Objective To investigate whether the spleen diameter,serum albumin and periphefial blood cells might be as non-invasive predictive indicators for the presence of esophageal varices(EV)in patients with liver cirrhosis.The predictive values of these parameters to the large esophageal varices were evaluated.Methods OBe hundred and sixty-seven patients with liver cirrhosis underwent endoscopic examination.Among them,127 patients(mild in 41,medium in 38,severe in 48)were found with EV and 40 patients without(NEV).The diameters of portal vein and spleen vein,the sizes of spleen and the ratio of platelet count/spleen size were examined by Doppler ultrasound.The platelet count and the level of albumin were calculated.Results The average of age,diameter of portal vein and spleen vein,and sizes of spleen were higher in EV group than those in NEV group,while the platelet count,the level of albumin and the ratio of platelet count/spleen size in EV groups were lower than those in NEV group.Multifactor analysis revealed that the index related to serious EV were the blood platelet count(＜70×109/L),the ratio of platelet count/spleen size(＜1.0)and albumin level (＜35 g/L).Conclusions The degree of EV in patients with liver cirrhosis were paralleled with the degree of portal hypertension.The patients who present with platelet count＜70×109/L,or platelet count/spleen size＜1.0 or albumin＜35 g/L should be considered as EV,and endoscopic examination is needed.

Objective To investigate the effects of Tat-NBD(NEMO-binding domain,NBD)peptide on LPS-stimulated AR42J acinus cells inflammatory response.Method Lipopolysaccharide(LPS)was added to culture media at doses of 10 mg/kg for 24 hours to stimulate the AR42J cells.For pretreatment.cells were incubated with different peptides for 2 hours before LPS stimulation.The expression of TNF-α mRNA WaS conducted using a semi-quantitative RT-PCR method.TNF-α protein in culture medium were detected by enzyme linked immunosorbent assay(ELISA).The expression and translocation of the NF-kB-p65 protein of AR42J was determined by Strept Actividin-Biotin Complex(SABC)method.Results LPS(10 mg/L)resulted in an increase of TNF-αmRNA and TNF-αprotein,whereas significant inhibitory effects were observed when cells were incubated with Tat-NBD(WT)just on dose of 0.1 me/L(P＜0.05).The Tat-NBD(WT)peptide decreased inflammatory cytokine expression by a dose-dependent manner and its peak role was on dose of 100 mg/L.Consisting with TNF-α expression decrease,NF-kB-p65 expression signitieantly decreased in Tat-NBD(WT)pretreatment group,especially on the largest dose.NO significant changes in the control peptide group.Conclusions Tat-NBD(WT)peptide can inhibit the inflammation of acinus simulated by LPS.

Objective To study the clinical characteristics and HBeAg status in HBV liver cirrhosis patients with different HBV DNA levels, Method Three hundred and thirty-seven patients with liver cirrhosis caused by chronic HBV infection were investigated. HBV DNA levels were detected by PCR, and HBV markers were detected by MEIA. The ratio of patients with HBeAg positive or negative in groups with different HBV DNA levels was compared, and the clinical characteristics in patients with different HBV DNA levels and HBeAg status were evaluated. Results The positive ratio of HBV DNA and HBeAg were 80.4% (271/337) and 31.5% (106/337). The negative ratio of HBeAg was 68.5% (231/337). The proportion of patients with Child-Pugh grade A, B or C and hepatocellular carcinoma (HCC) in different groups of HBV DNA levels and in different HBeAg status showed no significant difference, but the ratio of HCC in patients with HBV DNA 3-4 lg copies/ml was higher than that in patients with HBV DNA <3 lg copies/ml (P=0.014) and ≥7 lg eopies/ml (P =0.009). No significant difference of HBV DNA levels was found in different age groups, but the negative ratio of HBeAg increased with the increasing of the age. Conclusions More than 80% of patients with liver cirrhosis caused by chronic HBV infection axe HBV DNA positive, and 2/3 of them are HBeAg negative. Suppressing HBV replication may improve the prognosis of HBV related cirrhosis and HCC.

Objective To evaluate the effects of rheumatoid arthritis treated with modified Duhuo-Jisheng decoction and western conventional treatment. Methods 120 patients with heumatoid arthritis of our hospital from January 2010 to 2013 August were recruited and randomly divided into a treatment group and a control group, 60 patients in each group. The control group was treated with oral intake of Methotrexate, Sulfasalazine and Meloxicam in acute stage and oral intake of diclofenc in stable stage, while the treatment group was further added modified Duhuo-Jisheng decoction on the basis of the control group. TCM symptom score, arthritis symptom score, symptomatic relief time, ESR, CRP, RF were observed after 3 months’ treatment. Results After 3 mouths’ treatment, the total effective rate was 90.0%(54/60) in the study group and 70.0%(42/64) in the control group. There was no significant difference(χ2=4.193,P<0.05) between the two groups. CRP,ESR, RF[The treatment group respectively(22.06±10.31)mg/L, (25.18±17.80)mm/h, (28.19±4.17)IU/L,the control group respectively (14.11±7.32)mg/L, (24.16±22.09)mm/h, (36.08±5.24)IU/L]decreased after the treatment in both groups compared with the values before the treatment[The treatment group respectively (82.16± 21.37)mg/L, (68.84±9.71)mm/h, (84.92±15.31)IU/L,the control group respectively (52.46±22.26)mg/L, (62.72±33.31)mm/h, (85.17±14.23)IU/L, P<0.01],while the decrease of CRP in the treatment group was much obvious than the control group(P<0.05),but the change of ESR had no statistical significance between the two group after the treatment(P>0.05);Number of joint tenderness, The number of swollen joints, Time of morning stiffness, Dual hands grip strength , 20 m walking time decreased obviously in both groups after the treatment[After the treatment, the treatment group respectively (3.43 ± 1.46), (2.95 ± 1.35), (19.32 ± 16.54)min,(79.35±22.14)mmHg,(19.32±4.81)s,the control group respectively (4.63±4.21), (3.55±2.47), (21.23 ± 19.37)min,(77.81 ± 16.22)mmHg,(25.15 ± 5.81)s before the treatment, the treatment group respectively(10.71±5.12), (7.95±3.97), (109.32±68.52)min, (47.12±18.22)mmHg, (36.21±6.62)s, the control group respectively (11.54±5.32), (7.64±4.01), (96.02±58.39)min, (49.67±16.48)mmHg, (36.33± 7.23)s](P<0.05). Conclusion Duhuo-Jisheng decoction could effectively improve the clinical symptoms of aged patients with osteoporosis and reduce the levels of their ESR, CRP, and RF.

n of IL-6 and TNF-alpha,alleviate the inflammation of ANP.

Objective:To systematically evaluate the risks of anti-TNF-αtreatment-associated infection, severe infection and tuberculosis in rheumatoid arthritis (RA) patients, and to reduce the infection incidences associated with anti-TNF-αtherapy. Methods:We used Meta analysis to systematically review randomized controlled trials on anti-TNF-αtreatment associated risks of infecion, severe infection and tuberculosis in AR patients.Results:Although no statistically significant differences were detected in TB risk between anit-TNF-αtreatment and the control group (0.5%vs 0.07%;P=0.27, OR=1.85, 95%CI:0.62-5.52), there still existed a clinically obvious elevation of TB risk in monoclonal anti-TNF-αtreatment, which was illustrated by the results that no TB case was reported in the etanercept group, but 11 TBs in 2050 infliximab-treated cases, and 3 TBs in 722 adalimumab-treated cases. The total infection and severe infection risks were also signiifcantly higher in patients receiving anti-TNF-αtreatment (P<0.05). Subanalysis revealed that etanercept showed no signiifcantly higher infection or severe infection risk than control group (P>0.05), while both kinds of monoclonal antibodies of TNF-αblockers showed a signiifcantly elevated infection or severe infection risks (P<0.05). High doses of anti-TNF-αtreatment were associated with statistically increased risks of severe infection (6.0%vs 2.8%, P=0.04, OR=1.68, 95%CI:1.02-2.78). Conclusion:The TB risk of anti-TNF-αtreatment deserves close attention, especially in places with high rate of BCG vaccination and MTb infection. Monoclonal anti-TNF-αtreatment brings higher risks of infection and severe infection than soluble TNF-αreceptor.

Background and aim:Few studies have reported hepatitis B surface antigen(HBsAg)kinetics after nucleos(t)ide analog(NA)discontinuation in patients with noncirrhotic chronic hepatitis B(CHB).The study specifically investigated long-term HBsAg kinetics after NA discontinuation. Methods:Between January 2014 to January 2024,this study prospectively enrolled 106 outpatients with noncirrhotic CHB who met the discontinuation criteria after NA consolidation treatment.Demographic,clinical,and laboratory data were collected and analyzed after NA discontinuation. Results:Ninety-six patients who finished 5 years of follow-up were included.HBsAg remained unde-tectable in 29 patients with end of treatment(EOT)HBsAg negativity.Among 67 patients with EOT HBsAg positivity,HBsAg seroclearance occurred in 12(17.9％)patients with an estimated annual inci-dence of HBsAg seroclearance of 3.6％.Patients with EOT HBsAg levels of ≤1000 IU/mL had a higher HBsAg seroclearance rate than those with EOT HBsAg levels of＞1000 IU/mL(33.3％vs.5.4％).The pro-portion of patients with HBsAg ≤1000 IU/mL increased during follow-up.Logistic regression analysis indicated that the EOT HBsAg level was an independent factor for HBsAg seroclearance and an HBsAg level decline exceeding 1 log10 IU/mL.The optimal EOT HBsAg cutoff for both HBsAg seroclearance and an HBsAg level decline exceeding 1 log10 IU/mL was 359 IU/mL. Conclusions:Patients with EOT HBsAg negativity experienced no relapse and maintained HBsAg sero-clearance during 5 years of follow-up after NA discontinuation.A higher HBsAg seroclearance rate can be obtained in patients with EOT HBsAg levels of ≤1000 IU/mL during 5 years of follow-up after NA discontinuation.Close monitoring and proper NA retreatment are recommended to guarantee the safety of NA discontinuation.

Cuproptosis is a new type of cell death that depends on intracellular copper accumulation to trigger the aggregation of mitochondrial lipoacylated protein and the degradation of iron-sulfur cluster protein,with a different mechanism of action from autophagy,ferroptosis,pyroptosis,and necroptosis.Cuproptosis is closely association with the development of liver cancer and resistance to antitumor drugs,as well as the progression of various liver diseases such as hereditary liver diseases,nonalcoholic fatty liver disease,viral hepatitis,and liver cirrhosis.This article summarizes the mechanism of cuproptosis and its role in liver diseases,in order to provide a reference for further research and treatment of liver diseases.