Objectives To explore if the rat bone marrow mesenchymal stem cells (BMSCs) modified by human heme oxygenase 1 (hHO-1) gene combined with GATA-4 gene may promote the ability of anti-apoptosis and myocardial transdifferentiation in vitro in hypoxia ischemic environment.Methods The rat BMSCs were isolated and cultured by whole bone marrow adherence and identified in vitro,and then were transfected with recombinant adenovirus;Western blotting was used to determinate the optimal time of gene expression;the genetically modified BMSCs were taken to hypoxia serum-free conditions simulating ischemia hypoxia microenvironment in vivo;CCK-8 kit and trypan blue staining were performed to detect the 12,24,48 and 72h survival rates in hypoxia ischemia respectively;flow cytometry was used to detect the apoptosis of BMSCs in hypoxia ischemia for 24h.The cardiomyocyte-specific cardiac troponin Ⅰ (cTnI) was detected by Western blotting and cellular immunofluorescence.Results The 12,24,48 and 72h survival rates were higher in hHO-1+GATA-4 group cultured in ischemia and hypoxia condition than in hHO-1 group (P＜0.05) and GATA-4 group (P＜0.05).After 24h cultivation in ischemia hypoxia condition,the apoptotic rates were lower in hHO-1+GATA-4 group than in hHO-1 group (P＜0.05) and GATA-4 group (P＜0.05).No significant difference existed in cTnI expressions between GATA-4 group and hHO-1+GATA-4 group.Conclusion Compared with transfection of hHO-1 or GATA-4 single gene,hHO-1 combined with GATA-4 transduction can significantly increase the survival rate of BMSCs in hypoxia ischemic condition,but myocardial transdifferentiation does not increase significantly.

OBJECTIVETo identify risk factors of hepatocellular carcinoma (HCC) in cirrhotic patients with chronic hepatitis B (CHB).

METHODSA total of 715 cirrhotic patients with CHB were recruited from the Zhongshan Hospital Affiliated to Fudan University and enrolled in this case-control study between January 2009 and September 2014. All participants were Chinese Han residing in Shanghai and the surrounding areas. The patients were divided into a cirrhosis group (n =281) and a HCC group (n=434). History of hepatitis B infection and HCC, as well as clinical data from serological, imaging and pathological examinations were collected for analysis.SPSS software, version 19.0, was used for all statistical comparisons.

RESULTSSingle factor analysis indicated that development of HCC in cirrhotic patients with CHB was significantly associated with male sex, age of 50 years or more, family history of HCC, alcohol consumption,fatty liver, detectable levels of hepatitis B virus (HBV) DNA, and history of HBV infection without effective antiviral treatment. Multivariate logistic regression analysis indicated that age of 50 years or more (P =0.005, odds ratio [OR] =1.766), history of alcohol consumption (P =0.002, Or = 2.570), family history of HCC (P =0.014, Or = 2.268), fatty liver (P =0.023, Or = 3.390), and history of HBV infection without effective antiviral treatment (P < 0.001,Or = 5.389) were risk factors of HCC.The risk factors for development of HCC in cirrhotic patients with hepatitis B after achieving sustained virologic suppression (SVS) were family history of HBV infection (P =0.014, Or = 2.537), family history of HCC (P =0.037,Or = 3.339) and fatty liver (P =0.018, Or = 11.646).

CONCLUSIONRisk factors of HCC in cirrhotic patients with CHB include age,drinking history,family history of HCC, fatty liver, and ineffective antiviral treatment of CHB.Family history of HBV infection or HCC, and fatty liver disease, were significantly associated with HCC development after SVS in patients with hepatitis B-related cirrhosis.

Alcohol Drinking ; Antiviral Agents ; Carcinoma, Hepatocellular ; Case-Control Studies ; China ; Fatty Liver ; Hepatitis B virus ; Hepatitis B, Chronic ; Humans ; Liver Cirrhosis ; Liver Neoplasms ; Male ; Odds Ratio ; Risk Factors

Objective Continuous nursing intervention was conducted in patients with chronic hepatitis B by means of Weixin platform. The effect of this intervention on compliance of oral nucleoside (acid) analogues (NA) in patients with chronic hepatitis B was studied and analyzed.Methods A total of 240 patients with chronic hepatitis B treated in the Third People's Hospital of Guangyuan in Sichuan Province from October 2014 to December 2016 were recruited. According to the different nursing methods, all the research subjects were divided into experimental group (n=120) and control group (n=120). For the experimental group, a nursing WeChat team and related WeChat group was established to provide professional counseling, authoritative scientific diagnostic information, appointment registration and other continuous nursing intervention for 6 months. Patients in the control group were given routine nursing. All patients were given oral NA treatment. The score of compliance after 6 months' intervention, the rate of review at 1st, 3rd and 6th month after discharge, and the recurrence rate at 12th month after discharge.Results The score of compliance of the control group was (52.37±7.65), and experimental group (63.85±8.57) after intervention. The difference in compliance was statistically significant (t=10.947,P<0.05). After intervention, the number of high compliance patients was 51 in the experimental group, which was higher than 29 in the control group, and the difference was statistically significant (χ2=9.075,P<0.05). The rates of review at 1st, 3rd and 6th month after discharge of the experimental group were all 100.00％, which were higher than those of the control group (96.67％, 92.50％ and 82.50％). The recurrence rate at 12th month after discharge of the experimental group was 8.33％,which was lower than 20.00％ of the control group, and the difference was statistically significant (P<0.05). Conclusions With the help of WeChat platform, continuous nursing can significantly improve the compliance of oral NA, improve the degree of re-visit and reduce the recurrence rate after 1 years in patients with hepatitis B.