ObjectiveTo investigate the impact of metabolic associated fatty liver disease （MAFLD） on metabolic markers in patients with HIV infection， and to assess the risk of new-onset MAFLD in previously untreated HIV patients. MethodsA total of 161 HIV patients who attended the outpatient service of Zhongnan Hospital of Wuhan University from April 2020 to December 2021 were enrolled， and they were treated with the lamivudine/efavirenz/tenofovir disoproxil fumarate （3TC/EFV/TDF） regimen and were followed up for more than 36 months. According to the presence or absence of MAFLD， they were divided into MAFLD group with 42 patients and non-MAFLD group with 119 patients， and metabolic markers were compared between the two groups before and after treatment. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the paired t-test was used for comparison within each group before and after treatment； the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups， and the Wilcoxon signed-rank test was used for comparison within each group before and after treatment； the chi-square test was used for comparison of categorical data between groups. Hepatic steatosis index （HIS） and Zhejiang University （ZJU） index were used to assess the risk of new-onset MAFLD after antiretroviral therapy. ResultsAfter 36 months of 3TC/EFV/TDF treatment， the MAFLD group had significant increases in body mass index （BMI） ［24.8 （23.2 — 25.9） kg/m² vs 25.3 （22.8 — 27.7） kg/m²， Z=-2.540， P=0.011］， total cholesterol （TC） （4.0±0.6 mmol/L vs 4.3±0.6 mmol/L， t=-2.388， P=0.022）， and high-density lipoprotein cholesterol （HDL-C） ［0.9 （0.8 — 1.1） mmol/L vs 1.1 （0.9 — 1.2） mmol/L， Z=-2.858， P=0.004］ and a significant reduction in serum uric acid （462.1±101.6 μmol/L vs 383.3±85.2 μmol/L， t=4.361， P<0.001）. There was a significant difference in BMI between the MAFLD group and the non-MAFLD group after 3TC/EFV/TDF treatment ［25.3 （22.8 — 27.7） kg/m² vs 21.6 （19.9 — 23.4） kg/m²， Z=-5.462， P<0.001］， while there were no significant differences between the two groups in serum uric acid， TC， triglyceride， HDL-C， low-density lipoprotein cholesterol， lipoprotein a， and CD4⁺ T cell count （all P >0.05）. Furthermore， for the patients in the non-MAFLD group after treatment， there was a significant increase in the proportion of patients at a high risk of MAFLD based on HSI and ZJU indices （χ²=10.829 and 5.658， P=0.001 and 0.017）. ConclusionAfter 36 months of 3TC/EFV/TDF treatment， there are increases in blood lipid levels in HIV patients with MAFLD， and there is an increase in the risk of new-onset MAFLD in HIV patients without MAFLD.

Objective:To better evaluate the prevalence and epidemiological characteristics of metabolic-associated fatty liver disease (MAFLD) based on liver transient elastography.Methods:It was a cross-sectional study. A total of 6 961 patients without hepatitis, who underwent liver transient elastography examination at the Department of Hepatology, Zhongnan Hospital of Wuhan University from November, 2021 to April, 2022 were included. The patients were categorized into normal and mild, moderate, severe MAFLD groups according to FibroTouch controlled attenuation parameters (CAP). The CAP values among different body mass index (BMI) groups were compared using analysis of variance. The distribution characteristics and the incidence of MAFLD in different age, gender, body mass index(BMI), blood glucose and lipids groups using the chi-square test.Results:The total detection rate of MAFLD and severe MAFLD in the population with a BMI≥28.0 kg/m 2 was 99.6% and 71.8%, respectively. The detection rate of MAFLD in people with normal BMI was 28.4%. The detection rate of MAFLD in women of childbearing age or in the perimenopausal period were both significantly lower than that in men of the same age (40.3% vs 54.9%, χ 2=20.78, P<0.001; 43.1% vs 58.4%, χ 2=27.43, P<0.001), but there was no statistically significant difference in MAFLD detection rate between postmenopausal women and men of the same age. The detection rates of MAFLD in the group with abnormal blood glucose and lipids were both significantly higher than those in the group with normal blood glucose and lipids [69.7%(196/281) vs 35.2%(2 354/6 680), χ 2=138.36, P<0.001; 54.3%(1 696/3 124) vs 37.1%(1 420/3 837), χ 2=207.99, P<0.001]. Conclusion:Non-hepatitis patients had a higher prevalence of MAFLD. The BMI, gender, age, blood glucose, and lipids levels are all strongly associated with MAFLD.

Objective:To investigate the prevalence of liver fibrosis in patients with HBV infection detected by ultrasound transient elastography.Methods:A total of 2 689 patients with HBV infection who received liver transient elastography examination at the Department of Hepatology, Zhongnan Hospital of Wuhan University from November 2021 to April 2022 were enrolled in the study. The severity of liver fibrosis was graded according to the liver stiffness value. The association of liver fibrosis detection rate with gender, age and physiological stages of patients was analyzed, and the correlation between liver stiffness value and HBV DNA, HBsAg, HBeAg level, alanine aminotransferase (AST), aspartate aminotransferase (ALT) and serum albumin levels was further analyzed.Results:Among 2 689 patients with chronic HBV infection, there were 1 417 males aged 46 (34, 57) years and 1 272 females aged 45 (33, 55) years. A total of 1 382 patients (51.03%) showed varying degrees of liver fibrosis, including 381 cases (14.20%) of significant liver fibrosis and 259 (9.60%) cases of progressive fibrosis. Male patients had a significantly higher prevalence of liver fibrosis than that of female patients [60.78%(840/1 382) vs. 39.22%(542/1 382), χ2=74.566, P<0.001]. There were significant differences in liver stiffness values and liver fibrosis detection rates ( F=46.516, 199.079, P<0.001) among patients of different age groups. The liver stiffness index (9.41±4.49 vs. 8.10±3.89, t=9.011, P<0.001) and the prevalence of liver fibrosis in males was higher than those in females in age groups younger than 60 years [61.59%(643/1 044) vs. 38.41%(401/1 044), χ2=78.418, P<0.001]; However, there was no significant gender difference in people over 60 years of age [73.80%(200/271) vs. 71.71%(142/198), χ2=0.252, P>0.05; 20.30%(55/271) vs. 21.21%(42/198), χ2=0.059, P>0.05]. The prevalence of liver fibrosis was significantly lower in premenopausal and perimenopausal females than that in males of the same age groups [29.70%(188/633)and 52.20%(154/295) vs. 64.50%(202/313), χ 2=56.683, P<0.001; χ 2=9.519, P=0.029], whereas there was no significant difference between postmenopausal females and males in the same age group [65.40%(220/336) vs. 72.20%(319/441), χ 2=5.822, P=0.061]. The prevalence of liver fibrosis increased significantly in postmenopausal females as compared to premenopausal females[38.40%(497/1 294) vs. 67.50%(532/787), χ 2=56.683, P=0.002]. The value of liver stiffness in patients with chronic HBV infection was positively correlated with total bilirubin, AST and ALT levels( r=0.208, 0.227, 0.218, P<0.05). Conclusions:The prevalence of liver fibrosis detected by ultrasound transient elastography in chronic HBV-infected patients is substantial, the liver stiffness value and detection rate are higher in males than those in females, however, the prevalence is increased in postmenopausal females. The liver stifness value is related to some biochemical indicators of the liver.

Objective:To investigate the relationship between positive rate and titer of hepatitis B surface antibody (anti-HBs) and CD4 + T lymphocyte count level in human immunodeficiency virus (HIV) infected patients after hepatitis B virus (HBV) exposure. Methods:A total of 4 893 HIV-infected patients were admitted to Zhongnan Hospital of Wuhan University from January 2010 to December 2018. The demographic data, HIV-related diagnosis, treatment information, CD4 + T lymphocyte count and serum markers of HBV infection of HIV infected patients were retrospectively analyzed. The patients were grouped according to the CD4 + T lymphocyte count and serum markers of HBV infection, and the differences of anti-HBs positive rate and HBV exposure rate in patients with different CD4 + T lymphocyte counts were compared.The differences of CD4 + T lymphocyte count in patients with different titer of anti-HBs were compared. Statistical analysis was performed using chi-square test, analysis of variance or t test. Results:Patients with HIV infection were divided into CD4 + T lymphocyte count<200/μL group (3 293 cases), 200-500/μL group (1 200 cases) and CD4 + T lymphocyte count>500/μL group (400 cases). The HBV exposure rates in the three groups were 78.0%(2 569/3 293), 77.0%(924/1 200) and 76.2%(305/400), respectively. The anti-HBs positive rates were 38.2%(1 258/3 293), 53.8%(645/1 200) and 62.5%(250/400), respectively. The anti-HBs titers were (120.00±36.45) IU/L, (148.00±26.40) IU/L and (212.00±92.08) IU/L, respectively. The exposure rates of HBV in the three groups were similar ( χ2=0.992, P=0.609), but the positive rates and titers of anti-HBs were significantly different ( χ2=146.779 and F=45.362, respectively, both P<0.01). When the patients were grouped by anti-HBs titer, 2 740 cases were divided into anti-HBs negative group (<10 IU/L), 1 220 cases in low anti-HBs group (10-99 IU/L), 693 cases in medium anti-HBs group (100-499 IU/L) and 240 cases in high anti-HBs group (≥500 IU/L). The CD4 + T lymphocyte count levels of the four groups were (150.00±8.42)/μL, (185.00±7.08)/μL, (243.00±12.07)/μL and (308.00±22.60)/μL, respectively. The overall CD4 + T lymphocyte count levels among the four groups were significantly different ( F=68.479, P<0.01). Among the 90 HIV infected patients who received anti-retroviral therapy (ART), the anti-HBs titer increased from (91.96±21.87) IU/L to (200.76±56.43) IU/L after treatment, and the anti-HBs level before and after treatment was significantly different ( t=-2.542, P=0.035). Among 208 patients with negative HBV markers, no patients had hepatitis B surface antigen switched to positive when monitored for an interval time of (26.2±5.3) months. Conclusions:The risk of HBV exposure in patients with HIV infection is not significantly related to the disease stage, but the positive rate and titer of anti-HBs are significantly positively correlated with CD4 + T lymphocyte count level. The monitoring of anti-HBs and the serum markers of HBV infection in the same individual is conducive to the in-depth understanding of the protective effect of anti-HBs and the scientific evaluation of the risk of infection after HBV exposure.

Autophagy is a physiological process of normal cells that is activated in response to accumulation of abnormal proteins, damaged organelles, and cell starvation and involves their transport to lysosomes for degradation and recycling, enabling the mainte-nance of cellular homeostasis. Oncolytic viruses, which are obtained from naturally occurring or genetically modified viruses, specifical-ly target and kill tumor cells. Despite receiving much attention, the mechanisms underlying this process remain unclear, although re-cent studies have implicated autophagy in the phenomenon. Here we outline how oncolytic viruses cause cell death via autophagy and how they can be exploited for the treatment of cancer.

To investigate the clinical and pathological significance of melanin content and cyclin D1 expression in malignant melanoma. Methods: Melanin content and cyclin D1 expression were detected by immunohistochemical staining in one tissue micro-array containing 189 specimens of malignant melanoma between January 2001 and December 2014. Results: There were 76 cases (40.2%) of high melanin content among 189 malignant melanoma patients, and 80 cases (45.7%) of high expression of cyclin D1. The content of melanin was not correlated with the patients＇age, gender, tumor tissue source, and lymph node metastasis, but instead, it was correlated with tumor invasion depth (P=0.001) and clinical stage (P=0.038). The melanin content was much lower in advanced malignant melanoma (stageⅢandⅣor T3 and T4) than in non-advanced melanoma (stageⅠandⅡor T1 and T2). Regarding cyclin D1 expression, there was no significant difference in age, gender, invasion depth (T stage), clinical stage, lymph node metastasis, and tumor tissue source. Melanin content was negatively correlated with cyclin D1 expression in 58 cases of lymph node metastatic malig-nant melanoma (r=-0.271, P=0.039). Conclusions: Melanin content in melanoma tissues may be involved in the invasion, progression, and metastasis of malignant melanoma. The results will provide new evidence for the prognosis and pathological diagnosis of malig-nant melanoma.

Objective To observe the specific humoral and cellular immune response in BALB/c mice injected with pS and p18S. Methods pS and p18S were constructed separately by inserting HBsAg gene fragment and the fusion gene fragment of HBsAg and mouse interleukin 18(IL 18) into the reading frame of pcDNA3.1+. Mice were injected with either plasmid intramuscularly in a total dose of 300 ?g per mouse. Every serum sample was detected for anti HBs using enzyme linked immunosorbent assay(ELISA). Furthermore, HBsAg specific cytotoxic T lymphocytes activity was measured. Results The expression of HBsAg was demonstrated by ELISA in p815 cells transfected with pS and p18S. pS can stimulate a positive antibody response. The average level was 135 mIU/ml, with the highest level of 530 mIU/ml. p18S could elicit relatively lower antibody response which was 20 mIU/ml. HBsAg specific CTL activities were 37.1% and 34% separately in pS and p18S immunized mice. It was only 13.2% when detected in pcDNA3.1+ immunization. Conclusion pS is effective to stimulate a humoral and cellular response in H 2d mice. IL 18 gene can not enhance the immune response when fused with HBsAg gene. Conversely, it seems to inhibit an immune response.