LuckCong's Health Blog

1. The concept of hepatitis B Hepatitis B is caused by HBV infectious diseases worldwide. Around the world more than 300,000,000 hepatitis B surface antigen (HBsAg) carriers, of which China accounted for about 130,000,000 people, and 1 / 4 of the carriers can develop into chronic liver disease. Through mother to child transmission, neonatal HBV infection after about a 80% to 90% become chronic HBV carriers, calculated in accordance with the relevant data, about 80? 000,000 infants become carriers of HBV, as part of the baby after years of development Liver cirrhosis and liver cancer has a direct impact on the health of the next generation. Hepatitis B infection is the source of acute and chronic hepatitis B patients and HBV carriers, with chronic hepatitis B patients and carriers of the most important. Chimpanzees, gibbons, and other primates can also be transmitted to the source, but is largely meaningless. Hepatitis B and non-jaundice jaundice ratio of 1:1. Due to the high proportion of non-jaundice, is often misdiagnosed. As a result, the type of hepatitis B is a very important source of infection. 2. Mode of transmission of hepatitis B Hepatitis B transmission wide and complex, can be broadly divided into the following areas: (1) iatrogenic spread Iatrogenic spread of hepatitis B is one of the major route of transmission; it mainly through blood transfusion or blood products, or the patient's blood and body fluids of medical devices and materials, or accidental ingestion of contaminated blood and body fluids, and so on, so that the hepatitis B By the virus into the skin or mucous membrane of human infection. Between patients and medical workers, patients and between patients may exist, either directly or indirectly spread. (2) mother to child transmission The world is mother to child transmission of hepatitis B transmission. My mother to child transmission rate of an average of 60%. Pregnant women from the time of the occurrence of hepatitis B nearer the date of birth, infants infected with hepatitis B, the higher the risk. 6 months pregnant for the first occurrence of hepatitis B, there is enough time to produce antibodies, so that the protection of the fetus, only 6% of infants infected; pregnancy occurred in the last 3 months of hepatitis B, 69% of infants infected; post in the first 2 months took place Hepatitis B, 75% of infected infants. The latter part of pregnancy increased rate of infection may be caused by the leakage and the placenta, uterine and more easily through the placenta-related. HBV-DNA-positive mothers of newborns HBsAg-positive was significantly higher than the rate of HBV-DNA-negative mothers of newborns. All HBV-DNA in the mother's serum concentration is greater than 10pg/10ul, even if the birth of their children to receive hepatitis B vaccine and HBIG joint prevention, it is difficult to prevent HBV infection. HBeAg-positive babies born to mothers in 85% become carriers of HBsAg, HBeAg-negative mothers and infants born to be only 31% of people living with HBsAg, anti-HBe-positive babies born to mothers only 12.3 percent become HBsAg positive . Mother, the higher the titer of serum HBsAg, HBV infection in infants, the higher the percentage. When the mother of blood for HBsAg titer 1:32,1:128,1:256 and 1:512, the percentage of infants infected with HBV were 22.2% and 50%, 65.2% and 88.8%. Birth mothers carrying HBsAg vaginal secretions and newborn infants throat secretions, stomach contents HBsAg-positive rate of 95%, 30% of amniotic fluid. HBsAg-positive mother's milk, saliva, menstrual blood can be found to HBsAg. The reasons for occur mother to child transmission: ① through maternal-child benefit to infiltrate into the fetus; ② maternal blood or other body fluids infected mothers infant trauma or conjunctival surface; ③ baby in the delivery process, as I swallowed maternal blood, amniotic fluid or vaginal secretions. (3) sexual contact Sexual contact is an important route of transmission of HBV. HB3Ag of people living with hepatitis B or saliva, semen and vaginal secretion can be detected in HBV, therefore, can be transmitted through sexual intercourse HBV to the other side. name = "yg3"> 3. What are the types of hepatitis B? What are the clinical manifestations? The performance of the B complex, with the body's immune status is very close. A strong immune response can occur with severe acute hepatitis, cell immunocompromised persons vulnerable to chronic hepatitis and chronic carriers of the virus, and anti-liver cell membrane antibody component directly damage the liver cells' antibody or drug-dependent lymphocyte reaction (ADCC) of the Liver damage. Liver cell genome HBV-DNA and the integration of hepatitis B virus gene mutation can lead to chronic hepatitis. Tc cells in the liver cell membrane to identify the virus antigen, attacks the liver cells, so that the release of HBV, such as low immune function, it is difficult to clear HBV, were long-term sustainability of HBV infection and eventually can lead to the occurrence of liver cancer. For these reasons, can lead to several clinical types. (1) of acute hepatitis B super-hidden disease, fever generally not significant in pre-or early jaundice-like disease found in serum response, such as skin rash, joint pain. For the performance of the general fatigue, anorexia, nausea, vomiting, liver pain, and other areas. In the symptoms were significantly abnormal liver function examination, most of the patients showed no obvious symptoms, physical examination can be found hepatomegaly, a small number of patients can engage in large and spleen. No acute jaundice type of acute hepatitis B cases accounted for 2 / 3 more than 3-month course of disease, acute jaundice hepatitis B disease accounts for 1 / 3 below the average course of a month or so. (2) chronic hepatitis B is the course of acute hepatitis for more than half a year or more unless these are. Recurrent gastrointestinal symptoms, or do not liver area hepatosplenomegaly, tenderness, texture changes in liver function fluctuations large, dark, spider, liver and palm with foreign multi-organ damage, such as arthritis, nephritis, Colitis, thyroiditis, myocarditis, pleurisy eyes and dry mouth syndrome, and so on. If we do not actively control the treatment of disease, it is easy for the development of liver cirrhosis or liver cancer. (3) of this type of severe hepatitis patients often onset of acute hepatitis, often critical symptoms of the disease within 10 days of the liver in a coma, and other symptoms known as severe acute in more than 10 days after the onset of hepatic coma were known as the emergence of subacute Severe hepatitis. ① severe acute hepatitis (fulminant hepatitis, acute liver necrosis) Onset of acute hepatitis, jaundice better day by day, a clear tendency to bleeding, liver atrophy, liver foul, irritability, delirium, directed or barriers to computing power, lethargy in a coma. A majority of cerebral edema associated with liver and kidney syndrome, or less closed uric azotemia. Serum total bilirubin greater than 171umol / L over, and lower cholinesterase prothrombin time. ② subacute severe hepatitis with severe acute hepatitis in addition to the clinical manifestations, there is a high degree of fatigue, abdominal distension, anorexia and ascites or hepatic coma, liver and kidney syndrome and necrotizing into cirrhosis. ② chronic hepatitis with severe chronic hepatitis, also known as sub-acute liver necrosis. With the performance of the sub-acute hepatic necrosis, but on the basis of chronic hepatitis, cirrhosis and other chronic liver damage. ④ cholestatic hepatitis B are generally onset of acute hepatitis, as the disease progresses, symptoms and signs, but the resumption of jaundice and by the growing, and other similar type manifestations intrahepatic cholestasis. However, with the exception of bile duct system inside and outside the lesion or obstruction caused by jaundice. This type generally good prognosis. 4. HBsAg medical examination found that those who check what should be done? According to a local hospital conditions. ' (1), hepatitis B infection in two pairs of indicators and a half (or three) and HBV-DNA. (2) at the same time check liver function: ALT, AST, A / G, TBI (total bilirubin), one minute, bilirubin, ALP (alkaline), GGT (Y Zhou Bin advised W  take? . (3) of the liver and spleen B-ultrasound examination, liver and spleen in order to understand patterns of change. 5. Hepatitis B surface antigen in the body exist for how long? (1) HBsAg times After the hepatitis B virus infection, HBsAg for the first marker of the virus. Infection from blood appears to HBsAg intervals, with vaccination and infection related to the number of its channels. If the number of large, the short time interval, about 23 weeks. If the importation of HBsAg-positive blood, blood transfusion after 2 weeks can be detected HBsAg. Radioimmunoassay method, in 6 days after inoculation detected HBsAg. If the number of small, long time, up to 34 months, up to 6 months. In general, or 2943 days after infection (1884 days) occurred. (2) and the emergence of symptoms of hepatitis time In general HBsAG appear after 17 weeks (an average of 4 weeks) of symptoms of hepatitis and liver dysfunction, often at this time reached titers of HBsAg close to the peak time. Some people think the symptoms and abnormal liver function occurs early and late infection, blood infected 65 days, orally infected 98 days in the blood appeared in HBsAg. (3) HBsAg duration In the self-limiting infection, the majority of patients with HBsAg in the blood for the duration of 16 weeks; up to a maximum of 20 weeks. In general hepatitis symptoms within 14 weeks, most of the disappeared. Usually in the serum transaminase peaked at 112 weeks after the disappearance of more than 6 months if not disappear, patients may become chronic hepatitis and chronic hepatitis B virus carriers. (4) HBsAg spontaneous clearance HBsAg carriers spontaneous clearance rate varies with the virus is integrated into liver cells, whether or not the virus gene mutation and the patient's own immune system related to the state. Domestic data for the report of 28.1 percent, the highest outside of the report was 4.5%. What is asymptomatic carriers of HBsAg? Medical scientists at home and abroad through a large number of clinical and experimental research should be consistent with HBsAg asymptomatic carriers of the three following criteria: (1) sustained positive serum HBsAg for more than six months; (2) normal liver function; no clinical symptoms and signs; (3) examination slight majority of non-specific inflammation of the changes in the offering. H8sAg asymptomatic carriers of HBsAg persist in the blood of up to several years, decades or even for life. Although the symptoms and signs, mostly normal liver function, but there are varying degrees of liver damage. As a result, no longer on the clinical use of the so-called healthy carriers of HBsAg term. And as with chronic hepatitis B virus infection in mildly a hidden process, which may be more objectively reflect the real situation, have been in line with the above-mentioned three criteria for the asymptomatic carriers of HBsAg, as a doctor and I both carriers can not be ignored , On a regular basis to six months to 1 year to review three hepatitis B (HBsAg, HBsAb, HBeAg, HBeAb, HBcAg, HBcAb) and HBV-DNA, as well as liver function. Understanding of the dynamics of change at any time. 6. Surface antigen positive long-term Why? HBsAg-positive because of continued HBV-DNA with the DNA of host cells occurred in the integration after the integration of HBV-DNA can only express HBsAg, not to express HBeAg and HBcAg, DNA can not be copied, can not be assembled into a complete virus particle, blood Only the shell (HBsAg) is not infected. Now all the anti-viral drugs such integrated HBV without the ability to remove and can not enter the cells to kill HIV, the virus outside the cell only have a certain effect. After the integration of HBV will not be able to copy and re-active, long-term integration of DNA in cells of patients will not be induced cancer and other issues are still controversial, pending further study, but on a regular basis (six months to 1 year) review, if any clinical symptoms Performance should be timely to the hospital for an examination of its understanding of the dynamics of change. 7.HBsAg asymptomatic carriers of the evolution and Vesting Can be divided into the following 4 kinds of situations. (1) after a certain period to carry, some can be spontaneous HBsAg carriers to clear the body of HBsAg. Appear in the blood of hepatitis B surface antibody (anti-HBs). At this point the body have been cleared HBsAg. (2) the continued stability of HBsAg asymptomatic carrier status, up to several years, decades or even for life, and without the organization and changes in liver function, and so on. (3) some of asymptomatic carriers of HBsAg may appear abnormal liver function, the occurrence of acute hepatitis. The situation with non-HBsAg or twist with acute hepatitis B distinguish: ① can be learned from the history of the family members of patients with chronic hepatitis B carriers of HBsAg, or, as I used to be carriers of HBsAg. ② In addition to HbsAg positive, the early onset of a high titer of anti-HBc. ② HBsAg and HBeAg continued positive and easy for the development of chronic hepatitis B. (4) individual asymptomatic carriers of HBsAg can become chronic. Hepatitis, cirrhosis and hepatocellular carcinoma. Although hepatitis B virus in the liver of the precise role is unclear, but it is the primary factor-induced liver cancer. 8. What is hepatitis B surface antibody? What is the significance? When infected with hepatitis B virus, such as the emergence of hepatitis B surface antibody-positive, that the human body after infection by the hepatitis B virus hepatitis into the recovery phase. If a medical examination found that anti-HBs, is illustrated in the past have been infected with hepatitis B virus or hepatitis B vaccine have been inoculated; anti-HBs is a kind of protective antibodies, the body can maintain a very high titer to prevent hepatitis B virus general Re-infection, such as the input contains a certain number of hepatitis B virus in the blood, can not guarantee 100% no longer subject to the hepatitis B virus infection. ' About 10% of a 20% occurrence of arthritis and skin rash associated with the immune complexes in patients with hepatitis B, hepatitis and hyperlipidemia HBsAg in the beginning of the symptoms can be detected in anti-HBs. The vast majority of self-limiting HBV-infected people, only in the blood after the disappearance of HBsAg detected in anti-HBs. HBsAg in many patients just disappear, that is, using the most sensitive detection methods can not detect anti-HBs. About 1 / 2 of the self-limited hepatitis B virus infection, the disappearance of HBsAg anti-HBs to occur between the time interval of up to several months. About 10% of the transient detection of HBsAg in patients with hyperlipidemia not anti-HBs. Hepatitis B in the recovery phase, anti-HBs gradually increased, sustainable for many years. Anti-HBs occur sooner or later, whether in the past have been infected with hepatitis B virus, infected for the first time appear later, the earlier emergence of infected people again. Infection can also be shown for the first time for hidden infection, the liver and liver function tests were normal histology, the majority of infections in patients after 4-5 months when anti-HBs, and titer is not high, continuing to 6 months 3 years after the disappearance. Re-infected people there is no HBsAg. If the past has been hidden hepatitis B virus infection, anti-HBs titers lower Hepatitis B can prevent infection. In the re-infection of hepatitis B virus, which occurred within 2 weeks of anti-HBs, and high titer. Chronic HBsAg found with the sound, there should be no anti-HBs-positive, but after the disappearance of HBsAg, anti-HBs can occur rapidly. This is because carriers of HBsAg liquid does not completely immune, the body produced by a small amount of antibodies (anti-HBs) have been combined with antigen-antibody complex in China. As a result, the antibodies can not detected, the virus can not produce enough immune response o 9. There is a single anti-HBs-positive exist? Hepatitis B vaccine injection in too high or hepatitis B immunoglobulin (HBIG) after a single anti-HBs is normal on the ball for Vaccines and Immunization eggs produced their own immune response. In the normal population of 5% a 10% detected only a single anti-HBs, the majority of low titer, may be non-specific response, HBcAg than the strong immunogenicity of HBsAg, anti-HBc than the anti-HBs Titer relatively much higher, the only anti-HBs without anti-HBc is rare; although a single high titer of specific anti-HBs, often without protective anti-HBs -IgM, does not mean that the resumption of the hepatitis B virus infection or the presence of hepatitis B virus immunization. 10. HBsAb some positive condition has improved, there are occasional HBV-DNA testing positive? How? HBsAb positive for the vast majority of those who can be considered to be infected in the past have some immunity, but there are also about 10% have HBV or HBsAg-positive NA Xun. May be in a transitional period to clear the virus, HBsAg and the gradual removal of HBsAb there are still remnants of the virus is not completely clear. But bearing in mind that there are infected with the mutant possible. Although HBsAb as a result of natural (wild strain) vaccine or infection arising, but later the mutant HBV but does not work, so there is still HBsAg and HBV Xun NA expression and detection. The cluster-type HBV antigens have a, strong immunogenicity, antibody against a resistance to any subtype of HBV infection. In recent years, the adoption of a considerable amount of research that, HBV the S gene mutation, the synthesis of HBsAg encoding the characteristics of change, at the same time the existence of a prototype strain by the response generated by HBsAb, can not be combined with clear and mutation of the antigen is HBsAb both HBsAg and a common cause o 11. How to diagnose hepatitis B? The diagnosis of hepatitis B is more complex and acute hepatitis B, chronic hepatitis B, hepatitis B and heavy, chronic carriers of hepatitis B virus, hepatitis B surface antigen carriers. According to the epidemiological, clinical symptoms, signs and serological markers of hepatitis B virus, the virus replication signs, liver function, the gene mutation, gene integration, immunology and other related knowledge to judge. Clinical workers, I do not see the B-2 on the results of the just stand and take the two extremes, one to put it is disease-free condition, so that patients do not condition their attention, resulting in the near future or in a few years Into chronic hepatitis, cirrhosis, and some died quickly deteriorating. Second, some physicians to patients who are very light, and even to patients who have recovered very right, the last of the big dollars on prescription so that the heavy burden of mental patients and lead to a waste of funds. As a result, doctors warned that patients with hepatitis B encounter, such as do not have professional knowledge and clinical experience, not lip service, arbitrary conclusion, should guide patients to specialist clinics, please specialist. Patients should be to have their own specialist skills and good conditions for hospital treatment, do not believe that the newspaper, advertising a variety of media publicity, and it can not please the community of diagnosis and treatment of Youyi, otherwise you have serious consequences. 12. Prognosis of how the hepatitis B? Hepatitis B patients, such as in the acute phase was found in a timely manner, and actively carry out a comprehensive and reasonable treatment, most of them successfully recovered, but the hepatitis B virus in the body's immune-related components are difficult to remove, they often become chronic, persistent few , Repeated liver function impairment (liver disease activity), and eventually turned into cirrhosis or even liver cancer. Hepatitis B virus infection can occur following: (1)亚临床感染, asymptomatic, have not been vaccinated, but the serum anti-HBs-positive; (2), acute hepatitis, if sustained positive HBsAg after the onset of 6? 2 months or more, may become chronic; (3) asymptomatic carriers; (4) after infection of HBsAg titer than anti-HBs, the formation of smaller elements of HBsAg / anti-HBs immune complex, chronic glomerulonephritis, around tuberous artery complications go far; (5) chronic hepatitis activities can be repeated for the development of severe hepatitis. In general, the hepatitis B virus infection in about 85% of the fully restored, and 5 percent were carrying state (HBsAg positive); 5% showed a 10% chronic hepatitis, about 1% of a 4% were fulminant hepatitis or necrosis of the harmonious, 1 % For the development of liver cirrhosis or hepatocellular carcinoma. Hepatitis B virus infection and primary liver cancer closely related. From the perspective of molecular biology, the incidence of HBV and liver cancer relations are the following: (1) of the hepatitis B virus DNA integration, is caused by hepatitis B virus infection after liver cell genome sign of a serious loss of stability could cause the DNA rearrangement, as well as the loss of DNA, which activate or inhibit the growth of some related gene expression, May lead to cancer. (2) in liver cancer free copy of the HBV-NA Xun were defective virus, the virus can not have a full release into the blood, and that such defects may be related to cancer-causing virus, also may be associated with the phenomenon. (3) HBV may be equivalent to the promoter agent, as a result of liver cells, causing cancer-causing chemicals cause cell mutations, and clonal selection by the advantages, and the formation of the proliferation of lesions. (4) HBV infection, so that the liver cells to chemical carcinogens in DNA metabolism and repair process, to enhance the chemical carcinogens and cancer-causing effects of the change. HBsAg carriers of the prognosis, after the observation system, including the liver needle biopsy to prove after, HBsAg carriers are varying degrees of disease, respectively, while the length of time for the performance of various types of hepatitis, liver cirrhosis or liver cancer. There are indications HBsAg carriers followed for 12 years, of which 43% of hepatitis occurred. To carry from the occurrence of hepatitis in the shortest possible time a month, the longest in 11 years. An average of 5.4 years. 13. What is Hepatitis B "Dasan Yang" and "Xiao Sanyang," what do they mean? Hepatitis B, "Dasan Yang" is a popular scientific name, generally refers to hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg), and hepatitis B core antibody (HBcAb) were positive. Note the presence of hepatitis B virus in the body, and active hepatitis B virus replication, more infectious. Hepatitis B, "Xiao Sanyang" refers to the HBsAg, HbeAb, HbcAb three positive, indicating reduction of hepatitis B virus replication, to reduce infectious. 14. Make any hepatitis B surface antigen negative drugs? There have not been able to make sure the drug HBsAg negative. Recently on television, radio, newspapers and so much to promote and who is a "negative B", with particular emphasis able to HBsAg negative, the lack of scientific information is based on. Once again warned patients not to easily believe the advertising. HBsAg-positive patients each year, 1% 2% of the natural conversion rate, that is, without any treatment, these patients will be HBsAg negative nature, especially the low titer of HBsAg negative patients more easily. Often encountered in clinical treatment of patients described: "a very high medical doctors, a few injections crush, a few Chinese pay service after the HBsAg negative." This is in fact a doctor just encountered a very low titer of HBsAg (1 or 1:16; 8, etc.), will soon be changing nature of the patients. In recent years, the broad masses of medical workers through hard work, and also HBsAg developed in the conversion of the drug, but the effect is low, generally no more than 10%. Here are HBeAg negative for the drug so that there is HBsAg negative. It is still not satisfactory. Pending further research and development. At present, but also to interferon-based therapy, but also the efficiency of only 40? 0%. 15. Make the hepatitis B e antigen negative drug BCG combined with dipyridamole Hepatitis Ling (broad bean root) injection Hui pig polysaccharide vaccine combined with hepatitis B Ara-AMP (Ara-AMP) combined with thymosin Interferon Zadaxin (thymosin a1) 16. Evaluation of the efficacy of interferon Interferon treatment, often a reduction in the level or ALT normalization (in the treatment of a possible transient rise and then drop), HBV replication targets, HBsAg, HBV-DNA negative, stable condition, the general improvement of the situation. The effect of up to 50%. Some of the patients after the drug effective in the treatment of 6? 2 months relapse occurred, but the use of interferon is still valid. At this stage of a variety of drug treatment and removal of HBsAg is difficult to achieve the purpose of interferon treatment of chronic hepatitis B, so that is also not satisfied with the HBsAg negative. As a result, can not be too high, at present can not be HBsAg negative as the standard treatment. Interferon treatment of chronic hepatitis B, although satisfactory, but its effect is a scientific and objective, after all over the world repeatedly Clinical examination and strict verification, and completely reliable. Interferon not only inhibit replication of the hepatitis B virus and hepatitis B virus removal, and can greatly improve the histology of the liver diseases, the prevention of cirrhosis, liver cancer incidence. So far, a drug used in the treatment of chronic hepatitis B, antiviral, a drug which has not yet able to match with interferon. 24. Desirable of hepatitis B combination rule At present, the treatment of chronic hepatitis B drug several dozens, how to select an effective drug, how this combination? Here are several clinical tests would have to do by the effect of the combination of drugs and programs. Interferon-adult period of infection, increased aminotransferase (ALT), a virus replication in patients with good effect, the use of six months to one year, will enable 30% to 40% of patients with HBV-DNA or HBeAg negative, the restoration of liver function. However, some patients with poor prices and more expensive, has more side effects. Nucleoside drug lamivudine which inhibit viral replication and reduce the liver necrosis, inflammation, fibrosis and improve liver function. However, the need to take a long time and attention to the emergence of drug resistance. Oxymatrine wild plants for the extraction of bitter beans medicine, is "Ninth Five-Year Plan" key "Chronic hepatitis B drug treatment program of the new study" drug issues. There are drug suppression of hepatitis B virus, 3 months after treatment for hepatitis B patients with HBeAg and HBV-DNA negative conversion rates were 44.4 percent and 45.3 %, May also improve liver function, Huang returned to prevent cirrhosis, elevated white blood cell, so far found no obvious side effects, the drugs interferon was only 1 / 10. To enhance the efficacy, relapse prevention, the best combination, that is, anti-viral drugs, such as adjustment to increase immunity, such as: Oxymatrine + Levamisole coating agent, Oxymatrine thymosin +, + interferon Oxymatrine, interference +-Lamivudine, lamivudine + + Oxymatrine rhubarb Shu Wan Deng insects in the Pro The bed is used. If the liver, anti-fibrosis drugs to prevent the occurrence or development of liver cirrhosis. 25. Hepatitis virus, "a number" of governance At present, hepatitis B screening is the most commonly used method of hepatitis B virus antigens and antibodies measured, "a full set of HBV." However, the check is the hepatitis B virus antigens of these antigens and human immune response and can not represent the virus itself, no way of knowing how many of the virus in the body. Alternatively, PCR, years of clinical trials have proved that conventional PCR false-positive rate, false negative rate is too high, poor reproducibility, and not quantitative. In recent years, the successful development of a new fluorescent quantitative PCR for the emergence of hepatitis B diagnostic test provides a new means of a large number of clinical specimens results proved that the specificity of 100%, sensitivity of up to 0.01fg (10-12mg), equivalent to 2.5 A hepatitis B virus particles. FQ-PCR of the following conditions are unique in the diagnosis: Screening of patients before treatment with lamivudine, interferon patients and the efficacy of the amount of virus closely related to the treatment of the virus prior to the quantitative examination can guide the selection of antiviral drugs so as to avoid blind medication. Observation of the efficacy of treatment because of a full set of results of hepatitis B virus in the body can not reflect the volume of the number, we can not accurately judge the efficacy of the drug, and the fluorescence quantitative PCR direct and accurate determination of the number of virus in the body help to determine the effect. Birth mothers to guide the body of the number of hepatitis B virus intrauterine infection of hepatitis B is an important factor. Pre-pregnancy check for fluorescence quantitative PCR, will help choose a favorable time to pregnancy. Pregnant women for hepatitis B FQ-PCR examination to help accurately estimate the risk of intrauterine infection. The patient's diagnosis of problems are still 10% to 15% of the viral pathogen is unknown, fluorescence quantitative PCR can check some of the patients received the correct diagnosis in a timely manner. B-positive review of recent studies have shown that a small number of B-positive hepatitis B virus still exist in the body, especially those with symptoms and signs of hepatitis, liver function abnormalities should be more fluorescent quantitative PCR examination to promote the rehabilitation of patients. The early diagnosis of hepatitis B surface antigen occurred in the past to determine whether the hepatitis B infection. 26. Deprivation in patients with hepatitis garlic Garlic's active ingredient has strong anti-bacterial effect, diphtheria, dysentery, typhoid, Mycobacterium tuberculosis has a strong antibacterial and bactericidal action, but so far not been found in garlic has anti-viral hepatitis. On the other hand, some components of garlic have a stimulating effect on the gastrointestinal tract, can inhibit gastric secretion of digestive enzymes that affect the appetite and digestion and absorption of food. According to the study, garlic essential oil of red blood cells make blood, to reduce the white blood red, such as anemia caused by disease, hepatitis treatment and rehabilitation of patients with very unfavorable.