Objective To evaluate the efficacy and safety of genus Phyllanthus for chronic HBV infection. Design a systematic review of randomized clinical trials. Methods Randomized trials comparing genus Phyllanthus versus placebo, no intervention, general non-specific treatment, other herbal medicine, or interferon treatment for chronic HBV infection were identified by electronic and manual searches. Trials of Phyllanthus herb plus interferon versus interferon alone were also included. No blinding and language limitations were applied. The methodological quality of trials was assesses, by the Jadadscale plus allocation concealment. Results Twenty-two randomized trials (n=1 947) were identified. The methodological quality was high in five double blind trials and rest was low. The combined results showed that Phyllanthus species had positive effect on clearance of serum HBsAg (relative risk 5.64, 95%C1 1.85 to 17.21) compared with placebo or no intervention. There was no significant difference on clearance of serum HBsAg, HBeAg and HBV DNA between Phyllanthus and interferon. Phyllanthus species were better than non-specific treatment or other herbal medicines on clearance of serum HBeAg, HBeAg, HBV DNA, and liver enzyme normalization. Analyses showed a better effect of the Phyllanthus plus interferon combination on clearance of serum (1.56, 1.06 to 2.32) and HBV DNA (1.52, 1.05 to 2.21) than interferon alone. No serious adverse events were reported. Conclusions Based on the review Phyllanthus species may have positive effect on antiviral activity and liver biochemistry in chronic HBV infection. However, the evidence is not b due to the general low methodological quality and the variations of the herb. Further large trials are needed.
【Abstract】Objective To study the characteristics, diagnosis, treatment and prophylaxis of cytomegalovirus (CMV) infection after liver transplantation. Methods The literatures of recent 10 years were collected and reviewed. ResultsThe infection rate of CMV after liver transplantation was high, and it was frequently complicated with other types of infectious diseases. There was no specificity in the clinical features of CMV infection, and no effective measures were taken for early diagnosis, prevention and therapy.Conclusion CMV is the primary opportunistic pathogen after liver transplantation. Monitoring the status of CMV infection in recipients preoperatively and postoperatively, early prophylaxis and treatment are very important and useful to prevent and treat this disease.
Ｆｒｏｍ １９９０ ｔｏ １９９３， ｗｅ ｃａｒｒｉｅｄ ｏｎ ａ ｓｅｒｏｅｐｉｄｅｍｉｏｌｏｇｉｃａｌ ｓｕｒｖｅｙ ｏｎ ｈｅｐａｔｉｔｉｓ Ｂ ｖｉｒｕｓ （ＨＢＶ） ｉｎｆｅｃｔｉｏｎ ｏｆ ５２９７ ｇｅｎｅｒａｌ ｓｕｒｇｉｃａｌ ｐａｔｉｅｎｔｓ． Ｔｈｅ ｒｅｓｕｌｔｓ ｓｈｏｗｅｄ ｔｈａｔ ｔｈｅ ｐｏｓｉｔｉｖｅ ｒａｔｅｓ ｏｆ ＨＢｓＡｇ， ａｎｔｉＨＢｓ ａｎｄ ａｎｔｉＨＢｃ ｗｅｒｅ １９．４％ 、３５．９％ ａｎｄ ４１．１％ｒｅｓｐｅｃｔｉｖｅｌｙ， ａｎｄ ｔｈｅ ｏｖｅｒａｌｌ ｒａｔｅ ｏｆ ＨＢＶ ｉｎｆｅｃｔｉｏｎ ｗａｓ ７０．５％， ｗｈｉｃｈ ｗａｓ ｍｕｃｈ ｈｉｇｈｅｒ ｔｈａｎ ｔｈａｔ ｏｆ ｔｈｅ ｇｅｎｅｒａｌ ｐｏｐｕｌａｔｉｏｎ． Ｉｎ ｐａｔｉｅｎｔｓ ｗｉｔｈ ｈｅｐａｔｏｂｉｌｉａｒｙ ｏｒ ｐａｎｃｒｅａｔｉｃ ｄｉｓｅａｓｅｓ， ｔｈｅ ＨＢｓＡｇ， ａｎｔｉＨＢｃ ａｎｄ ｔｈｅ ｏｖｅｒａｌｌ ｒａｔｅ ｏｆ ＨＢＶ ｉｎｆｅｃｔｉｏｎ ｗｅｒｅ ３４．２％、５６．１％、８０．３％ｒｅｓｐｅｃｔｉｖｅｌｙ， ｗｈｉｃｈ ｗｅｒｅ ｈｉｇｈｅｒ ｔｈａｎ ｔｈｏｓｅ ｏｆ ｏｔｈｅｒ ｇｅｎｅｒａｌ ｓｕｒｇｉｃａｌ ｐａｔｉｅｎｔｓ．
Objective To investigate the influence of including HIV/AIDS patients on the consolidated fund under the New Cooperative Medical System （NCMS）. Methods Designed questionnaires were used to investigate 24 HIV/AIDS patients and 1155 randomized sample of the population to compare their income, requirement for public health service, expenditure of medical care and to analyze the influence of including HIV/AIDS patients. Results We found the income of HIV/AIDS patients was lower than healthy population in 2003 （722 vs. 2 162 RMB） ; but the requirement （outpatient：2 ：1, inpatient：5 ：1 ）and expenditure of medical care was higher in HIV/AIDS patients. Including HIV/ AIDS patients into NCMS would cause an adverse-effect on consolidated fund. When more than 293 HIV/AIDS patients were included, it would be beyond what the consolidated fund can afford. Conclusions Including HIV/AIDS patients into NCMS can decrease the HIV/AIDS expenditure to some degree. But the government still needs to get involved to share risks and to establish an HIV/AIDS fund to cover that part which NCMS could not afford.
目的 提高对成人系统性Epstein-Barr（EB）病毒阳性T细胞淋巴组织增殖性疾病（ASEBV+T-LPD）肠道病变的认识。 方法 报道2012年3月－10月我院收治的2例以肠道病变为首发表现的ASEBV+T-LPD，并结合3例文献报道进行分析讨论。 结果 2例成人患者以腹泻为主要表现，伴有发热、淋巴结长大，初期分别误诊为结核及肠道感染，淋巴结病检提示多克隆EBER+的T淋巴细胞浸润，确诊ASEBV+T-LPD。例1经3 周期GLIDE方案（吉西他滨+门冬酰胺酶+异环磷酰胺+地塞米松+依托泊苷）化学疗法（化疗）后疾病进展，死于肺部感染。例2经干扰素联合抗病毒药物治疗，病情稳定。复习文献目前仅3例以肠道病变为首发表现的ASEBV+T-LPD被报道，早期均被误诊为炎性肠病或感染，3例均出现肠道穿孔或大出血等并发症，其中2例死亡。 结论 成人系统性EB病毒阳性T细胞淋巴组织增殖性疾病的肠道病变较为罕见，容易误诊为结核及炎性肠病。部分患者病情进展迅速，可出现肠道穿孔及消化道大出血等致死性并发症，死亡率高，预后差。确诊本病需密切结合临床和病理学检查。常规化疗及抗病毒治疗仅部分有效，不能维持长期缓解。
目的:探讨激素及免疫抑制剂导致乙肝病毒再激活所致的肝损害的危害性及治疗效果，指导临床治疗。方法：总结本院近2年收治的7例慢性乙肝病毒感染者在使用激素及免疫抑制剂致肝炎再激活并加重患者的临床资料进行分析。结果：慢性乙肝病毒感染者因各种原因使用激素及免疫抑制剂所导致的慢性乙肝的复发加重，病情发展迅速，病死率高。结论：抗乙肝病毒治疗是预防肝病复发并恶化的关键，在激素或免疫抑制剂治疗前和治疗中都应使乙肝病毒降至尽可能低的水平。
ObjectiveTo improve the understanding of the diagnosis and therapy of chronic active Epstein-Barr virus (CAEBV) infection. MethodsData of 9 cases of CAEBV infection diagnosed between October 2008 and January 2013 were analyzed retrospectively,including clinical and auxiliary examination results,pathological data,especially EB virus (EBV) antibodies and DNA in peripheral blood mononuclear cells (PBMC) and infected tissue,and follow-up information. ResultsThe major manifestations of the 9 patients were fever,splenomegaly,hepatomegaly,lymphadenopathy,and others,including general fatigue,nausea,skin rash,jaundice,and so on.The abnormalities of auxiliary examination were as follows:anemia,leucopenia,neutropenia,thrombocytopenia,elevated LDH and HBDH levels,liver dysfunction and abnormal chest CT findings.EBV serologic tests revealed high IgA antibody levels against EB viral capsid antigen (VCA) in 6 patients,and 8 patients had positive IgG antibody levels against early D antigen (EAD).The mean load of EBV-DNA detected by real time polymerase chain reaction (PCR) in the PBMC was 3.07×105 copies/mL.Six of the nine patients presented a poor clinical course.One of them died of intracranial hemorrhage,one of them died of multiple organ failure,one of them died of EBV-associated hemophagocytic syndrome,and one of them died of severe pulmonary infection.Four patients developed lymphoma.One of them died of hepatic failure and one of them died of severe infection in the process of anti-tumor treatment. ConclusionThe clinical feature of CAEBV infection is varied.More attention should be paid to the disease because of its severe complications,poor prognosis and high mortality.