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Resumen Introducción: La Enfermedad de Chagas también conocida como Tripanosomiasis americana es un problema de salud pública. Se calcula que en el mundo hay entre 6 y 7 millones de personas infectadas por Trypanosoma cruzi, la mayoría de ellas en América Latina. Objetivo: Identificar la prevalencia de infección por Trypanosoma cruzi en donantes de un banco de sangre del departamento de Boyacá 2016-2018. Materiales y métodos: Estudio descriptivo retrospectivo realizado en 25.920 donantes de sangre del departamento de Boyacá. La fuente de información fue secundaria. Se determinó la prevalencia de la infección por Trypanosoma cruzi y se compararon según sexo, grupo etario y tipo de donante a través de análisis de frecuencias. Resultados: Se evaluaron 9187 donantes durante el año 2016; 8517 en el 2017 y 8216 en el 2018, de los cuales 56,1% eran de sexo femenino y 43,9% masculino. La prevalencia de la infección por Trypanosoma cruzi fue 0,17 % en la tamización y 0,08 % con las pruebas confirmatorias de las cuales el 70,0% eran mujeres, el 85,0% donantes voluntarios por primera vez, el rango de edad en el que se presentó mayor prevalencia de este marcador serológico fue de 41 a 50 y de 51 a 65 años con un 35,0% cada uno . La prevalencia de la infección de Chagas presentó asociación estadísticamente significativa con la edad (p < 0,05). Conclusiones: Los bancos de sangre resultan ser una de las fuentes de información disponibles para monitorear el comportamiento de la enfermedad de Chagas y evaluar la toma de decisiones en salud pública, teniendo en cuenta que la enfermedad se caracteriza de manera asintomática y sin compromiso clínico en la mayoría de los casos.
Abstract Introduction: Chagas Disease, also known as American Trypanosomiasis, is a public health problem. It is estimated that in the world there are between 6 and 7 million people infected with Trypanosoma cruzi, most of them in Latin America. Objectives: To identify the prevalence of Trypanosoma cruzi infection in donors from a blood bank in the department of Boyacá 2016-2018. Materials and methods: Retrospective-descriptive study carried out in 25,920 blood donors from the department of Boyacá (Colombia). The source of information was secondary. The prevalence of Trypanosoma cruzi infection was determined and compared according to sex, age group and type of donor through frequency analysis. Results: 9187 donors were evaluated during 2016; 8,517 in 2017 and 8,216 in 2018, of which 56.1% were female and 43.9% male. The prevalence of Trypanosoma cruzi infection was 0.17% in screening and 0.08% with confirmatory tests of which 70.0% were women, 85.0% first-time volunteer donors, the range of The age at which the highest prevalence of this serological marker was found was 41 to 50 and 51 to 65 years with 35.0% each. The prevalence of Chagas infection showed a statistically significant association with age (p <0.05). Conclusions: Blood banks turn out to be one of the sources of information available to monitor the behavior of Chagas disease and evaluate decision-making in public health, taking into account the characteristics of the disease in which the majority of cases they are asymptomatic and without clinical compromise.
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Humans , Male , Female , Adult , Middle Aged , Trypanosoma cruzi , Blood Banks , Blood Donors , Chagas Disease , Tissue Donors , Volunteers , Blood , Mass Screening , Prevalence , InfectionsABSTRACT
Neck injuries caused by traffic accidents increase by years, timely and effective treatment can greatly reduce the mortality rate. This paper summarized the characteristics, image features, evoked potential detection and serum markers detection of neck injury caused by traffic accidents. Then, the condition of injuries was comprehensively considered and analyzed, and the priorities were correctly judged. The injuries were classified and treated. It is conducive for the attending doctors to carry out precise individualized first aid and surgical treatment for the patients, in order to save lives to the maximum extent, reduce disabilities, and prevent and treat post traumatic stress disorders.
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Objective Currently, there is a lack of clinical precise methods in the early diagnosis of gastric cancer. The article aimed to investigate the effect of serum amyloid A1 (SAA1) on the biological behavior of gastric cancer cells and its role in the early diagnosis of gastric cancer. Methods We collected 82 specimens of gastric cancer patients and 30 specimens of healthy controls. Cultured human gastric cancer SGC-7901 cells were randomly divided into SAA1-siRNA group, NC-siRNA group and blank control group. SAA1-siRNA, NC-siRNA and transfection reagent were transfected into the SGC-7901, and the expression of SAA1 protein in each group was detected by western blot 48 h later. Cell viability in each group was detected by CCK8 and cell invasion ability was measured by Transwell chamber. The ROC curve was used to analyze the efficacy of SAA1 in the diagnosis of gastric cancer. The expression of SAA1 was detected by ELISA, and the correlation between SAA1 and clinicopathological factors was analyzed. Results The SAA1 protein expression in SAA1-siRNA group [(1.12±0.12)μg] was significantly lower than those in NC-siRNA group[(1.97±0.13)μg] and blank control group[(2.09±0.28)μg] (P<0.05). The cell viability of CCK8 assay showed that the cell viability of SAA1-siRNA group(52.44±12.30) was significantly lower than those of NC-siRNA group(77.16±7.70) and blank control group (97.78±11.80). Transwell test results showed that the migration ability of SAA1-siRNA group(22.21±6.53) was significantly lower than those of NC-siRNA group(52.02±4.29) and blank control group(54.10±5.40)(P<0.05). The expression of SAA1 in patients with gastric cancer was (50.03 ± 20.89μg / mL) significantly higher than those of healthy controls (24.06 ± 10.72μg / mL), and the difference was statistically significant (P <0.05). ROC curve analysis showed that the AUC of SAA1 diagnosis of gastric cancer was 0.791 (95% CI: 0.701~0.880), the detection threshold was 31.97μg, and the diagnostic sensitivity and specificity were 0.659 and 0.833, respectively. There was no significant correlation between the expression of SAA1 and gender, age and tumor metastasis of gastric cancer (P> 0.05), while it was correlated with tumor maximum diameter and invasion degree, and increased with tumor invasion degree (P< 0.05). Conclusion The expression of SAA1 in gastric cancer patients increases significantly, which can be used as a new potential marker for the diagnosis of gastric cancer.
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Chronic hepatitis B is caused by infection with hepatitis B virus (HBV), which can lead to the development of cirrhosis and primary hepatocellular carcinoma. Viral persistence and clinical outcomes after HBV infection depend on viral factors and host factors. With the rapid development of the invasion mechanism of HBV infection, host?related genes and proteins involved in HBV infection have been found and used as new diagnostic markers both in the treatment evaluation and prognosis of HBV infection. This review mainly introduces the clinical application and related progress of laboratory serum markers in chronic HBV infection based on host factors for optimizing clinical diagnosis.
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OBJECTIVE@#To evaluate the early cardiac injury caused by obstructive sleep apnea (OSA) before the development of cardiovascular symptoms of OSA.@*METHODS@#Ninety-two patients without any known cardiovascular disorders who underwent polysomnography (PSG) were enrolled in the study. Subjects were divided into mild, moderate, and severe OSA groups by their apnea hypopnea index (AHI), and 25 healthy individuals were identified as controls. After PSG examination, fasting blood samples for the evaluation of N-terminal pro-brain natriuretic peptide (NT-proBNP) and heart-type fatty acid binding protein (h-FABP) were collected in the morning, and left ventricular(LV) functions were assessed by using echocardiographic methods. Thirty moderate and severe OSA patients were treated with continuous positive airway pressure respectively (CPAP).@*RESULTS@#The levels of h-FABP and NT-proBNP were obviously higher in all OSA groups than those in the control group (<0.01), and were positively correlated with AHI (<0.01). The Em/Am values of all OSA groups and E/A values of the moderate and severe OSA groups were significantly reduced (<0.01). The difference in Em/Am values among the groups was statistically significant (<0.01). Compared with those before treatment, h-FABP and NT-BNP levels in serum of OSA patients after CPAP treatment were significantly reduced (<0.01), and Em/Am and E/A values were significantly increased (<0.01).@*CONCLUSIONS@#Left ventricular diastolic dysfunction and early myocardial microtrauma are major manifestations of early heart damage in patients with OSA. CPAP therapy could significantly improve early cardiac damage in OSA patients.
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Humans , Continuous Positive Airway Pressure , Heart Injuries , Polysomnography , Sleep Apnea, Obstructive , Ventricular Dysfunction, LeftABSTRACT
Objective To analyze the changes of serum markers of liver function and liver fibrosis in patients with fatty liver,and to explore the relationship between them,so as to provide scientific basis for the prevention and treatment of fatty liver into hepatic fibrosis. Methods From January 1st,2015 to December 31st, 2015,one thousand three hundred and forty-six healthy cases were selected,and 361 cases of fatty liver were diagnosed by ultrasound. Liver function index of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) was detected by automatic biochemical analyzer. Hyaluronic acid (HA),laminin (LN),serum type Ⅲprocollagen peptide ( PC Ⅲ) and type Ⅳ collagen ( C-Ⅳ) were detected by enzyme-linked immunosorbent assay. The correlation between liver function and serum liver fibrosis indexes was analyzed by Pearson parameter analysis. Results The liver function index ALT,AST((69. 04±18. 72) U/L,(59. 78±15. 65)U/L) in fatty liver group were higher than those in the non-fatty liver group((25. 71±10. 25) U/L,(23. 68±8. 23) U/L),the differences were statistically significant ( t＝279. 283,388. 461,P＜0. 05) . Four serum fibrosis index HA,LN, PCⅢ,C-Ⅳ in the fatty liver group were (112. 64±21. 63) μg/L,(125. 85±27. 52) μg/L,(127. 28±29. 37) μg/L,(79. 38±18. 52) μg/L,respectively,which were higher than those in the non-fatty liver group ( (53. 98 ±16. 84) μg/L,(86. 31±20. 46) μg/L,(53. 31±18. 23) μg/L,(57. 26±15. 86 ) μg/L),the differences were statistically significant ( t＝727. 724,170. 432,941. 357,71. 169,P＜0. 001) . The correlation analysis of liver function and serum liver fibrosis indexes showed that ALT and AST were positively correlated with the fibrosis indexes HA,LN,PCⅢ( correlation coefficient r＝0. 230,0. 119,0. 370;0. 363,0. 361,0. 509,P＜0. 001),and which had no significant correlation with C-Ⅳ(P＞0. 05). Conclusion Liver function and serum liver fibrosis index can be used as the important basis for monitoring and diagnosis on the progression of fatty liver disease.
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Objective To investigate the clinical value of long chain non-coding RNA ( lncRNA) combined with pepsinogen in the detection of gastric cancer. Methods Totally eighty-six gastric cancer patients hospitalized in Chongqing Three Gorges Central Hospital from June 2014 to June 2017 were selected as the gastric cancer group. Another 86 patients who had no obvious abnormalities in the stomach during the same period were selected as the control group. Univariate analysis was used to compare the differences in baseline data and Carcinoembryonic antigen (CEA),carcinoembryonic antigen 19-9 (CA19-9),pepsinogen I (PGⅠ), pepsinogen II (PGⅡ) and lncRNA BC200 between the two groups. Univariate analysis was applied to analyze the differences of the baseline date between the two groups and to select the statistically significant factors which are further detected by multivariate logistic regression analysis. Meanwhile,the correlation analysis was used to analyze the relationship between the above-mentioned factors and traditional variables. Furthermore, the sensitivity and specificity of these factors in the value of diagnosing gastric cancer was calculated by ROC curve. Results The level of CEA (2. 84(1. 63- 8. 45) μg/ L),CA19-9(9. 05(5. 89- 29. 47) U/ ml) and lncRNA BC200(1. 872(1. 125-2. 611) in the gastric cancer group were significantly higher than those in the control group (CEA (1. 26(0. 87-2. 66) μg/ L,CA19-9(6. 42(4. 32-9. 86) U/ ml,lncRNA BC200( 1. 006 (0. 594-1. 282))(U= 3684,4782,2764;P<0. 001,P<0. 001,P = 0. 007); while the levels of PGⅠ(68. 3 (51. 2-89. 4) μg/ L ) and PGⅡ(18. 85(10. 06-29. 37) μg/ L) in the gastric cancer group were lower than those in the control group ( PGⅠ(115. 1(81. 7 - 166. 0) μg/ L,PGⅡ(23. 38(13. 72 - 34. 09) μg/ L) ( P<0. 001). Multivariate logistic analysis showed that CA19-9 (OR = 1. 206,95%CI 1. 302-1. 375,P = 0. 039), PGⅠ (OR= 1. 300,95%CI 1. 224-1. 623,P= 0. 023),PGⅡ (OR = 1. 208,95%CI 1. 002-1. 501,P = 0. 044) and lncRNA BC200 (OR = 1. 276,95%CI 1. 008 ~ 1. 107,P = 0. 020) had significant effects on gastric cancer and PGⅠ had the highest degree of influence. Spearman rank correlation showed that there was a positive correlation between lncRNA BC200 and CA19-9,and the difference was statistically significant (rs = 0. 891,P<0. 05); while PGⅠ (rs= -0. 482,P = 0. 026) and PGⅡ (rs = -0. 531,P = 0. 014) were negative correlated with CA19-9. The ROC curve indicated that the area under the ROC curve of lncRNA BC200 combined with PGⅠ,lncRNA BC200 combined with PGⅡ and CA19-9 in the detection of gastric cancer were 0. 844,0. 783 and 0. 721 respectively. The AUC (Area Under Curve) of lncRNA BC200 combined with PGⅠ was the highest,with a sensitivity of 53. 5% and a specificity of 100% . Conclusion LncRNA BC200 combined with PGⅠ can detect the existence of gastric cancer to a certain extent, and has a certain clinical diagnostic value, thus providing a theoretical basis for further diagnosis of early gastric cancer.
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Objective To obtain serological prevalence data for HBV markers in inpatients of Xi'an area with consequence of providing basis for nosocomial infection control and clinical stuff.Methods The serological markers of HBV (HBsAg,HBsAb,HBeAg,HBeAb,HBcAb) in serum of inpatients including 5 248 males and 5 345 females in 2015 were quantitatively detected by chemiluminescent analyzer ARCHITECT i4000SR.Results The infection rate of HBV was 7.01％ (743/10593) and there were 14 patterns of HBV serum markers in inpatients.Of all patterns of HBV infection in this study,there were 5.17 ％ (548/10 593) with HBsAg+ HBeAb+ HBcAb+,1.34 ％ (142/10 593) with HBsAg+ HBeAg+ HBcAb+,0.25％ (27/10 593) with HBsAg+HBcAb+ and 0.25％ (26/10 593) with other uncommon ones.Of all patterns of HBV convalescent stage,there were 21.02％ (2 227/10 593) with HBsAb+,13.71％ (1 452/10 593) with HBsAb+HBeAb+ HBcAb+,and 15.07％ (1 596/10 593) with HBsAb+HBcAb+.The percentage of five serum markers with negative was 31.38％ (3 324/10 593).There existed statistical difference for patterns of HBV serum markers concerning gender and different age groups,respectively (P＜0.05).The clinical departments with highest percentages of HBsAg-+-HBeAg+ HBcAb +-,HBsAg+ HBeAb+ HBcAb+ and HBsAb+ were department of gastroenterology with 7.39 ％ (36/487),department of gastroenterology with 16.43％ (80/487) and thoracic surgery one with 89.23％ (58/65),respectively.Conclusion This study provided clinical data of management and controlling the transmitting of HBV and promotion of HBV vaccination.Meanwhile it is necessary for government to take effective measures to reduce the infection rate of HBV in Xi'an area.
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Objective To investigate the effect of Yunnan Baiyao Plaster on serum related markers levels in the patients with stroke ,to evaluate its improvement effect on the neurological dysfunction and pain and to analyze its effect mechanism .Methods Eighty cases of hemorrhagic stroke treated in the neurosurgical department of our hospital from February 2015 to June 2016 were screened as the research subjects and divided into the control group and observation group according to the random number table method ,40 cases in each group .All subjects were given the routine treatment ,while the observation group received the external use of Yunnan Baiyao Plaster around the head operative incision and drilling ,to give Yunnan white ointment ,with the attaching area of 5 cm × 4 cm ,once daily ,for consecutive 7 d ,meanwhile took oral Yunnan Baiyao Plaster 0 .5 g with warm boiling water ,once daily for consecutive 7 d .The serum markers levels before and after treatment ,neural function defect score ,decline proportion of NIHSS scores and prognostic indicators were compared between the two groups .Results The mean pain value within 1 week in the obser-vation group was lower than that in the control group ,the difference was statistically significant (P 0 .05);after 2 weeks ,ET ,TNF-α and IL-1β levels in the observation group and control group were lower than those before treatment in the intra-group comparison ,while the comparison between the two groups showed that the ob-servation group was lower than the control group ,the difference was statistically significant (P0 .05) .Conclusion The combined treatment of Yunnan Baiyao Plaster in the patients with hemorrhagic stroke conld relieve pain and reduce the neurological deficit ,which might be related to the mechanism of anti-inflammation and analgesia .
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Objective To investigate the diagnostic values of human epididymis (HE4)in lung cancer.Methods 80 patients with lung cancer were the experimental group,30 patients with benign pulmonary disease were the benign control group,and 30 healthy people were healthy control group.The levels of carcinoma embryonic antigen (CEA),cytokeratin protein fragment 21-1 (CYFRA21-1),neuron specific enolase (NSE) and HE4 in serum were detected.Results The levels of CEA,NSE,CYFRA21-1 and HE4 in lung cancer patients were higher than those in both the benign control group and the healthy control group (P＜0.05).The areas (AUC) under the receiver operating characteristic (ROC curve) were 0.870,0.818,0.746 and 0.897 for serum CEA,NSE,CYFRA21-1 and HE4 levels in diagnosis of lung cancer.The levels of CEA and HE4 were higher in patients with adenocarcinoma,the level of CYFRA21-1 was higher in patients with squamous cell carcinoma,the level of NSE was higher in patients with small cell lung cancer (SCLC) (P＜0.05).The detections of CYFRA21-1 (AUC=1.000),CEA (AUC=0.727) and HE4 (AUC=0.622) in serum are favorable for the diagnosis of squamous cell carcinoma,The detections of serum CEA (AUC=0.954) and HE4 (AUC=0.944) levels are favorable for the diagnosis of adenocarcinoma,and the detections of NSE (AUC=0.876) was favorable for the diagnosis of SCLC (P＜0.05).Conclusion The levels of CEA,NSE,CYFRA21-1 and HE4 in serum were abnormal in patients with lung cancer.The HE4 level in the patients was correlated with the pathological types and the metastasis of lung cancer.The detection of serum HE4 could be used in the diagnosis and evaluation of lung cancer.
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Objective To investigate the correlations of serum markers of hepatitis B virus,HBV DNA load and liver function indexes[alanine aminotransferase(ALT)and aspartate transaminase(AST)]in the peripheral blood.Methods Clinical data of 483 patients who were diagnosed with chronic hepatitis B and treated between March 2014 and March 2016 in Tongji hospital were retrospectively analyzed.The serum markers of hepatitis B virus were quantitatively detected by chemiluminescent microparticle immunoassay.Serum HBV DNA load was measured by real-time fluorescence quantitative PCR,and ALT and AST by continuous ultraviolet monitoring.Results There was no correlation between the HBsAg content and HBV DNA load or the rates of abnormal ALT(>41 U/L)and abnormal AST(>35 U/L)(P>0.05).The HBeAg content was not correlated with HBV DNA load and the rates of abnormal ALT(P>0.05),but weakly with the rate of abnormal AST(r=0.21,P0.05),it was weakly related to HBV DNA load and the rates of abnormal AST(r=0.16,P<0.05;r=0.19,P<0.01).The anti-HBc content had weak correlations with HBV DNA load,the rates of abnormal ALT and abnormal AST(r=0.25,P<0.01;r=0.29,P<0.01;r=0.29,P<0.01).The logarithm value of HBV DNA load was weakly positively correlated with ALT and AST(r=0.24;r=0.29).Conclusion Quantitative detection of both serum markers and the DNA of hepatitis B virus can complement each other,and when combined with detection of liver function indexes,it will help understand the damage of liver tissue.
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Objective To investigate the clinical significance of serum CEA , CA19-9, CA72-4, CA242, CA50, PGⅠand PGR ( PGⅠ/PGⅡ) in the Diagnosis of preoperative and postoperative gastric cancer.Methods Retrospective study.The levels of CEA , CA19-9, CA72-4, CA242, CA50, PGⅠand PGⅡin serum of 41 patients with gastric cancer preoperative and postoperative and 60 healthy people were detected by AutoLumo A2000 chemiluminescence immunoassay and compared.Statistical analysis was performed using Rank-sum test by SPSS 17.0.Results The median of CEA, CA19-9, CA72-4, CA242, CA50, PGI, PGII and PGR in postoperative gastric cancer group were 3.79 ng/ml, 17.85 U/ml, 3.50 U/ml, 14.52 U/ml, 17.62 U/ml, 32.81 ng/ml, 11.48 ng/ml, 3.35.The postoperative gastric cancer group were 1.67 ng/ml, 7.76 U ml, 1.73 U/ml, 6.30 U/ml, 7.57 U/ml, 20.56 ng/ml, 5.71 ng/ml, 2.94.The healthy group were 1.53 ng /ml, 7.59 U/ml, 1.47 U/ml, 6.08 U/ml, 5.68 U/ml, 90.86 ng/ml, 14.85 ng/ml, 6.67.There were statistical differences in the serum levels of CEA , CA19-9, CA72-4, CA242, CA50, PGⅠ, PGⅡand PGR among different groups (chi-squared values were 79.108, 20.678, 20.374, 7.252, 56.73, 131.212, 20.38, 86.37, P<0.05).By the Mann-Whitney rank sum test,the serum levels of CEA , CA19-9, CA72-4, CA242 and CA50 in patients with preoperative gastric cancer were significantly higher than those in healthy controls (Z values were -8.598, -4.425, -4.365, -2.000,-7.420, P<0.05).The level of postoperative group was significantly lower than that of preoperative group (Z value were -4.641, -2.383, -2.459, -2.399, -2.903, P<0.05).The serum PGⅠ, PGⅡand PGR levels in patients with preoperative gastric cancer were significantly lower than those in healthy controls (Z values were -10.309, -2.695, 8.637, P<0.05).The PGⅠlevel in the postoperative group was significantly lower than that in the preoperative group (Z value was -2.109, P<0.05).PGⅡ,PGR levels of postoperative group were lower than those of preoperative group , but the difference were not statistically significant.(Z values were -1.506,-0.838, P values were 0.132,0.402).Conclusion The detection of the seven serum markers can help to preoperative diagnosis and postoperative monitoring of gastric cancer .
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The current detection of serum tumor markers is still considered to be one of convenient and effective means for early diagnosis of tumor and monitoring tumor progression.Golgi phosphoprotein 2(GOLPH2) is a type Ⅱ transmembrane protein presenting in the Golgi apparatus.In recent years,many studies have suggested that GOLPH2 is one of the most promising early serum markers for early diagnosis of tumor.In addition,many studies have beer shown that GOLPH2 is related to prognosis of lung cancer,gastric cancer,prostate cancer and other cancer-related prognosis involved in immune regulation,intracellular signal factor activation and degrada-tion and promote epithelial-mesenchymal transition(EMT).Through these mechanisms to promote tumor pro-gression and metastasis,GOLPH2 reduces the disease-free survival(DFS)and overall survival(OS).In this pa-per,we review the role of GOLPH2 in the progress and a variety of malignant tumors.
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The current detection of serum tumor markers is still considered to be one of convenient and effective means for early diagnosis of tumor and monitoring tumor progression.Golgi phosphoprotein 2(GOLPH2) is a type Ⅱ transmembrane protein presenting in the Golgi apparatus.In recent years,many studies have suggested that GOLPH2 is one of the most promising early serum markers for early diagnosis of tumor.In addition,many studies have beer shown that GOLPH2 is related to prognosis of lung cancer,gastric cancer,prostate cancer and other cancer-related prognosis involved in immune regulation,intracellular signal factor activation and degrada-tion and promote epithelial-mesenchymal transition(EMT).Through these mechanisms to promote tumor pro-gression and metastasis,GOLPH2 reduces the disease-free survival(DFS)and overall survival(OS).In this pa-per,we review the role of GOLPH2 in the progress and a variety of malignant tumors.
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OBJECTIVE: To compare several noninvasive indices of fibrosis in chronic viral hepatitis B, including liver shear-wave velocity (SWV), hyaluronic acid (HA), collagen type IV (CIV), procollagen type III (PCIII), and laminin (LN). MATERIALS AND METHODS: Acoustic radiation force impulse (ARFI) was performed in 157 patients with chronic viral hepatitis B and in 30 healthy volunteers to measure hepatic SWV (m/s) in a prospective study. Serum markers were acquired on the morning of the same day of the ARFI evaluation. Receiver operating characteristic (ROC) analysis was performed to evaluate and compare the accuracies of SWV and serum markers using METAVIR scoring from liver biopsy as a reference standard. RESULTS: The most accurate test for diagnosing fibrosis F ≥ 1 was SWV with the area under the ROC curve (AUC) of 0.913, followed by LN (0.744), HA (0.701), CIV (0.690), and PCIII (0.524). The best test for diagnosing F ≥ 2 was SWV (AUC of 0.851), followed by CIV (0.671), HA (0.668), LN (0.562), and PCIII (0.550). The best test for diagnosing F ≥ 3 was SWV (0.854), followed by CIV (0.693), HA (0.675), PCIII (0.591), and LN (0.548). The best test for diagnosing F = 4 was SWV (0.965), followed by CIV (0.804), PCIII (0.752), HA (0.744), and LN (0.662). SWV combined with HA and CIV did not improve diagnostic accuracy (AUC = 0.931 for F ≥ 1, 0.863 for F ≥ 2, 0.855 for F ≥ 3, 0.960 for F = 4). CONCLUSION: The performance of SWV in diagnosing liver fibrosis is superior to that of serum markers. However, the combination of SWV, HA, and CIV does not increase the accuracy of diagnosing liver fibrosis and cirrhosis.
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Humans , Acoustics , Biomarkers , Biopsy , Collagen Type III , Collagen Type IV , Elasticity Imaging Techniques , Fibrosis , Healthy Volunteers , Hepatitis B , Hepatitis B, Chronic , Hepatitis , Hyaluronic Acid , Laminin , Liver Cirrhosis , Liver , Prospective Studies , ROC CurveABSTRACT
Objective To investigate the correlations on hepatitis B virus (HBV) preS1‐antigen (pre‐S1Ag) with HBV‐DNA , HBV markers(HBV M) and liver function in the patients with hepatitis B .Methods The markers ,preS1‐Ag ,HBV‐DNA and liver function were determined by CLIA and PCR in 905 patients with hepatitis B (HBV infection group ) and 100 healthy persons (healthy control group) .Results Among 905 samples ,the positive rates of preS1‐Ag and HBV DNA were 68 .51% (620/905) and 67 .96% (615/905) ,there was no statistically significant difference between them (χ2 =30 .064 ,P>0 .05);the positive rates of pre‐S1Ag in 570 patients with HBeAg positive were 85 .08% (485/570) ,which was significantly higher than 40 .30% (135/335) in 335 patients with HBeAg negative ,the difference was statistically significant (χ2 =108 .881 ,P<0 .01) .The abnormal rates of ALT and AST in the Pre‐S1 Ag positive and negative groups were 53 .22% ,25 .96% and 51 .29% ,32 .98% ,respectively ,the differences be‐tween them were statistically significant (χ2ALT =53 .148 ,P<0 .001 ,χ2AST =66 .635 ,P<0 .001) .Conclusion Pre‐S1Ag is a reliable index of the HBV infection and duplication and is highly correlated with HBV‐DNA positive ,which is important supplement and strengthening and can provide more timely and reliable experiment basis for guiding the clinical treatment .
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Objective:To discuss the application of Roche ECL instrument E601 in inspection serum markers of myocardial injury aspects.Methods: Dependent on the clinical experience of cardiology, the introduction of Roche E601 methodology and the instruments using, and the clinical significance analysis of myocardial injury markers, summarized the important considerations in accurate test results and clinical judgment when using ECL instrument checks serum markers of myocardial injury.Results: In order to make better clinical application, people who use Roche ECL instrument E601 should pay attention to proper storage and use reagents, note the use of the combined reagents and the clinically meaningful of detected projects. Conclusion: The quality control of technical procedures is very important to assure the testing results. Only understanding some of the important considerations,can we better integrate the device for clinical application.
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Introdução: O vírus da hepatite C tem como principal via de transmissão a parenteral. A biópsia hepática constitui poderosa ferramenta e tem como parâmetros o grau de alteração estrutural e atividade inflamatória, permitindo estadiar as hepatites crônicas. Sendo a biópsia procedimento invasivo, os marcadores sanguíneos como AST, ALT, alfa-fetoproteína e APRI (AST-to-platelet ratio índex) constituem fatores preditores do grau de fibrose. Objetivos: Estabelecer o perfil epidemiológico da hepatite C na população estudada; correlacionar e comparar os resultados das diferentes técnicas de biópsia hepática com marcadores séricos indiretos de comprometimento hepático (plaquetas, alfa-fetoproteína, transaminases) e com APRI, avaliando a fidedignidade destes como preditores de gravidade da lesão hepática. Casuística e método: Estudo observacional, retrospectivo, análise de 100 prontuários escolhidos aleatoriamente de pacientes infectados cronicamente pelo VHC. Todos os pacientes haviam sido submetidos ou estavam na vigência de tratamento com interferon associado à ribavirina. Resultados: 61,3% era do sexo masculino e 71,1% do genótipo tipo 1. A maior taxa de resposta virológica sustentada foi no gênero feminino (60,6% x 36,7%).Obteve-se 34,7% biópsias percutâneas às cegas; 27,5% percutâneas guiadas por USG e 37,8% videolaparoscópicas. A biópsia videolaparoscópica demonstrou maior correlação com marcadores e escore de APRI (p<0,05): as médias de F0-F2 e F3-F4 foram, respectivamente, TGO - 46,1 x 106,5; TGP - 67,5 x 123,6; Plaquetas - 223.863 x 160.500; alfafetoproteína - 3,02 x 11,97; e APRI - 0,07 x 0,24 . Conclusão: O APRI apresentou correlação com os graus de fibrose hepática na análise videolaparoscópica, sendo a técnica mais fidedigna.
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Objective To investigate the relationship between the serum markers and genotype with viral load in chronic hepati-tis B in order to improve the level of clinical treatment.Methods 819 patients with chronic hepatitis B in our hospital from April 2010 to April 2013were selected as the study subjects and performed the genotyping.The hepatitis B virus(HBV)DNA level was detected by using real-time fluorescence PCR.Results Among the 819 cases of positive HBsAg,357 cases were positive HBV-DNA,accounting for 43.59%;HBeAg(+)accounted for 90.11%;in the positive modes of serum markers and viral load,most of positive cases were HBsAg,HBeAg,HBcAb and HBsAg,HBeAb,HBcAb,accounting for 88.52%;HBV genotyping had B,C,BC mixed types and unclassified type,the logrithm levels of viral DNA were(7.187 ±1.668),(7.184 ±1.558),(7.208 ±1.447)and (7.313±1.505),there was no statistically significant difference among them(P >0.05).Conclusion The virus gene in the patients with chronic hepatitis B is dominated by type C,in which serum markers HBeAg and HBV-DNA viral load have the lose correlated, the infected virus genotype has the low correlation with the viral load.
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Objective To investigate the correlation of hepatitis B virus (HBV) markers between umbilical cord blood and maternal serum.Methods A total of 340 HBsAg positive mothers who delivered at the Third People' s Hospital of Changzhou during August 2009 and November 2010 were included in the study.HBV markers in the maternal serum before childbirth and umbilical cord blood after birth were quantitatively detected.The neonates received 3 doses of hepatitis B vaccine and 2 doses of hepatitis B immunoglobulin (HBIG),and followed up for 12 months.Measurement data were expressed as median (M),and Kruskal-Wallis test and Spearman correlation analysis were performed.Results There were 175HBeAg-positive and 165 HBeAg-negative mothers,and a total of 341 infants were delivered.The positive rates of HBsAg,anti-HBs,HBeAg,anti-HBe and anti-HBc in maternal serum were 100.00％,0.0％,51.47％,38.82％ and 99.41％,respectively; while those in umbilical cord bloods were 14.66％,0.59％,26.69％,39.88％ and 95.31％,respectively.HBsAg concentration in maternal serum of HBsAg-positive umbilical cord blood group was higher than that of HBsAg-negative umbilical cord blood group (419.40∶ 387.95,x2 =4.592,P ＜ 0.05) ; while HBsAg concentration in umbilical cord blood of HBeAg-positive maternal serum was higher than that of the HBeAg-negative maternal serum group (0.04 ∶ 0.01,x2 =5.674,P ＜ 0.05).Anti-HBe and anti-HBc in umbilical cord blood were positively correlated with those in maternal serum (r =0.838,0.764,P ＜ 0.01).Seven out of 62 (11.29％) infants were infected with HBV in HBeAg-positive maternal serum group; while no infant infected in HBeAg-negative matemal serum group.Conclusion The higher maternal serum HBsAg concentration,the greater the risk of perinatal transmission,and infants born by HBeAg-positive mothers are of high risk of HBV infection.