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Despite the remarkable progress in efforts to control disease spread, the nationwide elimination of hepatitis B in China is still hindered by the persistently high rate of hepatitis B virus (HBV) infection in Western China. This study aimed to evaluate the strategy of hepatitis B prevention and control in Western China and identify potential areas and strategies for improvement. Susceptible population vaccination, health education, professional training of doctors, and other prevention and control measures have been implemented in Wuwei city since 2010. Data were obtained from three representative cross-sectional serosurveys conducted in 2010, 2013, and 2015. The serum samples were subjected to enzyme-linked immunosorbent assays to detect the following seromarkers: HBV surface antigen (HBsAg), antibody against hepatitis B surface antigen (anti-HBs), and antibody against hepatitis B core antigen (anti-HBc). Estimates of variance were determined using Taylor series linearization methods. The three serosurveys revealed decreases in the prevalence of HBsAg (7.19% in 2010 vs. 6.51% in 2013 vs. 5.87% in 2015) and anti-HBc positivity (43.89% vs. 32.87% vs. 28.46%) and an increase in the prevalence of anti-HBs positivity (49.07% vs. 53.66% vs. 53.72%) over time. From 2010 to 2015, the legally reported incidence of hepatitis B in Wuwei city decreased from 686.53/100,000 to 53.72/100,000. Notably, persistently high HBsAg-positive rates (above 5.40%) were observed among subjects aged 20–69 years old in the three serosurveys; the prevalence of HBsAg was above 1% among children younger than 10 years old. Furthermore, rural subjects had higher rates of HBsAg and anti-HBc positivity than their urban counterparts (6.04% vs. 4.83% and 30.26% vs. 20.35%, respectively) in 2015 but had a lower rate of anti-HBs positivity (49.68 vs. 55.18%). Multivariate regression analysis showed that age, urban and rural areas, and education level were the main factors affecting HBV infection. Although vaccine-based prevention and control measures reduced the rate of HBV infection in Wuwei City over time, the hepatitis B infection rate in children younger than 10 years was still higher than the national average level. Therefore, the prevention and control of mother-to-child transmission and the management of the infected should be the focus of future prevention and control work. [ABSTRACT FROM AUTHOR]

The mol­ecules of the title compound, C20H18O6S2, lie across centres of inversion. The dihedral angle between the central and terminal benzene rings is 54.92 (9)°. [ABSTRACT FROM AUTHOR]

In the cation of the title compound, C16H14NO3S+·C7H7O3S−, the quinolinium ring system makes a dihedral angle of 69.14 (9)° with the benzene ring. [ABSTRACT FROM AUTHOR]

The prevalence of hepatitis B is high in China. Based on the National Disease Supervision Information Management System of China, the mean reported incidence of hepatitis B was 84.3 per 100,000 in China between 2005 and 2010. There are differences in population distribution based on region and ethnic group. Here, risk factors, virological characteristics, and prophylaxis of hepatitis B in China are reviewed. Although the prevalence of HBV infection is gradually declining, there are many challenges in HBV infection control, including higher prevalence in floating population, poor compliance of antiviral therapy, and high disease burden.

Objective: To evaluate the quality of life and influencing factors on patients with multiple myeloma (MM)., Methods: 227 MM cases were selected at 5 hospitals in Xi'an from August, 2010 to March, 2013. QLQ-C30 was used to evaluate the quality of life of MM patients, and their norms were as control. Factors which influencing the quality of life were investigated and analyzed with SPSS 17.0 software., Results: The total score of quality of life in MM patients was 49.0±21.7 which was lower than the norms (60.7±23.4). The scores on fatigue, nausea, vomiting, pain, short of breath, disturbance on sleeping, losing appetite, constipation, other symptoms and financial difficulty were significantly higher than data of the norms (P < 0.05). Factors as being elderly (especially those older than 70), under higher proportion of medical costs on their own expense or financial difficulty etc., had major influences on the quality of life (P < 0.05) of MM patients who in particular having worse quality of life when in worsening clinical ISS stage (P < 0.05). Low level of hemoglobin, high level of serum calcium and globulin all significantly reduced the quality of life of the MM patients (P < 0.05)., Conclusion: The quality of life of MM patients was significantly lower than the normal people or patients with other tumors. Fatigue, pain, and financial difficulty were main influencing factors on the quality of life of MM patients. The assessment on the effects of treatment should relate to the improvement of hemoglobin, serum calcium and globulin, which could all improve the quality of life of MM patients.

Objective: To observe the changes of human trophoblast cells after infected with hepatitis B virus., Methods: HBV positive serum was used to infect human trophoblast cells in vitro. HBsAg in cell culture medium were detected by ELISA method and HBV DNA in cell culture medium and cells were detected by PCR method. HBV fluorescence polymerase chain reaction diagnose kit were used to detect the HBV DNA concentration. Ultra structure of trophoblast cells were observed with transmission electron microscopy (TEM)., Results: HBsAg could be detected in infection group by ELISA. Infection group cell culture medium and infection group cells were HBV DNA positive. HBV DNA concentrations in HBV infection cell culture medium in 0, 12, 36, 60, 84 h after extensively PBS washed were < 10(3), 3 x 10(4), 6 x 10(5), 5 x 10(5), 3 x 10(5) copies/mL. HBV infected trophoblast cells were found many forms of endosomes, some of which contents virus like particle., Conclusion: HBV might take advantage of clathrin-mediated endocytosis to enter trophoblast cell, which might lead to cell infection or across the cell bar by transcytosis.

Objective: Using the indirect economic burden of stroke in a rural population to develop rational allocation of future health resources, in Hanzhong area., Methods: Cluster sampling which involved 53 natural villages with a total number of 75,000 people selected from the 'stroke monitoring base' of rural population was adopted in this study in the Hanzhong area. All of the 164 stroke cases were studied through a self-designed questionnaire. In calculating disability-adjusted life years (DALYs), fixed value was used in accordance with the value of GBD. The disability assessment was simplified in DALYs calculation and modified Barthel's ADL was used in disability assessment of stroke patients. In indirect economic burden analysis, the human capital method combined with DALYs was adopted with the formula as: indirect economic burden = GNP per capita x DALYs x productivity weight., Results: The total DALYs were 598.88, with an average DALY of stroke as 3.65 per case. The total indirect economic burden of stroke patients in rural areas was 1,993,977.8 RMB and the average of indirect economic burden of stroke was 12,158.4 RMB per case with the largest seen in the 45-59 age group, accounted for 74.4%., Conclusion: In our study, the use of method in combining the human capital with DALYs was the first time being adopted in calculation of the indirect economic burden of stroke in rural population in China. The burden seemed to be much lower than literature cited from other countries. It was reasonable to evaluate indirect economic burden of stroke using method in integrating DALYs with human capital, but it was difficult to calculate the DALYs.

Objective: To study the efficacy of hepatitis B immunoglobulin (HBIG) combining hepatitis B vaccine in high risk infants born to HBsAg positive mothers through a follow-up study program., Methods: 184 infants (4 twin pairs) born to HBsAg carrier mothers who were consecutively recruited from December 2002 to August 2004 were followed. Major HBV serologic markers in all infants were detected by enzyme-linked immunosorbent assay (ELISA) when they were at birth, at 7th, at 24th and at 36th months., Results: 7 of the 184 infants were HBsAg positive at birth, making the transplacental intrauterine infection rate of HBV as 3.80% (7/184). 125 infants were followed up at 7th months and 108 infants were followed up at 24th and 36th months. Only 2 of the 7 infants born to HBsAg-positive and HBeAg-positive mothers were persistently sera positive for HBsAg, making the chronic infection rate of HBV as 28.57%. The other 140 infants were HBsAg negative during t he follow-up period. The rate o f detectable anti-HBs i ninfants was 7.02% at birth. After infants were immunized by HBIG combining hepatitis B vaccine, the anti-HBs-positive rate reached 92% at 7th months, and gradually descended thereafter. 72.04% of the infants at 24th and 60% at 36th months showed detectable levels of anti-HBs. There was significant correlation between the produce of anti-HBs in infants and HBsAg-positive at birth while HBsAg-positive and HBeAg-positive in mothers did not relate to the produce of anti-HBs in their infants. Of 39 infants born to HBsAg-positive and HBeAg-positive mothers, 25 showed detectable levels of HBeAg. During the follow-up peirod, HBeAg was still detectable in 2 infants who were also HBsAg positive and the others all became HBeAg-negative but no infant became HBeAg-positive., Conclusion: The efficacy of HBIG combining hepatitis B vaccine in high risk infants was fine.

Objective: The purpose of this study was to describe survival status and risk factors of mortality on inpatients with ischemic stroke., Methods: 617 patients with continuous ischemic stroke cases were collected from January 2002 to June 2005 retrospectively in the Department of Neurology, Xijing Hospital, Fourth Military Medical University. In order to perceive relevant information on survival and the cause of death. All patients were followed through phone calls or mailing. The follow-up program was completed in January 2006. Kaplan-Meier methods were used for survival description. Monovariant and multivariant Cox's proportional hazard regression model were used to analyze prognostic factors on mortality., Results: The longest time in the follow-up program was 47 months with 59 dropped-out cases, making the dropout rate as 9.5%. Of these patients, 80 cases died during the period of study(60 for ischemic stroke,3 for cerebral hemorrhage, 10 for cardiac disease, 7 for other cause). The median survival time was 42. 16 months. The survival rates of one-year, two-year and three-year period were 91.9%, 89.4% and 85.3%, respectively. Monovariant and multivariant Cox's proportional hazard regression model showed that the risk factors associated with mortality were old age (RR = 1.043, 95% CI: 1.013-1.074), lower Glasgow scores (RR = 0.855, 95% CI: 0.742-0.985) ,poor conscious levels(RR = 4.085, 95% CI: 2.128-7.844) and having complication (RR = 1.765, 95% CI: 1.108-2.812)., Conclusion: The results of this study suggested that the risk factors were old age, lower Glasgow scores, poor conscious levels and having complication on mortality of ischemic stroke.

Objective: To examine risk factors of chronic obstructive pulmonary disease (COPD) deaths in Chinese military elderly men., Methods: A cohort analytic study was carried out in Xi'an, China. A total of 1268 retired military males aged 55 or older were examined in 1987 and followed for 18 years. Main outcome measures were all causes and COPD deaths., Results: The total person-years of follow-up from 1987 until June 2005 was 18 766.28. The mean follow-up time was 14.35 years; A total of 491 had died, with 748 alive and 29 lost of follow-up. COPD was the second cause of death in all deaths (16.90%). Results Univariate analysis of Cox model showed that age, number of smoking cigarettes per day, duration of smoking, negative affairs and existing COPD were risk factors of COPD deaths and the relative risks [95% confidence intervals (CI)] were 1.13 (1.09-1.17), 1.04 (1.02-1.06), 1.03 (1.01-1.04), 1.81 (2.85-6.77) and 4.39 (2.85-6.77) respectively. Data from Multivariate analysis of Cox model showed that age, number of smoking cigarettes per day and existing COPD were risk factors of COPD death with relative risks [95% confidence intervals (CI)] as 1.10 (1.06-1.15), 1.03 (1.01-1.06) and 3.07 (1.90-4.98) respectively. The risks for deaths increased significantly with increasing amount and duration of smoking resulting from all causes and COPD. Compared with current smokers, former smokers had lower risks of total mortality(excess risk reduction of 66.67%)., Conclusion: COPD was the second cause among all deaths in this cohort. Age, number of smoking cigarettes per day and existing COPD were the risk factors of COPD deaths which called for further survey to examine the relationship between quitting smoking and COPD deaths in this cohort.

Objective: To determine the role of hepatitis B Immunoglobulins (HBIG) in blocking hepatitis B virus (HBV) infection of trophoblast cell culture in vitro., Methods: Trophoblast cells were placed in the six-well cluster dishes and incubated with 10% fetal calf serum/Dubecco's modified Eagle's Medium (10% FCS DMEM) at 37 degrees C with 5% CO2 in air. At 24 h after plating cells were subjected to experiment. Group A: cells were cultured with 0.5 ml HBV positive serum plus 3 ml 2% FCS DMEM; Group B: cells were cultured with 3 ml 2% FCS DMEM plus 0.5 ml HBV positive serum pretreated with 80 U HBIG for 30 min at 37 degrees C; Group C: cells were cultured with 3 ml 2% FCS DMEM plus 0.5 ml HBV positive serum pretreated with 40 U HBIG for 30 min at 37 degrees C; Group D: cells were cultured with 3 ml 2% FCS DMEM plus 40 U HBIG for 30 min before 0.5 ml HBV positive serum was added; Group E: cells were cultured with 40 U HBIG plus 3 ml 2% FCS DMEM; Group F: cells were cultured with HBV negative serum plus 3 ml 2% FCS DMEM. Twenty-four hours later the inoculums were removed, and the cells were extensively washed with 0.01 mol/L phosphate-buffered saline (PBS). After PBS washing, 4 ml 2% FCS DMEM was added to each well and the medium was collected every 12 hours. Enzyme-Linked Immunosorbent Assay (ELISA) method was used to detect HBsAg in culture medium (absorption value, A). HBV DNA in cell culture medium was detected by polymerase chain reaction (PCR)., Results: Before PBS washing, the A value of groups A, B, C, D, E, F were 2.697, 0.040, 0.102, 0.198, 0.036, 0.040 respectively. The cell culture medium in groups of A, B, C, and D were HBV DNA positive, groups of E, F were HBV DNA negative. From 12 hours to 84 hours, the average A value of groups A, B, C, D, E and F was 1.55 +/- 0.27, 0.032 +/- 0.016, 0.100 +/- 0.087, 0.052 +/- 0.044, 0.034 +/- 0.020, 0.034 +/- 0.022 respectively. The A value of groups A was significantly higher than those of other groups (P < 0.01). Cell culture medium at 84 hours of group A was HBV DNA positive and those of group B, C, D, E, F were HBV DNA negative., Conclusion: HBIG could effectively block HBV infection of trophoblast cell culture in vitro.

Objective: To screen cellular proteins binding to the core region of hepatitis C virus (HCV) from human hepatoma cells., Methods: Unlabeled and labeled RNA transcripts were prepared by in vitro transcription. Cytoplasmic extracts were prepared from human hepatoma cells HepG2. Ultraviolet (UV) cross-linking was used to screen the cellular proteins that would bind to the core region of HCV. Competition experiment was performed to confirm the specificity of the binding in which excess unlabeled RNA of HCV core region and plasmid RNA were used as competitors., Results: Two cellular proteins of 6.6 x 10(4) and 5.5 x 10(4) were found binding to the core region of HCV RNA by UV cross-linking assay. The unlabeled core region of HCV RNA could compete out this binding whereas the unlabeled plasmid RNA could not., Conclusion: The cellular proteins from HepG2 cells could bind to the core region of HCV RNA.

Objective: To analyze the direct economic burden of stroke in rural areas of Hanzhong., Methods: Plan on primary interview was made after the purpose of the study had been informed to the managers of the 'surveillance field base', heads and members of the monitor assistants and detailed information was collected in the fields. Every single patient of stroke was then interviewed by the above said interviewers,using a self-designed questionnaire. 164 patients with stroke were interviewed in 53 villages with 75,000 persons lived there. The main items involved in the questionnaire would include: costs for inpatient or outpatient, reaching-out fees, fee for accommodation during treatment as outpatient, costs for treatment at home, long term medicine, caregivers and funerals as well as average income., Results: The median of annual direct economic burden was 3100 Yuan for each patient in Hanzhong rural area. There were no significant differences seen between males and females or among age groups (P > 0.05). The proportion of patients with medians of annual direct economic burden of: 1000 Yuan and below, 1001-5000 Yuan, 5001-10,000 Yuan, 10,001-20,000 Yuan and over 20,001 Yuan, were 29.2%, 36.0%, 18.3%, 9.8% and 6.0% respectively. The median of annual direct economic burden of first episode stroke was 5500 Yuan for each patient, and that of stroke was 1700 Yuan for each chronic patient. The direct economic burden of first episode was significantly higher than that of stroke (P < 0.01). The costs of hospitalization, accommodation of hospitalization and treatment at home of middle-aged patients were significant higher than that of old age patients (P < 0.05)., Conclusion: In this study, the direct economic burden of stroke was 2.9 times of the annual personal average income, which was contrary to the reports from other countries. However, the State Health Bureau bore 87.1% of the direct economic burden for urban patients, but patients in the rural areas had to pay from their own pockets. The direct economic burden of stroke was heavy in Hanzhong rural region, which called for measures to be made to decrease the direct economic burden of stroke in the region.

Objective: To establish a culture system of HBV positive serum infected Hep G2 cells in vitro., Methods: Hep G2 cells were seeded into six-well cluster dishes, at 1 x 10(-6) cells per well and incubated with 3 ml 10% fetal calf serum/ Dulbecco's modified Eagle's medium (10% FCS/DMEM) at 37 degrees in 5% CO2 air. At 24 h after plating, infection group Hep G2 cells were cultured with 0.5 ml HBV positive serum, in control group HBV negative serum was used, 24 h later the inoculums was removed. The cells were then extensively washed with 0.01 mol/L phosphate-buffered saline (PBS). After washing with PBS, 4 ml 2% FCS/DMEM were added to each well and the medium was collected every 12 h. ELISA method was used to detect HBsAg in culture medium. HBV DNA in cells and culture medium was detected by PCR., Results: In infection group, HBsAg could be detected from cell culture medium from 12 h (after PBS washed) to 84 h. HBV DNA could be detected by PCR in culture medium and cells., Conclusion: Infection of Hep G2 cells by HBV positive serum is feasible.

Previous studies reported that the HBV DNA level in maternal serum is an important risk factor for intrauterine infection. Two antiviral drugs, lamivudine (3TC) and interferon alpha (IFNalpha), are used extensively clinically to reduce maternal HBV DNA level, However, because of a lack of evidence on the efficacy and safety of these drugs during pregnancy, they are categorized as grade C which prevents their use during pregnancy. This study provides new data on the efficacy and safety of lamivudine and IFNalpha in HBV positive transgenic pregnant mice. In this study, transgenic mice with high titers of hepatitis B virus (HBV) were employed to study the antiviral effects of 3TC and IFNalpha during different gestation periods. The study also examined changes in several serological HBV markers, the effects of perinatal exposure to antiviral drugs on the mother and offspring, drug efficacy in reducing the level of HBV DNA in maternal blood, and the safety to both the mother and offspring. The main conclusion of the study is that a significant decrease in HBV DNA level can be obtained after treatment with lamivudine but not with IFNalpha. No adverse effects were observed in the maternal mice and the offsprings. This finding may provide a rationale for the potential use of lamivudine for the treatment of pregnant women as a safe and effective measure to reduce the level of maternal viremia., (Copyright 2005 Wiley-Liss, Inc.)

Objective: To observe the presence of hepatitis B virus (HBV) in first-trimester villi cells from pregnant women carrying HBsAg., Methods: Immunohistochemical streptavidin-biotin peroxidase complex (SABC) staining with monoclonal HBsAg, hepatitis B core antigen (HBcAg) and PCR, in situ hybridization were used for detection of HBV infection markers in villi. Positive villi ultramicrostructures were observed with transmission electron microscope., Results: HBV was detected in 8 of 25 villi of HBsAg positive pregnant women, the positive rate was 32%. HBsAg was located in the decidual cell, trophoblastic cell and villous mesenchymal cell. HBV analog was detected in rough endoplasmic reticulum of trophoblastic cell., Conclusions: HBV may infect villous cells in first-trimester pregnancy. It would be impossible for HBV to transmit the desmosomes.

Objective: To observe the efficacy and safety of lamivudine and interferon-alpha (IFN-alpha) therapy on decrease of serum hepatitis B virus (HBV) loading of HBV transgenic mice during pregnancy., Methods: Thirty-five transgenic mice replicating high levels of hepatitis B virus were randomly allocated into 5 groups, each of seven. Pregnant HBV transgenic mice in experimental groups 1 and 2 were given orally lamivudine [100 mg/(kg x d)] from pregnancy day 5 or 10 to delivery, mice in experimental groups 3 and 4 were given intramuscular (im) injection of IFN-alpha [5MU/(m(2) x 2d)], and mice in experimental group 5 were given normal saline at the same times. The changes of serum HBsAg, HBV DNA before and after the treatment were detected. At the same time, eighteen C57BL/6J female mice (clean level) were randomly allocated into control groups 1, 2 and 3 (each group of six), which were given lamivudine, IFN-alpha and saline respectively (the dosage was the same as that of experimental groups). The safety indexes of pregnant mice, fetus and newborns in experimental groups and control groups were observed., Results: (1) The changes of serum HBsAg titers: The average serum HBsAg titers from mice in experimental group 1 were lowered significantly from (166 +/- 98) ng/ml to (82 +/- 59) ng/ml after drug treatment (P < 0.05). Those from mice in experimental group 2 were also reduced from (159 +/- 49) ng/ml to (82 +/- 60) ng/ml after drug treatment, but there was no significant difference between before and after the treatment (P > 0.05). There was no significant difference in serum HBsAg between before and after the treatment in other groups (P > 0.05). (2) The changes of HBV DNA titers: The serum HBV DNA titers from mice in experimental groups 1 and 2 were significantly decreased, from (5.50 +/- 0.86) copies/ml to (2.58 +/- 2.01) copies/ml, with significant difference between before and after the treatment (P < 0.01). Those from mice in experimental groups 3 and 4 were reduced from (5.55 +/- 0.24) copies/ml to (5.46 +/- 0.45) copies/ml, without significant difference between before and after the treatment (P > 0.05). The serum HBV DNA titer from mice in experimental group 5 was not different between before and after the treatment (P > 0.05). (3) Observation of safety indexes: no evidence in toxicity were observed in mice from experimental groups and control groups. No significant abnormalities of live fetus were observed. The postnatal survival and weight of live pups were not different between the groups (P > 0.05). (4) Comparison of the rate of dead fetus and the rate of maternal dead fetus: The rate of dead fetus and the rate of maternal dead fetus from mice in experimental groups 1 and 2 were 8.3% and 50.0% respectively, those from mice in experimental groups 3 and 4 were 8.2% and 66.7% respectively, and those from mice in experimental group 5 were 9.7% and 66.7%. There was no significant difference in the rate of dead fetus and the rate of maternal dead fetus from mice between the groups (P > 0.05)., Conclusions: Effective lamivudine treatment during gestation can reduce hepatitis B viremia in pregnant HBV transgenic mice, thus lowering the risk of intrauterine infection. It has no significant adverse effect on safety of pregnant mice and their offspring.

Objective: Case-control study was employed to explore the association of sexual behavior during pregnancy and hepatitis B virus (HBV) intrauterine infection., Methods: 212 HBsAg positive pregnant women were consecutively collected and investigated as objects. Those neonates detected for HBsAg with S/N value > or = 5 by Abbott reagents in periphery sera were selected as cases, others as controls. Information on sexual behavior during pregnancy, maternal HBeAg status and other factors was collected, and were analyzed with univariate analysis, multivariate logistic regression analysis, etc, to explore the association of factors with HBV intrauterine infection., Results: Ten of the 214 neonates were validated as occurrence of HBV intrauterine infection. Sexual behavior in the second trimester during pregnancy, with odd ratios 9.15 (95% CI: 1.10 - 76.28), as well as maternal positivity for HBeAg and HBV DNA, was significantly associated with HBV intrauterine infection, and sequently affirmed by multiple logistic regression analysis. The strength of association increased with frequency of sexual behavior. Interaction analysis suggested that there was synergistic interaction between maternal positivity of HBeAg and sexual behavior in the second trimester., Conclusion: Sexual behavior was a newly discovered risk factor for HBV intrauterine infection, which need to be estimated in future studies. Inhibition of virus replication and moderate control of sexual behavior would be helpful to prevent HBV intrauterine infection.