Liver Fibrosis in the Natural Course of Chronic Hepatitis B Viral Infection: A Systematic Review with Meta-Analysis.

BACKGROUND: Quantitative data are limited on the natural course of liver fibrosis in patients with chronic HBV infection (CHB). AIMS: To estimate the prevalence of fibrosis status including non-fibrosis, significant fibrosis, advanced fibrosis, and cirrhosis throughout the natural course of CHB. METHODS: We searched Cochrane library, EMBASE, PubMed, SCOPUS, Web of Science, and ScienceDirect from January 1993 to November 2019 for studies with histologic data on liver fibrosis in CHB natural course. CHB course was defined based on current criteria for identifying infection phases as recommended by international clinical practice guidelines, including the HBeAg-positive immune-tolerant, HBeAg-positive immune-active, HBeAg-negative immune-inactive, HBeAg-negative immune-reactive, and HBsAg-negative phases. Pooled prevalence rate of fibrosis status at each phase was obtained from random-effect meta-analyses. RESULTS: Thirty-three studies with 9,377 adult participants (23.8-49.0 age years; 45.5-88.6% males) were eligible and finally included. The estimated prevalence of non-fibrosis, significant fibrosis, advanced fibrosis, and cirrhosis was, for HBeAg-positive immune-tolerant phase: 31.2% (95%CI 15.6-46.7), 16.9% (95%CI 7.8-26.1), 5.4% (95%CI 0.0-11.2), and 0.0% (95%CI 0.0-1.5); HBeAg-positive immune-active phase: 6.9% (95%CI 3.6-10.2), 50.6% (95%CI 39.2-61.9), 32.1% (95%CI 24.2-40.0), and 12.8% (95%CI 8.6-17.0); HBeAg-negative immune-inactive phase: 32.4% (95%CI 0.0-100.0), 24.8% (95%CI 4.5-45.1), 3.0% (95%CI 0.0-8.3), and 0.0% (95%CI 0.0-1.0); and HBeAg-negative immune-reactive phase: 6.3% (95%CI 3.5-9.2), 50.3% (95%CI 38.9-61.7), 30.3% (95%CI 20.9-39.6), and 10.0% (95%CI 6.6-13.5), respectively. There was only one study for HBsAg-negative phase, thus not allowing further meta-analyses. CONCLUSIONS: Fibrosis risk persists through CHB natural course. These data can support risk estimation in clinical practice and provide reference for noninvasive investigation.

Discovery and optimization of 3,4,5-trimethoxyphenyl substituted triazolylthioacetamides as potent tubulin polymerization inhibitors.

Based on our previous research, three series of new triazolylthioacetamides possessing 3,4,5-trimethoxyphenyl moiety were synthesized, and evaluated for antiproliferative activities and inhibition of tubulin polymerization. The most promising compounds 8b and 8j demonstrated more significant antiproliferative activities against MCF-7, HeLa, and HT-29 cell lines than our lead compound 6. Moreover, analogues 8f, 8j, and 8o manifested more potent antiproliferative activities against HeLa cell line with IC50 values of 0.04, 0.05 and 0.16 µM, respectively, representing 100-, 82-, and 25-fold improvements of the activity compared to compound 6. Furthermore, the representative compound, 8j, was found to induce significant cell cycle arrest at the G2/M phase in HeLa cell lines via a concentration-dependent manner. Meanwhile, compound 8b exhibited the most potent tubulin polymerization inhibitory activity with an IC50 value of 5.9 µM, which was almost as active as that of CA-4 (IC50 = 4.2 µM). Additionally, molecular docking analysis suggested that 8b formed stable interactions in the colchicine-binding site of tubulin.

[Clinical application of Meek skin grafting technique].

OBJECTIVE: To discuss the clinical application of Meek skin grafting technique. METHODS: Sixteen patients with TBSA>30% were treated by Meek grafting technique, and the results were compared with a control group treated with traditional stamp skin grafting. The skin expanding rate, graft survival, operating time, medical expense, and skin scar formation were evaluated and compared between the two groups. RESULTS: In the 16 cases managed with Meek grafting technique, the graft survival rate was above 95%, and there were significant differences in all the observed indices between Meek grafting group and the control group (P<0.01). CONCLUSION: Meek skin grafting technique possesses the advantages of more economic donor skin use, shorter operating time and hospital stay with reduced cost, and provides a good option for management of severely burned patients.

[Management of burn wounds with Hippophae rhamnoides oil].

OBJECTIVE: To observe the therapeutic effects of Hippophae rhamnoides oil, a preparation of traditional Chinese herbal medicine derived from the fruits of sea buckthorn, on the wounds in burn patients. METHODS: Hippophae rhamnoides oil dressing was applied on the burn wounds as an inner dressing and covered by disinfecting dressing. The oil dressing was changed every other day until wound healing. RESULTS: Totally 151 burned patients received the treatment with Hippophae rhamnoides oil dressing, which obviously alleviated the swelling and effusion of the wounds and relieved the pains. Compared with the control patients (treated with vaseline gauze), patients receiving the dressing showed more obvious exudation reduction, pain relief, and faster epithelial cell growth and wound healing, with statistically significant difference between the two groups. CONCLUSION: As a valuable plant oil with wide uses in medicine, Hippophae rhamnoides oil for external application has definite effects on the healing of burn wounds.