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For patients with Systemic Sclerosis (SSc), cardiac involvement (CI) is directly caused by myocardial fibrosisor ischemia or is secondary to pulmonary arterial hypertension1 Here we present a similar case of a femalepatient aged 45 yr old female who presented with complaint of recurrent syncopal attacks, and difficulty inswallowing food and liquids. She had typical CREST Syndrome manifestations with complete heart block(CHB). For which pacemaker implantation was done.
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Although oxymatrine (OMT) has been shown to directly inhibit the replication of hepatitis B virus (HBV), limited research has been done with this drug. In the present study, the antiviral effect of OMT was investigated in an immunocompetent mouse model of chronic HBV infection. The infection was achieved by tail vein injection of a large volume of DNA solution. OMT (2.2, 6.7 and 20 mg/kg) was administered by daily intraperitoneal injection for 6 weeks. The efficacy of OMT was evaluated by the levels of HBV DNA, hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg) and hepatitis B core antigen (HBcAg). The immunoregulatory activity of OMT was evaluated by serum ELISA and flow cytometry. Results shows that OMT at 20 mg/kg inhibited HBV replication, and it was more efficient than entecavir (ETV) in the elimination of serum HBsAg and intrahepatic HBcAg. In addition, OMT accelerated the production of interferon-(IFN-) in a dose-dependent manner in CD4T cells. Our findings demonstrate the beneficial effects of OMT on the enhancement of immunological function and in the control of HBV antigens. The findings suggest this drug to be a good antiviral therapeutic candidate for the treatment of HBV infection.
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Objective]The article summarizes the clinical experience of CHB by professor Wang Bangcai, the famous Zhejiang TCM physician. [Methods] From following professor Wang Bangcai clinical studies, summarize the experience and thoughts of treating CHB, and for two cases. [Results] Professor Wang Bangcai thinks the cause of CHB is the incubated epidemic pathogenic factor inside the body and the invasion of exogenous pathogenic factors. Its main pathogenesis is the insufficiency of healthy qi and the excess of exogenous pathogens. Insufficiency of healthy qi is the essential factor, while the accumulation of incubated epidemic pathogen and the disorder of liver and spleen is the subordinate factor. The course of the disease is generally long, the fight between healthy qi and pathogenic factors is always prolonged, and the insufficiency of healthy qi and the excess of exogenous pathogens usually both exist. Professor Wang emphasizes that strengthening healthy qi, eliminating pathogenic factors and regulating liver and spleen to comply with their nature characters are very important in order to defeat the incubated epidemic pathogen, as well as eliminating toxin inside the body and dispersing stagnant pathogens. The following two cases both have remarkable curative results. [Conclusion]Professor Wang Bangcai has original views on CHB about the etiology,pathogenesis and syndrome differentiation,which is worthy of in-depth study and understanding.
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Objective] To observe the diagnosis value of noninvasive diagnosis model S index used to evaluate the fibrosis degree of slight chronic hepatitis B(CHB). [Method] Trace back and investigate the routine serological indicators GGT, PLT, ALB and liver aspiration biopsy results of 63 cases of CHB;use noninvasive diagnosis formula to calculate:S index=1000×GGT/(PLT×ALB2),use ROC curve to analyze and evaluate the clinical diagnosis value of S index. [Result] S index is in positive relation with liver fibrosis degree. S index can forecast the fibrosis having or not with best truncation point 0.04h, the sensitivity 87.0%, specificity 47.5%and area under the curve(AUC) 0.690,close to 0. 7; in forecasting obvious fibrosis, with best truncation point 0.04h, sensitivity 100%,specificity 36.8%,AUC 0.664. [Conclusion] S index used for forecasting slight CHB having or not fibrosis has high value of diagnosis, but it has low correctness for diagnosing having or not obvious liver fibrosis.
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BACKGROUND: The incidence of Bacillus cereus bacteremia is increasing, but the identification of Bacillus species remains difficult. Brilliance Bacillus cereus agar (BBC agar; Oxoid, UK) is a new CHROMagar medium that allows selective isolation and identification of B. cereus; however, its clinical usefulness is seldom studied. We evaluated the usefulness of BBC agar to identify B. cereus isolates recovered from blood cultures. METHODS: We analyzed a total of 53 blood isolates that showed a Bacillus-like morphology on Gram staining. All isolates were identified by using both the API Coryne (bioMerieux, France) and API 50CH/B (bioMerieux) systems. They were subsequently subcultured on BBC agar, incubated for 24 hr, and then examined for characteristic blue-green colonies. The clinical characteristics of patients whose isolates were identified as B. cereus were assessed. RESULTS: Of the 53 isolates, 18 were identified as B. cereus by API 50CH/B. With the API 50CH/B system used as gold standard, the sensitivity and specificity for the identification of B. cereus were 100% (18/18) and 100% (35/35), respectively, using BBC agar, and 67% (12/18) and 100% (35/35), respectively, using the API Coryne system. Of the 18 patients with B. cereus bacteremia, 15 showed infectious signs, and 3 had more than 2 blood cultures positive for B. cereus on separate days. CONCLUSIONS: Our study shows, for the first time, that BBC agar, with its good agreement and ease of use, is a valuable alternative to the API 50CH/B system for the presumptive identification of B. cereus isolates from blood cultures.
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Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Agar/chemistry , Bacillus cereus/isolation & purification , Bacteremia/diagnosis , Chromogenic Compounds/chemistry , Culture Media , Gram-Positive Bacterial Infections/diagnosis , Reagent Kits, Diagnostic , Sensitivity and SpecificityABSTRACT
Objective To explore the effect of Compound Glycyrrhizin Combination with Matrine on treatment for Chronic Hepatitis B(CH-B).Methods Sixth-eight patients were devided,into treatment group 38 case and control group 30 case.Compound Glycyrrhizin Combination with Matrine were used daily in treatment group,and Matrine alone used daily in control group for eight weeks.The levels of ALT﹑AST﹑TBil and serum conversation of HBeAg and HBV-DNA were evaluated after treatment.Results The change of ALT﹑AST levels were not significantly in two groups.The level of TBil was more decread in treatment group than control group,there was a significantly difference (P
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Objective To investigate the efficacy of thymosin alpha-1(T?_1,Zadaxin)monotherapy for chronic HBV infection by a meta-analysis of the published data. Methods Randomized controlled trials on thymosin alpha-1 monotherapy in chronic HBV infection were searched from electronic databases such as MEDLINE、PUBMED and Blackwell. Results Meta-analysis of 7 randomized controlled studies investigating the safety and efficacy of thymosin alpha-1 monotherapy for the treatment of chronic hepatitis B showed that 6 months treatment with thymosin alpha-1(1.6 mg twice weekly)almost tripled the sustained response rate(38%)compared with controls(13%).Conclusion These results suggest that a 6-month course of thymosin alpha-1 therapy is effective and safe in patients with chronic hepatitis B;thymosin alpha-1 can effectively reduce HBV replication in CHB with patients. Compared with IFN-?,thymosin alpha-1 which has less side effects is better tolerated and seems to induce a gradual and more sustained normalization of ALT and loss of HBV DNA.
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Objective:To characterize the CD4+CD45RA+,CD4+CD45RO+,CD8+CD45RA+ and CD8+CD45RO+T lymphocyte subsets in the peripheral blood of the patients with chronic hepatitis B and to explore their relations with the disease state.Methods:The peripheral blood was collected from 104 patients with chronic hepatitis B and 30 healthy individuals,then CD4+CD45RA+,CD4+CD45RO+,CD8+CD45RA+ and CD8+CD45RO+T lymphocyte subsets were detected by flow cytometry with three-color fluorescence technology.Results:To compare with the control,the percent of CD8+CD45RA+T lymphocyte in patients with mild and severe grad CHB decreased markedly,the percent of CD8+CD45RO+T lymphocyte increased markedly,CD4+,CD8+,CD4+CD45RA+ and CD4+CD45RO+T lymphocyte did not change obviously. Compared with the mild grade CHB,the percent of CD8+CD45RA+T lymphocyte in patients with severe grade CHB decreased obviously(P