Metabolic (dysfunction)-associated steatohepatitis (MASH) is the advanced stage of metabolic (dysfunction)-associated fatty liver disease (MAFLD) lacking approved clinical drugs. Adenosine A1 receptor (A1R), belonging to the G-protein-coupled receptors (GPCRs) superfamily, is mainly distributed in the central nervous system and major peripheral organs with wide-ranging physiological functions; however, the exact role of hepatic A1R in MAFLD remains unclear. Here, we report that liver-specific depletion of A1R aggravates while overexpression attenuates diet-induced metabolic-associated fatty liver (MAFL)/MASH in mice. Mechanistically, activation of hepatic A1R promotes the competitive binding of sterol-regulatory element binding protein (SREBP) cleavage-activating protein (SCAP) to sequestosome 1 (SQSTM1), rather than protein kinase A (PKA) leading to SCAP degradation in lysosomes. Reduced SCAP hinders SREBP1c/2 maturation and thus suppresses de novo lipogenesis and inflammation. Higher hepatic A1R expression is observed in patients with MAFL/MASH and high-fat diet (HFD)-fed mice, which is supposed to be a physiologically adaptive response because A1R agonists attenuate MAFL/MASH in an A1R-dependent manner. These results highlight that hepatic A1R is a potential target for MAFL/MASH therapy.

目的 观察格卡瑞韦/哌仑他韦治疗慢性丙肝的疗效.方法 选取2019年7月至2021年12月在湖州市中心医院接受格卡瑞韦/哌仑他韦治疗的经输血感染的慢性丙肝患者27例,疗程为8周(无肝硬化)或12周(合并肝硬化).治疗开始后第1、2、4、6、8、12周检测血常规、肝肾功能及血浆丙型肝炎病毒RNA水平,观察病毒学应答(VR)、血常规及肝功能指标变化、用药期间不良反应等.结果 27例患者治疗第1、2、4、6、8周实现VR分别有5、10、10、1、1例.治疗12周后,患者Hb、白蛋白水平均明显升高(均P<0.05),ALT、AST水平均明显降低(均P<0.05);PLT、TBil水平治疗前后比较差异均无统计学意义(均P>0.05).用药期间不良反应发生率为29.6％,主要不良反应有胃肠道反应3例、皮肤瘙痒3例、乏力3例、关节酸痛3例.结论 格卡瑞韦/哌仑他韦治疗慢性丙肝的有效性较高,且患者耐受性和安全性较好.

Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by the progressive degeneration of neurons in the substantia nigra pars compacta. Deep brain stimulation (DBS) is an effective treatment for PD cardinal motor symptoms. DBS of GPe has been recognized as an effective treatment option for motor symptoms of PD, but the mechanism is still essentially unknown. To investigate the impact of DBS in the external segment of globus pallidus (GPe) on the pathway of the basal ganglia (BG), we recorded the electrical activities of single neurons and local field potential (LFP) of the internal segment of globus pallidus (GPi). The results showed that the firing rate of GPi neurons in the 6-OHDA lesioned rats returned to the normal level after GPe-DBS for two weeks. Moreover, the CV value of GPi neurons is significantly lower than that in the PD group. The different frequency bands of GPi LFP in PD rats have improved correspondingly. These findings indicate that the improvement of the electrical activity of GPi by GPe-DBS in PD rats may be an important electrophysiological mechanism for treating PD.

肥胖已成为威胁儿童身心健康的重大公共卫生问题.儿童体重状况与其所处环境、社会特征和家庭教养关系密切相关.随着社会经济的不断发展,年轻父辈教养人忙于生存竞争而在儿童教育中缺位,祖辈主动或被动参与孙辈教养成为一种不容忽视的社会现象.本文就隔代教养下祖辈的饮食行为、身体活动水平、教养方式和态度、社会经济地位和学历水平等因素对儿童身体质量指数的影响进行综述,以期为减小隔代教养对儿童身体质量指数的负向影响提供依据.

Objective:To compare the clinical efficacy and safety of ledipasvir/sofosbuvir (LDV/SOF) and elbasvir/grazoprevir (EBR/GZR) in treatment of patients with chronic hepatitis C (CHC).Methods:The clinical data of 143 patients with genotype 1b CHC treated in Huzhou Central Hospital from January 2020 to December 2021 were retrospectively analyzed, including 74 cases treated with LDV/SOF and 69 cases treated with EBR/GZR. The virological response after 4 and 12 weeks of treatment and 12wk after drug withdrawal was determined; and the serological and liver inflammation indexes before and after treatment in two groups were compared. SPSS 25.0 software was used for statistical analysis of the data.Results:The virological response rates of the LDV/SOF group and EBR/GZR group were 97.30% and 98.55%, 98.65% and 100.00%, 97.30% and 98.55% after 4 and 12 weeks of treatment and 12 weeks after the end of treatment, respectively (all P > 0.05). At the end of treatment, the liver inflammation indexes ALT, AST and GGT in the two groups were significantly lower than the baseline levels ( Z=-7.470 and -6.974, -9.757 and -6.832, -3.578 and -4.054, P<0.01). Adverse reactions in both groups were mild, and no serious adverse events occurred. Conclusion:Both LDV/SOF and EBR/GZR have good clinical efficacy in the treatment of genotype 1b CHC patients. And the patients are well tolerated.

口腔健康问题已成为威胁儿童健康的重大公共卫生问题.儿童口腔健康与其家庭教养模式密切相关.当前社会隔代教养模式日益普遍,对儿童口腔健康的影响不可小觑.研究探讨隔代教养下祖辈的口腔健康知识水平、行为习惯、性别、社会经济地位等因素对儿童口腔健康的影响并进行综述,以期为减小隔代教养祖辈相关因素对儿童口腔健康的负向影响提供理论依据和指导意见.

An unprecedented outbreak of pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection appeared in Wuhan, Hubei Province, China, in December 2019. On 11 February 2020, the World Health Organization (WHO) officially attributed the disease to infection with SARS-COV-2 as coronavirus disease 2019 (COVID-19). SARS-COV-2 is highly contagious, and people are generally susceptible to infection. Since the outbreak of the pandemic, which has changed the way most people live and work, the Chinese government and scientific community have acted quickly and taken measures to contain the pandemic. This review aims to look at the psychological impact of the outbreak on a specific segment of the population (e.g., students, recent college graduates, medical staff, older people, pregnant women, children, the general public, and others), and to isolate the mechanisms by which social isolation could cause loneliness, to improve our understanding of the emerging epidemic’s impact on people’s mental health, and therefore, to focus attention on mental health care.

目的观察阿德福韦酯及安络化纤丸对早期肝硬化的临床疗效和不良反应。方法治疗组75例患者采用阿德福韦酯剂量10 mg/次,1次/d,安络化纤丸,剂量6 g/次,3次/d;对照组75例单服阿德福韦酯剂量10 mg/次,1次/d,疗程均为6个月。结果安络化纤丸有效改善患者临床症状和体征,恢复肝功能,有效降低血清肝纤维化指标,治疗前后及组间比较有部分显著性差异。结论安络化纤丸不仅保肝降酶,更具有较好的抗纤维化作用。

目的探讨血清HBV DNA与HBV标志物(HBVM)表现模式、慢性乙型肝炎肝功能损害程度、血清肝脏纤维化指标的相互关系。方法HBV DNA定量采用荧光定量PCR分析系统HBV M;采用ELISA法监测肝功能生物化学指标:采用竞争性放射免疫分析法检测血清层粘连蛋白(LN)、透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原。结果血清HBV DNA与HBV M表现模式有关,HBeAg的存在影响HBV DNA水平的变化。肝脏功能损害程度与HBV DNA水平有关,肝脏纤维化指标与HBV DNA无显著相关。

目的:观察苦参碱注射液联合薄芝糖肽治疗慢性乙型肝炎(CHB)的疗效。方法:选择慢性乙型肝炎患者144例,随机分成治疗组72例,对照组72例,治疗组运用苦参碱注射液联合薄芝糖肽治疗;对照组单用重组人干扰素α-2b注射液治疗,疗程均为6个月,观察两组患者治疗前后肝功能及乙肝病毒标志物的变化情况。结果:苦参碱注射液联合薄芝糖肽治疗CHB,降ALT有效率为91.8%,HBV-DNA阴转率为31.9%,HBeAg阴转率为39.0%,与干扰素治疗CHB疗效相近,且治疗过程中末发现明显不良反应。结论:苦参碱注射液联合薄芝糖肽治疗CHB安全有效,与单用干扰素治疗CHB疗效相近。

目的观察岩黄连注射液治疗急慢性病毒性肝炎临床疗效。方法将所选择的病例随机分成治疗组和对照组,对照组采用基础治疗,治疗组在基础治疗的基础上加用岩黄连注射液静滴,观察两组的临床疗效。结果治疗组的疗效和肝功能的改善均优于对照组。结论岩黄连注射液治疗急慢性病毒性肝炎疗效明显,值得推广应用。

目的:观察苦参素注射液联合胸腺肽a1b治疗慢性乙型肝炎(CHB)的疗效.方法:选择慢性乙型肝炎患者168例,随机分成治疗组84例,对照组84例,治疗组运用苦参素注射液联合胸腺肽a1b治疗,对照组单用重组人干扰素a2b注射液治疗,疗程均为6个月,观察两组患者治疗前后肝功能及乙肝病毒标志物的变化情况.结果:苦参素注射液联合胸腺肽a1治疗CHB,降ALT有效率为92.8%,HBV-DNA阴转率为30.9%,HBeAg阴转率为38.0%,与干扰素治疗CHB疗效相近,且治疗过程中束发现明显不良反应.提示:苦参素注射液联合胸腺肽a1治疗CHB安全有效,与单用干扰素治疗CHB疗效相近.