AIM: To investigate gene expression of bax, bcl-2 and p53 in fetal skin at different gestational ages and children skin in order to explore their potentially biological significance. METHODS: Apoptosis in skin specimens was determined by terminal deoxynucleotidy transferase mediated dUTP-biotin nick-end labeling technique (TUNEL). Gene expressions of bax, bcl-2 and p53 in skin at different developmental stages was examined with reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: Along with fetal growth and development, the incidence rate of apoptosis was increased progressively in skin. In skin from early gestational fetus, bcl-2 was strongly expressed. This gene expression was progressively decreased with increment in gestational age. In children skin, the mRNA content of this gene was significantly reduced compared with fetal skin (P

Integrated traditional Chinese and Western medicine therapy is important feature and advantage of clinical medicine in China. This article reviews the recent advances in the clinical and basic research on hepatobiliary and pancreatic diseases, with a focus on the common diseases such as liver fibrosis, nonalcoholic fatty liver disease, chronic cholecystitis and cholelithiasis, and critical diseases including severe pancreatitis, liver cirrhosis, and pancreatic cancer. We hope to objectively reflect the understanding of hepatobiliary and pancreatic diseases in traditional Chinese medicine, the current status and development trend of integrated traditional Chinese and Western medicine therapy, and existing problems, in order to provide a reference for further improvement of clinical therapeutic level.

The combination of traditional Chinese medicine and Western medicine is an important approach to improve the treatment outcome of liver cirrhosis. Long-term diagnosis and treatment practice and clinical studies of the prevention and treatment of chronic hepatitis B cirrhosis have shown that antiviral drugs targeting the cause of the disease combined with anti-liver fibrosis traditional Chinese medicine can significantly improve the reversal rate of liver fibrosis and cirrhosis, and anti-liver fibrosis therapy can reduce the incidence rates of esophagogastric variceal bleeding and hepatocellular carcinoma in cirrhotic patients and improve the 5-year survival rate of patients with decompensated liver cirrhosis. It is necessary to conduct in-depth studies to clarify the target and mechanism of action of the main effective constituents of compound traditional Chinese medicine, strengthen the research on drug quality control standards, and obtain more high-quality evidence for clinical efficacy, so as to effectively promote the development of integrated traditional Chinese and Western medicine therapy for liver cirrhosis.

Objective:To use metagenomic sequencing to compare the differences in intestinal microbiota species and metabolic pathways in patients with hepatitis B cirrhosis with or without ascites and further explore the correlation between the differential microbiota and clinical indicators and metabolic pathways.Methods:20 hepatitis B cirrhosis cases [10 without ascites (HBLC-WOA), 10 with ascites (HBLC-WA), and 5 healthy controls (HC)] were selected from the previously studied 16S rRNA samples. Metagenome sequencing was performed on the intestinal microbiota samples. The Kruskal-Wallis rank sum test and Spearman test were used to identify and analyse differential intestinal microbiota populations, metabolic pathways, and their correlations.Results:(1) The overall structure of the intestinal microbiota differed significantly among the three groups ( R = 0.19, P = 0.018). The HC group had the largest abundance of Firmicutes and the lowest abundance of Proteobacteria at the genus level. Firmicutes abundance was significantly decreased ( Pfdr < 0.01), while Proteobacteria abundance was significantly increased ( Pfdr < 0.01) in patients with cirrhosis accompanied by ascites; (2) LEfSe analysis revealed that 29 intestinal microbiota (18 in the HBLC-WA group and 11 in the HBLC-WOA group) played a significant role in the disease group. The unclassified Enterobacteriaceae and Klebsiella species in the HBLC-WA group and Enterobacteriaceae in the HBLC-WOA group were positively correlated with the Child-Turcotte-Pugh (CTP) score, prothrombin time, and international normalized ratio score and negatively correlated with albumin and hemoglobin levels ( P < 0.05). Escherichia and Shigella in the HBLC-WA group were positively correlated with CTP scores ( P < 0.05); (3) The correlation analysis results between the KEGG pathway and 29 specific intestinal microbiota revealed that Enterobacteriaceae and arachidonic acid, α-linolenic acid, glycerolipid metabolism, and fatty acid degradation were positively correlated in the lipid metabolism pathway, while most Enterobacteriaceae were positively correlated with branched-chain amino acid degradation and negatively correlated with aromatic amino acid biosynthesis in the amino acid metabolic pathway. Conclusion:A significant increment of Enterobacteriaceae in the intestines of HBLC-WA patients influenced hepatic reserve function and was associated with amino acid and lipid metabolic pathways. Therefore, attention should be paid to controlling the intestinal microbiota to prevent complications and improve the prognosis in patients with hepatitis B cirrhosis, especially in those with ascites.