The association between myopia with overweight and obesity in middle school students in Zhengzhou / 中国学校卫生

Objective@#To understand associated factors of myopia among middle school students in Zhengzhou and to explore the correlation between myopia with overweight and obesity, to provide a scientific basis for myopia prevention.@*Methods@#A total of 3 297 middle school students from 8 middle schools in Erqi District, Zhongmu County and Xingyang County of Zhengzhou City were selected by a cluster random sampling method to participate in vision testing and questionnaire survey. Chi square test, and Logistic regression analysis were used.@*Results@#Overall prevalence of myopia of middle school students was 80.5%, overweight 14.7%, obesity 10.1% in Zhengzhou. The prevalence of myopia differed significantly by schooling stage, parental myopia status and sex ( χ 2= 18.34, 23.55, 8.98, 26.53, 27.46, 47.25, P <0.05). Significant differences in myopia detection rate by after school homework duration were observed in boys and the entire population( χ 2=12.40, 15.25, P <0.01), and significant differences in myopia detection rate by body mass index (BMI) were only observed in boys ( χ 2=6.32, P <0.05). The distribution of myopia severity was statistically significant by sex among junior school students, and by BMI categories among high school students ( χ 2=22.71, 20.37, P <0.01). Multivariate binary Logistic regression analysis showed that the risk for myopia among school students who were overweight and obese was 1.81 times higher than that of students who were not overweight and obese( P <0.01).@*Conclusion@#Overweight and obesity might increase the risk of myopia among middle school students, targeted measures should be taken to maintain the healthy weight of middle school students and reduce the risk of myopia.

Analysis of a cohort study on myopia among primary and secondary school students in Henan Province, 2019-2020 / 中国学校卫生

Objective@#To track and investigate the changes in visual acuity of primary and secondary school students in Henan Province during the COVID-19 pandemic home confinement, so as to provide theoretical basis for the prevention and control of myopia.@*Methods@#A cohort study design was employed for this research. In September 2019, visual acuity tests were conducted among 2 222 primary and secondary school students by Multi stage random cluster sampling method from four cities in Henan Province, including Zhengzhou, Xinxiang, Zhoukou, and Pingdingshan. A follow up study was conducted in June 2020, with on site visual acuity tests and questionnaire surveys. Wilcoxon rank sum test, Kruskal Wallis rank sum test, Chi square test, one way analysis of variance, and multiple linear regression model were used to analyze the changes in visual acuity of primary and secondary school students and the influencing factors from 2019 to 2020.@*Results@#Compared with 2019, the overall myopia rate of students increased in 2020, and the difference was statistically significant (55.7%, 64.9%, χ 2=1 035.91, P <0.01), and the difference between mild, moderate and severe myopia rates occurred at 2 years (2019:32.4%, 18.8%, 4.4%, 2020:36.7%, 22.5%, 5.7%, χ 2= 8.43, 9.23, 3.94, P <0.05). The myopia incidence rate of primary and secondary school students in 2020 was 28.3%. As presented in multiple linear regression analysis, middle school, grade 4th-6th and grade 1st-3rd of primary school, low economic level, using television for online classes, the study desk being not bright on sunny days, without looking far away during breaks, the brightness of the study desk and desktop which was average on sunny days, and using roof lamp only when studying at night were associated with myopia progression among students ( B=-0.16, -0.18, -0.20, -0.06, -0.21, -0.13, -0.11, -0.40, P <0.05).@*Conclusions@#During 2019-2020, primary and secondary school students in Henan Province experience a progression towards myopia, which is comprehensively influenced by education stage, economic level, the habit of using eyes, and visual environment. Myopia prevention and control should be actively intervened and strengthened to improve the eye environment for primary and secondary school students, in order to slow down the development of myopia.

Effect of Chahuang ointment on prevention of phlebitis from peripherally inserted central catheter: randomized clinical trial / Efeito da pomada Chahuang na prevenção de flebite de cateter central inserido perifericamente: ensaio clínico randomizado / Efecto de la pomada de Chahuang en la prevención de la flebitis por catéter central insertado periféricamente: ensayo clínico aleatorizado

ABSTRACT Objective: To assess the effect of Chahuang ointment, a Chinese herbal ointment, on the prevention of phlebitis in patients with peripherally inserted central catheters. Method: This was a multicenter randomized controlled trial, with 171 eligible patients randomly assigned into one of three groups: the Chahuang ointment group, the Mucopolysaccharide Polysulfate cream group, and the control group. The degrees of vein injuries at 72 hours after peripherally inserted central catheter insertion were the primary outcome. Secondary outcomes were the vascular wall thickness, tissue edema and microthrombus evaluated by Color Doppler Flow Imaging, the vascular endothelial growth factor, and endothelin-1 (ET-1) expression in vivo. Results: Compared with the control group, the Chahuang ointment group showed significantly lower incidence of postoperative phlebitis, tissue edema, and microthrombus at 72 hours after peripherally inserted central catheter insertion (all P<0.01). The VEGF and ET-1 expression were significantly inhibited in the Chahuang ointment group after 3 days of treatment (both P<0.01). There were no statistical differences in the degree of vein injuries, microthrombus, or tissue edema between the Chahuang ointment and mucopolysaccharide polysulfate groups (all P>0.05). Conclusion: Chahuang ointment was shown to provide effective prevention and protection against phlebitis after peripherally inserted central catheter insertion.

RESUMO Objetivo: Avaliar o efeito da pomada Chahuang, uma pomada à base de ervas chinesas, na prevenção de flebite em pacientes com cateter central de inserção periférica. Método: Este foi um estudo multicêntrico randomizado controlado, com 171 pacientes elegíveis aleatoriamente designados em um de três grupos: o grupo de pomada Chahuang, o grupo de creme de polissulfato de mucopolissacarídeo e o grupo de controle. Os graus de lesões das veias em 72 horas após a inserção do cateter central perifericamente inserido foram o resultado primário. Os desfechos secundários foram a espessura da parede vascular, edema tecidual e microtrombos avaliados por Color Doppler Flow Imaging, o fator de crescimento endotelial vascular e a expressão da endotelina-1 (ET-1) in vivo. Resultados: Comparado com o grupo controle, o grupo de pomada Chahuang apresentou incidência significativamente menor de flebite pós-operatória, edema de tecido e microtrombos 72 horas após a inserção do cateter central inserido perifericamente (todos P <0,01). A expressão de VEGF e ET-1 foi significativamente inibida no grupo de pomada Chahuang após 3 dias de tratamento (ambos P <0,01). Não houve diferenças estatísticas no grau de lesões das veias, microtrombos ou edema de tecido entre os grupos de pomada de Chahuang e polissulfato de mucopolissacarídeo (todos P> 0,05). Conclusão: A pomada Chahuang demonstrou fornecer prevenção e proteção eficazes contra flebite após a inserção do cateter central perifericamente inserido.

RESUMEN Objetivo: Evaluar el efecto de la pomada Chahuang, una pomada herbal china, sobre la prevención de la flebitis en pacientes con catéteres centrales insertados periféricamente. Método: Este fue un ensayo controlado aleatorio multicéntrico, con 171 pacientes elegibles asignados al azar en uno de tres grupos: el grupo de ungüento Chahuang, el grupo de crema de polisulfato de mucopolisacárido y el grupo de control. Los grados de lesiones de las venas a las 72 horas después de la inserción del catéter central insertado periféricamente fueron el resultado primario. Los resultados secundarios fueron el grosor de la pared vascular, el edema tisular y el microtrombo evaluados por imágenes de flujo con Doppler en color, el factor de crecimiento endotelial vascular y la expresión de endotelina-1 (ET-1) in vivo. Resultados: En comparación con el grupo de control, el grupo de ungüento Chahuang mostró una incidencia significativamente menor de flebitis posoperatoria, edema tisular y microtrombos a las 72 horas después de la inserción del catéter central insertado periféricamente (todos P <0,01). La expresión de VEGF y ET-1 se inhibió significativamente en el grupo de pomada de Chahuang después de 3 días de tratamiento (ambos P <0,01). No hubo diferencias estadísticas en el grado de lesiones venosas, microtrombos o edema tisular entre los grupos de pomada de Chahuang y polisulfato de mucopolisacárido (todos P> 0,05). Conclusión: Se demostró que la pomada de Chahuang proporciona una prevención y protección eficaces contra la flebitis después de la inserción de un catéter central insertado periféricamente.

Investigation of Accessibility in Hospitals at All Levels in Guangzhou, Guangdong, China / 中国康复理论与实践

Objective:To explore the problems of accessibility in the construction of hospital. Methods:From March to October, 2018, according to the limits and classifications of environmental factors proposed by International Classification of Functioning, Disability and Health (ICF), ten accessible facilities (entrance, routes and doors, handrails, stairs and steps, elevators, tactile indicator, parking lots, toilets, low-height service facilities and sign indentification system) were evaluated in 30 hospitals in Guangzhou, China. The limit value was judged by "obstacle". Each environmental factor was assessed according to five levels, the score ranged from 0 as barrier-free to four as complete obstacle. Results:The average barrier score of tertiary hospitals was 1.48, which was between mild and moderate obstacles; the average barrier score of secondary hospitals was 2.32, which was between moderate and severe obstacles, tending to moderate obstacles; the average barrier score of primary hospitals was 2.66, which was between moderate and severe obstacles, tending to severe obstacle. Conclusion:The accessibility of hospitals at all levels should be improved.

Clinical effectiveness of phacoemulsification combined with goniosynechialysis for cataract patients with glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To explore the effect of phacoemulsification combined with goniosynechialysis for cataract patients with glaucoma.METHODS:From May 2013 to December 2014,120 eyes of 113 patients with cataract and glaucoma admitted to our department were selected,and their clinical data were retrospectively analyzed.Among them,88 eyes received phacoemulsification combined with goniosynechialysis (Group A),32 eyes received phacoemulsification (Group B).All the patients were followed up at 1wk,1,2,and 6mo and 1a postoperatively.The visual acuity,intraocular pressure,visual field,anterior chamber depth and angle changes before and after the surgery were compared between the two groups.RESULTS:Vision:at each follow-up time point,their vision was improved significantly than before the surgery (P＜ 0.05) in both the groups,and Group A was significantly better than that in Group B (P＜ 0.05).Intraocular pressure:compared with preoperative data,it decreased significantly at each follow-up time point (P＜0.05),and Group A significantly decreased much more compared with Group B (P＜0.05).Visual field:compared with preoperative data,it increased significantly at each follow-up time point (P＜0.05),and Group A significantly had better effect than Group B (P＜ 0.05).After the surgery,the anterior chamber depth were evidently higher than those before the surgery (P＜ 0.001),and Group A significantly had higher anterior chamber depth than Group B (P＜0.05).The angle grading after the surgery were improved remarkably than before the operation (P＜ 0.05),and Group A was significantly superior to Group B.There were no serious complications in the two groups.CONCLUSION:Compared with simply phacoemulsification,phacoemulsification combined with goniosynechialysis is safer,and has better effectiveness for cataract patients with glaucoma.In addition,the latter has advantages in increasing the depth of the anterior chamber,and improving the openness of angle,as well as improving the vision and visual field,while reducing the intraocular pressure.

One-step dilation technique in minimally invasive percutaneous nephrolithotomy / 中国内镜杂志

Objective To evaluate the efficacy and safety of one-step dilation technique in minimally invasive percutaneous nephrolithotomy (MPCNL). Methods Clinical data of 2813 patients who underwent MPCNL by one-step dilation technique from February 2011 to March 2015 was retrospectively analyzed. Results 2813 patients were successfully underwent MPCNL by one-step dilation, including 2383 cases who were accessed by single tracts (84.71%) and 430 (15.29%) cases by multiple tracts. The mean operating time was (78.6 ± 41.1) min, the mean tract accessing time was (2.3 ± 0.8) min.The stone-free rate after one session operation was 78.59%. It improved to 91.50% one month after operation. During and after operation, 93 cases needed transfusion, 21 underwent selective renal artery embolization. Adjacent viscera damage: 9 cases with pleural lesions and 1 case with colon injury, 13 cases with urinary extravasation, perirenal hematoma in 15 cases, without liver and spleen injury. Septic shock in 2 cases, who was recovered after anti-infection treatment. Conclusion One-step dilation is safe and effective technique to establish tracts in MPCNL, which can reduce X-ray exposure and operation time, but does not increase the risk of bleeding.

One-step dilation technique in minimally invasive percutaneous nephrolithotomy / 中国内镜杂志

Objective To evaluate the efficacy and safety of one-step dilation technique in minimally invasive percutaneous nephrolithotomy (MPCNL). Methods Clinical data of 2813 patients who underwent MPCNL by one-step dilation technique from February 2011 to March 2015 was retrospectively analyzed. Results 2813 patients were successfully underwent MPCNL by one-step dilation, including 2383 cases who were accessed by single tracts (84.71%) and 430 (15.29%) cases by multiple tracts. The mean operating time was (78.6 ± 41.1) min, the mean tract accessing time was (2.3 ± 0.8) min.The stone-free rate after one session operation was 78.59%. It improved to 91.50% one month after operation. During and after operation, 93 cases needed transfusion, 21 underwent selective renal artery embolization. Adjacent viscera damage: 9 cases with pleural lesions and 1 case with colon injury, 13 cases with urinary extravasation, perirenal hematoma in 15 cases, without liver and spleen injury. Septic shock in 2 cases, who was recovered after anti-infection treatment. Conclusion One-step dilation is safe and effective technique to establish tracts in MPCNL, which can reduce X-ray exposure and operation time, but does not increase the risk of bleeding.

Efficacy of telbivudine in the treatment of chronic hepatitis b and liver cirrhosis and its effect on immunological responses / 华中科技大学学报（医学）（英德文版）

This study was aimed to evaluate the long-term effects of telbivudine (LdT) in the treatment of chronic hepatitis B (CHB) and HBV-related liver cirrhosis (LC) and to observe the changes of immunological responses during LdT treatment. Clinical data of 80 CHB and 28 HBV-related LC patients who were administered with LdT for 108 weeks and followed up were retrospectively analyzed. The liver function indicators including ALT, AST and γ-GT, HBV DNA copy number in serum and the rates of hepatitis B e antigen (HBeAg) seroconversion were analyzed before and 12, 24, 36, 48, 60, 72, 84, 96 and 108 weeks after LdT treatment in CHB and LC groups. Four serum fibrosis-related markers, including hyaluronic acid (HA), human laminin (LN), human type IV collagen (IV-C) and human N-terminal procollagen III peptide (PC-III), were detected before and after LdT treatment in LC group. The results showed favorable viral suppression and biochemical responses after treatment with LdT for 12 weeks, and a high rate of virological and biochemical control was maintained during the course of 108-week treatment in both CHB and LC groups. The four fibrosis-related markers, especially HA and LN, were down-regulated to some degrees in LC group. Moreover, LdT treatment led to the fluctuation of the circulating interferon-γ (IFN-γ) and interleukin-10 (IL-10) levels at different time points in CHB group. It was concluded that LdT could favorably lead to the virological suppression and biochemical remission. Besides, IFN-γ and IL-10 may represent a suitable and effective predictor of responsiveness during LdT therapy.

Efficacy of telbivudine in the treatment of chronic hepatitis b and liver cirrhosis and its effect on immunological responses / 华中科技大学学报（医学）（英德文版）

This study was aimed to evaluate the long-term effects of telbivudine (LdT) in the treatment of chronic hepatitis B (CHB) and HBV-related liver cirrhosis (LC) and to observe the changes of immunological responses during LdT treatment. Clinical data of 80 CHB and 28 HBV-related LC patients who were administered with LdT for 108 weeks and followed up were retrospectively analyzed. The liver function indicators including ALT, AST and γ-GT, HBV DNA copy number in serum and the rates of hepatitis B e antigen (HBeAg) seroconversion were analyzed before and 12, 24, 36, 48, 60, 72, 84, 96 and 108 weeks after LdT treatment in CHB and LC groups. Four serum fibrosis-related markers, including hyaluronic acid (HA), human laminin (LN), human type IV collagen (IV-C) and human N-terminal procollagen III peptide (PC-III), were detected before and after LdT treatment in LC group. The results showed favorable viral suppression and biochemical responses after treatment with LdT for 12 weeks, and a high rate of virological and biochemical control was maintained during the course of 108-week treatment in both CHB and LC groups. The four fibrosis-related markers, especially HA and LN, were down-regulated to some degrees in LC group. Moreover, LdT treatment led to the fluctuation of the circulating interferon-γ (IFN-γ) and interleukin-10 (IL-10) levels at different time points in CHB group. It was concluded that LdT could favorably lead to the virological suppression and biochemical remission. Besides, IFN-γ and IL-10 may represent a suitable and effective predictor of responsiveness during LdT therapy.

Preliminary study of establishing clinical effect evaluation methods of Chinese medicine based on combination of disease and syndrome, systematic staging, and multi-dimension index / 中国中西医结合杂志

The clinical effect evaluation of Chinese medicine (CM) has been the bottleneck restricting its development. Based on the current situation, in this study, we integrated and combined previous results of clinical effect evaluation of CM, and proposed the clinical effect evaluation method of CM based on combination of disease and syndrome, systematic staging, and multi-dimension index. We also made a specific exposition on the connotation, establishment methods and practice of the clinical effect evaluation methods of CM based on combination of disease and syndrome, systematic staging, and multi-dimension index.

Effects of anandamide on proliferation of and pErk expression in primary hepatic stellate cells of schistosome-induced liver fibrosis mice / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the potential therapeutic properties of the endogenous cannabinoid N-arachidonic acid aminoethanols (anandamide, AEA) in liver fibrosis by observing its affects on proliferation of and expression of phosphorylated-Erk (pErk) in primary hepatic stellate cells (HSCs) from a mouse model of schistosome-induced liver fibrosis.</p><p><b>METHODS</b>The schistosome-induced liver fibrosis model was established by attaching cercaria to the skin on the ventral side of the mouse and allowing infection to occur via direct penetration. Six weeks later, the model was confirmed by pathological analysis of liver, with Masson trichrome staining showing collagen fiber deposition around the blood vessels and hematoxylin-eosin staining showing eosinophilic granuloma formation. Primary HSCs were isolated by discontinuous density gradient centrifugation, confirmed by immunofluorescence detection of double-staining for a-smooth muscle actin and desmin (95% purity), and cultured in the presence of absence of various concentrations of AEA. Proliferative ability was evaluated by MTT assay and the expression of pErk was observed by Western blotting.</p><p><b>RESULTS</b>AEA treatment inhibited the proliferation of the primary HSCs in a concentration-dependent manner (AEA: 5 mumol/L, inhibition: 7.68%; 10 mumol/L, 11.65%; 20 mumol/L, 14.70%; 40 mumol/L, 15.07%; 60 mumol/L, 18.18%; 80 mumol/L, 20.26%; 100 mumol/L, 20.17%; 120 mumol/L, 29.24%). AEA treatment increased pERK expression in both a concentration-dependent manner (AEA: 20 mumol/L, average gray value: 39.90+/-4.61; 60 mumol/L, 43.45+/-0.91; 120 mumol/L, 52.91+/-1.97; vs. negative control, all P less than 0.05) and a time-dependent manner (time: 15 min, average gray value: 85.05+/-15.80; 30 min, 103.41+/-11.89; 1 h, 118.02+/-12.24; 3 h, 109.17+/-15.69; 6 h, 100.86+/-10.55; 12 h, 71.70+/-12.87; 24 h, 34.62+/-14.85; 48 h, 22.84+/-11.73; vs. negative control, all except 48 h had P less than 0.05).</p><p><b>CONCLUSION</b>AEA can suppress the proliferative capacity of primary HSCs from schistosome-induced fibrotic livers through activation of the Erk signaling pathway.</p>

Expression of ASMase in alcoholic liver fibrosis in rats / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the expression of the lysosomal enzyme acid sphingomyelinase (ASMase) in alcohol-induced hepatic fibrosis using a rat model.</p><p><b>METHODS</b>The model of liver fibrosis was induced by administration of alcohol and high fat diet using 20 rats. Six rats given no alcohol and normal diet served as the control group. Real-time PCR, western blotting, and immunohistochemistry were used to evaluate fibrosis-related changes in the mRNA and protein expressions of ASMase.</p><p><b>RESULTS</b>The fibrotic liver tissues of the model rats showed significantly higher expression levels of ASMase than the non-fibrotic liver tissues of the control rats (P less than 0.05).</p><p><b>CONCLUSION</b>Expression of ASMase is increased in the fibrotic liver tissue of an alcohol-induced hepatic fibrosis rat model, suggesting that this lysosomal enzyme may contribute to development of this disease condition.</p>

Membrane cholesterol mediates the endocannabinoids-anandamide affection on HepG2 cells / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To study the effect of anandamide (AEA) on necrosis in HepG2 cells and to explore the role of AEA in progression of liver cancer.</p><p><b>METHODS</b>Localization of the fatty acid hydrolytic enzyme (FAAH), cannabinoid receptors 1(CB1) and cannabinoid receptors 2 (CB2) proteins was detected in L02 and HepG2 cells using immunofluorescence. L02 and HepG2 cells were treated with different concentrations of AEA and methyl-beta-cyclodextrin, and the rates of cells necrosis were examined by PI stain. Meanwhile, the expression levels of FAAH, CB1 and CB2 receptor proteins, as well as P38 mitogen-activated protein kinase (p-P38 MAPK) and c-Jun-NH2-terminal kinase (p-JNK) proteins, were analyzed by Western blot.</p><p><b>RESULTS</b>The FAAH, CB1 and CB2 receptor proteins were observed both in cytoplasm and on membrane in L02 and HepG2 cells. The expression level of FAAH protein was higher in HepG2 than in L02 cells. The expression level of CB1 receptor protein was very low in both L02 and HepG2 cells. The expression level of CB2 receptor protein was high in both L02 and HepG2 cells. AEA treatment induced necrosis in HepG2 cells but not in L02 cells. Methyl-beta-cyclodextrin treatment prevented necrosis in HepG2 cells (t = 3.702; 5.274; 3.503, P less than 0.05). The expression patterns of FAAH, CB1 and CB2 receptor protein in L02 and HepG2 cells were confirmed by western blot, which were consistent with the immunofluorescence results. AEA treatment increased the levels of p-P38MAPK and p-JNK proteins in a dose-dependent manner in HepG2 cells (F = 11.908; 26.054, P less than 0.05) and the increase can be partially by prevented by MCD (t = 2.801; t = 12.829, P less than 0.05).</p><p><b>CONCLUSION</b>AEA treatment induces necrosis in HepG2 cells via CB1 and CB2 receptors and lipid rafts.</p>

The effects of sympathetic neurotransmitters and adrenergic receptors on liver fibrosis in murine schistosomiasis / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the effects of sympathetic neurotransmitters and adrenergic receptors on liver fibrosis in murine schistosomiasis.</p><p><b>METHODS</b>Mice were infestated with schistosoma by means of pasting cercariae on their abdomens. Thirty mice were randomly divided into a control group and a model group. Hematoxylin eosin and Van Gieson staining were used to view the histopathology of their livers. Immunofluorescence histochemistry and laser scanning confocal fluorescence microscopy were used to measure the a1A and beta2 adrenergic receptors in livers of the two groups of mice. High performance liquid chromatography-electrochemical detector (HPLC-ECD) was used to determine the concentration of norepinephrine (NE) and dopamine (DA) in the plasma of the mice.</p><p><b>RESULTS</b>Immunofluorescence histochemistry showed that a1A and beta2 receptors were present in hepatocytes and hepatic sinusoids of the livers of the mice of the two groups, but there were many more in the livers of the schistosoma infected mice (t=-2.888; t=-6.648) (P<0.05). The results of HPLC-ECD showed that the levels of NE and DA in the model group were higher than those of the control group (t=-3.372; t=-4.428) (P<0.05).</p><p><b>CONCLUSION</b>Sympathetic neurotransmitters and adrenergic receptors may participate in liver fibrogenesis in mice infected with schistosoma.</p>

Effects of anandamide on the activation and proliferation of hepatic stellate cells through cannabinoid-2 receptors / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To study the effects of endogenous cannabinoid anandamide (AEA) and its putative endocannabinoid receptors (CBR) on the activation and proliferation of hepatic stellate cells (HSC) and to study the role played by AEA during liver fibrosis.</p><p><b>METHODS</b>By using immunofluorescence and cell culture, the expression of CBR 1 and 2 in the PDGF-stimulated HSCs was investigated. By using PCR and Western-blot, the effects of 10, 20mumol/L AEA and CBR2 antagonist AM630 on the cultured and activated HSC were observed. Methyl thiazolyl tetrazolium and flow cytometry were used to investigate whether AEA induces growth inhibition or apoptosis in the activated HSCs.</p><p><b>RESULTS</b>Both CBR1 and CBR2 receptors were detectable in cultured HSCs with a higher level of CBR2 than CBR1 (F = 116.797, P less than 0.01). When HSCs were stimulated by PDGF, the expression of CBR2 receptors was significantly enhanced (F = 7.878, P less than 0.05). HSC proliferation was dose-dependently inhibited by 10, 20, and 50micromol/L AEA, with the rates of 7.12%+/-0.34%, 12.52%+/-0.78%, 80.13%+/-1.57% respectively (F = 533.41, P less than 0.01). However, it did not induce apoptosis, but necrosis. The expressions of alpha-SMA, TGFb1, a1(I), a1(III) and TIMP-1 were significantly suppressed by 20micromol/L AEA, but CBR2 antagonist AM630 reversed this suppressor action of AEA.</p><p><b>CONCLUSIONS</b>AEA may inhibit activation and proliferation of HSCs; CBR2 receptors mediate AEA-induced inhibitory action on the activation of HSCs. This CBR2 receptor-mediated action and AEA on HSCs could be used as a therapeutic target against liver fibrosis.</p>

Effects of norepinephrine on the proliferation and activation of rat hepatic stellate cells / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To elucidate the relationship between rat hepatic stellate cells (HSC) and sympathetic neurotransmitter norepinephrine (NE) during liver fibrosis.</p><p><b>METHODS</b>Using immunofluorescence and RT-PCR, the expressions of a1 and b2-adrenoceptors in activated HSC were detected. Methyl thiazolyl tetrazolium (MTT) was adopted to investigate the effect of NE on the proliferation of HSC. Meanwhile, the expressions of collagen-1, transforming growth factor beta (TGFb) and smooth muscle a-actin (a-SMA) in NE-stimulated HSC were detected by RT-PCR. The contents of NE in HSC were determined by high performance liquid chromatography-electrochemical detector (HPLC-ECD).</p><p><b>RESULTS</b>The a1 and b2-adrenoceptors were expressed in HSC. NE markedly stimulated the proliferation of HSC in a concentration-dependent manner (F = 140.464, P less than 0.05). NE induced the mRNA expressions of collagen-1, TGFb and a-SMA in HSC (t= -4.160; t= -8.763; t= -17.651, P less than 0.05). HSC were synthesizing and releasing NE, especially when stimulated with platelet-derived growth factor (PDGF) (10 ng/ml) (t= -32.907, P less than 0.05).</p><p><b>CONCLUSION</b>Our findings show that HSC are direct targets of NE and HSC are hepatic neuroglial cells that produce and respond to sympathetic neurotransmitter norepinephrine, suggesting that interrupting sympathetic nervous system signaling may be useful in the treatment of liver fibrosis.</p>

Expression and significance of hypoxia inducible factor-1 alpha in hepatocellular carcinoma tissues / 中华肝脏病杂志

<p><b>OBJECTIVES</b>To investigate the expression and significance of HIF1 alpha in hepatocellular carcinoma (HCC) tissues and in hepatoma carcinoma cell line HepG2.</p><p><b>METHODS</b>The expression of the HIF1 alpha mRNA and protein were detected with immunohistochemistry (IHC), Western blot and RT-PCR techniques in HCC, normal liver tissues and HepG2. Their relationship with the pathological characteristics of the HCC was also analyzed.</p><p><b>RESULTS</b>HIF1 alpha protein was obviously expressed in HCC. The positive rate of HIF1 alpha protein in HCC tissues was 76.4% and was higher than that in normal hepatic tissues. The expression of HIF1 alpha had a correlation to the differentiation degree of HCC tissues and intrahepatic and extrahepatic metastases (P<0.05), but there was no correlation to the existence of portal vein tumor emboli, the status of HBsAg and the prognosis (P<0.05). The results of Western blot and RT-PCR were similar to the results of IHC. The positive rate of HIF1 alpha in HepG2 was 93.6%. The levels of HIF1 alpha protein and mRNA began to increase after being treated two hours with hypoxia or with CoCl(2) (150 micromol/L).</p><p><b>CONCLUSIONS</b>HIF1 alpha protein is obviously expressed in HCC and it is mainly affected by hypoxia. The expression of HIF1 alpha is related to the differentiation of the HCC and its intrahepatic and extrahepatic metastases but has no correlation to the existence of portal vein tumor emboli, the status of HBsAg and the prognosis.</p>

The relationship between the plasma homocysteine level and the polymorphism of MTHFR gene C667T in liver cirrhosis / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To study the relationship between the plasma homocysteine (HCY) level and the polymorphism of N(5), N(10)-methylenetetrahydrofolate reductase (MTHFR) gene C667T in liver cirrhosis.</p><p><b>METHODS</b>112 normal subjects and 87 liver cirrhosis patients were recruited in the study. Their plasma HCY levels were measured using high performance liquid chromatography with fluorescence detection and polymorphisms of their MTHFR gene were analyzed using PCR-RFLP.</p><p><b>RESULTS</b>The mean level of plasma HCY was significantly higher in patients with liver cirrhosis (21.71+/-4.86) micromol/L than that in healthy individuals (8.34+/-3.59) micromol/L. There were three kinds of MTHFR genotypes: +/+ (TT, homozygous mutation), +/- (CT, heterozygous mutation) and -/- (CC, wild type). The frequencies of the three genotypes were as follows: +/+, 29.9%; +/-, 52.9%; -/-, 17.2% in cirrhosis patients and +/+, 19.6%; +/-, 33.9%; -/-, 46.4% in normal subjects. The frequency of homozygous or heterozygous mutation was significantly higher in cirrhosis patients than that in the normal control. Moreover, plasma homocysteine level was markedly higher in patients with MTHFR genetic mutation than those without mutation.</p><p><b>CONCLUSIONS</b>Hyperhomocysteinemia may be an independent risk factor for liver cirrhosis. MTHFR is the main enzyme related to homocysteine metabolism. The genetic mutation of MTHFR C667T is possibly an important mechanism of hyperhomocysteinemia in liver cirrhosis. The level of plasma homocysteine may be an early indicator for liver cirrhosis.</p>

Clinical study of lamivudine and interferon combinate administration to inhibit hepatitis B virus replication / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To explore a new strategy for effective and economical anti-virus therapy for HBV infection, we conducted a sequence administration of lamivudine and interferon alpha 1b to evaluate its effects on HBV replication and rebound as well as YMDD mutation induced by lamivudine.</p><p><b>METHODS</b>150 HBV patients having at least 6 months history of infection were assigned randomly into 5 groups. Each group of these patients was either treated with lamivudine, interferon alpha 1b, lamivudine combined with interferon, sequence administration of lamivudine and interferon (sequence group) or no anti-virus therapy (control group) for 12 months. The serum samples were collected at 0, 3, 6, 9, 12 and 18th months and were assayed for ALT, AST, HBeAg, HBV DNA (quantitive PCR) as well as YMDD mutation types by microarray.</p><p><b>RESULTS</b>The anti-virus replication effects were shown as early as the 3rd month in the sequence group but not in the IFN and control groups. The significant and persistent inhibition effect of it on HBV replication and improvement of liver function was shown. It was more effective than lamivudine or IFN treatments at the end of the drug administration and 6 months later after the drug was withdrawn. We also found that this sequence administration pattern can significantly shorten the period of treatment of lamivudine as well as reduce the rate of YMDD mutation and rebound of HBV replication after lamivudine withdrawal. It is also more economical than a combined therapy of lamivudine with IFN.</p><p><b>CONCLUSION</b>This sequence administration of lamivudine and IFN pattern can significantly improve the anti-virus effect on HBV replication, shorten the period of treatment with lamivudine, reduce the mutation rate of YMDD and prevent the rebound of HBV after drug withdrawal.</p>