Antiviral and antifibrotic therapies reduce occurrence of hepatocellular carcinoma in patients with chronic hepatitis B and liver fibrosis: a 144-week prospective cohort study / 南方医科大学学报

OBJECTIVE@#To compare the efficacy and safety of different antiviral and antifibrotic regimens in patients with chronic hepatitis B (CHB) and hepatic fibrosis and the incidence of hepatocellular carcinoma (HCC) associated with these therapies.@*METHODS@#A total of 840 patients with CHB and concurrent hepatic fibrosis, who received antiviral therapy in Nanfang Hospital between June, 2010 and June, 2018, were enrolled in this follow-up cohort study. The patients were assigned to 3 cohorts matched for gender, age (difference≤5 years), HBeAg status and liver stiffness measurement (LSM) for treatment with one of the 3 antiviral drugs, namely entecavir, tenofovir dipivoxil and adefovir dipivoxil; each cohort was divided into 2 groups, with one of the groups having a combined treatment with Fufang Biejiaruangan tablet. The cumulative negative conversion rate of HBV DNA, normalization rate of ALT, hepatic fibrosis regression and the incidence of HCC were compared among the 3 cohorts and across the 6 groups at 144 weeks.@*RESULTS@#A total of 749 patients were available to follow-up at 144 weeks. Compared with the baseline data, the cumulative negative conversion rate of HBV DNA increased gradually and the abnormal rate of ALT decreased significantly over time during the treatment in all the 6 groups (all < 0.001). Compared with the any of the antiviral drugs used alone, the combined treatments all resulted in significantly better antifibrotic effects (χ=11.345, χ=10.160, χ=6.358; all < 0.05). At 144 weeks, the incidence of HCC were 2.2%, 1.7%, 1.7% and 3.3% in enecavir group, enecavir with Biejiaruangan tablet group, adefovir group, and adefovir with Biejiaruangan tablet group, respectively, showing no significant difference between the two cohorts (4 groups; χ=6.813, =0.138). None of the patients in the 2 groups with tenofovir treatment had HCC by the end of the observation.@*CONCLUSIONS@#Antiviral therapy combined with antifibrotic therapy can effectively reverse hepatic fibrosis and reduce the incidence of HCC in patients with CHB; among the 3 antiviral drugs, tenofovir dipivoxil can be a better option for reducing the incidence of HCC in these patients.

Effects of blood purification ways on depression-related factors in end-stage renal disease patients / 中华行为医学与脑科学杂志

Objective To evaluate the influence of different blood purification ways on the incidence,distribution characteristics and related factors of depressive symptoms in end-stage renal disease (ESRD) patients.Methods Self-made questionnaires,short form 36 health survey questionnaire(SF-36),self-rating depression scale (SRS),medical coping modes questionnaire (MCMQ) and social support rating scale(SSRS) were performed to assess 80 hemodialysis patients and 78 continuous ambulatory peritoneal dialysis patients.If SDS score was higher than 53,the patient was diagnosed according to ICD-10.Results ①The detection rate of depressive symptoms in patients with ESRD was 61.22％,in which 50.8％ case met the diagnostic criteria of ICD-10.②Peritoneal dialysis group were better than hemodialysis group on the SF-36 (61.60± 18.50 vs 52.70 ± 20.00),comprehensive nutritional assessment (58.21 ± 13.56 vs 25.40 ± 11.21),urea clearance index(52.43± 14.20 vs 21.02±0.62) and SDS score (24.25±0.45 vs 23.89±0.91),and the results were statistically significant (P＜0.05).③Correlation analysis showed that the depression of ESRD patients was significantly negatively correlated with gender,educational level and household income (r =-0.278,-0.275,-0.283,P＜0.05),but positively correlated with course of disease(r=0.298,P＜0.05).In addition,the depressive symptoms were significantly negatively correlated with the face and avoidance factor of coping styles(r=-0.343,-0.316,P＜0.05),but positively correlated with yield(r=0.338,P＜0.05).Moreover,they were negatively correlated with objective support,subjective support and support utilization score (r=-0.330,-0.325,-0.297,P＜ 0.05).④Regression analysis showed that education level,social support and medical coping styles were influencing factors for patients with depression.The choice of dialysis way was also the influencing factor of depression occurrence.Conclusion Nutrition and urea nitrogen removal in peritoneal dialysis group is better than that in hemodialysis group.Education degree,social support,medical coping styles and dialysis way are the influencing factors of depression in ESRD patients.

Expression of Treg cells, TH17 cells and related cytokines in peripheral blood of patients with severe hand-foot-mouth disease caused by Enterovirus 71 virus / 中国综合临床

Objective To investigate the changes of Treg cells,Th17 cells and related cytokines in pe?ripheral blood of patients with severe hand?foot?mouth disease( HFMD) in the initial stage of infection caused by Enterovirus 71 virus. Methods Thirty?five cases of severe HFMD children in the Fifth Hospital of Shijiazhuang from May 2013 to December 2013 were selected as the research subjects,including 27 cases of severe formed group and 8 cases of danger severe formed group. The frequencies of Th17 cells ( CD3+CD8?IL?17+) and Treg cells( CD4+CD25+Foxp3+) in peripheral blood were detected by flow cytometry in patients with severe HFMD and 31 healthy children(control group). Moreover the serum levels of interleukin 6(IL?6),interleukin 17(IL?17) ,interleukin 10( IL?10) ,interleukin 23( IL?23) ,and human transforming growth factorβ1 ( TGF?β1) were measured by ELISA. Results As compared with those in control group,the frequencies of Treg cells,ratio of Treg/Th17,serum levels of TGF?β1, IL?10 in severe HFMD groups were significantly decreased ( F=23. 23, 30. 88,10. 766,11. 680 respectively;P<0. 05) . However the frequency of Th17 cells,serum levels of IL?6,IL?17,IL?23 in severe HFMD groups were significantly increased( F=646. 81,5. 904,10. 557,3. 490 respectively;P<0. 05) . Conclusion The changes of Treg and Thl7 cells and related cytokines appear in peripheral blood of patients with HFMD in the initial stage of infection caused by Enterovirus 71 virus. The frequency of Treg cell is decreased,however,the frequency of Thl7 cells frequency is increased,as a result,which may spread inflammato?ry reaction and cause complication.

Analysis of three wheat cytoplasmic male sterile lines mitochondrial DNA by AFLP / 生物工程学报

Cytoplasmic male sterility is an important way to utilize wheat heterosis. The purpose of thisstudy was to identify cytoplasmic type of three wheat male sterile lines. Amplified fragment length polymorphism (AFLP) marker technique was used to analyze the wheat mitochondrial DNA. We isolated mitochondria by differential centrifugation and density gradient ultracentrifugation. The results show that the extracted mitochondrial DNA was pure. It was suitable for PCR and genetic analysis. We got 4 pairs of specific primers from 64 primers combinations. Primer E1/M7 amplified 3 specific fragments in ms(Kots)-90-110. Primer E4/M2 generated 2 specific fragments in ms(Ven)-90-110. Primer E7/M6 amplified 2 specific fragments in ms(S)-90-110. Primer E6/M4 produced 2 specific fragments in ms(Kots)-90-110. Four specific primers could be used to identify three cytoplasmic types of Aegilops kotschyi, Ae. ventricosa and Triticum spelta. It provided the molecular basis to further study the mechanism of wheat cytoplasmic male sterility.

Influence of adefovir dipivoxil or telbivudine monotherapy on renal function of patients with chronic hepatitis B / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the changes in the renal function of patients with chronic hepatitis B (CHB) receiving adefovir dipivoxil (ADV) or telbivudine (L-DT) monotherapy.</p><p><b>METHODS</b>This retrospective analysis involved 101 patients with CHB and liver cirrhosis receiving either ADV or L-DT monotherapy for 52 weeks. Serum creatinine, estimates of glomerular filtration rate (eGFR), and the percentage of patients with eGFR≥90 ml·min(-1)·1.73 m(-2) at week 52 were compared with the baseline data between the two groups.</p><p><b>RESULTS</b>The mean changes of CR at week 52 from baseline were +0.05 mg/dl in ADV group and -0.12 mg/dl in L-DT group, showing a significant difference between the two groups (P=0.000). No patient was found to have an elevation of creatinine over 0.50 mg/dl. The median change of eGFR at week 52 from baseline differed significantly between ADV and L-DT groups (-4.09 vs+18.32 ml·min(-1)·1.73 m(-2), P=0.000). Ninety-two percent (12/13) of the patients with baseline eGFR<90 ml·min(-1)·1.73 m(-2) shifted to eGFR ≥90 ml·min(-1)·1.73 m(-2) after 52 weeks of L-DT treatment, as compared to 38% (3/8) in ADV group. The proportion of patients with eGFR≥90 ml·min(-1)·1.73 m(-2) in L-DT group increased from 76.36% (42/55) at baseline to 94.55% (52/55) at week 52, while that in ADV group decreased from 82.61% (38/46) at baseline to 78.26% (36/46). The constituent ratios of eGFR at different levels were similar at baseline (P=0.443) but significantly different at week 52 between the two groups (P=0.015).</p><p><b>CONCLUSION</b>L-DT treatment is associated with a renoprotective effect in patients with CHB, but the mechanism remains unclear.</p>