ObjectiveTo investigate the efficacy of sequential tenofovir alafenamide fumarate （TAF） therapy versus the regimen of entecavir （ETV） combined with TAF in chronic hepatitis B （CHB） patients experiencing low-level viremia （LLV） after ETV therapy， as well as their impact on virologic response， liver and renal function， and blood lipid levels. MethodsA total of 217 CHB patients with LLV after ETV treatment who were admitted to Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from May 2020 to December 2023 were enrolled， and according to the treatment regimen， they were divided into TAF group （180 patients receiving sequential TAF therapy） and combined group （37 patients receiving ETV+TAF therapy）. The propensity score matching （PSM） method was used to match the patients at a ratio of 1∶1， and finally 37 patients were included in each group to balance the baseline confounding factors. The two groups were compared in terms of hepatitis B virus DNA （HBV DNA） clearance rate， hepatitis B envelope antigen （HBeAg） clearance rate， liver and renal function parameters （liver stiffness measurement ［LSM］， platelet count ［PLT］， aspartate aminotransferase ［AST］， alanine aminotransferase ［ALT］， and creatinine ［Cr］）， blood lipid levels （total cholesterol ［TC］， triglyceride ［TG］， high-density lipoprotein cholesterol ［HDL-C］， and low-density lipoprotein cholesterol ［LDL-C］）， and the incidence rate of adverse reactions. 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； the chi-square test was used for comparison of categorical data between groups. ResultsAfter 48 weeks of treatment， compared with the TAF group， the combined group had significantly higher HBV DNA clearance rate （86.49% vs 59.46%， χ²=6.852， P=0.009） and HBeAg clearance rate （59.46% vs 35.14%， χ²=4.391， P=0.036）. After treatment， compared with the TAF group， the combined group had significantly lower levels of LSM （7.01±1.50 kPa vs 7.90±1.68 kPa， t=2.404， P=0.019）， AST （18.02±2.28 U/L vs 21.12±2.85 U/L， t=5.166， P<0.001）， and ALT （19.85±3.86 U/L vs 22.00±3.90 U/L， t=2.383， P=0.020） and significantly higher levels of PLT ［（218.35±42.60）×10⁹/L vs （192.82±44.13）×10⁹/L， t=2.532， P=0.014］ and Cr （70.92±6.54 μmoL/L vs 67.60±6.13 μmoL/L， t=2.253， P=0.027）. After treatment， there was a slight increase in the level of TC in both the TAF group （5.60±0.89 mmol/L vs 5.18±0.85 mmol/L， t=2.076， P=0.041） and the combined group （5.45±0.80 mmol/L vs 5.02±0.83 mmol/L， t=2.269， P=0.026）. There was no significant difference in the incidence rate of adverse reactions between the TAF group and the combined group （21.62% vs 18.92%， χ²=0.084， P=0.772）. ConclusionFor ETV-treated CHB patients experiencing LLV， compared with sequential TAF therapy， the ETV+TAF combined therapy can effectively increase virologic response rate， alleviate liver fibrosis， and improve liver function， whereas sequential TAF therapy has less impact on renal function. Sequential or combined therapy with TAF may induce a slight increase in the level of TC， which should be taken seriously in clinical practice.

ObjectiveTo investigate the liver-protecting and anti-liver fibrosis effects of astragaloside Ⅳ （AS-Ⅳ） in vitro and in vivo， as well as its mechanism of action in intervention against liver fibrosis. MethodsIn the animal experiment， C57BL/6J mice were divided into control group， model group， low-dose AS-Ⅳ （20 mg/kg） group， and high-dose AS-Ⅳ （80 mg/kg） group. The mice were given intraperitoneal injection of carbon tetrachloride for 6 weeks to induce liver fibrosis， and since week 3 of injection， the mice in the low-dose AS-Ⅳ group and the high-dose AS-Ⅳ group were given AS-Ⅳ by gavage at a dose of 20 mg/kg and 80 mg/kg， respectively. The serum levels of alanine aminotransferase （ALT） and aspartate aminotransferase （AST） were measured after 4 weeks of administration， as well as the serum levels of hyaluronic acid （HA）， laminin （LN）， procollagen Ⅲ N-terminal peptide （PⅢNP）， and collagen type Ⅳ （Col-Ⅳ）. HE staining， picrosirius red staining， and Masson staining were used to observe liver histopathology and collagen deposition； RT-qPCR was used to measure the mRNA expression levels of Acta2， Col1a1， and Col3a1 in liver tissue， and Western blot was used to measure the protein expression levels of α-smooth muscle actin （α-SMA）， collagen type Ⅲ （Col-Ⅲ）， phosphatidylinositol 3-kinase （PI3K）， phosphorylated PI3K （pPI3K）， protein kinase B （Akt）， and phosphorylated AKT （p-Akt） in liver tissue； transcriptome sequencing was performed for liver tissue to identify differentially expressed genes and perform a bioinformatics analysis. In the cell experiment， transforming growth factor-β （TGF-β） was used to induce the activation of LX-2 cells， and the PI3K inhibitor LY294002 and the PI3K activator 740 Y-P were used for intervention. The cells were divided into control group， model group， AS-Ⅳ group， LY294002 group， and AS-Ⅳ+740 Y-P group， and the cells were harvested after 36 hours of intervention. Changes in the protein expression levels of α-SMA， Col-Ⅲ， pPI3K/PI3K， and pAkt/Akt in LX-2 cells were measured， as well as changes in the relative mRNA expression levels of Acta2， Col1a1， and Col3a1. A one-way analysis of variance was used for comparison of continuous data between multiple groups， and the least significant difference t-test was used for further comparison between two groups. ResultsIn the animal experiment， compared with the model group， the AS-Ⅳ treatment group had significant reductions in the serum levels of ALT， AST， HA， LN， PⅢNP， and Col-Ⅳ （all P<0.01）， the mRNA expression levels of Acta2， Col1a1， and Col3a1 in liver tissue （all P<0.05）， and the protein expression levels of α-SMA， Col-Ⅲ， pPI3K， and pAkt （Ser473） in liver tissue （all P<0.05）. In the cell experiment， compared with the control group， the model group had significant increases in the protein expression levels of α-SMA， Col-Ⅲ， pPI3K， and pAkt （Ser473） after TGF-β induction （all P<0.05）； compared with the model group， the AS-Ⅳ group had significant reductions in the protein expression levels of α-SMA， Col-Ⅲ， pPI3K， and pAkt （Ser473） （all P<0.05）， and both the AS-Ⅳ group and the LY294002 group had significant reductions in the protein expression level of pPI3K and the relative mRNA expression levels of Acta2， Col1a1， and Col3a1 （all P<0.05）. Compared with the AS-Ⅳ group， there were significant increases in the protein expression level of pPI3K and the relative mRNA expression levels of Acta2， col1a1， and Col3a1 after 740 Y-P intervention （all P<0.05）. ConclusionAS-Ⅳ can inhibit hepatic stellate cell activation and improve liver fibrosis， possibly by inhibiting the PI3K/Akt signaling pathway.

Objective To investigate the effect of APOE4 in regulating LRP1 and on β-amyloid protein Aβ25-35-induced oxidative stress and inflammatory response in astrocytes.Methods Human astrocytes were transfected with sh-NC,sh-APOE4,pcDNA-NC,and pcDNA-LRP1,and then induced with 10 μM Aβ25-35 for 24 h to establish an AD cell model.The roles of APOE4 and LRP1 in Aβ25-35-induced oxidative stress and inflammatory response were assessed using Western blot,flow cytometry,the detection kits of MDA,SOD,and GSH,as well as enzyme-linked immunosorbent assay(ELISA)kits for TNF-α,IL-6,and IL-1β.The protein-protein interaction between APOE4 and LRP1 was detected through co-immunoprecipitation and western blot experiments.Results Aβ25-35 induction upregulated APOE4 expression(P<0.01),promoted the levels of ROS(P<0.001),MDA(P<0.001),and inflammatory cytokines TNF-α,IL-6,and IL-1β(P<0.001)in astrocytes,while inhibited the expression of SOD,GSH,and LRP1(P<0.001).Knockdown of APOE4 or overexpression of LRP1 suppressed the Aβ25-35-induced increase in ROS,oxidative stress markers,and inflammatory cytokines in cells(P<0.05).APOE4 negatively regulated LRP1 protein expression through protein-protein interactions.The levels of ROS,MDA,and inflammatory cytokines were higher(P<0.05),and the concentrations of SOD and GSH were lower(P<0.001),in cells with simultaneous knockdown of APOE4 and LRP1 compared to those with APOE4 knockdown alone.Conclusion Knockdown of APOE4 attenuates Aβ25-35-induced oxidative stress and inflammatory response in astrocytes by upregulating LRP1.

Objective:To understand the functional requirements and suggestions of relevant stakeholders on the Internet platform for remote rehabilitation management of patients after arthroscopy, so as to provide a reference basis for building a home rehabilitation management scheme and developing a remote Internet platform.Methods:Based on the technology acceptance model, a descriptive qualitative study was conducted using purposive sampling and maximum difference method to select 11 arthroscopic postoperative patients, 4 patient caregivers, and 7 clinical professionals from the Sports Medicine Department of Wuxi Ninth People′s Hospital (Orthopaedic Hospital) from October to December 2022. A total of 22 stakeholders were interviewed in a semi-structured manner, and the Colaizzi was used to analyze the interview data.Results:Among 22 interviewers, 12 males, 10 females, aged 25-65 years. A total of four topics were summarized: the willingness to use the Internet platform for remote rehabilitation management, the demand for the content provided by the Internet platform for remote rehabilitation management, the demand for the module functions of the Internet platform for remote rehabilitation management, and the demand for the operability of the Internet platform for remote rehabilitation management.Conclusions:The general attitude of the stakeholder groups towards the use of the Internet platform for remote rehabilitation management of patients after arthroscopy is positive. It is hoped that the platform will have diversified functions and good usability, improve the compliance and enthusiasm of patients in home rehabilitation exercise, and thus promote the recovery of limb function.

Objective:To understand the functional requirements and suggestions of relevant stakeholders on the Internet platform for remote rehabilitation management of patients after arthroscopy, so as to provide a reference basis for building a home rehabilitation management scheme and developing a remote Internet platform.Methods:Based on the technology acceptance model, a descriptive qualitative study was conducted using purposive sampling and maximum difference method to select 11 arthroscopic postoperative patients, 4 patient caregivers, and 7 clinical professionals from the Sports Medicine Department of Wuxi Ninth People′s Hospital (Orthopaedic Hospital) from October to December 2022. A total of 22 stakeholders were interviewed in a semi-structured manner, and the Colaizzi was used to analyze the interview data.Results:Among 22 interviewers, 12 males, 10 females, aged 25-65 years. A total of four topics were summarized: the willingness to use the Internet platform for remote rehabilitation management, the demand for the content provided by the Internet platform for remote rehabilitation management, the demand for the module functions of the Internet platform for remote rehabilitation management, and the demand for the operability of the Internet platform for remote rehabilitation management.Conclusions:The general attitude of the stakeholder groups towards the use of the Internet platform for remote rehabilitation management of patients after arthroscopy is positive. It is hoped that the platform will have diversified functions and good usability, improve the compliance and enthusiasm of patients in home rehabilitation exercise, and thus promote the recovery of limb function.

OBJECTIVE To study the effect of fluticasone on proliferation of adenoidal cell of children with adenoidal hypertrophy in vitro,and study its correlation with dose.METHODS Dissociated adenoids lymphocytes harvested intra-operatively from 36 children with adenoidal hypertrophy were cultured in control medium (CO),or incubated with different fluticasone dose (10-9-10-12) mol/L.Proliferation was evaluated via measurement of the absorbency.RESULTS The mean absorbency were difference among different groups(P＜0.0001),and were also different between every 2 groups (P＜0.05) except 10-9 versus 1010 mol/L group(P＞0.05).CONCLUSION Fluticasone can inhibit the proliferation of adenoidal cell in vitro and it shows dose dependent.

Objective: A marked deficiency of glutamine in clinical critical illness is correlated with mortality in the intensive care unit, and intestinal glutamine transport was reported to be impaired in late sepsis. Berberine was reported to protect against the intestine injury, and improve the survival rate in sepsis. We designed this study to gain further knowledge of the intestinal glutamine transport in early and late sepsis, and to find out whether beberine pretreatment has some effect on glutamine transport in sepsis. Methods: Berberine (50 mg/kg) was given intragastrically once a day for 5 days, and sepsis was induced by cecal ligation and puncture on day 5. The small intestinal samples were collected at 0, 2, 6, 12, 24 h. Intestinal brush border membrane vesicles were prepared by Mg~(2+) aggregation-differential centrifugation techniques, and brush border glutamine transport was studied by a rapid filtration technique. Results: Under control condition, Na~+-dependent glutamine transport accounted for about 90% of the total transport. The relative contributions of ATA2, ATB~(0,+), B~0AT1 were about 12, 25, 63%, respectively. Septic rats showed an early increase and a late decrease in intestinal glutamine transport. ATA2 had an earlier increase in the early stage, while B0AT1 had no significant increase. Berberine pretreated group had a relative less increase in early phase and a less decrease in late phase compared to sepsis group. Conclusion: Rat intestinal glutamine transport showed an early increase and a late decrease in sepsis, and berberine pretreatment could attenuate the impairment of glutamine transport in sepsis. It may provide some information for sepsis treatment.

Objective: To investigate the potential role and our experience of perioperative nutritional support in the management of patients with Crohn's disease (CD).Methods: 150 CD patients (male to female=101:49) performed with operation and from the year 1997 to 2007 were analyzed retrospectively. Their nutritional index, Crohn's Disease Activity Index (CDAI), sites of lesion, causes and procedures of operation, usage of nutritional support pre-operatively and post-operatively, and operation-related complications were all recorded.Results: Malnutrition, as indicated as BMI<18.5 kg/m2 or decrease of body weight>10% over the recent 3 months,occurred in 130 patients (88.67%)on admission.After aggressive nutritional support,patients' nutritional index, such as blood haemoglobin, serum albumin, pre-albumin, transferrin and lymphocytes counts all increased significantly pre-operatively and on discharge compared with on admission, while the change of BMI was not significant. For 53 patients receiving home enteral nutrition after discharge, their BMI increased significantly on last follow-up compared with on admission (19.24 vs 17.64, P<0.001). Operation-related complications occurred in 14 patients (9.33%), and two of them died due to severe intra-abdominal infections. Two patients with severe retroperitoneal infection on admission were successfully treated using the damage-control surgery.Conclusion: Malnutrition is a common complication in CD patients receiving surgery, and aggressive perioperative nutritional support may have a positive effect on the morbidity and mortality in such patients. Long-term maintenance therapy with enteral nutrition may delay the postoperative recurrence of the Crohn's disease and should be considered. For critically ill CD, damage-control surgery may get a better outcome than conventional treatment procedures.

OBJECTIVE: To investigate the epidemiological characteristics of allergic rhinitis (AR) in urban and rural areas of Ningbo and Yongzhou. METHOD: Fifteen fields in the two cities from October 2006 to June 2007 were randomly selected. Cases suspected with symptoms of AR by a self-administered and interview questionnaire were recommended to special examinations for confirmed diagnosis. RESULT: 1. A total of 9969 individuals from 3803 families were surveyed, of whom 303 suffered with AR. 2. The prevalence rate was 4.10% in Ningbo and 1.65% in Yongzhou (the sex-adjusted rate was 4.10% and 1.64% respectively, and the age-adjusted rate was 4.33% and 1.58%); the population of island inhabitants had the lowest prevalence rate of 0.73%. 3. The prevalence rate in patients with asthma and that with family genetic history was 8% and 12% respectively. CONCLUSION It demonstrates that the prevalence rate is higher in Ningbo than in Yongzhou, in urban than in rural and in adolescent than in other ages. Allergic rhinitis may be associated with asthma and related to genetic factors. Allergic rhinitis may be curable.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Asthma ; epidemiology ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Male ; Middle Aged ; Prevalence ; Rhinitis, Allergic, Perennial ; epidemiology ; Rhinitis, Allergic, Seasonal ; epidemiology ; Rural Population ; Surveys and Questionnaires ; Urban Population ; Young Adult

Object To define suitable gathering season of Ginkgo biloba L. leaves. Methods The content of total flavonoids and total terpene lactones in G. biloba leaves were determined by HPLC DAD and HPLC ELSD. Results The content of total flavonoids and total terpene lactones in G. biloba were distinct in different ages of tree and collecting seasons. Conclusion The content of total flavonoids and total terpene lactones in G. biloba are the highest in 2 3 ages of tree. The total flavonoid is the highest in May and total terpene lactone is the highest in September.