Objective To explore the effect of recombinant human endostatin combined with transcatheter arterial chemoembolization on vascular endothelial growth factor (VEGF), hypoxia inducible factor-1 alpha(HIF-1α), osteopontin (OPN) and connective tissue growth factor (CTGF) levels in serum of HCC patients.Methods 90 cases of primary liver cancer patients were randomly divided into control group and observation group, 45 cases in each group.The control group received the routine chemotherapy of hepatic artery embolization, and the observation group received recombinant human vascular endostatin combined with hepatic arterial chemoembolization.The serum levels of VEGF, HIF-1α, OPN, and CTGF were detected by enzyme-linked immunosorbent assay before treatment, 3 days and 5 days after operation, then the correlations were analyzed.Results The VEGF, HIF-1α, OPN, CTGF levels after 3 days and 5 days were higher than those before surgery in control group and observation group (P<0.05), the above indexes after 5 days were lower than those after 3 days in both groups (P<0.05), and VEGF, OPN and CTGF levels except for HIF-1αin observation group were significantly lower than those in control group after 5 days (P<0.05).There existed significant positive correlation between serum VEGF and HIF-1α, OPN, CTGF concentration levels(r=0.985, 0.995, 0.959,P<0.05) in 90 cases of liver cancer patients, highly positive correlation between HIF-1αand OPN, CTGF levels (r=0.842,0.874, P<0.05), and moderately positive correlation between OPN and CTGF concentrations (r=0.755,P<0.05).Conclusion The efficacy of recombinant human vascular endostatin combined with transcatheter arterial chemotherapy and embolization in the treatment of primary hepatocellular carcinoma is good.There exsits closely correlation of VEGF, HIF-1α, OPN and CTGF levels in serum, which could reflect clinical efficacy.

Objective To analyze the effect of polydatin on cardiac function and mitochondrion of platelet in peripheral blood of patients with severe hemorrhagic shockpolydatin.Methods 60 patients with severe hemorrhagic shock from January 2010 to May 2015 in the hospital were selected.The control group adopted the intravenous therapy of normal saline and transfusion therapy and observation group adopted polydatin (10mg/kg) and transfusion therapy.After treatment, the cardiac function index including heart ejection fraction and and cardiac output, protein kinase C (PKC), ATP levels in mitochondria of platelet, platelet mitochondrial membrane potential and lipid peroxide ( LPO ) in platelet were compared between two groups.Results After treatment, the ejection fraction and cardiac output of two groups increased compared with pre-treatment ( P <0.05 ) , and the above indicators in observation group increased compared with control group (P<0.05).After treatment, PKC content in cell membrane and cytoplasm increased compared with pre-treatment (P<0.05), and the above indicators in observation group increased compared with control group (P<0.05). After treatment, the ATP level in two groups increased compared with pre-treatment (P<0.05), and the above indicator in observation group increased compared with control group ( P <0.05 ).After treatment, platelet cell rate of low mitochondrial membrane potential in observation group decreased compared with pre-treatment (P<0.05), but there was no significant difference in control group, the above indicator in observation group was lower than that in control group (P<0.05).After treatment, LPO content in observation group decreased compared with pre-treatment (P<0.05), but there was no significant difference in control group, the above indicator in observation group was lower than that in control group (P<0.05).Conclusion The injury of mitochondrion plays an important role in occurrence and development of severe hemorrhagic shockpolydatin.The function of peripheral blood platelet mitochondrion could be seen as a simple index of judging the state of shock.After the application of protective agent of mitochondrion, the function of mitochondrion is protected.The cardiac function is also improved.It has an important significance for the diagnosis of severe shock.

ObjectiveTo evaluate therapeutic effect and the possible mechanism of smecta on paraqual plasma concentrations and multiorgans injury induced by paraquat intoxication in rats. Methods A total of 76 healthy adult SD rats were randomly ( random number) divided into group A (control group n =6),group B ( poisoned group n =30 ),group C (smecta-treated group n=30).Rats in groups B and C were treated intragastrically with PQ at 50 mg/kg,the rats in the group C were given with smecta at 50 mg/kg,while the rats in the other two groups were only intragastrically adminstered with saline.Live rats in groups B and C were sacrificed at 2,6,24,48,72 h after administration of PQ for the determination of paraquat plasma concentrations and for HE staining of lung,stomach and jejunum.The rats were executed at the end of trial by the same way in group A.All measurement data were expressed as means + standard deviation ((x) ±s).The data of pathological score were compared with Independent-samples T test and the data of PQ concentration compared with analysis of variance (ANOVA) followed by LSD-t multiple comparison test.P-values of less than 0.05 were considered statistically significant.ResultsThe paraquat plasma concentration ( ng/ml ) was 440.314 ± 49.776 to 4320.6150 ± 413.947.There were different pathological changes of lung,stomach and jejunum in group B. Lung injuries gradually deteriorated,congestion,edema,leukocyte infiltration,incrassated septa and lung consolidation were observed.The pathological changes were obvious such as abruption of mucosa,hyperemic gastric mucosa and leukocyte infiltration in stomach.Haemorrhage of jejunum mucosa,abruption of villus,gland damage and inflammatory cell infiltration were found. Compared with group B,all the pathological changes mentioned above were obviously alleviated in group C ( P ＜ 0.05 ),and the concentrations reduced ( P ＜ 0.01 ).Conclusions Smecta reduced paraquat plasma concentrations and alleviated pathologic injury of rats with PQ poisoning.

BACKGROUND:Tissue-engineered bone can be obtained by the combination of chondrocytes and polyglycolic acid scaffold. OBJECTIVE:To investigate the effect of alogeneic chondrocytes/polyglycolic acid scaffold compound in the repair of thyroid cartilage defects in rabbits. METHODS: Twenty New Zealand adult rabbits were randomly divided into experimental group with implantation of alogeneic chondrocytes/polyglycolic acid scaffold compound and control group with implantation of polyglycolic acid scaffold. Gross and histological observations were done at 4 and 8 weeks after implantation. RESULTS AND CONCLUSION: (1) Gross observation results: 4 weeks after surgery, cartilage defects in the experimental group were repaired certainly, and no necrosis appeared in the repair area; in the control group, the defects were filed with muscle and connective tissues. At 8 weeks after implantation, cartilage defects in the experimental group were further repaired, with unclear repair boundaries, and in the control group, cartilage defects were no repaired and showed a notable boundary with the surrounding normal cartilage tissues. (2) Immunohistochemical staining results: the expression of type II colagen in the experimental group was higher than that in the control group (P < 0.05) at 4 and 8 weeks after implantation. These findings indicate that the alogeneic chondrocytes/polyglycolic acid scaffold compound can promote the repair of thyroid cartilage defects in rabbits.

Objective To investigate obesity and hypertension risk among people aged over 40 years old in Xining based on cohort study. Methods In this prospective cohort study, the physical examination data of 1 149 physical examinees aged over 40 years in our hospital from August 2011 to August 2012 were included as baseline data. Follow up was performed from August 2015 to August 2017. The selected individuals were divided into four groups according to the body mass index (BMI), group A1, A2, A3, and A4, then the incidence of hypertension was recorded. With group A2 as reference group, the relative risks and 95% confidence intervals for hypertension of group A1, A3 and A4 were estimated using generalized linear regression model with Log-binomial regression methods. The population attributable risk proportion of obesity to hypertensive population based on gender and age stratification was calculated. Results Among 919 subjects, 53 cases had BMI<18.5kg/m², 546 cases had BMI of 18.5-23.9kg/m², 256 cases had BMI of 24.0-27.9kg/m² and 64 cases had BMI>27.9kg/m²; The incidence rate and risk of hypertension in group A4 were significantly higher than those in group A3, A2 and A1 [x2 incidence rate = 31.698, U incidence risk = 3.075 (model 1), 3.572 (model 2), 3.634 (model 3), 3.505 (model 4), all P=0.000]. The relative risks of developing hypertension of baseline normal weight-follow up overweight / obesity group, baseline overweight / obesity-follow up normal weight group, and baseline / follow-up overweight/obesity group were 52.00%, 26.00% and 74.00% in model 1, those were 52.00%, 29.00% and 75.00% in model 2, which were 49.00%, 28.00% and 68.00% in model 3, and were 30.00%, 8.00% and 35.00% in model 4; The risk of hypertension among overweight/obese people aged 40~65 and ≥66 years was 19% and 9%, and the population attributable risk proportion was 6.7% and 3.4%, respectively. Conclusion In Xining area, the risk of obesity induced hypertension in people over 40 years old is on the rise, and weight gain in middle-aged people is a risk factor for hypertension. Therefore, life intervention for middle-aged overweight or obese people is of vital importance to reduce the incidence of hypertension.

Objective To study the protective effect of trimetazidine pretreatment on myocardial I/R in a rat I/R model and its mechanism.Methods One hundred and twenty SD rats were divided into control group,I/R group,HSP70 inhibitor group,trimetazidine treatment group and combined treatment group (24 in each group).The rats in each group were further divided into 30 min reperfusion group,4 h reperfusion group and 8 h reperfusion group (8 in each group).Their HSP70-positive myocardial cells were calculated,their serum CK,CK-MB,MDA,SOD levels and their myocardial infarction size were measured.Results The serum CK and CK-MB levels were significantly higher in I/R group,HSP70 inhibitor group,trimetazidine treatment group and combined treatment group than in control group and were significantly lower in trimetazidine treatment group than in combined treatment group and I/R group after reperfusion for 4 and 8 h (P＜0.01).The serum levels of HSP70 and SOD were significantly higher,the MDA levels were significantly lower in trimetazidine treatment group than in combined treatment group and I/R group after reperfusion for 30 min,4 and 8 h (P＜0.01).The infraction size was significantly smaller in trimetazidine treatment group than in combined treatment group and I/R group after reperfusion for 4 and 8 h (P＜0.05).Conclusion Trimetazidine can increase the serum HSP70 level in myocardial cells,reduce the infarction size,and protect the myocardium against I/R in rats.

ObjectiveTo investigate the value of aspartate aminotransferase-to-platelet ratio index (APRI), fibrosis-4 (FIB-4) score, and gamma-glutamyl transpeptidase-to-platelet ratio (GPR) in diagnosis of liver inflammation grade in patients with chronic hepatitis B (CHB). MethodsA total of 545 patients with CHB who underwent percutaneous liver biopsy and routine laboratory examinations during hospitalization in Shanghai Public Health Clinical Center Affiliated to Fudan University from October 2016 to October 2019 were enrolled. Inflammation grade (G) was determined according to the Scheuer scoring system, and APRI, FIB-4, and GPR were calculated based on related clinical indicators. The t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. A Spearman correlation analysis was used to investigate the correlation between two variables. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic performance of the three serum noninvasive diagnostic models in determining liver inflammation grade, and the Delong test was used for comparison of the area under the ROC curve (AUC). ResultsAmong the 545 patients, 224 had grade G0-1 liver inflammation, 209 had grade G2 liver inflammation, and 112 had grade G3 liver inflammation. The Spearman correlation analysis showed that APRI, FIB-4, and GPR were positively correlated with liver inflammation grade (r=0.611, 0.470, and 0.563, all P＜0.001). APRI, FIB-4, and GPR had an AUC of 0.820, 0.719, and 0782, respectively, in the diagnosis of G≥2 liver inflammation, with optimal cut-off values of 0.53, 1.48, and 0.20, respectively; for the diagnosis of G≥2 liver inflammation, GPR had a better performance than FIB-4 (P=0.01) and a slightly lower performance than APRI (P=0.048). The stratified analysis based on alanine aminotransferase (ALT) level showed that in the ≤1×upper limit of normal (ULN) group, the (1-2)×ULN group, and the (2-5)×ULN group, APRI had an AUC of 0.847, 0.786, and 0.724, respectively, in the diagnosis of G≥2 liver inflammation, FIB-4 had an AUC of 0.777, 0.729, and 0.626, respectively, and GPR had an AUC of 0.801, 0.781, and 0.607, respectively; the subgroup analysis showed that GPR had a similar diagnostic performance to APRI and FIB-4 in all ALT stratification groups except the (2-5)×ULN group, in which GPR had a lower diagnostic performance than APRI (P=0.042). APRI, FIB-4, and GPR had an AUC of 0.791, 0.725, and 0.801, respectively, in the diagnosis of G≥3 liver inflammation, with optimal cut-off values of 0.66, 1.49, and 0.25, respectively; in the diagnosis of G≥3 liver inflammation, GPR had a similar diagnostic performance to APRI and a better diagnostic performance than FIB-4 (P=0.006). The stratified analysis based on ALT level showed that in the ≤1×ULN group, the (1-2)×ULN group, and the (2-5)×ULN group, APRI had an AUC of 0.900, 0.742, and 0.693, respectively, in the diagnosis of G≥3 liver inflammation, FIB-4 had an AUC of 0.874, 0.683, and 0.644, respectively, and GPR had an AUC of 0.890, 0.805, and 0.668, respectively. The subgroup analysis showed that GPR had a similar diagnostic performance to APRI and FIB-4 in all ALT stratification groups except the (1-2)×ULN group, in which GPR had a better diagnostic performance than FIB-4(P=0.015). ConclusionAPRI, FIB-4, and GPR may accurately diagnose liver inflammation grade in CHB patients, which helps to monitor the progression of CHB and determine the timing of antiviral therapy.

Objective: To explore the improvement rate of liver fibrosis in patients with chronic hepatitis B virus infection who received entecavir alone or in combination with anluohuaxianwan for 78 weeks. Methods: Patients with chronic HBV infection were randomly treated with entecavir alone or in combination with anluohuaxian for 78 weeks. Ishak fibrosis score was used for blind interpretation of liver biopsy specimens. The improvement in liver fibrosis condition before and after the treatment was compared. Student's t test and non-parametric test (Mann-Whitney U-Test and Kruskal-Wallis test) were used to analyze the measurement data. The categorical variables were analyzed by Chi-square test method and Spearman’s rank correlation coefficient was used to test bivariate associations. Results: Liver fibrosis improvement rate after 78 weeks of treatment was 36.53% (80/219) and the progression rate was 23.29% (51/219). The improvement of liver fibrosis was associated to the degree of baseline fibrosis and treatment methods (P < 0.05). The improvement rate of hepatic fibrosis in patients treated with anluohuaxianwan combined with entecavir at baseline F < 3 (54.74%, 52/95) was significantly higher than that in patients treated only with entecavir (33.33%, 16/48), P = 0.016 and the progression rate of hepatic fibrosis (13.68%, 13/95) was lower than that in patients treated alone (18.75%, 9/48), P = 0.466. In patients with baseline F < 3, the proportion of patients with improved and stable liver fibrosis in the combined treatment group (68.1%, 32/47) was higher than that in the treatment group alone (51.7%, 15/29). Conclusion Combined anluohuaxianwan and entecavir treatment can significantly improve the improvement rate of liver fibrosis in patients with chronic hepatitis B virus infection. Furthermore, it has the tendency to improve the stability rate and reduce the rate of progression of liver fibrosis.