Objective:To explore the characteristics of portal vein thrombosis (PVT) formation in patients with hepatitis B cirrhosis and its effect on long-term prognosis.Methods:The clinical data of a cohort of patients with hepatitis B cirrhosis who visited Beijing Youan Hospital from May 2009 to August 2020 were retrospectively analyzed. Enhanced CT examination was used as the standard for diagnosing PVT and its classification. Patients with hepatitis B cirrhosis without PVT at baseline were selected as the research subjects. According to whether PVT was formed during the follow-up period, they were divided into the PVT and control groups including 99 and 168 patients in the PVT and control groups with a follow-up time of 52.0 (46.7, 57.3) months. The changes in baseline and endpoint clinical indicators of the two groups were compared. Kaplan-Meier survival curve, log-rank test, and Cox regression were used to analyze the effect of PVT on prognosis.Results:In the PVT group, 28.28% (28/99) of patients underwent splenectomy, and 74.75% (74/99) did not receive anticoagulation therapy. The main portal vein thrombosis, portal vein branch thrombosis, and thrombosis in both groups accounted for 34.34% (34/99), 23.23% (23/99), and 15.15% (15/99), respectively. The splenic vein or superior mesenteric vein accounted for 27.27% (27/99). PVT was stable in 63.27% (63/99), progressed in 31.31% (31/99), and relieved in 5.05% (5/99) during the follow-up period. The white blood cell, hemoglobin, and platelet counts were all decreased in the PVT group compared with the baseline ( P<0.05). The international normalized ratio (INR) [1.28 (1.14, 1.39) vs. 1.33 (1.19, 1.46), P=0.041] and spleen length [(163.84±30.68) mm vs. (177.26±32.61) mm, P<0.001] was increased compared with the baseline. The proportion of gastroesophageal variceal bleeding was higher in the PVT group than in the control group (57.0% vs. 28.7%, P<0.001), and the constituent ratio of hepatic encephalopathy was not statistically significantly different ( P>0.05). The proportion of patients with ascites in the control group decreased (63.1% vs. 41.7%, P<0.001), while the proportion of patients with ascites in the PVT group was not statistically significantly different ( P>0.05). The incidence of composite clinical endpoint events in the PVT and the control group was 21.21% (21/99) and 4.17% (7/168), respectively ( P＜0.05). The incidence of composite clinical endpoint events in PVT patients without anticoagulation and anticoagulation treatment was 25.68% (19/74) and 8.00% (2/25), respectively ( P=0.062). Cox regression analysis found that PVT formation was an independent risk factor for liver-related adverse events in patients with hepatitis B cirrhosis ( HR=9.36, 95% CI: 3.65～24.02, P=0.001). Conclusions:The presence of PVT in patients with hepatitis B cirrhosis is assoliated with worse prognosis. The formation of PVT is closely related to the increased risk of liver-related adverse prognosis in patients with hepatitis B cirrhosis.

Objective:To analyze the differences in routine blood tests and infection markers among elderly AIDS patients with other opportunistic infections, to explore their immune status and inflammatory responses, and to provide new molecular markers for clinical diagnosis.Methods:The study included general indicators, routine blood tests, and infection markers of older HIV patients with other opportunistic infections admitted to Beijing You'an Hospital, Capital Medical University, from January 1, 2014, to December 31, 2024.Statistical analysis was performed using SPSS 27.0 software, with a significance level set at P<0.05. Results:A total of 94 elderly AIDS patients with various opportunistic infections were included in this study.Among them, the majority were co-infected with tuberculosis, accounting for 60 cases(63.83%), followed by 23 cases(24.47%)of AIDS patients co-infected with syphilis.Additionally, there were 7 cases of AIDS co-infected with amoebiasis(7.45%)and 4 cases of AIDS co-infected with monkeypox(4.26%).Almost all cases of combined infections were male, with males comprising 91.3% of AIDS patients co-infected with syphilis and 100% in the other co-infected groups.There were 9 blood routine and infectious markers that exhibited significant differences between patients with HIV co-infected with tuberculosis and those with other opportunistic infections.These markers included lymphocytes(LYM), hemoglobin(HGB), erythrocyte sedimentation rate(ESR), C-reactive protein(CRP), procalcitonin(PCT), T lymphocytes, CD4 + T cells, CD8 + T cells, and the CD4/CD8 ratio( P<0.05).Specifically, the levels of LYM, HGB, T lymphocytes, CD4 + T cells, CD8 + T cells, and the CD4/CD8 ratio in elderly AIDS patients with tuberculosis were significantly lower than those in patients with other co-infections(all P<0.05).Conversely, the levels of inflammatory factors such as PCT, ESR, and CRP were notably higher in the former group(all P<0.05).The receiver operating characteristic(ROC)curve analysis revealed that when LYM was utilized as an individual indicator for the differential diagnosis between AIDS patients with tuberculosis and those with other opportunistic infections, the area under the curve(AUC)amounted to 0.832.However, the CRP/LYM ratio demonstrated the optimal diagnostic performance in differential diagnosis, with an AUC reaching 0.866. Conclusions:The immune function of elderly AIDS patients is further compromised following co-infection with tuberculosis, which is accompanied by a severe inflammatory response.The CRP/LYM ratio shows promise as a hematological molecular marker for differentiating between AIDS patients with tuberculosis and those with other opportunistic infections.

Objective:To analyze the differences in routine blood tests and infection markers among elderly AIDS patients with other opportunistic infections, to explore their immune status and inflammatory responses, and to provide new molecular markers for clinical diagnosis.Methods:The study included general indicators, routine blood tests, and infection markers of older HIV patients with other opportunistic infections admitted to Beijing You'an Hospital, Capital Medical University, from January 1, 2014, to December 31, 2024.Statistical analysis was performed using SPSS 27.0 software, with a significance level set at P<0.05. Results:A total of 94 elderly AIDS patients with various opportunistic infections were included in this study.Among them, the majority were co-infected with tuberculosis, accounting for 60 cases(63.83%), followed by 23 cases(24.47%)of AIDS patients co-infected with syphilis.Additionally, there were 7 cases of AIDS co-infected with amoebiasis(7.45%)and 4 cases of AIDS co-infected with monkeypox(4.26%).Almost all cases of combined infections were male, with males comprising 91.3% of AIDS patients co-infected with syphilis and 100% in the other co-infected groups.There were 9 blood routine and infectious markers that exhibited significant differences between patients with HIV co-infected with tuberculosis and those with other opportunistic infections.These markers included lymphocytes(LYM), hemoglobin(HGB), erythrocyte sedimentation rate(ESR), C-reactive protein(CRP), procalcitonin(PCT), T lymphocytes, CD4 + T cells, CD8 + T cells, and the CD4/CD8 ratio( P<0.05).Specifically, the levels of LYM, HGB, T lymphocytes, CD4 + T cells, CD8 + T cells, and the CD4/CD8 ratio in elderly AIDS patients with tuberculosis were significantly lower than those in patients with other co-infections(all P<0.05).Conversely, the levels of inflammatory factors such as PCT, ESR, and CRP were notably higher in the former group(all P<0.05).The receiver operating characteristic(ROC)curve analysis revealed that when LYM was utilized as an individual indicator for the differential diagnosis between AIDS patients with tuberculosis and those with other opportunistic infections, the area under the curve(AUC)amounted to 0.832.However, the CRP/LYM ratio demonstrated the optimal diagnostic performance in differential diagnosis, with an AUC reaching 0.866. Conclusions:The immune function of elderly AIDS patients is further compromised following co-infection with tuberculosis, which is accompanied by a severe inflammatory response.The CRP/LYM ratio shows promise as a hematological molecular marker for differentiating between AIDS patients with tuberculosis and those with other opportunistic infections.

Objective:To explore the characteristics of portal vein thrombosis (PVT) formation in patients with hepatitis B cirrhosis and its effect on long-term prognosis.Methods:The clinical data of a cohort of patients with hepatitis B cirrhosis who visited Beijing Youan Hospital from May 2009 to August 2020 were retrospectively analyzed. Enhanced CT examination was used as the standard for diagnosing PVT and its classification. Patients with hepatitis B cirrhosis without PVT at baseline were selected as the research subjects. According to whether PVT was formed during the follow-up period, they were divided into the PVT and control groups including 99 and 168 patients in the PVT and control groups with a follow-up time of 52.0 (46.7, 57.3) months. The changes in baseline and endpoint clinical indicators of the two groups were compared. Kaplan-Meier survival curve, log-rank test, and Cox regression were used to analyze the effect of PVT on prognosis.Results:In the PVT group, 28.28% (28/99) of patients underwent splenectomy, and 74.75% (74/99) did not receive anticoagulation therapy. The main portal vein thrombosis, portal vein branch thrombosis, and thrombosis in both groups accounted for 34.34% (34/99), 23.23% (23/99), and 15.15% (15/99), respectively. The splenic vein or superior mesenteric vein accounted for 27.27% (27/99). PVT was stable in 63.27% (63/99), progressed in 31.31% (31/99), and relieved in 5.05% (5/99) during the follow-up period. The white blood cell, hemoglobin, and platelet counts were all decreased in the PVT group compared with the baseline ( P<0.05). The international normalized ratio (INR) [1.28 (1.14, 1.39) vs. 1.33 (1.19, 1.46), P=0.041] and spleen length [(163.84±30.68) mm vs. (177.26±32.61) mm, P<0.001] was increased compared with the baseline. The proportion of gastroesophageal variceal bleeding was higher in the PVT group than in the control group (57.0% vs. 28.7%, P<0.001), and the constituent ratio of hepatic encephalopathy was not statistically significantly different ( P>0.05). The proportion of patients with ascites in the control group decreased (63.1% vs. 41.7%, P<0.001), while the proportion of patients with ascites in the PVT group was not statistically significantly different ( P>0.05). The incidence of composite clinical endpoint events in the PVT and the control group was 21.21% (21/99) and 4.17% (7/168), respectively ( P＜0.05). The incidence of composite clinical endpoint events in PVT patients without anticoagulation and anticoagulation treatment was 25.68% (19/74) and 8.00% (2/25), respectively ( P=0.062). Cox regression analysis found that PVT formation was an independent risk factor for liver-related adverse events in patients with hepatitis B cirrhosis ( HR=9.36, 95% CI: 3.65～24.02, P=0.001). Conclusions:The presence of PVT in patients with hepatitis B cirrhosis is assoliated with worse prognosis. The formation of PVT is closely related to the increased risk of liver-related adverse prognosis in patients with hepatitis B cirrhosis.

Objective:To investigate the effect of rehabilitation exercise combined with resistance training on the postoperative recovery and quality of life among patients with pulmonary nodules.Methods:A randomized controlled study was conducted on 90 patients with pulmonary nodules who underwent thoracoscopic resection of pulmonary nodules at Zhejiang Veteran Hospital between January 2022 and April 2023. Patients were randomly allocated into an observation group and a control group, with 45 patients in each group using the random number table method. The control group underwent routine rehabilitation exercise, whereas the observation group received resistance training combined with routine rehabilitation exercise. All patients were treated for 1 week. The incidence of postoperative complications and the changes in lung function, exercise endurance, and quality of life from baseline levels were compared between the two groups.Results:The incidence of postoperative complications in the observation group was significantly lower than that in the control group [6.7% (3/45) vs. 24.4% (11/45), χ2 = 5.41, P = 0.020). After intervention, the forced expiratory volume in 1 second, maximal voluntary ventilation per minute, and forced vital capacity in the observation group were (83.84 ± 4.35)%, (96.53 ± 3.45) L/min, and (2.87 ± 0.16) L, respectively, which were higher than those in the control group [(78.98 ± 4.01)%, (92.13 ± 3.08) L/min, (2.62 ± 0.19) L, t = -5.51, -6.38, -6.75, all P < 0.001]. Additionally, the modified Medical Research Council dyspnea score in the observation group was (0.42 ± 0.13) points, which was significantly lower than that in the control group [(0.87 ± 0.19) points, t = 13.11, P < 0.001). The modified Barthel index score in the observation group was significantly higher than that in the control group [(89.53 ± 3.67) points vs. (82.94 ± 4.23) points, t = -7.89, P < 0.001). Conclusion:The combination of rehabilitation exercise and resistance training can effectively enhance lung function, exercise endurance, and overall quality of life in patients with pulmonary nodules. Furthermore, this combined therapy markedly reduces postoperative complications.

Objective To investigate the virological features of patients with chronic hepatitis B(CHB)and metabolic associated fatty liver disease(MAFLD)through a stratified analysis.Methods A retrospective analysis was performed for 131 patients with CHB and MAFLD and 168 patients with CHB alone who underwent percutaneous liver biopsy and did not receive antiviral therapy or withdrew from drugs for more than 6 months in Beijing YouAn Hospital,Capital Medical University,from January 1,2013 to December 31,2019.The two groups were compared in terms of general data,biochemical parameters,and virological parameters.The patients in the two groups were stratified according to liver inflammation grade(G)and liver fibrosis stage(S),and the patients with CHB and MAFLD were further analyzed based on the degree of hepatic steatosis and NAFLD activity score(NAS).Virological features(the serum levels of HBV DNA and HBV HBsAg)were compared between groups.The Wilcoxon test was used for comparison of continuous data between two groups,and the Kruskal-Wallis H test was used for comparison between multiple groups and further comparison between two groups;the chi-square test was used for comparison of categorical data between two groups.Results Compared with the CHB group,the CHB+MAFLD group had a significantly higher proportion of male patients,a significantly higher proportion of patients with hypertension or type 2 diabetes mellitus,and significantly higher levels of the blood biochemical parameters of triglyceride,low-density lipoprotein cholesterol,apolipoprotein B,alanine aminotransferase,gamma-glutamyl transpeptidase,uric acid,and fasting blood glucose(all P<0.05),as well as significantly lower levels of high-density lipoprotein cholesterol,apolipoprotein A1,and HBV DNA(all P<0.05).The stratified analysis based on liver fibrosis stage showed that for both the patients with CHB alone and those with CHB and MAFLD,the significant fibrosis(S2—4)group had a significantly lower level of HBV DNA than the non-significant fibrosis(S0—1)group(P<0.05),and for the patients with CHB alone,the significant fibrosis(S2—4)group had a significantly lower level of HBsAg than the non-significant fibrosis(S0—1)group(P<0.05).The stratified analysis based on inflammation grade showed that for the patients with CHB and MAFLD,the high inflammation grade(G3)group had a significantly higher level of HBV DNA than the low inflammation grade(G1—2)group(P<0.05),and in the low inflammation grade(G1—2)group,the patients with CHB and MAFLD had a significantly lower level of HBsAg than the patients with CHB alone(P<0.05).The stratified analysis based on the degree of hepatic steatosis showed that the level of HBV DNA gradually decreased with the increase in the degree of steatosis,and the severe steatosis group had a significantly lower level of HBV DNA than the mild group(P<0.05),while there was no significant difference in HBsAg level between the groups with different degrees of hepatic steatosis(P>0.05).The stratified analysis based on NAS score showed that the NAS≥4 group had significantly higher levels of HBV DNA and HBsAg than the NAS<4 group(both P<0.05).Conclusion Patients with CHB and MAFLD have significant abnormalities in metabolic markers and aminotransferases,while virological indicators show different features in stratified analyses based on various indicators.

Objective As important components in the microenvironment of hepatocellular carcinoma(HCC),hepatic stellate cells(HSCs)and hydrogen sulfide(H2S)participate in various biological processes that regulate the development and progression of HCC.Through the co-culture of HSCs and HCC cells,this article aims to investigate the role and mechanism of HSCs in regulating the apoptosis of HCC cells by secreting H2S.Methods The HSC cell line(LX-2)and HCC cell lines(HepG2 and PLC/PRF/5)were used for experiment.RT-qPCR and Western Blot(WB)were used to measure the mRNA and protein expression levels of cystathionine γ-lyase(CSE),a key synthase for H2S;ELISA was used to measure the concentration of H2S in supernatant;next-generation sequencing,cell immunofluorescence assay,chromatin immunoprecipitation(ChIP),and WB were used to measure the JNK/JunB-TNFSF14 signaling pathway genes,binding sites,and related proteins after HepG2 cells were treated by H2S.LX-2 cells were co-cultured with HepG2 or PLC/PRF/5 cells in a Transwell chamber;CCK-8 assay and flow cytometry were used to measure the viability and apoptosis of HCC cells,and WB was used to measure the H2S-TNFSF14 signaling pathway-related proteins.All cell experiments were repeated three times.The independent-samples t test was used for comparison of continuous data between two groups;a one-way analysis of variance or the analysis of variance with repeated measures was used for comparison between multiple groups,and the Dunnett-t test was used for further comparison between two groups.Results LX-2 cells synthesized H2S mainly through CSE,and the concentration of H2S in supernatant of LX-2 cells gradually increased over time(22.89±0.08 pg/mL vs 28.29±0.15 pg/mL vs 36.19±1.90 pg/mL,F=79.63,P<0.05).In LX-2 cells,the mRNA expression level of CSE was significantly higher than that of CBS and MPST(1.008±0.13 vs 0.320±0.014 vs 0.05±0.02,F=80.84,P<0.05).When CSE was inhibited by PPG,the concentration of H2S decreased with the increase in the concentration of PPG(P<0.05).LX-2 cells were co-cultured with HepG2 or PLC/PRF/5 cells,and over the time of culture,there were significant reductions in the viability of HepG2 cells(87.48%±0.82%vs 70.48%±0.641%vs 52.89%±0.57%vs 45.20%±0.69%,F=1 517.13,P<0.001)and PLC/PRF/5 cells(92.41%±0.48%vs 74.10%±0.73%vs 53.70%±0.60%vs 44.00%±0.27%,F=2626.21,P<0.001)and significant increases in the apoptosis of HepG2 cells(12.88%±0.64%vs 15.5%±0.16%vs 18.43%±0.37%vs 13.01%±0.58%,F=142.15,P<0.001)and PLC/PRF/5 cells(8.51±0.05 vs 12.80±0.33 vs 15.59±0.21 vs 10.72±0.30,F=676.40,P<0.001),with the most significant changes on day 3.Next-generation sequencing showed that endogenous H2S and NaHS(endogenous H2S donor)were involved in regulating the expression of various genes in HepG2 cells.By releasing H2S,NaHS and LX2 activated the JNK/JunB signaling pathway and upregulated the expression of the apoptosis gene TNFSF14 in HCC cells,with increased binding between p-JunB and the transcriptional regulatory regions of the TNFSF14 gene.Conclusion In the microenvironment of HCC,HSCs activate the JNK/JunB signaling pathway in HCC cells through the signal molecules CSE/H2S,and there is an increase in the expression of TNFSF14,thereby promoting the apoptosis of HCC cells.

Extrahepatic non-cirrhotic portal hypertension(NH-PH),a disease of portal hypertension repre-sented by extrahepatic non-cirrhotic portal vein thrombosis and budd-chiari syndrome,both of which are caused by splanchnic vein thrombosis and share a variety of common genetic susceptibility factors.The review summarized the research progress on genetic susceptibility to thrombotic NH-PH in recent decades,collating the reported genetic susceptibility genes and their mutation loci,as well as suggesting other potential gene tar-gets.The results of the study provided screening targets for subsequent large-sample validation in clinic,and delivered new ideas for the development of early diagnostic methods and pathogenesis of NH-PH.

OBJECTIVE To analyze the influential factors of cardioto xicity in patients with positive breast cancer of human epidermal growth factor receptor 2（HER-2）treated by trastuzumab combined with chemotherapy. METHODS From April 2017 to January 2021，200 HER-2 positive breast cancer patients receiving pirarubicin + cyclophosphamide combined with sequential paclitaxel+trastuzumab were collected from our hospital. According to the presence or absence of cardiotoxicity ，the patients were divided into cardiotoxicity group and non-cardiotoxicity group. The clinical data and echocardiographic results of the patients were collected，and the influential factors of cardiotoxicity were analyzed. RESULTS Among 200 patients，43 patients suffered from cardiotoxicity with the incidence of 21.5％. The proportion of patients with cardiotoxicity during pirarubicin+cyclophosphamide therapy accounted for 5.5％（11/200），and the proportion of patients with cardiotoxicity during sequential paclitaxel+trastuzumab therapy accounted for 20.5％（41/200）；the latter was significantly higher than the former （P＜0.01）. At the same time ，the decrease of left ventricular ejection fraction during sequential therapy of paclitaxel and trastuzumab was significantly higher than that during pirarubicin+cyclophosphamide therapy [ 14％（12％，17％）vs. 7％（3％，10％），P＜0.001]. Compared with patients without cardiotoxicity ，the proportion of patients with cardiotoxicity with a history of hyperlipidemia was significantly higher （P＜ 0.01），while the proportion of patients receiving dexrazoxane was significantly lower （P＜0.01）. Results of binary Logistic regression analysis showed that the history of hyperlipidemia [OR ＝3.672，95％ CI（1.499，8.992），P＝0.004] and the use of dextrazoxane [OR ＝0.154，95％ CI（0.072，0.330）， P＜0.001] were associated with the occurrence of cardiotoxicity. CONCLUSIONS Hyperlipidemia is an independent risk factor for cardiotoxicity induced by pirarubicin + cyclophosphamide combined with sequential paclitaxel+trastuzumab in HER 2 positive breast cancer patients ，while the use of dextrazoxane is a protective factor.