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BACKGROUND: Studies have shown that long-term high-impact exercise stress can cause adaptive changes in the bones, which have certain effects on cortical bone thickness and trabecular bone density in athletes. Calcaneus bone density is often used as a basis for judging changes in bone mass. OBJECTIVE: To measure the cortical thickness of the calcaneus and trabecular bone density and distribution trend in Taekwondo athletes, in order to provide reference for research on foot functional anatomy, imaging anatomy, foot movement biomechanics and ankle surgery. METHODS: Ten high-level Taekwondo athletes were enrolled as experimental group and nine ordinary sports enthusiasts as control group. The subjects in the two groups were all male, and there were no significant differences in height, weight and age. GE64-slice spiral CT was used to scan the subjects’ feet on both sides, and Mimics 21.0 software was used to measure the cortical thickness of the calcaneal tubercle, lateral process, and medial process as well as trabecular bone density. The length, width and height of the trabecular bone in the sagittal, horizontal and coronal image windows were measured. RESULTS AND CONCLUSION: The thickness of the left and right calcaneal tuberosity and medial process in the experimental group was greater than that in the control group (P < 0.05). In the experimental group, the thickness of the cortical bone of the left lateral process, medial process and calcaneal tubercle was greater than that of the right lateral process, medial process and calcaneal tubercle (P < 0.05). The bone mineral density of the left and right lateral calcaneus and medial process of the experimental group was higher than that of the control group (P < 0.01). The length, width and height of the trabecula of the left and right calcaneus (sagittal, horizontal and coronal planes) in the experimental group were larger than those in the control group (P < 0.05). Taekwondo strikes and jumps produce the stress and traction of the Achilles tendon and plantar muscle ligament, which can increase the cortical thickness of the calcaneus, increase the density of the trabecular bone, and change the shape of the trabecular bone, manifested by the increase in trabecular length, width and height, indicating that the cortical bone and trabecular bone of the calcaneus at force part have undergone adaptive changes, and the left and right feet have changed. [ABSTRACT FROM AUTHOR]

Early diagnosis of liver fibrosis and dynamic monitoring of relevant changes have great implications for the treatment and prognosis improvement of chronic liver diseases. So far, liver biopsy remains the "golden standard" for the diagnosis and staging of liver fibrosis. However, due to its inherent limitations, a great effort has been made to develop more accurate non-invasive diagnostic methods, including serum fibrosis markers and mathematical models, ultrasound, contrast-enhanced ultrasonography, ultrasonic elastography, computed tomography, magnetic resonance imaging, and nuclear medicine. The advantages and disadvantages of relevant methods are discussed. Furthermore, proper selection of the non-invasive diagnostic methods for clinical application and the means for mutual verification are analyzed. As for the future direction, it is expected to employ the above methods for combined analysis and comprehensive assessment, in order to enhance the clinical value of non-invasive liver fibrosis diagnosis. [ABSTRACT FROM AUTHOR]

BACKGROUND: Ankle injury is a high incidence type of sports injury. Common sequelae include chronic ankle instability and repeated ankle sprain. Long-term development will form secondary arthritis, resulting in ankle dysfunction. Elastic ankle brace is a common protective device used to prevent ankle injury. OBJECTIVE: To predict the influence of elastic ankle brace on stress of the ankle internal tissue under different motion states using finite element method so as to the influence of elastic ankle brace on ankle protection performance. METHODS: A healthy ankle three-dimensional finite element model was constructed using reverse engineering technology, based on CT image sequences. The plantar pressure test and anterior drawer test were utilized to validate the effectiveness of the model. Ankle varus and valgus were simulated in the absence of ankle brace and under the action of three different kinds of elastic ankle brace to extract overall ankle displacement and stress distribution of the internal tissue. RESULTS AND CONCLUSION: (1) The simulation results of plantar pressure of foot and ankle finite element model were in good agreement with the experimental results. The simulation results of anterior drawer test were in good agreement with the corpse experiment in literature, which proved the validity of this model. (2) Elastic ankle brace reduced the overall displacement of ankle and the peak stress of internal tissue in the states of varus, valgus, internal rotation and external rotation, and the effect was enhanced with the increase of the elastic modulus of the material. It demonstrates the protective effect of elastic ankle brace and provides a reference for the digital evaluation of the protective effect of elastic ankle brace. [ABSTRACT FROM AUTHOR]

乙型肝炎病毒(HBV)是导致慢性肝炎的主要病因,同时亦是原发性肝细胞癌(PHC)的主要危险因素之一,研究证实HBV可通过整合自身基因进入到宿主基因组中或通过其结构蛋白、分泌蛋白,或通过表观遗传导致宿主基因突变,突变主要包括肝细胞部分DNA缺失和染色体重排等。HBV DNA整合对病毒本身和宿主肝细胞可产生影响,系列研究表明,乙型肝炎慢性化和PHC的发生发展与HBV DNA选择性整合可能存在关联,与乙型肝炎慢性化和PHC相关联整合位点的鉴定,将为乙型肝炎慢性化机制研究提供新的思路和线索,对未来临床基因诊断和治疗CHB及PHC有指导意义。 [ABSTRACT FROM AUTHOR]

As reported by the world health organization, about 650 thousand people die of liver failure, liver cirrhosis, and hepatocellular carcinoma caused by hepatitis B virus ( HBV) infection every year. Although to a certain extent, the application of interferon and nucleos( t) ide analogues reduces the adverse outcome of chronic hepatitis B (CHB) , so far no effective therapeutic method can eliminate HBV. HBV carriers have a significantly lower incidence rate of adverse outcome than active CHB patients, but they still have the risk of progression to liver cirrhosis and liver cancer. This article discusses the clinical identification and management of HBV carriers, so as to further clarify the features of chronic HBV carriers and related treatment measures in clinical practice. [ABSTRACT FROM AUTHOR]

乙型肝炎病毒（ HBV）感染预后与环境、HBV病毒学、宿主先天和后天免疫反应以及机体的基因等因素有关。机体先天免疫状况及其基因多态性可以影响白细胞介素18（IL-18）的正常表达。 IL-18是促炎症细胞因子，在多种疾病发生和发展过程中具有重要作用，包括HBV感染。研究表明IL-1β和IL-18异常低水平表达可能与乙型肝炎慢性化存在关联，但具体机制尚未明确，推测可能与机体某些天然免疫受体异常有关。 IL-18基因启动子－607和－137位点单核苷酸多态性可以影响IL-18基因的表达，导致IL-18的合成水平不同。近期的一些研究表明，等位基因－137位点C是保护性基因，可能阻止慢性乙型肝炎的发生或发展；IL-18－607A／A基因型是慢性乙型肝炎的易感基因。 [ABSTRACT FROM AUTHOR]

Objective To investigate the noninvasive indicators of indications for antiviral therapy in HBeAg - negative chronic hepatitis B virus (HBV) infection patients with alanine aminotransferase (ALT)=40 U/ L under the guidance of liver pathology. Methods A retrospective analysis was performed for the clinical data of 377 HBeAg - negative chronic HBV infection patients with ALT =40 U/ L who were hospitalized in Affiliated Hospital of Yan’an University, from October 2013 to August 2018 and underwent liver biopsy, among whom the patients with inflammatory activity < A2 and fibrosis stage < F2 were enrolled as non - antiviral therapy group(n =266), and the patients with inflammatory activity =A2 or fibrosis stage =F2 were enrolled as antiviral therapy group(n =111). The chi - square test was used for comparison of categorical data between two groups;the t - test was used for comparison of normally distributed continuous data between two groups, and the Mann - Whitney U test was used for comparison of non - normally distributed continuous data between two groups;univariate and multivariate binary logistic regression analyses were used to screen out the influencing factors for the initiation of antiviral therapy;the receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic efficiency of each indicator in determining the need for antiviral therapy in HBeAg - negative chronic HBV infection patients with ALT =40 U/ L. Results Of all 377 patients, 266 (70. 6% )did not need antiviral therapy for the time being, and 111 (29. 4% )had marked liver damage and thus needed active antiviral therapy. The multivariate analysis showed that liver stiffness measurement (LSM) (odds ratio [HR]=2. 003, 95% confidence interval [CI]:1. 647 - 2. 437, P <0.05), HBsAg (HR =1. 563, 95% CI:1. 110 -2. 200, P <0. 05), HBV DNA (HR =1. 519, 95% CI:1.173 -1. 966, P < 0. 05), and albumin (HR =0. 939, 95% CI:0. 884 -0. 998, P <0. 05)were independent influencing factors for the initiation of antiviral therapy. The ROC curve analysis showed that the area under the ROC curve (AUC)was 0. 749 (95% CI:0. 699 -0.799)for LSM, 0.642 (95% CI:0. 586 -0. 699) for HBV DNA, and 0. 565 (95% CI:0. 507 -0. 623) for HBsAg, and the combination of LSM, HBV DNA, and HBsAg had a larger AUC of 0. 779 (95% CI:0. 732 -0. 827). Conclusion The levels of LSM, HBV DNA, and HBsAg have a reference value in determining the initiation of antiviral therapy in HBeAg - negative chronic HBV infection patients with ALT=40 U/ L. [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma(HCC) is one of the most common malignant tumors in the world. At present,the treatment methods for HCC mainly include surgical treatment,local regional treatment,radiotherapy,systematic treatment,and traditional Chinese medicine treatment. This article introduces the indications for surgical treatment,surgical procedures,and the advantages of postoperative adjuvant therapy,analyzes the indications for liver transplantation and its future application in clinical practice,and describes the basic principles,optimal indications,and technical advantages of mature and new ablation techniques at present. It is pointed out that for patients with early-stage HCC,the advantages and shortcomings of each treatment regimen should be fully understood to select a precise treatment regimen. [ABSTRACT FROM AUTHOR]

At present, hepatitis B virus (HBV) infection is recognized as an important risk factor for hepatocellular carcinoma (HCC) in the world; however, during the development and progression of hepatitis B, liver cirrhosis, and liver cancer, other factors may promote the development of HCC independently or synergistically with HBV, such as sex, age, family history, alanine aminotransferase/aspartate aminotransferase, smoking and drinking history, metabolic syndrome, and HCV or HIV infection. This article reviews the research advances in the risk factors associated with HCC. [ABSTRACT FROM AUTHOR]

Ｐａｔｉｅｎｔｓ ｉｎ ｔｈｅ ｉｍｍｕｎｅ ｔｏｌｅｒａｎｃｅ ｓｔａｇｅ ｏｆ ｃｈｒｏｎｉｃ ｈｅｐａｔｉｔｉｓ Ｂ ｖｉｒｕｓ （ＨＢＶ）ｉｎｆｅｃｔｉｏｎ ａｒｅ ｉｎ ａ ｓｔａｔｅ ｏｆ ｈｉｇｈ ｖｉｒａｌ ｒｅｐｌｉｃａｔｉｏｎ ａｎｄ ｌｏｗ ｉｎｆｌａｍｍａｔｉｏｎ ｉｎ ｔｈｅ ｌｉｖｅｒ，ａｎｄ ｔｈｅｙ ｏｆｔｅｎ ｈａｖｅ ｎｏ ｄｉｓｅａｓｅ ｐｒｏｇｒｅｓｓｉｏｎ． Ｔｈｅｒｅｆｏｒｅ，ａｎｔｉｖｉｒａｌ ｔｈｅｒａｐｙ ｉｓ ｎｏｔ ｒｅｃｏｍｍｅｎｄｅｄ ｉｎ ｒｅｌａｔｅｄ ｇｕｉｄｅｌｉｎｅｓ． Ｒｅｃｅｎｔ ｓｔｕｄｉｅｓ ｈａｖｅ ｆｏｕｎｄ ｔｈａｔ ｔｈｅ ｐａｔｉｅｎｔｓ ｉｎ ｔｈｅ ｉｍｍｕｎｅ ｔｏｌｅｒａｎｃｅ ｓｔａｇｅ ｈａｖｅ ｉｍｍｕｎｅ ｒｅｓｐｏｎｓｅ ａｎｄ ｌｉｖｅｒ ｉｎｊｕｒｙ，ｗｈｉｃｈ ｉｓ ａ ｒｉｓｋ ｆａｃｔｏｒ ｆｏｒ ｌｉｖｅｒ ｃａｎｃｅｒ，ａｎｄ ｔｈｅｒｅｆｏｒｅ，ａｎｔｉｖｉｒａｌ ｔｈｅｒａｐｙ ｓｈｏｕｌｄ ｂｅ ａｃｔｉｖｅｌｙ ｉｎｉｔｉａｔｅｄ ｔｏ ｐｒｅｖｅｎｔ ｄｉｓｅａｓｅ ｐｒｏｇｒｅｓｓｉｏｎ． Ｔｈｉｓ ａｒｔｉｃｌｅ ｓｕｍｍａｒｉｚｅｓ ｔｈｅ ｒｅｓｅａｒｃｈ ａｄｖａｎｃｅｓ ｉｎ ｔｈｅ ｄｉａｇｎｏｓｉｓ ａｎｄ ｔｒｅａｔｍｅｎｔ ｏｆ ｐａｔｉｅｎｔｓ ｉｎ ｔｈｅ ｉｍｍｕｎｅ ｔｏｌｅｒａｎｃｅ ｓｔａｇｅ ｏｆ ｃｈｒｏｎｉｃ ＨＢＶ ｉｎｆｅｃｔｉｏｎ ａｎｄ ｐｏｉｎｔｓ ｏｕｔ ｔｈａｔ ｔｈｅｒｅ ａｒｅ ｓｔｉｌｌ ｃｏｎｔｒｏｖｅｒｓｉｅｓ ｏｖｅｒ ｔｈｅ ａｐｐｌｉｃａｔｉｏｎ ｏｆ ａｎｔｉｖｉｒａｌ ｔｈｅｒａｐｙ ｉｎ ｓｕｃｈ ｐａｔｉｅｎｔｓ． Ａｐｐｒｏｐｒｉａｔｅ ｔｉｍｉｎｇ ｏｆ ａｎｔｉｖｉｒａｌ ｔｈｅｒａｐｙ ｈａｓ ａ ｇｒｅａｔ ｓｉｇｎｉｆｉｃａｎｃｅ ｉｎ ｉｍｐｒｏｖｉｎｇ ｐａｔｉｅｎｔｓ'ｐｒｏｇｎｏｓｉｓ ａｎｄ ｒｅｄｕｃｉｎｇ ｔｈｅｉｒ ｅｃｏｎｏｍｉｃ ｂｕｒｄｅｎ． [ABSTRACT FROM AUTHOR]

To investigate the value of liver stiffness measurement (LSM) in the diagnosis of liver fibrosis degree in HBeAg-positive patients with chronic HBV infection. Methods A retrospective analysis was performed for the clinical data of 330 HBeAg-positive patients with chronic HBV infection who were hospitalized in Affiliated Hospital of Yan’an University from October 2013 to August 2018 and underwent liver biopsy, and according to liver pathological results, these patients were divided into mild liver fibrosis group (F0-F1) and significant liver fibrosis group (F2-F4). The t-test or the Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. Univariate and multivariate analyses were performed to screen out the indices for the diagnosis of significant liver fibrosis, and the receiver operating characteristic (ROC) curve was plotted for these indices to evaluate their value in the diagnosis of significant liver fibrosis. Results Of all 330 patients, 245 had mild liver fibrosis and 85 had significant liver fibrosis. There were significant differences between the two groups in HBV DNA, HBsAg, HBeAg, HBcAb, alanine aminotransferase, aspartate aminotransferase, total bilirubin, and LSM (all P＜0.05). The multivariate analysis showed that HBsAg and LSM were independent risk factors for significant liver fibrosis (both P＜0.05). The ROC curve analysis showed that only LSM had a diagnostic value, with an area under the ROC curve of 0.744 (95% confidence interval: 0.680-0.808). At the optimal cut-off value of 6.15 kPa, LSM had a sensitivity of 62.4%, a specificity of 76.3%, an accuracy of 72.1%, a positive predictive value of 72.5%, and a negative predictive value of 67.0% in predicting significant liver fibrosis. ConclusionLSM has a good value in predicting significant liver fibrosis in HBeAg-positive patients with chronic HBV infection. [ABSTRACT FROM AUTHOR]

Objective To investigate the clinical features of immune control phase and immune escape phase of chronic hepatitis B virus(HBV) infection. Methods A total of 226 patients with chronic HBV infection(with positive HBsAg, anti-HBe, and anti-HBc) who visited or were hospitalized in Yan’an University Affiliated Hospital from January 2016 to February 2018 were enrolled, and all of them underwent liver biopsy. According to the liver pathological results, the patients were divided into immune control group(121 patients with A <2 and F < 2) and immune escape group(105 patients with A≥2 or F≥2). The two groups were compared in terms of general data, virology, liver function, and liver stiffness measurement(LSM). The independent samples t-test or the Mann-Whitney U test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. Results There were no significant differences in sex, age, and family aggregation of hepatitis B between the immune control group and the immune escape group(all P > 0.05). There was a significant difference in HBV DNA level between the two groups [1107.00(369.00-3876.00)IU/ml vs 2171.00(596.00-8887.00) IU/ml, Z =-2.425, P = 0.015], while there were no significant differences in the levels of HBs Ag and anti-HBc(both P > 0.05). Compared with group A, group B had significantly higher levels of alanine aminotransferase(ALT)[46.00(22.00-97.50) U/L vs 30.00(19.00-87.50) U/L, Z =-2.261, P = 0.024], aspartate aminotransferase(AST)(35.50 ±14.74 U/L vs 31.30 ± 12.17 U/L, t =-2.351, P = 0.020), and LSM(7.41 ± 1.51 k Pa vs 4.76 ± 1.23 k Pa, t =-9.021, P <0.001). Conclusion Patients with chronic HBV infection(with positive HBsAg, anti-HBe, and anti-HBc) in the immune escape phase have significantly higher viral load, ALT, AST, and LSM than those in the immune control phase. In future, multicenter studies can be performed to clarify the ranges of the references values of the above parameters, in order to provide accurate diagnosis and treatment for patients with chronic HBV infection. [ABSTRACT FROM AUTHOR]

In the natural history of chronic HBV infection, immune tolerance phase is the early stage of disease progression and plays a decisive role in disease monitoring and treatment. The latest CHB guidelines in China and foreign countries recommend regular follow-up for patients in immune tolerance phase, instead of antiviral therapy. Although patients with chronic HBV infection in immune tolerance phase tend to have a good prognosis, they may also have the risk of progression to end-stage liver diseases such as liver cirrhosis, hepatocellular carcinoma, and liver function decompensation. This article elaborates on the influencing factors for natural prognosis of patients with chronic HBV infection in immune tolerance phase and provides a theoretical basis for clinical judgment of patient′s conditions, determination of the most appropriate timing for the initiation of antiviral therapy, and individualized management. [ABSTRACT FROM AUTHOR]