Objective To evaluate the effectiveness and safety of Lipo-prostaglandin E1 injection in treating viral hepatitis.Methods We searched MEDLINE, EMBASE, The Cochrane Library and CNKI from 1978 to June 2007. We identified randomized control led trials of Kai Shi injection versus other medicines or blank controlin treating viral hepatitis. The quality of included trials was evaluated independently by two reviewers. Meta-analyses were performed with The Cochrane Collaboration’s RevMan 4.2.7 software. Results Fourteen studies involving 1 218 patients were included, one of these compared lipo-prostaglandin E1 injection versus Mai Anding injection, one compared lipo-prostaglandin E1 injection versus potassium-magnesium aspartate injection, and the other 12 compared Lipo-prostaglandin E1 injection versus blank control. Allincluded studies were assessed in terms of randomization, allocation concealment and blinding; and all were graded C(poor quality). Meta-analyses showed that, the total effective rate was significantly higher in the lipo-prostaglandin E1 injection group[RR 1.45, 95%CI (1.29, 1.63)] and the mortality was lower[RR 0.66, 95%CI (0.53, 0.83)] compared with the blank control group, but the incidence of phlebitis was significantlyhigher [RR 7.70, 95%CI (2.57, 23.07)]. There was no significant di f ference between Mai Anding inject ion and lipo-prostaglandin E1 injection in the total effective rate, but Lipo-prostaglandin E1 injection was more effective in improving patients’ liver functions. Compared with potassium-magnesium aspartate injection, the total effective rate was significantly higher in the lipo-prostaglandin E1 injection group[RR1.54, 95%CI (1.14, 2.08)].Conclusion The evidence currently available shows that the effectiveness and safety of lipo-prostaglandin E1 injection are not significantly different from those of Mai Anding injection for patients with viral hepatitis. Compared with potassium-magnesium aspartate injection, Lipo-prostaglandin E1 injection could significantly improve the total effective rate, but since we only include 1 relevant randomized trials, the strength of this evidence is weak. When compared with the blank control, Lipo-prostaglandin E1 injection significantly improved the total effective rate, decreased mortality but increased the incidence of side effects and the existing evidence is insufficiant to show whether Lipo-prostaglandin E1 injection improves patients’ liver functions.
Backgroud Chronic hepatitis is the major infectious disease of liver. There is no effective drug for it up to now. Clinical trials have showed that glycyrrhizin have potentional effective for chronic hepatitis. Objective To evaluate the effectiveness, safety and economics of glycyrrhizin for chronic hepatitis B and C. Search strategy The search terms include glycyrrhizin and its products’ name, chronic hepatitis and chronic carrier status. The thais registers of the Cochrane Hepato-Biliary Group, the Cochrane Complementary Medicine Field, and the central database of The Cochrane Library as well as MEDLINE, EMBASE and Chinese Biomedical CD Database were searched from their date of inception onward. And the free Internet search was operated to find ongoing and unpublished researches. Twenty Chinese medical journals and relevant academic conference proceedings have been searched by manual method. The reference lists of identified documents were checked as the complementary search. Inclusion criteria All randomized trials that tested glycryyhizin for chronic hepatitis B virus or hepatitis C virus infection were included in this review. Method of the review According to the principle of Cochrane systematic review, selection of thai for inclusion, assessment of methodological quality, data extraction and data syntheses were conducted by two reviewers.
【Abstract】ObjectiveTo investigate the relationship of magnetic resonance diffusion-weighted imaging (DWI) to histology in the patients of chronic viral hepatitis. MethodsThirty-five patients of chronic viral hepatitis who received liver biopsy and 10 healthy volunteers were included in this study. All of them underwent DWI on a 3.0T MRI device. Apparent diffusion coefficient (ADC) of the liver were measured respectively when b value were set as 100, 400, 600 and 800 s/mm2. Biopsy specimens were scored for fibrosis and necroinflammation according to the Knodell histology activity index (HAI). ResultsWhen b value was set as 800 s/mm2, statistical difference was showed between the fibrosis group and the nonfibrosis group, statistical difference was also shown among the different degrees of necroinflammation and fibrosis. ConclusionDWI is a valuable method for grading and staging of chronic viral hepatitis.
Objective To evaluate the effectivenss of Chinese herbal retention enema in viral hepatitis patients. Methods Such databases as The Cochrane library, PubMed, EMbase, VIP, CNKI, CBM and WanFang Data were searched from the inception to December, 2011 to collect the randomized controlled trials (RCTs) about Chinese herbal retention enema in treating viral hepatitis, and the references of the included literature were also retrieved. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and evaluated and cross-checked the methodological quality. Then meta-analysis was conducted using RevMan 5.0 software. Results A total of 20 RCTs involving 1 735 patients were included. The subgroup analyses based on the length of intervention time showed that: a) after 2-week intervention: the overall effective rate of the Chinese herbal retention enema group was higher than that of the control group, with a significant difference (OR=3.19, 95%CI 1.87 to 5.44, Plt;0.000 1). Compared with the control group, the Chinese herbal retention enema group better promoted the recovery of liver function by more reduction of AST (MD= ?82.50, 95%CI ?145.66 to ?19.34, P=0.01), ALT (MD= ?44.78, 95%CI 65.90 to ?23.66, Plt;0.000 1) and TBIL (MD= ?37.51, 95%CI ?74.07 to ?0.95, Plt;0.0001). b) After 1-month intervention: The overall effective rate of the Chinese herbal retention enema group was higher than that of the control group, with a significant difference (OR=4.17, 95%CI 2.37 to 7.32, Plt;0.000 01). Compared with the control group, the Chinese herbal retention enema group better promoted the recovery of liver function by more reduction of AST (MD= ?17.86, 95%CI ?29.97 to ?5.76, P=0.004), ALT (MD= ?27.84, 95%CI ?42.45 to ?13.24, P=0.000 2), and TBIL (MD= ?54.15, 95%CI ?116.52 to ?8.23, P=0.09). Conclusion Chinese herbal retention enema can improve the overall effective rate for viral hepatitis patients, alleviate virus damage to liver cell and promote liver function recovery. The commonly used Chinese medicinals for enema are Radix et Rhizoma Rhei, Herba Artemisiae Capillaris, Salvia miltiorrhiza, and Radix Paeoniae Rubra.
Objective To assess the efficacy of telbivudine in the treatment of chronic hepatitis B (CHB). Methods Randomized controlled trials (RCTs) of telbivudine therapy vs. lamivudine therapy in both Chinese and English were retrieved from seven electronic databases with a cut-off date in February 2010, including PubMed, EMbase, VIP, CBM, CNKI, and The Cochrane library. The meta-analyses and evaluation on methodology quality were performed for the included studies. Results Two RCTs as Grade-A study were included. The meta-analyses showed that telbivudine was superior to lamivudine in aspects of therapeutic response (RR=1.28, 95%CI 1.10 to 1.48, P=0.001), ALT normalization (RR=1.12, 95%CI 1.01 to 1.23, P=0.02), and PCR-negative HBV DNA or below the lower limit (RR=1.44, 95%CI 1.36 to 1.53, Plt;0.000 01), primary treatment failure (OR=0.28, 95%CI 0.18, to 0.43, Plt;0.000 01), viral breakthrough (OR=0.38, 95%CI 0.32 to 0.47, Plt;0.000 01) and viral resistance (OR=0.44, 95%CI 0.36 to 0.55, Plt;0.000 01). Conclusion Based on the current clinical evidence, telbivudine demonstrates superiority in comparison with lamivudine on all direct measures of antiviral efficacy for CHB. Because of the short follow-up duration and the small sample size of the included studies, it is expected to further discuss the long-term efficacy.
Objective To analyze the incidence and mortality of acute viral hepatitis in China, project its trends from 2022 to 2030, and provide valuable insights for the prevention and control of viral hepatitis. Methods The incidence and mortality rates of acute viral hepatitis in China from 1990 to 2021 were extracted from the Global Burden of Disease 2021 database. The change rates and the estimated annual percentage change (EAPC) for each indicator were calculated. Additionally, an autoregressive integrated moving average (ARIMA) model was used to project the incidence and mortality of acute viral hepatitis in China from 2022 to 2030. Results From 1990 to 2021, the incidence rates of acute hepatitis A (AHA), acute hepatitis B (AHB), acute hepatitis C (AHC), and acute hepatitis E (AHE) in China all showed a declining trend (EAPC=?1.980%, ?2.664%, ?2.078%, ?1.686%; P<0.05), with a particularly marked decrease in mortality (EAPC=?11.662%, ?7.411%, ?12.541%, ?7.504%; P<0.05). According to ARIMA model projections, the incidence rates of AHA and AHB were expected to continue declining from 2022 to 2030, while the incidence rates of AHC and AHE were expected to rise. In 2030, the projected incidence rates of AHA, AHB, AHC, and AHE were 890.425/100000, 824.158/100000, 59.202/100000, and 300.377/100000, respectively. The mortality rates of AHA, AHC, and AHE were projected to remain stable from 2022 to 2030, while the mortality rate of AHB was expected to decline. In 2030, the projected mortality rates of AHA, AHB, AHC, and AHE were 0.002/100000, 0/100000, 0.004/100000, and 0.011/100000, respectively. Conclusions From 1990 to 2021, the overall incidence and mortality of acute viral hepatitis in China showed a downward trend. However, the incidence rates of AHC and AHE may present an upward trend in the future, which suggests that the government and relevant health authorities should adjust their prevention and control strategies in a timely manner.
ObjectiveTo detect the expression of indoleamine2, 3-dioxygenase (IDO) and HBV preS mRNA in HepG2 cells and its inhibitory effect on the proliferation of human peripheral blood lymphocyte. MethodsThe AdIDOEGFPpreS was transfected to human hepatocarcinoma cell line HepG2 and the specific fragment of IDO mRNA and HBV preS mRNA in these HepG2 cells were detected by RT-PCR. Then the transfected HepG2 cells were cocultured with human peripheral blood lymphocyte and the inhibitory effect of IDO on the proliferation of human peripheral blood lymphocyte was observed. ResultsThe IDO and HBV preS mRNA were successfully transferred to HepG2 cells, so the specific fragment of IDO and HBV preS mRNA could be found in the transfected HepG2 cells but not in the control group HepG2 cells by RT-PCR. Furthermore, the relative expression intensity of IDO and HBV preS were 1.27 and 1.18, respectively. When co-cultured with human peripheral blood lymphocyte, the counts per minute in the transfected HepG2 cells 〔(7 471±1 375) beats/min〕 was significantly less than that in the control group 〔(13 821±1 997) beats/min〕, Plt;0.001. ConclusionThe target gene IDO and HBV preS can be transferred and expressed in HepG2 cells successfully, which can obviously suppress the proliferation of human peripheral blood lymphocyte.
ObjectivesTo systematically review the association between serum leptin level and hepatitis C virus.MethodPubMed, EMbase, Web of Science, CNKI, CBM, VIP and WanFang Data databases were electronically searched to collect case-control studies on the association between serum leptin level and hepatitis C virus from 2007 to July, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 11 studies including 1 115 patients were included. The results of meta-analysis showed the serum leptin level was higher in hepatitis C patients than in healthy people (SMD=0.68, 95%CI 0.44 to 0.91, P<0.000 01). The results of subgroup analysis showed that, in hepatitis C patients whose serum leptin levels detected by RIA and European population, serum leptin levels were higher. Women had higher serum leptin levels than men in hepatitis C virus patients (P<0.000 01).ConclusionThe serum leptin level is associated with hepatitis C virus and the serum leptin levels of women are higher than those in men. Due to limited quantity and quality of the included studies, more high quality studies are required to verify above conclusions.
Objective To analyze the clinical characteristics of individuals with high hepatitis B virus (HBV) pregenomic RNA (pgRNA), and further explore the value of pgRNA in the management of patients with chronic hepatitis B. Methods From December 1st, 2020 to April 1st, 2022, chronic hepatitis B patients who had been treated with nucleotide analogues for a long time and followed up in the Hepatitis Clinic of the Center of Infectious Diseases, West China Hospital, Sichuan University were included, and the clinical characteristics of chronic hepatitis B patients with high pgRNA were analyzed and summarized. Results A total of 107 patients were included. Male patients accounted for 66.4%, with an average age of 44.02 years. There were no statistically significant differences in gender, age, aspartate transaminase, alanine transaminase, γ-glutamyl transferase, HBV surface antigen, proportion of patients with HBV e antigen ≥0.1 U/mL, HBV DNA, and alpha fetoprotein between the high and low pgRNA groups (P>0.05). The proportion of patients with HBV surface antigen<100 U/mL in the high pgRNA group was lower than that in the low pgRNA group (4.4% vs. 22.6%, P<0.05). Conclusion The proportion of chronic hepatitis B patients with high pgRNA whose HBV surface antigen≥100 U/mL is higher.
ObjectiveTo investigate the psychological status of patients with chronic hepatitis B during the anti-virus treatment. MethodThe questionnaires of 150 outpatients with chronic hepatitis B treated between May 2013 and May 2014 were collected. And the date was properly processed. ResultsAll the patients were suffering from different degrees of worries, and the top 3 rates of worries were:the recurrence after stop using drugs (88.00%), the side effects of long-term medication (78.00%) and discrimination from people seeing the package of drugs (69.33%). ConclusionsPatients with chronic hepatitis B are in different degrees of psychological hazard during the treatment of anti-virus; further nursing work in psychological counseling and health education are needed to eliminate the hidden trouble, as to enhance the curative effect.