Value of highly sensitive nucleic acid detection and aminotransferase level in evaluating precise antiviral therapy for liver cirrhosis patients with a low viral load / 临床肝胆病杂志

ObjectiveTo investigate the clinical significance of highly sensitive nucleic acid detection in precise antiviral therapy for patients with liver cirrhosis and its association with aminotransferase level. MethodsA total of 377 patients with hepatitis B cirrhosis who were hospitalized or attended the outpatient service from May 2013 to April 2019 were enrolled and tested by both domestic HBV DNA detection and highly sensitive Cobas HBV DNA detection. All patients underwent biochemical examination, four blood coagulation tests, routine blood test, and upper abdominal computed tomography or ultrasound. Sensitivity of different HBV DNA detection reagents was compared in liver cirrhosis patients with a low viral load, and the correlation between alanine aminotransferase (ALT) level and viral load was analyzed. The paired t-test was used for comparison of continuous data before and after treatment. The receiver operating characteristic (ROC) curve was used to screen out the optimal predictive values of ALT at different cut-off values of HBV DNA. ResultsAmong the 377 patients with hepatitis B cirrhosis, 215 tested positive and 162 tested negative by domestic HBV DNA, and among these 162 patients, 104 (64.2%) tested positive by Cobas HBV DNA detection, with a mean level of 267.5±42.3 IU/ml. After 24 weeks of antiviral therapy, the 104 patients with hepatitis B cirrhosis had significant improvements in viral replication level, ALT, and Child-Pugh score for liver function; HBV DNA decreased from 267.5±32.2 IU/ml before treatment to 59.6±7.7 IU/ml after treatment (t=3.486, P=0.002), ALT decreased from 871±10.8 U/L before treatment to 36.5±7.6 U/L after treatment (t=3.235, P=0.020), and the Child-Pugh score decreased from 6.5±0.7 before treatment to 5.7±0.5 after treatment (t=2.928, P=0.041). The ROC curve analysis of ALT in predicting HBV DNA decision point showed that an ALT level of 29 IU/L was the most sensitive cut-off value for predicting HBV DNA ＜20 IU/ml, with an area under the ROC curve of 0.904, a sensitivity of 1.0, and a specificity of 0.237. ConclusionPrecise detection helps to guarantee the precise clinical treatment of patients with hepatitis B cirrhosis and improve their treatment outcome and prognosis. An ALT level of 29 IU/L is a sensitive indicator for predicting patients with negative Cobas HBV DNA, so as to achieve individualized precise screening and treatment.

Clinical features of 212 hepatitis B core antibody positive patients with liver injury / 中华传染病杂志

Objective To investigate the clinical features of hepatitis B core antibody (anti-HBc)positive patients with liver injury.Methods A total of 212 anti-HBc positive and HBsAg negative patients who were primarily diagnosed with liver injury from August 2013 to August 2014 at Ruijin Hospital were collected for this study.The patients were divided into cirrhosis group (n=60) and non-cirrhosis group (n =152) according to the status of cirrhosis.The 60 cases with cirrhosis were further compared with 60 cases with post-hepatitis B cirrhosis.The general information,biochemistry and immunology data were assessed.ANOVA was used to compare multiple groups of means,and Wilcoxon rank-sum test was used for non-parametric comparisons of the two groups.Results Only one case was positive for HBV DNA with the positivity rate of 0.5％.The causes for liver injury were as follows,60 cases with cryptogenic cirrhosis,which accounted for 28.3 ％;45 cases with drug-induced hepatitis,which accounted for 21.2 ％;33 cases with unexplained liver injury,which accounted for 15.6％;28 cases with acute hepatitis E,which accounted for 13.2％ and 15 cases with autoimmune hepatitis,which accounted for 7.1％.There were significant differences of T cell subpopulation,hepatitis B surface antibody (HBsAg) and hepatitis B e antibody (anti-HBe) quantitative level,red blood cells (RBC),platelet counts (PLT),prealbumin,albumin,alamine aminotransferase (ALT),aspartate transaminase (AST),international normalized ratio (INR),hyaluronic acid (HA),collagen Ⅲ (COL-Ⅲ) and collagen Ⅳ (COL-Ⅳ) between the cirrhosis group and non-cirrhosis group (all P＜0.05).The CD3+ CD4+ and CD3+ CD8+ counts,white blood cells (WBC),ALT,AST,total bilirubin (TBil) and albumin in anti-HBc-positive cirrhosis group were statistically different from those in post-hepatitis B cirrhosis group (all P＜0.05).Conclusions Some patients with positive anti-HBc still have HBV replication and infectivity.HBV anti-HBc positivity and HBsAg negativity may be associated with some cryptogenic cirrhosis and primary liver cancer.Patients with positive anti-HBc are prone to be complicated with drug-induced hepatitis,autoimmune hepatitis,and other liver damage related to immune mechanisms.Patients with cirrhosis have a higher risk to induce immune tolerance and progress to chronic disease than non-cirrhotic patients.Quantitative anti-HBc might be used as an indicator to predict disease progression after HBV infection.Disease condition in cirrhotic group with positive anti-HBc and negative HBsAg is less severe than that in post-hepatitis B cirrhosis group.

Expression of ER and type Ⅱ collagen in the condylar cartilage of ovariectomized rats / 重庆医学

Objective To observe the dynamic histological changes of condylar cartilage ,and detect expression of estrogen re‐ceptors and collagen typeⅡin the ovariectomized rat ,exploring the relationship between OA and abnormity of shorting estrogen . Methods Histological changes of condylar cartilage of the ovariectomized rat at different ages were observed by HE staining meth‐od .The expression of estrogen receptors and collagen typeⅡwere determined by immunohistochemical method ,and the average per‐centage of positive staining area was measured by image analyzer .Results The lack of estrogen led to the degeneration of condylar cartilage .The expression of ER and ColⅡ were suppressed at low concentration of estrogen ,and these effects were enhanced when the treating time was prolonged .Conclusion The lack of estrogen might lead to the rat′s condylar cartilage lesion ,and the low con‐centration of estrogen could suppress the expression of ER .These results highlight the results that expression of condylar cartilage collagen is associated with estrogen .

Association of ERα-29 gene polymorphisms with susceptibility to HBV-related hepatocellular carcinoma / 临床肝胆病杂志

ObjectiveTo evaluate the relationship between estrogen receptor-α-29 (ERα-29) gene polymorphisms and the development of HBV-related hepatocellular carcinoma (HCC) in Gansu Province, China, and to investigate the pathogenesis of HCC at the gene level. MethodsGene polymorphisms of ERα-29 were analyzed in 106 HBV-related HCC patients and 98 healthy individuals as normal controls using the polymerase chain reaction-restriction fragment length polymorphism technique. Population allele frequencies were calculated using the gene counting method and then tested using the Hardy-Weinberg law of genetic equilibrium. Comparisons of genotype and allele frequencies between groups were performed using the χ2 test. ResultsThe frequencies of TT genotype and T allele of ERα-29 gene in HBV-related HCC patients were significantly higher than those in the normal controls, i.e., 31.1% and 53.8% vs. 11.2% and 32.1% (χ2 = 3.449, P＜0.05; χ2 = 3.840, P＜0.05). In contrast, the frequencies of CC genotype and C allele of ERα-29 gene in HBV-related HCC patients were significantly lower than those in the normal controls, i.e., 23.6% and 46.2% vs. 47.0% and 67.9% (χ2 = 3.488, P＜0.05; χ2 = 3.840, P＜0.05). Compared with those carrying C allele, carriers of T allele had an increased risk (2.46-fold) of HBV-related HCC (OR = 2.46, 95% CI: 1.64-3.69). Conclusion T allele of ERα-29 gene can increase the risk of HBV-related HCC.

The application of self-made simple mask in painless fiberoptic bronchoscopy / 中国组织工程研究

BACKGROUND:How to effectively improve the airway management and improve oxygen supply at the same time through a simple and effective method becomes an operation key for physicians in fiberoptic bronchoscopy. OBJECTIVE:To observe the clinical effect of self-made simple masks in painless fiberoptic bronchoscopy. METHODS:A total of 60 patients receiving painless fiberoptic bronchoscopy, 32 males and 28 females, with a mean age of (57.8±10.9) years were randomized into two groups: test group with self-made simple mask during painless fiberoptic bronchoscopy and control group with laryngeal mask. In the course of examination, the changes of oxygen saturation, mean arterial pressure and heart rate were observed at different time points. And adverse events of both groups were also recorded. RESULTS AND CONCLUSION:Patients from both groups successfuly completed fibre bronchoscopy. The oxygen saturation, mean arterial pressure and heart rate in the two groups were not significantly different (P > 0.05). However, the test group (one case of bucking) was superior to the control group (seven cases of sore throat) in terms of adverse events (P < 0.05). The simple mask can improve the oxygen supply and reduce the adverse events.

Expression of the estrogen receptor and type II collagen in the mandibular condylar cartilage of the human embryo / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To study the expression of the estrogen receptor (ER) and type II collagen in the mandibular condylar cartilage of the human embryo.</p><p><b>METHODS</b>The expression and localization of ERalpha, ERbeta, and type II collagen in the mandibular condylar cartilage of the human embryo were examined through hematoxylin-eosin (HE) and immunohistochemistry staining.</p><p><b>RESULTS</b>Type II collagen was primarily localized in the transitional and hypertrophic layers of the condylar cartilage. ERa was mostly expressed in the transitional and hypertrophic cartilaginous layers of the condylar cartilage. ERa was evenly distributed in the cell, whereas ERbeta was localized in the nuclei. No expression of type II collagen and ER was found in the fibrage and the proliferative layer although minimal expression was found in the calcified cartilage.</p><p><b>CONCLUSION</b>The distribution of ER and type II collagen in the mandibular condylar cartilage was consistent. Estrogen can selectively combine with different subtypes of ER that regulate the ability of the condylar cartilage cells to secrete type II collagens.</p>

Effects of estrogen on the proliferation and differentiation of human embryo mandibular condylar chondrocytes / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To determine the effects of different estrogen concentrations on the proliferation and differentiation of human embryo mandibular condylar chondrocytes (MCCs).</p><p><b>METHODS</b>In vitro-cultured MCCs were incubated and treated with estrogen at different concentrations. The MCCs were identified by toluidine blue and type II collagen immunocytochemical methods, and cell proliferation was monitored using methyl thiazolyl tetrazolium assay.</p><p><b>RESULTS</b>The addition of 10(-12) or 10(-6) mol x L(-1) exogenous estrogen inhibited the growth of MCCs, whereas addition of 10(-10) or 10(-8) mol x L(-1) exogenous estrogen promoted growth. These estrogen effects were time-dependent.</p><p><b>CONCLUSION</b>Estrogen can affect cellular MCCs proliferation and differentiation in a biphasic manner depending on the concentration. Estrogen may be vital in the maintenance of normal functions of the temporomandibular joint (TMJ) and may be involved in the progression of certain TMJ diseases.</p>

Morphological observation and stereological analysis of muscle spindles in human masseter / 实用口腔医学杂志

Objective:To find out the characteristic topog ra phic distribution of the muscle spindles in human masseter.Methods: The muscle spindles of masseter on both sides of 5 human corpses fixed in for malin for more than 1 year were observed by histological technique and quantitat ively analyzed by picture analysis equipment.Results: The muscle spindles were maldistributed and the spindles were commonly clustered in some i ndividual portions,and the muscle spindles figures of the masseter were diversif orm,which were predominantly composed of the spindle simple and spindle complexe s. The spindle complexes in the deep portion was obviously more than that in the superficial. The muscle spindles in the muscle close to the temporomandibular j oint and muscle tendon in the deep portion were more than that in the other port ions.Conclusion:The distribution of muscle spindles in the masse ter is heterogeneous,muscle spindle density in the deep portion is greater than that in the superficial.

Properties of biomechanics and muscle architecture in human masseter and temporolis / 实用口腔医学杂志

Objective: To study the architectural features and the biomechanical properties of human masseter and temporolis muscles. Methods: The architecture parameters of masseter and temporolis muscles on both sides of 5 human corpes fixed in formalin for more than 1 year were measured and quantitatively analyzed. Results: Human masseter and temporolis muscles were multipennate, there existed many layers of aponeurosis to which muscle fibers attached especially within the superficial portion of the masseter. The parameters of superficial portion of the masseter were statistically different from those of the deep portion, so were those of anterior portion of temporolis from those of posterior portion; the posterior part of the temporolis was the heaviest, the deep of the masseter the lightest. The physiological cross-sectional area of the superficial part of masseter was the largest, the posterior of temporolis the second, the anterior of temporolis the third, and the deep of the masseter the smallest. Among the ratios of muscle weight vs physiological cross-sectional area in each portion of the masseter and temporolis, the ratio in the deep part of masseter was the largest, that in the posterior of temporolis the smallest, that in the superficial of the masseter was similar to that in the anterior of the temporolis. In addition, the fiber in the posterior of the temporolis was the longest and that in the deep of the masseter the shortest. Conclusion: The deep portion of masseter is designed for force production, the posterior of the temporolis for velocity production, and the superficial of the masseter and the anterior of the temporolis for both force and velocity production. The deep part of masseter and the anterior of temporolis play an important part in maintaining mandibular position and balence, and the superficial of masseter and the posterior of temporolis play a major role in producing occlusive force and mandibular fast retrusion.

INFLUENCE OF ARTESUNATE ON INFECTIVITY OF GAMETOCYTES OF PLASMODIUM FALCIPARUM / 中药新药与临床药理

A study was carried out in south of Vietnam 15 Patients with Plasmodium falciparum gametocytes and asexual parasites were distributed into groups A, B and C. Artesunate was given orally at a total dose of 600 mg for 5 days in group A, 200 mg for 2 days in group B and intravenously at a total dose of 360 mg for 5 days in group C respectively. Gametocytes count was done before medication and daily after medication. Meanwhile, Anopheles dirus as a vector was employed to study the infectivity of gametocyte, The result showed that the mean gametocyte clearance time in three groups were respectively 15.4?5.0, 20.6?4.8 and 20.3?4.0 days. The mosquitoes were not infected from the blood in 2, 5 and 5 of 5 patients respectively on days 7, 14 and 21 in group A; 1 and 5 of 5 patients on day 14 and 21 in group B; 2 of 5 patients and 3 of 3 patients on days 14 and 21 in group C. It indicates that artesunate has remarkable effect on Plasmodium falciparum gametocytemia and its infectivity to mosquitoes.