MicroRNAs (miRNAs) are small non-coding RNAs that regulate both mRNA and protein expression of target genes and play important roles in proliferation,differentiation,development and metabolism of cells.This paper reviews the research progress on miRNAs involvement in liver diseases,including viral hepatitis,fatty liver,drug induced liver disease,primary biliary cirrhosis and primary hepatocellular carcinoma.

Objective To compare the efficacy and safety of tenofovir (TDF) and entecavir (ETV) in patients with chronic hepatitis B (CHB) .Methods Studies that compared the treatment efficacy and safety between TDF and ETV in CHB patients were searched through electronic databases before Mar 2015 .Alanine aminotransferase (ALT) normalization rate ,hepatitis B virus (HBV) DNA suppression rate ,hepatitis B e antigen (HBeAg ) seroconversion rate ,drug resistance rate and safety profile were reviewed .RevMan 5 .2 was used for analysis .Results A total of 13 studies met inclusion criteria and 1 934 patients were analyzed ,including 884 patients treated with TDF and 1 050 with ETV .The HBV DNA suppression rate of TDF was superior to ETV at week 48 (OR=1 .36 ,95% CI:1 .05 -1 .76 ,P=0 .02) .The ALT normalization rate of ETV was superior to TDF at week 24 (OR= 0 .68 ,95% CI:0 .48-0 .96 ,P= 0 .03) .The virological response at week 24 ,ALT normalization rate at week 48 and serological response at week 24 and 48 were not significantly different between patients treated with TDF and ETV (all P>0 .05) .The resistance rate was not significantly different between patients treated with TDF and ETV 24 months after treatment (P=0 .51) .And the safety profiles of these two drugs were similar (P>0 .05) .Conclusions TDF has better virological response compared with ETV .The drug resistance rate and safety profile are similar between TDF and ETV .

Traditionally regarded as a vitamin regulating calcium and phosphorus homeostasis, vitamin D is now discovered as a highly versatile molecule involved in immunity, cancer, infectious diseases, fibrosis, fatty liver diseases, and alcoholic liver diseases.In several studies, lower vitamin D status has been found to be associated with increased risk and unfavorable outcome of acute infections.This paper reviews the research progress of the roles played by vitamin D in various inflammatory diseases and its mechanisms.

Clinical data of 113 patients with non-alcoholic fat liver disease (NAFLD) diagnosed by liver biopsy from January 2015 to January 2017 in Taizhou People's Hospital were retrospectively reviewed . Patients all underwent transient elastographic ( TE) examination and the values of fat attenuation index (FAI) were obtained.The hepatocyt fatty changes in pathological examination were scored as 0 (＜5%, n＝40), 1 (5%-33%,n ＝27), 2 (34% -66%,n ＝28) and 3 (＞66%, n ＝18).There were significant differences in AST , Glu, TC and FAI among patients with hepatocyte fatty change scores 0, 1, 2 and 3, and the FAI was significantly correlated with the degree of fatty liver disease .The areas under the ROC curve (AUCs) of FAI in patients with hepatocyte fatty change scores 1, 2 and 3 were 0.78, 0.90 and 0.96, respectively.Logistic regression analysis showed that FAI was correlated with TG , TC and BMI.The results suggest that FAI in TE can be a non-invasive, rapid and objective evaluation method for patients with NAFLD.

Objective To investigate the clinical manifestation,curative effect and prognosis of patients with EB viral hepatitis.Methods Clinical data of 40 hospitalized patients with EB viral hepatitis was retrospectively analyzed.The patients were divided into single EB viral hepatitis group (n =18) and EB viral hepatitis complicated with other liver damage group (n =22).The clinical characteristics were summarized.Results The main clinical manifestations of patients with EB viral hepatitis were fatigue,anorexia,jaundice,hepatosplenomegaly,and different degrees of damage.Levels of serum total bilirubin (TBIL),alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in EB viral hepatitis complicated with other liver damage group were significantly higher than those in single EB viral hepatitis group (P ＜ 0.05).Conclusion EB virus infection is one of the causes of liver function damage.

Objective To investigate the clinical manifestation,curative effect and prognosis of patients with EB viral hepatitis.Methods Clinical data of 40 hospitalized patients with EB viral hepatitis was retrospectively analyzed.The patients were divided into single EB viral hepatitis group (n =18) and EB viral hepatitis complicated with other liver damage group (n =22).The clinical characteristics were summarized.Results The main clinical manifestations of patients with EB viral hepatitis were fatigue,anorexia,jaundice,hepatosplenomegaly,and different degrees of damage.Levels of serum total bilirubin (TBIL),alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in EB viral hepatitis complicated with other liver damage group were significantly higher than those in single EB viral hepatitis group (P ＜ 0.05).Conclusion EB virus infection is one of the causes of liver function damage.

Objective:To investigate the effect of sevoflurane and propofol on cognitive function, respiratory and circulatory function, and stress response in patients undergoing laparoscopic radical gastrectomy.Methods:A prospective randomized controlled study was conducted. A total of 116 patients who underwent laparoscopic radical gastric cancer surgery in Liangshan Yi Autonomous Prefecture Hospital of Integrated Chinese and Western Medicine from January 2021 to January 2022 were selected, and all patients were divided into the propofol group and the sevoflurane group according to the random number table method, with 58 cases in each group. Propofol anesthesia was used in the propofol group and sevoflurane anesthesia was used in the sevoflurane group. The anesthesia-related indexes and respiratory and circulatory function indexes, oxidative stress parameters and cognitive function indexes neuron-specific enolase (NSE) levels, Mini-Mental State Examination (MMSE) scale score, and complications at different time points were compared between the 2 groups.Results:There were no statistically significant differences in the baseline data between the 2 groups (all P > 0.05). The differences in intraoperative bleeding, pneumoperitoneum time and anesthesia onset time between the 2 groups were not statistically significant (all P > 0.05); eye opening time [(13.2±2.6) min vs. (17.6±3.7) min] and respiratory recovery time [(12.6±2.2) min vs. (16.5±2.3) min] of patients in the sevoflurane group were shorter than those in the propofol group, and the differences were statistically significant ( t values were 7.41 and 9.31, respectively, both P < 0.001). Repeated measurement analysis of variance showed that the temporal, intergroup and temporal-intergroup interaction differences in heart rate, mean arterial pressure and oxygen saturation before induction of anesthesia, immediately after induction of anesthesia, and at the time of anesthesia duration of 10 min, anesthesia duration of 20 min, and anesthesia duration of 30 min between the propofol group and the sevoflurane group were not statistically significant (all P>0.05). The temporal, intergroup and temporal-intergroup interaction differences in the oxidative stress indexes of blood glucose, adrenaline, adrenocorticotropin, and cortisol between the 2 groups were statistically significant (all P < 0.001). The levels of blood glucose, epinephrine, adrenocorticotropin and cortisol in the sevoflurane group were lower than those in the propofol group immediately after induction of anesthesia, and at the time of anesthesia duration of 10 min, anesthesia duration of 20 min, and anesthesia duration of 30 min. The level of NSE before anesthesia in the propofol group and the sevoflurane group was (6.6±0.8) ng/ml and (6.5±0.7) ng/ml, respectively, and there was no statistically significant difference ( P > 0.05). The level of NSE in the sevoflurane group was higher than that in the propofol group immediately after surgery [(8.9±0.8) ng/ml vs. (8.2±0.9) ng/ml], 6 h after surgery [(10.2±1.2) ng/ml vs. (9.5±1.0) ng/ml], and 24 h after surgery [(9.3±1.1) ng/ml vs. (8.2±0.9) ng/ml] and 48 h after surgery [(8.7±0.9) ng/ml vs. (8.1±0.9) ng/ml]; and there were temporal, intergroup and temporal-intergroup interaction differences in NSE level of the 2 groups (all P < 0.001). The MMSE score in the sevoflurane group was lower than that in the propofol group immediately after surgery, 6 h after surgery, 24 h after surgery, 48 h after surgery, the temporal, intergroup and temporal-intergroup interaction differences in MMSE scale score of the 2 groups were statistically significant (all P < 0.001). The incidence of postoperative complications in the propofol group and the sevoflurane group was 24.1% (14/58) and 25.9% (15/58), respectively, and the difference was statistically significant ( χ2 = 2.12, P = 0.833). Conclusions:Sevoflurane and propofol anesthesia have no significant effect on the respiratory and circulatory functions of patients undergoing laparoscopic radical surgery for gastric cancer, whereas propofol has a smaller effect on cognitive functions, and sevoflurane inhibits oxidative stress better. Both of them are worthy of clinical application.

Objective To determine the predictive factors for antiviral therapy in hepatitis B e antigen (HBeAg)-negative chronic hepatitis B virus (HBV) infection [HBeAg(-) CHBI] patients with HBV DNA＜4.3 lg IU/mL.Methods A total of 179 HBeAg (-) CHBI patients were retrospective analyzed.Histology activity index (HAI) and fibrosis (S) were scored according to the Knodell HAI scoring system,and HAI＞3 and/or S≥3 was adopted as indications for treatment.Univariate and multiple regression analysis were used to assess factors associated with treatment indications.Receiver operating curves (ROC) and area under curve (AUC) were used to determine the predictive value of relevant factors.Results There were 81 cases with HAI＞3 (45.3％) and 72 with S≥3 (40.22％),and the proportion of patients with indications for treatment was 54.7 ％.Multiple regression analysis showed that age,γ-glutamyl transpeptadase (γ-GT),platelet (PLT) and albumin (Alb) were the predictive factors for the severity of liver damage and indication for treatment (all P＜0.05).The AUC for age,PLT,γ-GT and Alb were 0.655,0.657,0.726 and 0.65,respectively,and the corresponding Yoden index for age,PLT,γ-GT,and Alb were 0.297,0.426,0.03 and 0.012,respectively,the sensitivities of predicting HBeAg (-CHBI for treatment indications were 0.643,0.842,0.705 and 0.653,respectively.Conclusions This study shows that 54.7％ of HBeAg(-)CHBI patients with HBV DNA＜4.3 lg IU/ml have significant liver histological changes and require antiviral treatment.Older age,higher γ-GT,lower PLT and lower Alb levels are the predictive factors for treatment.

Objective:To identify the spatial clustering and its temporal trends among newly reported HIV/AIDS cases in Henan Province during 1995-2020, and to provide evidence for strategies on prevention and control of the disease.Methods:Information about newly reported HIV/AIDS cases in Henan between 1995 and 2020 were obtained from China Information System for Disease Control and Prevention and to describe their demographic characteristics, spatial autocorrelation and changing trends. This program was conducted at county level, using the ArcGIS 10.2.Results:A total of 96 528 HIV/AIDS cases with complete current address information in counties (districts) were newly reported during 1995-2020 in Henan, and the spatial autocorrelation analysis showed that Global Moran's I index was 0.249, Z G value of the Global Getis-Ord G coefficient was 6.472 (all P<0.001), indicating that there was a high clustered positive spatial autocorrelation of HIV/AIDS. The newly reported HIV/AIDS cases from 1995 to 2000, 2001 to 2005, 2006 to 2010, 2011 to 2015, and 2016 to 2020 in Henan Province all exhibited high values of global spatial clustering. Their Moran's I indices were 0.197, 0.103, 0.491, 0.411 and 0.383, respectively. The Z G values of the Global Getis-Ord G coefficient were 4.580, 3.386, 10.246, 8.378 and 8.093, respectively. All of global spatial correlation were statistically significant (all P<0.001). The results of local spatial autocorrelation analysis showed that newly reported HIV/AIDS cases in Henan Province had high-high clustering areas at each time stage mentioned above. The number of high-high clustering counties/districts gradually increased from 6 in 2001-2005 to 21 in 2016-2020, spreading from Zhumadian City and Zhoukou City in southeast Henan to Nanyang City in southwest Henan, Zhengzhou City and its surrounding counties/districts in central Henan. Conclusions:In Henan Province, an increasing trend of clusters appeared on HIV epidemic among newly reported HIV/AIDS cases from 1995 to 2020, and high-high clustering areas gradually expanded from Zhumadian City and Zhoukou City to Nanyang City, Zhengzhou City and its surrounding counties/districts, indicating that it is necessary to strengthen the AIDS prevention and control programs in these areas in Henan.

With the improvement in people's awareness of diseases and the level of diagnosis and treatment, the incidence rates of immunoglobulin G4-related disease (IgG4-RD) and autoimmune liver disease (AILD) are constantly increasing, and IgG4-related sclerosing cholangitis is the overlapping part of the disease spectrum of IgG4-RD and AILD, while the association between IgG4-related autoimmune hepatitis (IgG4-AIH) and these two diseases remains unclear. This article reviews the hepatic manifestation of IgG4-RD, summarizes the clinical features of IgG4-AIH, and analyzes whether IgG4-AIH is a subtype of AIH or a hepatic involvement of IgG4-RD. It is believed that IgG4-AIH has similar but different clinical manifestations and histopathological features from classical AIH, and IgG4-AIH may be classified as two types, i.e., a subtype of AIH and the liver manifestation of IgG4-RD. The research on the pathogenesis, clinical features, and clinical diagnosis and treatment of IgG4-AIH should be taken seriously in future.