Objective To evaluate the effect of dexmedetomidine on apoptosis in myocardial cells in rats with severe scald.Methods Eighteen healthy male Sprague-Dawley rats,weighing 220-280 g,were randomly divided into 3 groups (n =6 each) using a random number table:control group (group C),scald group (group B)and scald + dexmedetomidine 30 μg/kg group (group D).Thirty percent of the total body surface was shaved and then exposed to 94 ℃ water for 12 s.Rats were resuscitated with isotonic saline according to Parkland formula immediately after burn.Sham burn was produced in C group.In group D,the rats received inraperitoneal injection of dexmedetomidine 30 μg/kg immediately after burn,and the equal volume of normal saline was injected in group B.The left ventricle was removed at 12 h after burn to observe the pathological changes of myocardial tissues with light microscope and to detect the apoptosis in myocardial cells (TUNEL assay) and expression of glucose-regulated protein 78 (GRP78) and C/EBP-homologous protein (CHOP) (using Western blot).The apoptosis index was calculated.Results Compared with group C,the apoptosis index was significantly increased and the expression of GRP78 and CHOP was up-regulated in B and D groups (P ＜ 0.05).Compared with group B,the apoptosis index was significantly decreased and the expression of GRP78 and CHOP was down-regulated in group D (P ＜ 0.05).The pathological changes were obvious in group B and were significantly attenuated in group D.Conclusion Dexmedetomidine can protect myocardium through inhibiting endoplasmic reticulum stress-mediated apoptosis in myocardial cells in rats with severe scald.

Liver failure is a common pathophysiological process of various hepatic diseases developing into the end stage. Because of its intricate pathogenesis and lack of specific and impactful treatment, the incidence and mortality of hepatic failure remains high and life-threatening. Currently, the principle of therapy for liver failure includes eliminating the causes, medical treatment, and preventing complications. Various artificial liver support systems (ALSSs), such as non-bioartificial liver, bioartificial liver, and hybrid artificial liver, which can remove circulating toxins, provide essential substances, and improve the internal environment, act as a partial substitute of the liver and has been widely used as an important therapy for acute or chronic liver failure. Although substantial progress has been made in the clinical studies of ALSS, there are still many problems to be dealt with. This article reviews the clinical efficacy of ALSS, as well as current clinical application, existing problems, and research advances.

Gastroesophageal variceal bleeding is one of the most common and critical complications of liver cirrhosis, with high rebleeding and mortality rates. Esophageal and gastric varices is a special type of varices, and endoscopic treatment methods for this disease include endoscopic variceal sclerotherapy, endoscopic tissue adhesive injection, and combined sequential therapy, but there are still controversies over the selection of specific treatment method. This article reviews the recent research advances in the endoscopic treatment of esophageal and gastric varices in China and foreign countries.

Objective To investigate softening-hardness dissipating-binds effects of Fuzheng Huayu (reinforcing-healthy qi resolving-stasis)Tablet combined with anti-virus therapy on liver fibrosis, and relationship between these effects and regulation of pathway of miR-122-interleukin-10-reactive oxygen species(miR-122/IL-10/ROS).Methods The patients with chronic hepatitis and liver fibrosis(n=85)were chosen from Aug.2015 to Aug.2016,and then divided randomly into test group(n=45)and control group(n=40).The control group was treated with entecavir(0.5 mg/d)and monoammonium glycyrrhizinate(0.1 g/d),and test group, additionally with Fuzheng Huayu Tablet(4.5 g/d)for 48 weeks.After treatment,ISHAK fibrosis score was reviewed through routine pathology, and activities of serum superoxide dismutase(SOD)and ROS were detected by using ELISA.The expressions of miR-122 mRNA and IL-10 mRNA were detected by using RT-PCR, and content of serum inflammatory factors of liver fibrosis, including procollagen III N-terminal peptide(PCIIINP), type IV collagen(IV-C), hyaluronidase(HA)and laminin(LN),were detected by using immunoturbidimetry.Results ISHAK fibrosis score had no significant difference between 2 groups before treatment,and decreased in 2 groups after treatment,which was superior in test group to that in control group(P<0.05).The content of serum inflammatory factors of liver fibrosis all decreased in 2 groups after treatment,and the decreases of PCIIINP and HA were more significant in test group compared with control group(P <0.05).The activities of ROS and SOD had no difference in 2 groups before treatment,and ROS decreased in 2 groups after treatment.The inhibitory effect on ROS was better in test group than that in control group after treatment(P<0.05), and SOD increase was effectively relieved in test group after treatment(P <0.05).The expressions of miR-122 mRNA and IL-10 mRNA all decreased in 2 groups after treatment, which was more significant in test group compared with control group(P<0.05).Conclusion Fuzheng Huayu Tablet reduces directly the levels of collagen and HA, degrades abnormal deposition of extracellular matrix,and regulates dynamic balance of collagen,and it antagonizes effectively the genetic expressions of IL-10 and miR-122,relieves inflammatory disorders and controls progress of histology.

Objective:To investigate the clinical data of asymptomatic patients with 2019 novel Coronavirus (2019-nCoV) infection in Shijiazhuang and provide scientific evidence for prevention and treatment of Coronavirus Disease 2019(COVID-19).Methods:Retrospective study was conducted to analyze the clinical features and laboratory data of 9 asymptomatic 2019-nCoV infected patients, admitted to the Fifth Hospital of Shijiazhuang from January 21, 2020 to February 21, 2020.Results:Asymptomatic infection was found in all age groups, including 5 males and 4 females. On the first day of admission, the detection result of leukocytes, lymphocytes and neutrophils in asymptomatic patients were at normal levels. On the third day after admission, the results increased and continued to stabilize on the twelfth day. The levels of alanine aminotransferase and lactate dehydrogenase were at normal levels during hospitalization, without transient increase or decrease. The level of C-reactive protein reached the highest level on the third day after admission, but it was always in the normal range. D-dimer level was relatively stable during hospitalization. The absolute value of T cell subsets showed that the levels of CD 3+ , CD 4+ , CD 8+ T cells in asymptomatic infection patients were higher than those determined before admission. The average duration of pharyngeal nucleic acid positive detection in asymptomatic patients was 11.88 days. The average cycle threshold of ORF1ab gene and N gene was 36.94 and 35.43 respectively. Conclusions:The inflammatory reaction in patients with asymptomatic 2019-nCoV infection was mild, and the immune function was relatively good.

Vanishing bile duct syndrome (VBDS) manifests as progressive destruction and disappearance of the intrahepatic bile duct caused by various factors and cholestasis. VBDS associated with drug-induced liver injury (D-VBDS) is an important etiology of VBDS, and immune disorder or immune imbalance may be the main pathogenesis. According to its clinical symptoms, serological markers, and course of the disease, D-VBDS is classified into major form and minor form, and its clinical features are based on various pathomorphological findings. Its prognosis is associated various factors including regeneration of bile duct cells, number of bile duct injuries, level and range of bile duct injury, bile duct proliferation, and compensatory shunt of bile duct branches. This disease has various clinical outcomes; most patients have good prognosis after drug withdrawal, and some patients may experience cholestatic cirrhosis, liver failure, and even death. Due to the clinical manifestation and biochemical changes are similar to the primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC), it need to identify by clinical physician.

Objective: To investigate the methods for qualitative pathological assessment of dynamic changes in liver fibrosis/cirrhosis after antiviral therapy in patients with chronic hepatitis B (CHB), since antiviral therapy can partially reverse liver fibrosis and cirrhosis caused by hepatitis B and semi-quantitative, rather than qualitative, pathological assessment is often used for the research on liver fibrosis regression. Methods: Previously untreated CHB patients with liver fibrosis and cirrhosis were enrolled, and liver biopsy was performed before treatment and at 78 weeks after the antiviral therapy based on entecavir. The follow-up assessment was performed once every half a year. Based on the proportion of different types of fibrous septum, we put forward the new qualitative criteria called P-I-R classification (predominantly progressive, predominantly regressive, and indeterminate) for evaluating dynamic changes in liver fibrosis. This classification or Ishak fibrosis stage was used to evaluate the change in liver fibrosis after treatment and Ishak liver inflammation score was used to evaluate the change in liver inflammation after treatment. Results: A total of 112 CHB patients who underwent liver biopsy before and after treatment were enrolled, and among these patients, 71 with an Ishak stage of ≥3 and qualified results of live biopsy were included in the final analysis. Based on the P-I-R classification, 58% (41/71) were classified as predominantly progressive, 29% (21/71) were classified as indeterminate, and 13% (9/71) were classified as predominantly regressive; there were no significant differences between the three groups in alanine aminotransferase, aspartate aminotransferase, albumin, HBeAg positive rate, HBV DNA, and liver stiffness (P < 0.05). After treatment, the proportion of predominantly progressive, indeterminate, or predominantly regressive patients changed to 11% (8/71), 11% (8/71), and 78% (55/71), respectively. Among the 35 patients who had no change in Ishak stage after treatment, 72% (25/35) were classified as predominantly regressive and had certain reductions in the Laennec score, percentage of collagen area, and liver stiffness. Conclusion This new P-I-R classification can be used to assess the dynamic changes in liver fibrosis after antiviral therapy in CHB patients.