目的 分析乙型肝炎病毒（HBV）感染患者并发2型糖尿病（T2DM）相关风险因素。方法 研究收集2024年1月~2025年5月期间，于周口市传染病医院（周口市结核病防治所、周口市第五人民医院）接受治疗的HBV感染患者临床资料，共纳入患者95例，根据HBV感染后是否并发T2DM分组，合并T2DM患者纳入并发组（n=21），非合并T2DM患者纳入对照组（n=74），比较两组患者基线资料及实验室检查数据，逻辑回归分析HBV感染患者并发T2DM风险因素。结果 并发组年龄、体重指数（BMI）、甘油三酯（TG）高于对照组（P＜0.05），年龄≥45岁、BMI肥胖、HBV感染时间≥6个月、TG≥1.7mmol/L、吸烟、乙型肝炎表面抗原（HBsAg）阳性及纤维化-4（FIB-4）指数≥2.67例数占比高于对照组（P＜0.05）。年龄≥45岁[OR=21.599（95%CI：2.875-162.262）]、BMI（肥胖）[OR=16.729（95%CI：1.443-193.981）]、HBV感染时间≥6个月[OR=6.199（95%CI：1.101-34.904）]、吸烟[OR=9.429（95%CI：1.344-66.141）]、TG≥1.7mmol/L[OR=71.834（95%CI：7.060-730.897）]是HBV感染患者并发T2DM危险因素（P＜0.05）。结论 HBV感染患者并发T2DM受人口学特征年龄、BMI、临床病程HBV感染时间、共病血脂异常及生活方式吸烟的共同影响。

Abstract: Objective To analyze risk factors associated with the development of type 2 diabetes mellitus (T2DM) in patients with hepatitis B virus (HBV) infection. Methods Clinical data were collected from HBV-infected patients treated at the Zhoukou City Infectious Disease Hospital (Zhoukou City Tuberculosis Prevention and Control Institute)between January 2024 and May 2025. A total of 95 patients were included in the study, Patients were grouped based on the presence or absence of T2DM following HBV infection. Patients with T2DM were included in the T2DM group (n=21), while those without T2DM were included in the control group (n=74). Baseline characteristics and laboratory test data were compared between the two groups, and logistic regression analysis was performed to identify factors associated with the development of T2DM in HBV-infected patients. Results The age, body mass index (BMI), and triglycerides (TG) in the intervention group were higher than those in the control group (P < 0.05); The proportion of cases with age ≥45 years, obese BMI, HBV infection duration ≥6 months, TG ≥1.7 mmol/L, smoking, hepatitis B surface antigen (HBsAg) positivity, and a FIB-4 score ≥2.67 was higher than that in the control group (P < 0.05). Age ≥ 45 years [OR = 21.599 (95% CI: 2.875–162.262)], BMI (obesity) [OR = 16.729 (95% CI: 1.443–193.981)], duration of HBV infection ≥ 6 months [OR = 6.199 (95% CI: 1.101–34.904)], smoking [OR=9.429 (95% CI: 1.344–66.141)], and TG ≥ 1.7 mmol/L [OR=71.834 (95% CI: 7.060–730.897)] were risk factors for T2DM in patients with HBV infection (P < 0.05). Conclusion The development of T2DM in patients with HBV infection is influenced by a combination of demographic factors (age and BMI), clinical course (duration of HBV infection), comorbid dyslipidemia, and lifestyle factors (smoking).

目的 探究长链非编码RNA SNHG12在乙肝病毒X蛋白(HBx)诱导肝癌发生过程中的作用。方法 把课题组构建的肝前体细胞14-19、EGFP-14-19、HBx-EGFP-14-19通过小鼠肝门静脉注射到体内;采用 qRT-PCR、Western blot 方法检测30 d,90 d,180 d,360 d小鼠肝脏组织及细胞模型中HBx、SNHG12以及下游调节基因的mRNA和蛋白表达情况;使用si-SNHG12干扰其表达,并通过CCK-8、划痕实验、transwell实验、流式细胞术观察其对体外表型影响;检测SNHG12及下游的 mRNA 和蛋白表达;HE染色观察小鼠肝组织切片。结果 qRT-PCR结果表明SNHG12、Notch1、Hes1在HBx-EGFP-14-19细胞及各时间段的小鼠肝组织中均上调(F=48.808,P<0.000 1;F=13.322,P<0.000 1);Western blot结果显示在HBx过表达细胞及动物模型中,受HBx诱导SNHG12表达升高后Notch1信号通路被激活,促凋亡因子Bax下调,抗凋亡因子Bcl-2上调,细胞周期因子CDK2和Cyclin E上调;抑制SNHG12表达后,qRT-PCR、Western blot实验结果显示SNHG12(t=22.746,P<0.000 1)及其上述基因表达均扭转,CCK-8实验显示细胞增殖受到明显抑制,流式细胞术检测显示细胞凋亡增多,划痕及transwell实验表明细胞迁移及侵袭减弱。结论 HBx通过上调SNHG12诱导Notch1表达,导致细胞增殖、周期和凋亡异常,从而促进肝癌的发生。

Objective In order to explore the role of long non-coding RNA SNHG12 in hepatitis B virus X protein (HBx) induced hepatocarcinogenesis. Methods The liver precursor cells 14-19, EGFP-14-19 and HBx-EGFP-14-19 constructed by the research group was injected into the body through the hepatic portal vein of KM mice; qRT-PCR and Western blot were used to detect the mRNA and protein expression of HBx, SNHG12 and downstream regulatory genes in liver tissues of 30 d, 90 d, 180 d and 360 d mice and cell models. Si-SNHG12 was used to interfere with SNHG12 expression in vitro, the mRNA and protein expression of SNHG12 and downstream genes were detected, and its effect on phenotype in vitro was observed by CCK-8, flow cytometry, scratch test and transwell test. HE staining was used to observe the liver sections of mice. Results qRT-PCR showed that SNHG12, Notch1 and Hes1 were up-regulated in HBx overexpression cells and mouse liver tissue at each time point (F=48.808,P<0.000 1;F=13.322,P<0.000 1); the results of Western blot showed that in HBx over-expressing cells and animal models, the expression of SNHG12 was increased induced by HBx, resulting in the activation of Notch1 signal pathway, the down regulation of pro-apoptotic factor Bax, anti-apoptotic factor Bcl-2, and the up-regulation of cell cycle factors CDK2, cyclin E. After inhibiting the expression of SNHG12, the results of qRT-PCR and Western blot showed that SNHG12 (t=22.746,P<0.000 1) and the above genes were inhibited; CCK-8 experiment showed that cell proliferation was significantly inhibited, flow cytometry showed that cell apoptosis increased, scratch experiment and transwell experiment showed that cell migration and invasion decreased. Conclusions HBx induced Notch1 expression by up regulating SNHG12, resulting in abnormal cell proliferation, cycle and apoptosis, so as to promote the occurrence of liver cancer.

目的 探讨慢性乙型肝炎病毒（HBV）感染对妊娠期糖尿病（GDM）孕妇的妊娠并发症、孕晚期生殖道B族链球菌（GBS）感染情况以及妊娠结局的影响。方法 选取2020年1月1日—12月31日在广州市妇女儿童医疗中心定期产检、足月、单胎妊娠的GDM孕妇共583例,其中合并HBV感染者（GDM+HBV组）48例,无合并者（GDM组）535例。比较2组的妊娠期并发症、妊娠晚期（妊娠35~37周）生殖道GBS感染情况、妊娠结局以及阴道分娩者的母儿结局。结果 与GDM组患者相比,GDM+HBV组患者出现妊娠期肝内胆汁淤积症、孕晚期生殖道GBS感染者比例较高,孕期出现胎盘早剥者比例较高,阴道分娩过程中出现产时发热、羊水粪染和新生儿入住NICU者比例均较高（均P<0.05）。结论 与无合并慢性HBV感染的GDM患者相比,合并慢性HBV感染的GDM患者在围产期的母儿风险升高。

Objective To investigate the effects of chronic hepatitis B virus（HBV）infection on pregnancy complications,group B streptococcus（GBS）infection in third trimester and pregnancy outcome in pregnant women with gestational diabetes mellitus（GDM）．Methods A retrospective study of 583 pregnant women with GDM,singleton gestation and cephalic presentation delivered at term in Guangzhou Women and Children’s Medical Center was carried out．Including 48 GDM women complicated with chronic HBV infection（GDM+HBV group）and 535 GDM women without HBV infection（GDM group）．Pregnancy complications,GBS infection in third trimester（gestation 35-37 weeks）,pregnancy outcomes,maternal and neonatal outcomes of vaginal delivery were compared between the two groups．Results GDM+HBV group had a higher proportion of intrahepatic cholestasis of pregnancy（ICP）and GBS infection in third trimester than GDM group,and a higher proportion of placental abruption during pregnancy．GDM+HBV group showed a significantly increased proportion in intrapartum fever,meconium-stained amniotic fluid and neonatal intensive care unit admission during vaginal delivery than GDM group（all P<0.05）．Conclusions GDM women with chronic HBV infection are associated with increased maternal and fetal risk during pregnancy and delivery．

目的 分析单核细胞-淋巴细胞比率（MLR）联合游离三碘甲腺原氨酸（FT₃）对乙型肝炎病毒（HBV）相关慢加急性肝衰竭（ACLF）患者生存状况的预测效果。方法 纳入我院在2019年1月—2022年1月期间收治的HBV-ACLF患者共187例进行研究,随访患者90 d的生存状况,其中69例死亡患者设为死亡组,其余118存活患者设为存活组。对2组患者的各项资料进行单因素分析,对差异有统计学意义的因素行Logistic多因素分析,分析HBV-ACLF患者死亡的危险因素,并分析MLR联合FT3对HBV-ACLF死亡的预测效果。结果 死亡组患者的年龄、肝硬化发生率、原发性腹膜炎发生率、肝肾综合征发生率、电解质紊乱发生率、终末期肝病模型、MLR、中性粒细胞与淋巴细胞计数比值、国际标准化比值、肌酐、白细胞计数、总胆红素水平均高于B组,血钠、FT₃、总血清胆固醇水平均低于存活组,差异有统计学意义（P<0.05）。MLR≥0.60、FT₃≤2.50 pmol/L均为HBV-ACLF患者死亡的危险因素（P<0.05）。MLR、FT₃、MLR+FT₃对HBV-ACLF患者死亡均有一定的预测价值,但MLR+FT3的预测价值高于其他单项预测。结论 MLR≥0.60、FT₃≤2.50 pmol/L均为HBV-ACLF患者死亡的危险因素（P<0.05）,且二者联合应用对HBV-ACLF患者死亡有较佳的预测价值。

Objective To analyze the predictive effect of mononuclear-lymphocyte ratio（MLR）combined with free triiodothyronine（FT₃）on the survival of patients with hepatitis B virus-related acute-on-chronic liver failure（HBV-ACLF）．Methods In the study,187 patients with HBV-ACLF from January 2019 to January 2022 in our hospital were included,and the survival status of the patients was followed up for 90 days．Among them,69 patients were included in the death group and the rest 118 patients were included in the survival group．The data of the two groups of patients were analyzed by univariate analysis,and the statistically significant factors were analyzed by Logistic multifactor analysis．The risk factors of death in patients with HBV-ACLF were analyzed,and the predictive effect of MLR combined with FT₃ on the death of HBV-ACLF was analyzed．Results The age,incidence of cirrhosis,primary peritonitis,hepatorenal syndrome,electrolyte disturbance,ratio of neutrophil to lymphocyte count,international standardized ratio,model for end stage liver disease,MLR,creatinine,white blood cell count and total bilirubin of the patients in the death group were higher than those in survival group,and the levels of serum sodium,FT₃ and total cholesterol were lower than those in survival group,the differences were significant（P<0.05）．The results showed that MLR≥0.60,FT₃≤2.50 pmol/L were risk factors for death of HBV-ACLF patients（P<0.05）．MLR,FT₃,MLR+FT₃ had certain predictive value for the death of HBV-ACLF patients,but the predictive value of MLR+FT₃ was higher than other single prediction．Conclusions MLR≥0.60 and FT₃≤2.50 pmol/L are risk factors for death of patients with HBV-ACLF（P<0.05）,and the combination of the two has a better predictive value for death of patients with HBV-ACLF．

目的 分析妊娠期慢性乙型肝炎病毒携带者病毒载量与孕妇肝功能、妊娠并发症的相关性。方法 将本院2015年1月—12月间在本院住院并于本院分娩的携带慢性乙型肝炎病毒(HBV)的86例孕妇作为本次研究对象,于住院期间分娩前测定孕妇HBV脱氧核糖核酸(HBV-DNA)定量,依据HBV-DNA定量测定结果将全部患者分为阴性组与阳性组,分别对比2组患者的临床资料、肝功能、妊娠并发症发生率及母婴结局;分析HBV-DNA载量与孕妇妊娠期肝功能及妊娠并发症的相关性。结果 2组孕妇的年龄、BMI、孕次与产次均无差异,P>0.05;阴性组患者妊娠期肝功能指标优于阳性组,P<0.01。阴性组中羊水量异常(偏多或偏少)发生率高于阳性组,P<0.05;其他妊娠期并发症发生率2组均未见差异,P>0.05。2组母婴结局均未见统计学差异,P>0.05。HBV载量与ALT肝功能指标均呈正相关,0<r<1,说明HBV-DNA越高则ALT越高,孕妇的肝功能越差。HBV载量与并发症发生间基本不相关,|r|<0.3,P>0.05。结论 慢性乙型肝炎病毒携带者妊娠期时随着病毒载量的升高,孕妇的肝功能有所下降仍可维持在正常标准,但与妊娠并发症的发生无相关性;提示对HBV-DNA阳性的孕妇给予密切监护,通过临床常规对症治疗能够保证母婴安全。

Objective To analyze the correlation between viral load of chronic hepatitis B virus infection and liver function and pregnancy complications. Methods We selected 86 cases of pregnant women with chronic hepatitis B virus(HBV)in our hospital from January 2015 to December 2015 as the research objects, and then during the hospitalization to test the quality of the HBV deoxyribonucleic acid (HBV-DNA)for them before delivery. According to the HBV-DNA quantitative results, all patients were divided into low dosage group and high dosage group, and then the clinical data, liver function, the incidence rate of pregnancy complications and the outcomes of the two groups were compared; at last we analyzed the correlation among the HBV-DNA load, liver function of pregnant women during pregnancy and pregnancy complications. Results There was no difference between the two groups of pregnant women in the age, BMI, pregnancy and birth time, P>0.05; the low dose group was better than the high dose group in the liver function index during the pregnancy, P<0.01. The incidence of abnormal amniotic fluid volume (more or less) in the low dose group was higher than that in the high dose group, P<0.05; there was no significant difference between the two groups in the incidence of other complications, P>0.05. There was no statistical difference between the two groups in maternal and neonatal outcomes, P>0.05. The HBV load was positively correlated with the two liver function indexes ALT, 0<r<1, indicating that the higher the HBV-DNA, the higher theALT, the worse the liver function of the pregnant women. There was no correlation between HBV load and complications, |r|<0.3, P>0.05. Conclusion Chronic hepatitis B virus carriers during pregnancy with increasing viral load, liver function of pregnant women declined to maintain in normal level, but not associated with pregnancy complications; that of HBV-DNA positive pregnant women given close monitoring of disease through clinical routine treatment can ensure the safety of mother and child.