ObjectiveTo investigate the expression level of HBV cccDNA in patients in the convalescence stage of hepatitis B virus-related acute-on-chronic liver failure （HBV-ACLF） and its correlation with HBV markers and liver histopathological changes. MethodsA total of 30 patients in the convalescence stage of HBV-ACL who were hospitalized in The Ninth Hospital of Nanchang from January 2015 to October 2023 were enrolled as liver failure group， and 9 patients with chronic hepatitis B （CHB）， matched for sex and age， were enrolled as control group. The content of HBV cccDNA in liver tissue was measured， and its correlation with clinical data and laboratory markers was analyzed. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups， and a one-way analysis of variance or the Kruskal-Wallis H test was used for comparison between multiple groups； the Fisher’s exact test was used for comparison of categorical data between groups. A Spearman correlation analysis was performed. ResultsThe liver failure group had a significantly lower content of HBV cccDNA in liver tissue than the control group （-0.92±0.70 log₁₀ copies/cell vs -0.13±0.91 log₁₀ copies/cell， t=2.761， P=0.009）. In the liver failure group， there was no significant difference in the content of HBV cccDNA in liver tissue between the HBeAg-positive patients and the HBeAg-negative patients （P>0.05）； there was no significant difference in the content of HBV cccDNA in liver tissue between the patients with different grades （G0-G2， G3， and G4） of liver inflammatory activity （P>0.05）； there was no significant difference in the content of HBV cccDNA in liver tissue between the patients with different stages （S0-S2， S3， and S4） of liver fibrosis （P>0.05）； there was no significant difference in the content of HBV cccDNA in liver tissue between the patients with negative HBV DNA and those with positive HBV DNA （P>0.05）. For the liver failure group， the content of HBV cccDNA in liver tissue was positively correlated with the content of HBV DNA in liver tissue （r=0.426， P=0.043） and was not significantly correlated with the content of HBV DNA in serum （P>0.05）. ConclusionThere is a significant reduction in the content of HBV cccDNA in liver tissue in the convalescence stage of HBV-ACLF. HBV cccDNA exists continuously and stably in liver tissue and can better reflect the persistent infection and replication of HBV than HBV DNA in serum and liver tissue.

ObjectiveTo investigate the expression levels of miR-128-3p， SIRT1， and AMPK in the peripheral blood of patients with type 2 diabetes mellitus （T2DM） comorbid with nonalcoholic fatty liver disease （NAFLD）， as well as the role of miR-128-3p in predicting NAFLD in T2DM patients. MethodsA total of 80 patients with T2DM who were hospitalized in The First Affiliated Hospital of Anhui University of Chinese Medicine from September 2022 to August 2023 were enrolled and divided into T2DM group with 40 patients and NAFLD group with 40 patients， and according to the NAFLD fibrosis score （NFS）， the patients were further divided into progressive liver fibrosis group with 16 patients and non-progressive liver fibrosis group with 64 patients. General data and biochemical parameters were collected； quantitative real-time PCR was used to measure the mRNA expression levels of miR-128-3p， SIRT1， and AMPK in peripheral blood， and Western blot was used to measure the protein expression levels of SIRT1 and AMPK. The independent-samples t test was used for comparison of normally distributed data between two groups， and the Mann-Whitney U test was used for comparison of data with skewed distribution between two groups； the chi-square test was used for comparison of categorical data between two groups. The logistic regression analysis was used to identify the influencing factors for the presence of NAFLD and progressive liver fibrosis， and the receiver operating characteristic （ROC） curve analysis was used to determine the optimal cut-off value of miR-128-3p for predicting NAFLD. ResultsThere were significant differences between the NAFLD group and the non-NAFLD group in body mass index， fasting plasma glucose， glycated hemoglobin， fasting insulin， fasting C-peptide， alanine aminotransferase （ALT）， aspartate aminotransferase， gamma-glutamyl transpeptidase， alkaline phosphatase， fibronectin， triglycerides， high-density lipoprotein cholesterol， total triiodothyronine （TT3）， Homeostasis Model Assessment of Insulin Resistance （HOMA-IR）， and NFS （all P<0.05）. Compared with the non-NAFLD group， the NAFLD group had a significantly higher mRNA expression level of miR-128-3p in peripheral blood （t=-8.765， P<0.001） and significant reductions in the mRNA and proteins expression levels of SIRT1 and AMPK （P<0.001）. There were significant differences between the progressive liver fibrosis group and the non-progressive liver fibrosis group in age， ALT， free triiodothyronine， TT3， superoxide dismutase， and miR-128-3p （all P<0.05）. The logistic regression analysis showed that miR-128-3p was an independent risk factor for the development of NAFLD （odds ratio ［OR］=8.221， 95% confidence interval ［CI］： 2.735 — 24.714， P<0.001） and progressive liver fibrosis （OR=1.493， 95%CI： 1.117‍ ‍—‍ ‍1.997， P=0.007）. The ROC curve analysis showed that miR-128-3p had an area under the ROC curve of 0.890 （95%CI： 0.829 — 0.950）， with an optimal cut-off value of 13.165， a sensitivity of 89.3%， and a specificity of 72.7%. ConclusionThere is an increase in the expression of miR-128-3p in peripheral blood of T2DM patients with NAFLD， while there are reductions in the expression levels of SIRT1 and AMPK， suggesting that miR-128-3p has a certain diagnostic value in identifying NAFLD and liver fibrosis in such population.

Objective This study aimed to explore the effect of the combined Danzhi Jiangtang Capsule with dapagliflozin on the blood lipid profile and related inflammatory markers in patients with type 2 diabetes mellitus with peripheral vascular disease. Methods 72 patients with type 2 diabetes mellitus with peripheral vascular disease who met the inclusion criteria were admitted to the Department of Endocrinology,The First Affiliated Hospital of Anhui University of Chinese Medicine,from April 2021 to April 2023. The patients were assigned to the experimental group and the control group using the random number table method (36 cases in each group). The control group was treated with dapagliflozin in addition to standard treatment,while the experimental group received the Danzhi Jiangtang Capsule for 12 weeks. Clinical efficacy,glucose and lipid metabolism indicators,hypersensitive C-reactive protein (hs-CRP),body mass index (BMI) levels,and traditional Chinese medicine (TCM) syndrome scores were observed pre-and post-treatment.Results In post-treatment,the clinical efficacy was higher in the experimental group than in the control group. Significant reductions in fasting blood glucose (FPG),2 h postprandial glucose (2 hPG),triglycerides (TG),total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C),hs-CRP,BMI,and increased high-density lipoprotein cholesterol (HDL-C) were observed. Scores for TCM syndrome and individual items also decreased (P<0.05). Comparisons within the groups for pre-and post-treatment showed reductions in FPG,2 hPG,TG,TC,LDL-C,hs-CRP,and an increase in HDL-C,along with a decrease in total scores of TCM syndrome (P<0.05). Conclusion The Danzhi Jiangtang Capsule combined with dapagliflozin in the treatment of type 2 diabetes mellitus with peripheral vascular disease can regulate the blood lipid profile,reduce inflammatory factors,and improve patient's symptoms. Integrated traditional Chinese and Western medicine treatment are more conducive to controlling the disease,and TCM can be used in clinical practice as a combination treatment.

Objective: To explore the effects of different pretreatment agents on primary tooth dentin bonding durability. Methods : Forty-two retained primary molars were selected, 24 of which were cut along the mesial and distal directions; thus, 48 samples were obtained for shear bond strength tests, and the other 18 teeth were used for nanoleakage tests. According to different pretreatments, both experimental samples were divided randomly into three groups (Group A: distilled water pretreatment group; Group B: 2% chlorhexidine pretreatment group; Group C: 10 mg/mL resveratrol pretreatment group). The test specimens were prepared, the shear bond strength was tested, and interfacial nanoleakage evaluation and scanning electron microscope observation were performed to evaluate the effects of different pretreatment agents on the bonding interface immediately and after aging for one hour with 10% sodium hypochlorite aqueous solution. Results : The immediate shear bond strength results showed that there was no significant difference among the three test groups. After aging, the shear bond strength of Group C was significantly higher than that of Group A and Group B (P<0.05). After aging, the shear bond strength of Group A was significantly lower than the immediate shear bond strength (P<0.05), whereas there was no significant difference in shear bond strength before and after aging in Group B and Group C (P>0.05). For Group C, there was no significant difference in interfacial nanoleakage before and after aging. In addition, among the three groups, Group C had the lowest interfacial nanoleakage (P<0.05). Conclusion Both chlorhexidine and resveratrol pretreatment can improve the adhesion durability of deciduous dentin, but the effects of resveratrol are better than those of chlorhexidine.

Objective:To observe the clinical characteristics and guideline compliance of chronic obstructive pulmonary disease (COPD) patients with initial triple therapy in real-life world.Methods:This study is a cross-sectional study. The subjects of the study were COPD patients admitted to 13 hospitals in Hunan Province and Guangxi Zhuang Autonomous Region from December 2016 to December 2021. The initial treatment was triple inhaled drugs. The data collected included gender, age, diagnosis, body mass index (BMI), history of acute exacerbation (AE) in the past year, pulmonary function, COPD Assessment Test (CAT) score, modified British Medical Research Council Dyspnea Questionnaire (mMRC), inhaled drugs and other indicators. The characteristics and differences of COPD patients before and after 2020 were analyzed.Results:7 184 patients with COPD were enrolled in this study, including 2 409 COPD patients treated with initial triple therapy, accounting for 33.5%(2 409/7 184). Taking January 1st, 2020 as the cut-off point, 1 825 COPD patients (75.8%) received initial treatment with triple inhaled drugs before 2020 and 584 patients (24.2%) after 2020 were included in this study. Compared with COPD patients before 2020, the COPD patients after 2020 had higher FEV 1% [(40.9±15.5 )% vs (39.3±15.5)%, P=0.040], lower CAT [(15.8±6.5)point vs (17.5±6.2)point, P<0.001], less AE in the past year [1(0, 2)times vs 1(0, 2)times, P=0.001] and higher rate of non-AE [255(43.7%) vs 581(37.1%), P=0.006]. In addition, before 2020, patients with COPD were mainly treated with open triple drugs (1 825/1 825, 100%); after 2020, 306 patients (52.4%) received open triple inhaled drugs, and 278 patients (47.6%) received closed triple inhaled drugs. Conclusions:In real-life world, most of patients with COPD treated with triple therapy have severe lung function, obvious symptoms and high risk of acute exacerbation. The real-world prescribing of triple therapy in patients with COPD does not always reflect recommendations in guidelines and strategies, and overtreatment is common. After 2020, prescribing triple therapy for COPD patients is more positive and worse consistency with guideline.

Resin-modified glass ionomer cement (RMGIC) has good physical, chemical and biological properties and is suitable for the treatment of deciduous caries, aged root surface caries and wedge-shaped defects. Surface treatment is a common method to improve bonding strength, which can improve physical and chemical retention between different components. This paper mainly introduces the current research status of the influence of different dentin surface treatment methods on the bonding strength of RMGIC. At present, the common dentin surface treatment methods are pretreatment, acid etching, laser treatment, etc. The pretreatment agent can improve the bond strength of RMGIC by increasing the surface area and porosity of dentin. The bond strength of RMGIC could be effectively improved after the dentin was treated by an acid-etching bonding system. The dentin was treated with a laser to obtain a higher bonding strength. However, whether the use of resin adhesives will affect the release of fluoride ions in RMGIC into the deep dentin and thus affect the repair effect also needs further research.

Objective : To explore the effects of two hemostatic agents on the bonding strength of different bonding systems in primary tooth dentin. Methods : Seventy-two retained deciduous teeth were randomly selected. Forty-eight teeth were used to construct the microleakage model, the other 24 teeth were cut along the mesial and distal directions and 48 samples were obtained to construct the shear bond strength model. The two experiments were divided into 2 groups. Group A was the total-etch group: A1 (ViscoStat + Spectrum Bond NT); A2 (ViscoStat Clear + Spectrum Bond NT); and A3 (Non + Spectrum Bond NT); Group B was the self-etch group: B1 (ViscoStat + Single bond Universal Adhesive); B2 (ViscoStat Clear + Single bond Universal Adhesive); and B3 (Non + Single bond Universal Adhesive). Microleakage experiments and shear bond strength experiments were carried out respectively and the morphology of the fracture surface was observed by scanning electron microscopy. Results : There was no significant difference in microleakage among groups A1, A2, and A3 (P > 0.05). There was no significant difference in microleakage among groups B1, B2, and B3 (P > 0.05). There was no significant difference in the shear bond strength among groups A1, A2 and A3 (P > 0.05). The shear bond strength of groups B1 and B2 was significantly lower than that of group B3 (P < 0.05). There was no significant difference between groups B1 and B2 (P > 0.05). Conclusion ViscoStat and ViscoStat Clear had no effect on the marginal integrity of deciduous tooth dentin under the different bonding systems. The two hemostatic agents reduced the shear bonding strength of deciduous tooth dentin under the self-etch adhesive system, but had no effect on the shear bonding strength of deciduous tooth dentin under the total-etch adhesive system.

Objective To understand the rationality and safety of oral antihypertensive drugs on chronic renal disease(CKD)combined with hypertension hospitalized patients. Methods It was a multi-center and retrospective investigation. The electronic medical records of CKD with hypertension patients who were hospitalized in 6 comprehensive hospitals in Beijing and used oral antihypertensive drugs on October 1st,2013 to March 31st,2015 were collected. The pharmacists who participated in the project from the 6 research centers filled out the investigation form. According to the drug instruction,the rationality of antihypertensive medication was evaluated by daily dose,frequency of drug delivery,the dosage for renal insufficiency,contraindications and adverse interactions. Results There were 2 833 valid cases in this study,1 730 males and 1 103 females. The ratio of male to female was 1:0.64. The range of age was 18~101 years. The average age was(61 ± 18)years. There were 1 630(57.54%)cases whose age was≥60;314(11.1%)cases were CKD level 1,526(18.6%)cases were CKD level 2,1 117(39.4%)cases were CKD level 3,423(14.9%)cases were CKD level 4,453(16.0%)cases were CKD level 5. 144 (5.1%)cases were hypertension level 1,592(20.9%)cases were hypertension level 2,1 398 cases (49.3%)were hypertension level 3,and 699(24.7%)cases were not graded. The oral hypotensive drugs applied during the hospitalization of 2 833 patients included calcium channel blockers(CCB),beta blockers,diuretics,angiotensin Ⅱ receptor blocker(ARB),angiotensin converting enzyme inhibitors (ACEI),alpha/beta blockers and alpha blockers. 1 022(36.1%)cases used 1 kind of antihypertensive drugs,1 032(36.4%)cases used 2 kinds of antihypertensive drugs,591(20.9%)cases used 3 kinds of antihyper-tensive drugs,157(5.5%)cases used 4 kinds of antihypertensive drugs and 31(1.1%)cases used 5 kinds of antihypertensive drugs. A total of 6038 cases of antihypertensive drugs were administered. The top priority was CCB(35.11%,2 120),the second was beta blockers(17.26%,1 042)and the third was diuretics(16.23%,980). The choice of a single drug for antihypertensive drugs was reasonable. The 2,3,4,5 combined drug users who were not recommended by the guidelines were 4.8%(50/1 032), 21.2%(125/591),28.0%(44/157)and 64.5%(20/31)respectively. The situation of blood pressure control was evaluated with blood pressure target values achieved rate. With blood pressure below 130/80 mmHg as the standard,the admission and discharge blood pressure target achieved rate was 31.2%(884/2 833)and 29.5%(799/2 705)respectively. With blood pressure below 140/90 mmHg as the standard, the admission and discharge blood pressure target achievement rate was 53.6%(1 519/2 833)and 64.4%(1 743/2 705)respectively. Among the 2 833 cases,903(31.9%)cases had 1 204 times of unreasonable use of the drug. The top three were excessive daily frequency of medication(1 029,85.5%),total daily dosage(114,9.5%),and use of drugs that were contraindicated(51,4.2%). Two cases had adverse drug reactions related to antihypertensive drugs. Conclusion The use of antihypertensive drugs in patients with CKD in the six hospitals involved in the investigation was reasonable,but there was still some problems in the combination of drugs. Some doctors are not familiar with the drug instructions,and there are some problems such as increasing the frequency of drug use,overdose medication,and use of drugs that are contraindicated. Clinical pharmacists should be more involved in clinical work in these areas.

Objective To understand the rationality and safety of oral antihypertensive drugs on chronic renal disease(CKD)combined with hypertension hospitalized patients. Methods It was a multi-center and retrospective investigation. The electronic medical records of CKD with hypertension patients who were hospitalized in 6 comprehensive hospitals in Beijing and used oral antihypertensive drugs on October 1st,2013 to March 31st,2015 were collected. The pharmacists who participated in the project from the 6 research centers filled out the investigation form. According to the drug instruction,the rationality of antihypertensive medication was evaluated by daily dose,frequency of drug delivery,the dosage for renal insufficiency,contraindications and adverse interactions. Results There were 2 833 valid cases in this study,1 730 males and 1 103 females. The ratio of male to female was 1:0.64. The range of age was 18~101 years. The average age was(61 ± 18)years. There were 1 630(57.54%)cases whose age was≥60;314(11.1%)cases were CKD level 1,526(18.6%)cases were CKD level 2,1 117(39.4%)cases were CKD level 3,423(14.9%)cases were CKD level 4,453(16.0%)cases were CKD level 5. 144 (5.1%)cases were hypertension level 1,592(20.9%)cases were hypertension level 2,1 398 cases (49.3%)were hypertension level 3,and 699(24.7%)cases were not graded. The oral hypotensive drugs applied during the hospitalization of 2 833 patients included calcium channel blockers(CCB),beta blockers,diuretics,angiotensin Ⅱ receptor blocker(ARB),angiotensin converting enzyme inhibitors (ACEI),alpha/beta blockers and alpha blockers. 1 022(36.1%)cases used 1 kind of antihypertensive drugs,1 032(36.4%)cases used 2 kinds of antihypertensive drugs,591(20.9%)cases used 3 kinds of antihyper-tensive drugs,157(5.5%)cases used 4 kinds of antihypertensive drugs and 31(1.1%)cases used 5 kinds of antihypertensive drugs. A total of 6038 cases of antihypertensive drugs were administered. The top priority was CCB(35.11%,2 120),the second was beta blockers(17.26%,1 042)and the third was diuretics(16.23%,980). The choice of a single drug for antihypertensive drugs was reasonable. The 2,3,4,5 combined drug users who were not recommended by the guidelines were 4.8%(50/1 032), 21.2%(125/591),28.0%(44/157)and 64.5%(20/31)respectively. The situation of blood pressure control was evaluated with blood pressure target values achieved rate. With blood pressure below 130/80 mmHg as the standard,the admission and discharge blood pressure target achieved rate was 31.2%(884/2 833)and 29.5%(799/2 705)respectively. With blood pressure below 140/90 mmHg as the standard, the admission and discharge blood pressure target achievement rate was 53.6%(1 519/2 833)and 64.4%(1 743/2 705)respectively. Among the 2 833 cases,903(31.9%)cases had 1 204 times of unreasonable use of the drug. The top three were excessive daily frequency of medication(1 029,85.5%),total daily dosage(114,9.5%),and use of drugs that were contraindicated(51,4.2%). Two cases had adverse drug reactions related to antihypertensive drugs. Conclusion The use of antihypertensive drugs in patients with CKD in the six hospitals involved in the investigation was reasonable,but there was still some problems in the combination of drugs. Some doctors are not familiar with the drug instructions,and there are some problems such as increasing the frequency of drug use,overdose medication,and use of drugs that are contraindicated. Clinical pharmacists should be more involved in clinical work in these areas.

OBJECTIVETo explore the anesthetic effects of repeated administration of propofol combined with vitamin C in mice.

METHODSForty mice were subjected to daily intraperitoneal injections of 80 mg/kg propofol (P80 group), 70 mg/kg propofol and 50 mg/kg vitamin C (P70+Vc50 group), 55 mg/kg propofol and 100 mg/kg vitamin C (P55+Vc100 group), or 50 mg/kg propofol and 200 mg/kg vitamin C (P50+Vc200 group) for 6 consecutive days, and the anesthesia induction time and anesthesia duration were recorded.

RESULTSCompared with the P80 group, the mice in P55 + Vc100 group and P50 + Vc200 group showed significantly shorter anesthesia duration on the first 3 days (P<0.05). In all the groups, anesthesia duration was significantly shortened in the following days compared with that on day 1 (P<0.01); anesthesia duration was shorter on day 3 than on day 2 in P50 + Vc200 group (P<0.01), and was shorter on days 4, 5, and 6 than on day 2 in all the groups (P<0.01). In all the groups, the rate of loss of righting reflex (LORR) decreased gradually with time in a similar pattern.

CONCLUSIONVitamin C can reduce the dose of propofol without obviously affecting the anesthetic effect to reduce the incidence of drug tolerance and potential dose-related side effects of propofol.

Anesthesia ; Anesthesia Recovery Period ; Anesthetics, Intravenous ; administration & dosage ; pharmacology ; Animals ; Ascorbic Acid ; administration & dosage ; pharmacology ; Drug Tolerance ; Mice ; Propofol ; administration & dosage ; pharmacology