Repetitive transcranial magnetic stimulation (rTMS) fails to improve cognition in patients with parkinson's disease: a Meta-analysis of randomized controlled trials.

BACKGROUND: Cognitive decline is one of the greatest concerns for patients with Parkinson's disease (PD) and their care partners. Repetitive transcranial magnetic stimulation (rTMS) is a nonpharmacological treatment option used to improve cognitive function in PD, but its efficacy is unclear. We performed a meta-analysis to determine whether rTMS improves cognition in PD patients. METHODS: Eligibility criteria (PICOS) were as follows: (1) 'P': The patients participating were diagnosed with idiopathic PD; (2) 'I': Intervention using rTMS; (3) 'C': Sham stimulation as control; (4) 'O': The outcome of the study included cognitive evaluations; (5) 'S': The study adopted randomized controlled design. The standardized mean difference (SMD) of change of score was applied to measure efficacy, and we used Version 2 of the Cochrane tool to assess risk of bias. RESULTS: Twelve studies met the inclusion criteria. Compared with sham-controlled group, the pooled result showed a non-significant short-term effect of rTMS on global cognition (SMD: -0.15, 95% CI: -0.59 to 0.29, I2 = 36.7%), executive function (SMD: 0.03, 95% CI: -0.21 to 0.26, I2 = 0.0%), and attention and working memory (SMD: 0.05, 95% CI: -0.25 to 0.35, I2 = 0.0%). Long-term outcomes were either shown to be statistically nonsignificant. CONCLUSIONS: Based on a limited number of studies, rTMS fails to improve cognition in PD. We call for additional high-quality randomized controlled trials with adequate sample sizes to determine the efficacy of rTMS.

Alterations in intrinsic functional networks in Parkinson's disease patients with depression: A resting-state functional magnetic resonance imaging study.

AIMS: The aim of this research was to investigate the alterations in functional brain networks and to assess the relationship between depressive impairment and topological network changes in Parkinson's disease (PD) patients with depression (DPD). METHODS: Twenty-two DPD patients, 23 PD patients without depression (NDPD), and 25 matched healthy controls (HCs) were enrolled. All participants were examined by resting-state functional magnetic resonance imaging scans. Graph theoretical analysis and network-based statistic methods were used to analyze brain network topological properties and abnormal subnetworks, respectively. RESULTS: The DPD group showed significantly decreased local efficiency compared with the HC group (P = .008, FDR corrected). In nodal metrics analyses, the degree of the right inferior occipital gyrus (P = .0001, FDR corrected) was positively correlated with the Hamilton Depression Rating Scale scores in the DPD group. Meanwhile, the temporal visual cortex, including the bilateral middle temporal gyri and right inferior temporal gyrus in the HC and NDPD groups and the left posterior cingulate gyrus in the NDPD group, was defined as hub region, but not in the DPD group. Compared with the HC group, the DPD group had extensive weakening of connections between the temporal-occipital visual cortex and the prefrontal-limbic network. CONCLUSIONS: These results suggest that PD depression is associated with disruptions in the topological organization of functional brain networks, mainly involved the temporal-occipital visual cortex and the posterior cingulate gyrus and may advance our current understanding of the pathophysiological mechanisms underlying DPD.

[ROG,GATA3 and T-bet mRNA levels in peripheral blood mononuclear cells in patients with chronic hepatitis B].

OBJECTIVE: To investigate the role of ROG, GATA3 and T-bet in the progression of chronic hepatitis B (CHB). METHODS: The mRNA levels of ROG, GATA3 and T-bet in peripheral blood mononuclear cells (PBMCs) from 135 patients with CHB (including 45 mild cases, 42 moderate cases, and 48 severe cases) and 15 healthy control subjects were detected by real-time quantitative PCR. RESULTS: The levels of T-bet mRNA in the PBMCs were significantly higher in CHB patients than in the healthy controls (P<0.05), and also differed significantly between the 3 groups of CHB patients (P<0.05). ROG mRNA levels were significantly higher in severe cases of CHB than in the healthy controls and mild and moderate CHB cases (P<0.05), but were similar among the latter 3 groups (P>0.05). The mRNA level of GATA3 in the PBMCs were significantly higher in moderate and severe CHB cases than in the healthy controls and mild CHB cases (P<0.05). The T-bet/GATA3 ratio was significantly greater in the 3 CHB groups than in the control group (P<0.05) but comparable between the 3 CHB groups (P>0.05). ROG levels were not correlated with GATA3 levels or T-bet/GATA3 ratio in the CHB cases. CONCLUSIONS: The mRNA levels of ROG, GATA3 and T-bet in the PBMCs are obviously up-regulated in CHB patients and these 3 genes may participate in the progression of CHB. ROG plays an important role in correcting and maintaining the new balance of Th1/Th2.

Influence of chronic HBV infection on superimposed acute hepatitis E.

AIM: To investigate the influence of chronic hepatitis B virus (HBV) infection [based on the status of hepatitis B e antigen (HBeAg), HBV DNA, and cirrhosis] on superimposed acute hepatitis E. METHODS: A total of 294 patients were recruited from the Department of Infectious Diseases of the Third Affiliated Hospital, Sun Yat-sen University, from January 2003 to January 2012. The patients were classified into two groups: an HBV + hepatitis E virus (HEV) group (a group with chronic HBV infection that was superinfected with acute hepatitis E, n = 118) and an HEV group (a group with acute hepatitis E, n = 176). We retrospectively analyzed and compared the clinical features of the two groups. Statistical analyses were performed using the χ(2) test or Fisher's exact test for categorical variables and the Student's t test for continuous variables. A P value < 0.05 was considered statistically significant. RESULTS: The peak values of prothrombin time, serum total bilirubin, and Model for End-Stage Liver Disease scores were significantly higher in the HBV + HEV group. More patients in the HBV + HEV group had complications (39.8% vs 16.5%, P = 0.000) and developed liver failure (35.6% vs 8.5%, P = 0.000). Additionally, the mortality of the HBV + HEV group was significantly higher (20.3% vs 7.4%, P = 0.002). Further analysis of the HBV + HEV group showed that there were no significant differences in complication occurrence, liver failure incidence, or mortality between patients with different HBeAg and HBV DNA statuses. However, in patients with underlying cirrhosis, complication occurrence and liver failure incidence significantly increased. In total, 12.7% of the patients in the HBV + HEV group received anti-HBV treatment, but this therapy failed to reduce mortality in patients who developed liver failure. CONCLUSION: The presence of underlying cirrhosis in chronic HBV infection results in more severe clinical outcomes with superimposed acute hepatitis E. Anti-HBV treatment cannot improve the prognosis of liver failure caused by HBV-HEV superinfection.

[Construction and expression of non-structural protein gene 3-4b of HCV 1b based on the adenoassociated virus vector].

OBJECTIVE: To clone 1b type of HCV NS3-4b Gene and express in HEK 293 cells, lay the foundation for further study of the HCV NS3-4b recombinant adeno-associated virus vaccine and its dendritic cell vaccine. METHODS: HCV 1b patients' serum was collected, and full length NS3-4b segment was amplified by RT-PCR and cloned into adeno-associated virus' expression vector pAAV. CMV. EGFP in order to express in HEK 293 cells. At last, it was validated whether express or not by Western Blot. RESULTS: The 1b type gene NS3-4b were amplified and consistent to the expected size (2838 bp), the recombinant plasmid has been confirmed its successful restructured by double enzyme and sequencing, at last, Western Blot map can see objective protein expression after it transfect HEK 293 cells. CONCLUSION: The adeno-associsted virus recombination HCV NS3-4b plasmid have successfully constructed and it can express in eukaryotic cells.

[Comparative study on the clinical characteristics of HBV infection patients with different pathologic inflammation grade].

OBJECTIVE: The aim of this study was to compare the biochemical and virological characteristics among patients infected with hepatitis B virus (HBV) according to pathologic inflammation grade. METHODS: 428 patients with chronic HBV infection accept liver biopsy, liver function test, HBeAg detection and HBV DNA levels detection. They were studied and subdivided into four groups according to pathologic inflammation grade. The biochemical and virological characteristics were studied. Univariate analysis was performed with the SPSS 16.0. RESULTS: In different inflammation grading group, mean age and sex composition were no difference. Serum levels of ALT was highest in group G3 and lowet in group G0-1, there was statistically significant among groups (P = 0.005); AST and TBil were all highest in group G4 and lowest in group G0-1, statistically significant also found among groups (P = 0.000 & 0.004). Serum levels of ALB and PTA were all highest in group G0-1 and lowest in group G4, had statistically significant among groups (P = 0.000 & 0.000). There was no difference of HBV DNA level and percentage of HBeAg (+) among four groups (P = 0.565 & 0.065). CONCLUSIONS: The serum AST, TBil, ALB and PTA were different and can partly reflect the inflammation degree of liver damage in patients with HBV infection. ALT and PTA can reflect the inflammation degree of G0-1, G2 and G3; AST, TBil, ALB and PTA reflect the G3 and G4. HBV DNA level and HBeAg status can not indicate the inflammation degree in HBV infection patients.

[Genetic variation of IL-28B is associated with treatment response of patients with chronic hepatitis C].

OBJECTIVE: To explore the effect of IL-28B variation on the response of patients with chronic hepatitis C virus (HCV) infection to therapy. METHODS: A total of 220 patients with chronic hepatitis C (CHC) were prospectively treated with pegilated interferon (peg-IFN) in combination with ribavirin (RBV) for 48 weeks. After completing the therapy, the patients were followed-up for 24 weeks and the therapeutic effectiveness was evaluated. The rs8099917 was identified from each cohort. The IL28B genotype was compared in hepatitis C patients to assess the effect of single nucleotide polymorphism (SNP) on different treatment response. RESULT: The proportion of the rs8099917 TT, TG, and GG genotypes was 71.4%, 25.0%, and 3.6% in sustained viral response (SVR) group; 15.8%, 60.5%, 23.7% in null response (NR) group; 38.1%, 52.3%, 9.6% in relapse (RP) group. There was a statistically significant difference in the genotype among SVR, NR and RP groups (P < 0.001, Chi-square test). NR vs. SVR (TG vs. TT: OR = 7.67, 95% CI: 2.91-20.56, P < 0.001). RP vs. SVR (TG vs. TT: OR = 3.10, 95% CI: 1.14-6.36, P < 0.01). CONCLUSIONS: The genotypes of IL-28 B (rs8099917) is closely related to the effectiveness of peg-IFN-alpha/RBV therapy, and it is an important predictive factor before treatment in patients with chronic hepatitis C.

[Determination of serum IL-23 and its significance in patients with severe chronic hepatitis B].

OBJECTIVE: To investigate the level of the serum IL-23 and its correlation with serum biochemical indices of liver function tests and HBV DNA load in patients with chronic severe hepatitis B. METHODS: Fifty patients with chronic severe hepatitis B (severe hepatitis group) and 18 healthy controls (control group) were enrolled in the study. The serum IL-23 expression level was detected by ELISA method. The correlation between IL-23 and ALT, AST, TBil, HBV DNA load was analyzed using Pearson's correlation analysis, respectively. RESULTS: Serum IL-23 expression level in severe hepatitis group was significantly higher than that of control group (P < 0.05). Serum IL-23 level was positively correlated with serum ALT, AST, respectively (P < 0.05), but was not correlated with TBil and HBV DNA load, respectively (P > 0.05). CONCLUSION: Serum IL-23 expression level was increased in patients with chronic severe hepatitis B and was associated with the severe of inflammation. We, therefore, believe that IL-23 might be involved in the pathogenesis of chronic severe hepatitis B.

[Prognostic analysis and establishment of a prognostic model for patients with liver failure with hepatorenal syndrome].

OBJECTIVE: To identify the factors that may influence the prognosis of patients with hepatorenal syndrome and try to establish a prognostic model. METHODS: Data of 126 patients with hepatorenal syndrome were analyzed and 56 indexes that might affect the prognosis were focused on, involving history, symptoms, signs and lab findings. Cox model and Kaplan-Meier survival analysis were used. RESULTS: Many factors were found to affect the prognosis independently, including hepatic encephalopathy (HE) and its degree, gastrointestinal bleeding (GIB), blood neutrophil count (N1) and serum creatinine (Cr). The prognosis model was established as the following equation where PI represents prognosis index: PI = 0.711HE + 0.836GIB + 0.052N1 + 0.002Cr (GIB: no = 0, yes = 1; HE: no = 0, phase I = 1, phase II = 2, phase II = 3, phase IV = 4). When PI < 1, the average survival time was 42 days; when 1 < or = PI < or = 3, the average survival time was 15 days; when PI > 3, the average survival time was 2 days. CONCLUSION: The results obtained from this study may help in estimation of diagnosis, analysis of illness state and evaluation of therapy in clinical work.

[The relationship of HBeAg status with HBV DNA loads, MELD scores in patients with acute-on-chronic hepatitis B liver failure during terminal phases].

OBJECTIVE: To investigate the relationship and clinical significances of HBeAg status with serum HBV DNA loads, model for end-stage liver disease (MELD) scores in patients with acute-on-chronic hepatitis B liver failure during terminal phase. METHODS: 120 fatal patients were enrolled. At three phases of 0 -14 d, 15-28 d and 29-90 d before death, they were detected serum HBeAg, HBV DNA loads order meanwhile MELD scores were calculated. RESULTS: In 51 patients with HBeAg positive, HBV DNA levels were (5.25 +/- 1.99), (5.45 +/- 1.47) and (6.06 +/- 1.77) log10 copies/ml while MELD scores were (30.33 +/- 5.25), (26.36 +/- 6.43) and (20.13 +/- 6.47) respectively. In 69 patients with HBeAg negative,HBV DNA loads were (5.14 +/- 1.84), (5.49 +/- 1.75 ) and (4.62 +/- 1.65) log10 copies/ml while MELD scores were 32.38 +/- 9.95, 28.17 +/- 6.82 and 26.19 +/- 5.56 in sequence. Compared with the same phase between HBeAg-positive group and HBeAg-negative group, significant differences in both HBV DNA loads and MELD scores were found only at the phase of 29-90 d (P < 0.05). In multiple comparisons among three phases, regardless of the HBeAg status,there wasn't significant difference for HBV DNA loads (P > 0.05). But increasing MELD scores are associated with the disease exacerbation and significant differences were found (P < 0.05). CONCLUSIONS: To initiate acute-on-chronic hepatitis B liver failure, serum HBV DNA loads of HBeAg-positive patients are higher than that of HBeAg-negative ones. Once ACLF has been initiated,sustained high HBV DNA loads may promote the disease worsened and be fatal regardless of the HBeAg status.

[Interleukin-21 expression in serum of patients with acute-on-chronic liver failure and its significance].

OBJECTIVE: To investigate the level of the serum IL-21 and its correlation with serum biochemical indices of liver function test in patients with acute-on-chronic liver failure. METHODS: Sixty patients with acute-on-chronic liver failure (severe hepatitis group) and 18 normal cases (control group) were enrolled in the study. Peripheral blood lymphocytes were isolated and total RNA of lymphocytes was extracted by using Trizol. Real-time PCR was used to assay IL-21 mRNA level. The serum IL-21 expression level was detected by ELISA method. The correlation between IL-21 and ALT, AST, TBiL, ALB was analyzed using Pearson's correlation analysis, respectively. RESULTS: Serum IL-21 expression level in severe hepatitis group was higher than that of control group. Moreover, the difference between them was statistically significant (P < 0.05). Serum IL-21 level was positively correlated with serum ALT, AST, TBil, respectively (P < 0.05), but was negatively correlated with ALB, respectively (P < 0.05). CONCLUSION: Serum IL-21 expression level was increased in patients with acute-on-chronic liver failure and was associated with the severe of inflammation. We, therefore, believe that IL-21 might be involved in the pathogenesis of acute-on-chronic liver failure and might be an index of the severity of liver inflammation.

[MicroRNA differential expression profiles in DC after the stimulation of HBsAg].

OBJECTIVE: To establish the differential expression profiles for exploring new immune mechanism of hepatitis B virus infection. METHODS: DCs were separated from the bone marrow of healthy mouse and cultured in vitro. Then DCs were stimulated with HBsAg, LPS, TNF-alpha, respectively. Twenty-four hours later, the total RNA of cell was extracted. cDNA microarray was used to compare the differential expression of RNA. The significant differential expression of miRNA after the stimulation of HBsAg was chosen. Subsequently, target genes of the significant differential miRNA were forecasted by using computer software. RESULTS: There were 30 miRNAs whose significant differential expressions were beyond two times after the stimulation of HBsAg. Among them, 16 miRNAs expressions were increased and 14 miRNAs expressions were decreased. There was significant difference in differential expression of miRNA among the 3 different stimulations. The selected target genes included relevant elements of signal pathway of DC. CONCLUSION: The alteration of expression profiles of miRNA was specific after DC was stimulated by HBsAg. The selected target genes further demonstrated that miRNA could play important roles in the immune mechanism of HBV infection.

[Small interfering RNA targeting to hepatitis B virus X gene and 5-aza-2'-deoxycytidineon inhibited growth of the subcutaneous implanted tumor of hepatocellular carcinoma in nude mice].

OBJECTIVE: To investigate the anti-tumor effect of small interfering RNA targeting to HBV X gene (X-siRNA) and 5-aza-2'-deoxycytidine (5-aza-dC) on HBV-related hepatocellular carcinoma. METHODS: X-siRNA and control siRNA were synthesized. HepG2/GFP-HBx cells were treated with X-siRNA, and the levels of HBV X mRNA were detected by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR). Nude mice were inoculated with HepG2/GFP and HepG2/GFP-HBx cells subcutaneous respectively to establish implant models of hepatocellular carcinoma, and were treated with X-siRNA, 5-aza-dC alone or in combination, and tumor growth was observed. The methylation of p16 gene promoter was detected by methylation specific polymerase chain reaction (MSP). RESULTS: RT-PCR showed the expression of HBV X mRNA in HepG2/GFP-HBx cells was inhibited markedly by X-siRNA. The nude mice experiment showed that the gross tumor volume was much bigger in HepG2/GFP-HBx group than that in HepG2/GFP group (P < 0.05). The growth of palpable tumors in X-siRNA or 5-aza-dC treatment group notably decreased (P < 0.05). MSP analysis showed that p16 gene methylation was observed in HepG2/ GFP-HBx-caused palpable tumors, while no methylation was detected in HepG2/GFP group. However, after treatment with X-siRNA or 5-aza-dC, p16 gene methylation reduced. CONCLUSIONS: HBV X-siRNA and methylation inhibitor can inhibit the growth of hepatoma cells via reversing p16 methylation.

[Efficacy of two nucleoside analogs to treat resistant HBeAg-negative chronic hepatitis B].

OBJECTIVE: To observe the therapeutic effect and safety of entecavir and adefovir in the treatment of lamivudine-resistant HBeAg-negative chronic hepatitis B. METHODS: Sixty-five patients with lamivudine-resistant HBeAg-negative chronic hepatitis B were randomly divided into two groups. The entecavir treatment group included 33 patients, who were administrated entecavir 1.0 mg/d. The adefovir treatment group included 32 patients, who were administrated adefovir dipivoxil 10 mg/d. Changes in serum HBV DNA, liver functions, phosphocreatine kinase, creatinine and adverse reaction were dynamically monitored. RESULTS: At the end of the 12th, 24th, 48th week of treatment, the rates of serum ALT normalization of the entecavir treatment group were higher than that of the adefovir treatment group, but there wasn't statistically difference between two groups until the end of the 48 th week of treatment (P > 0.05). The rate of sera to turn negative for HBV DNA of the entecavir treatment group was significantly higher than that of the adefovir treatment group at the end of the 12th week. Moreover, the difference was statistically significant (P<0.05). CONCLUSION: Both entecavir and adefovir dipivoxil might have a good response to lamivudine-resistant HBeAg-negative chronical hepatitis B. Entecavir could achieve better therapeutic effects.

[Comparative study on the clinical characteristics of HBV/HCV co-infection patients with different HCV contaminnation mode].

OBJECTIVE: The purpose of this study was to compare the epidemiological, biochemical and virological characteristics among patients co-infected with hepatitis B virus (HBV) and hepatitis C virus (HCV) according to the mode of HCV contamination. METHODS: The study included 133 patients with chronic HBV/HCV co-infection. They were studied and subdivided into two groups (drug addicts group and Blood transfusion group) according to the mode of HCV contaminnation. The epidemiological, biochemical and virological characteristics were collected. Univariate analysis was performed with the SPSS 16.0. RESULTS: 78 patients were infected by the mode of drug addicts (IDU), whereas 55 were infected by the mode of blood transfusion( PTCH). Patients in drug addicts group had yonger age, shorter HBV and HCV infection history, and lower cirrhosis percentage than those of patients in PTCH group (P <0.05). However,serum levels of ALT (t =4.760, P =0.000), AST (t = 3.798, P = 0.000), TBil (t = 4.274, P = 0.000) of IDU patients were higher than those of PTCH patients. There was difference of sex composition between two groups (chi2 = 18.706, P = 0.000). CONCLUSIONS: The clinical characteristics of patients with HBV/HCV coinfection were significantly different among different HCV contamination mode. PTCH patients have the characteristics of older age, more cirrhosis and mild degree of liver injury; IDU patients have the characteristics of yonger age,fewer cirrhosis and severe liver injury.

[Detection of hepatitis C core antigen in intravenous drug addictions].

OBJECTIVE: To study the status of detection of hepatitis C core antigen in intravenous drug addictions, and discuss the foreground of the hepatitis C core antigen ELISA test system. METHODS: HCV core antigen, HCV RNA quantity, anti HCV-IgG, HBsAg were analysis in all the plasma samples taken from 93 cases of intravenous drug users. RESULTS: The specialty and sensitivity of HCV core antigen in intravenous drug addictions 100% -54% separately. When HBsAg were positive, the sensitivity of HCV core antigen was 38%, while HBsAg negative, the sensitivity of HCV core antigen was 69% (P < 0.01). CONCLUSION: The detections of HCV core antigen showed high specialty but low sensitivity in intravenous drug addictions. The positive rate has positive relation with HCV RNA virus logarithm quantity. Coinfection with HBV are the interfere factor of HCV core antigen detection. In screening experimentations, the detection of HCV core antigen in plasma may be applied as supplement method for anti-HCV-IgG. It can also be used to monitor viremia in HCV infection.

[Adenoviruses mediated BCL-X1 overexpression protects mice from fulminant hepatic failure].

OBJECTIVE: To indentify the relation between hepatic cells apoptosis and the lesion of liver tissue in acute toxic lethal hepatitis. METHODS: 60 Wistar mice were randomly divided into normal control, model group and treatment group. Normal control and model group were pretreated by portal vein injection of normal saline, the treatment group was pretreated by portal vein injection of BCL-X1 adenoviruses. The mice of model group and treatment group were received an injection of D-galn and LPS to establish fulminant hepatic failure models 7 days after pretrement. To observe BCL-X1 expression, serum ALT, AST, hepatocyte apoptosis rate, and mortality rate of the three groups. RESULTS: The BCL-X1 expression was higher in treatment group than in model group; 6 hours after fulminant hepatic failure models were established,the serum ALT, AST level of treatment group was lower than model group;The hepatocyte apoptosis rate of treatment group was lower than model group. The death rate of treatment group was lower than model group. CONCLUSION: In fulminant mice hepatic failure models, the hepatocyte apoptosis rate has a positive correlation with death rate, the overexpression of BCL-X1 can decrease the hepatocyte apoptosis rate and the death rate.

[The levels of HBsAg can predict the efficacy of peglated interferon-alpha 2a combined with adefovir dipivoxil, in HBeAg-positive chronic hepatitis B patients].

OBJECTIVE: To investigate the levels of HBsAg in predicting the efficacy of peglated interferon-alpha 2a combined with adefovir dipivoxil (ADV), in HBeAg-positive chronic hepatitis B patients. METHODS: This trial enrolled 62 HBeAg-positive chronic hepatitis B patients with detectable HBsAg for at least 6 months prior to screening, serum HBV DNA levels of at least 100 000 IU/ml. The efficacy assessment: viral suppression below 100 IU/ml. The patients with HBV DNA < or = 100 IU/ml after 24 weeks therapy were divided into group A, in which monotherapy continued; While the rest were divided into group B, in which ADV was combined until week 48. In group B, at the end-of-treatment, the patients with HBV DNA < or = 100 IU/ml were divided into group B1, the rest were divided into group B2. RESULTS: There was no significant difference on the baseline characteristics of patients between B1 and B2. There was significant difference on the levels of HBsAg at 12-week and 24-week between B1 and B2; while there was no significant difference on the levels of HBeAg. CONCLUSIONS: The levels of HBsAg at 12-week and 24-week would be predictors to evaluate the efficacy of combined therapy in HBeAg-positive chronic hepatitis B patients.

[Expression of fibroblast activation protein in HBV related hepatocellular carcinoma].

OBJECTIVE: To analyze the gene expression level of fibroblast activation protein in HBV related hepatocellular carcinoma patients and discuss its clinical significance. METHODS: FAP gene expression in 33 hepatocellular carcinoma patients cancer tissues, peficancerous tissues, distant relative normal liver tissues and 13 normal liver tissues were examined by reverse transcription PCR; and real-time fluorescent quantitative PCR (qRT-PCR) was used to quantify their expression. RESULTS: FAP were expressed in all the tissues,the relative expression values in cancer tissues, peficancerous tissues and distant relative normal liver tissues were 5.14 +/- 6.69, 1.58 +/- 0.96, 1.63 +/- 0.94, respectively, the differences were statistically significant (F = 4.401, P < 0.05); and in TNM stage I, II, IIII, they were 2.89 +/- 3.35, 4.15 +/- 4.69, 10.09 +/- 9.51 respectively; in well-differentiated, differentiated and poorly differentiated hepatocellular carcinoma were 1.62 +/- 1.74, 3.84 +/- 3.79, 1.26 +/- 13.34 respectively. The differences were all statistically significant (P < 0.05). CONCLUSION: FAP may play an important role in the occurrence and development of HBV related hepatocellular carcinoma.

[A clinical study on the efficacy of HBeAg-positive chronic hepatitis B patients treated with adefovir dipivoxil for 4 years].

OBJECTIVE: To observe the efficacy and safety on the efficacy of HBeAg-positive chronic Hepatitis B patients treated with adefovir dipivoxil for 4 years. METHODS: Ninety-five patients with HBeAg-positive chronic hepatitis B were treated with adefovir dipivoxil 10 mg per day orally. The patients were observed before and after treatment for their serum levels of ALT and HBV DNA, the new increasing rates of serum ALT normalization, HBV DNA clearances, HBeAg loss, HBeAg seroconversion and adverse drug events. RESULTS: At 4 years on study, the rates of ALT normalization, HBV DNA clearances, HBeAg loss, HBeAg seroconversion and HBV DNA rebound were 89.5%, 63.2%, 47.4%, 41.1% and 8.0%, respectively. No drug related to renal function impairment was found during the treatment, eight patients had adverse drug events but all were mild. CONCLUSION: Adefovir dipivoxil could effectively inhibit HBV replication, normalize ALT and enhance transformation from HBeAg to HBeAb for cases with naive and treated-first patients. The efficacy were increased with prolongation of the treatment period. It is safe and has a good tolerance.