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Objective:To study the effects of L-T4 gel combined with metformin on Ach and MCT8 content in hippocampus of hypothyroidism model rats.Methods:40 rats were randomly divided into 5 groups, normal control group (CON group) , hypothyroidism group (Hypo group) , L-T4 replacement group (L-T4 group) , metformin treatment group (MET group) and combined treatment group (L-T4+MET group) by random number table. Rats in CON group were given normal drinking water, and rats in the other four groups were given drinking water containing 0.05% propylthiouracil for 6-week hypothyroidosis modeling. At the 5th week of modeling, rats in MET group were given 1ml/100g metformin solution by intragastric administration, and rats in L-T4 group were applied with L-T4 gel agent at a dose of 0.1g/100g. L-t4+MET group were treated with L-T4 gel and metformin solution. At the end of 6-week modeling, the blood of abdominal aorta was collected, and the hippocampal tissue of the brain was quickly separated on an ice platform. Meanwhile, the trachea and thyroid were cut out and photographed to record their size. They were stored in a -80℃ refrigerator or soaked in 4% paraformaldehyde for fixation and used for immunohistochemical staining. T-test was used to confirm the difference between the data of each group, one-way analysis of variance was used to compare the means between multiple groups, and chi-square test was used when the count data were expressed as percentage ( χ2) . P<0.05 was used to indicate statistical significance between the data, and the difference was statistically significant. Results:Nishner staining showed that the optical density of the Hypo group was lower than that of the CON group ( t=8.944, P<0.001) , the optical density of the MET group was higher than that of the Hypo group ( t=4.472, P<0.001) , and the optical density of the L-T4 group was higher than that of the Hypo group ( t=4.472, P<0.001) . The optical density of rats in the combined treatment group was higher than that in the Hypo group ( t=8.944, P<0.001) , and recovered to the level of the CON group ( P=1.000) . After 2 weeks of treatment, the total thyroxine level (TT4) of the Hypo group was lower than that of the CON group ( t=14.536, P<0.001) , and the TT4 level of the MET group was higher than that of the Hypo group ( t=6.924, P<0.001) . TT4 level of L-T4 group was higher than that of Hypo group ( t=4.892, P<0.001) , TT4 level of combined treatment group was higher than that of Hypo group ( t=12.890, P<0.05) , and recovered to the level of CON group ( t=0.494, P=0.709) . After the study, the thyroid tissue of each group was collected. The thyroid tissue weight of the Hypo group was higher than that of the CON group ( t=7.906, P<0.001) , the thyroid tissue weight of the MET group and L-T4 group was lower than that of the Hypo group (MET: t=2.000, P<0.001; L-T4: t=3.000, P<0.001) , but higher than that of the CON group (MET: t=3.000, P<0.001; L-T4: t=2.000, P<0.001) . The thyroid weight of L-T4+MET group was similar to that of CON group ( P=1.000) . HE staining showed that the size of thyroid follicles was different in the combined treatment group, and the number of glial and absorbed vacuoles basically recovered similar to that of CON. After treatment, the Ach level in the Hypo group was lower than that in the CON group ( t=3.618, P<0.001) , the Ach level in the MET group was higher than that in the Hypo group ( t=3.121, P=0.016) , the Ach level in the L-T4 group was higher than that in the Hypo group ( t=3.321, P=0.027) , and the Ach level in the combined treatment group was higher than that in the Hypo group ( t=3.202, P=0.001) . And recovered to the level of CON group ( t=3.362, P=0.605) . After treatment, the MCT8 level in the Hypo group was higher than that in the CON group ( t=11.254, P<0.001) , the MCT8 level in the MET group was lower than that in the Hypo group ( t=5.679, P<0.001) , and the MCT8 level in the L-T4 group was lower than that in the Hypo group ( t=5.813, P<0.001) . The MCT8 level of the combined treatment group was lower than that of the Hypo group ( t=8.624, P<0.001) , and recovered to the level of the CON group ( t=0.587, P=0.477) . Conclusion:L-T4 gel combined with metformin has a good therapeutic effect on hypothyroidism, which can increase the level of Ach and decrease the level of MCT8 in hippocampus.
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Objective To investigate the genotype distribution of hepatitis C virus (HCV) in Guangdong Province by linear probe assay (LiPA) and core,non-structural protein 5B (NS5B) sequence analysis,and to evaluate the accuracy of LiPA for genotyping.MethodsOne hundred and ten HCV specimens from chronic hepatitis C (CHC) patients in Guangdong Province were genotyped by both core,NS5B sequence analysis and INNO-LiPA 2.0.The data were then analyzed with SPSS 10.0 software.ResultsAmong the 110 specimens,core and NS5B fragment could be amplified from 97 and 62 specimens,respectively,while both fragments were obtained from 57 specimens. The results of genotyping by core sequence analysis were completely consistent with the results of NS5B sequencing.One hundred and two specimens were classified into five subtypes,i.e.genotype 1a,2a,3a,3b,6a,with frequencies of 61.8％ (64),9.8％ (10),3.9％ (4),3.9％ (4),20.6％ (21),respectively.All but genotype 6 strains can be genotyped correctly by using INNO-LiPA 2.0.However,only subtype 1b and 3b could be genotyped accurately.81.5％ genotype 6a strains were genotyped as 1b by mistake. Conclusions Genotype 6a has become the second most prevalent genotype in Guangdong Province.The LiPA cannot distinguish genotype 6a from 1b strains accurately which needs further investigation.
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Objective To investigate the efficacy of pegylated interferon (PEG-IFN)+ ribavirin (RBV) treatment in patients with chronic hepatitis C (CHC),and to evaluate the predictors of treatment response.Methods One hundred and thirty CHC patients treated with PEG-IFN a-2a 180 μg weekly or PegIFNα-2b 80 μg weekly plus RBV 900-1200 mg/d for 48 weeks in Guangdong Province were enrolled.The clinical data including age,gender,body mass index (BMI),spleen index (SPI),the diameter of portal vein (PV),hepatitis C virus (HCV) genotype,HCV RNA level were collected at baseline,week 4,12,24,48 of treatment and week 24 of follow-up.Patients obtained sustained virological response (SVR) were compared to those with non-sustained virological response (NSVR).The related factors of SVR were analyzed.The data were compared by t test,chi square test or Logistic regression.Results The total SVR rate was 84％ (109/130),among which rapid virological response ( RVR ),early virological response ( EVR ),and end-of-treatment virological response (ETVR) were 21％ (27/130),72％ (94/130) and 93％ (121/130),respectively.HCV genotype was determined in 70 patients and the SVR rate was 82 ％ (45/55) in the genotype 1 patients and 87％ (13/15) in the genotype non-1 patients.Age,baseline HCV RNA,BMI and SPI were all negatively associated with SVR rate (regression coefficient＜0,all OR＜1,all P＜0.05),while EVR and total cumulative treatment dose of RBV were positively associated with SVR rate (regression coefficient＞0,both OR＞ 1,both P＜0.05).However,RVR,PV and total cumulative treatment doses of PEG-IFN were not associated with SVR rate (P＞0.05).Conclusions The SVR rate of PEG-IFN plus RBV combined treatment is high in CHC patients and more than 80％ of patients can be cured.However,the SVR rates are lower in patients elder than 35 years,with previous treatment failure history,baseline HCV RNA＞6 × 105 IU/mL,BMI＞26 kg/m2,SPI＞40 cm2,or the total cumulative treatment doses of RBV less than 80 ％ of standard dose.
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Objective To investigate the illness-related stigma in outpatients with chronic viral hepatitis B and C and its effects on interaction anxiousness and general self-efficacy.Methods Forty-eight patients with chronic hepatitis B ( CHB),41 patients with chronic hepatitis C (CHC) and 29 healthy volunteers were enrolled.Hepatitis-related Stigma Questionnaire (HRSQ) produced by researchers was used to assess stigma in patients of both CHB and CHC.All patients and healthy volunteers were evaluated by Interaction Anxiousness Scale (IAS),General Self-efficacy Scale (GSES) and Simplified Coping Style Questionnaire (SCSQ).Results Hepatitis-related stigma was common in both CHB and CHC.The most common positive items and their percentages of CHB and CHC were rejection in job seeking (81.2％,75.6％ ), keeping conditions about hepatitis secret (72.9％,75.6％ ),feeling discrimination in society (66.7％,56.1％ ) and rejection in mate selection (60.4％,61.0％ ),and the rarest ones and percentages were feeling lowest stress together with patients with the same disease (35.4％,31.7％ ) and being understood only by patients with the same disease (33.3％,26.8％ ).Differences of positive percentages of any items between CHB and CHC were not statistically significant (P ＞0.05 ).One-way ANOVA showed that difference of IAS scores among three groups of participants was not statistically significant ;and GSES score of CHB(2.41 ± 0.45 )was not statistically different from that of CHC (2.49 ±0.60 ),but they both were lower than that of healthy control (2.78 ± 0.52) (F=4.648,P =0.011 ).The multivariate stepwise regression analysis showed that the item feeling much different from others of HRSQ entered the formula of CHB IAS score (B =4.861,adjustment R2 =0.106),and the item being understood only by patients with the same disease of HRSQ entered the formula of CHC IAS score (B =6.745,adjustment R2 =0.113);negative coping dimension score of SCSQ ( B =- 0.424),the item feeling discrimination in society ( B =-0.359) and feeling lowest stress together with patients with the same disease ( B =-0.274) entered the formula of CHB GSES score (adjustment R2 =0.280).Conclusion Illness-related stigma is common in outpatients with chronic viral hepatitis,which probably raises patients' interaction anxiousness and weakens the general selfefficacy of patients with hepatitis B and C.