Noninvasive indicators of indications for antiviral therapy in HBeAg-negative chronic HBV infection patients with alanine aminotransferase ≤40 U/L / 临床肝胆病杂志

Objective To investigate the noninvasive indicators of indications for antiviral therapy in HBeAg-negative chronic hepatitis B virus (HBV) infection patients with alanine aminotransferase (ALT) ≤40 U/L under the guidance of liver pathology. MethodsA retrospective analysis was performed for the clinical data of 377 HBeAg-negative chronic HBV infection patients with ALT ≤40 U/L who were hospitalized in Affiliated Hospital of Yan’an University, from October 2013 to August 2018 and underwent liver biopsy, among whom the patients with inflammatory activity ＜A2 and fibrosis stage ＜F2 were enrolled as non-antiviral therapy group(n=266), and the patients with inflammatory activity ≥A2 or fibrosis stage ≥F2 were enrolled as antiviral therapy group(n=111). The chi-square test was used for comparison of categorical data between two groups; the t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; univariate and multivariate binary logistic regression analyses were used to screen out the influencing factors for the initiation of antiviral therapy; the receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic efficiency of each indicator in determining the need for antiviral therapy in HBeAg-negative chronic HBV infection patients with ALT ≤40 U/L. ResultsOf all 377 patients, 266 (70.6%) did not need antiviral therapy for the time being, and 111 (29.4%) had marked liver damage and thus needed active antiviral therapy. The multivariate analysis showed that liver stiffness measurement (LSM) (odds ratio ［HR］=2.003, 95% confidence interval ［CI］: 1.647-2.437, P＜005), HBsAg (HR=1.563, 95% CI: 1.110-2.200, P＜0.05), HBV DNA (HR=1.519, 95% CI: 1173-1.966, P＜0.05), and albumin (HR=0.939, 95% CI: 0.884-0.998, P＜0.05) were independent influencing factors for the initiation of antiviral therapy. The ROC curve analysis showed that the area under the ROC curve (AUC) was 0.749 (95% CI: 0.699-0799) for LSM, 0642 (95% CI: 0.586-0.699) for HBV DNA, and 0.565 (95% CI: 0.507-0.623) for HBsAg, and the combination of LSM, HBV DNA, and HBsAg had a larger AUC of 0.779 (95% CI: 0.732-0.827). ConclusionThe levels of LSM, HBV DNA, and HBsAg have a reference value in determining the initiation of antiviral therapy in HBeAg-negative chronic HBV infection patients with ALT≤40 U/L.

Selection of treatment regimens for early-stage hepatocellular carcinoma / 临床肝胆病杂志

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in the world. At present, the treatment methods for HCC mainly include surgical treatment, local regional treatment, radiotherapy, systematic treatment, and traditional Chinese medicine treatment. This article introduces the indications for surgical treatment, surgical procedures, and the advantages of postoperative adjuvant therapy, analyzes the indications for liver transplantation and its future application in clinical practice, and describes the basic principles, optimal indications, and technical advantages of mature and new ablation techniques at present. It is pointed out that for patients with early-stage HCC, the advantages and shortcomings of each treatment regimen should be fully understood to select a precise treatment regimen.

Risk factors for hepatitis B virus-related hepatocellular carcinoma / 临床肝胆病杂志

At present, hepatitis B virus (HBV) infection is recognized as an important risk factor for hepatocellular carcinoma (HCC) in the world; however, during the development and progression of hepatitis B, liver cirrhosis, and liver cancer, other factors may promote the development of HCC independently or synergistically with HBV, such as sex, age, family history, alanine aminotransferase/aspartate aminotransferase, smoking and drinking history, metabolic syndrome, and HCV or HIV infection. This article reviews the research advances in the risk factors associated with HCC.

Toxoplasma gondii infection among HBV patients / 中国人兽共患病学报

To investigate the prevalence of Toxoplasma gondii infection among hepatitis B virus (HBV) patients in northern Shaanxi Province,139 patients and 43 healthy controls were recruited.All the plasma was screened for IgG antibody of Toxoplasma gondii.Then,the association between Toxoplasma gondii infection and HBV were analyzed.Results showed that the prevalence of Toxoplasma gondii infection was relative low with just 5.04％ in HBV patients but zero in healthy control.Most of those infected with toxoplasma gondii were male,HBeAg positive or with higher HBV viral load.However,no significant relationship was found between Toxoplasma gondii infection and gender,HBeAg status or viral load in univariate analyses.This study indicated the relative low infection rate of Toxoplasma gondii,which had no association with HBV infection in northern Shaanxi Province.

Clinical identification and management of chronic HBV carriers / 临床肝胆病杂志

As reported by the world health organization, about 650 thousand people die of liver failure, liver cirrhosis, and hepatocellular carcinoma caused by hepatitis B virus (HBV) infection every year. Although to a certain extent, the application of interferon and nucleos(t)ide analogues reduces the adverse outcome of chronic hepatitis B (CHB), so far no effective therapeutic method can eliminate HBV. HBV carriers have a significantly lower incidence rate of adverse outcome than active CHB patients, but they still have the risk of progression to liver cirrhosis and liver cancer. This article discusses the clinical identification and management of HBV carriers, so as to further clarify the features of chronic HBV carriers and related treatment measures in clinical practice.

Insights into battles between Mycobacterium tuberculosis and macrophages

As the first line of immune defense for Mycobacterium tuberculosis (Mtb), macrophages also provide a major habitat for Mtb to reside in the host for years. The battles between Mtb and macrophages have been constant since ancient times. Triggered upon Mtb infection, multiple cellular pathways in macrophages are activated to initiate a tailored immune response toward the invading pathogen and regulate the cellular fates of the host as well. Toll-like receptors (TLRs) expressed on macrophages can recognize pathogen-associated-molecular patterns (PAMPs) on Mtb and mediate the production of immune-regulatory cytokines such as tumor necrosis factor (TNF) and type I Interferons (IFNs). In addition, Vitamin D receptor (VDR) and Vitamin D-1-hydroxylase are up-regulated in Mtb-infected macrophages, by which Vitamin D participates in innate immune responses. The signaling pathways that involve TNF, type I IFNs and Vitamin D are inter-connected, which play critical roles in the regulation of necroptosis, apoptosis, and autophagy of the infected macrophages. This review article summarizes current knowledge about the interactions between Mtb and macrophages, focusing on cellular fates of the Mtb-infected macrophages and the regulatory molecules and cellular pathways involved in those processes.

The curative effects of different surgery incisions on mammary gland fibroma / 中国基层医药

Objective To compare the curative effects of different surgery incisions on mammary gland fibroma.Methods 80 patients with mammary gland fibroma who would got surgery were randomly divided into observation group(by mammary areola arc incision) and control group (by radial incision).The surgery time,blood loss,first wound healing rate,symmetry rate of bilateral mamma,satisfactory appraisement of patients,postoperative complication and tumor recurrence rate of the two groups were observed and compared.Results Compared with control group,the surgery time of observing group was significantly longer(P ＜0.05),the blood loss was significantly less(P ＜0.05),.the symmetry rate of bilateral mamma and satisfactory appraisement of patients were significantly higher(P ＜ 0.05 or P ＜ 0.01),and the incidence rate of postoperative complication was significantly lower(P ＜ 0.05).But there was no difference of the first wound healing rate between the two groups (P ＞ 0,05).All the patients were followed up for 2-56 months,and only 1 case of recurrence in each group,and there was no significant difference between the two groups (P ＞ 0.05).Conchusion Treating mammary gland fibroma by mammary areola arc incision shows less blood-loss,maximum mamma symmetry preserving,high satisfactory appraisement of patients,low postoperative complication and does not increase the recurrence rate after surgery.

Immune clonal selection optimization method with combining mutation strategies / 药物分析学报

In artificial immune optimization algorithm, the mutation of immune cells has been considered as the key operator that determines the algorithm performance. Traditional immune optimization algorithms have used a single mutation operator, typically a Gaussian. Using a variety of mutation operators that can be combined during evolution to generate different probability density function could hold the potential for producing better solutions with less computational effort. In view of this, a linear combination mutation operator of Gaussian and Cauchy mutation is presented in this paper, and a novel clonal selection optimization method based on clonal selection principle is proposed also. The simulation results show the combining mutation strategy can obtain the same performance as the best of pure strategies or even better in some cases.

Immune clonal selection optimization method with combining mutation strategies / 西安交通大学学报·英文版

In artificial immune optimization algorithm, the mutation of immune cells has been considered as the key operator that determines the algorithm performance. Traditional immune optimization algorithms have used a single mutation operator, typically a Gaussian. Using a variety of mutation operators that can be combined during evolution to generate different probability density function could hold the potential for producing better solutions with less computational effort. In view of this, a linear combination mutation operator of Gaussian and Cauchy mutation is presented in this paper, and a novel clonal selection optimization method based on clonal selection principle is proposed also. The simulation results show the combining mutation strategy can obtain the same performance as the best of pure strategies or even better in some cases.

A clinical study on delayed encephalopathy after carbon monoxide poisoning / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate clinical and imaging characteristics of delayed encephalopathy after carbon monoxide poisoning(DEACMP).</p><p><b>METHODS</b>A retrospective and comparative analysis of neurological manifestations, course, periods of false-cure, prognosis and neuroimaging findings were conducted in 198 patients with DEACMP.</p><p><b>RESULTS</b>Of these patients, 60.1% obtained an initial recovery within 30 d, 23.7% within 31-60 d and 14.6% over 60 d. Total clinical rate was 32.8%, and effectiveness rate 70.1%. According to imaging findings, 15.2% patients were found to have bilateral lesions of basal ganglion, and 70.0% with lesions of subcortical white matter, 12.6% with lesions of two types above mentioned and 2.1% with no lesions. The intervals between onset of illness and initial recovery were (44.6 +/- 10.1), (38.2 +/- 11.9), (61.3 +/- 17.0) d, and (7.5 +/- 2.4) d respectively. Imaging findings can demonstrate the severity of brain injury, but not necessarily parallel to the improvement of illness, for which SPECT proves more useful.</p><p><b>CONCLUSIONS</b>DEACMP is involved in ischemic brain injury and a self-limited illness.</p>