| Background:Chronic hepatitis B(CHB)and urinary tract infection(UTI)are common infectious diseases,and the treatment plan involves many aspects.Hepatitis B virus(HBV)infection is a worldwide epidemic.There are about 2 billion people have been infected with HBV,and about 650,000 people die each year from hepatic failure,cirrhosis and hepatocellular carcinoma(HCC)caused by HBV infection.There are about 93 million chronic HBV infections in China,of which 20 million are CHB.Interferon(IFN),as a first-line drug for the treatment of chronic hepatitis B,may causes thyroid dysfunction in some patients during treatment.Does thyroid dysfunction before or during interferon therapy affect the efficacy of antiviral therapy?So far,no reports have been reported in this literature.The methods of diagnosis of UTI include routine urine examination,quantitative bacterial culture and urinary sediment smear.The false-negative and false-positive rate of routine urine test is high.Urine culture is the gold standard for UTI diagnosis,but the method has a long cycle to report and may lead to delays in illness.Therefore,in order to meet the urgent need of clinical treatment,UTI bacteriological test must take measures to shorten the reporting time.This study is divided into two parts,as follows:Part ?:Effect of interferon therapy on thyroid function in adult patients with chronic hepatitis B and its correlation with therapeutic effectObjective:To observe the changes of thyroid function in adults with chronic hepatitis B treated with interferon,and to explore the effect of thyroid dysfunction on antiviral efficacy.Methods:A retrospective study was conducted to investigate 342 adult patients with chronic hepatitis B who were treated with interferon for more than 12 weeks at Nanfang Hospital,Southern Medical University between December 2010 and December 2017.Patients with normal thyroid function before and during IFN treatment were defined as normal thyroid function group(n=201);patients with thyroid dysfunction before or during IFN treatment were defined as thyroid dysfunction group(n=141).The antiviral efficacy were compared between the two groups.Results:During the IFN treatment,69 of270(25.6%)patients with baseline normal thyroid function developed thyroid dysfunction,whereas 11 of 72(15.3%)patients with baseline thyroid dysfunction returned to normal thyroid function.Univariate analysis showed that the thyroid dysfunction group was significantly higher than the normal thyroid function group in the HBV DNA negative conversion rate and the low level of HBsAg rate(?2=21.830,P<0.001;?2=5.476,P=0.019).Logistic multivariate regression analysis showed that the abnormal thyroid function group was significantly higher in the HBsAg loss rate than that in the normal thyroid function group(OR:4.945;95%CI:1.325-18.462;P?0.017).Conclusion:These results suggested that thyroid dysfunction is not an absolute contraindication to IFN therapy,and can be used as a new indicator for predicting the efficacy of IFN.Part ?:Utility of Gram-stained urine sediment for the detection of bacterialurinary tract infectionObjective:To evaluate the role of gram staining of urinary sediment for the detection of bacterial urinary tract infection.Methods:298 urine samples were tested by bacterial culture and gram staining,respectively.Routine urine analysis results of the 221 of the 298 samples were collected to compare with the two methods mentioned above.Results:The consistency rate was 93.3%between gram staining and bacterial culture.The sensitivity,specificity,positive predictive value and negative predictive value of Gram staining for urine sediment smear are 91.9%,94.1%,90.2%,95.1%,which are higher compared to urine routine examination.Conclusion:Gram staining of urinary sediment smear can be used as a rapid screening method for urinary tract infection. |
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