The Clinical Research Progress of Vertebral Artery Dominance and Posterior Circulation Ischemic Stroke.

BACKGROUND: The diameters of the vertebral arteries on both sides are usually asymmetrical. Vertebral artery dominance (VAD) and congenital vertebral artery dysplasia are derived from the asymmetry of the vertebral artery diameters on both sides. They are usually regarded as normal congenital vascular variations and have no practical clinical significance. SUMMARY: Recently, several clinical studies have found that VAD is a risk factor for posterior circulation ischemic stroke (PCIS). The existence of VAD is clinically significant for the occurrence of PCIS, and it is recognized by an increasing number of clinicians. KEY MESSAGES: This article reviews the frequency and evaluation methods of VAD, its correlation with PCIS, and its mechanism.

Prediction for HBsAg seroconversion in children with chronic hepatitis B.

BACKGROUND: To establish a prediction of HBsAg seroconversion in children with chronic hepatitis B (CHB), so as to help clinicians to choose therapeutic strategy. METHODS: A total of 63 children with HBeAg-positive CHB aged 1 to 17 years, who admitted to the fifth medical center of Chinese PLA general hospital and treated with interferon α (IFNα) 48 weeks were enrolled, the clinical data were measured. Based on the results of HBsAg seroconversion (HBsAg < 0.05 IU/mL and anti-HBsAg > 10 IU/L) at week 48, the patients were divided into HBsAg seroconversion (S) group and non-HBsAg seroconversion (NS) group. Multivariate COX regression was used to identify the impact factors associated with HBsAg seroconversion. A novel prediction index was established and the area under the receiver operating characteristic curve (AUROC) was used to assess the prediction for HBsAg seroconversion. RESULTS: The 63 patients were divided into S group (20.6%, 13/63) and NS group (79.4%, 50/63). Univariate and multivariate analysis identified age, baseline intrahepatic cccDNA and serum HBsAg levels were independent impact factors for HBsAg seroconversion. Intrahepatic cccDNA was positively correlated with serum HBsAg (r = 0.464, p = 0.000). AUROC of HBV cccDNA was 0.83 (95% CI 0.71 to 0.95) and AUROC of baseline HBsAg was 0.77 (95% CI 0.61 to 0.92). Intrahepatic cccDNA ≤ 0.08 log10 copies/106 cell is regarded as cutoff value, the positive predictive value(PPV) and negative predictive value(NPV) for HBsAg seroconversion were 86.8% and 60.0%, respectively, with a sensitivity of 92.0% and specificity of 56.2%. HBsAg ≤ 3.68 log10 IU/mL is used as cut off value, the PPV and NPV for HBsAg seroconversion were 91.2% and 56.3%, respectively; the sensitivity and specificity was 86.0% of 69.2%, respectively. There was no statistical difference between them for predicting HBsAg seroconversion (p = 0.146). CONCLUSIONS: HBsAg seroconversion can be predicted by the baseline serum HBsAg or intrahepatic cccDNA in children with CHB. Using the index, clinicians can choose more reasonable therapeutic strategy and reduce the waste of medical resources.

IL28B SNP rs12979860 is the Critical Predictor for Sustained Viral Response in Chinese Children Aged 1 to 6 Years with Chronic Hepatitis C.

Clinical data on children with chronic hepatitis C (CHC) remain extremely limited. This study investigated sustained virologic response (SVR) to alfa-interferon 2b plus RBV treatment in children aged 1-6 years with unsafe injection-acquired CHC. 154 children with CHC aged 1 to 6 years were enrolled, 101 of them were male (65.6%) and 53 were female (34.4%), and they were treated with alfa-interferon at a dose of 1-5 MIU/m2 3 times weekly plus oral RBV (15 mg/kg/day) for 48 weeks. 57(39.3 %) of them were genotype 1b, 73(50.3%) were genotypes 2a, 15(10.3%) were undecided type. SVR was achieved in 53 of 57(93.0%) patients with genotype 1b, in 72 (98.6%) of 73 with genotype 2a, 15(100.0%) of 15 with undecided type. There was no significant statistical difference in SVR between male and female (98.0% vs 94.3%, p=0.340), genotype 2a and those with genotype 1b(98.6% vs 93.0%, p=0.160), ALT>40U/L group and ALT≤40U/L group(96.7% vs 96.8%, p=1.000), AST>40U/L group and AST≤40U/L group(95.9% vs 98.2%, p=0.654) as well as lower baseline viral load group (<6×105 IU/ml) and higher baseline viral load group(≥6×105 IU/ml)(97.3% vs 95.3%, p=0.916). Leucopenia, neutropenia, hemoglobin concentration decrease, fever, platelet count decrease and rash were 8.4%, 69.5%, 24.0%, 50.6%, 1.9% and 4.5%, respectively. And only 12(7.8%) individuals developed thyroid autoantibodies. The SVR was higher in patients with IL-28B genotype C/C than C/T (99.0% vs 80%, p=0.002). Compared with HCV viral genotype, ALT level and baseline viral load, IL-28B rs12979860 is more suitable for predicting antiviral efficacy in children with CHC. It is inappropriate to take the increase of ALT level as an essential indicator for antiviral treatment in children aged 1-6 years.

Serum thymidine kinase 1 concentration as a prognostic factor of chemotherapy-treated non-Hodgkin's lymphoma patients.

PURPOSE: This study was performed to examine possible use of thymidine kinase 1 concentration in serum (STK1) for prognosis of non-Hodgkin's lymphoma patients following chemotherapy treatment. METHODS: The STK1 levels of 37 patients were determined by enhanced chemiluminescent dot-blot assay on the day before chemotherapy, and on day 1 and day 28 after start of the treatment. The specificity and sensitivity was evaluated by Western blot with anti-TK1 IgY antibody and by receiver operating characteristic (ROC) analysis. RESULTS: Western blot and ROC analysis of TK1 in serum showed high specificity and sensitivity. The mean STK1 level of the non-Hodgkin's lymphoma patients was significantly higher compared to healthy persons (p < 0.001). The mean STK1 level increased significantly (p < 0.001) on day 1 and then declined, reaching on day 28 values corresponding to those of healthy persons. The mean STK1 values before treatment and at 1 and 28 days after start of the treatment also correlated significantly with the clinical response (CR, PR and NR) and five-year survival. CONCLUSION: Although the number of patients was limited in this study, TK1 in serum might possess an important reference value in the evaluation of treatment and prognosis of non-Hodgkin's lymphoma following chemotherapy.