Primary biliary cholangitis (PBC) is an autoimmune-mediated chronic cholestatic liver disease. Ursodeoxycholic acid (UDCA) is a first-line drug approved by the Food and Drug Administration for the treatment of PBC. It can effectively improve serum biochemical indicators, delay histological progress, and prolong the survival of non-transplant patients. However, around 40% of patients with PBC have a poor response to UDCA with a poor outcome. Early identification of patients with poor biochemical responses and timely second-line treatment may alter the course of the disease. This article summarizes the risk factors for the poor response of UDCA in the PBC.

ObjectiveTo evaluate the quality of life and treatment of patients with primary biliary cholangitis (PBC) using the PBC-40 scale. MethodsThe PBC-40 scale was used to perform an investigation of 37 patients who were diagnosed with PBC and received continuous treatment in Department of Gastroenterology, The First Affiliated Hospital of Air Force Medical University, from January 2017 to December 2018. With reference to patients’ baseline biochemical parameters and pathological staging, the scores of the six domains of the PBC-40 scale, i.e., “symptom”, “pruritus”, “weakness”, “cognitive function”, “social function”, and “emotional function”, were analyzed. The two-independent-samples t test was used for comparison of normally distributed continuous data between two groups, and an analysis of variance was used for comparison between multiple groups; the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups, and the Kruskal-Wallis H test was used for comparison between multiple groups. The paired-samples Wilcoxon signed rank sum test was used for comparison of pruritus score before and after treatment, and the paired samples t-test was used for comparison of weakness score before and after treatment. A Spearman analysis was used to investigate correlation. ResultsIn the PBC-40 scale, the scores of symptom, pruritus, weakness, cognitive function, social function, and emotional function were 16.5±4.3, 5.2±3.3, 26.4±8.3, 15.3±5.1, 25.4±8.4, and 8.1±2.7, respectively. A stratified analysis was performed for the patients aged ＜50 years, 50-60 years, and ＞60 years, and the results showed that there was a significant difference in the score of pruritus between the different age groups (χ2=8.290, P=0.016). The PBC patients with a body mass index of ≥24 kg/m2 had significantly lower scores of symptom and cognitive function than those with a body mass index of ＜24 kg/m2 (symptom: Z=-2.222, P=0025; cognitive function: t=2.255, P=0.030). The patients with positive anticentromere antibody had a significantly higher score of weakness than those with negative anticentromere antibody (t=3.453, P=0.001). The score of pruritus was positively correlated with alkaline phosphatase (ALP) (R2=0.325, P=0.049) and gamma-glutamyl transpeptidase (GGT) (R2=0.402, P=0.014). ConclusionThe PBC-40 scale can be used to evaluate the quality of life of Chinese patients with PBC. High levels of ALP and GGT may predict low quality of life.

ZM-1 tissue microarrayer designed by our group is manufactured in stainless steel and brass. It features an easier and faster preparation for tissue microarrays. By means of it, a group of biopsy needles are used to punch the donor tissue specimens respectively, and all the needles with the punched specimen cylinders are arranged into the array-board, where small holes have been digged to fit the needles. All the specimen cylinders arraying and the tissue microarray block's shaping are finished simultaneously. ZM-1 tissue microarrayer with a lower cost of manufacture, is capable of preparing the tissue microarrays conveniently, efficiently and quality-controllably.
Equipment Design ; Tissue Array Analysis ; instrumentation

A field trial was carried out to study the influence of different kinds of spring topdressing on growth, yield and quality of Ligusticum chuanxiong. The results showed that the spring topdressing had effects of improving root length, tiller numbers and plant height to some extent. At the same time the chlorophyll content and dry weight accumulation especially the dry weight of root increased significantly. It also showed that the yield increased and quality was improved significantly. The effect of different treatment with urea58.7 kg x hm(-2)(N 27 kg x hm(-2)) was the best and the treatment with N,P,K the second.
Alkaloids ; metabolism ; Coumaric Acids ; metabolism ; Fertilizers ; Ligusticum ; growth & development ; metabolism ; Seasons

The ZM-1 tissue microarrayer designed by our groups is manufactured in stainless steel and brass and contains many features that make TMA (tissue microarray) paraffin blocks construction faster and more convenient. By means of ZM-1 tissue microarrayer, biopsy needles are used to punch the donor tissue specimens respectively. All the needles with the punched specimen cylinders are arrayed into the array-board, with an array of small holes dug to fit the needles. All the specimen cylinders arraying and the TMA paraffin block shaping are finished in only one step so that the specimen cylinders and the paraffin of the TMA block can very easily be incorporated and the recipient paraffin blocks need not be made in advance, and the paraffin used is the same as that for conventional pathology purpose. ZM-1 tissue microarrayer is easy to be manufactured, does not need any precision location system, and so is much cheaper than the currently used instrument. Our method's relatively cheap and simple ZM-1 tissue microarrayer technique of constructing TMA paraffin block may facilitate popularization of the TMA technology.
Biopsy, Needle ; instrumentation ; Equipment Design ; Female ; Humans ; Immunohistochemistry ; Male ; Neoplasms ; enzymology ; Paraffin ; Tissue Array Analysis ; instrumentation

OBJECTIVETo investigate the liver pathological changes and the clinical features of patients with hepatitis B virus (HBV) infection in their immune tolerant phase and non-active status.

METHODSFifty-four patients with chronic HBV infection in their immune tolerant stage and another 47 patients with the same infection but in non-active status were involved in this study. Statistical analysis including the ages and sex of the patients, their serum levels of HBV DNA, hepatocytic expression of HBsAg and HBcAg and their liver pathology were studied and statistically analyzed. Histological grading of inflammation and staging of fibrosis in the livers were also compared and analysed in patients with different levels of serum ALT.

RESULTSThe sex ratio of the two groups was of no significant difference. The average age of the patients in the non-active status [(28.11+/-8.60) years.] was older than that of the patients in the immune tolerant stage [(24.93+/-7.21) years], showing a significant difference (P < 0.05). The serum levels of HBV DNA of the patients in the immune tolerant stage were high and 94% of them had a HBV DNA higher than 106 copies/ml. In the non-active status group, 89% of the patients were HBV DNA negative. Between the two groups of patients there were no significant differences in the histological grades of liver inflammation or in the hepatocytic expressions of HBsAg and HBcAg. The stage of fibrosis was higher in the non-active status group than in the immune tolerant stage group, showing a significant difference between these two groups (u = 2.004, P < 0.05). The fibrosis stages of the livers of patients of a higher but within normal ALT level were markedly higher than those of a lower but within normal ALT level patients (u = 3.274, P less than 0.01).

CONCLUSIONPatients infected with HBV in non-active status may have experienced some occult courses of immune active stages; they are older in age and have higher levels of fibrosis. ALT sustained at a high level but within the normal range may indicate a higher degree of fibrosis, therefore liver pathological studies should be recommended for this kind of patient.

Adolescent ; Adult ; DNA, Viral ; blood ; Female ; Hepatitis B ; immunology ; pathology ; virology ; Hepatitis B Surface Antigens ; blood ; Hepatitis B e Antigens ; blood ; Hepatitis B virus ; genetics ; immunology ; Humans ; Immune Tolerance ; Liver ; pathology ; Male ; Middle Aged ; Virus Replication ; Young Adult

Objective To investigate the distribution of water fluoride and the present status of water- improving delluoridation projects in the endemic fluorosis areas in Gansu Province. Methods According to "The National Technical Scheme for Endemic Disease Control in 2004" for the water improving projects, water fluoride content was determined from fluorosis villages in 34 counties of 11 cities in Gansu Province. The fluoride content in drinking water was assessed by F-ion selective electrode. Results Water fluoride content was determined in 1576 fluorosis villages of 34 counties. Water fluoride content of 7829 water samples was determined, and the fluoride content of 1891 samples was over standard. Water fluoride content was ≤ 1.00 mg/L(accounting for 75.19%) in 1185 villages and 1.00 mg/L(accounting for 24.81%) in 391 villages; the highest water fluoride content was 6.78 mg/L Nine hundred and ninety three water-improving and defluoridation projects were determined. Water fluoride content of 867 water-improving and defluoridation projects was determined; 768 projects had water fluoride content ≤1.00 mg/L(accounting for 87.67%) and water fluoride content of 108 projects was 1.00 mg/L(accounting for 12.33%),with the highest water fluoride content being 5.27 mg/L. Water-improving and delluoridation projects mostly relied on drilling a well to obtain under-grand water. Abandoned projects accounted for 30%. Conclusions In 34 counties of 11 cites(prefecture), nearly 30% of the villages had water fluoride content exceeding the standard. The situation of endemic fluorosis control is still serious in Gausu Province, countermeasures for endemic fluorosis must be carried out as soon as possible and surveillance of water-improving and defluoridation projects must be strengthened.

Objective To understand distribution of the endemic fluorosis areas and running status of water-improving defuoridation projects in Gausu province. Methods In 2006, Gansu province endemic fluorosis areas, the content of fluoride in drinking water was measured in villages where water was not improved, running status of delluoridation projects was investigated and the content of fluoride in drinking water were determined in villages where water was improved. Dental fluorosis and skeletal fluorosis prevalence were examined in children in identified high-fluorlde villages. The fluorine content in drinking water was determined by F-ion selective electrode, dental fluorosis of children was diagnosed using Dean method, and adults skeletal fluorosis was diagnosed according to "National Standard for Clinical Diagnosis of Endemic Skeletal Fhiorosis" (GB 16396-1996). Results Water samples were examined in 1997 villages of 26 countries, among which water fluoride content was higher than 1.0 mg/L in 598 villages, accounting for 29.94%(598/1997). All 1215 water-improving and defluoridation projects had been investigated, among which 94.90%(1153/1215) of the projects were functioning well, and intermittent and abandoned projects accounted for 2.96%(36/1215) and 2.14%(26/1215). Mean fluoride of treated water of 1084 water-improving and defluoridation projects had water fluoride content ≤ 1.0 mg/L, accounted for 90.79%(1084/1194) ; mean fluoride of water from 1068 water-improving and defluoridation projects had water fuoride content ≤ 1.0 mg/L, accounting for 91.75%(1068/1164). Total 86 390 children of 8 to 12 year-old were examined, the detectable rate of dental fluorosis was 22.47%(19 414/86 390) and 142 211 adults above 16 year-old were examined, the detectable rate of skeletal fluorosis was 4.20%(5967/142 211). Conclusions Some villages yet have water fluoride content exceeding the standard. Some projects are abandoned and running badly, leading to fluoride content exceeding the standard. In a few areas, the prevalence of children dental fluorosis and adult skeletal fluorosis still exists in Gansu province, the task of prevention and control for endemic fluorosis is still arduous. We must raise the effect of prevention and treatment of this disease.

OBJECTIVETo study the relationship between loss of sex chromosomes and prognosis in children with acute myeloid leukemia (AML) M2 subtype.

METHODSAccording to cytogenetic characteristics, 106 children with AML were divided into three groups: patients with normal karyotype (Group A, n=26), patients with abnormal karyotype who had no loss of sex chromosomes (Group B, n=52), and patients with abnormal karyotype who had loss of sex chromosomes (Group C, n=28). Prognosis was compared between the three groups.

RESULTSThe 5-year event-free survival (EFS) rates of Groups A, B, and C were (38.9±11.2)%, (59.3±7.3)%, and (66.5±10.5)%, respectively; the EFS of Group C was significantly higher than that of Group A (P=0.035). The 5-year overall survival (OS) rates of Groups A, B, and C were (54.3±13.5)%, (68.1±7.7)%, and (77.9±9.8)%, respectively (P>0.05). The 5-year EFS of 58 patients with t(8;21) was (63.3±7.3)%, significantly higher than that of patients with normal karyotype (P=0.015). All the 28 cases in Group C had t(8;21), and their 5-year EFS was not significantly different from that of patients with t(8;21) in Group B (P>0.05).

CONCLUSIONSLoss of sex chromosomes is a favorable karyotype in children with AML M2 subtype and the patients in this group mostly have t(8;21). Why loss of sex chromosomes indicates a favorable prognosis is probably because it is accompanied by t(8;21) in the patients.

Adolescent ; Child ; Child, Preschool ; Chromosomes, Human, Pair 21 ; Chromosomes, Human, Pair 8 ; Female ; Humans ; Karyotype ; Leukemia, Myeloid, Acute ; genetics ; mortality ; Male ; Prognosis ; Sex Chromosome Aberrations ; Translocation, Genetic