AIM To investigate the prevalence and clinical significance of autoimmune liver disease(ALD)-related autoantibodies in patients with biliary atresia(BA).METHODS Sera of 124 BA patients and 140 age-matched non-BA contr...AIM To investigate the prevalence and clinical significance of autoimmune liver disease(ALD)-related autoantibodies in patients with biliary atresia(BA).METHODS Sera of 124 BA patients and 140 age-matched non-BA controls were assayed for detection of the following autoantibodies: ALD profile and specific anti-nuclear antibodies(ANAs), by line-blot assay; ANA and antineutrophil cytoplasmic antibody(ANCA), by indirect immunofluorescence assay; specific ANCAs and antiM2-3 E, by enzyme linked immunosorbent assay. Associations of these autoantibodies with the clinical features of BA(i.e., cytomegalovirus infection, degree of liver fibrosis, and short-term prognosis of Kasai procedure) were evaluated by Spearman's correlation coefficient.RESULTS The overall positive rate of serum autoantibodies in preoperative BA patients was 56.5%. ALD profile assay showed that the positive reaction to primary biliary cholangitis-related autoantibodies in BA patients was higher than that to autoimmune hepatitis-related autoantibodies. Among these autoantibodies, anti-BPO was detected more frequently in the BA patients than in the controls(14.8% vs 2.2%, P < 0.05). Accordingly, 32(25.8%) of the 124 BA patients also showed a high positive reaction for anti-M2-3 E. By comparison, the controls had a remarkably lower frequency of anti-M2-3 E(P < 0.05), with 6/92(8.6%) of patients with other liver diseases and 2/48(4.2%) of healthy controls. The prevalence of ANA in BA patients was 11.3%, which was higher than that in disease controls(3.3%, P < 0.05), but the reactivity to specific ANAs was only 8.2%. The prevalence of ANCAs(ANCA or specific ANCAs) in BA patients was also remarkably higher than that in the healthy controls(37.9% vs 6.3%, P < 0.05), but showed no difference from that in patients with other cholestasis. ANCA positivity was closely associated with the occurrence of postoperative cholangitis(r = 0.61, P < 0.05), whereas none of the autoantibodies showed a correlation to cytomegalovirus infection or the stages of liver fibrosis.CONCLUSION High prevalence of autoantibodies in the BA developmental process strongly reveals the autoimmunemediated pathogenesis. Serological ANCA positivity may be a useful predictive biomarker of postoperative cholangitis.展开更多
Objective: To analyze the efficacy of phenobarbital combined with mild hypothermia in the treatment of neonatal asphyxia. Methods: Subjects selected 50 children with neonatal asphyxia treated in our hospital from Febr...Objective: To analyze the efficacy of phenobarbital combined with mild hypothermia in the treatment of neonatal asphyxia. Methods: Subjects selected 50 children with neonatal asphyxia treated in our hospital from February 2016 to August 2017. They were randomly divided into a control group and an observation group with 25 cases in each group. The two groups of children were given routine resuscitation treatment. The control group was given phenobarbital injection on the basis of this. The observation group was given phenobarbital combined with mild hypothermia treatment, the heart rate, respiration, blood pressure changes, liver and kidney function, coagulation function and blood gas analysis after treatment were analyzed and compared between the two groups. At the same time, the outcomes and NBNA scores of the two groups were compared. Results: During the course of treatment, the heart rate of the observation group at the same time period was significantly lower than that of the control group (P<0.05);After treatment, Respiratory, systolic and diastolic blood pressures in two groups of children, serum urea (BUN), serum creatinine (Scr), thromboplastin time (PT), plasma thrombin time (TT), arterial serum pH, blood, There was no significant difference in partial pressure of oxygen (PO2) and remaining alkali (BE) (all P>0.05), the alanine aminotransferase (ALT), aspartate aminotransferase (AST), and NBNA scores in the observation group were significantly higher than those in the control group (all P<0.05), the length of hospitalization and feeding time were significantly lower than those in the control group (all P<0.05). Conclusion: Phenobarbital combined with mild hypothermia for neonatal asphyxia can significantly improve brain damage and liver and kidney function in children, reduce acidosis and respiratory depression, and have no negative effect on heart rate, blood pressure, coagulation function, etc. The efficacy is good and its safety is high.展开更多
基金the Guangdong Provincial Science and Technology Planning Project,No.2014A020212520the Guangzhou Science and Technology Project,No.201707010014
文摘AIM To investigate the prevalence and clinical significance of autoimmune liver disease(ALD)-related autoantibodies in patients with biliary atresia(BA).METHODS Sera of 124 BA patients and 140 age-matched non-BA controls were assayed for detection of the following autoantibodies: ALD profile and specific anti-nuclear antibodies(ANAs), by line-blot assay; ANA and antineutrophil cytoplasmic antibody(ANCA), by indirect immunofluorescence assay; specific ANCAs and antiM2-3 E, by enzyme linked immunosorbent assay. Associations of these autoantibodies with the clinical features of BA(i.e., cytomegalovirus infection, degree of liver fibrosis, and short-term prognosis of Kasai procedure) were evaluated by Spearman's correlation coefficient.RESULTS The overall positive rate of serum autoantibodies in preoperative BA patients was 56.5%. ALD profile assay showed that the positive reaction to primary biliary cholangitis-related autoantibodies in BA patients was higher than that to autoimmune hepatitis-related autoantibodies. Among these autoantibodies, anti-BPO was detected more frequently in the BA patients than in the controls(14.8% vs 2.2%, P < 0.05). Accordingly, 32(25.8%) of the 124 BA patients also showed a high positive reaction for anti-M2-3 E. By comparison, the controls had a remarkably lower frequency of anti-M2-3 E(P < 0.05), with 6/92(8.6%) of patients with other liver diseases and 2/48(4.2%) of healthy controls. The prevalence of ANA in BA patients was 11.3%, which was higher than that in disease controls(3.3%, P < 0.05), but the reactivity to specific ANAs was only 8.2%. The prevalence of ANCAs(ANCA or specific ANCAs) in BA patients was also remarkably higher than that in the healthy controls(37.9% vs 6.3%, P < 0.05), but showed no difference from that in patients with other cholestasis. ANCA positivity was closely associated with the occurrence of postoperative cholangitis(r = 0.61, P < 0.05), whereas none of the autoantibodies showed a correlation to cytomegalovirus infection or the stages of liver fibrosis.CONCLUSION High prevalence of autoantibodies in the BA developmental process strongly reveals the autoimmunemediated pathogenesis. Serological ANCA positivity may be a useful predictive biomarker of postoperative cholangitis.
文摘Objective: To analyze the efficacy of phenobarbital combined with mild hypothermia in the treatment of neonatal asphyxia. Methods: Subjects selected 50 children with neonatal asphyxia treated in our hospital from February 2016 to August 2017. They were randomly divided into a control group and an observation group with 25 cases in each group. The two groups of children were given routine resuscitation treatment. The control group was given phenobarbital injection on the basis of this. The observation group was given phenobarbital combined with mild hypothermia treatment, the heart rate, respiration, blood pressure changes, liver and kidney function, coagulation function and blood gas analysis after treatment were analyzed and compared between the two groups. At the same time, the outcomes and NBNA scores of the two groups were compared. Results: During the course of treatment, the heart rate of the observation group at the same time period was significantly lower than that of the control group (P<0.05);After treatment, Respiratory, systolic and diastolic blood pressures in two groups of children, serum urea (BUN), serum creatinine (Scr), thromboplastin time (PT), plasma thrombin time (TT), arterial serum pH, blood, There was no significant difference in partial pressure of oxygen (PO2) and remaining alkali (BE) (all P>0.05), the alanine aminotransferase (ALT), aspartate aminotransferase (AST), and NBNA scores in the observation group were significantly higher than those in the control group (all P<0.05), the length of hospitalization and feeding time were significantly lower than those in the control group (all P<0.05). Conclusion: Phenobarbital combined with mild hypothermia for neonatal asphyxia can significantly improve brain damage and liver and kidney function in children, reduce acidosis and respiratory depression, and have no negative effect on heart rate, blood pressure, coagulation function, etc. The efficacy is good and its safety is high.
基金This research was supported by the Youth Talent Project of Hubei Provincial Department of Education(Q20162904)the Open Fund of Hubei Key Laboratory of Economic Forest Germplasm Improvement and Resources Comprehensive Utilization(202141704)the Open Fund of Key Laboratory of Biodiversity Science and Ecological Engineering,Ministry of Education(K201802).
