Objective To explore the value of liver biopsy in diagnosis of the severity of chronic hepatitis B (CHB).Methods The liver biopsy, laboratory examination and imaging were performed in 176 CHB patients. The clinical and histological diagnoses were compared. Biochemical indexes of liver function were also compared between patients with histological inflammation activity ＜G2 and≥G2 or the patients with fibrosis score ＜S2 and ≥S2. Rank sum test and χ2 test were used in univariate analysis. Binary Logistic regression was used in multivariate analysis. Results Among 176patients, the clinical diagnosis of CHB and cirrhosis were established in 171 patients and five patients,respectively. Among 171 CHB patients, the clinical diagnosis was consistent with histological diagnosis in 102 (59.6%) patients. The clinical diagnosis was more severe than histological diagnosis in 60 (35.1%) patients and the clinical diagnosis was less severe than histological diagnosis in nine (5.3%) patients. Among 44 patients with histological grade G2, 41 (93.2 %) patients had alanine aminotransferase (ALT)≥2 × upper limits of normal (ULN). According multiple Logistic regression analysis, age, overt symptom, ALT level, cholinesterase (CHE), albumin (Alb), total bile acid (TBA) and ultrasonic appearance of non-smooth liver surface were independent risk factors for the diagnosis of fibrosis score ≥S2. Conclusions The CHB diagnosis based on clinical evidences doesn't show acceptable consistency with the diagnosis based on histological evidences. G2 and S2 may be more reliable criteria for diagnosing moderate and severe CHB.

Objective To investigate the application of ultrasound and blood indicators in diagnosis of early liver cirrhosis (S4) for patients with chronic hepatitis B (CHB).Methods Data of blood and ultrasound examinations of 631 patients with CHB who received liver biopsy in the Sixth People' s Hospital of Shenyang during April 2002 and March 2011 were collected.Logistic regression analysis was performed to determine the factors independently correlated with early liver cirrhosis,and the diagnostic model was established using these indicators.The diagnostic value of the established model was assessed by using area under receiver operating characteristic curve (AUROC) and compared with FIB-4 index,aspartate aminotransferase (AST)/platelet (PLT) ratio index (APRI) and S index.Results Logistic regression analysis indicated that age,PLT,albumin globulin ratio (A/G) and splenic square area (SPS) in ultrasound findings were independently correlated to early liver cirrhosis (Wald =10056,46.236,3.751 and 10.669,P ＜0.01).AUROC of the model based on the above factors in diagnosing early liver cirrhosis was 0.908,which was higher than those of FIB-1 index,APRI index and S index (Z =8.322,4.334 and 4.087,P ＜ 0.05).Taking 0.063 as cut-off value,the sensitivity,specificity,positive predict value and negative predict value of the established model in diagnosis of early liver cirrhosis were 90.1％,77.8％,50.0％ and 97.1％,respectively.Taking ＜0.060 and ≥0.110 as the cut-off values to exclude,and diagnose early liver cirrhosis,69.7％ (440/631) patients could avoid liver biopsy.Conclusion The model based on age,PLT,A/G and SPS can effectively predict early liver cirrhosis,and can reduce liver biopsy.

Objective To verify the value of routine laboratory markers for assessment of liver fibrosis status in chronic hepatitis B virus (HBV) carriers.Methods A total of 196 patients who were clinically diagnosed with chronic HBV carriers with liver biopsy and routine laboratory test were included in this study. The data of complete blood count, aspartate aminofransferase/alanine aminotransferase (AST/ALT),aspartate aminotransferase to platelet ratio index (APRI) and ageplatelet index (API) were collected and calculated.Patients were divided into group S0 (n=112) and group S1- S3 (n =84) based on liver fibrosis stages.Measurement data were analyzed by Wilcoxon rank sum test and enumeration data were analyzed by chi square test.Results All 196 enrolled HBV carriers were HBV DNA positive,with 156 (79.6％) HBeAg-positive.Age,ALT,AST,AST/ALT,APRI and API were all significantly higher in group S1- S3 than those in group S0 (statistic value=7.705,6.33,7.095,4.977,11.059,8.936,respectively; all P＜0.05).However,PLT level was lower in the former group compared to that in the latter group (statistic value=10.196,P＜0.05 ).The area under receiver operating characteristic curve (AUROC) of APRI and API were 0.827and 0.829,respectively.The highest sensitivity and negative prediction value (NPV) were 70.46 ％and 71.43 ％ respectively when using API.The best specificity and positive prediction value (PPV)was 92.94％ and 92.86％,respectively when using APRI.When APRI≥0.30 was used as the cut-off of liver fibrosis,97.62 ％ of 119 patients were diagnosed with liver fibrosis; when API≥4.0 was used as the cut-off of liver fibrosis, 96.43％ of 112 patients were diagnosed with liver fibrosis.Conclusion APRI and API are two simple and feasible non-invasive biochemical markers that can be used to determine liver fibrosis status in chronic HBV carriers.

Objective To investigate the relationship between hepatic fibrosis stage and clinical serum fibrosis markers in patients with chronic hepatitis B (CHB).Methods Liver puncture biopsy was performed in 189 CHB patients.The serum levels of hyalyronic acid (HA),laminin (LN),procollagen Ⅲ (PCⅢ),collagen Ⅳ (Ⅳ C),liver function and peripheral blood routine were detected simultaneously. The comparison, correlation and regression analysis were performed based on different fibrosis stages (S).Results From SO to S4 group,levels of PC Ⅲ,γ-glutamyl transpeptidase (γ-G-T),total bilirubin (TBil),protein electrophoresis γ-globulin (Ely-γ) and prothrombin time (PT) were progressively elevated,the differences were statistically significant (F value was 3.325,6.218,2.958,10.160 and 7.028,P＜0.05),while cholinesterase (CHE),total protein (TP),albumin (Alb) and platelet (PLT) were progressively declined,the differences were also statistically significant (F value was 15.984,3.768,14.919 and 4.737,P＜0.05).The differences of LN,IVC,ALT and AST between groups were statistically significant (F value was 4.618,2.795,2.649 and 3.199,P＜0.05).Fibrosis stages (s) was positively correlated with LN,PCIII,ALT,AST,TBil,γ-GT,Ep-γand PT (r=0.200,0.306,0.172,0.273,0.153,0.402,0.415,0.269,respectively);while it was negatively correlated with CHE,TP,Alb and PLT (r=-0.502,-0.208,-0.413,-0.390,respectively);I.N,AI.T,CHE,PLT and Ep-γ were the independent risk factors which affecting hepatic fibrosis stages.Conclusions Liver fibrosis stage in histopathology was correlative in certain degree with the serum markers of hepatic fibrosis,liver function,and blood routine examination.Combined analysis of clinical data may be used to early diagnose hepatic fibrosis non-invasively.

Background The advantages of endothelium keratoplasty(EK)include without corneal surface incision and sutures,remaining normal corneal topography,minimizing astigmatism and providing a healthy donor endothelial cell count and function.Using anterior segment optical coherence tomography(AS-OCT) to examine the morphology of the corneal graft after EK is helpful for the evaluation of the outcome of EK.ObjectiveThis study applies AS-OCT to observe the relationship of recipient cornea and donor graft and offer a basis for the evaluation of operative outcome.MethodsThe clinical data from 44 eyes of 42 patient who received DSAEK in Peking University Eye Center from September 2007 through April 2009 was reviewed retrospectively.These patients included 30 male and 12 female with the age from 15 to 83 years.Structure of cornea and relationship between recipient cornea and graft disc after surgery were clinically examined and recorded by slit-lamp digital camera and AS-OCT.This study was approved by the Ethics Committee of Peking University.Written informed consent was obtained from all of the patients before the operation.ResultsThe donor graft attached to posterior central surface of recipient in 28 eyes under the slit-lamp microscopy and AS-OCT.The thickness of donor graft was decreased,and graft sticked more closely to recipient cornea and was more transparent with the lapse of time.Complete dislocation of the donor graft in early stage was found in 5 eyes(11.36%) and partial dislocation in 2 eyes(4.55%).Curliness of graft edge occurred in 1 eye(2.27%) and eccentricity of donor graft in 8 eyes(18.18%).ConclusionAS-OCT can display the morphology and structure of cornea as well as the relationship between donor graft and recipient after DSAEK.It is helpful for evaluating the clinical effectiveness of DSAEK.

Objective:To investigate the preventive and protective effects of Schisandrin B in the mice of Alzheimer's disease (AD),and to clarify its mechanism.Methods:Fifty Balb/c mice were randomly divided into blank group,model group,pasitive control group,low dose of Schisandrin B group(0.1 g·kg-1)and high dose of Schisandrin B group(0.5 g·kg-1);there were 10 mice in each group.Step-through test was conducted after last administration to detect the latencies and number of errors of the mice in various groups,and the brain tissue was taken.Congo red staining was to detect the morphology changes of cells and neuronal amyloidosis in brain tissue of the mice.The levels of ROS in brain tissue of the mice were tested by Flow Cytometry.The contents of MDA,the levels of LDH,and the activities of CAT,GSH-Px and SOD in brain tissue of the mice were tested by biochemical method.Western blotting method was used to detect the expression levels of signaling pathway proteins Nrf2 and Keap1 in brain tissue of the mice.Results:Compared with model group,the latencies of the mice in low and high dose of Schisandrin B groups were increased (P<0.01) and the number of errors in step-through tests was decreased (P<0.05 or P<0.01).The Congo red staining results showed that compared with model group,the neuronal amyloidosis in brain tissue of the mice in Schisandrin B groups was decreased significantly.Compared with model group,the levels of ROS,LDH and the contents of MDA in brain tissue of the mice in low and high doses of Schisandrin B groups were decreased (P<0.05 or P<0.01),and the activities of CAT,SOD and GSH-Px were increased (P<0.01).Compared with low dose of Schisandrin B group,the content of MDA and the activities of SOD and GSH-Px in brain tissue of the mice in high dose of Schisandrin B group were increased (P<0.001).Compared with model group,the expression level of Nrf2 protein in brain tissue of the mice in low dose of Schisandrin B group was increased (P<0.01),while the expression level of Nrf2 protein in brain tissue of the mice in high dose of Schisandrin B group was decreased (P<0.01);the expression levels of Keap1 protein in brain tissue of the mice in low and high doses of Schisandrin B groups was decreased (P<0.01).Conclusion:Schisandrin B could decrease the level of peroxidation in brain tissue of the mice and reduce the oxidative damage and improve the memory function of the AD mice.The mechanism is related to the activation of Nrf2 signaling pathway which improve the activity of antioxidant enzymes.

Aim To study the effect of diazoxide on the apoptosis of PC12 cells induced by oxygen-glucose deprivation(OGD)and expression of Bcl-2 protein.Methods Cultured PC12 cells,treated with OGD,diazoxide and 5-HD,were divided into A(control group),B(OGD group),C(OGD+diazoxide group)and D(OGD+diazoxide+5-HD group).Neuronal apoptosis was detected by Annexin V-FITC/PI double-dyed flow cytometry,and the expression of Bcl-2 protein was detected by immunofluorescence and Western blot.Results The number of apoptotic PC12 cells increased after OGD in B,C,D group.C group and B,D groups were significantly different(P

Objective To investigate the efficacy of using Xinjiang wild Artemisia rupestris L. crude polysaccharides ( WARCP) as an immunologic adjuvant for influenza virus vaccine( IVV) .Methods ICR mice were subcutaneously immunized with 0.3 μg of IVV and 1.5 μg of IVV alone or co-administered with 200 μg of WARCP on 0 d and 14 d.Antibody levels in serum samples were detected by using indirect ELISA.MTT method was used to measure the proliferation of splenocytes.The growth conditions of mice were observed as well.Results No significant differences in the body weight were observed between mice from different groups (P>0.05).The levels of influenza virus-specific IgG, IgG1 and IgG2a were signifi-cantly increased in mice injected with WARCP adjuvant (P<0.05).The levels of IgG antibody in mice im-munized with low-dose of IVV and WARCP were significantly higher than those in mice immunized with high-dose of IVV alone (P<0.05), indicating at least 80% reduction in vaccine dosage by adding WARCP as adjuvant.Moreover, WARCP significantly promoted the proliferation of lymphocytes (P<0.05).Conclu-sion Adding WARCP to IVV enhanced the efficacy of IVV by boosting humoral and cellular immunity re-sponses with the advantages of high safety and dose-sparing.This study suggested the possibility of using WARCP as a novel immunologic adjuvant for influenza virus vaccine.

Idiopathic pulmonary fibrosis(IPF)is a chronic,progressive interstitial lung disease.IPF incidence is increasing yearly with high mortality and poor prognoses.At present,IPF pathogenesis remains unclear,and its treatments are limited.The experimental model is important to further study IPF pathogenesis and explore effective preventive and therapeutic measures.In recent years,its modeling method have been continuously developed and optimized.This study summarizes the establishment method and research progress of IPF experimental models in recent years to provide ideas and references for preclinical research to select appropriate experimental models.

Objective To evaluate the clinical effect of endoscopic retrograde biliary drainage (ERBD) and endoscopic naso-biliary drainage (ENBD) on hilar cholangiocarcinoma (HACC).Methods The clinical data of 87 patients with HACC,who underwent ERBD and ENBD form January 2010 to January 2016,were retrospectively analyzed.The incidence of postoperative severe cholangitis,biliary obstruction again within 4 weeks,reduction of total bilirubin and survival time were studied.Results There were significant differences between ERBD group and ENBD group on the incidence of severe cholangitis[29.2％ (14/48) VS 10.3％ (4/39),x2 =4.689,P=0.030] and bile duct obstruction in 4 weeks after operation [47.9％ (23/48) VS 23.1％ (9/39),x2=5.710,P =0.017].The total bilirubin within 2 weeks and 4 weeks postoperatively was significantly reduced compared with that before operation (P＜0.05).There was no statistical difference in descend range of total bilirubin between the two groups.There was significant difference between ERBD group and ENBD group in the median survival time [14 weeks (range,0-60 weeks) VS 34 weeks (range,2-96 weeks),x2 =10.101,P=0.010].Conclusion Compared to ERBD,ENBD has certain advantages on palliative care for HACC.