中国是乙型肝炎(乙肝)慢性感染者数量最多的国家,每年约有100万例乙肝病毒(hepatitis B virus,HBV)表面抗原(HBsAg)阳性孕妇需要生育,其中约26万例为乙肝病毒e抗原(HBeAg)阳性孕妇。对HBsAg阳性孕妇实施科学的母婴阻断措施,减少新发感...中国是乙型肝炎(乙肝)慢性感染者数量最多的国家,每年约有100万例乙肝病毒(hepatitis B virus,HBV)表面抗原(HBsAg)阳性孕妇需要生育,其中约26万例为乙肝病毒e抗原(HBeAg)阳性孕妇。对HBsAg阳性孕妇实施科学的母婴阻断措施,减少新发感染是当前我国进一步控制乙肝面临的主要工作。无论母亲感染状态如何,实施新生儿出生后24 h内接种乙肝疫苗(HepB)是最重要和最根本的策略。对于HBV感染的高病毒载量的孕妇的抗病毒治疗,需要考虑起始时间节点、纳入标准、服药持续时间和停药时间等。做好我国HBV感染母婴阻断,主要策略包含4种:(1)对孕妇进行HBsAg筛查;(2)对HBsAg阳性母亲的新生儿出生12 h内接种HepB和乙肝免疫球蛋白(HBIG),然后完成全程乙肝疫苗免疫;对HBsAg阴性母亲的新生儿出生24 h内接种HepB,然后完成全程乙肝疫苗免疫;(3)仅对HBV DNA高载量的孕妇实施抗病毒预防;(4)对母亲HBsAg阳性的新生儿进行接种后监测并评价阻断效果。展开更多
目的调研重庆地区乙型肝炎病毒(hepatitis B virus, HBV)基因型构成,探讨HBV基因型与乙型肝炎疾病进程的相关性。方法用SSP-PCR法对360例HBV DNA阳性患者HBV基因分型,采用多因素Logistic回归分析HBV基因型与疾病表型的相关性。结果本回...目的调研重庆地区乙型肝炎病毒(hepatitis B virus, HBV)基因型构成,探讨HBV基因型与乙型肝炎疾病进程的相关性。方法用SSP-PCR法对360例HBV DNA阳性患者HBV基因分型,采用多因素Logistic回归分析HBV基因型与疾病表型的相关性。结果本回顾性研究人群中,HBV-B型占45.6%,HBV-C型占53.9%,分型失败0.5%。随着疾病从慢性乙型肝炎到肝硬化、原发性肝细胞癌的进展,C型HBV所占比例显著上升(χ2=23.368,P<0.001)。Logistic回归分析显示HBV基因型是HBV感染者罹患肝癌的独立风险因素(OR=3.2,P=0.01)。B、C基因型患者的HBV DNA水平和HBeAg阳性率无显著差异(P>0.05)。结论重庆地区HBV基因型以B、C型为主,C型HBV更易导致严重的肝病,HBV基因型是影响疾病进程的重要因素。展开更多
Objective： To observe the efficacy of retention enema with Huchang Jiedu Decoction （护肠解毒汤, HJD） in treating chronic severe hepatitis B （CSHB）. Methods： Sixty patients of CSHB were equally randomized into th...Objective： To observe the efficacy of retention enema with Huchang Jiedu Decoction （护肠解毒汤, HJD） in treating chronic severe hepatitis B （CSHB）. Methods： Sixty patients of CSHB were equally randomized into the treated group and the control group. Both groups were treated with conventional integrative medicine, but to patients in the treated group, retention enema with HJD was given in addition, once every day for 3 weeks. The dominant symptoms, physical signs, and related biochemical indices, as well as the incidence of complications in patients before and after treatment, were observed. Results： Good therapeutic effects were shown in the treated group, with a total effective rate better than that in the control group （83.3% versus 60.0%, P〈0.05）, superior in terms of lowering alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, total bilirubin （TBil）, globulin （GIb）, and endotoxin （ET） levels and increasing prothrombin activity （PTA）, total cholesterol （TC）, and calcium （Ca） levels, as well as eliminating ascites and preventing hepatic encephalopathy （P〈0.05）; especially in treating middle/early stage patients with Chinese medicine syndrome differentiated as water-toxin accumulation pattern. Conclusion： Retention enema with HJD is surely effective in treating CSHB, and its primary mechanism may be related to the mitigation of enterogenous endotoxemia.展开更多
目的：了解北京地区三甲医院产科护理人员关于乙肝患者母乳喂养的认知和态度，为今后科学指导并提高这一特殊人群的母乳喂养率提供借鉴与参考方案。方法采用便利抽样的方法对来自北京地区7家三甲医院的186名在职产科护理人员进行问卷调...目的：了解北京地区三甲医院产科护理人员关于乙肝患者母乳喂养的认知和态度，为今后科学指导并提高这一特殊人群的母乳喂养率提供借鉴与参考方案。方法采用便利抽样的方法对来自北京地区7家三甲医院的186名在职产科护理人员进行问卷调查，调查其对乙肝患者能否母乳喂养的认知及对乙肝患者母乳喂养的态度。结果186名产科护理人员接受调查，其中仅64．6％的受访护士可以正确回答合并乙肝产妇能否提供母乳喂养相关问题；82．3％的护士错误地认为乳汁中 HBV DNA 滴度高低对母乳喂养有影响；仅有29．6％的受访护士知晓《乙型肝炎病毒母婴传播预防临床指南》。调查其意愿时仅45．2％的护士表示支持乙肝产妇进行母乳喂养。不同职称护士在新生儿接受免疫阻断后能否母乳喂养及乙肝产妇咨询能否母乳喂养时，护士是否会鼓励其进行母乳喂养等认知和态度方面差异有统计学意义。结论医院及科室管理者应重视产科护理人员对新知识、新技术的持续不断的学习与关注，落实继续教育的实施，增强护理人员自我价值的认同感和对自我知识水平的自信心，为母婴安全提供科学、准确、有效的健康教育而努力。展开更多
基金Supported by the Keystone Item of Shandong Provincial Science and Technique Development Plan(No.2007GG 2NS02076)
文摘Objective： To observe the efficacy of retention enema with Huchang Jiedu Decoction （护肠解毒汤, HJD） in treating chronic severe hepatitis B （CSHB）. Methods： Sixty patients of CSHB were equally randomized into the treated group and the control group. Both groups were treated with conventional integrative medicine, but to patients in the treated group, retention enema with HJD was given in addition, once every day for 3 weeks. The dominant symptoms, physical signs, and related biochemical indices, as well as the incidence of complications in patients before and after treatment, were observed. Results： Good therapeutic effects were shown in the treated group, with a total effective rate better than that in the control group （83.3% versus 60.0%, P〈0.05）, superior in terms of lowering alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, total bilirubin （TBil）, globulin （GIb）, and endotoxin （ET） levels and increasing prothrombin activity （PTA）, total cholesterol （TC）, and calcium （Ca） levels, as well as eliminating ascites and preventing hepatic encephalopathy （P〈0.05）; especially in treating middle/early stage patients with Chinese medicine syndrome differentiated as water-toxin accumulation pattern. Conclusion： Retention enema with HJD is surely effective in treating CSHB, and its primary mechanism may be related to the mitigation of enterogenous endotoxemia.
文摘目的：了解北京地区三甲医院产科护理人员关于乙肝患者母乳喂养的认知和态度，为今后科学指导并提高这一特殊人群的母乳喂养率提供借鉴与参考方案。方法采用便利抽样的方法对来自北京地区7家三甲医院的186名在职产科护理人员进行问卷调查，调查其对乙肝患者能否母乳喂养的认知及对乙肝患者母乳喂养的态度。结果186名产科护理人员接受调查，其中仅64．6％的受访护士可以正确回答合并乙肝产妇能否提供母乳喂养相关问题；82．3％的护士错误地认为乳汁中 HBV DNA 滴度高低对母乳喂养有影响；仅有29．6％的受访护士知晓《乙型肝炎病毒母婴传播预防临床指南》。调查其意愿时仅45．2％的护士表示支持乙肝产妇进行母乳喂养。不同职称护士在新生儿接受免疫阻断后能否母乳喂养及乙肝产妇咨询能否母乳喂养时，护士是否会鼓励其进行母乳喂养等认知和态度方面差异有统计学意义。结论医院及科室管理者应重视产科护理人员对新知识、新技术的持续不断的学习与关注，落实继续教育的实施，增强护理人员自我价值的认同感和对自我知识水平的自信心，为母婴安全提供科学、准确、有效的健康教育而努力。
