Objective:To explore the feasibility of withdrawing immunosuppression after pediatric liver transplantation (LT) and to explore the related influencing factors of immune tolerance.Methods:Clinical data were retrospectively reviewed for 14 children undergoing LT and withdrawing immunosuppressant postoperatively from January 2013 to January 2017. There were 8 boys and 6 girls with a body mass index (BMI) of (20.32±4.65) kg/m 2. The age of recipients at the time of transplantation ranged from 0.58 to 0.71 years and the median age was 0.58 years. The recruiting age ranged from 2.65 to 4.52 years and the median age was 3.75 years. And the interval from transplantation to inclusion was (3.08±1.10) years. Among donors, there were 6 males and 8 females with an age range of (22.84±13.93) years. In 14 cases, liver transplant was performed for patients with biliary atresia, including living donor liver transplantation (n=10) and cadaveric liver transplantation (n= 4) . Among participants in immunosuppressant withdrawing, 4 cases had immunosuppressant removed for post transplant lymphoproliferative disorder (PTLD) . All of them received immunotherapy post-LT. Children aged >6 years received a triple regimen of steroid + tacrolimus (FK506) + montecoculphate while those aged ≤6 years had a double regimen of hormone + FK506. In 10 cases, immunosuppressant was withdrawn according to the withdrawal plan. Four PTLD children received immunosuppressive tapering alone according to pathological type and clinical symptoms. Periodic liver function tests and programmed liver biopsies were performed at the beginning of the study, 1 year and 2 years. Hematoxylin eosin (HE) staining was performed for evaluating acute liver rejection and fibrosis by Banff standard and Ishak scoring system. Results:Among them, 5/14 children successfully stopped immunosuppressive to achieve immune tolerance. Nine children became immune intolerant and 3 had normal liver function during follow-ups. However, the pathological results of programmed liver biopsy hinted at rejection. The remaining 6 cases showed abnormal liver function during follow-ups and liver function normalized after resuming immunosuppressive therapy. As compared with immune intolerants, age at the time of transplantation was smaller for immune tolerants. The median age of transplantation was 0.58 (0.50~0.58) years. The age of immune intolerants during transplantation was 0.67 (0.58~ 2.04) years and the difference was statistically significant ( P=0.012, Z= -2.51 ) . The level of direct bilirubin (DBIL) in immune tolerants was lower than that in immune intolerants. The median value of DBIL was 2.47(2.23~2.53) μmol/L in immune tolerants and 2.63(2.52~2.99) μmol/L in immune intolerants and the difference was statistically significant ( P=0.004, Z= -2.87) . Conclusions:The proportion of immune tolerance after pediatric liver transplantation remains high and age and DBIL level affect immune tolerance.

Objective:To evaluate the efficacy of basiliximab plus single steroid induced immunotherapy during donor-recipient ABO-compatible pediatric liver transplantation(LT).Methods:From January 1, 2019 to January 19, 2020, a total of 150 children of donor-recipient ABO-compatible LT were randomly divided into basiliximab group(basiliximab plus single steroid induction and postoperative immunosuppression with tacrolimus alone)and steroid group(conventional dose of steroid induction plus postoperative immunosuppression with tacrolimus and steroid). Clinical characteristics, survival rate of recipients and liver allografts, rejection rate and infection rate were observed.Results:The median follow-up time was 9.2(0.7~15.5)months.No significant inter-group differences existed in survival rate of recipients/grafts or the incidence of acute rejection, early postoperative pulmonary infection, cytomegalovirus and Epstein Barr virus infection. However, in 56 living donor LT, acute rejection(6cases, 10.7%)occurred in basiliximab group versus(12cases, 25.5%)in steroid group. During living donor LT, the incidence of acute rejection declined markedly in bsiliximab group as compared with steroid group( P=0.043). Conclusions:Both safe and effective for donor-recipient ABO-compatible pediatric LT, basiliximab plus single steroid induced immunotherapy can significantly lower the occurrences of acute rejection during living donor LT.

目的 比较拉米呋定与乙肝疫苗方案预防乙型肝炎核心抗体(hepatitis B core antibody,HBcAb)阳性供肝儿童肝移植术后新发乙型肝炎病毒(hepatitis B virus,HBV)感染效果.方法 对天津市第一中心医院自2013年5月—2019年6月251例接受HBcAb阳性供肝儿童肝移植的资料进行回顾性分析,依据采用预防方案的不同分为拉米呋定组和乙肝疫苗组,对两组患儿的新发乙肝病毒感染情况以及临床资料进行比较分析.结果 拉米呋定组45例和乙肝疫苗组206例,两组在供受者的临床特征方面无显著差异,两组的新发乙肝病毒感染例数分别为5例(11.1％)和10例(4.9％),发生率无显著统计意义(P=0.075),停用拉米呋定与新发乙肝存在关系.结论 单用拉米呋定和乙肝疫苗均是有效预防HBcAb阳性供肝术后新发乙肝的方案,停用拉米呋定会增加新发乙肝的风险.

目的:通过应用体外膜氧合技术(ECMO)再灌注猪心脏死亡供体腹腔器官,观察灌注过程中猪肠黏膜屏障功能的变化情况.方法:选取巴马小型猪20头,建立马斯特里赫特(Maastricht)Ⅱ类猪心脏死亡模型,模型成功建立后,于腹主动脉和下腔静脉行ECMO插管,连接ECMO持续运行6h.在ECMO运行过程中,持续观察猪小肠色泽、弹性及水肿情况,并于基础阶段、判定心脏死亡时、ECMO运行2h、4h及6h时取血液标本检测内毒素、二胺氧化酶(DAO)及肠型脂肪酸结合蛋白(I-FABP);切取猪小肠组织观察病理组织学变化.结果:血清学检测结果示,猪心脏死亡后,各项指标均比基础阶段显著升高(均P＜0.05),ECMO运行至2h时,血清内毒素、DAO和I-FABP分别为(0.305±0.034) EU/mL、(66.28±5.98)U/mL和(22.03± 1.38)ng/mL,相比心脏死亡时均有所下降,内毒素和DAO下降更为显著(均P＜0.05),I-FABP亦有所下降,但差异无统计学意义(P＞0.05),ECMO运行至4h,血清内毒素、DAO和I-FABP分别为(0.243±0.021)EU/mL、(60.22±5.41)U/mL和(17.86± 1.73)ng/mL,与运行ECMO 2 h相比均呈进一步下降趋势(均P＜0.05),当ECMO运转至6h时,血清内毒素、DAO和I-FABP分别为(0.251±0.023)EU/mL、(59.36±8.40)U/mL和(22.48±1.96)ng/mL,相比ECMO运行4h,血清I-FABP水平明显上升(P＜0.05),DAO、内毒素水平无明显差异.病理检查示,猪心脏死亡后,小肠绒毛部分脱落,黏膜腺体排列不规则,大量炎细胞浸润,随着ECMO的运行,肠壁血运逐渐恢复,猪小肠组织病理情况随时间逐渐好转,至ECMO运行4h时,光镜下可见小肠绒毛偶见脱落,肠黏膜腺体排列大致规则,炎细胞浸润减轻,但ECMO继续运转至6h时,小肠水肿严重,病理改变较前变差.结论:短期运行ECMO支持技术,对猪心脏死亡后肠黏膜屏障功能具体有一定的保护支持作用,随ECMO运行时间延长,可使肠黏膜屏障功能受到进一步损伤.

Objective To start emergency rescue transfusion on an RhD-negative patient,and to analyze the clinical effect of the "recommended scheme" according to the "recommended scheme for emergency blood transfusion under special circumstances" (hereinafter referred to as "recommended scheme").Methods The clinical features,the start indication,the process of blood transfusion and the effect in this transfusion case of an O Rh D negative patient which met the "recommended scheme" were retrospectively analyzed.Results The total blood volume of O RhD(-) patient consisted of 3.5 U of suspended red blood cells,11.5 U of frozen red blood cells and 1 430mL of fresh frozen plasma.A trauma patient with blood type of O RhD-negative was saved because she received enough transfused blood in a timely manner.Conclusion The "recommended scheme for emergency blood transfusion under special circumstances" is of great significance to guide transfusion workers and clinical workers to solve clinical emergency rescue,and to allow patients with rare blood type to receive proper blood transfusion according to the "recommended scheme".

目的 构建新型常温机械灌注(normothermic machine perfusion,NMP)系统,利用猪自体肾移植模型,探讨NMP改善猪心脏死亡器官捐献(donation after cardiac death,DCD)供肾保存质量及相关机制.方法 选用健康巴马小型猪10只,随机分为两组,在原位夹闭右肾动脉30分钟后,UW液低温灌注,A组(n=5)以NMP保存8小时,B组(n=5)以UW液4℃低温保存8小时,然后两组均行自体肾移植术,比较术后血清生化指标、肾组织病理变化、细胞因子的表达情况等指标.结果 两组均成功在经过30分钟热缺血和8小时保存后,进行自体肾移植.血流开放1小时后,A组肾组织免疫组化肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、天冬氨酸特异性半胱氨酸蛋白酶-3(cysteinyl aspartate specific proteinase-3,Caspase-3)、内毒素(endotoxin-1,ET-1)水平明显低于B组,TUNEL法测定凋亡细胞比例也明显低于B组,两组之间差异有统计学意义(P<0.05);血流开放6小时后,A组血清肌酐(serum creatinine,SCr)、TNF-α、Caspase-3水平明显低于B组,两组之间差异有统计学意义(P<0.05);开放后肾脏活检常规病理检查提示,A组肾脏损伤程度明显减轻.结论 NMP保存可明显减轻猪DCD供肾的缺血/再灌注损伤;其保护机制与NMP可模拟器官的生理环境,维持充足能量与氧气供应,减少保存期间和再灌注后炎性细胞因子释放等有关.

目的 本研究拟利用体外膜肺氧合(extracorporeal membrane oxygenation,ECMO)的原理,构建自己的常温机械灌注(normothermic machine perfusion,NMP)体系,通过对巴马小型猪肝脏灌注保存过程中进行劈离,验证其效果及稳定.方法 健康巴马小型猪4只,常温下切取肝脏,连接NMP装置开始灌注.劈离过程中,监测门静脉、肝动脉流量、压力、肝脏保存温度.结果 劈离过程中,门静脉压力控制在8.75~9.75 mmHg(1 mmHg=0.133 kPa),肝动脉压力维持在92~92.75 mmHg;门静脉流量从劈离前(455.00±107.55)mmHg降至劈离后(392.50±125.27)mmHg,肝动脉流量则从(180.75±59.46)mmHg降至(126.25±6.99)mmHg.劈离前,保存液pH值(7.24±0.10)较基础值(7.50±0.08)降低,劈离结束后pH值(7.60±0.13)高于基础值;PO2在劈离过程维持在482.25~521.00 mmHg,较基础值(304.00±78.11)mmHg增高;HCO3-劈离前(10.10±5.04)mmol/L较基础值(24.05±0.31)mmol/L降低,随后HCO3-逐渐升高;Na+在劈离过程中维持在142.75~149.25 mmol/L;K+在劈离过程中从基础值(3.45±0.33)mmol/L升高至劈离后(4.98±1.12)mmol/L;乳酸在劈离前(2.86±1.77)mmol/L较基础值(3.85±2.58)mmol/L降低,劈离结束后,升高至(6.00±3.73)mmol/L.随着劈离的进行,胆汁分泌量减少,劈离前(16.75±3.30)ml/h,劈离中(10.55±1.83)ml/h,劈离后(6.53±1.33)ml/h.灌注保存开始,丙氨酸转氨酶(alanine aminotransferase,ALT)、乳酸脱氢酶(lactic dehydrogenase,LDH)、碱性磷酸酶(alkaline phosphatase,ALP)处于较基础值的低水平,随着劈离进行,ALT、LDH水平逐渐增高,ALP始终维持在一个较低的水平.天冬氨酸转氨酶(aspartate transaminase,AST)在保存开始时的水平和基础值接近,随着劈离的进行,AST水平逐渐增高.与保存前比较,NMP保存劈离后肝组织细胞结构无明显改变.结论 自建NMP系统在供肝劈离过程中相对稳定,具有一定临床应用价值.

目的 总结无静脉转流条件下猪劈离式原位肝移植模型建立的经验.方法 选取40只巴马小型猪,随机分为供受体各20只,通过建立无静脉转流条件下猪劈离式原位肝移植模型,观察术中血流动力学及血气分析变化,探讨围手术期相关处理对模型建立的影响.结果 20只无静脉转流条件下猪劈离式原位肝移植受体中,18只巴马小型猪于术后1~2小时顺利脱机拔管并于当天麻醉清醒,术后第2天正常进食水,3只受体猪术后第3天因腹腔感染死亡,术后5天存活率为65%.与无肝期前相比,无肝期受体猪的平均动脉压、中心静脉压明显降低,心率明显增快〔平均动脉压(mmHg):58.5±8.2比105.3±10.0,中心静脉压(cmH2O):2.17±2.11比5.51±4.06,心率(次/分):151.3±16.0比121.9±8.8,均P<0.05〕.与无肝期相比,新肝期时pH值显著下降,K+浓度和乳酸浓度显著升高〔pH:7.307±0.083比7.514±0.071,K+浓度(mmol/L):5.86±0.71比3.36±0.28,乳酸浓度(mmol/L):6.53±1.54比3.39±1.03,均P<0.05〕结论 猪劈离式原位肝移植术中血流动力学和血气分析结果波动大,应通过无肝期快速补液、适量给予血管活性药物以维持血流动力学稳定,并尽量缩短无肝期时间,有助于劈离式肝移植手术的成功.

Objective To detect the protective effect of extracorporeal membrane oxygenation (ECMO) on Maastricht type Ⅱ donation after cardiac death (DCD) liver transplantation in pigs.Methods Twenty mini-pigs were randomized into ECMO group (n =10) and control group (n =10).Then 10 pigs in each group were randomized into donors and recipients.Maastricht type Ⅱ DCD model was induced in all of the 10 donors.Donors of ECMO group received 2-h ECMO after cardiac death,then underwent liver graft procurement.The donors of control group underwent liver procurement directly after cardiac death.Recipients of two groups underwent orthotopic liver transplantation without venovenous bypass.During this procedure,vital signs were monitored continuously,lactate and liver biochemistry were tested,and 5-day survival rate was observed.Results Maastricht type Ⅱ DCD model was successfully built in all of the donors with consequent dark liver.For donors of ECMO group,liver turned sanguinous and soft quickly after treatment of ECMO.There were no significant differences in operation time,anhepatic time and anhepatic hemodynamic changes between these two groups (P ＞ 0.05).As compared with control group,ECMO group had better hemodynamic parameters 30 min after reperfusion,lower lactate,ALT and AST levels 30 min after reperfusion and before closing the abdomen,and higher 5-day survival rate (P ＜ 0.05).Conclusion ECMO may improve the quality of Maastricht type Ⅱ DCD liver graft,and increase the survival rate of DCD liver transplantation.

OBJECTIVE:To determine the effective dose of hepatitis B immunoglobulin (HBIG) for clearing maternally-transmitted hepatitis B virus (HBV) from a newborn.METHODS:Full-term neonates born to HBV-infected mothers were tested for hepatitis B surface antigen (HBsAg) and HBV DNA in venous blood, Individuals with positive results within two hours after birth were selected for study, and divided among two treatment groups: research group receiving HBIG continually adjusted to quantitative levels of neonatal HBsAg and HBV DNA levels; control group receiving standard HBIG 200IU dose. All neonates were also treated with 10 micrograms of recombinant vaccine. The decreases in HBsAg and HBV DNA over 12 months were comparatively analyzed between the two treatment groups.RESULTS:The two treatment groups (HBIG adjusted vs. standard) were statistically similar in Apgar score (9.38+/-0.49 vs. 9.37+/-0.48), neonate body weight (3458.67+/-374.93 vs. 3558.61+/-322.85 g), maternal age (26.33+/-3.63 vs. 25.33+/-3.03), and initial HBsAg and HBV DNA levels (rank sum test Z = 1.381, and Z = 0.700, respectively) (all, P more than 0.05). Successful clearance of HBV infection within 12 months was achieved in significantly more neonates in the HBIG adjusted therapy group than in the standard therapy group (82.8% vs. 57.4%; x2 = 9.696, P less than 0.05).CONCLUSION:Adjusting the neonatal HBIG dose according to HBsAg and HBV DNA levels can improve the success rate of clearing maternally-transmitted HBV.

目的提高以头孢唑啉为主短程策略预防剖宫产手术部位感染的实施情况。方法制定有循证基础的以一代头孢菌素为主短程预防剖宫产手术部位感染抗菌药物预防性使用指南(以下简称《指南》)。2009年9月～2011年8月对某院妇产科全部剖宫产病例进行前瞻性手术部位感染监测,并每月对围手术期预防性抗生素使用情况进行反馈。自2010年3月～2010年8月进行干预。结果干预前、干预中、干预后预防剖宫产手术部位感染的抗菌药物使用对《指南》的依从率逐步提高,分别为20.80%,63.34%,90.91%,P<0.001;手术部位感染分别为0.73%(2/274),1.06%(3/284),0.00%(0/550),P<0.01;抗菌药物费用下降,分别为83.36(48.6,145.80),6.30(2.10,72.90),2.10(2.10,6.30)元,P<0.001。结论对短程应用以头孢唑啉为主预防剖宫产术后感染指南的依从性在干预下明显提高,安全经济。

Objective To observe the HBsAg neutralization capability of hepatitis B immune globulin(HBIG) in vitro test and in vivo among newborn infants.Methods A group of 63 infants born to HBsAg-positive mothers were successfully immunized with HBV vaccine and HBIG.Forty-three of the infants had serum HBsAg less than or equal to 40 ng/ml(group Ⅰ) and 17 of the cases had serum HBsAg greater than 40 ng/ml(group Ⅱ).The concentration of anti-HBs was evaluated on day 4-7 after the application of 200 IU HBIG.The HBsAg neutralization capability of HBIG in vivo was compared the capability in vitro.Results The average amount of anti-HBs was 226.4 IU in newborn infants on day 4-7 after the application and HBIG and HBV vaccine.One IU HBIG neutralized 42 ng HBsAg in vitro,while 1 IU neutralized only 2.04 ng and 1.87 ng HBsAg for the infants of Group Ⅰ and Group Ⅱ in vivo as evaluated,respectively.The HBsAg neutralization capability of HBIG was around 20 times higher in vitro than in vivo.Conclusions The HBsAg neutralization capability of HBIG was different in vitro test vs in vivo evaluation.HBsAg levels in blood and other tissues may difference.

Objective: To evaluate the effect of short-term prophylactic antibiotics (24 h) on prevention maternal/neonatal infectious morbidity of cesarean section in patients with pelvic inflammatory disease (PID). Methods: Two hundred and twenty-seven patients with PID were collected from patients with cesarean section. Patients were divided into 2 groups according to the short-term prophylaxis (24 hours, n=109) or long-term prophylaxis (48 hours, n=118). It was compared between the two groups including maternal trimester, body mass index, white blood cell count before surgery primipara,premature rupture of membranes,pregnancy-induced hypertension syndrome and surgical site infection(SSI),postoperative endometritis,puerperal morbidity,hemogram,frequency and cost of antibiotic defined daily dose(DDDs), neonatal score and infection. Results: There were no significant differences in the basic data, before operation, duration of surgery and blood loss during surgery between two groups (P 0.05). Also there were no significant differences in the incidence of SSI, endometritis, puerperal morbidity and hemogram between two groups (P 0.05). It was found that the DDDs of short-term antibiotic prophylaxis strategy was 1/7 DDDs of long-term one (P 0.01), but no significant difference was found in the neonatal score and infection between two groups (P 0.05). Conclusion: The effect of short-term (24 hours) prophylaxis by cefazolin or combined with metronidazole was equivalent to the long-term strategies ( 48 h) in pelvic inflammatory diseases, with a decreased antibiotic usage and cost.

OBJECTIVE To evaluate the clinical effect on prophylactic antibiotics in cesarean delivery.METHODS The intervention including evidence-based guideline of prophylactic use of antimicrobial for cesarean section single-dose of the first generation cephalosporins at cord clamping was performed to increase in post-discharge surveillance as a strategy to reassure surgeons of the safety of the reduction.A retrospective investigation of antimicrobial consumption,endometritis,surgical site infections(SSIs)and postoperative incidence between the pre and post operation were performed randomly to comparison of the intervention.RESULTS The SSIs rates before and after the intervention were 1.54%,and the incidence rates of post intervention were 3.08% and 2.31%,respectively.There was about 90% cost reduction in prophylactic antimicrobial use on average per cesarean section after the intervention(RMB 179.79±51.79 to RMB 14.96±15.19,P=0.00).CONCLUSION The intervention of the first generation of cephalosporins by single-dose use administrated after cord clamping is safe and more unexpensive compared with the previous stractegy of third generation of cephalosporin plus metronidazde long use.

ObjectiveTo evaluate the impact of prophylactic administration of antimicrobials in cesarean section on controlling surgical site infection (SSI) and postpartum endometritis. MethodsComprehensive Chinese randomized controlled trials retrieval about preventing postpartum infection related to cesarean section by antimicrobial prophylactic use was performed via searching electronic database,hand searching bibliographies of books and relevant journals. ResultsCompared with long-term antimicrobial prophylaxis started after operation,short-term antimicrobial prophylaxis started 0.5~2 hours before operation or started after clamping of umbilical cord showed lower SSI rate (OR=0.34,95%CI 0.24～0.48,P<0.05) and puerperal morbidity (OR=0.40,95%CI 0.32～0.48,P<0.05),and there was no significant difference in lowering postpartum endometritis incidence between selective cesarean-section (OR=0.45,95%CI 0.11～1.83,P>0.05) and selective/unselective cesarean-section (OR=0.55,95%CI 0.16～1.96,P>0.05). ConclusionShort-term antimicrobial prophylaxis started 0.5 to 2 hours before operation or after clamping of umbilical cord is a recommendable strategy for preventing SSI and puerperal morbidity.

目的 探讨HBV感染母亲所产婴儿HBV感染情况以及生后免疫效果.方法 以新生儿出生2 h内静脉血定量检测HBsAg作为新生儿HBV感染指标,治疗组新生儿在出生后0、1、4、6个月使用重组乙型肝炎疫苗(酵母)各一次,每次10 μg,乙型肝炎免疫球蛋白用量根据新生儿出生后即刻检测结果而定,使新生儿体内的抗-HBs水平达到500～600 U/L,6个月龄评价疗效;与以未针对性免疫的6个月龄婴儿作为对照组进行比较.结果 治疗组共纳入1 460例婴儿,189例出生后感染,6个月龄时15例HBV阳性,占1.0%;对照组共纳入653例,6个月龄时64例HBV阳性,占9.8%(P＜0.01).结论 生后免疫在阻断HBV母婴传播方面有一定意义.

目的 探讨孕妇不同传染性与分娩方式对HBV母婴垂直传播的影响.方法 将409例HBsAg阳性孕妇分为HBeAg阳性组与HBeAg阴性组,同时按照分娩方式分为剖宫产组与阴道分娩组,新生儿出生1小时内检测股静脉血,HBsAg阳性和(或)HBVDNA阳性为宫内感染.结果 HBeAg阳性与HBeAg阴性两组感染率分别为17.5%和7.2%,两组比较有极其显著的差异(P＜0.01).其中HBeAg阴性组阴道分娩与剖宫产分娩的感染率分别为14.7%和2.7%,差异具有统计学意义(P＜0.05).结论 HBeAg阳性母亲其新生儿HBV感染率显著高于HBeAg阴性母亲,HBeAg阴性组剖宫产分娩新生儿感染率低于阴道分娩.

Objective: In order to cut off validly HBV from mother to new born, it is divided into different types according to the embryo acquired HBV-markers and HBV DNA degrees. Methods: HBV-markers and HBV DNA were tested for 831 new born within 2 hours from 825 HBsAg positive mothers and divided into 5 types in order to run several immunity methods of HBIG(hepatitis B immunity globulin ) and hepatitis B vaccine. Six hundred and sixty five new born as a treatment group and control group of 166 were retested in 7～8 month old. Results: The immunity effect were significant different between the treatment and control groups(P 0.05). Conclusion: The effect of running immunity according different types is better than the traditional immunity. It is an important step to prevent HBV from morthers to their infants effectively.

Objective:To explore the spread pathway, relative factors, and treatment of HBV intrauterine infection of HBV during pregnancy.Methods:Serous HBV -markers and HBV-DNA were detected in 498 newborns whose mothers' HBsAg were positive. According to the results of HBV-DNA and the use of HBIG, the pregnant women were divided into 4 groups.Results:The intrauterine infection of HBV was 39.6%in 283 pregnant women with HBV-DNA positive, and 13.5%in 215 pregnant women with HBV-DNA negative. There was a significant difference between two groups. There was no correlation in the use of HBIG. Conclusion: The intrauterine infection is relative to HBV-DNA positive.There is no effect with the use of HBIG to prevent HBV infection during pregnancy.

1病例报告 患者男,47岁,主因间断皮疹、尿黄伴乏力8年,加重10 d于2000年7月23日入院.8年前出现全身瘙痒,皮肤、巩膜黄染,厌食,乏力,大便颜色无变浅,因谷丙转氨酶(ALT)189 U/L,胆红质(BIL)234μmol/L以病毒性肝炎收住院.