Exercise-induced modulation of miR-149-5p and MMP9 in LPS-triggered diabetic myoblast ER stress: licorice glycoside E as a potential therapeutic target

Background:This study explores the relationship between endoplasmic reticulum(ER)stress and diabetes,particularly focusing on the impact of physical exercise on ER stress mechanisms and identifying potential therapeutic drugs and targets for diabetes-related sepsis.The research also incorporates traditional physical therapy perspectives,emphasizing the genomic insights gained from exercise therapy in disease management and prevention.Methods:Gene analysis was conducted on the GSE168796 and GSE94717 datasets to identify ER stress-related genes.Gene interactions and immune cell correlations were mapped using GeneCard and STRING databases.A screening of 2,456 compounds from the TCMSP database was performed to identify potential therapeutic agents,with a focus on their docking potential.Techniques such as luciferase reporter gene assay and RNA interference were used to examine the interactions between microRNA-149-5p and MMP9.Results:The study identified 2,006 differentially expressed genes and 616 miRNAs.Key genes like MMP9,TNF-α,and IL1B were linked to an immunosuppressive state.Licorice glycoside E demonstrated high affinity for MMP9,suggesting its potential effectiveness in treating diabetes.The constructed miRNA network highlighted the regulatory roles of MMP9,IL1B,IFNG,and TNF-α.Experimental evidence confirmed the binding of microRNA-149-5p to MMP9,impacting apoptosis in diabetic cells.Conclusion:The findings highlight the regulatory role of microRNA-149-5p in managing MMP9,a crucial gene in diabetes pathophysiology.Licorice glycoside E emerges as a promising treatment option for diabetes,especially targeting MMP9 affected by ER stress.The study also underscores the significance of physical exercise in modulating ER stress pathways in diabetes management,bridging traditional physical therapy and modern scientific understanding.Our study has limitations.It focuses on the microRNA-149-5p-MMP9 network in sepsis,using cell-based methods without animal or clinical trials.Despite strong in vitro findings,in vivo studies are needed to confirm licorice glycoside E’s therapeutic potential and understand the microRNA-149-5p-MMP9 dynamics in real conditions.

关于冠心病患者PCI术后双心治疗成本-效果比的临床研究

目的比较冠心病(coronary artery disease,CAD)患者经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后双心治疗与常规治疗的成本-效果,为冠心病患者PCI术后双心治疗提供依据。方法共纳入2021年8月—2023年6月于首都医科大学附属北京安贞医院住院行PCI手术治疗的195例CAD患者,随机分为双心治疗组(79例)与常规治疗组(116例)。通过2周,1、3、6、12、18个月随访,比较两种治疗方法的疗效,计算成本-效果比(cost-effectiveness ratio,CER)、增量成本-效果比(incremental cost-effectiveness ratio,ICER)。结果双心治疗组共79例,其中1例因急性冠脉综合征(acute coronary syndrome,ACS)再入院行PCI治疗,有效率为98.73%;常规治疗组116例,10例因ACS再入院,7例行PCI治疗,1例行冠脉造影检查,2例保守治疗,有效率为91.38%,双心治疗组的临床有效率明显高于常规治疗组(P=0.028)。常规治疗组的CER为766.74,双心治疗组CER为713.44,双心治疗的CER显著低于常规治疗。ICER为50.86。结论与常规治疗比较,冠心病患者PCI术后双心治疗有更显著的临床疗效,较低的CER,且有更好的卫生经济学价值。

Add-on pegylated interferon augments hepatitis B surface antigen clearance vs continuous nucleos(t)ide analog monotherapy in Chinese patients with chronic hepatitis B and hepatitis B surface antigen≤1500 IU/mL:An observational study

BACKGROUND Nucleos(t)ide analog(NA)has shown limited effectiveness against hepatitis B surface antigen(HBsAg)clearance in chronic hepatitis B(CHB)patients.AIM To evaluate the efficacy and safety of add-on peginterferonα-2a(peg-IFNα-2a)to an ongoing NA regimen in CHB patients.METHODS In this observational study,195 CHB patients with HBsAg≤1500 IU/m L,hepatitis B e antigen(HBeAg)-negative(including HBeAg-negative patients or HBeAg-positive patients who achieved HBeAg-negative after antiviral treatment with NA)and hepatitis B virus-deoxyribonucleic acid<1.0×10^2 IU/mL after over 1 year of NA therapy were enrolled between November 2015 and December2018 at the Second Affiliated Hospital of Xi'an Jiaotong University,China.Patients were given the choice between receiving either peg-IFNα-2a add-on therapy to an ongoing NA regimen(add-on group,n=91)or continuous NA monotherapy(monotherapy group,n=104)after being informed of the benefits and risks of the peg-IFNα-2a therapy.Total therapy duration of peg-IFNα-2a was 48 wk.All patients were followed-up to week 72(24 wk after discontinuation of peg-IFNα-2a).The primary endpoint was the proportion of patients with HBsAg clearance at week 72.RESULTS Demographic and baseline characteristics were comparable between the two groups.Intention-to-treatment analysis showed that the HBsAg clearance rate in the add-on group and monotherapy group was 37.4%(34/91)and 1.9%(2/104)at week 72,respectively.The HBsAg seroconversion rate in the add-on group was 29.7%(27/91)at week 72,and no patient in the monotherapy group achieved HBsAg seroconversion at week 72.The HBsAg clearance and seroconversion rates in the add-on group were significantly higher than in the monotherapy group at week 72(P<0.001).Younger patients,lower baseline HBsAg concentration,lower HBsAg concentrations at weeks 12 and 24,greater HBsAg decline from baseline to weeks 12 and 24 and the alanine aminotransferase≥2×upper limit of normal during the first 12 wk of therapy were strong predictors of HBsAg clearance in patients with peg-IFNα-2a add-on treatment.Regarding the safety of the treatment,4.4%(4/91)of patients in the add-on group discontinued peg-IFNα-2a due to adverse events.No severe adverse events were noted.CONCLUSION Peg-IFNα-2a as an add-on therapy augments HBsAg clearance in HBeAg-negative CHB patients with HBsAg≤1500 IU/m L after over 1 year of NA therapy.

Signaling pathway of insulin-like growth factor-Ⅱ as a target of molecular therapy for hepatoblastoma

AIM： To address the possibility that insulin-like growth factor （IGF）-Ⅱ is a growth factor and its signaling pathway so as to develop a molecular therapy for hepatoblastoma. METHODS： Huh-6 and HepG2, human hepatoblastoma cell lines, were used. IGF-Ⅱ was added to the medium deprived of serum. Western blot analysis was performed to clarify the expression of IGF-Ⅰ receptor （IGF-IR）. Inhibitors of IGF-IR （piclopodophyllin, PPP）, phosphatidyl-inositol （PI） 3-kinase （LY294002 and Wortmannin）, or mitogen-activated protein （MAP） kinase （PD98059） were added to unveil the signaling pathway of IGF-Ⅱ. Cells were analyzed morphologically with hematoxylin-eosin staining to reveal the mechanism of suppression of cell proliferation. RESULTS： IGF-Ⅱ stimulated cells proliferated to 2.7 （269% ± 76%） （mean ± SD） （Huh-6） and 2.1 （211% ± 85%） times （HepG2）. IGF-IR was expressed in Huh-6 and HepG2. PPP suppressed the cell number to 44% ± 11% （Huh-6） and 39% ± 5% （HepG2）. LY294002 and Wortmannin suppressed the cell number to 30% ± 5% （Huh-6）, 44% ± 0.4% （HepG2）, 49% ± 1.0% （Huh-6） and 46% ± 1.1% （HepG2）, respectively. PD98059 suppressed the cell number to 33% ± 11% for HepG2 but not for Huh-6. When cell proliferation was prohibited, many Huh-6 and HepG2 cells were dead with pyknotic or fragmented nuclei, suggesting apoptosis. CONCLUSION： IGF- Ⅱ was shown to be a growth factor of hepatoblastoma via IGF-Ⅰ receptor and PI3 kinase which were good candidates for target of molecular therapy.

High levels of Zinc-α-2-Glycoprotein among Omani AIDS patients on combined antiretroviral therapy

Objective:To investigate the levels of zinc-α-2-glycoprotein(ZAG) among Omani AIDS patients receiving combined antiretroviral therapy(cART).Methods:A total of 80 Omani AIDS patients(45 males and 33 females),average age of 36 vears.who were receiving cART at the Saltan Qaboos University Hospital(SQUH).Muscat,Oman,were tested for the levels of ZAG.In addition,SO healthy blood donors(46 males and 34 females),average age of 26 years,attending the SOUH Blood Bank,were tested in parallel as a control group.Measurement of the ZAG levels was performed using a competitive enzyme—linked immunosorbent assay and in accordance with the manufacturer's instructions.Results:The ZAG levels were found to he significantly higher among AIDS patients compared to the healthy individuals(P=0.033).A total of 56(70%) of the AIDS patients were found to have higher levels of ZAG and 16(20%) AIDS patients were found to have high ZAG levels,which are significantly(P>0.031) associated with weight loss.Conclusions:ZAG levels are high among Omani AIDS patients on cART and this necessitales the measurement of ZAG on routine basis,as it is associated with weight loss.

Specific activation of 2'-5'oligoadenylate synthetase gene promoter by hepatitis C virus-core protein:A potential for developing hepatitis C virus targeting gene therapy

AIM： TO examine whether 2＇-5＇oligoadenylate synthetase （OAS） gene promoter can be specifically activated by hepatitis C virus （HCV）-core protein. METHODS： Human embryo hepatic cell line L02 was transfected with pcDNA3.1-core plasmid and selected by G418. Expression of HCV-core was detected by reverse transcription polymerase chain reaction and Western blotting. The OAS promoter sequence was amplified from the genomic DNA and inserted into pGL3-basic vector. The resultant pGL3-OAS-Luci plasmid was transiently transfected into L02/core cells and luciferase activity was assayed. I^ESULTS： L02/core cell line stably expressing HCV- core protein was established. The pGL3-OAS-Luci construct exhibited significant transcriptional activity in the L02/core cells but not in the L02 cells. CONCLUSION： HCV-core protein activates the OAS gene promoter specifically and effectively. Utilization of OAS gene promoter would be an ideal strategy for developing HCV-specific gene therapy.

Effect of photodynamic therapy with(17R,18R)-2-(1-hexyloxyethyl)-2-devinyl chlorine E6 trisodium salt on pancreatic cancer cells in vitro and in vivo

AIM To investigate the antitumor effects and underlying mechanisms of(17 R,18 R)-2-(1-hexyloxyethyl)-2-devinyl chlorine E6 trisodium salt(YLG-1)-induced photodynamic therapy(PDT) on pancreatic cancer in vitro and in vivo.METHODS YLG-1 is a novel photosensitizer extracted from spirulina. Its phototoxicity, cellular uptake and localization, as well as its effect on reactive oxygen species(ROS) production, apoptosis, and expression of apoptosis-associated proteins were detected in vitro. An in vivo imaging system(IVIS), the Lumina K imaging system, and mouse models of subcutaneous Panc-1-bearing tumors were exploited to evaluate the drug delivery pathway and pancreatic cancer growth in vivo.RESULTS YLG-1 was localized to the mitochondria, and the appropriate incubation time was 6 h. Under 650 nm light irradiation, YLG-1-PDT exerted a potent cytotoxic effect on pancreatic cancer cells in vitro, which could be abolished by the ROS scavenger N-acetyl-L-cysteine(NAC). The death mode caused by YLG-1-PDT was apoptosis, accompanied by upregulated Bax and cleaved Caspase-3 and decreased Bcl-2 expression. The results from the IVIS images suggested that the optimal administration route was intratumoral(IT) injection and that the best time to conduct YLG-1-PDT was 2 h post-IT injection. Consistent with the results in vitro, YLG-1-PDT showed great growth inhibition effects on pancreatic cancer cells in a mouse model.CONCLUSION YLG-1 is a potential photosensitizer for pancreatic cancer PDT via IT injection, the mechanisms of which are associated with inducing ROS and promoting apoptosis.

Evaluating the evolving evidence: The challenges of molecular-targeted therapy in management of gastric cancer

Over the past decade, a multitude of molecular targeted agents have been explored in the treatment of advanced metastatic gastric. Recent advances in molecular signaling pathways that are dysregulated in gastric cancer lead to the development of new targeted therapies for the treatment of advanced and metastatic gastric cancer. The addition of trastuzumab to first-line chemotherapy is now a standard of care for the treatment of Human epidermal growth factor receptor (HER2-) positive advanced or metastatic disease, and other HER2-targeted therapies are in late-stage clinical development. Findings from recent major clinical trials provide important insight into the future of metastatic gastric cancer management, which may include the use of anti-angiogenesis, Mesenchymal epithelial transition factor (MET) and Hedgehog Pathways Inhibitortherapy across multiple treatment lines, in the salvage setting, and as part of novel regimens in combination with other targeted agents.

八段锦联合放松功对轻中度抑郁的影响研究

【目的】探究中医行为心理疗法八段锦联合放松功干预轻中度抑郁的效果。【方法】将40例轻中度抑郁患者随机分为干预组和对照组,每组各20例。干预组给予八段锦锻炼联合放松功干预治疗,对照组给予西药氢溴酸西酞普兰片治疗,疗程为6周。观察2组患者干预前后汉密尔顿抑郁量表(HAMD)评分、蒙哥马利抑郁量表(MADRS)评分、匹兹堡睡眠质量指数(PSQI)评分以及生活质量综合评定问卷(GQOL-74)评分的变化情况,并评价2组患者的抑郁改善疗效。【结果】(1)抑郁改善疗效方面,治疗6周后,干预组的总有效率为95.0%(19/20),对照组为90.0%(18/20),组间比较(χ2检验),差异无统计学意义(P>0.05)。(2)抑郁程度方面,治疗后,2组患者的HAMD评分和MADRS评分均较治疗前明显下降(P<0.01),但治疗后组间比较,差异均无统计学意义(P>0.05)。(3)生活质量方面,治疗后,2组患者的GQOL-74的躯体功能、心理功能、社会功能、物质生活等各项评分及总分均较治疗前明显改善(P<0.01),但治疗后组间比较,差异均无统计学意义(P>0.05)。(4)睡眠质量方面,治疗后,2组患者的PSQI的睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、催眠药物和日间功能等各项评分及总分均较治疗前明显改善(P<0.01),且干预组对PSQI的睡眠质量、入睡时间评分及总分的改善作用明显优于对照组(P<0.05)。【结论】八段锦锻炼联合放松功干预对轻中度抑郁症状的改善有明确的疗效,可以为轻中度抑郁症患者提供更广泛的选择可能,特别是对西药治疗不耐受的患者更具有一定的优势。

1例肾阳虚型高血压患者的“双心护理”体会

本文总结了1例肾阳虚型高血压患者的“双心护理”体会。护理要点包括病情观察、血压监测、用药护理、中医特色护理等,并在此基础上给予心理评估、“双心”教育等干预措施。基于“双心护理”模式开展中西医结合护理,有助于改善患者症状,缓解心理压力,提高治疗依从性,促进患者康复。

基于双心理论的强心康颗粒+耳穴贴压联合西药治疗慢性心衰合并中重度焦虑临床观察

目的观察强心康颗粒+耳穴贴压联合氟哌噻吨美利曲辛片对慢性心力衰竭(以下简称“心衰”)合并中重度焦虑的疗效。方法纳入合并中重度焦虑[广泛性焦虑量表(GAD-7)测评≥10分]的慢性心衰患者72例,纽约心脏病协会(NYHA)心功能分级Ⅱ~Ⅲ级,分为观察组与对照组,各36例;两组均给予血管紧张素转化酶抑制剂(ACEI)、β受体阻滞剂等心衰基础治疗,观察组给予强心康颗粒+耳穴贴压联合氟哌噻吨美利曲辛片,对照组给予强心康颗粒。观察两组的心功能分级、6 min步行试验、N末端B型脑钠肽原(NT-proBNP)、中医证候评分、GAD-7评分。结果治疗后,两组患者的心功能分级疗效、6 min步行试验、NT-proBNP、中医证候评分、GAD-7评分等指标均较治疗前明显改善,且观察组优于对照组(P<0.05)。结论强心康颗粒+耳穴贴压联合氟哌噻吨美利曲辛片可明显提高慢性心衰合并中重度焦虑患者的临床疗效。

行为-心理疗法治疗早泄的临床试验研究

目的：观察行为-心理疗法治疗早泄的临床疗效。方法：对符合纳入标准的58例早泄患者,采用行为-心理疗法进行治疗。每周2~3次,6次为一个疗程。治疗1个疗程。观察临床疗效和患者CIPE-5评分治疗前后的变化。结果：58例患者中临床治愈27例（46.55%）,有效19例（32.76%）,无效12例（20.69%）,总有效率为79.31%。治疗后患者CIPE-5评分由治疗前的7.97±2.30上升为22.50±6.64,与治疗前比较有统计学意义。治疗后患者射精潜伏期延长、患者及配偶对性生活的满意度提高、性生活焦虑程度及延迟射精困难程度减轻,各项评分与治疗前比较均有统计学意义。结论：行为-心理疗法治疗早泄有显著的疗效。

线上接纳承诺疗法对抑郁症康复期患者心理灵活性疗效的随机对照试验

目的:探讨线上接纳承诺疗法(ACT)干预抑郁症康复期患者心理灵活性的效果。方法:选取抑郁症康复期患者58例,随机分为线上ACT干预组(n=27)和等待对照组(n=31)。干预组进行为期20d的线上ACT干预,对照组保持等待。在基线、20d干预后和干预结束后1个月追踪时采用心理灵活性综合问卷(CompACT)、9条目病人健康问卷抑郁量表(PHQ-9)、五因素正念问卷(FFMQ)和简式心理健康连续体量表(MHC-SF)评估。结果:干预组20d干预后和追踪时的CompACT得分和MHC-SF得分均低于对照组(均P<0.05);干预组20d干预后和追踪时的CompACT得分、PHQ-9得分、FFMQ得分和MHC-SF得分均低于基线(P<0.001或P<0.01)。结论:线上接纳承诺疗法可以提高抑郁症康复期患者的心理灵活性、正念和心理健康水平,降低其抑郁水平。

基于生物心理社会医学探析G-CBT配合丙戊酸镁缓释片对双相情感障碍的价值

目的基于生物-心理-社会医学探究团体认知行为治疗(G-CBT)联合丙戊酸镁缓释片治疗双相情感障碍的价值。方法选取92例双相情感障碍患者,分成研究组和对照组各46例,对照组仅采用丙戊酸镁缓释片治疗,研究组在药物治疗基础上配合G-CBT治疗,从生物-心理-社会医学角度评估两组患者治疗效果。结果研究组的总有效率为93.48%,对照组为78.26%,研究组总有效率高于对照组(P<0.05)。治疗后两组BRMS、PANSS评分均较治疗前下降,研究组BRMS、PANSS评分均低于对照组(P<0.05)。治疗后两组SF-36评分均较各自治疗前升高(P<0.05),治疗后研究组SF-36除躯体疼痛外各维度评分均高于对照组(P<0.05)。治疗后研究组WMS记忆商数、瞬时记忆、短时记忆和长时记忆评分均高于对照组(P<0.05)。治疗后两组患者炎性因子水平均较治疗前下降(P<0.05),研究组IL-1β、TNF-α指标水平低于对照组(P<0.05)。结论G-CBT联合丙戊酸镁缓释片治疗双相情感障碍可更好地缓解症状、改善患者的生存质量,消除机体炎症,从生物、心理以及社会功能多方面进行改善,值得推广。

植物雌激素α-ZAL和17βE_2对大鼠单个心室肌细胞缩舒功能和胞内钙瞬时变化的影响

目的:比较植物雌激素α-ZAL和17βE2对大鼠心肌细胞缩舒和胞内钙瞬变的影响。方法:从成年雌性大鼠心脏分离单个心肌细胞,应用美国Ionoptix视频跟踪计算机图像分析系统在0.5Hz的电刺激下测定离体单个心肌细胞的收缩参数,其中包括最大收缩幅度(PS)、最大收缩幅度时间(TPS)、90%舒张幅度时间(TR90)和最大收缩速率(+dL/dttmax)及最大舒张速率(-dL/dttmax);同时用Fura2/AM钙荧光指示剂测定胞内钙浓度的变化。结果:10-9~10-5mol/L17βE2能使PS产生浓度依赖性的增加,最大增加35%,高浓度的17βE2对TPS有显著影响(P<0.05),能够使ΔFFI最大增加25%;而10-9~10-5mol/Lα-ZAL无论是心肌细胞缩舒功能还是胞内钙含量均无明显变化。且α-ZAL和17βE2对心室肌细胞静息状态下胞内钙浓度和胞内钙的荧光衰减率均无显著影响。结论:α-ZAL对心室肌细胞的作用与17βE2有很大不同,17βE2对心肌细胞缩舒有直接刺激作用,增强心肌收缩可能是通过胞内钙释放与胞外钙内流所介导;而α-ZAL无这种作用,它可能是通过抑制胞外钙内流和其抗氧化反应达到保护心室肌细胞的作用。

14-3-3 proteins—an update

14-3-3 is a highly conserved acidic protein family, composed of seven isoforms in mammals. 14-3-3 protein caninteract with over 200 target proteins by phosphoserine-dependent and phosphoserine-independent manners. Little isknown about the consequences of these interactions, and thus are the subjects of ongoing studies. 14-3-3 controls cellcycle, cell growth, differentiation, survival, apoptosis, migration and spreading. Recent studies have revealed newmechanisms and new functions of 14-3-3, giving us more insights on this fascinating and complex family of proteins.Of all the seven isoforms, 14-3-3σ seems to be directly involved in human cancer. 14-3-3σ itself is subject to regulationby p53 upon DNA damage and by epigenetic deregulation. Gene silencing of 14-3-3σ by CpG methylation has beenfound in many human cancer types. This suggests that therapy-targeting 14-3-3σ may be beneficial for future cancertreatment.

Pegylated interferon α-2b up-regulates specific CD8+ T cells in patients with chronic hepatitis B

AIM:To investigate the effect of pegylated interferon (IFN) α-2b on specific CD8+ T lymphocytes in patients with chronic hepatitis B (CHB). METHODS:Twenty-one patients with CHB were treated with pegylated IFN α-2b. Periphery blood mononuclear cells were isolated from fresh heparinized blood by Ficoll-Hypaque density gradient centrifugation (density:1.077 g/L,Pharmingen) at weeks 0,4,8,12,and 24,respectively. Frequency of circulating hepatitis B virus (HBV) epitope-specific CD8 T cells was detected by flow cytometry. Cytokines were detected by cytometric bead assay. RESULTS:The frequency of circulating HBV core or env-specific CD8 T cells was higher (P < 0.05),the number of HBV core specific CD8 T cells was greater at week 24 (P < 0.05),the level of Th1-type cytokines [interleukin (IL)-12,tumor necrosis factor-α,and IFN-γ] was higher,while that of Th2-type cytokines (IL-4,IL-6,and IL-10) was lower in responders than in nonresponders (P < 0.05) after pegylated IFN α-2b treatment. The IL-6 level was correlated with HBV DNA (r = 0.597,P = 0.04),while the inducible protein-10 (IP-10) level was correlated with serum alanine aminotransferase (ALT) (r = 0.545,P = 0.005). The IP-10 level at week 8 after pegylated IFN α-2b treatment could predict the normalization of ALT in CHB patients (positive predict value = 56%,negative predict value = 92%). CONCLUSION:Pegylated IFN α-2b can enhance the immune response of CHB patients by increasing the frequency of HBV specific CD8+ T cells and regulating the Th1/Th2 cytokines.

Effect of switching from treatment with nucleos(t)ide analogs to pegylated interferon α-2a on virological and serological responses in chronic hepatitis B patients

AIM To investigate the efficacy of switching to pegylated interferon-α-2a(Peg IFNα-2a) treatment in nucleos(t)ide analog(NA)-treated chronic hepatitis B(CHB) responder patients. METHODS A 48-wk prospective and retrospective treatment trial of NA-treated CHB patients who had received entecavir(ETV) for at least 48 wk and had serum hepatitis B virus(HBV)-DNA < 500 IU/m L, serum hepatitis B envelope antigen(HBe Ag) < 100 S/CO, serum alanine aminotransferase, and aspartate aminotransferase levels < 2 × the upper limit of normal of 40 IU/L was performed. The effects on virological and serological responses and adverse reactions to 0.5 mg daily ETV for 48 wk vs switching to Peg IFNα-2a were compared. Forty-four patients were randomized to be switched from NA treatment to the Peg IFNα-2a group, and 44 patients were simultaneously randomized to the ETV group. RESULTS After 48 wk of therapy, the decrease in hepatitis B surface antigen(HBs Ag) levels was greater in the Peg IFNα-2a group than in the ETV group(3.1340 log10 IU/m L vs 3.6950 log10 IU/m L, P = 0.00). Seven patients who were anti-HBs-positive at baseline achieved HBs Ag loss when switched to Peg IFNα-2a(15.91% vs 0%,P = 0.018). The HBe Ag serological conversion rate was higher in the Peg IFNα-2a group than in the ETV group; however, the difference was not significant because of the small sample sizes(34.38% vs 21.88%, P = 0.232). In the Peg IFNα-2a group, patients with HBs Ag levels < 1500 IU/m L at baseline had higher HBe Ag seroconversion and HBs Ag loss rates at week 48 than those with HBs Ag levels ≥ 1500 IU/m L(HBe Ag seroconversion: 17.86% vs 62.5%, P = 0.007; HBs Ag loss: 41.67% vs 6.25%, P = 0.016). Moreover, patients with HBs Ag levels < 1500 IU/m L at week 24 had higher HBs Ag loss rates after therapy than those with HBs Ag levels ≥ 1500 IU/m L(36.84% vs 0%, P = 0.004). However, there were no statistically significant differences in HBe Ag seroconversion rates(47.06% vs 25.93%, P = 0.266). CONCLUSION NA-treated CHB patients switched to sequential Peg IFNα-2a achieved highly potent treatment termination safely.