Objective　To study the role of bcl-2 and bax in the pathogenesis of hepatitis D. Methods　Expression of HDAg， bcl-2 and bax in liver specimens of 79 patients with hepatitis D were studied by immunohistochemistry technique. Meanwhile， the relationship between expression of HDAg and that of bcl-2／bax in liver specimens of patients were studied by double labelling technique and serial sections.Results　bcl-2 was mainly expressed in the cytoplasm of hepatocytes， bax mainly in the cytoplasm of hepatocytes and partly in the nucleus of hepatocytes， and HDAg mainly in the nucleus of hepatocytes. Most of HDAg and bax positive cells were distributed among infiltrating lymphocytes at the periportal region especially at the advancing edges of areas of “piecemeal necrosis”. Most of hepatocytes of bax positive was found to locate near to positive cells of HDAg， and there were positive correlations between degrees of bax expression and HDAg expression（P＜0.05）. Conclusions　The distribution and the expression of bax and HDAg are significantly correlated with the activity of inflammation and the severity of the liver damage， and HDV infection may induce the expression of bax in the hepatocytes，and hepatocyte apoptosis mediated by bcl-2／bax may play an important role in the liver cell injury by HDV infection.

Objective To investigate the influence of vitamin E on type Ⅰ collagen, messenger RNA expression of transforming growth factor ? 1 (TGF? 1) and tissue inhibitor of matrix metalloproteinases-2 (TIMP 2) in hepatic stellate cells (HSC). Methods HSC s were cultured in vitro, the effect of vitamin E on type Ⅰ collagen was observed by mean of immunohistochemistry; mRNA expression of TGF? 1 and TIMP 2 were investigated with in situ hybridization. Results In experiment group, vitamin E markedly inhibited expression of type Ⅰ collagen of HSC as compared with control group, but could not suppress mRNA expression of TGF? 1 and TIMP 2.Conclusions Anti-fibrotic effect of Vitamin E may be implemented through inhibiting the expression of type Ⅰ collagen.

Objective To evaluate the effectiveness and safety of Shuangyi Qushi Tongluo Capsules ( SQTC) in treating ankylosing spondylitis (AS), and to explore the synergistic action of SQTC combined with sulfasalazine. Methods A randomized and parallel-controlled trial was carried out in 80 AS patients. The enrolled subjects were evenly randomized into testing group and control group. Both groups were given oral use of sulfasalazine enteric-coated tablets, and the testing group was additionally given oral use of SQTC, which is mainly composed of silky ant (Formica Fusca), black-winged Termitidae, Scorpio, Radix Ginseng, Radix Astragali, Rhizoma Atractylodis Macrocephalae, Radix Angelicae Sinensis, Flos Carthami, Radix Salviae Miltiorrhizae, Radix Achyranthis Bidentatae, Caulis Spatholobi, Herba Epimedii, and Radix Morindae Officinalis. The treatment for the two groups covered 24 weeks. On treatment week 4, 12, 24, we recorded the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), visual analog scale (VAS) scores of rachialgia, patients’ general assessment (PGA), VAS scores of night pain, spondylitis scores, Bath Ankylosing Spondylitis Functional Index ( BASFI) , Bath Ankylosing Spondylitis Metrology Index ( BASMI) , scores of the quality of life ( QOL) , erythrocyte sedimentation rate ( ESR) , C-reactive protein ( CRP). Moreover, the adverse reaction of the two groups was also monitored. Results ( 1) Compared with the control group, testing group had high ASAS 20 percentage on treatment week 4, 12 and 24 (P<0.05 or P<0.01). (2) After treatment for 12, 24 weeks, the observation indexes were much improved in the testing group ( P<0.05 or P<0.01 compared with the control group). ( 3) In the control group, one case ( 2.86%) had slight abnormal hepatic function, and one case (2.63%) in the testing group had slight gastrointestinal discomfort, the difference being insignificant (P>0.05). Conclusion SQTC are effective and safe in treating AS, starting an effect shortly and having synergistic effect on salfasalazine for the treatment of AS.

Objective To study the roles of apoptosis genes bcl 2, bax, and bak in the pathogenesis of hepatitis D. Methods Expressions of HDAg, bcl 2, bax, and bak in liver specimens of 77 patients with hepatitis D were studied by immunohistochemical method. Meanwhile, the relationship of HDAg expression with the expressions of bcl 2, bax, and bak was studied by double labelling. Results Bcl 2 was mainly expressed in the cytoplasm of hepatocytes, and bax and bak mainly in the cytoplasm of hepatocytes and partly in the nucleus of hepatocytes, and HDAg mainly in the nucleus of hepatocytes. Lots of HDAg and bax/bak positive cells were distributed in infiltrating lymphocytes at the periportal region especially at the advancing edges of areas of piecemeal necrosis. Apoptosis of many hepatocytes was found to locate near the HDAg positive cells. There was positive correlation between the expression of bax/bak and HDAg expression ( P

Objective　To investigate the possible relationship between the vitamin E(VE) contents in the plasma and development of hepatosis.Methods　VE and malondialdehyde(MDA) contents in 217 cases infected by various types of viral hepatitis were measured by means of fluorescence and TBA.Moreover,the relationship between both of the contents and the alteration of liver function was observed dynamically.Results　The plasma levels of VE in all cases were decreased obviously.Interestingly,lower the contents of VE were,more severity the disease was.Howevey,the levels of VE recovered step by step when the liver function return to normal in the acute hepatitis cases.Unfortunately,the levels in the chronic hepatitis cases were higher in the recovering phase than in the acute phase,but still lower than normal.Moreover,VE kept low levels and showed a negative relationship to the bilirublin in both worsening and dying cases.Conclusion　To observe the VE contents is helpful to the clinical evaluation of the hepatosis progress and prognosis.

Objective　To study the probability of using hepatitis D virus (HDV) ribozyme as a kind of anti-hepatitis-C-virus (HCV) gene thera-py drugs. Methods　The natural HDV genomic ribozyme′s stem Ⅳ was optimized and its substrate-binding region reconstructed, thus three recombinant HCV-specific HDV genomic ribozymes RzC1, RzC2 and RzC3 were obtained. HCV RNA 5'-noncoding region and 5'-fragment of C region (HCV RNA5'-NCR-C) were transcribed from plasmid pHCV-neo by T7 phage RNA polymerase in vitro, and radiolabelled at its 5'-end. The trans-cleaving reaction was performed by mixing the ribozymes and substrate at mol ratio 100∶1 under conditions as follows: 37℃, pH7.5, Mg2+ 20 mmol/L and deionized formamide 2.5 mol/L. Percentage of trans-cleaved products were calculated at different time points and used as the activity indicator of the three ribozymes. Results　RzC1, RzC2 trans-cleaved more substrate when the time extended, and got to 24.9%,20.3% after reac-ting for 90 minutes respectively; RzC3 was not able to trans-cleave its substrate. Conclusion　Recombinant HDV genomic ribozymes have the ability to trans-cleave HCV RNA, but the appropriate target sequence should be selected.

Objective To explore the pathogenesis of hepatitis D virus by analyzing the clinic characteristics of 507 cases of hepatitis B (HB) with hepatitis D virus (HDV) infection. Methods The occurrence of different types of hepatitis, the prognosis, clinical features, major biochemistry results, and hepatitis virus marks were analyzed in 507 cases of HB with positive HDV and compared with 213 cases of HB with negative HDV. Results The incidence and the mortality of serious chronic hepatitis, severe hepatitis, and liver cirrhosis were all higher in the HB patients with positive HDV than negative one. The incidence of bleeding, ascites, hepat-coma complication, and the level of ALT were higher in HDV-positive patients than in HDV-negative patients (P < 0.01,0.05), and the changes of the major biochemistry results were more obvious than the same types of hepatitis B with negative HDV (P < 0.01). The detection rate for HBeAg in serum of the patients positive for HDV was obviously lower than that of the patients negative for HDV(P < 0.01). In patients with acute hepatitis, severe hepatitis, and liver cirrhosis, the expression of positive HDAg and negative HBeAG was obviously higher than that of positive HDAg and HBeAg. Conclusion After HDV infection, the incidences and poor prognosis of serious chronic hepatitis, severe hepatitis, and liver cirrhosis increase. HDV infection can inhibit the replication of HBV DNA or HBeAg expression. The effects of direct cytotoxicity of HDV on hepatocytes may play a major pathogenic role in acute hepatitis and in aggravating illness status to severe type.

Objective To study the role of bcl-2, bax and hepatocyte apoptosis in the pathogenesis of hepatitis D. Methods Expression of HDAg, bcl-2, bax, and hepatocyte apoptosis in liver specimens of 77 patients with hepatitis D were studied by immunohistochemistry, double labelling and serial sections, and TUNEL assay. Six-seven hepatitis B patients served as control. Results Bcl-2 and bax were mainly expressed in the cytoplasm of hepatocytes, and HDAg mainly in the nucleus of hepatocytes. A large number of HDAg and bax positive cells were distributed among infiltrating lymphocytes at the periportal region in which many apoptosis hepatocytes were found. There were positive correlations between the expression of bax, HDAg and hepatocyte apoptosis (P<0.05). Conclusions The distribution and the expression of bax, HDAg and hepatocyte apoptosis are significantly correlated with the activity of inflammation and the severity of the liver damage. Hepatitis D virus infection may induce the expression of bax in the hepatocytes and exacerbate hepatocyte apoptosis through which take a part in the pathogenesis of hepatitis D.

Objective:To explore the effects of Xiao's double-C nursing mode based on enhanced recovery after surgery (ERAS) on perioperative related indexes and pain in patients undergoing mixed hemorrhoid surgery.Methods:From August 2019 to August 2020, 60 patients undergoing mixed hemorrhoid surgery who were admitted to anorectal surgery department of Anqing Municipal Hospital were enrolled as the research objects by single center, random, single blind and parallel control methods. They were divided into control group (routine perioperative nursing) and observation group (ERAS-based Xiao's double-C nursing mode) by random number table method, 30 cases in each group. The perioperative indexes, scores of postoperative Visual Analogue Scale (VAS) and wound healing, postoperative complications and nursing satisfaction were compared between the two groups.Results:The first urination time, defecation time, hospitalization time and hospitalization cost were (5.78±1.38) h, (13.37±2.38) h, (7.32±0.72) d and (7 337.84±524.99) yuan in the observation group, and (6.48±1.26) h, (16.72±2.33) h, (8.85±0.93) d, (8 689.54±688.34) yuan in the control group, and the differences were statistically significant ( t values were 2.052-8.552, P<0.01 or 0.05). There were between-group, time and interaction differences in the scores of VAS and postoperative wound healing between the two groups ( Fbetween-group values were 36.24, 42.36, Ftime values were 256.71, 377.42, Finteraction values were 88.62,90.62, P<0.01). There was no significant difference in the incidence of postoperative complications between the two groups ( P>0.05). The scores of nursing satisfaction with health education and services accessibility were (94.37±2.92), (95.11±3.85) points in the observation group, and (92.38±3.01), (91.72±4.31) points in the control group, and the differences were statistically significant ( t values were 2.599, 3.213, P<0.05). Conclusions:ERAS-based Xiao's double-C nursing mode is beneficial to shorten first defecation time, incision healing time and hospitalization time of patients undergoing mixed hemorrhoid surgery, accelerate wound healing and alleviate pain, with higher nursing satisfaction.