Difference and clinical value of metabolites in plasma and feces of patients with alcohol-related liver cirrhosis

BACKGROUND Alterations in plasma and intestinal metabolites contribute to the pathogenesis and progression of alcohol-related liver cirrhosis(ALC).AIM To explore the common and different metabolites in the plasma and feces of patients with ALC and evaluate their clinical implications.METHODS According to the inclusion and exclusion criteria,27 patients with ALC and 24 healthy controls(HCs)were selected,and plasma and feces samples were collected.Liver function,blood routine,and other indicators were detected with automatic biochemical and blood routine analyzers.Liquid chromatography-mass spectrometry was used to detect the plasma and feces metabolites of the two groups and the metabolomics of plasma and feces.Also,the correlation between metabolites and clinical features was analyzed.RESULTS More than 300 common metabolites were identified in the plasma and feces of patients with ALC.Pathway analysis showed that these metabolites are enriched in bile acid and amino acid metabolic pathways.Compared to HCs,patients with ALC had a higher level of glycocholic acid(GCA)and taurocholic acid(TCA)in plasma and a lower level of deoxycholic acid(DCA)in the feces,while L-threonine,L-phenylalanine,and L-tyrosine increased simultaneously in plasma and feces.GCA,TCA,L-methionine,L-phenylalanine,and L-tyrosine in plasma were positively correlated with total bilirubin(TBil),prothrombin time(PT),and maddrey discriminant function score(MDF)and negatively correlated with cholinesterase(CHE)and albumin(ALB).The DCA in feces was negatively correlated with TBil,MDF,and PT and positively correlated with CHE and ALB.Moreover,we established a P/S BA ratio of plasma primary bile acid(GCA and TCA)to fecal secondary bile acid(DCA),which was relevant to TBil,PT,and MDF score.CONCLUSION The enrichment of GCA,TCA,L-phenylalanine,L-tyrosine,and L-methionine in the plasma of patients with ALC and the reduction of DCA in feces were related to the severity of ALC.These metabolites may be used as indicators to evaluate the progression of alcohol-related liver cirrhosis.

一种简易的硫辅助方法制备多孔蜂窝状的铁超小原子簇和单原子Fe/g-C3N4

超小原子簇和单原子分散的活性位点(USCAD)催化剂由于其高原子利用率、高活性、高稳定性等优点,成为多相催化领域一个新兴的研究热点.USCAD通常由载体缺陷、配体和分子筛或金属有机框架的孔道和笼锚定.而制备高密度的USCAD催化剂需要载体上有足够的锚定位点.石墨相氮化碳(g-C3N4)具有高稳定性、高密度且均匀分散的氮原子,是制备USCAD催化剂的理想载体.但是传统热解法制备的金属/g-C3N4催化剂通常为块体结构,会导致金属物种被严重包覆,进而导致催化活性下降.加入固体模板可以制备得到多孔金属g-C3N4催化剂,但是后续复杂的除模板过程制约了其实际应用.因此,开发一种简易的无模板方法制备USCAD金属/g-C3N4催化剂具有重要意义.本工作开发了一种简易的硫辅助热解法制备得到蜂窝状结构的高密度(Fe载量为17.7wt%)USCADFe/g-C3N4催化剂.其多孔蜂窝状结构使催化剂能够暴露更多的USCADFe活性位点,增加了活性位点与反应物的可接近性.通过球差电镜和同步辐射X射线吸收技术证明了Fe物种的分散形式.硫辅助热解法只需要在热解铁盐/三聚氰胺前驱体中加入适量的硫源即可得到蜂窝状的USCAD Fe/g-C3N4催化剂.硫元素作为一种"牺牲载体"通过与铁离子配位促进铁物种在前驱体混合物中分散,经过高温煅烧后以SO2的形式释放而不残留在催化剂中,免除了后续的除模板过程.通过TG-MS,XPS和IR等手段证明了硫元素在热解过程中的状态变化.这种硫辅助热解法表现出非常好的普适性,改变硫源种类(硫脲、硫粉、硫氰酸铵)和铁盐种类都可以得到具有蜂窝状孔道结构的USCADFe/g-C3N4催化剂.将催化剂应用于高级氧化过程可以高效降解各种有机污染物(苯酚、亚甲基蓝、亚甲基橙、罗丹明B),催化剂性能远远优于文献报道的其它Fe基催化剂和传统热解法制备的Fe/g-C3N4催化剂.该硫辅助热解法为无模板法制备纳米多孔USCAD金属/g-C3N4催化剂开辟了一条简易可行的途径.

Application of transient burning rate model of solid propellant in electrothermal-chemical launch simulation

A 30 mm electrothermal-chemical(ETC) gun experimental system is employed to research the burning rate characteristics of 4/7 high-nitrogen solid propellant. Enhanced gas generation rates(EGGR) of propellants during and after electrical discharges are verified in the experiments. A modified 0D internal ballistic model is established to simulate the ETC launch. According to the measured pressure and electrical parameters, a transient burning rate law including the influence of EGGR coefficient by electric power and pressure gradient(dp/dt) is added into the model. The EGGR coefficient of 4/7 high-nitrogen solid propellant is equal to 0.005 MW-1. Both simulated breech pressure and projectile muzzle velocity accord with the experimental results well. Compared with Woodley's modified burning rate law, the breech pressure curves acquired by the transient burning rate law are more consistent with test results. Based on the parameters calculated in the model, the relationship among propellant burning rate, pressure gradient(dp/dt) and electric power is analyzed. Depending on the transient burning rate law and experimental data, the burning of solid propellant under the condition of plasma is described more accurately.

Impact of Fuzheng Huayu tablet on antiviral effect of entecavir in patients with hepatitis B cirrhosis

Background:Fuzheng Huayu tablet is a traditional Chinese medicine(TCM)used for the treatment of liver fibrosis and cirrhosis.However,whether the combination with Fuzheng Huayu tablet could affect the antiviral efflcacy of nucleos(t)ide remains a concern.The objective of this trial was to explore the impact of Fuzheng Huayu tablet on antiviral effect of entecavir in patients with hepatitis B cirrhosis.Methods:A prospective,randomized control trial was conducted.Patients with compensated hepatitis B cirrhosis were randomly divided into the treatment group(entecavir capsule plus Fuzheng Huayu tablet)and the control group(entecavir capsule plus simulant of Fuzheng Huayu),and followed up for 48 weeks.The dynamic changes of HBV DNA load,the rate of serological conversion of HBeAg,liver function,renal function and liver stiffness measurement(LSM)were monitored.The general clinical data and adverse events were also recorded.Results:There was no significant difference in the rate of virological response and cumulative virological response between the treatment group and the control group(P>0.05).After 48 weeks of treatment,the HBeAg seroconversion rate,biochemical response rate and LSM value were 21.05%and 4.76%(P=0.164),86.96%and 65.96%(P=0.017),9.5 kpa and 10.6 kpa(P=0.827)in the treatment group and the control group,respectively.No serious adverse events related to the study therapy occurred during the trial.Conclusions:The antiviral entecavir combined with Fuzheng Huayu tablet did not affect the antiviral efflcacy of entecavir,but could improve the rate of biochemical response,and had a tendency to improve the rate of serological conversion of HBeAg and liver fibrosis in patients with hepatitis B cirrhosis.Fuzheng Huayu tablet is clinically safe for patients with hepatitis B cirrhosis.

Score model for predicting acute-on-chronic liver failure risk in chronic hepatitis B

AIM: To establish a clinical scoring model to predict risk of acute-on-chronic liver failure(ACLF) in chronic hepatitis B(CHB) patients.METHODS: This was a retrospective study of 1457 patients hospitalized for CHB between October 2008 and October 2013 at the Beijing Ditan Hospital, Capital Medical University, China. The patients were divided into two groups: severe acute exacerbation(SAE) group(n = 382) and non-SAE group(n = 1075). The SAE group was classified as the high-risk group based on the higher incidence of ACLF in this group than in the non-SAE group(13.6% vs 0.4%). Two-thirds of SAE patients were randomly assigned to risk-model derivation and the other one-third to model validation. Univariate risk factors associated with the outcome were entered into a multivariate logistic regression model for screening independent risk factors. Each variable was assigned an integer value based on the regression coefficients, and the final score was the sum of these values in the derivation set. Model discrimination and calibration were assessed using area under the receiver operating characteristic curve and the Hosmer-Lemeshow test. RESULTS: The risk prediction scoring model includedthe following four factors: age ≥ 40 years, total bilirubin ≥ 171 μmol/L, prothrombin activity 40%-60%, and hepatitis B virus DNA > 107 copies/m L. The sum risk score ranged from 0 to 7; 0-3 identified patients with lower risk of ACLF, whereas 4-7 identified patients with higher risk. The Kaplan-Meier analysis showed the cumulative risk for ACLF and ACLF-related death in the two risk groups(0-3 and 4-7 scores) of the primary cohort over 56 d, and log-rank test revealed a significant difference(2.0% vs 33.8% and 0.8% vs 9.4%, respectively; both P < 0.0001). In the derivation and validation data sets, the model had good discrimination(C index = 0.857, 95% confidence interval: 0.800-0.913 and C index = 0.889, 95% confidence interval: 0.820-0.957, respectively) and calibration demonstrated by the Hosmer-Lemeshow test(χ2 = 4.516, P = 0.808 and χ2 = 1.959, P = 0.923, respectively).CONCLUSION: Using the scoring model, clinicians can easily identify patients(total score ≥ 4) at high risk of ACLF and ACLF-related death early during SAE.

Body mass index and serum lipid profile influence serum prostate-specific antigen in Chinese men younger than 50 years of age

This study is to assess the potential factors that could affect the serum prostate-specific antigen （PSA） level in healthy younger men. We evaluated the associations of age, body mass index （BMI） and serum lipid profile with serum PSA level in 6774 Chinese men （aged 20-49 years） who received a routine health examination. Eligible men were classified into 10-year age groups, BMI was categorized as underweight （〈18.5）, normal （18.5-22.9）, overweight （23.0-24.9）, obese （25.0-29,9） and very obese （〉30） according to the redefined World Health Organization （WHO） criteria for the Asia-Pacific region. PSA levels were compared among groups as well, In multiple linear regression analysis, PSA was positively correlated with age （P〈0.0001）. Negative correlations existed between PSA and BMI （P〈0.0001） and triglyceride level （P=0.01）. No relationship could be found between PSA and serum cholesterol （P=0.711） or high-density lipoprotein （HDL; P =0.665）. In addition, we found that serum PSA levels increased with age and decreased with BMI. Our study demonstrates that age, BMI and triglyceride levels influence the PSA level in men 〈50 years of age.

Method of ballistic control and projectile rotation in a novel railgun

In order to realize the ballistic control of the railgun and the flight stability of the projectile, a new type of railgun is designed, which can control the muzzle velocity and rotation rate. The method of the muzzle velocity and overload control is to adjust the voltage or other parameters of pulse power supply. It would be easy to change velocity accurately in large wide. Another widespread concern problem is launching the spinning stability projectile by railgun. This paper designed a new structure of additional rails to generate an unsymmetrical magnetic field to produce rotational torque in armature. The structure is simple and can control the rotation rate by linear changing the barrel parameters. The calculation formulas of interior ballistic are derived by Biot-Safar law. The important parameter is the deflection angle of the additional rails relative to the symmetry plane of main rail. The larger the angle, the greater the rotation torque generated in the armature. To maintain the flight stability of the projectile, the barrel structural parameters should be proportional to the projectile structural parameters. When changing the muzzle velocity, the rotation rate will also be the equal proportion change. So that the gyro stability is the same. The experiment proves that the railgun designed in this paper can launch the projectile to rotate. And the rotational projectile may not cause the transition or much arcs. This method expands the application of the railgun.

CLDASSD:Reconstructing Fine Textures of the Temperature Field Using Super-Resolution Technology

Before 2008,the number of surface observation stations in China was small.Thus,the surface observation data were too sparse to effectively support the High-resolution China Meteorological Administration’s Land Assimilation System(HRCLDAS)which ultimately inhibited the output of high-resolution and high-quality gridded products.This paper proposes a statistical downscaling model based on a deep learning algorithm in super-resolution to research the above problem.Specifically,we take temperature as an example.The model is used to downscale the 0.0625°×0.0625°,2-m temperature data from the China Meteorological Administration’s Land Data Assimilation System(CLDAS)to 0.01°×0.01°,named CLDASSD.We performed quality control on the paired data from CLDAS and HRCLDAS,using data from 2018 and 2019.CLDASSD was trained on the data from 31 March 2018 to 28 February 2019,and then tested with the remaining data.Finally,extensive experiments were conducted in the Beijing-Tianjin-Hebei region which features complex and diverse geomorphology.Taking the HRCLDAS product and surface observation data as the"true values"and comparing them with the results of bilinear interpolation,especially in complex terrain such as mountains,the root mean square error(RMSE)of the CLDASSD output can be reduced by approximately 0.1℃,and its structural similarity(SSIM)was approximately 0.2 higher.CLDASSD can estimate detailed textures,in terms of spatial distribution,with greater accuracy than bilinear interpolation and other sub-models and can perform the expected downscaling tasks.

Numerical simulation on the pressure wave in a 30 mm electrothermal-chemical gun with the discharge rod plasma generator

An axisymmetric two-dimensional(2D)internal ballistic model including the transient burning rate law is used to simulate the 30mm electrothermal-chemical(ETC)launch with the discharge rod plasma generator(DRPG).The relationship between the pressure wave and the initial parameters,such as input electric power,discharging timing sequence,loading density and propellant web thickness,is researched through the change of initial parameters in the model.In the condition of synchronous discharging,the maximum of the pressure wave can be controlled while the ratio of the input electric energy to the propellant chemical energy(electric energy ratio)is less than 0.11.If the electric energy ratio is larger than 0.11,the maximum of the pressure wave increases rapidly with the electric energy ratio.With the increasing of the electric energy ratio,the change of the first negative amplitude value can be ignored.In the condition of timing sequence discharging,the allowed input electric energy ratio to control the pressure wave is proportional to the current pulse duration.At the high electric energy ratio,the maximum of the pressure wave is inverse proportional to the current pulse duration.The pressure wave increases with the increasing of the loading density.But the allowed electric energy ratio to control the pressure wave and the variation trend of the first negative amplitude wave value doesn't change.During the discharging of the DRPG,the influence of changing propellant web thickness in ETC launch can be ignored.

Design and manufacture of a 100 kA coaxial pulsed power cable for plasma generator and PPS in ETC guns

Based on our previous pulsed current and internal overvoltage test data and the experience of common commercial high power cables,a 100 kA coaxial pulsed power cable is designed and manufactured to adapt the coaxial electric energy breech transmission between the plasma generator and the pulsed power supply(PPS) in electrothermal-chemical(ETC) guns.The index parameters are analyzed and determined.Semi-conductor layers and a shield stiffener are introduced to prevent the deformation and burst of the pulsed power cable structurally.The semi-conductor layer can eliminate the air gap and balance the electric field in the cable.The shield stiffener can multiply the mechanical strength to restrain the strong electrodynamic force produced by the core dislocation of the outer conductor.The multi-coupling of electromagnetic field,stress field and thermal field analysis are established to assist in aided design of electrical strength,mechanical strength and temperature rise characteristics.Both a DC voltage withstand test and pulsed discharge tests are introduced to verify and inspect the performance and dynamic response of the pulsed power cable.The 25 kV/5 min DC voltage withstand test result shows that the sample leakage current is nearly 3 μA and no abnormal phenomena of the pulsed power cable sample occurred.The pulsed discharge tests show that the sample can sustain the 100 kA peak current.Furthermore,this 100 kA coaxial pulsed power cable can satisfy the ETC test requirements.

A Study on Measurement of Forest Soil Redox Potential

Redox potential has principal influences on formation and attribute of soils and it is necessary to research the measurement of soil redox potential. The self-made potentiometer and two indigenous FJA-5 potentiometers were employed to measure the Eh values of fir forest soils in situ, which lied in Savage Sea Beauty Spot in Sichuan Province. Simultaneously fresh soils in situ were collected and made into suspensions with various soil-water ratios and standing time to measure Eh values. The results demonstrated that the total tendency of Eh values measured by the self-made potentiometer was gradually falling with soil-water ratios increasing and standing time prolonging. There is a great difference between Eh values measured in laboratory and in situ. Only in situ may the measured Eh values show realistic oxidation-reduction conditions and formation characteristics of forest soil. The self-made potentiometer has a preferable performance than indigenous FJA-5 potentiometers and it can be applied to measuring forest soil Eh in situ.

Association of Cytokines with Alanine Aminotransferase, Hepatitis B Virus Surface Antigen and Hepatitis B Envelope Antigen Levels in Chronic Hepatitis B

Background： Cytokines play an important role in occorrence and recovery of hepatitis B virus （HBV） infection. The aim of this study was to investigate the changes ofcytokines concentration and its correlation to alanine aminotransferase （ALT）, HBV deoxyribonucleic acid （HBV-DNA）, hepatitis B envelope antigen （HBeAg）, and HBV surface antigen （HBsAg） in the development of chronic hepatitis B （CHB）. Methods： Thirteen healthy individuals （HI）, 30 chronic HBV-infected patients in immune tolerant （IT） phase, and 55 CHB patients were enrolled between August 2015 and May 2017. The peripheral blood samples were collected from all individuals. Tile levels of interferon （IFN）-α2, interleukin （IL）-10, transforming growth factor （TGF）-β1, HBV-DNA, HBsAg, and HBeAg and liver function were measured. The quantitative determinations of cytokines levels, including I FN-ct2, IL-10, and TGF-[31 were performed using Luminex multiplex technology. The correlation of cytokines to ALT, HBV-DNA, HBsAg, and HBeAg was analyzed by linear regression analysis. Results： IFN-ct2 levels were similar between HI and IT groups （15.35 [5.70, 67.65] pg/ml vs. 15.24 [4.07, 30.73] pg/ml, Z = -0.610, P - 0.542）, while it elevated significantly in CH B group （35.29 [ 15.94, 70.15] pg/ml vs. 15.24 [4.07, 30.73] pg/ml; Z = -2.522, P = 0.012）. Compared with HI group （3.73 [2.98, 11.92] pg/ml）, IL-10 concentrations in IT group （5.02 [2,98, 10.11] pg/ml）, and CHB group （7.48 [3. I 0, 18.00] pg/ml） slightly increased （X^2 = 2.015, P - 0.365）, and there was no significant difference between IT and CHB group （Z =- 1.419, P = 0.156）. The TGF-β1 levels among HI （3.59 ±0.20 pg/ml）, IT （3.62 ±0.55 pg/ml）, and CHB groups （3.64±0.30 pg/ml） were similar （X^2=2.739, P = 0.254）. In all chronic HBV-infected patients （including patients in IT and CHB groups）, the elevation of IFN-α2 level was significantly associated with ALT level （β = 0.389, t = 2.423, P = 0.018）, and was also negatively correlated to HBV-DNA load （β = -0.358, t=-2.308, P = 0.024）, HBsAg （β = -0.359, t = -2.288, P = 0.025）, and HBeAg contents （β = -0.355, t = -2.258, P = 0.027）. However, when both ALT level and cytokines were included as independent variable, HBV-DNA load, HBsAg, and HBeAg contents were only correlated to ALT level （[β= -0.459, t = -4.225, P = 0.000; β = -0.616, t = -6.334, P = 0.000; and β = -0.290, t = -2.433, P = 0.018; respectively）. Conclusions： IFN-α2 elevation was associated with ALT level in patients with chronic HBV infection. However, in CHB patients, only ALT level was correlated to HBV-DNA, HBsAg and HBeAg contents.

Plasmacytoid Dendritic Cell Function and Cytokine Network Profiles in Patients with Acute or Chronic Hepatitis B Virus Infection

Background： Plasmacytoid dendritic cells （pDCs） and cytokines play an important role in occurrence and recovery of hepatitis B virus （HBV） infection. The aim of this study was to explore the frequency and function ofpDC and serum cytokine network profiles in patients with acute or chronic HBV infection. Methods： The healthy individuals （HI group）, hepatitis B envelope antigen （HBeAg）-positive chronic HBV patients in immune tolerance （IT） phase （IT group）, HBeAg-positive chronic HBV patients （CHB group）, and acute HBV patients （AHB group） were enrolled in this study. The frequency of cluster of differentiation antigen 86 （CD86） ＋ pDC and the counts of CD86 molecular expressed on surface ofpDC were tested by flow cytometer. The quantitative determinations ofcytokines, including Fins-like tyrosine kinase 3 ligand （FIt-3L）, interferon （1FN）-α2, IFN-γ, interleukin （IL）-17A, IL-6, IL-10, transforming growth factor （TGF）-β1 and TGF-β2, were performed using Luminex multiplex technology. Results： In this study, there were 13 patients in HI group, 30 in IT group, 50 in CHB group, and 32 in AHB group. Compared with HI group, HBV infected group （including all patients in IT, CHB and AHB groups） had significantly higher counts of CD86 molecular expressed on the surface ofpDC （4596.5 ± 896.5 vs. 7097.7 ± 3124.6; P 〈 0.001）. The counts of CD86 molecular expressed on the surface of pDC in CriB group （7739.2 ±4125.4） was significantly higher than that of IT group （6393.4 ± 1653.6, P=0.043）. Compared with IT group, the profile of cytokines of FIt-3L, IFN-γ, and IL-17A was decreased, IFN-α2 was significantly increased （P =0.012） in CH B group. The contents of IL-10, TGF-{31, and TGF-132 in AHB group were significantly increased compared with IT and CHB groups （all P 〈 0.05）. Conclusions： This study demonstrated that the function of pDC was unaffected in HBV infection. The enhanced function of pDC and IFN-α2 might involve triggering the immune response from IT to hepatitis active phase in H BV infection. Acute patients mainly presented as down-regulation of the immune response by enhanced IL-10 and TGF-β.

Early Serum HBsAg Kinetics as Predictor of HBsAg Loss in Patients with HBeAg-Negative Chronic Hepatitis B after Treatment with Pegylated Interferonα-2a

Hepatitis B surface antigen(HBsAg)loss is an ideal treatment endpoint for patients with chronic hepatitis B(CHB).We investigated the predictive value of on-treatment HBsAg levels for HBsAg loss in hepatitis B e antigen(HBe Ag)-negative CHB patients who received 120-week PEG-IFNα-2a treatment.Serum HBV DNA,HBsAg,and anti-HBs levels were assayed at baseline and every 3 months during the treatment.Of 81 patients,12 achieved HBsAg loss,20 achieved HBsAg\100 IU/mL,and 49 maintained HBs Ag C 100 IU/mL.HBsAg loss rate was only 3.7%at 48 weeks,while it reached to 11.1%and 14.8%after treatment of 96 weeks and 120 weeks.The cutoff HBs Ag levels at 12 weeks predicting HBsAg loss at 96 weeks and 120 weeks of treatment were 400 IU/mL and 750 IU/mL,with AUC 0.725 and 0.722,positive predictive value(PPV)29.41%and 30.56%,and negative predictive value(NPV)93.75%and 97.78%,respectively.The cutoff HBsAg levels at 24 weeks predicting HBsAg loss at 96 weeks and 120 weeks of treatment were 174 IU/m L and 236 IU/mL respectively,with AUC 0.925 and 0.922,PPV 40.0%and 46.15%,and both NPV 100%.The predictive ability of the cutoff HBsAg levels at 24 weeks was better than that at 12 weeks for HBs Ag loss at either 96 or 120 weeks(χ~2=3.880,P=0.049 andχ~2=4.412,P=0.036).These results indicate that extended therapy is critical to HBsAg loss in HBe Ag-negative CHB patients during PEG-IFN treatment,and the HBsAg level at 24 weeks can be used to predict HBsAg loss during tailoring PEG-IFN therapy.

Ratios of T-helper 2 Cells to T-helper 1 Cells and Cytokine Levels in Patients with Hepatitis B

Background：Hepatitis B is an immune response-mediated disease.The aim of this study was to explore the differences of ratios of T-helper （Th） 2 cells to Thl cells and cytokine levels in acute hepatitis B （AHB） patients and chronic hepatitis B virus （HBV）-infected patients in immune-tolerance and immune-active phases.Methods：Thirty chronic HBV-infected patients in the immune-tolerant phase （IT group） and 50 chronic hepatitis B patients in the immuneactive （clearance） phase （IC group）,32 AHB patients （AHB group）,and 13 healthy individuals （HI group） were enrolled in the study.Th cell proportions in peripheral blood,cytokine levels in plasma,and serum levels of HBV DNA,hepatitis B surface antigen,and hepatitis B e antigen were detected.Results：The Th1 cell percentage and Th2/Th1 ratio in the HBV infection group （including IT,IC,and AHB groups） were significantly different from those in HI group （24.10% ± 8.66% and 1.72 ± 0.61 vs.15.16% ± 4.34% and 2.40 ± 0.74,respectively;all P 〈 0.001）.However,there were no differences in the Th1 cell percentages and Th2/Th1 ratios among the IT,IC,and AHB groups.In HBV infection group,the median levels of Flt3 ligand （Flt3L）,interferon （IFN）-γ,and interleukin （IL）-17A were significantly lower than those in HI group （29.26 pg/ml,33.72 pg/ml,and 12.27 pg/ml vs.108.54 pg/ml,66.48 pg/ml,and 35.96 pg/ml,respectively;all P 〈 0.05）.IFN-α2,IL-10,and transforming growth factor （TGF）-β2 median levels in hepatitis group （including patients in AHB and IC groups） were significantly higher than those in IT group （40.14 pg/ml,13.58 pg/ml,and 557.41 pg/ml vs.16.74 pg/ml,6.80 pg/ml,and 419.01 pg/ml,respectively;all P 〈 0.05）,while patients in hepatitis group had significant lower Flt3L level than IT patients （30.77 vs.59.96 pg/ml,P =0.021）.Compared with IC group,patients in AHB group had significant higher median level s of IL-1 0,TGF-β 1,and TGF-β2 （22.77 pg/ml,10,447.00 pg/ml,and 782.28 pg/ml vs.8.66 pg/ml,3755.50 pg/ml,and 482.87 pg/ml,respectively;all P 〈 0.05）.Conclusions：Compared with chronic HBV-infected patients in immune-tolerance phase,chronic HBV-infected patients in immune-active phase and AHB patients had similar Th2/Th 1 ratios,significantly higher levels of IFN-α2,IL-10,and TGF-β.AHB patients had significantly higher IL-10 and TGF-β levels than chronic HBV-infected patients in immune-active phase.

Evaluation of the Prostate Imaging Reporting and Data System for Magnetic Resonance Imaging Diagnosis of Prostate Cancer in Patients with Prostate-specific Antigen 〈20 ng/ml

Background： The European Society of Urogenital Radiology has built the Prostate Imaging Reporting and Data System （PI-RADS） for standardizing the diagnosis of prostate cancer （PCa）. This study evaluated the PI-RADS diagnosis method in patients with prostate-specific antigen （PSA） 〈20 ng/ml. Methods： A total of 133 patients with PSA 〈20 ng/ml were prospectively recruited. T2-weighted （T2WI） and diffusion-weighted （DWI） magnetic resonance images of the prostate were acquired before a 12-core transrectal prostate biopsy. Each patient＇s peripheral zone was divided into six regions on the images; each region corresponded to two of the 12 biopsy cores. T2WI, DWI, and T2W1 ＋ DWI scores were computed according to PI-RADS. The diagnostic accuracy of the PI-RADS score was evaluated using histopathology of prostate biopsies as the reference standard. Results： PCa was histologically diagnosed in 169 （21.2%） regions. Increased PI-RADS score correlated positively with increased cancer detection rate. The cancer detection rate for scores 1 to 5 was 2.8%, 15.0%, 34.6%, 52.6%, and 88.9%, respectively, using T2W1 and 12.0%, 20.2%, 48.0%, 85.7%, and 93.3%, respectively, using DWI. For T2WI ＋ DWI, the cancer detection rate was 1.5% （score 2）, 13.5% （scores 3-4）, 41.3% （scores 5-6）, 75.9% （scores 7-8）, and 92.3% （scores 9-10）. The area under the curve for cancer detection was 0.700 （T2WI）, 0.735 （DWI） and 0.749 （T2WI ＋ DWI）. The sensitivity and specificity were 53.8% and 89.2%, respectively, when The summed score ofT2Wl ＋ DWI

Negative Correlation of Serum Hepatitis B Surface Antigen and Hepatitis B e Antigen Levels with the Severity of Liver Inflammation in Treatment-naive Patients with Chronic Hepatitis B Virus Infection

Background： Estimating the grades of liver inflammation is critical in the determination ofantiviral therapy in patients chronically infected with hepatitis B virus （HBV）. The aim of this study was to investigate the correlation ofserum levels of hepatitis B surface antigen （HBsAg） and hepatitis B e antigen （HBeAg） with the liver inflammation grades in treatment-naTve patients with chronic HBV infection. Methods： We retrospectively enrolled 584 treatment-na＇l＇ve HBeAg-positive patients who underwent liver biopsy in Ditan Hospital from January 2008 to January 2016. Based on the severity of liver inflammation, the patients were divided into minimal, mild, and moderate groups. SPSS software was used lbr statistical analysis of all relevant data. Results： The liver histological examinations showed that 324, 194, and 66 patients had minimal, mild, and moderate liver inflammation, respectively. The median age of the three groups was 30, 33, and 38 years, respectively （X2 =26.00, P 〈 0.001 ）. The median HBsAg levels in minimal, mild, and moderate inflammation groups were 4.40, 4.16, and 3.67 log U/ml, respectively, and the median HBeAg levels in the three groups were 3.12, 2.99, and 1.86 log sample/cutoff. respectively; both antigens tended to decrease as the grade of inflammation increased （X2 = 99.68 and X2 =99.23, respectively; both P 〈 0.001 ）. The cutoff values of receiver operating characteristic curve in the age, HBsAg and HBeAg levels were 36 years, 4.31 log U/ml, and 2.86 Iog S/CO, respectively, 1 to distinguish minimal grade and other grades of treatment-naTve HBeAg-positive patients with chronic HBV infection. Conclusions： Serum HBsAg and HBeAg quantitation might gradually decrease with aggravated liver inflammation and the corresponding cutoff values rnight help us to distinguish rninimal grades and other grades and detect those who do not need antiviral therapy in treatment-naive HBeAg-positive patients with chronic HBV infection.

Consolidation treatment needed for sustained HBsAg-negative response induced by interferon-alpha in HBeAg positive chronic hepatitis B patients

Hepatitis B surface antigen(HBsAg)clearance is considered as functional cure in patients with chronic hepatitis B(CHB).This study aimed to assess the durability of HBsAg clearance achieved by interferon-based therapies in patients with CHB who were originally positive for hepatitis B envelope antigen(HBeAg).In this prospective study,HBeAg-positive CHB patients with confirmed HBsAg loss under interferon-based therapies were enrolled within 12 weeks from end of treatment and followed up for 48 weeks.Virological markers,biochemical indicators,and liver imaging examinations were observed every 3–6 months.Sustained functional cure was analysed as primary outcome.Factor associated with sustained HBsAg loss or reversion was also investigated.The rate of HBsAg loss sustainability was 91.8%(212/231).Patients receiving consolidation treatment for 12–24weeks or≥24 weeks had higher rates of sustained HBsAg negativity than those receiving consolidation treatment for<12 weeks(98.3%and 91.2%vs.86.7%,P=0.068),and the former groups had significantly higher anti-HBs levels than the later(P<0.05).The cumulative incidence of HBsAg reversion and HBV DNA reversion was 8.2%and 3.9%,respectively.Consolidation treatment of≥12 weeks[odd ratio(OR)3.318,95%confidence interval(CI)1.077–10.224,P=0.037)was a predictor of sustained functional cure,and HBeAg-positivity at cessation of treatment(OR 12.271,95%CI 1.076–139.919,P=0.043)was a predictor of HBsAg reversion.Interferon-alpha induced functional cure was durable and a consolidation treatment of≥12–24 weeks was needed after HBsAg loss in HBeAg-positive CHB patients.

Longitudinal study of a community hospital integrated model for diabetes management in the Beijing Jingsong community

Objective:To determine the effects of a community hospital integrated model on the longitu-dinal management of diabetic patients.Methods:Four hundred forty-one patients with type 2 diabetes residing in Jingsong Commu-nity were randomly assigned to intensive and standard groups.Metabolic parameters were meas-ured in the two groups at baseline and after 36 months of management to compare the rate of goal achievement.Results:After comprehensive management,the overall control rate in the intensive group was increased from 2.7%to 9.6%compared with 2.3%-4.5%in the standard group.Specifically,the control rates for fasting plasma glucose,glycosylated hemoglobin,and blood pressure in the intensive group were significantly increased from 54.1%,40.0%,and 68.2%to 85.5%,74.6%,and 89.1%,respectively.The control rate for glycosylated hemoglobin in the intensive group was significantly higher than the standard group after 36 months of treatment.Conclusion:The community hospital integrated model for longitudinal management effec-tively improved the control rate of glycosylated hemoglobin and the overall control rate in patients with type 2 diabetes.