Objective:To investigate the mechanism of Smad7 gene modified bone marrow mesenchymal stem cells ( Smad7-BMSCs) to prevent hepatic fibrosis in vitro. Methods:Smad7-EGFP-BMSCs were established by isolating and purifying BMSCs of rats, and transfecting Ad-Smad7-EGFP. HSC-T6 were divided into Group A, Group B, Group C and Group D, which were respectively incubated with Smad7-EGFP-BMSCs, BMSCs, Smad7 plasmid and PBS for 72 hours. The level of Smad7and TGF-β1protein in the culture solution was determined by ELISA. The expression of mRNA and protein of Smad7,TGF-β1,Col Ⅰ and α-SMA in the hepatic stellate cells were respectively determined by Western blot and RT-PCR. Cellular apoptosis was determined by flow cytometry. Results:(1)The results of ELISA showed that the level of TGF-β1 protein decreased(P<0. 01) but the level of Smad7 protein increased (P<0. 01) in Group B,Group C and Group D compared with Group A;the level of TGF-β1 protein decreased(P<0. 01) but the level of Smad7 protein increased (P<0. 01) in Group D compared with Group B and Group C. (2)The results of Western blot and RT-PCR showed that the level of mRNA and protein of Smad7,TGF-β1,Col Ⅰ and α-SMA decreased(P<0. 01) but the level of mRNA and protein of Smad7 protein increased (P<0. 01) in Group B,Group C and Group D compared with Group A;the level of mRNA and protein of Smad7,TGF-β1,ColⅠandα-SMA decreased(P<0. 01) but the level of mRNA and protein of Smad7 protein increased (P<0. 01) in Group D compared with Group B and Group C. (3)The results of flow cytometry showed that the rate of cellular apoptosis de-creased(P<0. 01),but the level of Smad7 protein increased (P<0. 01) in Group B,Group C and Group D compared with Group A;the rate of cellular apoptosis decreased(P<0. 01)in Group D compared with Group B and Group C. Conclusion:Smad7-BMSCs can have the effect of anti-hepatic fibrosis by affecting TGF-β1 signal pathway and promoting cellular apoptosis in hepatic stellate cells.

AIM:To evaluate the efficacy and safety of adefovir dipivoxil in treating patients with hepatitis B resistant to lamivudine. METHODS: 68 patients with hepatitis B resistant to lamivudine were administered 10 mg adefovir dipivoxil orally daily for over 1 years.The serum HBV-DNA levels were measured by quantitative PCR and liver function test,HBeAg/anti-HBe and safety assessments were also performed at 0,12,24,52 weeks after treatment. RESULTS: After 12,24,52 weeks of treatment, the mean HBV-DNA levels were reduced by 1.6 lg copies/mL (t=10.10,P

OBJECTIVE:To evaluate the clinical effect of Dahuang zhechong pill on chronic hepatitis with hepatic fibrosis.METHODS:A total of 128 patients with chronic hepatitis with hepatic fibrosis were randomly divided into treatment group(68 cases) and control group(60 cases).The control group received routine hepatic protective therapy,while the treatment group received routine hepatic protective therapy and Dahuang zhechong pills(6 g?d-1) concomitantly.The course of treatment lasted for 6 months.The clinical symptoms,liver function,hyaluronic acid(HA),pro-collagen Ⅲ(PC Ⅲ),cholyglycine(CG) and collagen type Ⅳ(ⅣC),and ultrasound image were observed in both groups.RESULTS:Levels of serum HA,PCⅢ,CG,and ⅣC decreased significantly in treatment group,and the difference between two groups was significant(P

Objective To analyze the clinical features of patients with acute stage brucellosis in Shenzhen,and provide a scientific basis for prevention and control of brucellosis in immigrant city.Methods A retrospective analysis was conducted to collect clinical data of patients with brucellosis admitted to the Department of Infectious Diseases,Shenzhen People's Hospital from May 2013 to May 2018.The patient's epidemiology manifestations,pathogen and laboratory examination results,diagnosis and treatment outcomes and prognosis were analyzed.Results Among the 39 patients with brucellosis,males were predominant,with a male to female ratio of 1.4 ∶ 1.0 (23 ∶ 16),an age of (44.91 ± 17.18) years and 24 cases were non-Guangdong natives.There were 23 cases with epidemiological history,including 14 cases with mutton,sheep viscera and goat milk history;the disease occurred throughout the year,mainly from February to July,a total of 26 cases.The clinical manifestations of the patients were mainly fever,sweating,fatigue,joint and muscle pain,weight loss,and liver or spleen or lymph nodes swelling.The blood culture was identified as 38 cases of Brucella melitensis and 1 case of Brucella suis.All strains were sensitive to common antibiotics in vitro.All cases were diagnosed as acute stage of brucellosis,2 cases with orchitis,1 case with brucellosis meningoencephalitis,3 cases with spondylitis,and 3 cases with misdiagnosis.Thirty-nine patients were cured according to the "Brucellosis Diagnosis and Treatment Guidelines (Trial)" and were followed up for 1 year.Conclusions Patients with brucellosis in Shenzhen are mainly infected with Brucella melitensis;fever,sweating,joint and muscle pain are the main clinical symptoms;the patient's efficacy and prognosis are better after treatment;for the occurrence of occasional misdiagnosis,it is recommended that in immigrant cities,medical staff should strengthen their understanding of brucellosis.

Objective:To investigate the efficacy of azithromycin combined with different-dose methylprednisolone therapy for refractory mycoplasma pneumoniae pneumonia(RMPP)in children.Methods:Two hundred and twenty cases of RMPP admitted to Chengdu Women′s and Children′s Central Hospital between January 2014 and December 2019 were selected.They were treated with azithromycin combined with 1~2 mg/(kg·d)(low-dose)of methylprednisolone for 3 days, then they were divided into 2 groups, 152 cases with effective treatment in the control group A(effective group), 68 cases with ineffective treatment in observation group B(ineffective group). Among group B, according to the IgG, IgM and IgA as defined in Zhu Futang Practice of Pediatrics, 45 cases with normal immunity named normal-immune group B, change methylprednisolone dose to 10~30 mg/(kg·d)(high-dose)for 3 days, and 23 cases with low immunity named weakened-immune group B, change methylprednisolone dose to 10~30 mg/(kg·d)for 3 days and give immunomodulator therapy, that is human immunoglobulin for intravenous injection(IVIG)200 mg/(kg·d)for 3 days.After treatment, duration of fever, lung inflammation, extrapulmonary complications, hospitalization days and other indicators were compared.Results:Comparison between group A and group B, the lung rale absorption time[(11.32±3.62)d vs(10.00±2.32)d], lung consolidation absorption rate(64.10% vs 83.33%), pulmonary atelectasis retentive rate(52.38% vs 82.60%), effusion absorption rate(66.67% vs 100.00% ), the incidence rate of extrapulmonary complications(38.82% vs 25.00%), the disappearance time of complications[(10.96±2.98)d vs(8.94±2.86)d], the average hospitalization stay[(12.30±3.56)d vs(11.25±3.84)d]were significantly different( P<0.05). Comparison between normal-immune group B and weakened-immune group B after giving high doses of methylprednisolone, the fever dropped time[(10.51±3.26)h vs(8.60±3.31)h], the lung rale absorption time[(10.51±2.24)d vs(9.00±2.19)d], lung consolidation absorption rate(72.00% vs 100.00%), the average hospitalization stay[(12.00±3.96)d vs(9.78±3.19)d]were significantly different( P<0.05). Conclusion:Compared to low-dose of methylprednisolone, azithromycin combined with high-dose methylprednisolone therapy is better for RMPP.For the children with weakened immunity, better curative effect was obtained by IVIG.

Sarcopenia, which is characterized by progressive and generalized loss of skeletal muscle mass and strength, has been well described to be associated with numerous poor postoperative outcomes, such as increased perioperative mortality, postoperative sepsis, prolonged length of stay, increased cost of care, decreased functional outcome, and poorer oncological outcomes in cancer surgery. Multimodal prehabilitation, as a concept that involves boosting and optimizing the preoperative condition of a patient prior to the upcoming stressors of a surgical procedure, has the purported benefits of reversing the effects of sarcopenia, shortening hospitalization, improving the rate of return to bowel activity, reducing the costs of hospitalization, and improving quality of life. This review aims to present the current literature surrounding the concept of sarcopenia, its implications pertaining to colorectal cancer and surgery, a summary of studied multimodal prehabilitation interventions, and potential future advances in the management of sarcopenia.

The novel coronavirus (2019-nCoV or SARS-CoV-2) is a highly contagious and deadly virus that has infected more than 50 000 people and killed more than 1 000 people in 25 countries around the world. People who infected by the novel coronavirus may suffer from fever and cough, some may gradually appear breathing difficulties and other serious manifestations, some severe patients may have acute respiratory distress syndrome and septic shock leading to death. However, there are no definite and effective antiviral drugs for the novel coronavirus pneumonia all around the world. Therefore, this article aims to provide new idea for the effective treatment of the novel coronavirus pneumonia by summarizing the basic research and clinical progress of antiviral drugs at home and abroad.

Objective: To understand the epidemiological and clinical features of patients with hemorrhagic fever and renal syndrome (HFRS) in Shenzhen, and to accumulate experience in the diagnosis and treatment of HFRS in this area. Methods: A retrospective analysis was conducted by collecting the clinical data from 46 patients who were confirmed with HFRS and admitted to the Department of Infectious Diseases of Shenzhen People's Hospital from January 2015 to December 2018. The demographic characteristics, epidemiological, clinical manifestations, examinations, treatments and prognosis, and other characteristics were analyzed. Results: All the 46 patients with HFRS were residens in Shenzhen, with a male-to-female ratio of 6.67∶1.00(40∶6), aged (40.18 ± 15.63) years old, and 38 patients (82.61%) aged 23-45 years old. There were 41 patients (89.13%) with a history of HFRS epidemiology, and there were mice in their houses or workplaces. The houses of 39 patients (84.78%) were rented, and 34 patients(87.18%) rented their houses in urban villages. There were morbidity throughout the year, and 33 patients (71.74%) were ill from January to June. In clinical classification, 44 cases (95.65%) were mild, 2 cases (4.35%) were medium, and there were no severe or critical cases. The clinical manifestations were that all patients were hospitalized due to fever mainly with hyperthermia. Thirty-nine patients (84.78%) were presented with systemic aches, headaches, low back pain and eyelid pain, and 28 patients (60.87%) had skin and mucous membrane hyperemia flushing. Clinical stages showed that all patients had pyretogenesis stage and polyuria stage, including pyretogenesis stage [(7.34 ± 6.82) d], polyuria stage [(9.94 ± 5.77) d], only 4.35% (2/46) patients with hypotension shock stage, all patients did not have oliguric stage. On the next day of admission, the number of white blood cells in 46 patients was (8.17 ± 3.19) × 10⁹/L, and 38 cases (82.61%) in the normal range; platelet was (61.92 ± 32.53) × 10⁹/L, and 42 cases (91.30%) were decreased; the procalcitonin was (1.62 ± 0.38) ng/ml, and 41 cases (89.13%) were increased; C-reactive protein was (74.33 ± 30.48) mg/L, and 46 patients (100.00%) were elevated; creatinine was (176.25 ± 55.15) μmol/L, and 19 cases (41.30%) were increased. Abnormal liver function was manifested by increased enzymology, alanine aminotransferase was (137.58 ± 46.76) U/L, and aspartate aminotransferase was (129.82 ± 40.29) U/L. All patients were positive for Hantavirus IgM. B-ultrasound results showed that in 58.70% (27/46) patients, both kidneys were plump and the parenchymal echo was enhanced. Liver injury occurred in 39 patients (84.78%) and sinus bradycardia in 2 patients (4.35%). All the 46 patients were clinically cured. Conclusion The epidemiological characteristics of patients with HFRS in Shenzhen are typical, the clinical manifestations are mild, and the curative effect and prognosis are good.