目的 评价以FibroScan为代表的瞬时弹性成像所检测的肝硬度联合脾硬度对慢性乙型肝炎患者肝纤维化病理分期诊断的价值.方法 回顾性分析2018年1月—2021年12月于联勤保障部队第九〇九医院收治的317例接受肝脏活检的慢性乙型肝炎患者临床资料.利用ROC曲线分析FibroScan所测量的肝脏硬度值(liver stiffness measurement,LSM)、脾脏硬度值(spleen stiffness measurement,SSM)与肝脏病理所诊断纤维化关系.采用logistic回归构建基于LSM和SSM的纤维化分级阶段模型.结果 纳入患者的肝脏病理S0-S1为79例(24.92％),S2为102例(32.18％),S3为87例(27.44％),S4为49例(15.46％).炎症情况G1为31(9.78％)例,G2为109例(34.38％),G3为128例(40.34％);G4为49例(15.46％).LSM对显著纤维化(≥S2)、严重纤维化(≥S3)和肝硬化(S4)的最佳诊断LSM值为7.4 kPa(AUC=0.861)、9.8 kPa(AUC=0.909)和16.6 kPa(AUC=0.915),SSM值依次为36.2 kPa(AUC=0.817)、42.4 kPa(AUC=0.913)和分别为49.1kPa(AUC=0.930).根据logistic回归构建基于LSM和SSM的预测肝脏病理诊断模型,并优化后得到R=LSM+SSM.所构建的诊断模型预测,较单独使用LSM或SSM与病理诊断一致性更高(P<0.001).对显著纤维化、严重纤维化和肝硬化预测诊断AUC依次为0.913、0.962和0.991.结论 基于瞬时弹性成像技术检测LSM联合SSM可提高对慢性乙型肝炎患者肝脏纤维化分级诊断效能.

目的:探讨谷氨酰胺联合恩替卡韦对病毒型肝硬化小鼠肝脏病变指标及免疫水平的影响.方法:将60只健康雄性BABL/cJ小鼠按照随机数字表法分为模型组、谷氨酰胺组,谷氨酰胺联合恩替卡韦组(联合组),对照组,每组15只.采用高压水注射方法将50 μL HBV质粒通过尾静脉注入模型组、谷氨酰胺组,联合组三组小鼠体内,然后腹腔注射50％CCL4(5 mL/kg)以构建肝硬化模型小鼠.对照组经尾静脉注射50μL生理盐水,然后腹腔注射生理盐水(5mL/kg).谷氨酰胺组接受谷氨酰胺(0.5 mL/10g)治疗,联合组接受恩替卡韦联合谷氨酰胺(0.5 mL/10 g)治疗,对照组、模型组接受生理盐水(0.5mL/10g)治疗,每天1次,治疗周期均为4周.比较四组小鼠的肝功能、病毒载量、肝纤维化指标、免疫功能.结果:成模后,模型组、谷氨酰胺组、联合组的病毒载量、ALT、AST、HA、PⅢP水平无统计学差异(P＞0.05);治疗4周后,谷氨酰胺组、联合组两组病毒载量、ALT、AST、HA、PIIIP水平显著下降,且联合组病毒载量、ALT、AST、HA、PIIIP水平低于谷氨酰胺组,差异具有统计学差异(P＜0.05);治疗4周后,谷氨酰胺组病毒载量、ALT、AST、HA、PⅢP水平低于模型组,差异具有统计学差异(P＜0.05);治疗4周后,谷氨酰胺组、联合组两组脾脏指数、CD4+、CD4+/CD8+百分率升高组脾脏指数、CD4+、CD4+/CD8+百分率高于谷氨酰胺组,差异具有统计学差异(P＜0.05).结论:谷氨酰胺联合恩替卡韦可改善病毒型肝硬化小鼠肝脏肝功能,减轻组织纤维化,并有助于增强其免疫功能.

目的 探讨聚乙二醇干扰素α2a联合替诺福韦对耐药性乙肝患者肝功能及乙肝病毒脱氧核糖核酸(HBV-DNA)转阴率的影响.方法 方便选取该院2015年3月—2017年8月收治的76例耐药性乙肝患者以随机数字表法分组,观察组与对照组各38例,对照组采用替诺福韦治疗,观察组采用聚乙二醇干扰素α2a联合替诺福韦治疗,对两组疗效、肝功能、HBV-DNA转阴率、不良反应发生率进行观察.结果 观察组与对照组治疗总有效率分别为89.47％、68.42％,两组差异有统计学意义(x2=5.067,P<0.05);观察组治疗后的各肝功能指标均优于对照组,差异有统计学意义(t=10.058、10.401、10.453,P<0.05),;观察组患者HBV-DNA转阴率为76.32％,明显较对照组52.63％高,差异有统计学意义(x2=4.653,P<0.05),两组不良反应发生率差异无统计学意义(x2=0.350,P>0.05).结论 聚乙二醇干扰素α2a联合替诺福韦治疗耐药性乙肝能改善患者肝功能,提高HBV-DNA转阴率,值得推广.

目的 研究分析内镜黏膜下剥离术与传统外科手术在消化道早癌或癌前病变患者中的应用效果及对患者生活质量的影响.方法 纳入解放军第175医院2015年7月至2017年9月收治的90例消化道早癌及癌前病变患者,应用随机数字表法分为对照组与研究组,对照组行传统外科手术治疗,研究组行ESD术式治疗.观察两组患者的治疗效果、安全性,并应用生活质量量表(SF-36)与视觉模拟评分(VAS)对患者生活质量及疼痛感进行评价.结果 研究组临床治疗效果显著优于对照组(P＜0.05).研究组住院时间、手术时间以及治疗费用均显著低于对照组(P均＜0.05).两组均有患者发生并发症,对照组并发症总发生率为26.7％,显著高于研究组的8.9％(P＜0.05).手术前,两组的SF-36评分差异不明显,手术后两组的SF-36评分都有所增加,但是研究组的评分明显高于对照组(P＜0.05).手术前,两组的VAS评分差异不明显,手术后,两组的VAS评分都有所降低,但是研究组的VAS评分明显低于对照组(P＜0.05).结论 ESD术式相比于传统外科手术更具安全性,治疗消化道早癌及癌前病变患者的疗效显著提高,有利于改善患者的预后提高生活质量,降低患者的疼痛.

目的 通过检测不同乙型肝炎病毒(HBV)载量受试者血脂水平的差异及其与HBV的关系及其意义.方法 选择2017年6月至2018年1月住院的100例HBV携带者及同期入院体检的100例健康人作为研究对象,对其健康状态进行复检,确定受试者无其他疾病影响的条件下,将受试者根据HBV载量分为三组:病毒载量≤500拷贝/ml(正常组,n=100),500拷贝/ml＜病毒载量＜1 ×105拷贝/ml(HBV携带组,n=37),病毒载量≥1×105拷贝/ml(乙肝患者组,n=63).检测血清血脂指标[甘油三脂(TG)、胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、载脂蛋白(Apo)A1]水平和血浆ApoB水平;对转染与未转染pHBV1.3质粒的两种HepG2细胞中AopBmRNA的表达进行测定;对转染与未转染ApoB的两种HepG3细胞中HBsAg、HBeAg含量及HBV-DNA含量进行测定.结果 HBV数量随着患者病情加重而增多,正常者体内不含HBV.血清学检测显示,随受试者体内病毒载量(正常组→HBV携带组→乙肝患者组)的递增,其血清TC、HDL、LDL、AopA1和血浆ApoB水平均呈递降(P均＜0.05);其中,LDL含量下降最为明显.进一步对作为HDL主要载脂蛋白的ApoB进行的RT-PCR检测显示,转染pHBV1.3质粒的HepG2细胞其ApoB mRNA表达水平低于未转染细胞.HBV指标检测显示,未转染ApoB的HepG3细胞其HBsAg、HBeAg和HBV-DNA含量均明显高于转染细胞(P均＜0.01).结论 HBV感染可减少患者血脂水平,并以LDL及其主要载脂蛋白ApoB的下降最明显,HBV感染可降低ApoB对HBV复制的抑制作用,促进HBV的复制.该作用是否通过微粒体TC转移蛋白(MTP)途径而产生,有待进一步研究.

· AIM: To compare the effect of pars plana vitrectomy ( PPV) combined with internal limiting membrane peeling ( ILMP) for macular hole retinal detachment ( MHRD) . · METHODS: Totally 78 patients with MHRD from December 2013 to December 2015 in our hospital were randomly divided into control group(39 patients 43 eyes) and experimental group ( 39 patients 40 eyes ) . The control group was treated with PPV, experimental group with PPV combined with ILMP. We observed the therapeutic effect and recorded the occurrence of postoperative complications. After 6mo follow-up, the vision improvement of the two groups were compared as the average of the best corrected visual acuity ( BCVA ) before and at 3, 6mo after surgery. · RESULTS: The reattachment rate of experimental group was 92%( 37/40 ) with significant difference compared with control group (x2=6. 882, P=0. 009). The improvement of visual acuity in the experimental group was better than that in the control group (x2=14. 216, P<0. 001). The postoperative BCVA of the experimental group at 3 and 6mo was significantly higher than that of the control group ( t =7. 119, P<0. 001; t=10. 573, P<0. 001). There were less patients with the situation of increased intraocular pressure and visual field defect (x2=11. 323, P=0. 001;x2=8. 573, P=0. 003). The lens opacity occurrence rate had not significantly changed (x2=1. 835, P=0. 176). · CONCLUSION: MHRD patients treated with PPV combined with ILMP recovered better and the incidence of complications was lower. It can improve the patient's retinal restoration effect more.

Objective To investigate PD-L1 expression from hepatic tissues in chronic hepatitis B (CHB)patients with antiviral treatment of pegylated interferon α-2a,and the relationship between PD-L1 expression and antiviral efficacy.Methods Fifty CHB patients treated with pegylated interferon α-2a for 48 weeks were enrolled.According to antiviral efficacy,patients were divided into 3 groups:complete virologic response,partial virologic response and non virologic response group.HBV-M,liver pathology,levels of ALT and HBV DNA were examined in all groups before and after treatment.Meanwhile,PD-L1 expression from liver was detected by immunohistochemistry and computer image quantitative analysis.Results After 48 weeks antiviral treatment of pegylated interferon-2a,remarkable improvements were observed in complete virologic response group when compared to baseline with ALT normalization,HBV DNA undetectable,HBeAg seroconversion,inflammation from liver alleviation and expression of PD-L1 from liver reduction (P <0.05).Some improvements were observed in partial virologic response group with ALT normalization,inflammation alleviation,expression of PD-L1 reduction (P <0.05),but level of HBV DNA was still detected and ,non HBeAg loss was observed.However,no significant changes were observed in non virologic response group.Conclusion Direct suppression of HBV replication and alleviation of inflammation from liver by pegylated interferon-2a in CHB patients may be achieved through decreasing PD-L1 expression.

Objective To explore the influencing factors of hepatic steatosis in patients with chronic hepatitis B (CHB),and to provide a theoretical basis of hepatic steatosis prevention and control.Methods A total of 291 hospitalized CHB patients in affiliated Southeast Hospital of Xiamen University were enrolled and divided into two groups:132 CHB patients with hepatic steatosis as the case group and 159 CHB patients without hepatic steatosis as the control group.Conducted a case control study and compared the two groups in terms of body mass index (BMI),waist-to-hip ratio (WHR),fasting blood glucose (FBG),triglyceride (TG),total cholesterol (TC),aspartate aminotransferase (AST),gamma-glutamyl transpeptidase (γ-GT),hepatitis B e antigen (HBeAg),hepatitis B virus DNA (HBV DNA) by descriptive analysis and inferential statistics to analyze the association of these factors with hepatic steatosis in CHB patients.The histological characteristics of the liver were observed.The date analysis used rank sum test and t test.Results FBG,TG,TC,γ-GT,AST of the case group and the control group were (5.11±0.62) mmol/L,(1.81±0.89) mmol/L,(5.29±1.05) mmol/L,(65.04±53.89) U/L,(65.60±71.52) U/L and (4.94±1.89) mmol/L,(1.21±0.79) mmol/L,(4.25±1.58) mmol/L,(146.48±200.39) U/L,(165.35±180.57) U/L,respectively.The case group had significantly higher FBG,TG and TC than the control group (Z=3.607,4.039 and 4.197,respectively,all P＜0.01),while the control group had significantly higher γ-GT and AST (Z=2.672 and 3.020,respectively,both P＜0.01).BMI of the two groups were (26.89±2.78) kg/m2 and (21.17±2.96) kg/m2,respectively,higher in the case group (t=9.711,P＜0.01).WHR in male patients of two groups were 0.93±0.05 and 0.87 ± 0.06,respectively,higher in male patients of the case group (t=4.469,P＜0.01).Positive rate of HBeAg,HBV DNA between the case group and the control group hadn't significantly difference (x2 =0.334,2.960; both P＞0.05).The case group had more severe degree of hepatic steatosis than the control group (Z=-16.145,P＜0.01),while the inflammatory activity and fibrosis were more advanced in the control group (Z=-12.639,P＜0.01; Z=-11.242,P＜0.01,respectively).Conclusions BMI,WHR,FBG,TG and TC appear to be the influencing factors of CHB with hepatic steatosis.The hepatic steatosis in CHB patients is mainly caused by the changes of anthropometric indexes and metabolic factors rather than the effect of HBV.If effective measures are taken,hepatic steatosis in CHB patients can be effectively prevented.

Objective To evaluate the treatment outcomes of entecavir reducing liver damage of pulmonary tuberculosis patients with hepatitis B after administration of anti-tuberculosis medications. Methods All pulmonary TB patients were randomly divided into three groups. The group received 0.5 mg entecavir before anti-TB treatment (group A). The group received 0.5 mg entecavir together with anti-TB treatment (group B). The group received simple anti-TB treatment (group C), the liver damage of patients in the three groups after treatment were observed. Results The group A had 3 cases who had liver damage, the incidence rate was 10.7% (3/28). The group B had 6 cases, the incidence rate was 18.2% (6/33). The group C had 18 cases, the incidence rate was 51.4% (18/35). The difference of the three groups was statistically significant (χ 2 = 15.215,P < 0.01). In Comparison between two groups, the incidence rate of liver damage of the first two groups (the group A and the group B) was significantly lower than that of the group C (χ 2 =11.604,P < 0.01;χ 2 = 8.221,P < 0.01), but the group A and the group B had no statistical difference (χ 2= 0.000,P > 0.05) in the incidence rate of liver damage. The patients of the group C had a high incidence rate of clinical symptoms and liver damage and needed a long time to recover liver function, even some patients can not complete the anti-TB treatment. Conclusions Entecavir therapy can improve TB treatment success among pulmonary tuberculosis patients with hepatitis B. Therefore we recommend that the pulmonary tuberculosis patients with hepatitis B use entecavir for prophylaxis before receiving anti-TB therapy.

Objective To study the prevalence and the epidemiologic features of hepatitis A and E in Fujian of a certain army. Methods According to the principle of stratiifed random cluster sampling method, 850 soldiers were investigated from 3 battalions of a certain army in Fujian. Anti-hepatitis A (HAV) and hepatitis E (HEV), including anti-IgG and IgM, were screened by enzyme-linked immunosorbent assay (ELISA). Results Anti-HAV lgM and anti-HEV lgM of all the 850 detected soldiers were negative, however the positive rate of anti-HAV lgG and anti-HEV lgG were 68.1%and 24.4%, respectively. Anti-HAV lgG positive rate of soldiers from village and cities were 53.3%and 84.1%, respectively;anti-HEV lgG positive rate of soldiers from village and cities were 19.2%and 32.8%, respectively. Conclusions There was no HAV or HEV infection in a certain army of Fujian, however, army has the epidemic conditions of HAV and HEV infection outbreak, so, in addition to strengthening the military food hygiene management, hepatitis A and E vaccines should be inoculated in susceptible populations,particularly in soldiers from villages.

Objective: This study aimed to explore clinical and virological characteristics of chronic hepatitis B (CHB) patients with hepatic steatosis in order to provide a theoretical basis for the prevention and control of hepatic steatosis.Methods: A total of 360 CHB inpatients were recruited from Affiliated Dongnan Hospital of Xiamen University and divided into hepatic steatosis group and non-hepatic steatosis group. The body mass index (BMI), waist-to-hip ratio (WHR), fasting blood glucose (FBG), triglyceride (TG), total cholesterol (TC), aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (GGT), hepatitis B e antigen (HBeAg), hepatitis B virus DNA (HBV DNA) and hepatic histological changes were detected and compared between the two groups. The association of these factors with hepatic steatosis was evaluated in CHB patients.Results: BMI, FPG, TG, TC, GGT, AST and HBV DNA showed statistically significant differences between two groups (P<0.01). The patients with hepatic steatosis had markedly higher BMI, FBG, TG and TC than those without steatosis did. No significant differences were found in ALT and HBeAg between two groups (P>0.05). In male patients, there was marked difference in the WHR between two groups (P < 0.01), which was not found in female patients (P > 0.05). The severity of hepatic steatosis increased in patients with hepatic steatosis, compared to those without steatosis (P < 0.01), but the severities of inflammation and fibrosis in the non-hepatic steatosis group were dramatically higher than those in the hepatic steatosis group (P < 0.01).Conclusions: BMI, WHR, FBG, TG and TC appeared to be influencing factors of CHB combined with hepatic steatosis. Hepatic steatosis in CHB patients was closely related to changes in anthropometric indices and metabolic factors but not HBV. It is necessary to improve these factors to effectively prevent hepatic steatosis in CHB patients.

OBJECTIVE:To explore risk factors of nonalcoholic fatty liver disease (NAFLD) in men in order to provide a theoretical basis for developing more effective NAFLD prevention and control strategies.METHODS:One-hundred-and-two male patients (37.3+/-11.4 years old) hospitalized with NAFLD at the Dongnan Affiliated Hospital of Xiamen University between January 2009 and December 2010 were enrolled in the study, along with 23 age-matched healthy men (34.4+/-16.7 years old) to serve as the control group. The correlation(s) of body mass index (BMI; overweight defined as more than or equal to 22.717 kg/m2), waist circumference (WC), waist-to-hip ratio (WHR; central obesity defined as more than or equal to 0.866), fasting plasma glucose (FPG), triglyceride (TG), and total cholesterol (TC) with NAFLD was analyzed by univariate and multivariate logistic regression analyses. Receiver operating characteristic (ROC) curves were used to select proper thresholds for classification.RESULTS:BMI, WC, WHR, FPG, TG, and TC were significantly different between the cases and controls (P less than 0.01). BMI, WC, WHR, TG and TC were identified as risk factors of NAFLD in these male cases (P less than 0.01). Relative to WC, TG and TC, both BMI and WHR had significant predictive value for NAFLD (odds ratio (OR) = 10.819 and 10.588, respectively). In addition, BMI had the highest diagnostic value for the prediction of NAFLD (area under the curve (AUC) = 0.931) followed by WHR (AUC = 0.879).CONCLUSION:BMI, WC, WHR, TG, and TC are risk factors of NAFLD in Chinese men. BMI and WHR are effective anthroposomatology indices of NAFLD and may be useful factors on which to base future prevention and early diagnosis strategies for NAFLD in males.

肝纤维化是肝脏在多种致病因素长期作用下,肝细胞外基质成分在肝组织中大量沉积,进而引起肝内结缔组织过度增生,最终演变至肝硬化;肝纤维化是肝硬化的早期阶段,组织学病理表现为肝细胞炎症坏死、局部网状支架塌陷,融合而形成胶原纤维.肝纤维化阶段病因明确及时治疗,往往可以逆转,一旦病情持续进展,往往演变成假小叶,最终发展至肝硬化.故临床对纤维化的早期诊断具有非常重要的意义.

患者,男性,37岁,因"乏力、纳差、尿黄、右胁部闷痛不适1月余"入院.查体:生命体征平稳,神清,表情轻度痛苦,无贫血貌,全身皮肤、巩膜无黄染,无皮疹、出血点及瘀斑,胸前皮肤有蜘蛛痣,未见肝掌.浅表淋巴结未触及.面色无晦暗,颈软,心肺无明显异常发现.腹部不平,右上腹轻度隆起,未见腹壁静脉曲张,腹肌软,右上腹压痛,无反跳痛,肝肋下2.3 cm,质较硬,表面较平,触痛,脾肋下未触及,墨菲氏征阴性,肝浊音界无缩小,肝区叩痛,腹部无移动性浊音,双下肢无水肿.实验室检查:乙型肝炎病毒标志物抗HBs阳性、抗HBe阳性、抗HBc阳性.

Objective To explore the correlation between body mass index (BMI),waist to hip ratio (WHR) and chronic hepatitis B (CHB) patients with nonalcoholic fatty liver diseases (NAFLD). Methods A total of 110 subjects with NAFLD and 143 CHB patients with NAFLD were enrolled in Dongnan Affiliated Hospital of Xiamen University,and 23 normal subjects were selected as control group. Differences of BMI,WHR,waist circumference (WC),fasting plasma glucose (FPG),total cholesterol (TCHO),triglyceride (TG),aspartate aminotransferase (AST),alanine aminotransferase (ALT),alkaline phosphatase (ALP),gamma-glutamyl transpeptidase (GGT) among three groups were analyzed by ANOVA and Bonferroni correction methods. Results Compared with the control group,the levels of BMI,WHR,WC,TG,AST,ALT,GGT were significantly higher in CHB patients with NAFLD and NAFLD patients (P< 0.05). WHR and WC of NAFLD patients were higher than that of CHB patients with NAFLD. There was no significant difference in other indexes. Conclusions The hepatic steatosis changes in CHB patients with NAFLD are mainly caused by the metabolic factors. WHR and WC may be helpful for early diagnosis in CHB patients with NAFLD.

Objective To explore the relationship between mannose-binding protein (MBP) codon 54 polymorphism and patients with liver cirrhosis and hepatocellular carcinoma. Methods Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and fluorescent quantitative PCR (FQ-PCR) were conducted on the MBP codon 54 polymorphism in 73 patients with compensated cirrhosis (CC), 78 with decompensated cirrhosis (DC), 35 with hepatocellular carcinoma (HCC) and 88 normal controls. Results The genotype frequency of GGC/GAC heterozygotes and GAC allele frequency were significantly higher in group CC and DC as compared with that of control group and HCC group (P < 0.05), while no difference was found between HCC group and normal subjects (P > 0.05). GAC allele frequency was also highest prevalence (36.5%) in DC group than that in CC group and HCC group (P < 0.05). Conclusions The MBP codon 54 polymorphism is associated with the progression of liver cirrhosis and might not play an important role in the development of hepatocellular carcinoma.

Objective To study the expression of RUNX3 mRNA in primary liver cancer (PHC) tissue and its surrounding normal tissue,and its clinical significance.Methods Reverse transcription polymerase chain reaction (RT-PCR) was performed to detect the expression of RUNX3 mRNA in tumor and peritumor tissues in 51 patients with PHC.The relationship between RUNX3 mRNA expression and some clinical pathological parameters was analyzed.Results The relative expression values of RUNX3 mRNA in the tumor tissue and the surrounding normal tissue were 0.4509±0.0963 and 0.9147± 0.0222,respectively.The difference was significant (t=33.6087,P＜0.001).The RUNX3 mRNA expression in tumor tissue correlated with some clinical pathological parameters including low tumor differentiation,positive cancer embolus and intrahepatic invasion and metastasis.The RUNX3 mRNA expression was not correlated with other clinicopathological parameters including gender,cancer diameter,cancer location,hemorrhage and necrosis of cancer,and histotype.Conclusion RUNX3 may be a new tumor suppressor gene for PHC.

OBJECTIVE:To determine the influences of Mannose binding protein (MBP) gene polymorphisms on HBV DNA loads and on the progression of liver disease in patients with chronic HBV infection.METHOD:The Codons on 54 MBP gene polymorphisms and HBV DNA loads in a cohort of 395 patients with chronic HBV infection, including 244 with chronic hepatitis B (CHB), 151 with liver cirrhosis (LC) and 88 normal controls were examined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and fluorescent quantitative PCR (FQ-PCR).RESULT:The MBP genotype frequencies of GGC/GAC and alleles genetic frequencies of GAC in CHB group showed no significant differences comparing to the normal control group (P > 0.05). The MBP genotype frequencies of GGC/GAC and alleles genetic frequencies of GAC on CHB group (severe), compensation phase of LC group and decompensation phase of LC group were higher than those in the normal control group (P < 0.05), the genetic polymorphism of decompensation of LC was 36.5%, highest of all. The MBP genotype frequencies of GGC/GAC and alleles genetic frequencies of GAC of patients with chronic HBV infection were not changed with the differences of HBV-DNA loads.CONCLUSION:The codes on 54 MBP gene polymorphisms is not closely related to HBV DNA loads, but was associated with the progression of hepatitis B infection.

Objective To investigate the status of hepatitis B infection and the effect of hepatitis B vaccine in recruits of a certain army. Methods Determined the unit's survey of 630 recruits by cluster sampling and conducted a unified epidemiological survey.Serum HBV marker(HBV-M) was tested by ELISA.To those who were all HBV-M negative,gave 20μg HBV vaccine according to 0,2 programs and tested the antibody level after 2 months. Results Among all survey,the number of recruits with HBsAg positive,anti-HBs positive and anti-HBs negative were 3(0.5%),390(61.9%) and 240(38.1%) respectively.The number of recruits with anti-HBe and/or anti-HBc positive was 28(4.4%).57 recruits tested their serum HBV-M among the 60 recruits who got the injection of HBV vaccine and 49(85.96%) engendered anti-HBs. Conclusion The present HBV infection rate among the recruits in this army is far lower than the average HBV infection rate among common population.Giving 20μg HBV vaccine according to 0,2 programs had good immune effect on the recruits who were HBV-M negative.

目的 研究慢性乙型肝炎(CHB)合并非酒精性脂肪性肝病(NAFLD)患者体质量指数(BMI)和血脂与其发病的关系.方法 选取经临床和病理确诊的CHB并NAFLD患者80例为病例组,另选取同期住院的47例CHB患者为对照组；测量身高、体质量,同时检测两组患者的总胆固醇(TC)、甘油三酯(TG),采用病例对照研究的方法,Logistic回归分析BMI、TC、TG与CHB并NAFLD的相关性.结果 两组患者的BMI、TC、TG水平的差异有统计学意义(P＜0.05) ;BMI、TC及TG均为CHB并NAFLD的危险因素(P＜0.05)；经Logistic回归分析,BMI、TG与CHB并NAFLD有相关性(P＜0.01).结论 TC对CHB并NAFLD的发病无明显影响,BMI和TG均为CHB并NAHD的独立影响因子;TG在预测CHB并NAFLD的发生上比BMI更具有优势.