Objective:To observe the clinical effect of Jiangan Jiangzhi Pill in treating nonalcoholic fatty liver diseases(NAFLD).Methods:One hundred and twenty patients with NAFLD were randomized into two groups.The patients in treatment group were treated by taking two Jiangan Jiangzhi Pills,three times a day.And those in control group were treated by taking two Silibinin Capsules,three times a day.All these patients were followed up 3 months to observe the changes in symptom,liver function,blood-lipid,FBG,BMI,and USG.Results:The effective rate of the treatment group in alleviating symptoms was significant different compared with that of the control group,such as Anergy、indisposition in hepatic region、anorexia、abdominal distension、diarrhoea、dyspnea(P0.05 or P0.01).The total effective of symptoms was 91.7% in treatment group,and the total effective rate of symptoms was 53.3% in the control group.And there were significant differences in the total effective rates between two groups(P0.01).There were significant differences in lowering the levels of GGT between the two groups(P0.01).There was no significant differences in lowering the levels of ALT、AST、CHO、LDL-C、FBG、BMI and USG between the two groups(P0.05).Conclusion:Jiangan Jiangzhi Pill can significantly lower the levels of blood-lipid、FBG、BMI,improve the liver function,ameliorate the USG exhibition of liver,and exhibit more effect in alleviating symptoms in treating NAFLD than Silibinin Capsules.

目的 分析天津市急性病毒性肝炎流行现状、发展趋势及探讨控制对策.方法 回顾性统计1997～2007年急性病毒性肝炎病例,数据用Excel整理,采用描述性流行病学分析方法.结果 报告急性病毒性肝炎9455例,其中以乙型肝炎和戊型肝炎所占比例为高,分别为36.28%和27.94%,其次为未定型肝炎(20.95%),甲型肝炎和丙型肝炎所占比例为最低,分别为12.98%/和.85%;戊型和未定型以中老年(31～60a)为主,分别占78.8%(2082/2642),64.0%(1267/1981),甲型以青少年(11～30a)为主,占59.8%(734/1227),乙型、丙型以中青年(21～50a)为主,分别占80.85%(2773/3 430)、70.86%(124/175);各型肝炎男性所占比例均显著高于女性;甲型肝炎以1～4月为发病高峰期,戊型肝炎以12～6月为发病高峰期,未定型肝炎以12～5月为发病高峰期,乙型及丙型肝炎发病无明显季节性;感染途径甲、戊、未定型肝炎传播途径以消化道感染为主,乙型肝炎传播途径以性接触为主,丙型肝炎传播途径多数有不洁注射史.结论 急性病毒性肝炎以乙型、戊型及未定型肝炎为主,近2年总体发病例数里减少趋势.防治仍需从饮食卫生、注射用具的管理、加强宣传教育及健康人群保护入手.

AIM To study the effects of chronic hepatitis B complicated with fatty liver on the response to telbivudine anti-hepatitis B virus therapy.METHODS This is a restrospective analysis of the clinical data and pathologic study of liver biopsy from 128 chronic hepatitis B patients treated with telbivudine anti-hepatitis B virus.Forty-three chronic hepatitis B patients complicated with fatty liver were included in A group,consisting of 32 male,11 famale,and average age of (36±s 6);and 85 another patients without fatty liver in B group of 62 male patients and 23 famale and average age of (37±11).RESULTS After one year treatment with telbivudine,the percent of alanine aminotransferase (ALT) returning to normal and HBV DNA transforming to negative in A and B group were 60 % and 84% (X~2=5.892,P0.01),and 70%and 86% (X~2=5.315, P0.01),respectively.We identified the percent ages of biochemical response and virological response to telbivudine therapy were definitely decreased in patients with chronic hepatitis B complicated with fatty liver via liver biopsy.CONCLUSION The liver cell fatty change may be an important determinant of telbivudine antiviral response.

OBJECTIVE:To study the relationship between HBeAg expression and HBV-DNA in serum and peripheral blood mononuclear cells (PBMCs).METHODS:208 patients with chronic hepatitis B were included in this present study. HBV-DNA in the PBMCs were performed by polymerase chain reaction (PCR), with the serum HBV-DNA level being determined by the way of fluoresces quantities PCR (FQ-PCR). Meanwhile, HBV-GM was also detected via enzyme-linked immunosorbent assay (ELISA).RESULTS:There were 106 patients for positivity in the HBV-DNA level of PBMCs with 102 for negativity, in which the HBV-DNA high levels (HBV DNA load > or = 1.0E5) in serum were 91.5%, 45.1% (chi2=52.12, P>0.01) respectively, with 76.4% and 50.9% (chi2=21.55, P>0.01) for the positive percentage of HBeAg expression.CONCLUSION:A significantly positive correlation was found between HBV-DNA in PBMCs and serum HBV-DNA along with the positive percentage of HBeAg, indicating that obvious PBMCs' increase infected by HBV in patients with positivity of HBeAg and high level of serum HBV-DNA.

OBJECTIVETo study the relationship between TCM syndrome type and HBV-DNA in serum and peripheral blood mononuclear cells (PBMCs) in chronic hepatitis B (CHB) patients.METHODSThe serum HBV markers,HBV-DNA levels in serum and PBMCs, were quantitatively detected in 220 CHB patients by PCR method, and TCM syndrome type of 205 patients were differentiated.RESULTSArranged from low to high, the percentages of CHB patients with the serum HBV-DNA > or = 1.0 x l0(5) copy/mL (high viral loading) in the five syndrome types were as follows: damp-heat retention in middle-jiao syndrome (DHRS, 55.2%), blood stasis blocking collateral syndrome (BSBC), Gan-Shen yin deficiency syndrome (GSYS), Pi-Shen yang deficiency syndrome (PSDS) and Gan stagnation with Pi deficiency syndrome (GSPS, 82.5%), the difference was significant between DHRS and GSPS; those with HBV-DNA in PBMCs infection were: GSYS (27.3%), DHRS (34.3%), BSBC (53.1%) and GSPS (77.2%). The percentage in GSPS was the highest, which was significantly different to that in other syndromes.CONCLUSIONAmount of serum HBV-DNA and PBMCs HBV-DNA infection has certain correlation with the TCM syndrome type of CHB. The highest percentage of patients with HBV-DNA > or = 1.0 x l0(5) copy/mL and PBMCs HBV-DNA infection presented in CHB patients of GSPS type. We should pay more attention to strengthen genuine qi to eliminate pathogenic factors in treatment of CHB.

抗纤丸是本院制剂室生产的中药蜜丸剂,临床应用已20余年,抗纤丸具有活血化瘀、扶正祛邪和抗纤维化作用,主要治疗慢性肝炎和肝硬化。通过查阅文献,分析总结了抗纤丸中药成分的药理作用。

[目的]观察严重急性呼吸综合征(SARS)的临床特征及中西医结合治疗疗效.[方法]在西医对症治疗、抗菌、抗病毒、吸氧和辅助治疗基础上,根据患者全部症状、体征、舌苔、脉象所出现的频率进行辨证,在早期和中期以白虎加苍术汤加味或三仁汤加味,恢复期以清暑益气汤加味治疗.[结果]41例患者中39例(95.10%)痊愈出院,1例(2.44%)恢复期,1例(2.44%)死亡.其中服用中药患者发热、憋气、胸闷等症状改善均明显好于单纯西药治疗者,同时胸片表明服用中药可促进炎症吸收,中药并可防止激素减量后的反跳.[结论]中西医结合治疗SARS疗效较好,值得进一步深入研究.

目的探讨乙型肝炎患者血清中HBsAg-IgM特异性循环免疫复合物(HBsAg-IgM CIC)与HBVDNA之间相关关系机理.方法采用酶联免疫吸附检测法(ELISA),聚合酶链反应方法(PCR).结果 80例急性乙型肝炎中HBsAg-IgM CIC阳性率为85%,HBVDNA阳性率94%.80例慢性活动性肝炎HBsAg-IgM CIC与HBVDNA的阳性率分别为65%和48.7%.80例慢迁肝HBsAg-IgM CIC与HB-VDNA的阳性率分别为15%和17.5%.80例乙型肝炎恢复期患者中HBsAg-IgM CIC中与HBVDNA的阳性率分别为0%和5%.40例健康成人中HBsAg-IgM CIC中与HBVDNA的阳性率均为0%. 结论各型乙型肝炎中HBsAg-IgM CIC中与HBVDNA的阳性率经统计学处理有非常显著性差异P=0.001,各型乙型肝炎中HBsAg-IgM CIC与HBVDNA之间r＝0.9586,呈正相关.

1 对象与方法1.1 治疗对象120例患者诊断符合1990年第六届全国肝炎会议拟定标准。男32例,女42例,年龄24～58岁,平均年龄45岁,慢性迁延性乙型病毒性肝炎32例,慢性活动性乙型病毒性肝炎88例。1.2 方法治疗组80例患者在维生素,利肝丸等保肝综合治疗基础上加用ＨｅＮｅ激光...