The effect of a tailored message package for reducing antibiotic use among respiratory tract infection patients in rural Anhui, China: a cluster randomized controlled trial protocol.

BACKGROUND: Antibiotics are over-used for patients with respiratory tract infections (RTIs) in primary care, especially in the rural areas of China. METHODS: A cluster randomized controlled trial (RCT) will be carried out to estimate the effectiveness of a tailored message package for educating patients to reduce antibiotic use for symptomatic respiratory tract infections (RTIs). In the intervention group, patients will receive 12 short messages in 12 consecutive days. The whole process of the message design, modification, translation (of substitution variables), and sending will be facilitated by a user-friendly mini-computer program. The primary measure for assessment is the reduction in number of days in which antibiotics are used by patients with symptomatic RTIs. The secondary measures include (1) patients' knowledge about and attitude toward antibiotics; (2) patients' quality of life (EQ-5D-5L) and symptom severity and duration; (3) times of re-visits to clinics and antibiotics re-prescription for the same RTI episode; and (4) times of re-occurrence of RTIs and related health service seeking and antibiotics consumption. DISCUSSION: This study will determine the efficacy of a 12-message intervention to educate patients to reduce excessive antibiotic use in rural China. TRIAL REGISTRATION: ISRCTN29801086 . Registered on 23 September 2022.

Usefulness of Self-Assessment of Gastrointestinal Symptoms: Web-Based Study in Anhui, China.

BACKGROUND: Gastrointestinal symptoms (GISs) are caused by a combination of biopsychosocial factors and are highly prevalent worldwide. Given their complex nature, coupled with ineffective communication of diagnoses by physicians, patients with intimate GISs often feel stigmatized. This, in turn, can inhibit their ability to express their thoughts and feelings adequately, leading them to over- or underreport their symptoms. Moreover, selective service-seeking for and reporting of GISs have a direct bearing on the stage of disease at presentation and, consequently, on the overall prognosis. OBJECTIVE: This study aimed to investigate the usefulness of a web-based self-assessment of GISs as a supplementary means to cope with potential over- or underreporting during routine consultations. METHODS: GIS data were collected using a novel web-based self-assessment tool (n=475) and from nonparticipative observation of doctor-patient consultations (n=447) and household surveys (n=10,552) in Anhui, China. Data analysis focused primarily on the description of the composition of respondents and the occurrence rates of GISs by sociodemographics, and by symptom solicitation methods and settings. Chi-square power tests were used when necessary to compare differences in the occurrence rates between relevant groups. The level of significance for the 2-sided test was set at α<.05. RESULTS: The average occurrence rates of both upper and lower GISs derived from the web-based self-assessment were higher than those from the observation (upper GISs: n=661, 20.9% vs n=382, 14.2%; P<.001; lower GISs: n=342, 12.9% vs n=250, 10.8%; P=.02). The differences in 6 of the 9 upper GISs and 3 of the 11 lower GISs studied were tested with statistical significance (P<.05); moreover, a higher frequency rate was recorded for symptoms with statistical significance via self-assessment than via observation. For upper GISs, the self-assessed versus observed differences ranged from 17.1% for bloating to 100% for bad mood after a meal, while for lower GISs, the differences ranged from -50.5% for hematochezia or melena to 100% for uncontrollable stool. Stomachache, regurgitation, and dysphagia had higher occurrence rates among participants of the self-assessment group than those of the household survey group (20% vs 12.7%, 14% vs 11%, and 3% vs 2.3%, respectively), while the opposite was observed for constipation (5% vs 10.9%), hematochezia or melena (4% vs 5%), and anorexia (4% vs 5.2%). All differences noted in the self-assessed occurrence rates of specific, persistent GISs between sociodemographic groups were tested for nonsignificance (P>.05), while the occurrence rates of any of the 6 persistent GISs among respondents aged 51-60 years was statistically higher than that among other age groups (P=.03). CONCLUSIONS: The web-based self-assessment tool piloted in this study is useful and acceptable for soliciting more comprehensive GISs, especially symptoms with concerns about stigmatization, privacy, and shame. Further studies are needed to integrate the web-based self-assessment with routine consultations and to evaluate its efficacy.

Differentiated Effects and Determinants of Home Blood Pressure Telemonitoring: Three-Year Cohort Study in Jieshou, Anhui, China.

BACKGROUND: Home blood pressure telemonitoring (HBPT) is witnessing rapid diffusion worldwide. Contemporary studies documented mainly short-term (6-12 months) effects of HBPT, and there are limited data about its uptake. OBJECTIVE: The aim of this study was to explore the 3-year use and determinants of HBPT, and the interactions with systolic and diastolic blood pressure (SBP/DBP) and overall blood pressure (BP) control rate. METHODS: HBPT records were obtained from a 3-year cohort of 5658 patients with hypertension in Jieshou, Anhui, China, and data from a structured household survey of a random sample (n=3005) of the cohort. The data analysis comprised (1) timeline trajectories of the rates of monthly active HBPT and mean SBP/DBP for overall and subgroups of patients with varied start-month SBP/DBP; and (2) multivariable linear, logistic, and percentile regression analyses using SBP/DBP, BP control rate, and yearly times of HBPT as the dependent variable, respectively. RESULTS: HBPT was followed by mixed changes in mean monthly SBP/DBP for varied patient groups. The magnitude of changes ranged from -43 to +39 mmHg for SBP and from -27 to +15 mmHg for DBP. The monthly rates of active HBPT all exhibited a rapid and then gradually slower decline. When controlled for commonly reported confounders, times of HBPT in the last year were found to have decreasing correlation coefficients for SBP/DBP (from 0.16 to -0.35 and from 0.11 to -0.35, respectively) and for BP control rate (from 0.53 to -0.62). CONCLUSIONS: HBPT had major and "target-converging" effects on SBP/DBP. The magnitude of changes was much greater than commonly reported. BP, variation in BP, and time were the most important determinants of HBPT uptake. Age, education, duration of hypertension, family history, and diagnosis of hypertension complications were also linked to the uptake but at weaker strength. There is a clear need for differentiated thinking over the application and assessment of HBPT, and for identifying and correcting/leveraging potential outdated/new opportunities or beliefs.

Differences in service and antibiotics use following symptomatic respiratory tract infections between 2016 and 2021 in rural Anhui, China.

In the past 10-15 years, the government of China has made various efforts in tackling excessive antibiotics use. Yet, little is known about their effects at rural primary care settings. This study aimed to determine the impact of government policies and the COVID-19 pandemic on antibiotic prescribing practices at such settings utilizing data from separate studies carried out pre- and during the pandemic, in 2016 and 2021 in Anhui province, China, using identical sampling and survey approaches. Data on antibiotics prescribed, diagnosis, socio-demographic, etc., were obtained through non-participative observation and a structured exit survey. Data analysis comprised mainly descriptive comparisons of 1153 and 762 patients with respiratory infections recruited in 2016 and 2021, respectively. The overall antibiotics prescription rate decreased from 89.6% in 2016 to 69.1% in 2021, and the proportion of prescriptions for two or more classes of antibiotics was estimated as 35.9% in 2016 and 11.0% in 2021. There was a statistically significant decrease in the number of days from symptom onset to clinic visits between the year groups. In conclusion, measures to constrain excessive prescription of antibiotics have led to some improvements at the rural primary care level, and the COVID-19 pandemic has had varying effects on antibiotic use.

Polyacrylamide crosslinked by bis-vinylimidazolium bromide for high elastic and stable hydrogels.

A series of ionic compounds 1,n-dialkyl-3,3'-bis-l-vinylimidazolium bromide (C n VIM) are prepared and employed to crosslink acrylamide for polyacrylamide (PAAM) hydrogel preparation via in situ solution polymerization. The swelling behavior, mechanical properties and thermal stability of the prepared C n VIM crosslinked PAAM hydrogels are investigated. C n VIM effectively crosslink the PAAM networks to form porous structures in the hydrogel, which could stably absorb water as much as 75.9 fold in weight without structural degradation. The prepared hydrogels could endure compressive stress up to 1.95 MPa and compressive deformation more than 90%. Meanwhile, the C n VIM crosslinked networks show superior thermal stability, and could retain the structural integrity under 150 °C for more than 240 h. The swelling degradation resistance, mechanical strength and thermal stability of C n VIM crosslinked hydrogels are much better than those of a conventional N,N'-methylenebisacrylamide crosslinked PAAM hydrogel. Using bis-vinylimidazolium bromides as crosslinkers provides an optional strategy for constructing thermally and mechanically robust hydrogel networks.

Downregulated CDKN1C/p57kip2 drives tumorigenesis and associates with poor overall survival in breast cancer.

CDKN1C, also known as p57kip2, is considered to be a potential tumor suppressor implicated in several kinds of human cancers. However, the current knowledge of CDKN1C in breast cancer remains obscure. In the present study, we demonstrated that CDKN1C was dramatically downregulated in breast cancer compared with normal tissues by using real-time quantitative polymerase chain reaction, western blot and two public data portals: The Cancer Genome Atlas (TCGA) and Oncomine datasets. Moreover, the expression of CDKN1C was correlated with age and tumor size in the TCGA cohort containing 708 cases of breast cancer. Low expression of CDKN1C was significantly associated with poor overall survival (OS) in the TCGA cohort and validated cohort composed of 1402 patients. Multivariate Cox regression analysis indicated that CDKN1C was an independent prognostic factor for worse OS (HR = 1.78, 95% CI: 1.09-2.89, p = 0.020). Furthermore, gene set enrichment analysis (GSEA) revealed that CDKN1C was significantly correlated with gene signatures involving DNA repair, cell cycle, glycolysis, adipogenesis, and two critical signaling pathways mTORC1 and PI3K/Akt/mTOR. In conclusion, our data suggested an essential role of CDKN1C in the tumorgenesis of breast cancer. Targeting CDKN1C may be a promising strategy for anticancer therapeutics.

The effects of MIBG on the invasive properties of HepG2 hepatocellular carcinoma cells.

The aim of the present study was to investigate the effects of meta-iodobenzylguanidine (MIBG) on the invasive properties of hepatocellular carcinoma (HCC) cells and examine whether these effects are due to the ability of MIBG to inhibit arginine-specific mono-ADP-ribosylation. Samples from patients with HCC were divided into 2 groups, a metastatic group and a non-metastatic group. Immunohistochemistry and RT-PCR were used to detect the protein and mRNA expression of arginine-specific adenosine diphosphate-ribosyltransferase 1 (ART1) and integrin α7 in the HCC tissues. In addition, the expression of ART1 was measured in HepG2 HCC cells by immunofluorescence. The inhibition of the metastasis of HepG2 cells by MIBG at various concentrations was measured by MTT assay. In addition, the effects of MIBG on HepG2 cell metastasis were measured using a scratch wound assay and a transwell invasion assay. Western blot analysis was used to detect the protein expression of ART1, integrin α7, focal adhesion kinase (FAK), phosphatidylinositol 3-kinase (PI3K) and urokinase-type plasminogen activator (uPA) in the HepG2 cells. The mRNA and protein levels of ART1 and integrin α7 were higher in the metastatic HCC samples than in the non-metastatic HCC samples. ART1 expression was detected in the HepG2 cells. The half maximal inhibition concentration (IC50) of MIBG in the HepG2 cells was 200 µmol/l (P<0.05). Within a certain dose range, MIBG exerted inhibitory effects on HepG2 cell migration in a dose-dependent manner. Treatment with MIBG significantly inhibited the migration and invasion of the HepG2 cells relative to the control cells (P<0.05) and reduced the protein expression of ART1, integrin α7, FAK, PI3K and uPA (P<0.05). Our data demonstrate that ART1 and integrin α7 may be involved in the invasive and metastatic properties of HCC cells. MIBG inhibited the migration and invasion of HepG2 cells, possibly through the inhibition of arginine-specific single-adenosine diphosphate ribosylation and the suppression of the protein expression of integrin α7ß1, FAK and PI3K and the secretion of uPA, leading to reduced invasion by HepG2 cells.

Species composition and diversity of parasitoids and hyper-parasitoids in different wheat agro-farming systems.

Insect communities depend on both their local environment and features of the surrounding habitats. Diverse plant communities may enhance the abundance and species diversity of local natural enemies, which is possible due to a higher abundance and species diversity in complex landscapes. This hypothesis was tested using cereal aphid parasitoids and hyper-parasitoids by comparing 18 spring wheat fields, Triticum aestivum L. (Poales: Poaceae), in structurally-complex landscapes (dominated by semi-natural habitat, > 50%, n = 9) and structurally-simple landscapes dominated by arable landscape (dominated by crop land, > 80%, n = 9). The agricultural landscape structure had significant effects on the number of parasitoid and hyper-parasitoid species, as 26 species (17 parasitoids and 9 hyper-parasitoids) were found in the complex landscapes and 21 were found in the simple landscapes (14 parasitoids and 7 hyper-parasitoids). Twenty-one species occurred in both landscape types, including 14 parasitoids and 7 hyper-parasitoids species. The species diversity of parasitoids and hyper-parasitoids were significantly different between the complex and simple landscapes. In addition, arable fields in structurally-simple agricultural landscapes with little semi-natural habitats could support a lower diversity of cereal aphid parasitoids and hyper-parasitoids than structurally-complex landscapes. These findings suggest that cereal aphid parasitoids and hyper-parasitoids need to find necessary resources in structurally-complex landscapes, and generalizations are made concerning the relationship between landscape composition and biodiversity in agricultural landscapes. Overall, abundance, species richness, and species diversity increased with increasing plant diversity and landscape complexity in spring wheat fields and increasing amounts of semi-natural habitats in the surrounding landscape.

[Effects of resistin on hepatic fibrosis: possible mechanisms in non-alcoholic fatty liver disease in in vitro and in vivo].

To investigate the effects and possible mechanisms of resistin on hepatic fibrosis in non-alcoholic fatty liver disease, this review used an in vivo model utilizing Wistar rats with a high fat diet. Recombinant resistin was selected to play role in hepatic stellate cells in the HSC-T6 cell line. We observed the degrees of hepatic fibrosis, measured the levels of Liver fibrosis spectrum and detected expression levels of resistin mRNA and protein in liver tissue as well as the expression levels of TGFß-1 and TNF-α mRNA in HSC-T6. The results showed that expression of resistin in rat liver tissue and the degree of hepatic fibrosis increased over time with a high fat diet. Along with the increased concentration of resistin and levels of fibrosis index, TGFß-1and TNF-α also increased in HSC-T6 cells. Compared with the control group, significant differences were found between each group, suggesting resistin by proinflammatory cytokine TNF-α and TGF-ß1 induced the occurrence and development of NAFLD in hepatic fibrosis.

[The effect of resistin on nuclear factor-kB and tumor necrosis factor-a expression in hepatic steatosis].

OBJECTIVE: To investigate the potential regulatory role played by the hormone resistin in lipid metabolism and expression of nuclear factor (NF)-kB and tumor necrosis factor (TNF)-a during hepatic steatosis. METHODS: A non-alcoholic fatty liver disease (NAFLD) cell model was established by treating the normal human hepatic cell line, L02, with palmitic acid. Four research groups of L02 cells were generated: C group (control, no palmitic acid treatment), P group (NAFLD model, treated with 20 microg/ml palmitic acid), CR group (C group treated with 50 microg/L recombinant human resistin), and PR group (P group treated with 50 microg/L recombinant human resistin). All treatments were carried out for 72 hours. Oil red O staining was used to detect the intracellular changes in lipid drops. Biochemical assays were used to measure triglycerides (TGs), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transpeptidase (GGT) levels in culture medium. The mRNA and protein expression levels of insulin receptor substrate (IRS)-2, NF-kB, and TNF-a were determined by reverse transcription-polymerase chain reaction and Western blot analysis, respectively. RESULTS: The TG, ALT, AST, and GGT levels were higher in the P, CR, and PR groups than in the C group. The NF-kB mRNA level was also higher in the P, CR, and PR groups (Student's t = 17.64, 22.03, 26.06 respectively) than in the C group, as was the TNFa mRNA level ( t = 5.67, 5.38, 11.64), but the IRS-2 mRNA level was lower ( t = 8.19, 9.23, 20.93) (all, P less than 0.05). In addition, no significant difference in these mRNA levels were found between the P group and the CR group (NF-kB: t = 1.75, TNFa: t = 0.58, IRS-2: t = 2.14; all, P more than 0.05). The detected protein levels of NF-kB, TNFa, and IRS-2 were consistent with the mRNA levels. CONCLUSION: Resistin can promote steatosis in LO2 cells through the NF-kB signaling pathway, thereby contributing to the NAFLD pathogenic process.

[Clinical significance of histopathologic and ultrastructural pathologic examination in etiological diagnosis of infantile cholestatic diseases].

OBJECTIVE: To study the features of histopathologic and ultrastructural pathologic changes of liver biopsy in patients with infantile cholestatic disease, and to investigate its diagnostic significance combining with the clinical data. METHODS: Thirty-six children diagnosed as infantile cholestatic disease and received liver biopsy in Chongqing Medical University Children's Hospital from Jun 2007 to Oct 2008 were enrolled and the pathologic and ultrastructural pathologic changes of liver were analyzed. RESULTS: Morphologic changes under light microscope in liver tissues included hepatocyte swelling, hepatocyte denaturation, hepatocyte necrosis, multinucleated giant cell formation, bile duct proliferation, fiber tissues proliferation and inflammatory cells infiltration in liver lobules and portal regions. The characteristics of cholestasis including intralobular cholestasis, acinus formation, feather-like cytoplasmic filaments and bile stasis in bile canaliculi were observed. The morphologic changes of biliary atresia were observed in 7 cases whose image investigations showed no obstruction of biliary tract. Nuclear changes, resolution of cytoplasm, inflammatory cell infiltration, collagen fiber proliferation and increased number of lysosomes were observed under electromicroscope. Two cases of glycogen storage disease, 1 case of Niemann-Pick disease and 1 case of lipid storage disease with unknown cause were confirmed by the combination of histological changes and clinical manifestations. CONCLUSION: Common pathologic changes of liver tissues existed under light microscope or electroscope. The diagnosis of hereditary metabolic disorders could be made increasingly by application of these two technologies in clinical practice. It is difficult to diagnose biliary atresia in early childhood by image investigations and the pathological changes of liver tissues are helpful.

[Influence of genipin and vitamin E on UCP2 and other correlation factors in non-alcoholic fatty liver disease].

This study was aimed to detect the effect of genipin and Vitamin E (VitE) on non-alcoholic fatty liver disease. L02 cells were divided into five groups:control group, palmic acid treated group, VitE treated group, genipin treated group, and a combination group. All treatments were terminated at the end of 72 hours. Pathological changes of L02 cells were observed. Mitochondrial membrane potential changes were detected by flow cytometry. MDA, SOD, ALT, AST, GGT, TG in culture medium and expression of UCP2 mRNA and protein in L02 cells were detected. We also studied the effects of genipin and VitE on UCP2 and other related factors such as NF-kappaB and TNF-alpha on the L02 cell model of non-alcoholic fatty liver disease. In combination group, the degree of adipose degeneration of L02 cells mitigated significantly; mitochondrial membrane potential and the level of SOD activity increased; the level of MDA, ALT, AST, GGT, TG and the expression of UCP2, NF-kappaB,TNF-alpha in L02 cells decreased. The use of genipin in combination with VitE can increase mitochondrial membrane potential and markedly relieve the adipose degeneration of liver cells.

[Effect of tea polyphenols on expression of nuclear factor kappa B].

OBJECTIVE: To investigate the effect of tea polyphenols (TP) on expression of nuclear factor kappa B (NF-kB) in rats with alcoholic liver diseases and in cells treated with alcohol. METHODS: 22 female Wistar rats were randomly divided into three groups: a control group, an alcohol model group and a TP plus alcohol group. All treatments were injected into stomach through intragastric tube. L02 cells were divided into five groups: a control group, an alcohol treated group, a prevention group (cells were treated with TP for 3 days, and then treated with alcohol), an intervention group (cells treated with TP and alcohol), and a therapeutic group (cells were treated with alcohol for 3 days, and then treated with TP). Histopathology was observed under light microscope (LM); serum MDA, ROS in cells were quantified by optical density measurement; the expression of NF-kB and IkB was determined by RT-PCR; and the activity of NF-kB was checked with Electrophoretic Mobility Shift Assay (EMSA). RESULTS: LM indicated hepatocytes were injured obviously in the model group. Serum MDA and cells ROS in TP treated groups were significantly lower than the alcohol treated group. The level of NF-kB mRNA expression in TP treated groups(rats: 0.58+/-0.16, cells: 0.60+/-0.03, 0.59+/-0.01, 0.59+/-0.01) were significantly lower than the alcohol treated group (rats: 1.15+/-0.03, cells: 0.76+/-0.03) (P<0.01), the level of IkB mRNA expression in the prevention group, intervention group, and therapeutic group (0.51+/-0.01, 0.50+/-0.01, 0.50+/-0.12) were significantly higher than the alcohol treated group (0.61+/-0.03) (P<0.05), the difference among the three groups was not significant (P>0.05). The activity of NF-kB in TP treated rats(DNA stain: 669.85+/-41.34, Protein stain: 675.35+/-18.27) was significantly lower than the alcohol treated rats(DNA stain: 1410.78+/-22.19, Protein stain:1426.08+/-33.15) (P<0.01); NF-kB activity in cells of the prevention, intervention, therapeutic groups (DNA stain: 713.07+/-11.91, 710.79+/-14.99, 693.45+/-71.69; Protein stain: 758.88+/-34.65, 753.07+/-76.78, 725.77+/-36.09) was significantly lower than the alcohol treated cells (DNA stain: 849.94+/-12.45, Protein stain: 925.96+/-5.78) (P<0.01), the difference among the three TP treated groups was not significant (P>0.01). CONCLUSION: TP can alleviate and prevent alcohol-induced liver injury via inhibiting NF-kB activation.

[The clinicopathological study of infantile cytomegalovirus hepatitis].

OBJECTIVE: To investigate the clinicopathological features of infantile cytomegalovirus hepatitis. METHOD: Liver biopsies from 30 cases of infantile cytomegalovirus hepatitis were observed under optical microscope and electronic microscope. RESULT: The main clinical manifestations were jaundice, splenohepatomegaly and hypohepatia. Laboratory test showed dysfunction of liver, high level of CMV DNA, and high titer of anti-CMV antibody. Imaging examination demonstrated hepatomegaly. The histological changes were hepatocellular degeneration, necrosis, apoptosis, and fibrosis. The histological characteristics of cytomegalovirus hepatitis, including intranuclear inclusions in multinucleated giant cells and pseudo-lumens, were also observed under optical microscope. In addition, virion was observed in the nuclei and cytoplasm of hepatocytes under electronic microscope. CONCLUSION: The viral DNA and serological tests have limited utility for the diagnosis of infantile cytomegalovirus hepatitis, and the final diagnosis depends on histopathology.

[Expression of augmenter of liver regeneration in hepatic tumor cells and its clinical significance].

OBJECTIVE: To investigate the effects of augmenter of liver regeneration (ALR) on the proliferation of hepatocytes and hepatic tumor cells and the expression of ALR in herpatocellular carcinoma (HCC). METHODS: Primary rat hepatocytes, QGY and HepG2 cells were cultured separately with ALR from different species. Cell proliferation was detected by their 3H-TdR uptake. The expression of ALR was examined in 9 normal hepatic tissues and 21 HCC cases using immunohistochemistry method. RESULTS: Different ALRs could stimulate the proliferation of HepG2 and QGY cells in a dose-dependent way in vitro, but all ALR had no influence in the proliferation of primary rat hepatocytes. The expression of ALR was absent in normal hepatic tissues, but present in all HCC hepatic tissues. However, the expression of ALR had no relationship with the differentiation and size of the carcinomas. CONCLUSION: ALR might play an important role in the occurrence and development of HCC.

[A study on the clinical and pathological efficacy of lamivudine in the treatment of chronic hepatitis B].

OBJECTIVE: To investigate clinical effect, liver pathohistological changes (including pathology, HBV markers in liver tissue) in patients with chronic hepatitis B. METHODS: 70 patients of chronic hepatitis B were administered 100 mg Lamivudine orally daily for 1 year. The serum HBV-DNA, HBeAg/anti-HBe, hepatic chemistry and the hepatic fibrosis markers were studied. The needle biopsy of liver were performed in 35 patients before and after treatment and Knodell pathological score were done, HBsAg, HBcAg, alpha-SMA in liver tissue were examined by immunohistochemistry method. RESULTS: After 1 year treatment the full response rate, partial response rate and no response rate were 23.72%, 69.49% and 6.78%, the patients in whom HBeAg seroconversion had higher base-line Alanine aminotransferase levels than the patients without seroconversion. Activity index of hepatic histology in 41.18% patients had a significant decrease. Histological assessment revealed that necrosis in portal area, pylenphlebitis and fibrosis were obviously alleviated. The liver immunohistochemistry examination showed HBcAg and alpha-SMA in liver decreased significantly in the patients with HBeAg seroconversion, no obvious alteration was observed in HBsAg expression. Lamivudine seems an effective compound with high safety and low side effect. CONCLUSION: These results suggested that lamivudine (100mg/d) could suppress HBV-DNA replication, promote ALT normalization, accelerate HBeAg/anti-HBe seroconversion, improve the liver pathological changes, slow down the development of liver fibrosis

[Effect of Rhein on the development of hepatic fibrosis in rats].

OBJECTIVE: To investigate the effect of rhein on the development of hepatic fibrosis. METHODS: The animal models were made with carbon tetrachloride (CCl(4)) mixed with vegetable oil (3/2, v/v), which was injected subcutaneously twice a week for 6 weeks, and with 5% ethanol for free drinking water. At the same time, Rhein was administrated at the dose of 25 mg/kg or 100 mg/kg once a day for 6 weeks. The changes of both biochemical markers, such as the levels of alanine aminotransferase (ALT), hyaluronic acid (HA), procollagen type III (PCIII) in serum and SOD, malondialdehyde (MDA) in liver, and related histopathological parametres were determined. RESULTS: Compared with the model group, there were three kinds of changes in the larger quantity of rhein treated group. (1) The levels of ALT, HA, PCIII in serum and MDA in liver homogenate were decreased significantly (from 150 U/L +/- 16 U/L to 78 U/L +/- 18 U/L, 321 microg/L +/- 97 microg/L to 217 microg/L +/- 75 microg/L, 31 microg/L +/- 14 microg/L to 16 microg/L +/- 6 microg/L and 3.67 nmol/mg +/- 0.68 nmol/mg to 1.88 nmol/mg +/- 0.34 nmol/mg, respectively, t > or 2.977, P<0.01). However the level of SOD in liver was increased (from 62.45 NU/mg +/- 8.74 NU/mg to 91.26 NU/mg +/- 14.04 NU/mg, t=4.453, P<0.01). (2) The expressions of transforming growth factor beta 1 (TGF-beta 1) and alpha-smooth muscle actin (alpha-SMA) in liver were markedly reduced (P<0.05 and P<0.01). (3) The collagen staining positive area was decreased and the grade of fibrosis was reduced significantly in liver (P<0.05 and P<0.01). CONCLUSION: Rhein can protect hepatocyte from injury and prevent the progress of hepatic fibrosis in rats, which may associate with that rhein plays a role in antioxidation, anti-inflammation, inhibiting the expression of TGF-beta1 and suppressing the activation of hepatic stellate cells (HSCs).