Objective To evaluate the association of Smad2/3,Smad4 and P-Smad3 protein expressions in tissue with liver fibrosis in patients with chronic HBV infections.Methods Liver biopsy was performed to determine the liver fibrosis grades in 131 cases of chronic HBV infections.Immunohistochemistry and semiquantitative analysis were applied to detect the expression of Smad2/3,Smad4 and P-Smad3 proteins in liver tissues.Results Smad2/3,Smad4 and P-Smad3 were detected mainly in fibrous septum,portal areas,myofibroblasts,sinus and cytoplasm in the liver tissue.The expression of Smad2/3,Smad4 and P-Smad3 was increased with the development of fibrosis ( r =0.81,0.58and 0.68,P =0.000),and a strong positive correlation was observed among three proteins (r =0.75,0.87and 0.84,P =0.000).Conclusion The expression of Smad2/3,Smad4 and P-Smad3 is correlated with liver fibrosis in chronic HBV infection,which suggests that the up-regulation of Smad proteins may be involved in the progression of liver fibrosis.

Objective To observe the individualized insertion choice in treatment of upper cervical injury with posterior atlantoaxial short-segmental pedicle screws or lateral mass screws and the relevant clinical outcome.Methods A total of 23 cases of upper cervical injuries received skull traction preoperatively.Individual surgery plan including internal fixation using pedicle screws or lateral mass screws as well as diameter,length,entry point,direction,and angle of screws was determined according to their atlantoaxial CT scan and three-dimensional reconstruction results.Results Six cases of Frankel grade C and eight of grade D were all recovered to grade E after operation.All cases presented rigid fixation and bony fusion in the follow-up of 6 to 36 months.Besides,screws were removed after bony fusion for three young cases and one case with left atlas pedicle screws emerged laterally out of cortex.Clinical outcome was all satisfactory.Conclusion Individualized posterior atlantoaxial fixation using pedicle screws or lateral mass screws is an effective way to treat upper cervical injury and gains advantages of stable threedimensional structures,short fixation segments,and few postoperative complications.