Background/Aims: Chronic hepatitis B (CHB) and fatty liver (FL) often co-exist, but natural history data of this dual condition (CHB-FL) are sparse. Via a systematic review, conventional meta-analysis (MA) and individual patient-level data MA (IPDMA), we compared liver-related outcomes and mortality between CHB-FL and CHB-no FL patients. Methods: We searched 4 databases from inception to December 2021 and pooled study-level estimates using a random- effects model for conventional MA. For IPDMA, we evaluated outcomes after balancing the two study groups with inverse probability treatment weighting (IPTW) on age, sex, cirrhosis, diabetes, ALT, HBeAg, HBV DNA, and antiviral treatment. Results: We screened 2,157 articles and included 19 eligible studies (17,955 patients: 11,908 CHB-no FL; 6,047 CHB-FL) in conventional MA, which found severe heterogeneity (I2=88–95%) and no significant differences in HCC, cirrhosis, mortality, or HBsAg seroclearance incidence (P=0.27–0.93). IPDMA included 13,262 patients: 8,625 CHB-no FL and 4,637 CHB-FL patients who differed in several characteristics. The IPTW cohort included 6,955 CHB-no FL and 3,346 CHB-FL well-matched patients. CHB-FL patients (vs. CHB-no FL) had significantly lower HCC, cirrhosis, mortality and higher HBsAg seroclearance incidence (all p≤0.002), with consistent results in subgroups. CHB-FL diagnosed by liver biopsy had a higher 10-year cumulative HCC incidence than CHB-FL diagnosed with non-invasive methods (63.6% vs. 4.3%, p<0.0001). Conclusions IPDMA data with well-matched CHB patient groups showed that FL (vs. no FL) was associated with significantly lower HCC, cirrhosis, and mortality risk and higher HBsAg seroclearance probability.

Objective:To compare the setup errors in the supraclavicular regions of two different postures (arms placed on each side of the body, namely the body side group; arms crossed and elbows placed above forehead, namely the uplifted group) using the chest and abdomen flat frame fixation device in lung and esophageal cancer.Methods:Clinical data of patients with stage Ⅰ to Ⅳ lung or esophageal cancer who received three-dimensional radiotherapy with chest and abdomen flat frame fixation device in our institution from November 2020 to April 2021 were retrospectively analyzed. The setup errors of two postures were compared.Results:A total of 56 patients were included, including 31 patients (55%) in the body side group and 25 patients (45%) in the uplifted group. A total of 424 CBCTs were performed in the whole group. The overall setup errors in the X, Y and Z directions were similar in both groups ( P>0.05). The setup errors of sternoclavicular joint in the X and RZ directions in the body side group were significantly smaller than those in the uplifted group [(0.163±0.120) cm vs. (0.209 ±0.152) cm, P=0.033; 0.715°±0.628° vs. 0.910°±0.753°, P=0.011]. The setup errors of acromioclavicular joint in the Y, Z and RZ directions in the body side group were significantly smaller than those in the uplifted group [(0.233±0.135) cm vs. (0.284±0.193) cm, P=0.033; (0.202±0.140) cm vs. (0.252±0.173) cm, P=0.005; 0.671°±0.639° vs. 0.885°±0.822°, P=0.023]. The margins of target volume for setup errors were smaller in the X (0.45 cm vs. 0.54 cm) and Y (0.54 cm vs. 0.65 cm) directions of the sternoclavicular joint, as well as in the Y (0.59 cm vs. 0.78 cm) and Z directions (0.53 cm vs. 0.72 cm) of the acromioclavicular joint in the body side group. Conclusions:For lung and esophageal cancer patients requiring supraclavicular irradiation, the body side group yields smaller setup errors and corresponding margins of target volume than the uplifted group. In clinical practice, it is necessary to take comprehensive consideration of the accuracy of radiotherapy and additional radiation of the limbs to select appropriate posture.

To explore the effect and mechanism of Dahuang Zhechong Pills(DHZCP), a classical prescription, in improving testicular aging(TA) in vivo, the authors randomly divided 24 male rats into four groups: the normal, model, DHZCP and vitamin E(VE) groups. The TA rat model was established by continuous gavage of D-galactose(D-gal). During the experiment, the rats in the DHZCP and VE groups were given DHZCP suspension and VE suspension, respectively by gavage, while those in the normal and model groups were gavaged saline separately every day. After the co-administration of D-gal and various drugs for 60 days, all rats were sacrificed, and their blood and testis were collected. Further, various indexes related to TA and necroptosis of testicular cells in the model rats were examined and investigated, which included the aging phenotype, total testicular weight, testicular index, histopathological features of testis, number of spermatogenic cells, sex hormone level, expression characteristics of reactive oxygen species(ROS) in testis, expression levels and characteristics of cyclins in testis, and protein expression levels of the key molecules in receptor-interacting serine/threonine-protein kinase 1(RIPK1)/receptor-interacting serine/threonine-protein kinase 3(RIPK3)/mixed lineage kinase domain like pseudokinase(MLKL) signaling pathway in each group. The results showed that, for the TA model rats, both DHZCP and VE improved their aging phenotype, total testicular weight, testicular index, pathological features of testis, number of spermatogenic cells, serum testosterone and follicle stimulating hormone levels, expression characteristics of ROS and protein expression levels and characteristics of P21 and P53 in testis. In addition, DHZCP and VE improved the protein expression levels of the key molecules in RIPK1/RIPK3/MLKL signaling pathway in testis of the model rats. Specifically, DHZCP was better than VE in the improvement of RIPK3. In conclusion, in this study, the authors found that DHZCP, similar to VE, ameliorated D-gal-induced TA in model rats in vivo, and its mechanism was related to reducing necroptosis of testicular cells by inhibiting the activation of RIPK1/RIPK3/MLKL signaling pathway. This study provided preliminary pharmacological evidence for the development and application of classical prescriptions in the field of men's health.
Aging ; Animals ; Drugs, Chinese Herbal ; Male ; Necroptosis ; Protein Kinases/genetics* ; Rats ; Reactive Oxygen Species/metabolism* ; Receptor-Interacting Protein Serine-Threonine Kinases/pharmacology* ; Serine/pharmacology* ; Signal Transduction ; Testis ; Threonine/pharmacology*

Objective:To investigate the setup errors of postoperative radiotherapy immobilized with integrated cervicothoracic board (mask) system in breast cancer patients.Methods:Thirty-two breast cancer patients treated with postoperative radiotherapy immobilized with integrated cervicothoracic board (mask) system were prospectively recruited in this study. Breast/chest wall (cw) and supra/infraclavicular nodal region (sc) were irradiated with intensity-modulated radiotherapy. CBCT location verification in radiotherapy and target areas of the breast/chest wall and upper and lower collarbone were carried out, respectively. The consistency between setup errors and the position of the upper and lower target areas of 239 CBCT images was analyzed.Results:The translational setup errors of the breast/chest wall in the X-cw (left-right), Y-cw (superior-inferior), Z-cw (anterior-posterior) directions were (1.84±2.36) mm, (1.99±2.48) mm, and (1.75±1.86) mm, respectively. The translational setup errors of the supra/infraclavicular nodal region in the X-sc (left-right), Y-sc (superior-inferior), Z-sc (anterior-posterior) directions were (1.98±2.44) mm, (1.98±2.48) mm, and (1.71±1.79) mm, respectively. The differences of translational setup errors between the breast/chest wall and supra/infraclavicular nodal region in the X, Y, Z directions were (0.38±0.66) mm, (0.07±0.41) mm, and (0.45±0.92) mm, respectively. Conclusion:For the breast cancer patients treated with postoperative radiotherapy covering breast/chest wall and supra/infraclavicular nodal region, the integrated cervicothoracic board (mask) immobilization system provides good reproducibility and yields Sfew setup errors.

Salvia miltiorrhiza is a commonly used Chinese materia medica for promoting blood circulation and removing blood stasis. It has a wide range of pharmacological effects and is mainly used for the treatment of irregular menstruation, palpitation, insomnia and various cardiovascular diseases, particularly angina pectoris and myocardial infarction. The chemical constituents of S. miltiorrhiza are the important material basis for its pharmacological effects. This paper reviews the research progress of the chemical constituents and pharmacological effects of S. miltiorrhiza. The research status and research direction of S. miltiorrhiza are analysed, which will provide a reference for its further research and development.

Objective:To evaluate the effect of general practice service based on network platform in health management of patients with multiple chronic conditions (MCC).Methods:Based on network platform, the general practitioners provided health management service for 626 MCC patients in a petrochemical company in Panjin city of Liaoning province from June 2015 to June 2016. The individualized health management plan included health counseling, diet and exercise guidance, health information delivery, health file establishment, and rational medication guidance. After intervention the patient activeness, quality of life, clinical variables were evaluated.Results:Ninety participants dropped out of study (14.38%, 90/626), the questionnaire survey was conducted in rest 536 participants. After 1-year intervention, the scores of physical functioning, role-physical, general health, vitality, social functioning, role-emotional, mental health, and total scores in SF-36 were significantly increased ( F=12.350, 13.215, 10.515, 29.114, 42.972, 10.951, 89.783 and 33.311, respectively, all P<0.05); the values of BMI, waist, systolic and diastolic blood pressure, total cholesterol, triglycerides, low density lipoprotein cholesterol, fasting blood glucose were significantly decreased( F= 30.039, 33.849, 7.152, 27.453, 59.938, 214.270, 73.488 and 62.014, respectively, all P<0.05); the values of high density lipoprotein cholesterol were markedly increased ( F=16.491, P<0.01); the overall scores of activation were increased ( F=9.471, P<0.01), the level of activation was changed (χ 2=16.183, P<0.05); but there was no change in body pain ( F=1.486, P=0.227). There was a weak correlation between patient activation and the general health ( r=0.099, P=0.013), vitality ( r=0.101, P=0.011), mental health ( r=0.099, P=0.013). Conclusion:General practice service based on network platform is feasible and effective for patients with multiple chronic conditions, after the implementation, the activation and the health outcomes are improved significantly.

OBJECTIVE: To evaluate the tooth loss status of mandibular molars with furcation involvements after 5-year non-surgical periodontal treatment, and to analyze the factors that affected the tooth loss. METHODS: A retrospective analysis was conducted in 79 patients with chronic periodontitis, who had received non-surgical periodontal treatment and 5 years of periodontal maintenance treatment in Department of Periodontology, Peking University School and Hospital of Stomatology from 1988 to 2012. Their clinical indexes, including probing depth (PD), bleeding index (BI), furcation index (FI) and tooth mobility were both evaluated before treatment and at the last time of the maintenance treatment. Bone resorption at furcation area was measured at the first visit by periapical radiographs taken by professional doctors of medical imaging. The status of tooth loss after 5-year non-surgical periodontal treatment on mandibular molars with furcation involvement, and the factors that affected the tooth loss were analyzed. RESULTS: (1) Non-surgical treatment was significantly effective on the changes of PD in the patients of chronic periodontitis with furcation involvement, while the presence of furcation involvement could affect the improvement of PD here. (2) PD at the furcation area, tooth mobility, vertical bone resorption, and bone resorption area were all significant risk factors of mandibular molar missing (P<0.001), and the same with FI=3 and FI=4 (P=0.017, P=0.007), while age (P=0.703), gender (P=0.243) and smoking history (P=0.895) were not related to the tooth loss in this study. (3) The risk of tooth loss in mandibular molars with FI≥3 were significantly higher than those with FI≤2, and the survival rate of the former was less than 50%. CONCLUSION The loss of mandibular molars with furcation involvement was related to the furcation involvement, meanwhile the degree of furcation involvement and bone resorption can significantly increase the risk of tooth loss.
Chronic Periodontitis ; Furcation Defects ; Humans ; Molar ; Retrospective Studies ; Tooth Loss

Flavonoids are widely found in medicinal plants, which have important medical properties. Flavonoids were proved to have many pharmacological activities, such as anti-oxidation, antitumor, antimutation, anti-inflammatory, antibacterial and anti-aging. The extraction of flavonoids is the crucial link in their clinical applications. In recent years, many emerging Chinese medicine extraction methods have also been widely used in the extraction of flavonoids. This paper reviews the current application of new methods for flavonoid extraction, in order to provide references for the extraction, development and utilization of flavonoids. These new extraction methods include supercritical fluid extraction (SFE), ultrasonic assisted extraction (UAE), microwave assisted extraction (MAE), pressurized liquid extraction (PLE), pulsed electric field (PEF) assisted extraction, enzyme assisted extraction (EAE), green solvent extraction, steam explosion assisted extraction, dynamic high pressure microfluidization (DHPM) assisted extraction, etc.

OBJECTIVE: To observe the protective effect of simvastatin on renal injury in diabetic rats and to explore the possible molecular mechanism. METHODS: Twenty-four SD rats were randomly divided into normal control (NC) group (=8) and modeling group (=16).The rats in modeling group were injected with streptozotocin intraperitoneally at a dose of 55 mg/kg to establishing diabetic rat model. After diabetic ratmodel established successfully, the diabetic rats were randomly subdivided into diabetes mellitus (DM) group and diabetes mellitus + simvastatin (DM+Sim) group (=8).Rats in DM+Sim group were given simvastatin at a dose of 40 mg/kg by oral gavages, once a day for 4 weeks. Morphological changes and interstitial fibrosis of kidney were observed by histopathological method. The expressions of relative protein in endoplasmic reticulum stress, inflammatory molecules in renal tissues and cells apoptosis were detected by molecular biology method. RESULTS: ① Compared with NC group, the pathological changes of glomerulus and tubulointerstitium were obvious, and the collagen fibers were obviously erythrophilous and unevenly distributed in DM group. Compared with DM group, the morphological changes and fibrosis were significantly improved in DM+Sim group. ② The expressions of GRP78, p-IRE1α, NF-κB p65 and MCP-1 in DM group were significantly higher than those in NC group (<0.05), while the expressions of GRP78, p-IRE1α, NF-κB p65 and MCP-1in DM + Sim group were decreased (<0.05). ③ There were a small number of apoptotic nuclei in the glomeruli and adjunctive renal tubules in NC group detected by TUNEL assay, while there were a large number of apoptotic nuclei in DM group (<0.01). The number of apoptotic nuclei was decreased significantly in DM+Sim group (<0.01). CONCLUSIONS Morphologicalchanges and fibrosis of renal tissue are improved obviously, and the number of apoptotic cells is decreased significantly after administration of simvastatin in diabetic rats. Simvastatin exertsthe protective effect on diabetic nephropathy by inhibiting endoplasmic reticulum stress and NF-κB inflammatory signaling pathway, and reducing renal cell apoptosis.
Animals ; Diabetes Mellitus, Experimental ; Diabetic Nephropathies ; Kidney ; Rats ; Rats, Sprague-Dawley ; Simvastatin ; pharmacology

OBJECTIVE: To investigate the protective effects and the possible mechanisms of simvastatin on myocardial injury induced by diabetes. METHODS: Twenty-four SD rats (180~220)g were randomly divided into control group (control, =8) and modeled groups(=16), the modeled groups were injected with streptozotocin intraperitoneally to induce diabetes. Then the modeled rats were randomly divided into diabetes mellitus group (DM group, =8) and diabetes mellitus + simvastatin group (DM+S group, =8). Rats in DM+S group were treated with simvastatin at the dose of 40 mg/(kg·d)by gavage for 4 weeks, and the other two groups were treated with the same amount of saline. At the end of experiments, the heart tissues were collected for further observation. The content of malondialdehyde (MDA) and the activity of superoxide dismutase (SOD) in heart tissues were measured by spectrophotometry; HE staining of rat heart slides was used to observe the pathological changes; TUNEL assay was used to determine the apoptosis index of myocardial cells in each groups; The distribution of p53 in the heart tissues was evaluated by immunohistochemistry; Western blot was used to detect the expressions of p53, p53-phospho-serine 15, Bax and Bcl-2 in the heart tissues. RESULTS: ①Compared with control group, the content of malondialdehyde (MDA) was increased while the activity of superoxide dismutase (SOD) was decreased significantly in DM group (<0.01). After simvastatin administration, the activity of SOD was increased and the content of MDA was decreased significantly (<0.01). ② HE staining results showed that the myocardial cells in the DM group were disorganized, with unclear morphological structure and a large number of inflammatory cells infiltration. Compared with DM group, the myocardial morphology in DM+S group was improved significantly. ③TUNEL staining results showed that the apoptosis index of myocardial cells in DM group was increased significantly compared with that of control group, and the apoptosis index was decreased significantly after the treatment of simvastatin (<0.01).④ Immunohistochemistry showed that compared with control group,the expression of p53 in DM group was increased significantly, and was expressed in both cytoplasm and nucleus, while the expression of p53 in DM+S group was decreased and the expression of p53 in nucleus was decreased significantly (<0.01). ⑤ The results of Western blot showed that the expression levels of p53, p53-phospho-serine15 and Bax were higher than those in control group, and the expression of Bcl-2 was lower than that in control group (<0.01). After simvastatin administration, the expression levels of p53,p53-phospho-serine 15 (<0.01) and Bax were decreased significantly (<0.05) and the expression of Bcl-2 was increased (<0.05). CONCLUSIONS Simvastatin exerted protective effects on myocardial injury caused by diabetes through improving the abnormal morphological changes of diabetic myocardium, alleviating oxidative stress and inhibiting apoptosis of myocardial cells. The mechanism is related to the regulation of apoptosis pathway mediated by p53.
Animals ; Apoptosis ; Diabetes Mellitus, Experimental ; Myocardium ; Oxidative Stress ; Rats ; Rats, Sprague-Dawley ; Simvastatin