Qidong hepatitis B virus (HBV) infection cohort (QBC) is a prospective community-based study designed to investigate causative factors of primary liver cancer (PLC) in Qidong, China, where both PLC and HBV infection a...
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Qidong hepatitis B virus (HBV) infection cohort (QBC) is a prospective community-based study designed to investigate causative factors of primary liver cancer (PLC) in Qidong, China, where both PLC and HBV infection are highly endemic. Residents aged 20-65 years, living in seven townships of Qidong, were surveyed using hepatitis B surface antigen (HBsAg) serum test and invited to participate in QBC from June 1991 to December 1991. A total of 852 and 786 participants were enrolled in HBsAg-positive and HBsAg-negative sub-cohorts in May 1992, respectively. All participants were actively followed up in person, received HBsAg, alanine aminotransferase, alpha-fetoprotein tests and upper abdominal ultrasonic examination, and donated blood and urine samples once or twice a year. The total response rate was 99.6%, and the number of incident PLC was 201 till the end of February 2017. The ratio of incidence rates was 12.32 [95% confidence interval (CI): 7.16-21.21, P < 0.0001] in HBsAg-positive arm compared with HBsAg-negative arm. The relative risk of PLC was 13.25 (95%CI: 6.67-26.33, P < 0.0001) and 28.05 (95% CI: 13.87-56.73, P < 0.0001) in the HBsAg+/HBeAg-group and the HBsAg+/HBeAg+ group, respectively, as compared to the HBsAg-/HBeAg- group. A series of novel PLC-related mutations including A2159G, A2189C and G2203W at the C gene, A799G, A987G and T1055A at the P gene of HBV genome were identified by using samples from the cohort. The mutation in HBV basal core promoter region of HBV genome has an accumulative effect on the occurrence of PLC. In addition, the tripartite relationship of aflatoxin exposure, P53 mutation and PLC was also investigated. QBC will be used to develop dynamic prediction model for PLC risk by using its long-term follow-up information and serial blood samples. This model is expected to improve the efciency of PLC screening in HBV infection individuals.
目的 Miller fisher综合征1例及其与Bickerstaff脑干脑炎(BBE)的鉴别。方法分享1例我院fisher综合征患者的临床资料,并综合文献,阐述疾病的临床特点及发病机制、治疗方法,并且与BBE相鉴别。结果此患者表现为四肢乏力、共济失调、眼外肌...
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目的 Miller fisher综合征1例及其与Bickerstaff脑干脑炎(BBE)的鉴别。方法分享1例我院fisher综合征患者的临床资料,并综合文献,阐述疾病的临床特点及发病机制、治疗方法,并且与BBE相鉴别。结果此患者表现为四肢乏力、共济失调、眼外肌麻痹、视物双影、及腱反射减弱,化验脑脊液未见有明显蛋白-细胞分离,治疗好转出院。进一步阐述BBE与此病的鉴别要点。结论 MFS与BBE的鉴别主要依靠病史及临床表现,做到早期诊断早期治疗。
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