[Effects of pre-electroacupuncture on blood pressure and cardiac function in high-salt-induced hypertension rats].

OBJECTIVE: To observe the effects of pre-electroacupuncture at "Taichong"(LR3), "Neiguan"(PC6) and "Waiguan"(TE5) on blood pressure and cardiac function of high-salt-induced hypertension rats, so as to explore the possible mechanism of pre-electroacupuncture in improving hypertension. METHODS: Twenty-four SD rats were randomly divided into control group, high-salt group and pre-electroacupuncture group, with 8 rats in each group. The hypertension model was established by feeding high-salt diet for 7 weeks. In the pre-electroacupuncture group, rats received electroacupuncture intervention at bilate-ral LR3, PC6 and TE5 (2 Hz/15 Hz, 2 mA) for 30 min, once a day, from the first day of modeling, for a total of 7 weeks. The blood pressure of rats was monitored by caudal artery noninvasive blood pressure measurement technique before and at the 1st, 3rd, 5th and 7th week of modeling. At the 8th week of the experiment, left ventricular catheterization was performed and biological signal acquisition system was used to detect left ventricular hemodynamics indexes and analyze left ventricular function, the car-diac mass ratio was measured to evaluate the degree of myocardial hypertrophy. The mRNA expressions of atrial natriuretic peptide(ANP), myosin heavy chain 7(MYH7), α-smooth muscle actin(α-SMA), interleukin(IL)-1ß, and IL-6 of myocardial tissues were detected by quantitative real-time PCR. Sirius red staining was used to observe the degree of myocardial fibrosis. RESULTS: Compared with the control group, systolic blood pressure, diastolic blood pressure, mean arterial pressure, left ventricular end-diastolic pressure (LVEDP), cardiac mass ratio，and the mRNA expressions of ANP, MYH7, α-SMA, IL-1ß, and IL-6, and sirius red staining area of myocardium were all significantly increased(P<0.01,P<0.05)，maximal rate of rise and descent of left ventricular pressure(LVP±dP/dtmax) were decreased (P<0.05,P<0.01) in the high-salt group. Compared with the high-salt group, rats in the pre-electroacupuncture group had lower systolic blood pressure, diastolic blood pressure, mean arterial pressure, LVEDP，cardiac mass ratio，higher LVP±dP/dtmax,down-regulated mRNA expressions of ANP, MYH7, α-SMA, IL-1ß, IL-6, and smaller area of sirius red staining(P<0.05, P<0.01). CONCLUSION: Pre-electroacupuncture tends to lower blood pressure, improve cardiac function and reduce myocardial fibrosis in high-salt-induced hypertension rats, which may be associated with inhibiting inflammatory response.

Single-nucleotide polymorphisms of HLA and Polygonum multiflorum-induced liver injury in the Han Chinese population.

BACKGROUND: Polygonum multiflorum is one of the leading causes of herb-induced liver injury in China. HLA-B*35:01 is reported to be a potential biomarker of Polygonum multiflorum-induced liver injury (PM-DILI). However, little is known about the relationship between single-nucleotide polymorphisms (SNPs) and PM-DILI. AIM: To identify SNPs that indicate susceptibility to PM-DILI. METHODS: We conducted a systematic study enrolling 382 participants from four independent hospitals, including 73 PM-DILI patients, 118 patients with other drug-induced liver injury (other-DILI) and 191 healthy controls. Whole-exome sequencing was performed for 8 PM-DILI patients and 8 healthy controls who were randomly selected from the above subjects. Nineteen SNPs that showed high frequencies in the 8 PM-DILI patients were selected as candidate SNPs and then screened in 65 PM-DILI patients, 118 other-DILI patients and 183 healthy controls using the MassARRAY system. HLA-B high-resolution genotyping was performed for the 73 PM-DILI and 118 other-DILI patients. The Han-MHC database was selected as a population control for HLA-B analysis. P < 6.25 × 10-3 after Bonferroni correction was considered significant. RESULTS: The frequencies of rs111686806 in the HLA-A gene, rs1055348 in the HLA-B gene, and rs202047044 in the HLA-DRB1 gene were significantly higher in the PM-DILI group than in the control group [27.2% vs 11.6%, P = 1.72 × 10-5, odds ratio (OR) = 3.96, 95% confidence interval (CI): 2.21-7.14; 42.5% vs 8.6%, P = 1.72 × 10-19, OR = 13.62, 95%CI: 7.16-25.9; 22.9% vs 8.1%, P = 4.64 × 10-6, OR = 4.1, 95%CI: 2.25-7.47]. Only rs1055348 showed a significantly higher frequency in the PM-DILI group than in the other-DILI group (42.5% vs 13.6%, P = 1.84 × 10-10, OR = 10.06, 95%CI: 5.06-20.0), which suggested that it is a specific risk factor for PM-DILI. rs1055348 may become a tag for HLA-B*35:01 with 100% sensitivity and 97.7% specificity in the PM-DILI group and 100% sensitivity and 98.1% specificity in the other-DILI group. Furthermore, HLA-B*35:01 was confirmed to be associated with PM-DILI with a frequency of 41.1% in the PM-DILI group compared with 11.9% (P = 4.30 × 10-11, OR = 11.11, 95%CI: 5.57-22.19) in the other-DILI group and 2.7% (P = 6.22 × 10-166, OR = 62.62, 95%CI: 35.91-109.20) in the Han-MHC database. CONCLUSION: rs111686806, rs1055348, and rs202047044 are associated with PM-DILI, of which, rs1055348 is specific to PM-DILI. As a tag for HLA-B*35:01, rs1055348 may become an alternative predictive biomarker of PM-DILI.

Application of deep residual neural network in detecting small bowel obstruction by abdominal plain film / 西安交通大学学报(医学版)

Objective: To study whether a deep residual neural network can detect small bowel obstruction patterns on upright abdominal radiographs. Methods:The data of training set and test set used in this study were obtained from The First Affiliated Hospital of Xi'an Jiaotong University and No.215 Hospital of Shaanxi Nuclear Industry; the data of validation set came from No.215 Hospital of Shaanxi Nuclear Industry. Totally 3 298 clinical upright abdominal radiographs obtained from two hospitals were classified into obstructive and non-obstructive categories independently by two radiologists on the basis of the four signs on upright abdominal radiographs, who discussed and reached consensus when disagreements arose. Among them, 569(17.3%) images were found to be consistent with small bowel obstruction, and 2 729 (82.7%) images had no small bowel obstruction. A total of 2 305 training sets and 993 test sets (training set: test set = 2.3:1) were composed of data from the two groups, including 405 cases (17.6%) of small bowel obstruction, 1 900 cases (82.4%) of non-small bowel obstruction, 164 cases (16.5%) of small bowel obstruction, and 829 cases (83.5%) of non-small bowel obstruction. The diagnosis of small bowel obstruction in training and testing sets was based on experienced radiologists' evaluation. Totally 861 abdominal upright abdominal radiographs constituted the validation set (99 with small bowel obstruction and 762 with no small bowel obstruction); the surgical results and clinical diagnosis were set as the gold standard. In this study, the image 2012 large-scale visual recognition challenge data set (ILSVRC2012) was used for pre-training the deep residual neural network (ResNet38). The retraining of deep residual network (ResNet38) with training set data was used to establish the diagnostic model. The test set was mainly used in the learning algorithm process to adjust the algorithm parameters to modify the network, so as to make the network model more efficient. Results: After training, the deep residual neural network achieved an AUC of 0.83 on the test set (95% CI 0.82-0.92). The sensitivity of the system for small bowel obstruction was 84.1%, with a specificity of 65.0%. And on validation set it achieved an AUC of 0.87 (95% CI 0.82-0.92), the sensitivity of the system for small bowel obstruction was 89.9%, with a specificity of 68.0%. Conclusion: Transfer learning with deep residual neural network may be used to train a detector for small bowel obstruction on upright abdominal radiographs even with limited training data.

Is Spinal Surgery Safe for Elderly Patients Aged 80 and Above? Predictors of Mortality and Morbidity in an Asian Population.

OBJECTIVE: We aimed to determine the 2-year mortality and morbidity rates following spine surgery in elderly patients (age ≥80 years) and to study the associated risk factors. METHODS: The records of patients ≥80 years of age who underwent spine surgery during the years 2003-2015 at Tan Tock Seng Hospital, Singapore were retrospectively reviewed. Information was collected on their demographic characteristics, comorbidities, diagnosis, general and neurological status, type of surgery, and outcomes. The mortality and morbidity rates over a 2-year period were analyzed. Bivariate analyses were carried out to identify factors associated with mortality. RESULTS: We selected 47 patients (mean age, 83.3 years; range, 80-91 years) who were followed up for a mean duration of 27.7 months. The mortality rates at 30 days, 6 months, 1 year, and 2 years following surgery were 2.1%, 8.5%, 10.6%, and 12.8%, respectively. The factors significantly associated with mortality included multiple comorbidities, nondegenerative aetiology, and vertebral fractures. The overall morbidity rate was 48.9%, and 17% of this cohort had major complications. CONCLUSION: Surgeons should strategize management protocols with due consideration of the mortality and morbidity rates, and be wary of operating on patients with multiple comorbidities, nondegenerative conditions, and vertebral fractures.

A Simple, Sensitive, and Reliable Method for the Simultaneous Determination of Multiple Antibiotics in Vegetables through SPE-HPLC-MS/MS.

Antibiotics, widely used in livestock breeding, enter the environment through animal manure because of incomplete absorption in animals, especially the farmland ecosystem. Therefore, antibiotics may be adsorbed by plants and even become hazardous to human health through the food chain. In this study, a simple, sensitive, and reliable method was developed for the simultaneous determination of eleven antibiotics, including four sulfonamides, two tetracyclines, three fluoroquinolones, tylosin, and chloramphenicol in different vegetable samples using SPE-HPLC-MS/MS. Vegetable samples were extracted by acetonitrile added with hydrochloric acid (125:4, v/v). The extracts were enriched by circumrotating evaporation, and then cleaned through SPE on a hydrophilic-lipophilic balance (HLB) cartridge. All compounds were determined on a C18 reverse phase column through HPLC-MS/MS. The mean recoveries of 11 antibiotics from spiked samples of vegetables ranged from 71.4% to 104.0%. The limits of detection and quantification were 0.06⁻1.88 µg/kg and 0.20⁻6.25 µg/kg, respectively. The applicability of this technique demonstrated its good selectivity, high efficiency, and convenience by the analysis of 35 vegetable samples available from a vegetable greenhouse. Antibiotic residues in vegetables have aroused wide concern from the public. Therefore, standards should be established for antibiotic residues in vegetables to ensure food safety and human health.

Intraoperative Measurements of Joint Line Changes Using Computer Navigation Do Not Correlate With Postoperative Radiographic Measurements in Total Knee Arthroplasty.

BACKGROUND: The adverse effects of joint line (JL) changes on kinematics and outcomes of total knee arthroplasty (TKA) have been studied. Some authors have quantified JL changes using intraoperative data from computer navigation, despite no studies validating these measurements to date. We designed a prospective study to determine whether intraoperative measurements of JL changes using computer navigation correlate with measurements obtained on weight-bearing radiographs postoperatively. METHODS: A total of 195 consecutive patients (195 knees) underwent computer-navigated cruciate-retaining TKA by the senior author. Twenty-four patients had missing radiographic data and were excluded from the study. The final JL change was calculated intraoperatively from the verified bony cuts and planned JL change as determined by the computer. JL position was also measured on preoperative and postoperative radiographs using an anteroposterior method. RESULTS: One hundred seventy-one knees were evaluated. Using computer-navigated and radiographic measurements, the mean JL change was 1.95 ± 1.5 mm (0-8.0 mm) and 4.05 ± 2.9 mm (0-17.3 mm), respectively. One hundred fourteen (67%) vs 129 (75%) had JL elevation, 44 (26%) vs 30 (18%) had JL depression, and 13 (7%) vs 12 (7%) had no JL change, respectively. Inter-rater and intrarater reliability of radiographic measurements was excellent. We found a poor correlation between computer-navigated and radiographic measurements (r = 0.303). CONCLUSION: There is a poor correlation between computer-aided and radiographic measurements of JL changes post-TKA. Elevation/depression of the JL needs to be considered in patients who remain symptomatic despite TKA, although the optimal method of assessment remains uncertain.

Hepatitis B surface antigen quantification at hepatitis B e antigen seroconversion predicts virological relapse after the cessation of entecavir treatment in hepatitis B e antigen-positive patients.

OBJECTIVES: To assess off-treatment virological relapse rates and to determine the role of hepatitis B surface antigen (HBsAg) quantification in predicting virological relapse after stopping entecavir (ETV) treatment in patients with hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB). METHODS: One hundred and twelve CHB patients for whom ETV was stopped in accordance with the Asian Pacific Association for the Study of the Liver guidelines stopping rules were enrolled. Patient HBsAg and HBV DNA levels were monitored every 4-12 weeks during ETV treatment and after ETV cessation. Post-treatment virological relapse was defined as a serum HBV DNA level of >10 000 copies/ml after stopping ETV treatment. RESULTS: The virological relapse rate at 52 weeks after stopping ETV was 48.2%. The post-treatment virological relapse rate was significantly higher in patients aged >50 years than in those aged <50 years (p < 0.001), and the virological relapse rate was significantly lower in patients with an HBsAg level <2.0 log10 IU /ml than in those with a level ≥ 2.0 log10 IU /ml at ETV cessation (p = 0.005). An HBsAg level of 2.5 log10 IU/ml at HBeAg seroconversion was the optimal cut-off value for predicting post-treatment virological relapse (p < 0.001). In those aged <50 years and with HBsAg ≤ 2.5 log10 IU/ml at HBeAg seroconversion, the relapse rate was only 5%. In patients with HBsAg ≤ 2.5 log10 IU/ml at HBeAg seroconversion, 52.4% achieved HBsAg levels ≤ 2.0 log10 IU/ml at ETV cessation, while in those with HBsAg >2.5 log10 IU/ml at HBeAg seroconversion, only 4.4% achieved this criterion. CONCLUSIONS: HBsAg levels can help guide the timing of cessation of ETV treatment. HBsAg levels of 2.5 log10 IU/ml at HBeAg seroconversion may be a useful marker to predict virological relapse after the cessation of ETV treatment in HBeAg-positive CHB patients.

The efficacy and safety of entecavir in patients with advanced schistosomiasis co-infected with hepatitis B virus.

OBJECTIVE: To evaluate the efficacy and safety of entecavir (ETV) in patients with advanced schistosomiasis and hepatitis B virus (HBV) co-infection. METHODS: Sixty-seven patients with advanced schistosomiasis and HBV co-infection were enrolled in this study. The patients were randomly divided into the ETV treatment group (n=35) and the control group (n=32). The patients in the control group adopted routine supportive therapy for 52 weeks, and those in the ETV treatment group received ETV at a dose of 0.5mg once daily on the basis of routine supportive therapy for 52 weeks. Hepatic fibrosis markers (hyaluronic acid, type III procollagen, type IV collagen, laminin, and fibronectin), Ishak fibrosis score, alanine transaminase (ALT), HBV DNA, and Child-Pugh score were compared between the two groups. The intention to treat (ITT) population was used for the analysis. The measurement data and count data were analyzed by t-test and Chi-square test, respectively. RESULTS: After 52 weeks of treatment, the hepatic fibrosis markers (hyaluronic acid, type III procollagen, type IV collagen, laminin, and fibronectin) were significantly improved in the ETV treatment group compared to the control group (all p<0.05). A ≥1-point improvement in the Ishak fibrosis score was found in 25.7% (9/35) of the ETV group, and the mean change from the baseline in the Ishak fibrosis score was a 0.3-point reduction. The control group showed disease progression in the Ishak fibrosis score. More patients in the ETV group than in the control group had undetectable serum HBV DNA levels (82.9% vs. 3.1%, p<0.05) and ALT normalization (68.6% vs. 18.3%, p<0.05). The ETV treatment group demonstrated an improvement in Child-Pugh score at week 52 (-3.7 vs. 0.3, p<0.05). In addition, no obvious adverse reactions were observed during ETV treatment. CONCLUSION: ETV is safe and effective in patients with advanced schistosomiasis and HBV co-infection.

[Relationship between effect of lamivudine in the treatment of cirrhotic patients with uncompensated hepatitis B with HBV genotypes and cytotoxic T lymphocyte].

OBJECTIVE: To explore relationship between effect of Lamivudine in the treatment of cirrhotic patients with uncompensated hepatitis B with hepatitis B virus (HBV)genotypes and HBV specific cytotoxic T lymphocytes (CTL). METHODS: 80 cases of uncompensated cirrhotic hepatitis B (40 cases with genotype B and 40 with genotype C), HBV DNA positive, HBeAg positive and human leukocyte antigen (HLA)-A2 positive,were treated with Lamivudine 100 mg/d, one year later, its effect and relationship with HBV genotypes and HBV specific CTL were observed. RESULTS: HBV DNA turned negative:40 cases with genotype B turned negative (100%). In the 9th and 10th month of treatment, there was one case with genotype C had YMDD variation respectively and Adefovir dipivoxil was used for treatment, of the rest 38 cases, HBV DNA of 26 cases (68.42%) turned negative,HBV DNA negative rate of patients with genotype is lower than that of patients with genotype B, chi2 = 14.91, P < 0.01. HBeAg turned negative: 18 cases with genotype B (45%) turned negative, more than that of patients with genotype C (7 cases, 18.42%), chi2 = 6.32, P < 0.05. Peripheral blood HBV specific CTL level: before treatment, it was (0.33 +/- 0.03)% of patients with genotype B,higher than that of patients with genotype C [(0.11 +/- 0.02)%], t = 8.12, P < 0.001. 1 year after treatment: it was (0.44 +/- 0.04)% of patients with genotype B, higher than that before treatment, t = 4.01, P < 0.001, it was also higher than that of patients with genotype C 1 year after treatment [(0.23 +/- 0.03)%], t = 5.63, P < 0.01, alanine amino-transferase (ALT) returned to normal: 38 cases with genotype B (95%) returned to normal, more than that of patients with genotype C (28 cases, 73.68%), X2 = 6.79, P < 0.01. CONCLUSION: Effect of Lamivudinein the treatment of cirrhotic patients with uncompensated hepatitis B is better in patients with genotype B than patients with genotype C, its mechanism may be related to lower level of HBV specific CTL in patients with genotype C than patients with genotype B.

[Effects of shuang shen tong guan decoction on the blood flow dynamics in rat model with myocardial infarction].

OBJECTIVE: To research the effects of Shuang Shen Tong Guan Decoction (SSTGD) on hemodynamics in rats with acute myocardial infarction (AMI). METHODS: SD rats were divided into sham operation group,model group, SSTGD low-dose group (2.5 g/kg), SSTGD middle-dose group (5 g/kg) and SSTGD high-dose group (7.5 g/kg). The levels of HR, MAP, LVSP, LVEDP, LVdp/ dt(max) and LVdp/dt(min) were detected by PowerLab at 0, 15, 30, 60, 90, 120, 180 min after administration. RESULTS: Compared with the sham operated group, the levels of HR, MAP were increased, the levels of LVSP, LVEDP, LVdp/dt(max) and LVdp/dt(min) were reduced at each detected point in model group, the difference was significant (P < 0.05). Compared with the model group, HR and MAP were decreased in SSTGD low-dose group, SSTGD middle-dose group and SSTGD high-dose group after 15 min; LVSP, LVEDP, LVdp/dt(max) and LVdp/dt(min) were higher, there was significantly difference (P < 0.05). Compared with SSTGD low-dose group and SSTGD middle-dose group, the difference of LVSP, LVEDP, LVdp/dt(max) and LVdp/dt(min) was statistically significant in SSTGD high-dose group (P < 0.05). CONCLUSION: SSTGD can improve cardiac function by increasing heart stroke volume, decreasing cardiac oxygen consumption and total peripheral vascular resistance.

Relationship between effect of lamivudine in the treatment of cirrhotic patients with uncompensated hepatitis B with HBV genotypes and cytotoxic T lymphocyte / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To explore relationship between effect of Lamivudine in the treatment of cirrhotic patients with uncompensated hepatitis B with hepatitis B virus (HBV)genotypes and HBV specific cytotoxic T lymphocytes (CTL).</p><p><b>METHODS</b>80 cases of uncompensated cirrhotic hepatitis B (40 cases with genotype B and 40 with genotype C), HBV DNA positive, HBeAg positive and human leukocyte antigen (HLA)-A2 positive,were treated with Lamivudine 100 mg/d, one year later, its effect and relationship with HBV genotypes and HBV specific CTL were observed.</p><p><b>RESULTS</b>HBV DNA turned negative:40 cases with genotype B turned negative (100%). In the 9th and 10th month of treatment, there was one case with genotype C had YMDD variation respectively and Adefovir dipivoxil was used for treatment, of the rest 38 cases, HBV DNA of 26 cases (68.42%) turned negative,HBV DNA negative rate of patients with genotype is lower than that of patients with genotype B, chi2 = 14.91, P < 0.01. HBeAg turned negative: 18 cases with genotype B (45%) turned negative, more than that of patients with genotype C (7 cases, 18.42%), chi2 = 6.32, P < 0.05. Peripheral blood HBV specific CTL level: before treatment, it was (0.33 +/- 0.03)% of patients with genotype B,higher than that of patients with genotype C [(0.11 +/- 0.02)%], t = 8.12, P < 0.001. 1 year after treatment: it was (0.44 +/- 0.04)% of patients with genotype B, higher than that before treatment, t = 4.01, P < 0.001, it was also higher than that of patients with genotype C 1 year after treatment [(0.23 +/- 0.03)%], t = 5.63, P < 0.01, alanine amino-transferase (ALT) returned to normal: 38 cases with genotype B (95%) returned to normal, more than that of patients with genotype C (28 cases, 73.68%), X2 = 6.79, P < 0.01.</p><p><b>CONCLUSION</b>Effect of Lamivudinein the treatment of cirrhotic patients with uncompensated hepatitis B is better in patients with genotype B than patients with genotype C, its mechanism may be related to lower level of HBV specific CTL in patients with genotype C than patients with genotype B.</p>

[The efficacy of antiviral therapy for hepatitis B virus related decompensated cirrhosis].

Not Abstract.

[Therapeutic effect of dahuangzhechong pills on advanced schistosomiasis].

OBJECTIVE: To evaluate the therapeutic effect and safety of Dahuangzhechong pills on advanced schistosomiasis. METHODS: Sixty-two patients with advanced schistosomiasis were divided randomly into two groups, a treatment group and a control group, and treated with Dahuangzhechong pills and routine therapy, respectively. The course of treatment was 52 weeks in the two groups. Before and after the 52-week treatment, the indexes of liver function and hepatic fibrosis, prothrombin time (PT), Child-Pugh scores and changes of B-type ultrasonic images were detected for all the patients. RESULTS: There were significant differences in the levels of alanine aminotransferase (ALT) and total bilirubin (TBIL), the indexes of hepatic fibrosis, portal venous inside diameters and portal venous flow between the two groups after 52 weeks treatment (P < 0.05). In addition, there were no obvious adverse effects during the treatment in the patients of the Dahuangzhechong pill group. CONCLUSION: Dahuangzhechong pill treatment is a safe and effective therapy for the patients with advanced schistosomiasis.

Study on SDF-1α and CD44v6 expression in multiple myeloma patients / 白血病·淋巴瘤

Objective To explore the relationship of stromal derived factor 1α (SDF-1α) and CD44variant isoforms (CD44v6) with progress of multiple myeloma (MM). Methods Bone marrow mononuclear cells(MNCs) and bone marrow stromal cells (BMSCs) from 24 cases of MM patients (14 cases of untreated and relapsed and 10 cases of stable MM patients) and 15 cases of subjects were investigated as potential SDF-1αand CD44v6 product. The level of SDF-1α and CD44v6 of the conditioned media from MM patients and subjects were analyzed by ELISA. Results The level of SDF-1α and CD44v6 from MNCs in untreated and relapsed MM patients [(7232.41 ± 2644.97) pg/ml and (34.34 ± 13.20) ng/ml] were significantly higher than stable MM patients [(2315.49 ± 748.29) pg/ml and (15.69 ± 5.28) ng/ml] (t =6.25, t= 7.82, P ＜0.05) and 15 subjects [(1149.52 ± 636.06) pg/ml and (4.85 ± 3.62) ng/ml] (t= 4.60, t = 7.61, P＜ 0.05). The level of SDF-1α in stable MM patients was different from healthy subjects (P ＜0.05), but the level of CD44v6 in stable MM patients was not different from controls. The level of SDF-1α and CD44v6 in stable MM patients were significantly higher than health subjects (t = 2.99, t= 4.87, P ＜0.05). The level of SDF-1α was also detected from BMSCs of MM patients. When human MM cell lines U266 were adhered to BMSCs of 9 untreated and relapsed MM patients,and added rhIL-6 to it, there was significant increase of SDF-1α, compared with BMSCs in subjects and MM patients. The expression level of SDF-lα was correlated with the level of CD44v6 (r =0.51, P =0.03). Conclusion The increase of SDF-1α (may be produced by myeloma cells and BMSCs) and CD44v6 (may be produced by myeloma cells) activity is associated with the progress or pathogenesis of MM, and may be involved with tumor invasion. The completion of these processes in vivo may need participation of myeloma cells, BMSCs, IL-6,SDF-lα and CD44v6.

[A study on the treatment of chronic hepatitis B with YMDD mutation].

OBJECTIVE: To explore the strategy for the treatment of chronic hepatitis B with YMDD mutation. METHODS: A total of 120 chronic hepatitis B patients with YMDD mutation were randomly assigned into four groups. In group A, patients received adefovir dipivoxil for 48 weeks. In group B, patients received adefovir dipivoxil in combination with lamivudine during the first 12 weeks and adefovir dipivoxil only for the following 36 weeks. In group C, patients received adefovir dipivoxil in combination with lamivudine for 48 weeks. In group D, patients received entecavir for 48 weeks. RESULTS: The rate of rebound of alanine aminotransferase (ALT) was 30.0% (9/30), 10.0% (3/30), 6.7% (2/30), 10.0% (3/30) (P < 0.05) during the first 12 weeks, and one patient with severe hepatitis was found in group A. The positive rate of YMDD mutation was 17.9%, 0, 0, 0 at week 12. There was no significant difference in the level of ALT and the rate of HBeAg seroconversion after 48-week treatment (P > 0.05). At week 48, there was significant difference in the ALT normalization rate and undetectable HBV DNA rate between group C and group A, and also between group D and group A, and the rate of drug resistant genotype was 6.9%, 6.7%, 0, 0. Two patients had rtN236T mutation in group A, and one patient had rtN236T mutation and another one had rtA181V mutation in group B. CONCLUSION: Adefovir dipivoxil in combination with lamivudine or entecavir are safe and effective therapies for chronic hepatitis B patients with YMDD mutation.

A study on the treatment of chronic hepatitis B with YMDD mutation / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To explore the strategy for the treatment of chronic hepatitis B with YMDD mutation.</p><p><b>METHODS</b>A total of 120 chronic hepatitis B patients with YMDD mutation were randomly assigned into four groups. In group A, patients received adefovir dipivoxil for 48 weeks. In group B, patients received adefovir dipivoxil in combination with lamivudine during the first 12 weeks and adefovir dipivoxil only for the following 36 weeks. In group C, patients received adefovir dipivoxil in combination with lamivudine for 48 weeks. In group D, patients received entecavir for 48 weeks.</p><p><b>RESULTS</b>The rate of rebound of alanine aminotransferase (ALT) was 30.0% (9/30), 10.0% (3/30), 6.7% (2/30), 10.0% (3/30) (P < 0.05) during the first 12 weeks, and one patient with severe hepatitis was found in group A. The positive rate of YMDD mutation was 17.9%, 0, 0, 0 at week 12. There was no significant difference in the level of ALT and the rate of HBeAg seroconversion after 48-week treatment (P > 0.05). At week 48, there was significant difference in the ALT normalization rate and undetectable HBV DNA rate between group C and group A, and also between group D and group A, and the rate of drug resistant genotype was 6.9%, 6.7%, 0, 0. Two patients had rtN236T mutation in group A, and one patient had rtN236T mutation and another one had rtA181V mutation in group B.</p><p><b>CONCLUSION</b>Adefovir dipivoxil in combination with lamivudine or entecavir are safe and effective therapies for chronic hepatitis B patients with YMDD mutation.</p>