The natural course of chronic hepatitis C

Abstract: In 1988, investigators from the Chiron Company (USA) detected the non-A, non-B agent and named it hepatitis C virus (HCV). An anti-HCV antibody assay (ELISA) and subsequently confirmation tests (immunoblot and polymerase chain reaction) were developed. HCV exposure results in a chronic infection in a majority of cases. This chronic infection is associated with slowly progressive chronic liver disease. Chronic HCV infection is, like HBV, also associated with the development of hepatocellular carcinoma. Most HCV carriers are infected by parenteral routes. Intravenous drug users have the highest risk of becoming infected. Intrafamiliar spread is seen in certain parts of the world but sexual and perinatal transmission does not play an important role in spreading the infection. Antiviral therapy (alpha-interferon) in patients with chronic hepatitis C will normalize liver function tests in about 25% of the cases.     

D-Amino acids in chronic renal failure and the effects of dialysis and urinary losses

Summary Total D-amino acids were measured in plasma for 20 non-dialysed patients (creatinine clearance < 12 ml/minute), 20 on CAPD, 20 on haemodialysis and 20 normals. Plasma D-tyrosine and D-phenylalanine were measured in 8 of each group by HPLC. Total D-amino acids, D-tyrosine and D-phenylalanine were significantly greater for patients than normals. D-amino acids and D-tyrosine correlated with creatinine and were decreased during HD. During dialysis, the mean losses for D-tyrosine and D-phenylalanine were similar, about 0.2 mg/CAPD exchange and 3 mg/4 hour haemodialysis (i.e. 2% of the total amino acid, as in plasma). Clearance was unaffected by stereochemical configuration. Urinary losses/24 hour in the non-dialysed patients were 0.35 mg D-tyrosine and 0.25 mg D-phenylalanine. Clearance for D-phenylalanine was greater than for the L-enantiomer. Increases in D-amino acids in renal failure are probably due to depletion of D-amino acid oxidase, but may be enhanced by a D-amino acid rich diet, peptide antibiotics and D-amino acid oxidase inhibiting drugs and metabolites. Possible toxic effects need further investigation.     

Increasing infiltration and activation of CD8+ tumor-infiltrating lymphocytes after eliminating immune suppressive granulocyte/macrophage progenitor cells with low doses of interferon γ plus tumor necrosis factor α

By secreting granulocyte/macrophage colonystimulating factor (GM-CSF), metastatic Lewis lung carcinoma (LLC-LN7) tumors induce the appearance of myelopoiesis-associated immune-suppressor cells that resemble granulocytic-macrophage (GM) progenitor cells. The presence of these GM-suppressor cells in mice bearing LLC-LN7 tumors was associated with a reduced capacity of splenic T cells to proliferate in response to interleukin-2 (IL-2). Administration of low doses of 100 U interferon (IFN) plus 10 U tumor necrosis factor (TNF) to the tumor bearers, a combination treatment that we previously showed to diminish the presence of GM-suppressor cells synergistically, restored proliferative responsiveness of the splenic T cells to IL-2. These LLC-LN7-bearing mice were also examined for whether cells that phenotypically resemble GM-progenitor cells (ER-MP12⁺ cells) infiltrate the tumor mass. ER-MP12⁺ cells composed approximately 10% of the cells isolated from dissociated tumors of mice that had been treated with placebo or with either IFN or TNF alone, but IFN/TNF therapy markedly reduced the number of tumor-infiltrating ER-MP12⁺ suppressor cells. The IFN/TNF treatment to eliminate GM-suppressor cells and restore T cell responsiveness to IL-2 was next coupled with low dose IL-2 therapy (100 U twice daily). Addition of IL-2 to the treatment regimen did not significantly influence the effectiveness of the IFN/TNF treatment in eliminating GM-suppressor cells from the LLC-LN7 tumor mass. However, inclusion of IL-2 with the IFN/TNF treatment regimen enhanced the CD8⁺, but not the CD4⁺, cell content within the tumor, and diminished the number of metastatic lung nodules within the mice. When these tumors were excised, dissociated, and bulk-cultured with a low dose of IL-2, an increased level of cytotoxic T lymphocyte (CTL) activity was generated in the TIL cultures from mice that had received IFN/TNF plus IL-2 treatments. A lesser but detectable level of CTL activity was generated in TIL cultures from mice that were treated with only IFN/TNF, while no CTL activity was generated in tumor cultures from mice receiving only placebo or low-dose IL-2. These results suggest the effectiveness of IFN plus TNF therapy in restoring IL-2 responsiveness in mice bearing GM-suppressor cell-inducing tumors and at enhancing both the intratumoral CD8⁺ cell content and the generation of CTL activity in bulk cultures of these tumors.This study was supported by the Medical Research Service of the Department of Veterans Affairs, by grants CA-45080 and CA-48080 from the National Institutes of Health, and by the American Cancer Society, Illinois     

HBIG,无环鸟苷,干扰素联合对慢性乙型肝炎抗病毒效应观察

本文报道血清ＨＢＶ复制标志阳性的慢乙肝５４例,随机分为治疗组及对照组各２７例进行ＨＢＩＧ、无环鸟苷、干扰素联合近、远期抗病毒效应观察。治疗组为无环鸟苷第一周按２５～２０ｍｇ／ｋｇ／ｄ计后改１７～１５ｍｇ／ｋｇ／ｄ×５３天,共６０天;人白细胞干扰素１×１０６Ｕ肌注每周３次×４周,后改１．０×１０６Ｕ肌注每周２次×６周,共１０周;ＨＢＩＧ４００Ｕ肌注隔日１次,共１０周,对照组仅给予一般“保肝”药物。其中治疗组１８例,对照组１９例进行治后半年到２年追踪观察,结果近、远期ＨＢｃＡｇ、ＤＮＡＰ、ＨＢＶ－ＤＮＡ阴转率治疗组均高于对照组,其中治疗组近、远期ＨＢｃＡｇ,ＨＢＶ－ＤＮＡ阴转率均达４０％以上,明显高于对照组（Ｐ＜０．０５～０．０１）,治疗组近、远期各有４例及２例ＨＢｓＡｇ阴转,而对照组则无一例阴转,从近、远期综合抗病毒效应观察,治疗组全阴率分别为３３．３％、４４．４％,而对照组分别为３．７９％及０％,Ｐ＜０．０１,治疗组无明显毒副反应。对比单用无环鸟苷,全阴率３１．８％;无环鸟苷加干扰素两药联合全阴率３７．５％,均有所提高,达到４４．４％,值得进一步研究。     

猪胃螺杆样细菌与幽门螺杆菌的比较研究

我们检测１０例普通猪的胄组织,有８例分离到螺杆菌样细菌（ＨＬＯ）。其菌落、菌体形态和某些生化反应与幽门螺杆菌（ＨＰ）相似,但其尿素酶活性较低,ＨＬＯ全菌蛋白的ＳＤＳ一ｐＡＧＥ图谱也与ＨＰ的不同。本文就ＨＰ和ＨＬＯ及其伴发的人、猪慢性胃炎的特点,作了比较和讨论。     

慢性前列腺炎厌氧菌感染的研究

本文对１０６例前列腺标本进行了细菌学研究。慢性前列腺炎厌氧菌检出率为２７．３％（２９／１０６）。厌氧菌阳性者中６８．９％（２０／２９）与需氧菌组成混合感染３１％（９／２９）为单纯厌氧菌感染。研究还提示：厌氧菌感染是慢性前列腺炎不可忽视的原因,氟呱酸对厌氧菌有强大杀灭作用。     

促髓细胞分化的锌指基因单向PCR扩增直接测序的研究

锌指基因是一种造血调节基因,编码锌指结构蛋白,主要在髓细胞中表达,促进髓细胞分化,在急性早幼粒白血病维甲酸治疗中,促使病情缓解。本文报道了我们从基因分子上研究锌指基因作用中,探索并建立了单向聚合酶链反应（ＰＣＲ）扩增特定单链ＤＮＡ,直接测序的新方法。它能产生质和量均佳的单链ＤＮＡ,无需纯化即可直接用于测序,使复杂的测序研究简便易行,可在２,３天内完成。这种单向ＰＣＲ扩增特定单链ＤＮＡ直接测序的方法,经对锌指基因的ｃＤＮＡ测序,得到验证。此法不仅适用于疾病研究中的ＤＮＡ测序,还可制各单链ＤＮＡ探针,更利于基因结构组成的研究。     

血清NEP、PTX3及H-FABP在慢性心力衰竭的表达水平及与疾病的相关性分析

摘要 目的：探讨血清脑啡肽酶（NEP）、正五聚蛋白3（PTX3）及心型脂肪酸结合蛋白（H-FABP）在慢性心力衰竭（CHF）的表达水平及其与疾病严重程度的相关性。方法：选入我院2019年10月~2021年10月收治的110例CHF患者作为观察组,并根据美国纽约心脏病学会（NYHA）标准进行心功能分级,另取同期健康志愿者50例作为对照组。比较两组之间、观察组不同心功能分级之间的血清NEP、PTX3及H-FABP的表达水平,并分析三者与CHF严重程度的相关性。出院后随访90 d,记录主要心脏不良事件（MACE）情况。结果：观察组血清NEP和LVEF水平明显低于对照组（P＜0.05）,而PTX3、H-FABP及LVEDD显著高于对照组（P＜0.05）;且随着NYHA分级升高,NEP和LVEF逐渐降低（P＜0.05）,PTX3、H-FABP及LVEDD逐渐提高（P＜0.05）,各组间差异显著（P＜0.05）;相关性分析结果显示：PTX3、H-FABP与NYHA分级和LVEDD存在明显正相关（P<0.05）,与LVEF呈明显负相关（P<0.05）,NEP与NYHA分级、LVEF和LVEDD均无明显相关性（P＞0.05）。MACE患者血清NEP水平显著低于非MACE患者,血清PTX3和H-FABP水平显著高于非MACE患者,差异有显著意义（P＜0.05）。结论：血清NEP、PTX3和H-FABP均是CHF诊断的重要生物学标志物,尤其是PTX3和H-FABP与病情严重程度和预后存在密切关系,联合检测对CHF早期诊断、病情和预后评估具有重要意义。     

心元胶囊对慢性心力衰竭心血瘀阻证患者心脏超声参数、脂质代谢及血液流变学的影响

摘要 目的：探讨心元胶囊对慢性心力衰竭（CHF）心血瘀阻证患者心脏超声参数、脂质代谢及血液流变学的影响。方法：根据随机数字表法,将我院2020年3月~2022年3月期间收治的的CHF心血瘀阻证患者120例分为对照组（常规西药治疗,n=60）和观察组（心元胶囊联合常规西药治疗,n=60）。对比两组中医疗效、心功能指标、血脂指标、肌酸激酶（CK）、肌酸激酶同工酶（CK-MB）、N-末端脑钠肽前体（NT-proBNP）、血液流变学指标,并观察两组不良反应情况。结果：观察组的中医总有效率明显高于对照组（P<0.05）。两组治疗后左室射血分数升高,左室舒张末期容量、左室收缩末期容量缩小,且观察组的改善效果优于对照组（P<0.05）。两组治疗后三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）下降,高密度脂蛋白胆固醇（HDL-C）升高,且观察组的改善效果优于对照组（P<0.05）。两组治疗后CK、CK-MB、NT-proBNP下降,且观察组的改善效果优于对照组（P<0.05）。两组治疗后全血高切黏度、全血低切黏度、血浆黏度、纤维蛋白原下降,且观察组的改善效果优于对照组（P<0.05）。两组不良反应发生率对比,差异无统计学意义（P>0.05）。结论：心元胶囊治疗CHF心血瘀阻证可提高临床疗效,改善心功能,调节脂质代谢、血液流变学水平,安全有效。     

2型糖尿病伴慢性牙周炎患者龈沟液Omentin-1、MMP-9、OPG/RANKL比值与牙周指标、氧化应激和NLRP3炎症小体的关系

摘要 目的：探讨2型糖尿病（T2DM）伴慢性牙周炎（CP）患者龈沟液网膜素-1（Omentin-1）、基质金属蛋白酶-9（MMP-9）、骨保护素（OPG）/细胞核因子κB受体活化因子配体（RANKL）比值与牙周指标、氧化应激和核苷酸结合寡聚化结构域样受体蛋白3（NLRP3）炎症小体的关系。方法：选择2020年6月至2022年6月首都医科大学附属北京康复医院收治的73例T2DM患者（T2DM组）,77例CP患者（CP组）,83例T2DM伴CP患者（T2DM伴CP组）。检测所有患者龈沟液中Omentin-1、MMP-9、OPG/RANKL比值,分析其与牙周指标、氧化应激和NLRP3炎症小体相关分子信使核糖核酸（mRNA）表达的相关性。结果：T2DM伴CP组龈沟液中Omentin-1,OPG/RANKL比值、总抗氧化能力（TAC）、超氧化物歧化酶（SOD）低于T2DM组和CP组（P＜0.05）,MMP-9、丙二醛（MDA）、NLRP3mRNA、凋亡相关斑点样蛋白（ASC）mRNA、半胱氨酸蛋白酶-1（caspase-1）mRNA表达以及出血指数（SBI）、菌斑指数（PLI）、牙周袋探诊深度（PD）、附着丧失（AL）高于T2DM组和CP组（P＜0.05）。T2DM伴CP患者龈沟液中Omentin-1、OPG/RANKL比值与TAC、SOD呈正相关（P＜0.05）,与MDA、NLRP3mRNA、ASC mRNA、caspase-1mRNA表达以及PLI、SBI、AL、PD呈负相关（P＜0.05）,MMP-9与TAC、SOD呈负相关（P＜0.05）,与MDA、NLRP3mRNA、ASC mRNA、caspase-1mRNA表达以及PLI、SBI、AL、PD呈正相关（P＜0.05）。结论：T2DM伴CP患者龈沟液中Omentin-1水平、OPG/ RANKL比值降低,MMP-9水平升高,与牙周组织破坏加重、氧化应激、NLRP3炎症小体激活有关。