Objective: To compare the efficacy and safety of plasma exchange (PE) combined with double plasma absorption and simple PE in the treatment of acute-on-chronic liver failure. Methods: We retrospectively analyzed 251 cases of acute-on-chronic liver failure treated with artificial liver treatment since January 2015. Changes in clinical manifestations, laboratory tests, and complications of the patients before and after different modes of treatment were compared and short-term efficacy was tracked. In accordance with different data, t-test, Pearson's chi-squared test and Fisher's exact test were used for statistical analysis. Results: The effectiveness of low-volume PE combined with double plasma molecular adsorption system (DPMAS) and equal amount of PE combined with DPMAS was significantly better than simple PE (83.7%, 84.05% and 82.15 vs 55.6%, P < 0.05) in early stage of liver failure. In late-stage of liver failure, there was no significant difference in the treatment efficiency of each group (P > 0.05). Bilirubin and bile acid levels were significantly decreased in combined treatment groups than that to simple PE group (P < 0.05). PTA and albumin improvement rate of DPMAS PE groups were significantly lower than that of simple PE group (P < 0.05). There was no statistical difference in adverse reactions between each group. Conclusion PE combined with DPMAS improves the treatment efficiency of early hepatic failure and decrease dosage of plasma when compared with simple PE. A beforehand DPMAS treatment after PE treatment can improve the adverse effects of DPMAS on blood coagulation function and albumin levels.

Objective: To analyze the composition and richness of intestinal microflora in children with non-alcoholic fatty liver disease (NAFLD) and the role of which in pathogenesis of NAFLD. Methods: This was a prospective case-control study. From November 2015 to June 2017, 19 children diagnosed with NAFLD according to the 2010 edition of diagnostic criteria were enrolled voluntarily in the Second and First Affiliated Hospitals of Zhejiang Chinese Medicine University. Twenty-two healthy children were enrolled in the control group. Among the patients, 10 were males and 9 were females, at the mean age of (11.0±1.0) years; 10 males and 12 females in the control group, at the mean age of (9.0±1.2) years. The body mass index (BMI) and waist circumference were recorded, and the fasting blood glucose, total cholesterol, triglyceride, high-density lipoprotein and low-density lipoprotein were detected. Feces were collected and the fecal microorganisms were extracted with magnetic beads methods; the composition and the richness of intestinal microflora in the two groups were detected with 16S rDNA high throughput sequencing technology. The KO differential gene expression and KEGG signal pathway enrichment were analyzed with PICRUST software. The intestinal flora characteristics between the two groups were compared with t test or Mann-Whitney U test and Willcoxon W test. Results: The BMI, waist circumference and triglyceride were higher in NAFLD group than those in the control group (BMI (25.1±2.7) vs. (18.2±1.5)kg/m², t=9.912, P=0.000; waist circumference (88.6±6.6) vs. (71.5±6.3) cm, t=8.520, P=0.000; triglyceride (0.9±0.4) vs.(0.7±0.3)mmol/L, t=2.060, P=0.046). The abundance and diversity index of intestinal microflora were lower in the NAFLD group (Shannon index 3.99 (3.13, 4.54) vs. 4.63 (4.21, 4.81), Z=-2.065, P=0.039; Simpson index 0.85 (0.70, 0.89) vs. 0.90 (0.88, 0.93), Z=-2.431, P=0.015; ACE index 235.76 (205.26, 361.94) vs. 326.96 (275.34, 368.65), Z=-2.092, P=0.036). At the level of phylum, the proportion of Actinomycetes was lower and the proportion of Thermus was higher in NAFLD group (Actinobacteri 29.807 (14.723, 62.080) ×10^-3 vs. 63.212 (46.133, 172.071) ×10^-3, Z=-2.667, P=0.008; Thermus 0.033 (0.000, 0.226) ×10^-3 vs. 0.000 (0.000, 0.031) ×10^-3, Z=-2.729, P=0.006) . At the level of genus, the proportion of Bacteroides and Bifidobacterium in the NAFLD group were significantly lower (Bacteroides 78.757 (11.430, 151.621) ×10^-3 vs. 356.821 (161.049, 403.037) ×10^-3, Z=-2.771, P=0.006; Bifidobacterium 19.680 (6.181, 53.944) ×10^-3 vs. 54.721 (31.911, 146.410) ×10^-3, Z=-2.458, P=0.014); the proportion of Prevotella in NAFLD group was significantly higher (3.089 (0.165, 63.502) ×10^-3 vs. 0.432 (0.029, 2.257) ×10^-3, Z=-2.112, P=0.035). Based on the KEGG database, 78 differentially expressed genes and 26 differential metabolic pathways were found, among which the function genes of K01470, K01961 and K07258 were concentrated in the pathways of arginine and proline metabolism, fatty acid synthesis, and polysaccharides biosynthesis and metabolism. Besides, these three function genes were related to Bacteroides, Prevotella, Bifidobacterium and Ruminococcus. Conclusion NAFLD children have intestinal flora disturbances in both diversity and abundance, which may alter lipid metabolic pathways through differential gene expressions, contributing to the pathogenesis of NAFLD.

[Purpose]To summarize Professor SHI Weiqun's clinnical experience in cirrhosis by Huayu method of traditional Chinese medicine, who is the famous doctor of traditional Chinese medicine in Zhejiang Province.[Method] To study and research Professor SHI Weiqun' s subjects and books on cirrhosis, to learn revelant theoretical knowledge, to follow his guidance, to collect and arrange typical cases record, and his methods of TCM differentiation of symptoms and signs^by these methods to explore the thinking and syndrome differentiation of the syndrome, summrize Professor SHI Weiqun's clinnical experience in cirrhosis by Huayu method of traditional Chinese medicine.[Result]Professor SHI Weiqun thinks main points of pathogenesis is blood stasis, but, when treating individuals, need to combine the difference among Qi, blood, Yin and Yang, and form the academic experience of Xingqi Huoxue, Yiqi Huayu, Yangxue Huayu, Wenyang Huayu, Ziyin Huayu.He often selects Chaihu Shugan powder, Buzhong Yiqi decoction, Chinkuei Shin Chewan pills, Liuwei Dihuang Wan, Erzhi pills, Xuefu Zhuyu decoction ect.[Conclusion]Professor SHI Weiqun has rih clinical experiences, merges ancient and modem, makes good use of activating blood circulation drugs, selects precise and appropriate, has formed a relatively rigorous thought of diagnosis and treatment, the academic thought and clinical experience is worthy of inheritance and promotion.

Objective To investigate the effect of hydrochloric acid (HCl) stimulation and mechanical stretch on epithelial-mesenchymal transition (EMT) and hyaluronan (HA) production in human lung epithelial cells. Methods Human lung epithelial cell line BEAS-2B was cultured in vitro, which was divided into phosphate-buffer saline (PBS) + static group, HCl + static group, PBS + stretch group, and HCl + stretch group respectively in the logarithmic phase. The BEAS-2B cells in two stretching groups were challenged by cyclic stretch with 20% amplitude, frequency of 0.33 Hz, sine wave of the FX-5000T system for 48 hours. The morphology changes in cells before and after stretch were observed with inverted microscope. The protein expressions of epithelial markers E-cadherin and cytokeratin-8 (CK-8) as well as mesenchymal markers vimentin and α-smooth muscle actin (α-SMA) were determined by Western Blot. The secretion of HA was determined by enzyme linked immunosorbent assay (ELISA). Results ① It was shown by microscopic observation that BEAS-2B cells displayed cobblestone morphology, linked closely and cell polarity in PBS + static group, which did not change obviously after HCl stimulation alone. Given purely mechanical stretch after 48 hours, the cells morphology changed from cobblestone shape into long spindle, and increased intercellular space obviously. Double hit of HCl and stretch changed the cells morphology more significantly. ② It was shown by Western Blot that compared with the PBS + static group, HCl alone or combined with purely mechanical stretch after 48 hours, the expressions of E-cadherin and CK-8 were decreased, while those of vimentin and α-SMA were increased, and it was more pronounced in HCl + stretch group [the expression quantity (gray value) as base 1 in PBS + static group, E-cadherin: 0.16±0.08 vs. 1, CK-8: 0.10±0.03 vs. 1, vimentin: 3.35±0.38 vs. 1, α-SMA: 3.10±0.45 vs. 1, all P < 0.01]. ③ It was shown by ELISA that both HCl stimulation and stretch could induce BEAS-2B cells secreting HA as compared with PBS + static group (μg/L: 55.763±0.687, 63.005±0.493 vs. 49.876±1.867), and the production of HA increased more remarkably after double hit (μg/L: 78.220±1.085 vs. 49.876±1.867, P < 0.01). Conclusions Both HCl and mechanical stretch could induce EMT and increase HA secretion in human lung epithelial cells in vitro. Double hit of HCl stimulation and mechanical stretch induced EMT apparently, and further increased the production of HA.

[Objective] This paper sums up Professor Shi Weiqun’s ointment experience in balancing body and treating the chronic liver disease by cream formula.[Methods] Through col ecting cream formula these 3 years to summarize Dr. Shi Weiqun ’s principle and experience on cream formula, and intro-duce 2 medical records. [Results] Treating chronic liver disease by cream formula should not only connect“sign”,“syndrome”,“symptom”,“distinguishes the throttle”, but also combine using of the four diagnostic methods, the rational use of drugs, and balance the body's immune. That would be used for preventive treatment of disease and prolonging life. [Conclusions] Professor Shi Weiqun ’s ointment experience of treating chronic liver disease by cream formula is effective and is trusted and welcomed by patients. His clinical experience is worth extending and applying.

Objective To investigate the significance of B-type natriuretic peptide (BNP) in acute coronary syndrome(ACS).Methods 151 in-patients of ACS during May 2006 to June 2008 were selected as the treatment group.Other 212 impatients with essential hypertension were selected as control group.Blood lipid,blood glucose,blood routine,renal function,high sensitive C-reaction protein (hs-CRP) and BNP were examined in all patients.Their blood pressure,heart rate,and history of smoking,hypertension,diabetes mellitus and hyperlipidemia 62.0±14.2,t = 5.043,P＜0.001 ),blood creatinine [ (95.0±67.4 ) vs.(72.8±29.0) μmol/L,t = 4.164,P ＜0.001 ),blood uric acid[ (360.2±104.4 ) vs.(300.8±92.7 ) μmol/L,t = 5.521,P ＜ 0.001 ],BNP (80.81 vs.352.38 ng/L,Z = - 7.295,P ＜ 0.001 ),hs-CRP (7.99 vs.17.08,Z = - 3.983,P ＜ 0.001 ),white blood cells (WBC) [ (7.843 +3.025)×109/L vs.(6.333±3.569)×109/L,t =4.209,P ＜0.001 ],monocytes [ (0.522±0.201)×109/L vs.(0.417±0.157)×109/L,t = 5.084,P ＜0.001 ] and blood glucose [ (6.518±2.303 ) vs.(5.691±2.085 ) mmol/L,t = 3.461,P = 0.001 ] had significant difference.Systolic blood pressure had difference between two groups [ (134.7±27.8 ) vs.(142.0±26.3 ) mm Hg,t = 2.536,P=0.012 ].However,the percentage of smoking[ 43.7% (66/151)vs.23.1% (49/212),X2 = 17.283,P ＜0.001 ] and male gender[ 74.8% ( 113/151 )vs.48.6% ( 103/212),X2 = 25.217,P ＜ 0.001 ) ] had significant difference between two groups ( P ＜0.001 ).Multivariable regression analysis showed that age (X2 = 10.369,P =0.001 ),gender (X2 = 12.836,P ＜ O.001 ),BNP (X2 =4.807,P =0.028) and WBC(X2= 10.788,P =0.001 ) were the main factors of difference between the two groups.Moreover,BNP was linearly correlated with left ventricular ejection fraction(EF) in ACS patients (t =5.789,P ＜ 0.001 ).Conclusion Old age,male,WBC and BNP are closely related with ACS,of which BNP has certain predictive value for ACS.

The purified elementary bodies of C. pneumoniae TW-183 were used for immunization of male BALB/c mice, the spleen cells of these mice were fused with SP2/0 cells and the hybrid cells were cloned by limiting dilution. One clone that secreted the C. pneumoniae monoclonal antibody (Cpn-McAb) stably was obtained finally. The Cpn-McAb belonged to IgG2b class and anti-Cpn-MOMP; the outcome of micro-immunofluorescence showed its weak cross reaction with the C. psittaci elementary body but it has no cross reaction with C. trachoma elementary body. It has the same speciality of the imported Cpn-McAb. For the evaluation of Cpn-McAb, the peripheral blood mononuclear cell specimens of 454 patients were detected by self-made Cpn-McAb and imported Cpn-McAb at the same time. The positive rates of Cpn-antigen were 53.3% for self-made Cpn-McAb and 52.6% for imported Cpn-McAb,showing high concordance between them (Kappa=0.714). The results showed that self-made Cpn-McAb has almost the same high specificity and sensitivity as imported Cpn-McAb, so the self-made Cpn-McAb may replace imported Cpn-McAb to detect Cpn specific antigen and be helpful to diagnosing and treating the clinical diseases associated with Cpn infection.
Animals ; Antibodies, Bacterial ; immunology ; Antibodies, Monoclonal ; biosynthesis ; genetics ; Antibody Specificity ; Chlamydia Infections ; diagnosis ; microbiology ; Chlamydophila pneumoniae ; immunology ; Hybridomas ; secretion ; Male ; Mice ; Mice, Inbred BALB C

OBJECTIVE:To evaluate the curative effect and safety of reduced glutathione for injection(Atomolan) on the Alcoholic Liver Disease(ALD).METHODS:This was a randomized,placebo controlled study,in which the reduced glutathione for injection(Gluthion) was used as control substance.A total of 261 ALD patients were randomly divided into 2 groups in 1:1 ratio(trial group,n=135;control group,n=126).The dosage,route and course of treatment in two groups were the same.Clinical data including biochemical parameters,symptoms and signs in two groups were monitored.RESULTS:The excellent effective rate,effect rate and total effective rate in the trial group were 58.5%,23.7% and 82.2%,respectively,those in the control group were 57.9%,22.2% and 80.2%,respectively,showing no significant difference between the 2 groups(P=0.90).CONC-LUSION:The study showed that the domestic glutathione for injection had a sound efficacy in improving clinical symptoms and recovery of liver biochemical parameters,showing equivalent efficacy to the control preparation good safety.

Objective:To investigate the efficacy and security of umbilical Chinese materia medica paste on the endotoxemia of cirrhosis patients.Methods:Based on the TAL blood cell matrix color test,80 cases of cirrhosis patients with endotoxemia positive were divided into two groups by randomly number:40 in the received regular treatment period for both groups was one month.The clinical symptoms was given to the level of treatments;Additionally,Chinese materia medica paste on umbilicus was given to the treatment group,the endotoxin,ammonia and complement component 3 in serum,cruor function,liver function,and blood routine test were statistical analysised and efficacy compared in both groups after treatment.Results:After treatment,endotoxin decreased significantly in the treatment group and the control group(P

Objective To study the mechanism of killing microfilariae in host by detecting the change of amino acids in Brugia malayi microfilariae. Methods The composition and contents of amino acid in microfilariae of periodic Brugia malayi before and after the effect of cytotoxicity were analyzed with automatic amino acid analyzer. Results The result showed that microfilariae contained 17 kinds of amino acids, but lacked Tryptophan. The total amount of amino acids of the microfilariae after cytotoxicity was lower than that before cytotoxicity( P