Objective To analyze the relationship between HBsAg level and HBV DNA level as well as illness severity in patients with HBV-related acute-on-chronic liver failure (ACLF).Methods One hundred and nineteen patients with chronic hepatitis B (CHB group) and 98 patients with ACLF(ACLF group) were enrolled.HBsAg and HBeAg were assayed with Roche electrochemical luminescence method.HBV DNA was quantified using a real-time polymerase chain reaction (PCR) assay.HBsAg and HBV DNA levels were compared between two groups and between HBeAg-positive and HBeAg-negative patients in ACLF group respectively,also the correlationbetween HBsAg and HBV DNA was studied.Results The proportions of HBeAg-negative patients were 68.4％(67/98) and 42.9％(51/119) in ACLF group and CHB group respectively,and there was significant difference between two groups (P ＜0.01).There was no significant difference in HBV DNA between two groups (P ＞ 0.05).HBV DNA in HBeAg-positive patients was higher than that in HBeAg-negative patients in two groups(P ＜ 0.05).There was no significant difference in HBsAg between HBeAg-positive patients and HBeAg-negative patients in ACLF group (P ＞ 0.05 ),but they were higher than that in HBeAg-positive patients in CHB group (P＜ 0.05).HBsAg was correlated to ALT,AST in HBeAg-positive patients (P ＜ 0.05).No significant correlation was found among HBsAg and HBV DNA as well as biochemical changes (P＞ 0.05).There was no significant difference in the ratio of different HBsAg levels among the patients of different HBV DNA in ACLF group (P＞ 0.05).Conclusion The level of HBsAg does not directly correlate with serum HBV DNA level,and has no directly correlation with the severity of the disease in patients with HBV-related ACLF.

Objective:To study the optimal extraction process of Yinxiejing. Methods: An orthogonal experimental method was used with reflux time, reflux times, ethanol concentration and volume as the influencing factors, and emodin and osthole content as the indices. Results:The optimal extraction conditions for Yinxiejing were as follows:refluxing twice with 2 h every time using 8-fold 80%ethanol. Conclusion:The optimum process is stable and feasible.

Objective To study the relationship between programmed death-1 (PD-1)/programmed death-1 ligand (PD-L1) expressions and serum hepatitis B virus (HBV) DNA levels in chronic hepatitis B (CHB) patients. Methods A total of 137 CHB patients and 10 healthy controls were enrolled in the study. The peripheral blood mononuclear cells (PBMCs) were isolated from fresh blood samples. HBV-specific cytotoxic T lymphocyte (CTL) was expanded in vitro in 64 human leucocyte antigen (HLA)-A2 positive patients. Flow cytometry was used to detect HLA-A2 type,expressions of PD-1/PD-L1 on PBMCs and PD-1 on HBV specific CTL. Interferon gamma (IFN-γ)was measured by commercial enzyme-linked immunosorbent assay (ELISA) kits. PD-1/PD-L1expressions on PBMCs, HBV-specific CTL and IFN-γ level in PBMC culture medium were compared among patients with different baseline HBV DNA levels. Ten hepatitis B e antigen (HBeAg) positive patients were treated with telbivudine for 24 weeks. The above mentioned parameters were determined and compared before and after the antiviral treatment. Independent-samples t test were used to compare means between two groups and one-way A NOVA were used to compare means among multigroups. We used the pearson corretation test to assess corretation significance. Results The PD-1 and PD-L1 expressions on PBMCs in patients with baseline HBV DNA＜3 lg copy/mL, 3-6 lg copy/mL and ＞6 lg copy/mL were all significant higher than those in healthy control group, but no statistical differences were found. PD-1 expressions on HBV-specific CTL in the three CHB patient groups were (69.3±11.2)%, (76.5±9. 1)% and (78.0±11.7)%, respectively. However, PD-1 expression on HBV-specific CTL was higher, while the frequency of HBV-specific CTL cells was lower in HBV DNA ＞6 lg copy/mL group compared to HBV DNA＜3 lg copy/mL group. The above parameters, including expressions of PD-1 and PD-L1, the frequency of HBV-specific CTL and its PD-1 expression were not significantly different between HBeAg-positive group and HBeAg-negative group. Compared with baseline, PD-1 and PD-L1 expression decreased obviously accompanying with increase of HBV-specific CTL cells frequency and IFN-γ level after 12 weeks and 24 weeks of telbivudine treatment. Conclusions PD-1 expression on HBV-specific CTL correlates with serum HBV DNA level, but not HBeAg status in CHB patients. Suppression of HBV replication can reduce PD-1/PD-L1 expressions and partially restore HBV specific CTL function.

ObjectiveTo investigate the finasteride application during the off-cycle of intermittent androgen blockade (IAB) in patients with advanced prostate cancer treated with IAB.MethodsEighty-seven patients with advanced prostate cancer were divided into two groups: forty-nine patients received IAB (group A), and thirty-eight patients underwent IAB and finasteride during the off-cycle of IAB (group B). The time of treatment cycle and the time to disease progression were compared between the two groups. ResultsThe patients in group A completed 89 treatment cycles and the mean cycle length was (12.8±5.4) months [treatment time and non-treatment time were (6.6±3.5) months and (7.1±4.8) months, respectively]. The patients in group B completed 85 cycles and the mean cycle length was (15.3±5.9) months [treatment time and non-treatment time were (6.9±3.2) months and (9.2v±3.9) months, respectively]. There was a significant difference between group A and B in the mean cycle length and the non-treatment time (P=0.0428,P=0.03).The 3-year progression rate was ( 34.8±3.5 )% in group A and ( 28.4±2.7)% in groups B ( P=0.035). ConclusionsThe application of finasteride during the off-cycle of IAB in patients with advanced prostate cancer treated with intermittent androgen blockade (IAB) can delay progression of advanced prostate cancer.

Objective To investigate the quality of life in man after treatment of advanced prostate cancer by surgical castration. Methods A total of 69 patients with advanced prostate cancer treated by sur-gical castration completed the European organization for research and treatment of cancer quality of life questionnaire (QLQ-C30) and QLQ-prostate specific 25-item (PR25) module third at a 12-month interval.The assessment points were preoporative,6 months postoperative and 12 months postoperative. Results Although there were improvement on pain relief (P ＜ 0.01 ) and symptom of urinary (P ＜ 0.01 ) and global health (P ＜ 0.01 ), the physical functioning (P ＜ 0.05 ), role functioning (P ＜ 0.01 ), emotional functioning (P ＜ 0.01 ), cognitive functioning (P ＜ 0.05 ), social functioning (P ＜ 0.05 or ＜ 0.01 ) were found significantly reduced , and insomnia (P ＜ 0.05) and fatigue (P ＜ 0.01 ) aggravated, treatment related symptoms (P ＜0.01 )appeared predominantly, especially deprivation of sexual functioning. Conclusion The surgical cas-tration when treating advanced prostate cancer did appear to impair the physical and psychological of patients, especially the sexual functioning.

Objective To study the incidence and distribution features of spontaneous decrease of hepatitis B virus (HBV) DNA level and its correlative factors in chronic hepatitis B (CHB) patients.Methods The incidence,demographic features and distribution of different clinical types of spontaneous decrease of HBV DNA were investigated with clinical epidemiological study in 315 CHB or live cirrhosis (LC) patients.The correlative factors of spontaneous decrease of HBV DNA were analyzed by Logistic regression methods.Results Among the 315 patients,171 patients (54.3%) underwent spontaneous decrease of HBV DNA within 12 weeks,of which 61 patients (19.4%) had undeteetable HBV DNA (＜3 lg copy/mL).The stratified study showed that the incidence of spontaneous decrease of HBV DNA in young patients was 58.6% (116/198 cases),which was higher than that (25.0%,2/8 cases) in juvenile patients (X2 = 2.956,P=0.048).The incidence of decrease in relatively more severe patients was higher than that in relatively less severe patients (all X2 in significant groups＞3.84,all P＜0.05),and the highest incidence was 78.7% (48/61 cases) in patients with chronic severe hepatitis B.The incidence of spontaneous decrease of HBV DNA in hepatitis E virus (HEV)/HBV coinfected patients was 75.0% (21/28 cases),which was higher than that (51.8%,146/282 cases) in single HBV-infected patients (X2 =5.530,P=0.019).The incidence of spontaneous decrease of HBV DNA in patients with alanire aminotransferase (ALT)＞400 U/L was 61.8%(102/165 cases),which was higher than that (46.0%,69/150 cases) in patients with ALT≤400 U/L (X2 =7.922,P=0.005).The incidence of spontaneous decrease of HBV DNA in patients with TBil＞200 μmol/L was 68.7% (79/115 cases),which was higher than that (46.0%,92/200 cases) in patients with TBil≤200 μmol/L (X2 = 15.155,P=0.000).The multivariate Logistic analysis demonstrated that chronic severe hepatitis B,ALT＞ 400 U/L and TBil＞ 200 μmol/L were the correlative factors with spontaneous decrease of HBV DNA in CHB or LC patients (all OR＞1,all P＜0.05).Conclusions The spontaneous decrease of HBV DNA level is a common phenomenon during the natural course (immune clearance phase) of CHB or LC patients.Patients with sever conditions,elevated levels of ALT and total bilirubin (TBil) tend to develop spontaneous decrease of HBV DNA.

This study was aimed to observe the effect ofIllicium verum water extract on excess-cold syndrome in rats. The intragastric administration of the decoction of gypsum, gentian, phellodendron andrhizoma anemarrhenae (2:1.2:1:1.5) was used to establish the excess-cold rat model. Effects ofI. verum water extract on general body signs of excess-cold syndrome rats were observed. The detection was made on the contents of LD, PA, TG, TSH, T4 in the serum and LD, PA, glycogen in liver tissues. The vitality of the LDH, SDH and ATPas was also detected. The results showed thatI. verum water extract can improve the general body signs of excess-cold syndrome rats. It reduced the content of TG; increased the content of PA, T4, TSH; reduced the content of LD, glycogen, and the vitality of LDH;increased the vitality of LDH, Ca2+-Mg2+-ATPase in liver tissues. It was concluded thatI. verum water extract can improve some general body signs of excess-cold syndrome rats, improve the substance and energy metabolism, and regulate the thyroid axis function, in order to achieve the warmingyang for dispelling cold effect.

BACKGROUND/AIMS: The motility change after peroral endoscopic myotomy (POEM) in achalasia is currently focused on lower esophageal sphincter (LES). This study aims to investigate the correlation of motility response between distal and proximal esophagus after POEM. METHODS: A total of 32 achalasia patients who received POEM and high-resolution manometry (HRM) were included for analysis. Eckardt score was used to assess symptom improvement. HRM was applied for studying motility. Main parameters analyzed were (1) LES: resting pressure (restP), 4-second integrated relaxation pressure; (2) esophageal body (EB): contractile integral of distal segment with myotomy (CI-DM) and proximal segment without myotomy (CI-PNM); and (3) upper esophageal sphincter (UES): relaxation pressure (UES-RP). RESULTS: There were 6 type I, 17 type II, and 9 type III achalasia patients included for analysis. (1) Eckardt score, LES tone, CI-DM, CI-PNM and UES-RP were reduced remarkably after POEM (P < 0.001). (2) no significant correlation was noted between LES tone and contractile intergral of EB. (3) a positive linear correlation of CI-DM and CI-PNM changes was detected (P < 0.001). (4) the change of UES-RP was positively correlated with the change of contractile integral of EB (P < 0.001). CONCLUSIONS: Myotomy of the distal esophagus would attenuate proximal EB contraction and assist UES relaxation in achalasia patients after POEM.
Esophageal Achalasia* ; Esophageal Sphincter, Lower ; Esophageal Sphincter, Upper* ; Esophagus* ; Humans ; Manometry ; Relaxation*

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.

OBJECTIVETo investigate the possible effects of long-term exposure to dust containing thorium and thoron progeny on dust-exposed miners.

METHODSA negative, high voltage, exhaled thoron progeny measurement system was used to estimate the miners' thorium lung burden.

RESULTSThe highest thorium lung burden of 638 miners was 11.11 Bq. The incidence of stage 0(+) pneumoconiosis was higher among dust-exposed miners. Lung cancer mortality of the dust-exposed miners was significantly higher than that of controls (P < 0.005).

CONCLUSIONThere is a difference in cancer rates between those who have long-term exposure to dust containing thorium (in which carcinogenic ThO(2) and SiO(2) exist) and thoron progeny and those who have not.

Air Pollutants, Radioactive ; adverse effects ; Body Burden ; China ; epidemiology ; Dust ; Follow-Up Studies ; Humans ; Lung Neoplasms ; epidemiology ; Mining ; Occupational Diseases ; epidemiology ; Occupational Exposure ; adverse effects ; Thorium ; adverse effects