BACKGROUND: The efficacy of entecavir (ETV) add-on peg-interferon therapy compared with ETV monotherapy in treatment-naïve hepatitis B virus (HBV) patients remains controversial. We investigated whether adding peg-interferon to ongoing ETV treatment leads to a better curative effect or not. METHODS: All patients have been recruited between August 2013 and January 2015 from the Shanghai Public Health Clinical Center and Zhongshan Hospital (China). Eligible HBV patients (n = 144) were randomly divided (1:1) to receive either ETV monotherapy (n = 70) or peg-interferon add-on therapy from week 26 to 52 (n = 74). Patients were followed-up for at least 2 years. Indexes including hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) seroconversion rate, sustained virologic response, transient elastography value, and histological scores were evaluated every 3 months until the end of the study. The rate of patients with HBsAg loss was defined as the primary endpoint criteria. RESULTS: At week 26, no patient achieved HBsAg seroconversion in either group. At week 52, one patient in the monotherapy group was HBsAg-negative but there was none in the combination therapy group. The monotherapy group showed significantly better liver function recovery results than the combination therapy group. At week 78, one patient in the combination group had HBsAg seroconverted. At week 104, only three patients in the combination therapy group were HBsAg-negative compared with one patient in monotherapy. The mean alanine aminotransferase and aspartate aminotransferase levels and transient elastography values decreased significantly compared with baseline. Both groups showed a favorable decrease in alpha-fetoprotein (monotherapy: 4.5 [2.8, 7.1] vs. 2.2 [1.8, 3.1] ng/mL, P < 0.001; combination therapy: 5.7 [3.0, 18.8] vs. 3.2 [2.0, 4.3] ng/mL, P < 0.001) and an improved result of liver biopsy examination scores. The combination group showed a better improvement in histology compared with the monotherapy group (mean transient elastography value 6.6 [4.9, 9.8] vs. 7.8 [5.4, 11.1] kPa, P = 0.028). But there was no significant difference in HBsAg conversion rate (1.8% [1/56] vs. 4.1% [3/73], P = 0.809) and HBeAg conversion rate (12.5% [7/56] vs. 11.0% [8/73], P = 0.787), as well as HBV-DNA, sustained virologic response (93.2% vs. 98.5%, P = 0.150) between the two groups. CONCLUSIONS: Both therapies supported liver function recovery and histology improvement. Combination therapy did not show better anti-viral efficacy in HBsAg or HBeAg seroconversion compared with monotherapy. However, combination therapy played a more positive role in reversing hepatic fibrosis compared with monotherapy. TRIAL REGISTRATION ClinicalTrials.gov: NCT02849132; https://clinicaltrials.gov/ct2/show/NCT02849132.

OBJECTIVE: To analyze the effects of hand-transmitted vibration exposure on the finger vibratory and pain perception thresholds among drill workers in a gold mine. METHODS: By the judgement sampling method,134 male drill workers from a gold mine in the northern area of China were selected as the hand-transmitted vibration exposure group and102 fit-up workers without vibration exposure in the same mine were chosen as the control group. The finger vibratory perception thresholds,the pain perception thresholds and the occupational health examination were conducted and analyzed in these two groups. Based on the self-report with vibration-induced white finger( VWF),the workers of hand-transmitted vibration exposure group were divided into non-VWF subgroup( 105 workers) and VWF subgroup( 29 workers). RESULTS: The incidence of finger numbness,pain and self-reported white finger in the exposure group were significantly higher than those in the control group( P < 0. 05). Compared with the control group,the vibratory perception thresholds of the index finger,middle finger and ring finger of the right hand among the vibration exposure group workers were significantly higher( P < 0. 05),but there was no significant difference in the vibratory perception thresholds of the left ring finger between the two groups( P > 0. 05). The vibratory perception thresholds of both ring fingers,right index finger and right middle-finger in VWF subgroup were higher than those in control group( P < 0. 05). But no significant differences was found in the above 4 indexes in these two groups after compared to those of control group,respectively( P > 0. 05). The vibratory perception thresholds of left ring finger,right ring finger and right index finger in VWF subgroup were all higher than those in non-VWF subgroup( P < 0. 05),but the vibratory perception thresholds of right middle finger in these two groups showed no significant difference( P > 0. 05). The pain perception thresholds of index finger,middle finger and ring finger in both hands of the vibration exposure group workers were all higher than those in control group( P < 0. 05). The pain perception thresholds of middle finger and ring finger in both hands of the VWF subgroup and non-VWF subgroup were higher than those of control group( P < 0. 05). CONCLUSION: The hand-transmitted vibration can increase the thresholds of finger vibratory and pain perception in drill workers. The finger sensory perception examination could be used to assist the early detection of peripheral nerve damage induced by hand-transmitted vibration.

OBJECTIVETo observe the effect of pure total flavonoids from Citrus (PTFC) on the hepatic fatty degeneration, inflammation, oxidative stress and SIRT1/PGC-1alpha expressions in mice with non-alcohol steatohepatitis (NASH), and discuss the action mechanism of PTFC on NASH.

METHODMice were given high-fat diet for 16 weeks to induce the NASH model. Since the seventh week after the model establishment, the mice were intervened with 100, 50 and 25 mg x kg(-1) x d(-1) PTFC for 10 weeks. The pathologic changes in hepatic tissues were observed with HE staining. The contents of TG, CHOL in hepatic tissue, as well as the levels of AST, ALT in serum were detected by using the biochemical process. The expression of SIRT1, PGC-1alpha and MnSOD mRNA in hepatic tissues were detected with Real-time PCR assay. SIRT1, PGC-1alpha protein and 8-OHdG expressions were determined with the immunohistochemical method. The SOD level in hepatic tissues was tested by the xanthine oxidase method. The MDA content in hepatic tissues was examined by the thiobarbituric acid method.

RESULTThe contents of TG, CHOL, NAFLD activity scores and ALT level in serum in hepatic tissues of mice in the model induced by fat-rich diet were obviously higher than that of the normal group (P < 0.010. The SIRT1, PGC-1alpha, MnSOD mRNA and protein expression in hepatic tissues were significantly lower than that of the normal group (P < 0.01). The expression of 8-OHdG and the content of MDA in hepatic tissues were obviously higher than that of the normal group (P < 0.01). After the intervention with different doses of PTFC, the NAFLD activity scores, the content of TG and the level of AST in serum were notably lower than that of the normal group (P < 0.01, P < 0.05); whereas the SIRT1, PGC-1alpha, MnSOD mRNA and protein expression were obviously higher than that of the normal group (P < 0.01, P < 0.05), with the significant decrease in the expression of 8-OHdG and the content of MDA (P < 0.01).

CONCLUSIONOxidative stress/lipid peroxidation enhancement in in NASH mice induced by high-fat diet may be related to the changes in SIRT1/PGC-1alpha signal transduction pathway. PTFC could enhance the anti-oxidant capacity in liver, relieve the damage of reactive oxygen during the fatty acid metabolic process, and prevent NASH from the occurrence and development by regulating the SIRT1/PGC-1alpha signal pathway.

Animals ; Citrus ; chemistry ; Fatty Liver ; drug therapy ; genetics ; metabolism ; Flavonoids ; chemistry ; pharmacology ; Inflammation ; drug therapy ; genetics ; metabolism ; Liver ; drug effects ; metabolism ; Male ; Mice ; Mice, Inbred C57BL ; Non-alcoholic Fatty Liver Disease ; Oxidative Stress ; drug effects ; genetics ; Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-alpha ; Sirtuin 1 ; genetics ; metabolism ; Transcription Factors ; genetics ; metabolism

This paper aims to establish a method for the determination of sulfur dioxide in sulfur fumigation Chinese herbs. Sample powder and hydrochloric acid solution were isolated by paraffin layer in order to avoid early reactions, with the generation of sulfur dioxide, headspace with airtight needle was used to transfer sulfur dioxide into gas chromatograph, and detected with thermal conductivity detector. The analytical performance was demonstrated by the analysis of 12 herbs, spiked at four concentration levels. In general, the recoveries ranging from 70% to 110%, with relative standard deviations (RSDs) within 15%, were obtained. The limit of detection (LOD) was below 10 mg x kg(-1). Standard addition can be used for low recovery samples. The method is simple, less time-consuming, specific and sensitive. Methods comparison revealed that gas chromatography is better than traditional titration in terms of method operability, accuracy and specificity, showing good application value.
Chromatography, Gas ; methods ; Fumigation ; Limit of Detection ; Plants, Medicinal ; chemistry ; Sulfur ; chemistry ; Sulfur Dioxide ; analysis

Objective To observe the association between adiponectin gene polymorphism, serum adiponectin lev-els with the incidence of coronary artery disease (CAD) and the severity of coronary artery stenosis in patients with essential hypertension (EH). Methods A total of 414 patients with EH (234 cases with CAD and 180 cases without CAD) and 185 control subjects were recruited in this study. Serum adiponectin levels were measured by enzyme-linked immunosorbent as-say (ELISA). Adiponectin single-nucleotide polymorphisms rs266729,rs7649121,rs1501299 and rs3774262 were geno-typed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Results Serum adiponectin levels were significantly lower in EH with CAD group than those in control group and EH without CAD group. Adiponectin SNP rs7649121 AT genotype reduced the risk of CAD compared with AA genotype (adjusted OR=0.566,95%CI 0.346-0.925,P=0.023). Logistic regression analysis showed that age and LDL-C were risk factors of CAD, and adiponectin was the protective factor for CAD in EH patients. The severity of coronary artery stenosis was negatively related to the level of adipo-nectin. Adiponectin levels were not affected by the adiponectin gene polymorphism. Conclusion The decreased serum adi-ponectin level was the independent risk factor for CAD in EH patients, which was negatively related to the severity of coro-nary artery stenosis. Adiponectin SNP rs7649121 may contribute to the risk factors of CAD in EH patients.

OBJECTIVETo investigate the opportune time of secondary definitive surgery for patients with multiple injuries from earthquakes based on the acute physiology and chronic health evaluation II (APACHE II) score and the principles of damage control.

METHODSTwenty-one patients with critical earthquake injuries were treated with damage control strategies, followed by medical support and surgical intervention to restore their physical potential in the intensive care unit (ICU). Successive APACHE II scoring was adopted to evaluate the patients'physiological status, and then, internal fixation of fractures and other definitive operations were performed.

RESULTSAll the patients were effectively treated with few complications, low deformity rate and no death.

CONCLUSIONSAppropriate evaluation of patients?physiological potential, right decision on surgical time and proper operative method can reduce the rates of complications, disability and death for patients with critical earthquake injuries.

APACHE ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; China ; Disasters ; Earthquakes ; Female ; Humans ; Male ; Middle Aged ; Multiple Trauma ; surgery

Background and Objective: Studies showed that cetuximab combined with chemotherapy was effective on advanced colorectal cancer (ACRC)in recent years,however,few reports based on large case cohort are available in China.This study was to analyze the efficacy of cetuximab combined with chemotherapy for 53 chinese patients with ACRC. Melhods:Clinical data of 53 patients with ACRC.treated with cetuximab combined with chemotherapy in Sun Yat-sen Cancer Center from March 2005 to April 2008,were analyzed for short-term efficacy and safety.The efficacy of the regimen used as first-line and non-first-line treatment was compared by Chi-square test;the effect of the regimen on prognosis was analyzed by multivariate Cox proportional hazards model.Results:Of the 53 patients with colorectal adenocarcinoma,40 were men and 13 were women, with a median age of 55 years. A total of 572 weeks(median,8 weeks) of cetuximab treatment were completed.The overall response rate(RR)of the regimen was 39.6%and the disease centrel rate 66.0%.The disease control rates were similar when the regimen was used as first-line and non-first-line treatment(80.3%MS.60.5%,P=0.177).For all 53 patients,clinical stage was an independent prognostic factor(P=0.002,OR>1).The most common Grade 3 to 4 adverse events included acne-like rash(7.5%),neutropenia (18.9%), and diarrhea (5.6%). No hypersensitive reaction or treatmentrelated death was observed. Only one patient discontinued treatment because of Grade 4 diarrhea and neutopenia. Conclusions: Cetuximab combined with chemotherapy can achieve relatively high disease control rate for ACRC patients.with less adverse events.Whether cetuximab has better effect in first-line treatment than in non-first-line treatment needs further study.