the procedure (group 1) and eight survived for at least 10 weeks (group 2). Factors were sought that might permit prediction of a high risk of early death (group 1). The pre-embolisation angiograms reviewed by a "blind" observer showed no differences in vascularity or tumour size between the groups and no difference in the extent of arterial occlusion after embolisation. The portal vein was patent in all patients. No significant difference was seen between the groups in the pre-embolisation biochemical values, with the exception of lower serum albumin concentrations and higher alkaline phosphatase activities in group 1. All those who died early had serum alkaline phosphatase activities of 45 KAU or above, while six of the eight who survived longer had activities below this value (p less than 0.02). These findings suggest that serum alkaline phosphatase activity of 45 KAU or more (normal range 3-13) might alone be a useful predictor of early death. Stepwise discriminant analysis using a weighted combination of serum alkaline phosphatase activity and albumin concentration predicted the outcome in all but one of the patients studied (p less than 0.002).     

Absence of increase of serum alkaline phosphatase activity with parenteral nutrition-associated cholestasis: possible consequence of hypozincemia and hypomagnesemia

We reviewed charts of 38 Patients who developed cholestasis whilst receiving total parenteral nutrition (TPN). A standard protocol was followed for administration of TPN and included crystalline amino acid solution with lipid emulsion and dextrose as calorie sources. 5 of the 38 patients did not exhibit an increase in alkaline phosphatase. This may be related to the concomitant low levels of either serum zinc or magnesium or both. We also obtained a positive correlation between serum levels of zinc and magnesium and the peak activity of alkaline phosphatase (r = 0.49, p less than 0.01, r-0.55, p less than 0.01, respectively) associated with cholestasis. We hypothesize that the reason for this association is related to both zinc and magnesium being activators of alkaline phosphatase activity.     

Adenosine deaminase and guanosine deaminase activities in sera of patients with viral hepatitis.

In order to investigate purin and primidin metabolism pathways in hepatitis, adenosine deaminase (ADA) and guanosine deaminase (GDA) activities in sera of patients with different types and manifestations of viral hepatitis disease (A, B, C, D, E, chronic, acute) were investigated and compared with the control group of healthy individuals. Hepatitis cases were classified with respect to their serological findings and clinics. When compared all the hepatitis cases with the controls, levels of aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase enzymes, as well as ADA and GDA, were significantly higher than the control group (p<0.01). Levels of ADA and GDA in hepatitis cases were determined as 26.07 11.98 IU/l and 2.37 1.91 IU/l, respectively. When compared their ADA and GDA levels amongst the classified hepatitis groups, there was no difference in ADA levels amongst cases (p>0.05). However, GDA levels in hepatitis A group were closed to the controls. Increase in serum ADA activities in hepatitis forms may be dependent on and reflect the increase in phagocytic activity of macrophages and maturation of T-lymphocytes, and may be valuable in monitoring in viral hepatitis cases.     

Correlation between serum alkaline phosphatase activity and blood glucose levels

Fasting blood glucose levels and serum alkaline phosphatase activity of age-matched Libyan diabetic men (168) and women (168) were determined. The mean levels of blood glucose of men and women were 227 +/- 6 and 237 +/- 5 mg/dl, respectively. The respective values of serum alkaline phosphatase were 179 +/- 5 and 199 +/- 6 IU/l. The mean serum phosphatase activity of women was significantly higher (p less than 0.001) than that of their male counterparts. A statistically significant positive correlation was found between serum alkaline phosphatase and blood glucose levels of these diabetic patients (r = 0.35; p less than 0.001).     

Response of blood serum constituents to production of and recovery from a kwashiorkor-like syndrome in the young pig.

Twenty-six 3-week-old genetically obese pigs were fed in two experiments to determine the serum chemistry profile during severe protein malnutrition and repletion. Severe protein deficiency was produced in pigs fed the high-fat, low-protein diet (growth failure, rough hair, low serum total protein and albumin). In Experiment 1, blood was sampled from the anterior vena cava of each pig five times during depletion and three times during repletion to determine serum total cholesterol, high density lipoprotein (HDL)-cholesterol, triglycerides, total protein, albumin, glucose, Ca, inorganic P, Mg, Na, K, Cl, total bilirubin, urea N, creatinine, alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyltransferase. In Experiment 2, blood was sampled weekly for 8 weeks for serum total cholesterol, HDL-cholesterol, triglycerides, albumin, glucose, Ca, P, Mg and alkaline phosphatase. HDL-cholesterol was increased (P less than 0.01) and albumin was decreased (P less than 0.01) in protein-deficient pigs in both experiments. Creatinine, total bilirubin, gamma-glutamyltransferase, alanine aminotransferase, and aspartate aminotransferase were elevated in protein-deficient pigs compared with controls after 7 weeks of depletion. Inorganic P (P less than 0.01), Ca (P less than 0.01), and Mg (P less than 0.05) concentrations were depressed in protein-depleted pigs compared with controls in both experiments. After 8 weeks of repletion in Experiment 1, all elements except inorganic P were similar in the two groups. Short-term, severe, protein malnutrition affected lipid, electrolyte, and structural mineral metabolism and indices of liver function in the absence of parasites, diarrhea, and infection. The effects were reversed after 8 weeks of repletion. We conclude that the elevated serum cholesterol in protein deficiency is related primarily to an increase in the HDL fraction.     

Die blutgruppenassoziierten Elektrophoresetypen der alkalischen Serumphosphatase bei Gesunden und bei Patienten mit gastrointestinalen Erkrankungen

Zusammenfassung Mit Hilfe der Stärkegelelektrophorese wurden die phänotypischen Variationen der alkalischen Serumphosphatase bei 746 Gesunden, 62 Patienten mit Ulcus duodeni, 95 Patienten mit Ulcus ventriculi und 65 Patienten mit Magencarcinom untersucht. Die Beziehungen der quantitativen Variationen der langsamer wandernden B-Komponente zum ABO-Blutgruppensystem, zum Lewis-Blutgruppensystem, zum ABH-Ausscheidersystem und ihre Abhängigkeit von der Nahrungszufuhr werden bestätigt.Bei der Untersuchung von 637 nicht nüchternen Gesunden wurde eine positive Korrelation der B-Bande zu den Blutgruppen O, B und Le(a-/b+) und den Ausscheidern von ABH-Substanzen gefunden. Eine negative Korrelation der B-Bande fand sich zu den Blutgruppen A₁, Le(a+/b-) und den Nichtausscheidern von ABH-Substanzen.Bei einem Vergleichskollektiv von 109 nüchternen Gesunden wurde im Prinzip wieder die gleiche Korrelation gefunden. Die Häufigkeit und auch die Intensität der B-Bande war jedoch insgesamt geringer als bei den nicht nüchternen Gesunden.Nach Nahrungsaufnahme kommt es zu einem Anstieg der Intensität der B-Komponente der alkalischen Phosphatase im Serum, wie in einem Diätversuch bei drei Personen gezeigt werden konnte.Bei Patienten mit Ulcus duodeni, Ulcus ventriculi und Carcinoma ventriculi war sowohl die Häufigkeit als auch die Intensität der B-Bande geringer als bei Gesunden. Diese Abweichung wird auf eine Änderung der Ernährungsweise oder eine Störung im Bereich des Gastrointestinaltraktes zurückgeführt. Für einen Zusammenhang zwischen der B-Komponente der alkalischen Serumphosphatase und der bekannten ABO-Blutgruppenassoziation der drei untersuchten gastrointestinalen Erkrankungen ergab sich kein eindeutiger Hinweis.

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The alkaline serum phosphatase has been studied by starch gel electrophoresis in 746 healthy individuals, 62 patients with duodenal ulcer, 95 patients with stomach ulcer, and 65 patients with stomach cancer (Fig. 1, Table 1). The previously reported quantitative variations of the B-component of alkaline phosphatase, which is presumably identical with the intestinal component, has been confirmed. The variations of the B-component are associated with the ABO blood group system, the Lewis blood group system, and the ABH secretor status; they are also influenced by diet.In a sample of 637 healthy, nonfasting persons the B-component was positively correlated to the O, B and Le(a-/b+) blood groups and to ABH secretion. The B-component was negatively associated with the A₁ and Le(a+/b-) blood groups and the ABH non-secretor status (Table 2 and 3).In a sample of 109 fasting healthy individuals the B-component was less frequent and also less intense if present. Nevertheless, the same correlations to the ABO and Lewis blood groups and the ABH secretor status are found as in the non-fasting control (Table 5 and 6).In three persons the increase of the B-component of alkaline phosphatase in serum was followed after intake of a fatty meal (Table 7, Fig. 2 and 3).In patients with duodenal ulcer, stomach ulcer and stomach cancer the B-component is less frequent and less intense than in the control group of fasting healthy individuals. This deviation is related to differences in the diet or to disturbances of the gastrointestinal functions in these patients. There was no clear indication of a connection between the B-component of alkaline phosphatase and the ABO blood groups association with these gastrointestinal diseases (Table 8, 9, and 10).

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Mit Unterstützung durch die Deutsche Forschungsgemeinschaft, Bad Godesberg.     

Vitamin A toxicity and hypercalcaemia in chronic renal failure.

Serum vitamin A concentrations were measured in 38 patients undergoing haemodialysis, 24 of whom were taking multivitamin preparations containing vitamin A. Vitamin A concentrations were significantly higher in patients undergoing haemodialysis than in 28 normal controls (p less than 0.001). Patients taking vitamin A supplements had significantly higher vitamin A concentrations than those not taking them (p less than 0.05), and hypercalcaemic patients had higher concentrations than normocalcaemic patients (p less than 0.005). Withdrawal of vitamin A supplements in seven patients caused significant falls in serum vitamin A concentrations and plasma calcium concentrations (p less than 0.01 at two and three months in both cases) and in plasma alkaline phosphatase concentrations (p less than 0.01 at two months). Vitamin A toxicity can contribute to hypercalcaemia in patients undergoing haemodialysis, probably by an osteolytic effect. Multivitamin preparations containing vitamin A should therefore be prescribed with caution in these patients.     

Involvement of intestinal alkaline phosphatase in serum apolipoprotein B-48 level and its association with ABO and secretor blood group types

Serum levels of intestinal alkaline phosphatase (IAP), a protein implicated in transcellular transport of chylomicrons, vary among ABO blood groups. In rat enterocytes, IAP is associated with chylomicron secretion, but the rat expresses only blood group A. It is not known whether chylomicron secretion may be affected in humans who express multiple blood group types. Serum samples from 40 healthy subjects were obtained after overnight fast and 3h after a high-fat meal, and assayed for IAP and apolipoprotein B-48 (apoB-48), both proteins exclusive to intestine, although only apoB-48 is found in chylomicrons. The two proteins were greater in subjects without blood antigen A (B and O) than in those with this antigen (A and AB); 2.4- and 4.7-fold for IAP and 1.5- and 2.0-fold for apoB-48 before and after the meal, respectively. Moreover, IAP and apoB-48 levels were strongly correlated in the subjects with the secretor phenotype (r > 0.81). These results indicate that IAP is strongly involved in chylomicron formation and fatty acid metabolism might change among ABO blood type. In addition, ABO blood type classification in apoB-48 measurement would improve the diagnostic value in the evaluation of metabolic syndrome.     

ABO blood group and the risk of hepatocellular carcinoma: a case-control study in patients with chronic hepatitis B

Background

Studies have observed an association between the ABO blood group and risk of certain malignancies. However, no studies of the association with hepatocellular carcinoma (HCC) risk are available. We conducted this hospital-based case-control study to examine the association with HCC in patients with chronic hepatitis B (CHB).

Methods

From January 2004 to December 2008, a total of 6275 consecutive eligible patients with chronic hepatitis B virus (HBV) infection were recruited. 1105 of them were patients with HBV-related HCC and 5,170 patients were CHB without HCC. Multivariate logistic regression models were used to investigate the association between the ABO blood group and HCC risk.

Results

Compared with subjects with blood type O, the adjusted odds ratio (AOR) for the association of those with blood type A and HCC risk was 1.39 [95% confidence interval (CI), 1.05–1.83] after adjusting for age, sex, type 2 diabetes, cirrhosis, hepatitis B e antigen, and HBV DNA. The associations were only statistically significant [AOR (95%CI) = 1.56(1.14–2.13)] for men, for being hepatitis B e antigen positive [AOR (95%CI) = 4.92(2.83–8.57)], for those with cirrhosis [AOR (95%CI), 1.57(1.12–2.20)], and for those with HBV DNA≤10⁵copies/mL [AOR (95%CI), 1.58(1.04–2.42)]. Stratified analysis by sex indicated that compared with those with blood type O, those with blood type B also had a significantly high risk of HCC among men, whereas, those with blood type AB or B had a low risk of HCC among women.

Conclusions

The ABO blood type was associated with the risk of HCC in Chinese patients with CHB. The association was gender-related.     

One year follow-up of patients treated with misoprostol in acute phase of viral hepatitis B

The study was undertaken to determine the long-term effect of misoprostol, on hepatitis B virus (HBV) elimination in patients treated during acute phase of viral hepatitis B. Forty male patients were evaluated 12 months after treatment with misoprostol (M-group) or sylimarin (S-group). HBsAg clearance, as an indicator of HBV elimination, and serum bilirubin concentration, prothrombin index, and activities of alanine transaminase, aspartate transaminase, alkaline phosphatase as well as gamma glutamyltranspeptidase were analysed. At the end of treatment phase, improvement of liver function demonstrated through these biochemical indices was faster in M-group. After 12 months of follow-up HBsAg was cleared in all misoprostol treated patients and in 85% among S-group. Moreover misoprostol treatment resulted with normalization of bilirubin concentration and enzymes activity in all patients. Two among sylimarin treated patients (both HBsAg positive), had transaminases activities elevated over 100 U/l, that resulted with significantly higher values than in M-group. These results confirm beneficial effect of misoprostol treatment in patients with liver injury, but promising effect on HBV clearance should be confirmed in a study involving more patients.     

Haptoglobin patterns in essential hypertension and associated conditions--increased risk for Hp 2-2

Blood samples from 257 hypertensive patients and 180 normotensive controls were analysed for their association with haptoglobin levels and phenotypes. Compared to controls, patients with Hp 2-2 phenotype showed a significantly increased risk for essential hypertension (p less than 0.001) and hypertension associated with ischaemic heart disease (p less than 0.05). There was a significant decrease in the mean levels of serum haptoglobins in hypertension as compared to controls, suggesting the possibility for intravascular haemolysis due to vascular damage leading to further complications.     

C677T mutation of methylenetetrahydrofolate reductase gene and serum homocysteine levels in Turkish patients with coronary artery disease

Elevated levels of homocysteine is a risk factor for coronary artery disease. The C677T transition in methylenetetrahydrofolate reductase (MTHFR) is associated with increased homocysteine levels in the general population. We analysed the association between the MTHFR C677T polymorphism and serum homocysteine concentrations in patients with coronary artery disease (CAD). Allele frequencies for the 'C' (wild-type) and 'T' alleles were 0.71 and 0.29 in CAD patients and 0.70 and 0.30 in controls, respectively. There was no difference in the distribution of MTHFR genotypes between patients with CAD and control subjects (p > 0.05). In the patient group, homocysteine levels were higher than controls but not significantly (13.99 +/- 7.44 vs. 11.77 +/- 5.18 micromol l(-1); p > 0.05). Serum homocysteine concentration was significantly higher in the TT genotype with respect to CC and CT genotypes in both the control group (p < 0.01) and patient group (p < 0.01). Systolic and diastolic blood pressures in subjects with different MTHFR genotypes did not differ significantly. In conclusion, MTHFR C677T mutation was significantly related to hyperhomocysteinemia. In spite of the clear effect of the MTHFR polymorphism on elevated homocysteine levels, we did not observe any associations among the MTHFR genotypes with a the risk of CAD in the Turkish population.     

Large-scale survey of hepatitis B virus infection in families

To investigate HBV transmission in families on three islands in Okinawa, Japan, prevalence of HBV markers in two groups of inhabitants was determined. One group consisted of members of families in which there was at least one HBsAg carrier (carrier families); the other group consisted of members of families in which there were no HBsAg carriers (non-carrier families). A total of 3,261 serum samples were collected from subjects on Iriomote Island, Hateruma Island, and Yonaguni Island. These samples were tested for HBsAg by reversed passive hemagglutination (RPHA) and for antibody to hepatitis B core antigen (anti-HBc) by radioimmunoassay. Overall prevalences of HBsAg and anti-HBc were 8.2 and 65.8 per cent respectively. The prevalence of anti-HBC among members of carrier families (80.8%) was significantly higher than that among members of non-carrier families (61.6%) (P less than 0.001). The prevalence of anti-HBc among members of carrier families was higher in all age groups, and was particularly so in children. Within carrier families, the prevalence of anti-HBc was significantly higher in families in which there was at least one HBsAg carrier with HBeAg (94.5%) than in families with no HBeAg-positive carriers (76.1%). This difference was especially marked in young children. These data suggest that in families with HBsAg carrier(s), the risk of transmitting HBV to members, particularly to young children, is higher than in families without carriers, and that the risk is further increased in families with HBeAg-positive carrier(s).     

Transferrin C subtypes and occupational photodermatosis of the face

In a factory in northern Sweden where 120 workers were uniformly exposed to photoactive substances 73 developed occupational facial eczema while 47 showed no reaction. The workers were examined with respect to 16 genetic marker systems: HLA, blood groups (ABO, Rh, MNSs, P, K, Le and Fy) and serum groups (Hp, Tf, Gc, Pi, Bf, C3, C4 and C6). Between reactors and nonreactors the following differences were found: (1) a significant decrease (p less than 0.05) of HLA A11 among the reactors; (2) a significant increase (p less than 0.05) of the C3 FS type among the reactors; (3) a highly significant increase (p less than 0.001) of the transferrin C2 gene and of the C2 variant among the reactors. The association with Tf C2 remained significant also after correction for number of significance tests. Since transferrin (iron) is known to catalyze the formation of hydroxyl radicals we hypothesize that the Tf C2 variant is more efficient in promoting radical formation and thereby cell damage. Other results supporting the notion that transferrin C2 may be associated with an increased susceptibility to toxic damage are discussed.     

Serum biochemical values in two inbred strains of mastomys (Praomys coucha).

Serum samples collected from 119 (72 male and 47 female) mastomys (Praomys coucha) of 2 specific-pathogen-free inbred strains (RI4 and RI7) were analyzed for 12 serum biochemical parameters. Sex-related differences (p < 0.01) were noted in alkaline phosphatase and glucose; the both higher in females than in males. Age-related changes (p < 0.01) were observed in total protein, albumin, total cholesterol, and alkaline phosphatase, with higher values for the first three parameters in the older group (200-250 days of age) than in the younger group (90-140 days of age). Four out of 12 parameters showed strain-related differences (p < 0.01), consistent with the large amount of genetic heterogeneity reported in this species. These serum biochemical reference values should provide information for the use of mastomys in laboratory research.     

RXRA introne polymorphism and ABO blood groups in chronic heart failure

Retinoic X receptor alpha (RXRA), a member of nuclear receptor superfamily, plays a key role in development, metabolism, glucose homeostasis, and intestinal cholesterol balance. The aim of this study was to examine an association of RXR alpha introne 5 A(39526)AA polymorphism and ABO blood groups with chronic heart failure (CHF) in the Czech population. A total of 238 patients with chronic heart failure and a control group of 246 subjects were included in the study. The RXR alpha gene polymorphism and ABO blood groups were detected by PCR and RFLP methods. Significant differences in distributions of RXRA A(39526)AA alleles and genotypes between CHF patients and controls were observed (P_g=0.03, P_a=0.02). The RXRA gene polymorphism differences of within blood group A between CHF patients and controls were highly significant in genotype distributions (P_g=0.002) and in allele frequency comparisons (P_a=0.0001). The prevalence of AA allele in CHF patients with A blood group was four-fold lower than in controls with the same blood group (OR=0.24; P_corr=0.0001). A highly significant association of RXRA introne single-nucleotide insertion polymorphism and A blood group in chronic heart failure was observed. Our results suggest close linkage between RXRA A(39526)AA polymorphism and ABO blood groups.     

Association of ABO and Rh(D) blood groups with filariasis

ABO and Rh blood groups in 344 filarial patients and 320 controls matched with respect to age, community and residence are reported. An excess of B and a deficiency of AB was observed among the filarial patients. The relative risks for the B and AB were 1.53 and 0.36, respectively. Only males showed clearly significant risks. The Rh(D) blood groups revealed no association with filariasis.     

抗原抗体复合物型治疗性疫苗(乙克)临床研究中患者血清乙型肝炎病毒表面抗原下降的分析与启示

近年来全球慢性乙型肝炎(chronic hepatitis B,CHB)防治指南提出了“功能性治愈”(functional cure)的概念,即患者经过治疗达到血清乙型肝炎病毒表面抗原(hepatitis B virus surface antigen,HBsAg)消失,但现有抗病毒治疗很难实现这一目标。本研究对既往临床试验中经抗原抗体复合物型治疗性疫苗(乙克)治疗后的CHB患者HBsAg下降情况进行了归纳分析,结果显示,经乙克治疗随访后达到乙型肝炎e抗原(hepatitis B e antigen,HBeAg)血清学转换者的HBsAg下降高达0.95log₁₀IU/mL,显著高于未达到HBeAg血清学转换者的0.32log₁₀IU/mL(P<0.01),而经氢氧化铝佐剂治疗随访后发生HBeAg血清学转换(0.49log₁₀IU/mL)者与未发生HBeAg血清学转换者(0.36log₁₀IU/mL)之间HBsAg下降无统计学差异。乙克组治疗过程中,丙氨酸氨基转移酶(alanine aminotransferase,ALT)骤升(ALT flare)在HBsAg下降>1.0log₁₀IU/mL者中较多见,氢氧化铝组未观察到此现象。回归分析显示,乙克治疗后HBsAg下降的影响因素有患者出现HBeAg血清学转换、感染的HBV为B基因型、治疗过程中ALT出现10倍增高,以及基线血清HBsAg为高水平。结果提示,乙克诱导的特异性免疫对降低CHB患者血清HBsAg水平有一定效果,采用“抗病毒药物治疗＋针对HBsAg的中和性抗体被动免疫＋乙克主动免疫”的“三明治”治疗策略可能会提高“功能性治愈”率。