目的 研究替诺福韦联合扶正化瘀胶囊治疗乙型肝炎肝硬化患者的疗效.方法 100例乙型肝炎肝硬化患者被随机分为替诺福韦治疗50例和替诺福韦联合扶正化瘀胶囊治疗18个月.使用瞬时弹性成像仪检测肝脏硬度(LSM),同时检测血清透明质酸(HA)、层粘连蛋白(LN)和III型前胶原(PCIII)水平的变化.结果 治疗结束时,两组LSM及血清HA、LN和PCIII水平均降低(P<0.05),而联合组各指标水平较替诺福韦治疗组更低,差异有统计学意义(P<0.05).结论 应用替诺福韦联合扶正化瘀胶囊治疗乙型肝炎肝硬化患者能在一定程度上获得抗纤维化的作用.

Objective To investigate the relationship between interleukin (IL)-28B gene polymorphisms (rs12979860 and rs8099917) and treatment response in patients with chronic hepatitis C in China.Methods Taqman probes single nucleotide polymorphism genotyping methods were used to detect the genotypes of rs12979860 (C/T) and rs8099917 (T/G) located at IL-28B gene in 105 included patients.The patients were treated with standard doses of pegylated interferon plus ribavirin and were followed up regularly for therapeutic response and adverse reaction.The relationship between IL-28B gene polymorphism and antiviral treatment response of patients were analyzed.Categorical data were analyzed using Pearson chi-square test or Fisher exact test.Results Totally 105 cases were included in our study and 2 cases lost to follow-up because of moving away.Eight-one cases (78.6%) of the remaining 103 patients were CC/TT genotype (CC/TT group) at rs12979860 and rs8099917, 19 cases (18.4%) were CT/TG (CT/TG group) and 3 cases (2.9%)were TT/TG (TT/TG group).No other genotypes were detected and linkage disequilibrium was discovered at the two polymorphism loci (r2=0.11).After 4 weeks of treatment, 35 cases (43.2%) in CC/TT group, 3 cases (15.8%) in CT/TG group and non in TT/TG group achieved rapid virological response (RVR).There were statistically significant differences among three groups (P=0.033).After 12 weeks of treatment, 45 cases (55.6%) in CC/TT group, 6 cases (31.6%) in CT/TG group and none in TT/TG group achieved early virological response (EVR).There were statistically significant differences among three groups (P=0.025).At the end of the treatment, 68 cases (83.9%) in CC/TT group, 10 cases (52.6%) in CT/TG group and only 1 case (33.3%) in TT/TG group achieved end-of-treatment response (ETR).There were significant statistical differences among the three groups (P=0.003).After 24 weeks of follow-up, 62 cases (76.5%) in CC/TT group, 9 cases (47.4%) in CT/TG group and 1 case (33.3%) in TT/TG group achieved sustained virological response (SVR).There were statistically significant differences among the three groups (P=0.014).One hundred and one cases in CC/TT group developed adverse events, among them 19 cases needed clinical treatment.There were 43 cases in CT/TG group developed adverse events and 9 cases needed treatment.Seven cases in TT/TG group developed adverse events and only 1 case needed treatment.There were no statistically significant difference among three groups (χ2=0.139,P>0.05).Conclusions The genotype of rs12979860 (C/T) and rs8099917 (T/G) at IL-28B gene could affect the treatment response in patients with chronic hepatitis C.RVR and SVR are higher in patients with genotype CC/TT, which might help to guide HCV treatment.

目的 探讨体外环境下,七氟烷对胶质瘤干细胞增殖的影响.方法 由手术标本获取并培养胶质瘤干细胞,研究七氟烷处理后干细胞增殖改变,并检测七氟烷处理前后干细胞内CD133、低氧诱导因子(HIF)-1α、HIF-2α以及蛋白激酶(p-Akt)的表达变化情况.结果 七氟烷处理后,胶质瘤干细胞增殖显著增快,细胞内HIF-1α、HIF-2α以及p-Akt的表达呈时间及浓度依赖性上升,CD133表达水平无显著改变.结论 七氟烷可通过激活PI3K/Akt途径,上调HIF-1α和 HIF-2α的表达,促进胶质瘤干细胞的增殖.

全球超过3．5亿人感染 HBV ，感染后的自然病程可分为免疫耐受期、免疫清除期、病毒低水平复制或无复制期。有些HBV感染者可终生处于免疫耐受期，而有些感染者易出现肝功能反复波动。且慢性HBV感染者是发生失代偿性肝病及肝细胞癌（HCC ）的高危人群，而未经抗病毒治疗的HBeAg阴性的CHB患者发生 HCC的概率高于 HBeAg 阳性者［1］。有研究认为，CHB自然病程受病毒因素和宿主因素的影响［2］。最近，全基因组关联研究（GWAS ）显示， IL‐28B单核苷酸多态性（SNP）与 HCV的病毒清除及抗病毒治疗的持续病毒学应答（SVR）相关［3］，但 IL‐28B SNP 与HBV感染是否相关的研究鲜见报道。本研究旨在探讨HBeAg阴性的CHB患者自然病程与IL‐28B SNP的关系。

目的探讨还原型谷胱甘肽(GSH)对大鼠肝纤维化肝内抗氧化体系的影响。方法将36只雄性SD大鼠随机分为三组:正常组、模型组、GSH组,每组各12只。除正常组外,大鼠造模采用腹部皮下注射四氯化碳法制备大鼠肝纤维化模型,GSH组在造模的同时进行GSH治疗,各组于第14周测定大鼠肝脏中过氧化氢酶(CAT)、超氧化物歧化酶(SOD)、维生素E(VitE)和丙二醛(MDA)。结果模型组大鼠肝组织中CAT、SOD、VitE明显低于正常组(P<0.01),而MDA明显升高(P<0.01);GSH组与模型组比较,各组的SOD、CAT、VitE均明显升高,而MDA明显下降,差异均有统计学意义(P<0.01)。结论 GSH能有效降低大鼠肝纤维化肝内脂质过氧化。