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目的临床上经常以ALT是否正常等因素将乙型肝炎感染者分为乙型肝炎携带者或乙型肝炎患者，并且以ALT ≥2UNL作为临床抗病毒治疗的适应症之一，但是目前尚缺乏足够的文献阐明其理论学依据，本文借助乙型肝炎病毒对肝星状细胞的影响对此进行探讨。方法分层随机选取不同ALT状态下不同病毒载量的慢性乙型肝炎的患者132例，作为干扰血清。经干扰血清干预HSC后，分别用MTT法检测HSC增殖， 流式细胞仪检测HSC细胞周期， RT-PCR 和免疫印迹分别检测TGF-β1、Smad3、 Smad7、α-SMA、collagen Ⅰ、collagen Ⅲ mRNA 及蛋白的表达，同时对ALT ≥2UNL的慢性乙肝患者抗病毒治疗随访24周，对比分析治疗前后患者干扰血清对肝星状细胞的影响。结果在ALT正常状态下，不同病毒载量的乙型肝炎病毒对肝星状细胞增殖、细胞周期及细胞分泌无差别性影响。而在ALT异常状态下，特别是 ALT ≥2UNL组中，随着病毒载量的增加，HSC增殖加速，处于G0/G1期的明显减少，而处于S期，G2/M期的明显增多以及TGF-β1、Smad3、Collagen Ⅰ、Collagen Ⅲ、α-SMA mRNA及相应蛋白的表达明显增高，Smad7 mRNA及蛋白明显减少，差异有统计学意义。与抗病毒治疗前相比抗病毒治疗后，干扰血清对肝星状细胞的影响明显减弱。结论本文揭示了在不同ALT状态下乙型肝炎病毒对HSC的差异性影响，并通过抗病毒治疗前后对比分析。补充说明了以ALT 为节点抗病毒治疗乙型肝炎病毒的细胞学理论基础。

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In order to accurately obtain area distribution under the complex terrain of the Jiangdingya landslide in Nanyu Town, Zhouqu County, Gansu Province. Digital orthophoto map and digital elevation model were used to accurately obtain the landslide area and analyze the landslide information. Based on image supervision classification, a certain impact factor constraint analysis was superimposed to further screen the landslide area, and the three operation methods of corrosion, expansion and opening operation in mathematical morphology were used to process the image to realize the automatic identification and extraction of the landslide area. The experimental results show that the superposition interpretation with digital orthophotos and the accuracy evaluation, the producer accuracy was 81. 25% and the user' s accuracy is 92. 85%, indicating that the interference caused by the rich terrain types in the complex terrain can be well the automatic identification and extraction of Jiangdingya landslide in Nanyu Town in Zhouqu the results show that the combination of the three methods can provide reference for identifying and extracting landslide areas under complex terrain. [ABSTRACT FROM AUTHOR]

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The incidence rate of nonalcoholic fatty liver disease-related hepatocellular carcinoma (NAFLD-HCC) tends to increase worldwide, while its pathogenesis remains unclear. With reference to the literature in recent years, this article summarizes the role of adipose tissue inflammation, oxidative stress, gut microbiota, and insulin resistance in the pathogenesis of NAFLD-HCC and the advances in the prevention and treatment of the above mechanisms, so as to provide new ideas for the treatment of NAFLD-HCC. [ABSTRACT FROM AUTHOR]

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Objective To investigate the association between T-lymphocyte phenotype and immune status in chronic hepatitis B(CHB)and its application value.Methods A total of 77 CHB patients who attended The First Hospital of Lanzhou University from January 2015 to May 2019 were enrolled, and according to the status of HBeAg and the serum levels of alanine aminotransferase(ALT), HBsAg, and HBV DNA, they were divided into immune tolerance group and non-immune tolerance group. The laboratory results of T-lymphocyte phenotype, HBV serological test, HBV DNA load, routine blood test, and liver function were obtained, and aspartate aminotransferase-to-platelet ratio index(APRI) and fibrosis-4(FIB-4) were calculated. Thettest was used for comparison of normally distributed continuous data between two groups; and the Mann-WhitneyUtest was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between groups. Spearman correlation analysis was used to test the correlation effect between the two variables. The diagnostic efficacy of Treg, CD8~+PD-1~+T lymphocyte percentage and CD8~+CD45 RO~+T lymphocyte percentage were evaluated by AUC.Results Compared with the non-immune tolerance group, the immune tolerance group had significantly higher percentages of Treg and CD8~+PD-1~+T cells(U= 12.0 and 59.0, P< 0.001, P= 0 013) and significantly lower percentages of CD3~+CD8~+T cells and CD8~+CD45 RO~+T cells(U= 50.0 and 38.5, bothP< 0.05). Compared with the high HBV DNA load group, the low HBV DNA load group had significantly lower percentages of Treg and CD8~+PD-1~+T cells(U= 178 5 and 255.0, P= 0.003 and 0.018) and significantly higher percentages of CD3~+T cells and CD8~+CD45 RO~+T cells(U= 104.0 and1495, P= 0.033 and 0.025). APRI was negatively correlated with the percentage of Treg(r=-0.379, P= 0.013), and FIB-4 was negatively correlated with the percentages of CD3~+CD4~+, CD3~+CD8~+, CD4~+CD45 RO~+, and CD8~+CD45 RO~+T cells(r=-0.259, -0.275, -0.233, and-0.229, P= 0.023, 0.016, 0.041, and 0.045). Treg, CD8~+PD-1~+T cells, and CD8~+CD45 RO~+T cellshad an area under the ROC curve of 0.793(95% confidence interval [CI]: 0.651-0.936), 0.802(95% CI: 0.678-0.927), and0.816(95% CI: 0.706-0.927), respectively, in evaluating immune status.Conclusion There are various T-lymphocyte phenotypesin patients with chronic HBV infection, and different T lymphocytes have different abilities to eliminate HBV. Detection of T-lymphocytephenotype helps to understand the immune status and adjust the immune function in CHB patients and can provide a reference for the func-tional cure of CHB patients. [ABSTRACT FROM AUTHOR]

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