1.Effect of Quercetin on Improving Myelin Sheath Injury and Neuropsychiatric Symptoms of VaD by Inhibiting Activation of Microglia in mPFC via RIPK1/NLRP3/Caspase-1 Pathway
Shiting LIANG ; Xinxian SHI ; Chen CHEN ; Xiaoxia FENG ; Jing QIU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(24):126-134
ObjectiveTo investigate the ameliorative effects of quercetin on neuropsychiatric symptoms associated with vascular dementia (VaD) and to elucidate the molecular mechanism, specifically whether quercetin inhibits pro-inflammatory activation of microglia by modulation of the receptor-interacting serine/threonine-protein kinase 1 (RIPK1)/NOD-like receptor protein 3 (NLRP3)/Caspase-1 signaling pathway, thereby promoting myelin repair in the medial prefrontal cortex (mPFC). MethodsA C57BL/6J mouse model of VaD with neuropsychiatric symptoms was established by bilateral common carotid artery stenosis (BCAS) combined with chronic restraint stress (CRS). Mice were randomly divided into a sham group, a model group, low-dose, medium-dose, and high-dose quercetin groups (30, 60, 120 mg·kg-1·d-1), and a fluoxetine group (10 mg·kg-1·d-1). After intervention, depressive- and anxiety-like behaviors were assessed by the sucrose preference test (SPT), forced swim test (FST), open field test (OFT), and elevated plus maze (EPM). mPFC tissue was collected. Immunofluorescence (IF) was used to detect myelin basic protein (MBP) expression and microglial morphology. Western blot was used to measure the protein level of MBP, myelin oligodendrocyte glycoprotein (MOG), myelin-associated glycoprotein (MAG), inducible nitric oxide synthase (iNOS), CD86, RIPK1, phosphorylated RIPK1 (Ser166), NLRP3, and Caspase-1. Enzyme-linked immunosorbent assay (ELISA) was used to determine the level of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and interleukin-1β (IL-1β). ResultsCompared with the sham group, the model group exhibited significant depressive- and anxiety-like behaviors (P<0.01), significantly decreased protein expression of MBP, MOG, and MAG in the mPFC (P<0.01), activated microglia (characterized by enlarged cell bodies, reduced protrusions, and upregulated iNOS and CD86 expressions, P<0.01), and significantly elevated p-RIPK1/RIPK1 ratio, NLRP3, Caspase-1 protein expression, and level of TNF-α, IL-6, and IL-1β (P<0.01, P<0.05). Compared with the model group, the quercetin treatment (especially at medium and high doses) significantly ameliorated these behavioral abnormalities (P<0.05, P<0.01), increased the expression of MBP (protein and fluorescence intensity), MOG, and MAG in the mPFC (P<0.05, P<0.01), suppressed excessive microglial activation (characterized decreased cell bodies, increased protrusions, and downregulated iNOS and CD86 expressions, P<0.01), and significantly reduced the p-RIPK1/RIPK1 ratio, NLRP3, Caspase-1 protein expression, and inflammatory cytokine levels (P<0.01). ConclusionQuercetin effectively alleviates neuropsychiatric symptoms in VaD mice. Its mechanism may be associated with the inhibition of microglial inflammatory activation mediated by the RIPK1/NLRP3/Caspase-1 signaling pathway, thereby promoting myelin repair in the mPFC region.
2.Multi-organ inflammatory phenotypes and transcriptomic characterization in an inflammation-driven mouse model of preeclampsia induced by LPS.
Ning WANG ; Jing-Qiu FENG ; Ying XIE ; Meng-Can SUN ; Qi WANG ; Zhe WANG ; Lu GAO
Acta Physiologica Sinica 2025;77(5):775-791
Preeclampsia (PE) is a severe gestational disorder characterized by hypertension and proteinuria, with a subset of cases exhibiting an immune-driven phenotype marked by placental overexpression of proinflammatory cytokines and chronic inflammatory damage, profoundly impacting fetal development. To elucidate the pathophysiology of this PE subtype, we established an inflammation-driven PE mouse model via lipopolysaccharide (LPS) intraperitoneal injection, systematically evaluating histopathological changes in maternal heart, liver, lung, kidney, and placenta, and integrating transcriptomic profiling to uncover molecular mechanisms. LPS administration robustly induced maternal hypertension and proteinuria, hallmarks of PE, without significantly altering organ or fetal weights. Histological analyses revealed pronounced inflammatory damage in the maternal lung, kidney, and placenta, with the lung exhibiting the most severe pathology, characterized by inflammatory cell infiltration, alveolar wall thickening, and interstitial edema-challenging the conventional focus on placental and renal primacy in PE. Placental labyrinth and junctional zones displayed extensive structural disruption and necrosis, indicating functional impairment. Transcriptomic analysis identified 27 inflammation-related genes consistently upregulated across tissues, with protein-protein interaction networks pinpointing Il1β, Il6, Ccl5, Ccl2, Cxcl10, Tlr2, and Icam1 as hub genes. Quantitative PCR validation confirmed Tlr2 as a central regulator, evidenced by significant upregulation of Tlr2 in lung, kidney, and placenta of LPS-induced PE mice, while Cxcl10 exhibited placenta-specific upregulation, suggesting a synergistic inflammatory axis in placental pathology. These findings highlight the lung as a critical, yet underappreciated, target in inflammation-driven PE, reframe the multi-organ inflammatory landscape of the disease, and nominate Tlr2 and Cxcl10 as potential diagnostic biomarkers and therapeutic targets, offering new avenues for precision intervention in PE.
Animals
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Female
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Pregnancy
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Mice
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Pre-Eclampsia/genetics*
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Inflammation
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Lipopolysaccharides/adverse effects*
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Disease Models, Animal
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Transcriptome
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Placenta/pathology*
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Phenotype
3.Identification of GSK3 family and regulatory effects of brassinolide on growth and development of Nardostachys jatamansi.
Yu-Yan LEI ; Zheng MA ; Jing WEI ; Wen-Bing LI ; Ying LI ; Zheng-Ming YANG ; Shao-Shan ZHANG ; Jing-Qiu FENG ; Hua-Chun SHENG ; Yuan LIU
China Journal of Chinese Materia Medica 2025;50(2):395-403
This study identified 8 members including NjBIN2 of the GSK3 family in Nardostachys jatamansi by bioinformatics analysis. Moreover, the phylogenetic tree revealed that the GKS3 family members of N. jatamansi had a close relationship with those of Arabidopsis. RT-qPCR results showed that NjBIN2 presented a tissue-specific expression pattern with the highest expression in roots, suggesting that NjBIN2 played a role in root growth and development. In addition, the application of epibrassinolide or the brassinosteroid(BR) synthesis inhibitor(brassinazole) altered the expression pattern of NjBIN2 and influenced the photomorphogenesis(cotyledon opening) and root development of N. jatamansi, which provided direct evidence about the functions of NjBIN2. In conclusion, this study highlights the roles of BIN2 in regulating the growth and development of N. jatamansi by analyzing the expression pattern and biological function of NjBIN2. It not only enriches the understanding about the regulatory mechanism of the growth and development of N. jatamansi but also provides a theoretical basis and potential gene targets for molecular breeding of N. jatamansi with improved quality in the future.
Brassinosteroids/metabolism*
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Steroids, Heterocyclic/metabolism*
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Gene Expression Regulation, Plant/drug effects*
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Plant Proteins/metabolism*
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Phylogeny
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Nardostachys/metabolism*
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Plant Growth Regulators/pharmacology*
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Plant Roots/drug effects*
4.Effect and mechanism of Xintong Granules in ameliorating myocardial ischemia-reperfusion injury in rats by regulating gut microbiota.
Yun-Jia WANG ; Ji-Dong ZHOU ; Qiu-Yu SU ; Jing-Chun YAO ; Rui-Qiang SU ; Guo-Fei QIN ; Gui-Min ZHANG ; Hong-Bao LIANG ; Shuai FENG ; Jia-Cheng ZHANG
China Journal of Chinese Materia Medica 2025;50(14):4003-4014
This study investigates the mechanism by which Xintong Granules improve myocardial ischemia-reperfusion injury(MIRI) through the regulation of gut microbiota and their metabolites, specifically short-chain fatty acids(SCFAs). Rats were randomly divided based on body weight into the sham operation group, model group, low-dose Xintong Granules group(1.43 g·kg~(-1)·d~(-1)), medium-dose Xintong Granules group(2.86 g·kg~(-1)·d~(-1)), high-dose Xintong Granules group(5.72 g·kg~(-1)·d~(-1)), and metoprolol group(10 mg·kg~(-1)·d~(-1)). After 14 days of pre-administration, the MIRI rat model was established by ligating the left anterior descending coronary artery. The myocardial infarction area was assessed using the 2,3,5-triphenyltetrazolium chloride(TTC) staining method. Apoptosis in tissue cells was detected by the terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling(TUNEL) assay. Pathological changes in myocardial cells and colonic tissue were observed using hematoxylin-eosin(HE) staining. The levels of tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), interleukin-6(IL-6), creatine kinase MB isoenzyme(CK-MB), and cardiac troponin T(cTnT) in rat serum were quantitatively measured using enzyme-linked immunosorbent assay(ELISA) kits. The activities of lactate dehydrogenase(LDH), creatine kinase(CK), and superoxide dismutase(SOD) in myocardial tissue, as well as the level of malondialdehyde(MDA), were determined using colorimetric assays. Gut microbiota composition was analyzed by 16S rDNA sequencing, and fecal SCFAs were quantified using gas chromatography-mass spectrometry(GC-MS). The results show that Xintong Granules significantly reduced the myocardial infarction area, suppressed cardiomyocyte apoptosis, and decreased serum levels of pro-inflammatory cytokines(TNF-α, IL-1β, and IL-6), myocardial injury markers(CK-MB, cTnT, LDH, and CK), and oxidative stress marker MDA. Additionally, Xintong Granules significantly improved intestinal inflammation in MIRI rats, regulated gut microbiota composition and diversity, and increased the levels of SCFAs(acetate, propionate, isobutyrate, etc.). In summary, Xintong Granules effectively alleviate MIRI symptoms. This study preliminarily confirms that Xintong Granules exert their inhibitory effects on MIRI by regulating gut microbiota imbalance and increasing SCFA levels.
Animals
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Gastrointestinal Microbiome/drug effects*
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Rats
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Male
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Myocardial Reperfusion Injury/genetics*
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Drugs, Chinese Herbal/administration & dosage*
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Rats, Sprague-Dawley
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Apoptosis/drug effects*
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Humans
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Tumor Necrosis Factor-alpha/metabolism*
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Interleukin-6/genetics*
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Malondialdehyde/metabolism*
5.Dimeric sesquiterpenoids with anti-inflammatory activities from Inula britannica.
Juan ZHANG ; Jiankun YAN ; Hongjun DONG ; Rui ZHANG ; Jing CHANG ; Yanli FENG ; Xinrong XU ; Wei LI ; Feng QIU ; Chengpeng SUN
Chinese Journal of Natural Medicines (English Ed.) 2025;23(8):961-971
In continuation of research aimed at identifying anti-inflammatory agents from natural sesquiterpenoids, an activity-guided fractionation approach utilizing lipopolysaccharide (LPS)-mediated RAW264.7 cells was employed to investigate chemical constituents from Inula Britannica (I. britannica). Seven novel sesquiterpenoid dimers inulabritanoids A-G (1-7) and two novel sesquiterpenoid monomers inulabritanoids H (8) and I (9) were isolated from I. britannica together with eighteen known compounds (10-27). The structural elucidation was accomplished through comprehensive analysis of 1D and 2D nuclear magnetic resonance (NMR), high-resolution mass spectrometry (HR-MS), and electronic circular dichroism (ECD) spectra, complemented by quantum chemical calculations. Compounds 1, 2, 12, 16, 19, and 26 demonstrated inhibitory effects on NO production, with IC50 values of 3.65, 5.48, 3.29, 6.91, 3.12, and 5.67 μmol·L-1, respectively. Mechanistic studies revealed that compound 1 inhibited IκB kinase β (IKKβ) phosphorylation, thereby blocking nuclear factor κB (NF-κB) nuclear translocation, and activated the kelch-like ECH-associated protein 1 (Keap1)/nuclear factor erythroid 2-related factor 2 (Nrf2) signal pathway, leading to decreased expression of NADPH oxidase 2 (NOX-2), inducible nitric oxide synthase (iNOS), tumor necrosis factor α (TNF-α), interleukin-6 (IL-6), monocyte chemotactic protein-1 (MCP-1), IL-1β, and IL-1α and increased expression of NAD(P)H: quinone oxidoreductase 1 (NQO-1) and heme oxygenase-1 (HO-1), thus exhibiting anti-inflammatory effects in vitro. These results indicate that dimeric sesquiterpenoids may serve as promising candidates for anti-inflammatory drug development.
Mice
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Animals
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Sesquiterpenes/isolation & purification*
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Anti-Inflammatory Agents/isolation & purification*
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Inula/chemistry*
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RAW 264.7 Cells
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Nitric Oxide
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Molecular Structure
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NF-kappa B/immunology*
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NF-E2-Related Factor 2/immunology*
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Macrophages/immunology*
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Nitric Oxide Synthase Type II/immunology*
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Plant Extracts/pharmacology*
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Lipopolysaccharides
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Tumor Necrosis Factor-alpha/immunology*
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I-kappa B Kinase/genetics*
6.Effect of Huanglian Jiedutang in Improving Brain Iron Metabolism Disorders, Myelin Damage, and Aggressive Behavior in VaD Mice via Regulation of FBXL5/IRP2
Xiaoxia FENG ; Chen CHEN ; Jing QIU ; Guang YANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(24):1-9
ObjectiveThis study aims to investigate the effect of Huanglian Jiedutang on brain iron metabolism disorders, myelin damage, and aggressive behavior in vascular dementia (VaD) mice by regulating the F-box leucine-rich repeat protein 5 (FBXL5)/iron regulatory protein 2 (IRP2) pathway. MethodSixty C57BL/6J mice were randomly divided into six groups: sham operation group, model group, risperidone group (2 mg·kg-1·d-1), and low-dose, medium-dose, and high-dose groups of Huanglian Jiedutang (0.25, 0.5, 1 g·kg-1·d-1), with 10 mice in each group. The VaD model was established by bilateral carotid artery stenosis (BCAS). Drug intervention was administered for two weeks starting from the seventh week. Behavioral assessments, including the touch escape and resident-intruder tests, were conducted in the ninth week. After the behavioral tests, ventromedial hypothalamus ventrolateral (VMHvl) tissue samples were collected. Western blot was used to detect the expression of myelin-associated glycoprotein (MAG), myelin oligodendrocyte glycoprotein (MOG), myelin basic protein (MBP), 4-hydroxynonenal (4-HNE), glutathione peroxidase 4 (GPX4), transferrin receptor 1 (TFR1), ferritin light chain (Ft-L), ferroportin 1 (FPN1), FBXL5, and IRP2. Immunofluorescence was used to measure MBP fluorescence intensity. Transmission electron microscopy was employed to observe ultrastructural changes in the myelin sheath. Perl's staining was used to detect tissue iron deposition. Malondialdehyde (MDA) and superoxide dismutase (SOD) levels were measured by enzyme linked immunosorbent assay (ELISA). ResultCompared to the sham operation group, the model group exhibited a significant increase in biting, aggression, and irritability scores, along with a reduced latency of the attack (P<0.01). The expression levels of MAG, MOG, and MBP, as well as the fluorescent density of MBP, were significantly decreased (P<0.01). Disordered myelin ultrastructure, increased Ft-L and TFR1 expression, decreased FPN1 expression, and elevated iron deposition were observed (P<0.01). Antioxidants GPX4 and SOD were reduced, while 4-HNE and lipid peroxidation product MDA were increased (P<0.01). FBXL5 protein expression decreased, and IRP2 protein expression increased (P<0.01). Compared with the model group, in the middle-dose and high-dose groups of Huanglian Jiedutang and the risperidone group, the number of bites, aggressive behaviors, and irritability scores were reduced (P<0.05, P<0.01), while the latency of the attack increased (P<0.01). In the middle-dose and high-dose groups of Huanglian Jiedutang, the expression levels of MAG, MOG, and MBP, as well as MBP immunofluorescence increased (P<0.01). The ultrastructure was orderly arranged. Ft-L and TFR1 expression decreased; FPN1 expression increased, and iron deposition was reduced (P<0.01). GPX4 and SOD expression levels increased, and 4-HNE and MDA expression levels decreased (P<0.01). FBXL5 protein expression increased, and IRP2 protein expression decreased (P<0.01). ConclusionHuanglian Jiedutang may alleviate brain iron metabolism disorders, myelin damage, and aggressive behavior in VaD mice by regulating FBXL5/IRP2 expression in the VMHvl region.
7.Clinical Characteristics Analysis of EBV-associated Hemophago-cytic Lymphohistiocytosis Patients with Acute Kidney Injury
Meng-Ya ZHAO ; Yu QIU ; Jing-Feng LIU ; Dong-Chen GUO ; Jin LIN
Journal of Experimental Hematology 2024;32(4):1248-1257
Objective:To analyze the clinical characteristics of patients with Epstein-Barr virus(EBV)-associated hemophagocytic lymphohistiocytosis(HLH)with acute kidney injury(AKI).Methods:EBV-HLH patients who were hospitalized in our hospital from January 2014 to December 2020 were collected,and their clinical characteristics,treatment,concurrent acute kidney injury and prognosis were retrospectively analyzed.Results:In this study,the incidence of AKI complicated by EBV-HLH was 65.5%,and the 28-day mortality rate was 15.3%.Compared with non-AKI group,patients in the AKI group had higher levels of bilirubin,lactate dehydrogenase,creatinine,urea nitrogen,and β2-microglobulin(β2-MG),poorer coagulation,and lower soluble IL-2 receptor(sCD25).Patients in the AKI group had a higher proportion of chemotherapy,transplantation,mechanical ventilation,and the application of vasoactive medications,and were hospitalized for longer periods of time,with higher in-hospital mortality rates and 28-day mortality rates.Patients in the AKI group were analyzed in subgroups according to the Kidney Disease Improving Global Outcomes(KDIGO)classification,and the levels of leukocytes,bilirubin,albumin,creatinine,urea nitrogen,β2-MG,activated partial thromboplastin time(APTT),and prothrombin time activity(PTA)were more responsive to the severity of the patient's condition.KDIGO grade 2 and 3 had higher proportions of receiving transplants,diuretics,organ support(mechanical ventilation,application of vasoactive medications,and renal replacement therapy),and admissions to the intensive care unit(ICU),and with higher in-hospital mortality rates and 28-day mortality rates.Regression analysis found that creatinine,β2-MG,APTT,transplantation,and chemotherapy were independent risk factors for the development of AKI;the application of vasoactive drugs was both an independent risk factor for the development of AKI and for death at 28 days;and chemotherapy,length of hospitalization,and HGB and fibrinogen levels were protective factors for death at 28 days.Conclusion:AKI in EBV-HLH has high incidence and high rate of progression to severe disease and death,early attention should be given and strengthened in order to carry out early treatment and improve the prognosis of patients.
8.A randomized positive parallel-controlled clinical study of Dibai Yijing Formula for the treatment of male infertility with essence deficiency in the kidney and damp-heat type in the essence chamber
Shuang WU ; Chao-Qian CHEN ; Yun-Zhi LI ; Qiu-Jian FENG ; Hui LÜ ; Xiao-Jing AN ; Jun GUO
National Journal of Andrology 2024;30(11):1019-1024
Objective:This study aims to evaluate the clinical efficacy and safety of Dibai Yijing Formula(DYF)in the treat-ment of male infertility with essence deficiency in the kidney and damp-heat in the essence chamber(Abbreviation:kidney deficiency and damp-heat type).Methods:This study employed a randomized,controlled clinical trial design,recruiting 72 male patients with infertility due to kidney deficiency and damp-heat type.Patients were randomly assigned to an treatment group(36 patients)and a control group(36 patients)using a random number table.The control group received oral Clomiphene Citrate Capsules(50 mg,twice daily),while the treatment group received oral DYF(one dose daily,200 ml each time,30 minutes after breakfast and dinner).Both groups underwent a 12-week treatment period.After treatment,sperm concentration(SC),percentage of progressively motile sperms(PR),total sperm motility[PR+percentage of non-progressively motile sperms(NP)],and semen volume(SV)were compared between the two groups before and after treatment.Additionally,the total score of Traditional Chinese Medicine(TCM)syndrome score and sperm DNA fragmentation index(DFI)and pregnancy outcomes of the patients'spouses were compared between the two groups.Results:Three patients dropped out from the treatment group and four from the control group.There were no statistically sig-nificant differences in semen parameters between the two groups(P>0.05).After treatment,the patients in the treatment group showed significant difference in the percentage of SC([19.42±5.30]x 106/ml vs[10.75±2.41]x 106/ml),PR([27.72±6.62]%vs[20.04±4.10]%),PR+NP([49.86±10.68]%vs(33.74±5.58)%],DFI([12.33±3.43]%vs[15.06±3.98]%)and TCM symtom score([7.45±1.82]vs[13.85±1.91]),and the difference was statistically significant(P<0.05).The patients in the control group showed significant difference in the percentage of SC([19.56±5.24]× 106/ml vs[11.31±2.08]× 106/ml)and TCM symptom score([12.81±1.86]vs[14.06±1.64]).But no significant changes were observed in the PR([21.75±5.93]%vs[20.05±4.67]%),PR+NP([34.23±7.15]%vs[32.35±4.09]%),SV([3.19±1.08]ml vs[3.12±1.13]ml),and DFI([15.11±4.76]%vs[15.51±4.35]%)were not statistically significant(P>0.05).Improve-ments in PR,PR+NP,TCM symptom score and DFI in the treatment group were better than those in the control group after treatment(P<0.05);the differences in SC and SV and spousal pregnancy in the treatment group were not statistically significant compared with those in the control group(P>0.05).No serious adverse events occurred in both groups during the treatment period.Conclusion:The treatment of male infertility with DYF is effective and safe.
9.Clinical and imaging analysis of COVID-19-related osmotic demyelination syndrome
Yuyue QIU ; Chenhui MAO ; Jialu BAO ; Li SHANG ; Tianyi WANG ; Bo LI ; Yixuan HUANG ; Yuhan JIANG ; Shanshan CHU ; Wei JIN ; Liling DONG ; Feng FENG ; Jing GAO
Chinese Journal of Neurology 2024;57(7):763-769
Objective:To analyze the clinical and imaging features of patients with COVID-19-related osmotic demyelination syndrome (ODS).Methods:COVID-19-related ODS cases diagnosed in the Department of Neurology, Peking Union Medical College Hospital from January 2020 to September 2023 were retrospectively reviewed. And their past medical history, possible triggers, clinical manifestations, imaging manifestations, treatment and prognosis were summarized.Results:A total of 5 patients with COVID-19-related ODS were included. Electrolyte disturbances acted as an inducement of ODS in all patients (5/5),4 of whom with hyponatremia. Four of 5 patients first presented with disturbance of consciousness, followed by predominant dystonia. Imaging of all patients (5/5) showed isolated extrapontine myelinolysis (EPM). With the prolongation of the course of disease, such signal intensity could return to normal, and lesions showed atrophic changes in some patients. The patients′ clinical symptoms were partly relieved within a few days to a few months after treatment.Conclusions:COVID-19-related ODS is mostly associated with hyponatremia, and EPM is more common. COVID-19 should be considered as a risk factor for ODS.
10.Efficacy and safety of tenofovir amibufenamide in the treatment of patients over 65 years of age with chronic hepatitis B
Sasa CHU ; Xing LIU ; Cheng XU ; Guozheng QIU ; Yao XU ; Jing DENG ; Meili FU ; Yulong PENG ; Feng GAO
Chinese Journal of Hepatology 2024;32(10):904-909
Objective:To investigate the efficacy and safety of tenofovir amibufenamide in patients over 65 years old with chronic hepatitis B and liver cirrhosis.Methods:We recruited 45 patients in Linyi People's Hospital with chronic hepatitis B and liver cirrhosis who were treated with TMF antiviral therapy for 48 weeks, compared the virologic response rate and HBV DNA decrease level at 12, 24 and 48 weeks, and the changes in hepatitis B surface antigen, alanine aminotransferase, glomerular filtration rate, creatinine, triglycerides, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, serum phosphorus and blood lipids, and the changes in ALT normalization rate at 48 weeks. P<0.05 was statistically significant. Results:The age of the enrolled patients was 69.0 (67.0, 72.5) years. At 12, 24, and 48 weeks of treatment, the complete virological response rates were 32.4% (12/37), 70.0% (28/40), and 84.6% (33/39) respectively, and the level of HBV DNA decreased from baseline ( P<0.05). After 48 weeks of treatment, the level of HBsAg decreased ( P<0.05), and there was no negative HBsAg conversion and seroconversion. After 48 weeks of treatment, the level of ALT decreased ( P<0.05). At 48 weeks of treatment, the rates of ALT reverted to normality were 88.9% (16/18) and 70.4% (19/27), respectively. There was no significant difference in the levels of glomerular filtration rate, creatinine, phosphorus, triglycerides, total cholesterol, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol estimated at baseline before and after treatment ( P>0.05), and no serious adverse events were observed. Conclusions:For patients over 65 years old with chronic hepatitis B and liver cirrhosis, TMF can significantly inhibit HBV DNA replication, and the ALT normalization rate is high and well tolerated.

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