Serum marker Golgi protein 73 (GP73) is a type Ⅱ integral membrane protein located in cellular Golgi apparatus. GP73 not only processes proteins, but also participates in cell differentiation, intercellular signaling, and apoptosis. With the development of proteomics technology, GP73 has been used as a novel serum marker for detecting liver diseases. This article reviews the research progress of GP73 in the clinical diagnosis value and prognosis prediction of chronic hepatitis B in recent years, in order to provide new ideas for the diagnosis and treatment of patients with chronic hepatitis B.
At present, the most commonly used nucleoside (acid) anaog (NAs) treatment regimen in clinical practice cannot completely cure chronic viral hepatitis B (CHB). However, although the polyethylene glycol interferon treatment regimen is superior to the NAs regimen in terms of immune mechanism, it has the disadvantage of low hepatitis B virus DNA response rate. In recent years, the cure of CHB is being studied all over the world. Various mechanisms and drug targets are being explored, and diversified therapeutic strategies are also being used. Clinical cure of hepatitis B is possible, but it is still in the early stage, and many potential drugs and better therapeutic strategies are still being tested. This article mainly reviews the latest progress in the treatment of CHB based on the recent research achievements in direct antiviral drugs and host immunotherapy as well as the research progress in combination therapy.
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.
目的 探討替比夫定治療乙肝e抗原（HBeAg）陽性慢性乙型肝炎（CHB）患者72周的療效及預測因素的分析。 方法 選擇2007年9月－2012年9月符合入選標準的82例CHB患者接受替比夫定治療72周，于治療前基線、治療后每3個月查丙氨酸氨基轉移酶（ALT）、乙肝病毒DNA（HBV DNA）、乙肝病毒血清標志物，觀察治療期間累計生化學應答率、完全病毒學應答率(CVR)、HBeAg血清學轉換率（SR）及耐藥率，分析基線ALT水平[分為＜5 ULN（正常值檢測下限）組及≥5 ULN組]、HBV DNA水平（分為＜107 copies/mL組及≥107 copies/mL組）、24周HBV DNA水平（＜3 log 10 copies/mL組及≥3 log 10 copies/mL組），預測72周CVR及SR。 結果 172周累計生化學應答率、CVR、SR、耐藥率分別為86.6%、81.7%、42.7%、18.2%；2基線ALT≥5 ULN對72周SR有預測價值（χ2=5.651，P=0.017），HBV DNA＜107 copies/mL對CVR有預測價值（χ2=7.083，P=0.008）；324周HBV DNA＜103 copies/mL對72周CVR及SR均有預測價值（χ2=27.339，5.131；P=0.000，0.023）。 結論 替比夫定初治HBeAg陽性CHB患者療效及安全性好，治療24周HBV DNA＜103 copies/mL是72周療效的最佳預測指標。
ObjectiveTo analyze the epidemiological and clinical characteristics of severe cases of coronavirus disease 2019 (COVID-19) in order to provide reference for clinical diagnosis and treatment.MethodThe epidemiological histories, clinical characteristics, laboratory examinations, chest images, and treatment outcomes of 20 confirmed cases of severe COVID-19 admitted to Public Health Clinical Center of Chengdu from January 16th to February 5th, 2020 were retrospectively analyzed.ResultsAmong the 20 patients with severe COVID-19, 12 were male and 8 were female. The age ranged from 34 to 84 years old, with an average of (57.4±16.5) years old. Thirteen patients (65.0%) had one or more co-existing diseases, such as hypertension (9 cases), diabetes (6 cases), and coronary atherosclerotic heart disease (4 cases). Eleven cases (55.0%) had a history of living or traveling in Wuhan, 4 cases (20.0%) had a history of living in non-Wuhan areas of Hubei Province, 3 cases (15.0%) had a history of contact with confirmed COVID-19 patients, while 2 cases had no above-mentioned epidemiological history, but had a history of traveling in non-epidemic areas. The main symptoms were fever (100.0%), cough (100.0%), shortness of breath (75.0%), and fatigue (65.0). Some patients developed into acute respiratory distress syndrome in 3-10 d after onset. The white blood cell count of the patients was normal or decreased, the hypersensitive C-reactive protein and serum amyloid protein significantly increased, while the CD4+ T lymphocyte count and CD56+ natural killer cell count significantly decreased. Sixteen patients (80.0%) were given transnasal hyperbaric oxygenation [among whom 6 patients (30.0%) were transferred to non-invasive ventilator after no improvement], 3 patients (15.0%) were given tracheal intubated ventilator, and 1 patient (5.0%) was treated by tracheal intubated ventilator combined with extracorporeal membrane oxygenation to support breathing. By April 8th, 2020, 3 patients died and the remaining 17 had been cured and discharged, with an average length of hospital stay of 21.4 d. The 3 death cases were all elderly with underlying diseases such as heart disease and pulmonary disease.ConclusionsSevere COVID-19 is associated with hypertension, diabetes, heart disease, and other basic diseases, and some patients develope acute respiratory distress syndrome. Respiratory support may help to improve prognosis.