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一种基于血液检测的诊断和预测HBV相关疾病的弹性方法 Article
侯格格, 陈云茹, 刘小静, 张东, 耿智敏, 司书宾
《工程（英文）》 2024年 第32卷 第1期 页码 174-185 doi: 10.1016/j.eng.2023.06.013
乙肝病毒(HBV)感染威胁着全球公共卫生安全，是导致肝脏相关疾病发病率和死亡率的主要原因。HBV持续感染引起的肝脏疾病检查方法包括实验室检测、超声、CT、核磁共振和肝活检等，重复的检查和多次诊断可能导致患者每次就医都面临高额费用。因此，迫切需要建立一种经济有效的诊断方法简化乙肝相关疾病的医疗流程。基于临床血液检测，我们构建复杂网络模型并定义功能恢复力评价指标，可以帮助医生评估患者的肝脏状况。其次，通过结合网络模型和动力学，发现导致患者向肝硬化或肝癌转化的关键血液指标及其相应的阈值，为进一步研究疾病临界状态和预防疾病恶化提供思路。
Impact of HBV replication in peripheral blood mononuclear cell on HBV intrauterine transmission
null
《医学前沿（英文）》 2017年 第11卷 第4期 页码 548-553 doi: 10.1007/s11684-017-0597-5
This study determined the effect of hepatitis B virus (HBV) replication in peripheral blood mononuclear cell (PBMC) from HBsAg-positive mothers on HBV intrauterine transmission. A total of 150 HBsAg-positive mothers and their neonates were recruited in this study. Within 24 h after birth, HBV serological markers, serum HBV DNA, PBMC HBV relaxed circular DNA (rcDNA), and covalently closed circular DNA (cccDNA) were measured in the HBsAg-positive mothers and their neonates before passive-active immune prophylaxis. The relationship between HBV replication in PBMC and HBV intrauterine transmission was examined through Chi-square test and logistic regression. The rate of HBV intrauterine transmission was 8.00% (12/150) in the 150 neonates born to HBsAg-positive mothers. The positivities of PBMC HBV rcDNA and cccDNA in the HBsAg-positive mothers were 36.67% (55/150) and 10% (15/150), respectively. Maternal PBMC HBV cccDNA was a risk factor of HBV intrauterine transmission (OR= 6.003, 95% CI: 1.249–28.855). Maternal serum HBeAg was a risk factor of PBMC HBV rcDNA (OR= 3.896, 95% CI: 1.929–7.876) and PBMC HBV cccDNA (OR= 3.74, 95% CI: 1.186–11.793) in the HBsAg-positive mothers. Administration of hepatitis B immune globulin was a protective factor of PBMC HBV cccDNA (OR= 0.312, 95% CI: 0.102–0.954) during pregnancy. The positivity of PBMC HBV rcDNA was related to that of cccDNA in the HBsAg-positive mothers (c2=5.087, P= 0.024). This study suggests that PBMC is a reservoir of HBV and an extrahepatic site for virus replication and plays a critical role in HBV intrauterine transmission.
关键词： PBMC HBV cccDNA HBV rcDNA HBV intrauterine transmission
Current recommendations of managing HBV infection in preconception or pregnancy
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《医学前沿（英文）》 2014年 第8卷 第2期 页码 158-165 doi: 10.1007/s11684-014-0340-4
Hepatitis B remains a leading cause of cirrhosis, hepatocellular carcinoma and liver transplantation worldwide. Management of chronic hepatitis B during pregnancy is challenging. Transmission of hepatitis B to infants still occurs perinatally although immunoprophylaxis is widely available for infants born to mothers with chronic hepatitis B infection. The emerging data suggest that initiation of antiviral therapy in the beginning of the third trimester in highly viremic mothers can prevent immunoprophylaxis failure in their infants. The available drug safety data show that lamivudine, telbivudine and tenofovir are generally safe to be used during the pregnancy. In order to minimize the fetal exposure to the antiviral medication, antiviral therapy during the pregnancy should be limited to a selected group of patients with cirrhosis, high hepatitis B viral load, or prior history immunoprophylaxis failure. An elective Caesarean section may reduce the risk of perinatal transmission. For those females planning for pregnancy or in early stage of pregnancy, communication and follow-up among obstetrician, gastroenterologist, and primary care physician are important. In this article, we will review the features of hepatitis B infection before, during and after the pregnancy; the risk factors that increase mother-to-child transmission; safety data on antiviral drug use during pregnancy; and the potential role of Caesarean section in selected cases.
关键词： antiviral therapy Caesarean section cirrhosis hepatitis B immunoprophylaxis mother-to-child transmission pregnancy prevention
New perspective on the natural course of chronic HBV infection
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《医学前沿（英文）》 2014年 第8卷 第2期 页码 129-134 doi: 10.1007/s11684-014-0339-x
Chronic hepatitis B virus (HBV) infection is a significant threat to public health and an enormous burden on society. Mechanisms responsible for chronic HBV infection remain poorly understood. A better understanding of the natural course of chronic HBV infection may shed new light on the mechanisms underlying this disease and help in designing new antiviral strategies. Natural course of chronic HBV infection is conventionally viewed as an uninterrupted process that is usually marked by HBV e antigen (HBeAg) seroconversion or characterized by different phases associated with assumed host responses to HBV infection. However, none of these descriptions captures or highlights the core events that determine the natural course of chronic HBV infection. In this review, we briefly present the current knowledge on this subject and explain the significance and implication of events that occur during infection. A pre-core mutant becomes predominant in the viral population following elimination of the wild-type virus in duck hepatitis B virus-chronically infected animals. The coupled events in which first there is viral clearance that clears wild-type virus and then there is the reinfection of wild-type virus cleared livers with mutant virus are highly relevant to understanding of the natural course of chronic HBV infection under both treated and untreated conditions. In our new perspective, a general natural course of chronic HBV infection comprises cycles of viral clearance and reinfection, and such cycles prolong the chronic HBV infection course. Reviewing published data on the natural course of chronic HBV infection can reduce the possibility of missing important points in the initial data interpretation.
关键词： hepatitis B virus chronic HBV infection natural course hepatitis B seroconversion
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《医学前沿（英文）》 2017年 第11卷 第4期 页码 502-508 doi: 10.1007/s11684-017-0590-z
Although the efficacy of nucleos(t)ide analogue (NA) has been confirmed for treatment of chronic hepatitis B, long-term therapy has been recommended due to the high frequency of off-therapy viral DNA rebound and disease relapse. In this review, the RNA virion-like particles of hepatitis B virus (HBV) are integrated into the life cycle of HBV replication, and the potential significance of serum HBV RNA is systematically described. The production of HBV RNA virion-like particles should not be blocked by NA; in this regard, serum HBV RNA is found to be a suitable surrogate marker for the activity of intrahepatic covalently closed circular DNA (cccDNA), particularly among patients receiving NA therapy. Therefore, the concept of virological response is redefined as persistent loss of serum HBV DNA and HBV RNA. In contrast to hepatitis B surface antigen (HBsAg) that can originate from either the cccDNA or the integrated HBV DNA fragment, serum HBV RNA, with pregenomic RNA origination, can only be transcribed from cccDNA. Therefore, the loss of serum HBV RNA would likely be a promising predicator for safe drug discontinuation. The clinical status of consistent loss of serum HBV RNA accompanied with low serum HBsAg levels might be implicated as a “para-functional cure,” a status nearly close to the functional cure of chronic hepatitis B, to distinguish the “functional cure” characterized as serum HBsAg loss with or without anti-HBs seroconversion.
关键词： chronic hepatitis B serum HBV RNA nucleos(t)ide analogs virological response para-functional cure
Eliminating mother-to-child transmission of HBV: progress and challenges in China
Wenzhan Jing, Jue Liu, Min Liu
《医学前沿（英文）》 2020年 第14卷 第1期 页码 21-29 doi: 10.1007/s11684-020-0744-2
关键词： hepatitis B virus mother-to-child transmission progress challenge
张祝琴,刘德培
《中国工程科学》 2017年 第19卷 第2期 页码 112-116 doi: 10.15302/J-SSCAE-2017.02.019
重大慢性非传染性疾病包括心脑血管疾病、癌症、呼吸系统疾病、糖尿病等，其流行给全球居民健康造成了重大威胁。为进一步对慢性病进行有效预防控制，促进健康、推动经济和社会发展，2014年中国工程院立项并开展了“重大慢性非传染性疾病防治的国际对比研究”项目，对国内外慢性病预防控制情况以及可供我们借鉴的经验进行了详细分析本文从慢性病发病概况入手，分析了各种疾病的预防控制措施，并对不同国家的慢性病预防控制体系进行比较，凝练有益经验和方法，提出了增强我国慢性病预防控制的措施和建议。
王陇德
《中国工程科学》 2009年 第11卷 第10期 页码 148-152
阐述临床医学与公共卫生的割裂给中国疾病预防控制工作带来的严重危害；并说明中国卫生系统近年来在弥合这一裂痕方面所做的巨大努力，例如建立了传染病网络直报系统和“不明原因肺炎”监测报告体系，加强了结核病控制工作中医疗机构与疾控机构的紧密衔接，以及临床医学逐步接纳现代疾病防控理念，为适应患者需求，在控制重大慢性疾病—&mdash虽然这些改革措施已经在调整和加强临床与公共卫生两个子系统的联系与合作中发挥了作用，提高了疾病控制体系的整体效能，但是这些进展仅仅是初步的。卫生系统还需要在制定和实施“医疗机构公共卫生工作规范”等方面做出更多的努力，以推动疾病控制效能的进一步提高。
夏家辉
《中国工程科学》 2000年 第2卷 第11期 页码 1-11
介绍了中国医学遗传学国家重点实验室在遗传病家系收集、疾病基因定位、疾病基因克隆和疾病基因功能研究方面的研究工作。用细胞遗传学G显带技术于1975年发现了一条与鼻咽癌相关的标记染色体t（1；3）（q44；p11）；1981年将睾丸决定基因（TDF）定位于Yp11.32带；1991年以来收集遗传病家系345种共590个；1996年用显微切割、PCR、微克隆技术克隆了EXT2基因；1998年用基因家族-候选疾病基因克隆方法克隆了遗传性神经性耳聋基因GJB3；1999年用连锁分析和全基因组扫描将一种遗传性弥漫性浅表性光敏性汗孔角化症定位于
关键词： 遗传病家系 基因定位和克隆 基因家族-候选疾病基因克隆 基因组扫描 基因功能研究
Current hepatitis B treatment guidelines and future research directions
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《医学前沿（英文）》 2014年 第8卷 第2期 页码 145-157 doi: 10.1007/s11684-014-0335-1
Hepatitis B virus (HBV) infection causes a tremendous clinical burden across the world with more than half a million people dying annually from HBV related disease. Significant advances have been made in HBV treatment in the past decade and several guidelines have been published by professional societies and expert panels. Although these recommendations have been valuable to help optimize HBV treatment, there is discordance in treatment criteria and many patients infected with HBV may fall outside of these recommendations. This paper systematically reviews the natural history of the disease and compares and contrasts the recommendations for initiation of treatment from the various societies. There is also discussion of special groups that require particular consideration and some of the open research questions and future research directions within the field.
关键词： chronic hepatitis B HBV treatment guidelines APASL guidelines EASL guidelines AASLD guidelines
Current advances in the elimination of hepatitis B in China by 2030
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《医学前沿（英文）》 2017年 第11卷 第4期 页码 490-501 doi: 10.1007/s11684-017-0598-4
With its 78 million chronic carriers, hepatitis B virus (HBV) infection is still one of the leading public health challenges in China. Over the last two decades, China has made great progress on the prevention of HBV transmission through national vaccination programs. Zero transmission from mother to infant has been proposed as the current goal. Available anti-HBV therapy is efficacious in suppressing HBV replication; however, it fails to completely cure patients with chronic hepatitis B and even requires lifelong treatment. To reduce the costs and improve the efficacy, several trials have been recently conducted in China to optimize the current anti-HBV managements. Novel biomarkers were identified to predict treatment outcomes, and new promising treatment strategies were developed. Reports also indicate that coinfections of HBV with other hepatotropic viruses and human immunodeficiency virus are common in China and cause severe liver diseases, which should be recognized early and treated properly. Work is still needed to eliminate hepatitis B in China by 2030.
兽医流行病学在疾病控制、预防和农场生物安全性中的作用 Review
Ian D. Robertson
《工程（英文）》 2020年 第6卷 第1期 页码 20-25 doi: 10.1016/j.eng.2019.10.004
家养和非家养的动物包括野生动物给人类社会带来了巨大的经济利益和非经济利益，然而，疾病会对这些动物群体的发病率、病死率和生产力产生巨大的影响，因此也会直接和间接地影响与之相关的人类社会。本文概述了预防和控制疾病（主要是家畜疫病）的重要方面，并强调了兽医流行病学在其中发挥的关键作用。总结了疾病频率的衡量标准，确定了疾病风险因素所需的流行病学研究类型，重点在于疾病控制措施制定时的应用。结论：在制定疾病控制策略及在农场、区域和国家层面实施生物安全规划时，需要具备良好的兽医流行病学知识。
关键词： 生物安全性，疾病控制，流行病学
标题 作者 时间 类型 操作
Impact of HBV replication in peripheral blood mononuclear cell on HBV intrauterine transmission
null
期刊论文
Potential use of serum HBV RNA in antiviral therapy for chronic hepatitis B in the era of nucleos(t)ide
null
期刊论文
Eliminating mother-to-child transmission of HBV: progress and challenges in China
Wenzhan Jing, Jue Liu, Min Liu
期刊论文
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