[Current status and challenges of clinical research and development of new drugs for liver diseases].

Liver disease is a serious public health problem worldwide, affecting human health. However, there are still many unmet needs for the treatment of liver disease, especially with new therapeutic drugs. At present, there is no treatment method to eradicate the hepatitis B virus, nor are there therapeutic drugs for liver fibrosis, liver failure, and others. Chemotherapy and targeted immunotherapy are still unsatisfactory for liver cancer. This article provides an overview of the current status and challenges that arise in new drug research and development for liver diseases.

[Challenges and optimization strategies for clinical research and the development of new drugs for liver fibrosis].

Liver fibrosis is a key step in the developmental process of various chronic liver diseases, including cirrhosis. Therefore, the focus and difficulty of liver disease research have always been on how to reverse liver fibrosis. However, due to complex mechanisms, difficulties in endpoint evaluation, a lack of non-invasive diagnostic methods, and other factors, the research and development of new drugs are hindered and lengthy. Currently, some new drugs are being researched and developed, which signifies the prospect is optimistic.

[Functional recompensation during decompensated-stage cirrhosis].

Recent studies suggest that recompensation of liver function appears in decompensated cirrhosis after effective treatment. However, liver function recompensation degree, recompensation evaluation diagnostic criteria, how to predict recompensation from the perspective of liver function, and others still need to be further explored. Therefore, functional recompensation is explored here from the perspective of decompensated-stage cirrhosis.

[Research progress of liver sinusoidal endothelial cells in nonalcoholic fatty liver disease].

Non-alcoholic fatty liver disease (NAFLD) is widespread worldwide and thereby a very serious public health problem. There are currently no effective drug treatment measures. Liver sinusoidal endothelial cells (LSECs) are the most abundant non-parenchymal cells in the liver; however, it is still not clear what role LSECs play in NAFLD. This article reviews the research progress of LSECs in NAFLD in recent years in order to provide some reference for subsequent research.

[Emotional disorder: a neglected symptoms of chronic liver disease].

Patients with chronic liver disease generally have emotional disorders that typically manifest as depression, and seriously affects the quality of life. The mechanism of emotional disorders in patients with chronic liver disease is unclear, and may be related to variety of factors such as disease type, etiological treatment, economic, social support, and an individual psychology. Moreover, emotional disorders in patients with chronic liver disease can be assessed on a variety of scales and managed comprehensively through non-drug and drug therapy. This article reviews the potential pathogenesis, evaluation and treatment methods, in order to improve and provide more help for its effective treatment.

[Risk and control management of endoscopic retrograde cholangiopancreatography in patients with liver cirrhosis].

Endoscopic retrograde cholangiopancreatography (ERCP) is the most direct and effective method for the diagnosis and treatment of biliary and pancreatic diseases. Compared with surgery, ERCP has the advantages of minimal trauma, shorter surgery time, fewer complications, and shorter hospital stay. Liver cirrhosis, as the advanced stage of liver disease, has reduced tolerance to surgical stresses, and complications such as hepatic encephalopathy, esophagogastric varices, and coagulation dysfunction may occur during the decompensated stage, which poses a challenge to ERCP, and thus increase the intraoperative risk and postoperative complications. This article reviews and discusses the indications, risk and control management of ERCP in patients with liver cirrhosis.

[The descending pathophysiology model of cholestatic liver disease].

Intrahepatic cholestasis is a pathological condition in which the synthesis, secretion, and excretion of bile are blocked, and thus the bile does not flow normally into the duodenum and bloodstream. According to cytological damage site, it can be divided into hepatocellular cholestasis, biliary duct cell cholestasis and mixed cell cholestasis. The two kinds of pathophysiological models [ascending or upstream (damage begins with cholangiocytes and then extends to the hepatocytes) and descending or downstream (the damage starts from the liver cells and then extends to the bile duct cells)] has distinct features in the process of disease occurrence and development. This article mainly elaborates the "descending" pathophysiological model of cholestatic liver disease (hepatocytic damage progresses to biliary duct cell), and further explores its etiology, pathogenesis and treatment methods.

Chemically specific termination control of oxide interfaces via layer-by-layer mean inner potential engineering.

Creating oxide interfaces with precise chemical specificity at the atomic layer level is desired for the engineering of quantum phases and electronic applications, but highly challenging, owing partially to the lack of in situ tools to monitor the chemical composition and completeness of the surface layer during growth. Here we report the in situ observation of atomic layer-by-layer inner potential variations by analysing the Kikuchi lines during epitaxial growth of strontium titanate, providing a powerful real-time technique to monitor and control the chemical composition during growth. A model combining the effects of mean inner potential and step edge density (roughness) reveals the underlying mechanism of the complex and previously not well-understood reflection high-energy electron diffraction oscillations observed in the shuttered growth of oxide films. General rules are proposed to guide the synthesis of atomically and chemically sharp oxide interfaces, opening up vast opportunities for the exploration of intriguing quantum phenomena at oxide interfaces.

Are genetic polymorphisms in the renin-angiotensin-aldosterone system associated with essential hypertension? Evidence from genome-wide association studies.

In candidate gene era, dozens of single-nucleotide polymorphisms (SNPs) within renin-angiotensin-aldosterone system (RAAS) have been reported to be significantly associated with hypertension. However, the unbiased genome-wide association studies (GWAS) rarely identified the SNPs within RAAS were associated with hypertension or blood pressure (BP) traits. In order to figure out whether genetic polymorphisms of RAAS are really associated with hypertension, we systemically searched the GWAS Catalogue and identified all the known RAAS genes and relevant diseases/traits. After data processing, we found that polymorphisms within REN, AGT, ACE2, CYP11B2, ATP6AP2 and HSD11B2 were not associated with any disease or trait. SNPs within ACE, AGTR1, AGTR2, MAS1, RENBP and NR3C2 were associated with other diseases or traits, but showed no direct connection with hypertension. The only SNP associated with a BP trait, systolic BP was rs17367504. However, it is located in the intronic region of MTHFR near many plausible candidate genes, including CLCN6, NPPA, NPPB and AGTRAP. Therefore, the effect of RAAS polymorphisms may have been overestimated during the 'candidate gene era'. In the time of 'precision medicine', the power of RAAS variants needs to be reconsidered when evaluating one's susceptibility of hypertension.

[Four-handed procedure for nasal endoscopic surgery].

Nasal endoscopic surgery was born in the 1950 of the last century in Europe.The original Hopkins and other scholars proposed nose rigid endoscopy to the application of modern advanced "chameleon" nasal endoscopic,roughly experienced 60 years of evolution and development.The development and improvement of endoscopic surgery also in constant evolution,by traditional single hand operation that patients in one hand and holding a mirror,on the other hand took the instrument to attract or punch,to modern groping in the dark hands operation technology,namely assistant control nasal endoscope,surgery were both hands operation,this is called the four hand operation to solve the a lot of nasal endoscopic surgery problem,lay a solid foundation to the continuous expansion of the endoscopic surgery.Nasal endoscopic surgery is the optimal operation mode of the nasal cavity and even the skull base surgery.It is a great breakthrough in the history of endoscopic surgery,and it is also a major improvement in the development of microsurgical technique.

Myofibroblastic transformation of rat hepatic stellate cells: the role of Notch signaling and epithelial-mesenchymal transition regulation.

OBJECTIVE: The development of liver fibrosis has been shown to be associated with the transition of quiescent hepatic stellate cells (HSCs) into myofibroblastic HSCs, and the Notch signaling system has been shown to be activated in this process. The Notch signaling pathway is also known to regulate epithelial-mesenchymal transition (EMT). MATERIALS AND METHODS: In the current study, quiescent HSCs were examined for expression of EMT markers, and experiments were performed to determine whether these markers change as quiescent HSCs transition into myofibroblastic HSCs and whether the process is modulated by Notch signaling. To promote myofibroblastic transition under experimental conditions, enzymatic perfusion and density gradient centrifugation were used to isolate rat HSCs, which were then cultured. A γ-secretase inhibitor was used to inhibit Notch signaling pathway activity in primary rat HSCs. RESULTS: Upregulated expression of myofibroblastic markers was observed, but expression of quiescent HSC markers and epithelial markers was downregulated during the transition of HSC in vitro. Data indicate that expression of the classical EMT marker; i.e., E-cadherin, was decreased and that of N-cadherin and snail 1 increased. Notch 2 and Notch 3 receptors and Hey2 and HeyL target genes expression increased significantly as quiescent HSCs transitioned into myofibroblastic HSCs. When Notch signaling was blocked, however, the myofibroblastic transition of HSCs reverted, and epithelial marker expression was restored. CONCLUSIONS: Thus, targeting Notch signaling may provide new insights into the mechanism of HSC transition and may offer a possible therapeutic target for the treatment of hepatic injury.

Apoptosis induced by emodin is associated with alterations of intracellular acidification and reactive oxygen species in EC-109 cells.

Emodin (1,3,8-trihydroxy-6-methylanthraquinone), a natural anthraquinone derivative found in several herbal medicines, is highly active in suppressing the proliferation of various tumor cells such as breast, hepatocellular, and lung cancer cells under in vitro conditions. The mechanism of emodin-induced apoptosis in esophagus carcinoma cells, EC-109, is not completely understood. In this study, EC-109 cells treated with emodin underwent rapid apoptosis as judged by morphological changes and flow cytometry analysis. The addition of emodin to EC-109 cells led to the inhibition of growth in a time- and dose-dependent manner. Fluorescence measurements of cells indicated that the intracellular pH (pHi) decreased significantly by 0.47-0.78 units. The results obtained from flow cytometry suggested that bursts of reactive oxygen species took place after the application of emodin. The present study indicates that emodin may be a strong anticancer drug against esophagus cancer cells by causing various early events leading to growth inhibition, including the production of reactive oxygen species and decrease of pHi, which may result in cellular apoptosis.

Arbuscular mycorrhizal fungi associated with sedges on the Tibetan plateau.

The arbuscular mycorrhizal (AM) status of nine dominant sedge species and the diversity of AM fungi in Tibetan grassland were surveyed in the autumn of 2003 and 2004. Most of the sedge species and ecotypes examined were mycorrhizal, but Carex moorcroftii and Kobresia pusilla were of doubtful AM status, and Kobresia humilis was facultatively mycorrhizal. This is the first report of the mycorrhizal status of eight of the nine sedge species examined. Intraradical vesicles and aseptate hyphae were the structures most frequently observed. Appressoria, coils, and arbuscules were found in the roots of a few sedge species. A strong negative correlation was found between soil organic matter content and the extent of mycorrhizal colonization. Using trap cultures, 26 species of AM fungi belonging to six genera, Glomus, Acaulospora, Paraglomus, Archaeospora, Pacispora, and Scutellospora, were isolated from the soil samples collected. The frequency of occurrence of different taxa of AM fungi varied greatly. Glomus and Acaulospora were the dominant genera, and Acaulospora scrobiculata was the most frequent and abundant species. The species richness of AM fungi was 2.73 in the study area. Species richness and diversity index differed among the sedge species but were not correlated with soil factors such as pH, available P, or organic matter content.

A preliminary survey of the arbuscular mycorrhizal status of grassland plants in southern Tibet.

We report for the first time the arbuscular mycorrhizal (AM) status of native plant species and AM fungal diversity in the grasslands of southern Tibet. A total of 51 soil samples were collected from the rhizospheres of the dominant plant species, and AM fungal structures were observed in 18 (82%) of 22 plant species examined. Vesicles and aseptate hyphae were the structures most frequently observed in the plant roots. After trap culture for 5 months, 25 AM fungal taxa were identified in the soil samples collected, of which nine belonged to Glomus, ten to Acaulospora, one to Entrophospora and five to Scutellospora. The frequency of occurrence of different genera and species varied greatly. Glomus was the dominant genus, and the most frequent and abundant species was Glomus mosseae. Over the whole sampling area, spore density in the rhizosphere soil of different host plant species ranged from 2 to 66 per 20 g air-dried soil. Overall AM fungal species richness was 2.10 and species diversity was 2.35. AM fungal diversity was also compared among the four different land use types (farmland and normal, disturbed and highly disturbed montane scrub grassland). Spore densities in the farmland and normal grassland were much higher than in the grasslands that had been degraded to varying degrees. The species richness in normal grassland was the highest of the four land use types examined. Species diversity varied from 1.99 to 0.94 and was highest in normal grassland, intermediate in degraded grassland and farmland, and lowest in the highly disturbed grassland.