Objective:To compare the cost-effectiveness ratio among lamivudin(LMV),adefovir dipivoxil(AFD) and entecavir(ETC)in the treatment of chronic hepatitis B to find the best scheme.Method:1026 patients with chronic hepatitis B from 9 reports were given LMV(359 patients),SFD(345 patients)and ETC(322 patients)for 48 weeks.Then a cost-effectiveness analysis was carried out.Result:The cost for LMV was 5 231.52 yuan,the cost for AFD was 5006.4 yuan,and the cost for ETC was 12 559.68 yuan.The therapeutic effects were 42.90,51.59 and 76.09,respectively.The cost-effectiveness analyses of LMV,AFD and ETC were 121.95,97.04 and 165.06,respectively.Conclusion:AFD AFD is the best scheme in the treatment of chronic hepatitis B.

This study aimed to investigate the mechanism of resveratrol(RES) combined with irinotecan(IRI) in the treatment of colorectal cancer(CRC). The targets of RES, IRI, and CRC were obtained from databases, and the targets of RES combined with IRI in the treatment of CRC were acquired by Venn diagram. The protein functional cluster analysis, GO and KEGG enrichment analyses were performed. In addition, the protein-protein interaction(PPI) network was constructed. The core target genes were screened out and the target-signaling pathway network was set up. IGEMDOCK was used to dock the core target gene molecules. Besides, the relationship between the expression level of key target genes and the prognosis and immune infiltration of CRC was analyzed. Based on the in vitro cell experiment, the molecular mechanism of RES combined with IRI in the treatment of CRC was explored and analyzed. According to the results, 63 potential targets of RES combined with IRI were obtained for CRC treatment. Furthermore, cluster analysis revealed that protein functions included 23% transmembrane signal receptors, 22% protein modifying enzymes, and 14% metabolite converting enzymes. GO analysis indicated that BPs were mainly concentrated in protein autophosphorylation, CCs in receptor complex and plasma membrane, and MFs in transmembrane receptor protein tyrosine kinase activity. Moreover, KEGG signaling pathways were mainly enriched in central carbon metabolism in cancer. The key targets of RES combined with IRI in the treatment of CRC were PIK3CA, EGFR, and IGF1R, all of which were significantly positively correlated with the immune infiltration of CRC. As shown by the molecular docking results, PIK3CA had the most stable binding with RES and IRI. Compared with the results in the control group, the proliferation ability and EGFR protein expression of CRC cells in the RES-treated group, the IRI-treated group, and the RES+IRI treated group significantly decreased. Moreover, the cell proliferation ability and EGFR protein expression level of CRC cells in the RES+IRI treated group were remarkably lower than those in the IRI-treated group. In conclusion, PIK3CA, EGFR, and IGF1R are the key targets of RES combined with IRI in CRC treatment. In addition, RES can inhibit the proliferation of CRC cells and improve IRI chemoresistance by downregulating the EGFR signaling pathway.
Humans ; Irinotecan ; Colorectal Neoplasms/genetics* ; Resveratrol ; Molecular Docking Simulation ; ErbB Receptors/genetics*

In recent years, the clinical treatment of colorectal cancer(CRC) has made great progress, but chemoresistance is still one of the main reasons for reducing the survival rate of patients with colorectal cancer. Therefore, ameliorating chemotherapy resis-tance is an urgent problem to be solved. The purpose of this study was to investigate the regulatory role and related molecular mechanisms of hydroxysafflor yellow A(HSYA) in colorectal cancer cell proliferation, migration, and 5-fluorouracil(5-FU) chemoresistance. In this study, HCT116 and HT-29 cells were used as research subjects. Firstly, methyl thiazolyl tetrazolium(MTT) assay and colony formation assay were used to detect and analyze the effect of HSYA on the proliferation of CRC cells. Secondly, the effect of HSYA on the cell cycle in CRC cells was analyzed by cell cycle assay. Furthermore, the effect of HSYA on the migration of CRC cells was analyzed by wound-healing assay and Transwell assay. Based on the above, the influences of HSYA on 5-FU chemoresistance of CRC cells and related molecular mechanisms were explored and analyzed. The results showed that HSYA significantly inhibited the proliferation and migration of CRC cells, and arrested the cell cycle in G_0/G_1 phase. In addition, HSYA significantly ameliorated the chemoresistance of CRC cells to 5-FU. The results of acridine orange staining and Western blot showed that the autophagy activity of CRC cells in the HSYA and 5-FU combined treatment group was significantly higher than that in the 5-FU single drug treatment group. As compared with the 5-FU single drug treatment group, the phosphorylation levels of protein kinase B(Akt) and mammalian target of rapamycin(mTOR) in the HSYA and 5-FU combined treatment group were significantly reduced, indicating that the Akt/mTOR signaling pathway in the combined treatment group was down-regulated in CRC cells. In conclusion, HSYA may upregulate autophagy activity through the Akt/mTOR signaling pathway, thereby inhibiting the proliferation and migration of CRC cells and ameliorating the chemoresistance to 5-FU.
Humans ; Proto-Oncogene Proteins c-akt/metabolism* ; Drug Resistance, Neoplasm ; Cell Line, Tumor ; TOR Serine-Threonine Kinases/metabolism* ; Fluorouracil/pharmacology* ; Cell Proliferation ; Autophagy ; Colorectal Neoplasms/drug therapy*

OBJECTIVETo observe the effect of compound of gardenia oil and jujube seed oil learning and memory in ovariectomized rats and its mechanism.

METHODSAnimals were randomly divided into six groups: sham group, model group, estrogen group, low dose group, middle dose group and high dose group. The ovariectomized rat models were established by resection of the lateral ovaries. The effect of compound of gardenia oil and jujube seed oil on learning and memory in ovariectomized rats was observed by means of Morris water maze. Acetylcholinesterase (AchE) and nitric oxide synthase (NOS) activities in rat brain were determined.

RESULTSThe compound of gardenia oil and jujube seed oil could shorten the incubation period of appearance in castration rats and increase the number passing through Yuan Ping table in ovariectomized rats. As the training time extended, the incubation period of appearance was gradually shortened. The compound of gardenia oil and jujube seed oil could increase NOS activity, and decrease AChE activity in brain of ovariectomized rats.

CONCLUSIONThe compound of jujube seed oil and gardenia oil could promote the learning and memory in ovariectomized rats. This effect may be related with the increase in activities of NOS, AchE in rat brain.

Acetylcholinesterase ; metabolism ; Animals ; Brain ; enzymology ; Drugs, Chinese Herbal ; pharmacology ; Female ; Gardenia ; chemistry ; Maze Learning ; drug effects ; Memory ; drug effects ; Nitric Oxide Synthase ; metabolism ; Ovariectomy ; Plant Oils ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Seeds ; chemistry ; Ziziphus ; chemistry

Minimal hepatic encephalopathy(MHE) is an early stage of hepatic encephalopathy with an insidious onset and a high rate of missed diagnosis in clinical practice, and it is of great importance to diagnose MHE as early as possible and provide effective clinical intervention. There are many diagnostic methods for MHE, among which psychometric hepatic encephalopathy score is the most commonly used method at present, but its wide application in clinical practice is limited by its complex and time-consuming operation, and therefore, it is urgent to find a simple, rapid, and effective clinical diagnostic method. Stroop test is a test for psychomotor speed and cognitive flexibility, and its value in the diagnosis of MHE has been verified in various countries including the United States and South Korea. This article introduces the development of Stroop test and its application in MHE, and the analysis shows that Stroop test based on mobile devices has a high sensitivity in the diagnosis of MHE and is simple, convenient, and feasible. It is hoped that this test can be widely used in the clinical work of MHE screening in China in the future.

OBJECTIVE: To explore the effect of general anesthesia combined with epidural anesthesia and patient-controlled epidural analgesia on the incidence of the post-operative cognitive dysfunction (POCD) in elderly patients.
 METHODS: A total of 100 elderly patients with gastric cancer, who underwent radical gastrectomy in Yan'an People's Hospital from March 2012 to March 2015, were randomly divided into 3 groups: a general anesthesia and patient-controlled intravenous analgesia (PCIA) (Group I, n=35), a general anesthesia combined with epidural anesthesia and PCIA (Group II, n=30), and a general anesthesia combined with epidural anesthesia and patient-controlled epidural analgesia (PCEA) (Group III, n=35). There was no significant difference in age, gender, body mass index (BMI), length of operation, American Society of Anesthesiologists (ASA) grade and Mini-Mental State Examination (MMSE) score (all P>0.05). The cognitive function was assessed at the 1st day before operation and at the 6 h, 12 h, 2 d and 6 d after operation by the Mini-Mental State Examination test (MMSE), and the incidence of POCD was compared among the 3 groups. The mean arterial pressure (MAP), blood glucose, cortisol and tumor necrosis factor α (TNF-α) content during the operation were considered. The dosage of sevoflurane (SEVO) in the operation process and the pain score at the 6, 12 and 24 h after operation were recorded.
 RESULTS: The incidence of POCD at 6 h was 45.71% in the Group I and 34.28% in the Group II, which were higher than that in the Group III (10.00%). The incidence of POCD at 12 h was 34.29% in the Group I and 28.57% in the Group II, which were higher than that in the Group III (3.33%). The incidence of POCD at the 2 d was 28.57% in the Group I and 17.14% in the Group II, which were higher than that in the Group III (0). The incidence of POCD at 6 d was 17.14% in the Group I and 2.85% in the Group II, which were higher than that in the Group III (0). The blood glucose, cortisol and TNF-α content were consistent with the incidence of POCD, with significant difference (all P<0.05). The amplitude of MAP in the Group II and the Group III was significantly less than that in the Group I, and the postoperative analgesia effect in the Group III was obviously better than that in the other two groups (both P<0.05).
 CONCLUSION The general anesthesia combined with epidural anesthesia and patient-controlled epidural analgesia can effectively maintain the stable hemodynamic status in the patients and display inhibitory effect on postoperative cognitive dysfunction.
Analgesia, Epidural ; Analgesia, Patient-Controlled ; Anesthesia, Epidural ; Anesthesia, General ; Cognition ; Cognition Disorders ; Cognitive Dysfunction ; Gastrectomy ; Humans ; Incidence ; Methyl Ethers ; Neuropsychological Tests ; Postoperative Complications ; Sevoflurane ; Stomach Neoplasms ; Tumor Necrosis Factor-alpha

With the prevalence of obesity and metabolic syndrome, nonalcoholic fatty liver disease (NAFLD) has become the largest chronic liver disease in China. However, the pathogenesis of NAFLD remains unclear, and recent studies have found that interleukin-10 (IL-10) not only plays an important role in the pathogenesis of autoimmune diseases, inflammatory diseases, and malignant tumors, but also plays a key regulatory role in the pathogenesis of NAFLD. This article reviews the protective mechanism of IL-10 against NAFLD and its prospect in treatment, so as to further explore the clinical value of IL-10 in the diagnosis and treatment of NAFLD.

OBJECTIVETo explore the changes of the neurotransmitters in patients with chronic pulmonary heart disease (CPHD) and its clinical significance.

METHODSSeventy-two patients with CPHD (42 males, 30 females, mean age 55.6-/+8.9 years) were enrolled in the study, including 48 patients with compensated CPHD and 24 with uncompensated CPHD. Plasma endothelin (ET), thromboxance B2 (TXB2) and 6-keto-prostaglandin F1 alpha (6-K-PGFlalpha) were detected by radioimmunoassay. Thirty blood donors were selected as the normal control.

RESULTSCompared with the normal controls, CPHD patients showed abnormal pulmonary function, and significantly elevated levels of plasma ET and TXB2 (P<0.01) and lowered 6-K-PGFlalpha(P<0.01), but no significant differences were found between the patients with compensated CPHD and uncompensated CPHD (P>0.05). Plasma ET and TXB2 levels were inversely correlated to 6-K-PGFlalpha level (r=-0.4571, P<0.05).

CONCLUSIONThe patients with CPHD present with obvious changes of plasma ET, TXB2 and 6-K-PGFlalpha.

6-Ketoprostaglandin F1 alpha ; blood ; Adult ; Case-Control Studies ; Chronic Disease ; Endothelins ; blood ; Female ; Humans ; Male ; Middle Aged ; Pulmonary Heart Disease ; blood ; Thromboxane B2 ; blood

Colorectal cancer (CRC) is one of the malignant tumors with the highest incidence and mortality in the world. The pathogenic mechanism of CRC has not been fully elucidated until now. Ubiquitination plays an important role in CRC development, and its effects mainly depend on E3 ubiquitin ligases, which could modify substrate proteins by ubiquitination, in turn altering their activity or mediating ubiquitin-proteasome degradation. Here research progress of the regulatory roles of RING (really interesting new gene) type and HECT(homologous to E6AP C-terminus) type E3 ubiquitin ligases in CRC cell proliferation, apoptosis, migration, invasion and chemotherapy sensitivity as well as targeted inhibitors of these E3 ligases are reviewed, providing new clues for the study of pathogenesis and targeted therapy of CRC.

This paper aims to study the effects of traditional Chinese medicine on multidrug resistant human gastric cancer cells in the cell proliferation, migration, invasion and apoptosis, and to study the apoptosis-inducing pathway. Different dilutions of extract were used to process human multidrug resistant gastric cancer SGC7901/ADR cells. Cell proliferation inhibition phenomenon was determined by MTT experiment. Nuclear morphological changes of apoptotic cells and apoptotic indexes were observed and determined by Hochest33528 staining followed with fluorescence microscope observing. Flow cytometry was used to detect cell apoptosis rate. Cell migration and invasion ability were observed and determined by Transwell method. Spectrophotometry was used to detect caspase-3 and caspase-9 enzyme activity. Western blotting was used to detect subcellular distribution of cytochrome c. The results showed that extract had obvious inhibition effect on proliferation of gastric cancer multidrug resistant SGC7901/ADR cells, which was time- and concentration-dependent. After processing multidrug resistant gastric cancer SGC7901/ADR cells with extract, the apoptotic index and apoptosis rate were significantly increased than those in the control group, which showed a time- and dose-dependent mode; but if a caspase inhibitor was added, apoptosis index was not obviously increased. Transwell method showed that migration and invasion ability of the extract-processed SGC7901/ADR cells dropped significantly. Spectrophotometry showed that in extract-processed SGC7901/ADR cells, caspase-3 and caspase-9 expression were increased, which had significant differences with the control group. Western blotting test showed that the distribution of cytochrome c decreased in mitochondria, while increased in the cytoplasm (i.e., cytochrome c escaped from mitochondria to the cytoplasm). In conclusion, extract could inhibit the proliferation, migration and invasion, and induce apoptosis in human gastric cancer multidrug resistant SGC7901/ADR cells; and cytochrome c, caspase-9 and caspase-3 might be involved in cell apoptosis induced by extract, suggesting endogenous or mitochondrial apoptotic pathway.