核苷类似物治疗早中期HBV-ACLF患者随机对照临床研究

Objective To clinically study the antiviral effects of lamivudine and entecavir on patients with early-to-mid stage Hepatitis B related acute on chronic liver failure(HBV-ACLF).Methods A prospective,randomized,open and parallel controlled clinical trial was designed to observe the antiviral effects of nucleoside analogues on patients with early-to-mid stage HBV-ACLF.Three groups were set for controlled study,i.e.basic treatment group,lamivudine plus basic treatment group and entecavir plus basic treatment group.Results One month after treatment,the improvement rates of lamivudine group and entecavir group were 58.85% and 59.15% respectively,significantly hisher than that of basic treatment group which was 34.84%(X2=9.8323,P=0.043).By the end of six months,the cumulative survival rates of patients with the antiviral treatments,i.e.,lamivudine,entecavir,were 65.8%,60.1%,significantly higher than that(42%) without the antiviral treatment(P=0.045,P=0.04 respectively).The cumulative survival rate in patients with a MELD score <30 was higher than that with a MELD score over 30(X2= 3.920 P=0.048).For the patients with pretreatment HBV DNA≥107,the cumulative survival rate in patients with entecavir treatments group was higher than that of patients in basic treatment group(X2=5.014 P=0.025).According to the Ordinal Regression analysis,antiviral therapy by using either lamivudine or entecavia could significantly increase the improvement rate of patients with early-to-mid stage HBV-ACLF. But severe complications, including hepatorenal syndrome, electrolyte imbalance and hepatic encephalopathy,medical history of liver cirrhosis,and pretreatment HBV DNA≥107 had significant impacts on prognosis of this group patients.Conclusions Antiviral therapy by using either lamivudine or entecavia could significantly increase the survival rate of patients with early-to-mid stage HBV-ACLF.     

Roux-en-Y gastric bypass for Chinese type 2 diabetes mellitus patients with a BMI,28kg/m~2:a multi-institutional study

Roux-en-Y gastric bypass surgery(RYGB) has been demonstrated to be successful for treating type-II diabetes2mellitus(T2DM) patients with a body mass index(BMI),30 kg/m,but reports of RYGB for T2 DM patients with22 a BMI,28 kg/mare lacking.T2 DM patients with a BMI,28 kg/mwere prospectively recruited to participate in this study in four hospitals.The endpoint was T2 DM remission(defined by fasting blood glucose(FBG) level,110 mg/d L and hemoglobin(Hb)A1c level,6.0% at 12 months postoperatively).Predictors of remission were investigated by univariate and multivariate analyses.Eighty-six patients were assessed.Eighty-five patients underwent RYGB,with one conversion to open surgery.We compared the values of various variables before and after2 surgery.The mean BMI decreased from 24.68±2.12 to 21.72±2.43 kg/m(P,0.001).Fifty-eight(67.4%) patients were not treated by drugs or insulin after surgery,and 20 patients(23.3%) had complete remission of T2 DM at12 months after surgery with an acceptable number of complications.The mean Hb A1 c level in the remission group was significantly lower than that in the non-remission group.Patients with a higher weight,lower Hb A1 c level,higher C-peptide level,and higher FBG level were more likely to have T2 DM remission in multivariate2 analyses.In conclusion,RYGB was effective and safe for treating T2 DM patients with a BMI,28 kg/m.Complete remission can be predicted by cases having a higher weight,lower Hb A1 c level,higher C-peptide level,and higher FBG level.     

A new free-hand pedicle screw placement technique with reference to the supraspinal ligament

We sought to compare the safety and accuracy of a new free-hand pedicle screw placement technique to that of the conventional technique.One hundred fifty-three consecutive adult patients with simple fracture in the thoracic or/and lumbar spine were alternately assigned to either the new free-hand or the conventional group.In the new free-hand technique group,preoperative computerized tomography(CT) images were used to calculate the targeted medial-lateral angle of each pedicle trajectory and the pedicle screw was inserted perpendicular to the corresponding supraspinal ligament.In the conventional technique group,the medial-lateral and cranial-caudal angle of each pedicle trajectory was determined by intraoperatively under fluoroscopic guidance.The accuracy rate of pedicle screw placement,the time of intraoperative fluoroscopy,the operating time and the amount of blood loss during operation were respectively compared.All screws were analyzed by using intraoperative radiographs,intraoperative triggered electromyography(EMG) monitoring data,postoperative CT data and clinical outcomes.The accuracy rate of pedicle screw placement in the new free-hand technique group and the conventional technique group was 96.3% and 94.2%(P < 0.05),respectively.The intraoperative fluoroscopy time of the new technique group was less than that of the conventional technique group(5.37 seconds vs.8.79 seconds,P < 0.05).However,there was no statistical difference in the operating time and the amount of blood loss during operation(P > 0.05).Pedicle screw placement with the free-hand technique which keeps the screw perpendicular to the supraspinal ligament is an accurate,reliable and safe technique to treat simple fracture in the thoracic or lumbar spine.     

Immunoexpression and prognostic role of p53 in different subtypes of epithelial ovarian carcinoma

We sought to investigate the significance of p53 expression for epithelial ovarian carcinoma.In this study,we used immunohistochemical method to investigate the expression patterns of p53 in different subtypes of epithelial ovarian carcinoma.We found that the expressions of p53 protein in epithelial ovarian cancer(pituita,serosity and intima) were 88.9%,75% and 100%,respectively,while the recurrence rates among three cancer subtypes were significantly different(33.3%,12.5% and 0%,respectively;P 0.05).Compared with patients without lymph node metastasis,the expression of p53 in patients with lymph node metastasis was significantly strong(68.75% and 100%,respectively;P 0.05).However,the recurrence rate in the patients with lymph node metastasis(40%) was higher than that without lymph node metastasis(6.25%,P 0.05).The expressions of p53 protein in ovarian cancer betweenⅠ-Ⅱ(25%) stage and Ⅱ-Ⅳ stage(100%) were significantly different(P 0.05),and the recurrence rates between the two groups were significantly different(0% and 31.25%,respectively,P 0.05).Therefore,p53 protein has an intimate relationship with the malignant degree and the prognosis of ovarian cancer.     

核苷类似物治疗早中期HBV-ACLF患者随机对照临床研究

Objective To clinically study the antiviral effects of lamivudine and entecavir on patients with early-to-mid stage Hepatitis B related acute on chronic liver failure(HBV-ACLF).Methods A prospective,randomized,open and parallel controlled clinical trial was designed to observe the antiviral effects of nucleoside analogues on patients with early-to-mid stage HBV-ACLF.Three groups were set for controlled study,i.e.basic treatment group,lamivudine plus basic treatment group and entecavir plus basic treatment group.Results One month after treatment,the improvement rates of lamivudine group and entecavir group were 58.85% and 59.15% respectively,significantly hisher than that of basic treatment group which was 34.84%(X2=9.8323,P=0.043).By the end of six months,the cumulative survival rates of patients with the antiviral treatments,i.e.,lamivudine,entecavir,were 65.8%,60.1%,significantly higher than that(42%) without the antiviral treatment(P=0.045,P=0.04 respectively).The cumulative survival rate in patients with a MELD score <30 was higher than that with a MELD score over 30(X2= 3.920 P=0.048).For the patients with pretreatment HBV DNA≥107,the cumulative survival rate in patients with entecavir treatments group was higher than that of patients in basic treatment group(X2=5.014 P=0.025).According to the Ordinal Regression analysis,antiviral therapy by using either lamivudine or entecavia could significantly increase the improvement rate of patients with early-to-mid stage HBV-ACLF. But severe complications, including hepatorenal syndrome, electrolyte imbalance and hepatic encephalopathy,medical history of liver cirrhosis,and pretreatment HBV DNA≥107 had significant impacts on prognosis of this group patients.Conclusions Antiviral therapy by using either lamivudine or entecavia could significantly increase the survival rate of patients with early-to-mid stage HBV-ACLF.     

乳腺癌前哨淋巴结术中分子诊断的临床实用性初探

Objective To evaluate the application of GeneSearchTM breast lymph node assay in intraoperative detection of metastases in sentinel lymph node (SLN) from breast cancer patients. Methods A total of 225 SLN from 88 patients was prospectively studied. Each SLN was cut into 2 mm slabs which were examined by intraoperative imprint cytology (ⅡC) first, followed by GeneSearch assay and postoperative serial sectioning. GeneSearch used real-time fluorescence quantitative RT-PCR technology to detect the expression of CK19 and mammaglobin in SLN. The results of GeneSearch assay were correlated with those of ⅡC and post-operative serial sectioning. Results Amongst the 88 cases studied, 225 SLNs were found, and obvious metastatic carcinoma cells were identified in 27 SLNs and micrometastasis in 9 SLNs.One hundred and eight-nine SLNs were considered as "negative" (with "isolated tumor cells" present in 5 SLNs). The turn-around time of intraoperative GeneSearch assay ranged from 35 to 45 minutes (mean = 40 minutes). The concordance rate between GeneSearch assay and post-operative serial sectioning was 95.6% (215/225), with a sensitivity of 86.1% (31/36), compared with 94.7% (213/225) and 72.2% (26/36)respectively for ⅡC. The size of metastatic foci correlated with the Ct value of CK19 and mammaglobin (P ＜0.01). Conclusions GeneSearch assay for intraoperative detection of metastase in SLN has a satisfactory performance and demonstrates a relatively higher sensitivity than ⅡC. The potential clinical application still requires further evaluation of larger number of cases.     

人乳头瘤病毒检测在宫颈病变中的应用价值

Objective To detect the human papillomavirus(HPV) infectious condition in women with abnormal cytology and evaluate its values in the screening of high grade cervical intraepithelial lesion.Method 1O1 patients who underwent thinprep cell test(TCT) with abnormal cervical cytology were selected to undergo HPV test, all subjects also received tissue biopsy at the same time. Results ( 1 )Among the 101 patients,the incidence rates of high risk HPV infection of those with ASCUS, LSIL, HSIL and squamous cell carcinoma were 84. 2% ,88.6% , 100. 0% and 2/2 respectively. (2)Among the patients with abnormal cytology,the number of patients with pathologically confirmed results of CIN Ⅰ and CIN Ⅱ or worse were 20 and 81, the incidence rates of high risk HPV infection of those with CIN Ⅰ and CIN Ⅱ or worse were 60.0% and 97.5% respectively. (3) In the ASCUS group, the incidence rates of CIN Ⅱ or worse with high risk HPV infection were 87.5% and the incidence rates of CIN Ⅱ or worse without high risk HPV infection were 16.7%. (4)The prevalence of high risk HPV types from highest to lowest order were follow: HPV16 (39. 6% ) ,58( 17. 8% ) ,52 ( 16. 8% ), 18 ( 9. 9% ) ,33 ( 9.9% ). Conclusions The infection rate of high risk HPV was positively correlated with the levels of cervical lesions. HPV test is a good triage approach for the patients with ASCUS. HPV16,58,52,18,33 are the most common in the patients of cervical lesions.     

Weekly intravenous nanoparticle albumin-bound paclitaxel for elderly patients with stage IV non-small-cell lung cancer:a series of 20 cases

The purpose of this study was to evaluate the efficacy and safety of nanoparticle albumin-bound paclitaxel as a rescue regimen in the treatment of patients with advanced non-small-cell lung cancer.We retrospectively reviewed the medical records of 20 patients with stage IV non-small-cell lung cancer.The patients had progressive disease after standard antitumor therapy and subsequently received intravenous albumin-bound paclitaxel at the dose of 100 mg/m2 in weekly schedule.Cumulative findings showed that the overall response rate was 30.0%,the disease control rate amounted to 40%,and the 1 year survival rate was 30%.In addition,the median time to progression and the median survival time reached 5 and 10 months,respectively.Meanwhile,no severe hypersensitivity reactions and grade 4 adverse effects were reported.In summary,weekly-administered albumin-bound paclitaxel seems to be an effective and safe regimen for elderly patients with stage IV non-small-cell lung cancer who were refractory to conventional therapy.     

Significance of the antigenic epitopes in heterogenous nuclear ribonucleoproteins-Ⅰ for the diagnosis and prognosis of systematic sclerosis

To assess the presence of autoantibodies against epitopes of heterogenous nuclear ribonucleoprotein-Ⅰ(hnRNP-Ⅰ) in systematic sclerosis (SSc) and to analyze their clinical significance, polypeptides of hnRNP-Ⅰwere designed by biological technical software and analyzed with both the Wonderful Biology Information System and DNA Star-Protean Analysis Software at the same time. In these ways, two polypeptides of hnRNP-Ⅰwere obtained based on their amino acid sequences, folding features, hydrophilic, curl style, dough kneading sensation and the possibility on the surface of proteins. They are named as hnRNP-Ⅰ-1 ( NVKYNNDKSRDYTRPDLPSGDSQPSLDQT, 264-292 aa) and hnRNP-Ⅰ-2 (QLP4REGQEDQGLTKDYGNSOL, 441-461 aa), simply designated asⅠ-1 andⅠ-2. The autoantibodies against hnRNPs were detected by means of ELISA using the synthetic epitopes polypeptides as antigen. It was found that the positive rate of detection for anti-Ⅰ-1 and anti-Ⅰ-2 autoantibodies were rather higher in SSc patients than that in other CTDs and the sensitivities and specificities of the testing with ELJSA for anti-Ⅰ-1 and anti-Ⅰ-2 antibodies in SSc patients were 47. 62%/93. 43% and 38. 1%/ 91.08% , without any significant difference between these two groups of testings. Also, there was no significant difference in the clinical features and laboratory findings, such as age, involvements in digestive and respiratory tracts and erythrocyte sedimentation rate etc., between the anti-Ⅰ-1-positive and -negative groups in SSc patients. However, the hnRNP-Ⅰ-autoantibody-positive group of patients had obviously shorter duration of disease course compared with that of the autoantibody-negative group. Anti-Ⅰ-1 and anti-Ⅰ-2 autoantibodies also had no association with antinuclear antibody, anti-Scl70 and anti-centromere antibody (ACA) in SSc patients. So, it is apparent that the autoantibodies related with SSc may act through different pathways in the pathogenesis of SSc, and the hnRNP-Ⅰautoantibody is a new type antibody occuring during the early stage of disease and appearing to have diagnostic and prognostic significances .     

Complications and death causes of peripheral blood stem cell transplantation in the treatment of thalassemia major北大核心

BACKGROUND: Allogeneic hematopoietic stem cell transplantation is the only effective method to cure thalassemia major. However, the risk factors influencing the prognosis of transplantation remain unclear. OBJECTIVE: To analyze the distribution of common complications and cause of death after allogeneic hematopoietic stem cell transplantation in children with thalassemia major, and to explore the prognostic factors so as to provide references for improving the survival rate of patients. METHODS: This retrospective cohort study included 257 patients with β-thalassemia major who underwent allogeneic hematopoietic stem cell transplantation at Department of Hematology and Oncology, Guangzhou Women and Children Medical Center between September 2013 and September 2019. There were 172 males and 85 females, with a median age of 6 years at the time of transplantation. The basic clinical data before transplantation and complications after transplantation were compared between the surviving group and dead group using single factor. The overall survival rate was analyzed by the Kaplan-Meier method, and the overall survival rate was compared by the Log-rank test. Multivariate Cox regression was used to analyze factors affecting survival. RESULTS AND CONCLUSION: The median follow-up time was 29 months, and no cases were lost to follow-up. (1) Univariate analysis results showed that there were significant differences in the risk classification between surviving patients and dead patients (P=0.033). Patients with higher risk class had an increased risk of death after transplantation. Multivariate analysis showed that risk classification and severe pneumonia were independent risk factors for overall survival after thalassemia major hematopoietic stem cell transplantation (P < 0.05). (2) Among 20 dead patients, there were 13 patients with severe pneumonia and respiratory failure, 2 patients with grade IV intestinal graft-versus-host disease, 1 patient with intracranial hemorrhage due to thrombocytopenia, 1 patient with thrombocytopenia with acute pulmonary hemorrhage, 1 patient with sepsis with shock, and 1 patient with myasthenia gravis. (3) Totally 17 cases died within 1 year after transplantation, while the rest 3 patients died of severe pneumonia more than 1 year after transplantation. (4) The incidence of bronchiolitis obliterans was significantly higher in patients who died after transplantation than in those who survived (P < 0.000 1). (5) It is concluded that the important factors that affect survival rate in thalassemia major patients after hematopoietic stem cell transplantation are infection and severe graft-versus-host disease. The risk of death increased in patients with bronchiolitis obliterans after transplantation. © 2023, Chinese Journal of Tissue Engineering Research. All rights reserved.     

评价多重连接探针扩增法诊断染色体22q11.2微缺失结果研究

Objective To evaluate multiplex ligation-dependent probe amplification (MLPA) assay detection in analysis of chromosome 22q11.2 microdeletion. Methods Between March 2008 and September 2009, thirty-two patients including 10 males and 16 females aged between years (3.6±3.1) were selected and evaluated by history, physical examination and medical records. Of these patients, sixteen patients who were previous diagnostic as 22q11.2 microdeletion were in positive control group, the other 16 healthy children were in negative control group. All the patients were detected by MLPA and fluorescence in situ hybridization (FISH) for the presence of a 22q1 1.2 microdeletion after informed consent. Diagnostic efficacy was assessed by sensitivity, specificity and Kappa analysis. Results We have applied the two assays of detection of chromosome 22q11.2 microdeletion in 32 patients. Sixteen patients in positive control group were found to have a 22q11. 2 deletion and, with the deletion size of 3-Mb. However, as expected,chromosome 22q11.2 deletion was not found in negative control group. The MLPA results were in good agreement with that by FISH. Therefore, MLPA has high sensitivity and specificity. Conclusion MLPA is a rapid, reliable, high-throughput and relatively economical alternative to FISH technology for the diagnosis of 22q11.2 microdeletion. It can provide reliable and helpful information for clinical diagnosis of 22q11.2 microdeletion syndrome.     

评价多重连接探针扩增法诊断染色体22q11.2微缺失结果研究

Objective To evaluate multiplex ligation-dependent probe amplification (MLPA) assay detection in analysis of chromosome 22q11.2 microdeletion. Methods Between March 2008 and September 2009, thirty-two patients including 10 males and 16 females aged between years (3.6±3.1) were selected and evaluated by history, physical examination and medical records. Of these patients, sixteen patients who were previous diagnostic as 22q11.2 microdeletion were in positive control group, the other 16 healthy children were in negative control group. All the patients were detected by MLPA and fluorescence in situ hybridization (FISH) for the presence of a 22q1 1.2 microdeletion after informed consent. Diagnostic efficacy was assessed by sensitivity, specificity and Kappa analysis. Results We have applied the two assays of detection of chromosome 22q11.2 microdeletion in 32 patients. Sixteen patients in positive control group were found to have a 22q11. 2 deletion and, with the deletion size of 3-Mb. However, as expected,chromosome 22q11.2 deletion was not found in negative control group. The MLPA results were in good agreement with that by FISH. Therefore, MLPA has high sensitivity and specificity. Conclusion MLPA is a rapid, reliable, high-throughput and relatively economical alternative to FISH technology for the diagnosis of 22q11.2 microdeletion. It can provide reliable and helpful information for clinical diagnosis of 22q11.2 microdeletion syndrome.     

Renal arterioles in patients with type I diabetes and microalbuminuria before and after treatment with antihypertensive drugs

 Antihypertensive drugs can slow or even reverse the progression of diabetic nephropathy at the microalbuminuric stage. This study was performed to obtain quantitative data on changes in the renal arterioles in a follow-up study. Twelve patients with type I diabetes and with microalbuminuria were allocated to treatment for 3 years with either an ACE inhibitor (group I, 6 patients) or a beta blocker (group II, 6 patients). Baseline and follow-up renal needle biopsy specimens were taken and serially sectioned at 1 μm for light microscopy, enabling identification of arterioles as afferent or efferent. Thin sections for electron microscopy were made at 50-μm intervals, and micrographs were taken of arteriolar profiles. Matrix volume fraction of the media and a calculated matrix thickness were obtained. At baseline, structural parameters were higher than normal values. At follow-up all patients were normoalbuminuric. Both groups showed only minor changes in arteriolar structures over 3 years. In the afferent arterioles in group II there was a significant increase in the matrix volume fraction of the media, and there was a tendency to an increase in matrix thickness in both groups. In the efferent arterioles there were no significant changes in parameters. There were no differences between the two groups in arteriolar structural changes from baseline to follow-up. Thus, this study shows a slight but significant matrix accumulation in the afferent arterioles during treatment with antihypertensive drugs. This may have implications for the progression to overt nephropathy, which indicates a need for more long-term studies of treatment with antihypertensive drugs in incipient nephropathy in type I diabetes. Received: 29 September / Accepted: 19 January 1999     

细胞因子诱导杀伤细胞分泌因子影响人肝癌干细胞的凋亡

BACKGROUND: Immunotherapy with autologous immune cells has been developed as a major adjuvant therapy for malignant tumors, but its mechanism of action has not been elucidated. OBJECTIVE: To investigate the relationship between cytokine-induced killer cell secretion and apoptosis in human liver cancer stem cells. METHODS: Human liver cancer stem cells, HepG2 cells, were isolated and enriched using serum-free suspension method. The peripheral blood mononuclear cells from patients with liver cancer were induced by γ-interferon, CD3 monoclonal antibody and recombinant human interleukin-2 to form killer cells. Passage 1 liver cancer stem cells were divided into control group (culture alone) and experimental group (co-culture of cytokines-induced killer cells and human liver cancer stem cells). At 48 hours after culture, apoptosis in human liver cancer stem cells was detected using flow cytometry, and expression of caspase-3 mRNA and protein was detected using RT-PCR and western blot, respectively. RESULTS AND CONCLUSION: The apoptotic rate in the control group was significantly lower than that in the experimental group (P < 0.05). The expressions of caspase-3 at mRNA and protein levels were both higher in the experimental group than the control group (P < 0.05). Experimental findings show that cytokines-induced killer cells can significantly promote apoptosis in human liver cancer stem cells, and up-regulate the caspase-3 mRNA and protein expressions dramatically.  中国组织工程研究杂志出版内容重点：干细胞;骨髓干细胞;造血干细胞;脂肪干细胞;肿瘤干细胞;胚胎干细胞;脐带脐血干细胞;干细胞诱导;干细胞分化;组织工程      

Preoperative administration of intramuscular dezocine reduces postoperative pain for laparoscopic cholecystectomy

Postoperative pain is the most common complaint after laparoscopic cholecystectomy.This study was carried out to evaluate whether preoperative administration of intramuscular dezocine can provide postoperative analgesia and reduce postoperative opioid consumption in patients undergoing laparoscopic cholecystectomy.Patients (ASA Ⅰ or Ⅱ) scheduled for laparoscopic cholecystectomy were randomly assigned into intramuscular dezocine group (group 1) or intramuscular normal saline group (group 2).Dezocine and equal volume normal saline were administered intramuscularly 10 min before the induction of anesthesia.After operation,the severity of postoperative pain,postoperative fentanyl requirement,incidence and severity of side-effects were assessed.Postoperative pain and postoperative patient-controlled fentanyl consumption were reduced significantly in group 1 compared with group 2.The incidence and severity of side effects were similar between the two groups.Preoperative single-dose administration of intramuscular dezocine 0.1 mg/kg was effective in reducing postoperative pain and postoperative patient-controlled fentanyl requirement in patients undergoing laparoscopic cholecystectomy.     

Comparison of Three External Wet Compress Methods in The Treatment of Facial Hormone Dependent Dermatitis

Objective:To compare the therapeutic effects of three different external wet compress methods on facial hormone dependent dermatitis(FCAD),and to provide reference for clinical treatment of FCAD.Methods:From June 2016 to June 2019,160 FCAD patients in our dermatology clinic were selected and divided into three groups according to random number table:the first group was treated with Compound Cortex Phellodendri liquid coating,the second group was treated with collagen paste dressing,and the third group was treated with 0.9% sodium chloride injection solution.Apply 8 layers of gauze or cold compress directly to the skin lesions for 4 weeks in each group.Results:After 4 weeks of treatment,no adverse reactions were found.The effective rates of the first group,the second group,and the third group were 72.22%,62.26% and41.51%,respectively.Compared with the third group,the effective rate of the first group and the second group was significantly higher,and there was statistical significance between the groups(χ~2=10.294,χ~2=4.573,P0.05);but there was no significant statistical difference between the first group and the second group(χ~2=1.205,P0.05).Conclusion:Compound Cortex Phellodendri coating is suitable for FCAD patients with severe inflammation,collagen paste dressing is suitable for FCAD patients with mild to moderate inflammatory reaction and pigmentation,and 0.9% sodium chloride injection is suitable for patients with mild facial flushing and swelling.Clinical treatment should be selected according to the patient's condition and rash characteristics.     

HBV基因型与HBV感染慢性化、重症化的关系

Objective To explore the association between HBV genotype and chronic/severe liver disease with HBV infection in Chinese patients.Methods Serum samples were collected from 2922 patients with HBV infection.HBV genotyping was performed with type-specific primers polymerase chain reaction,and the virological and biochemical markers were detected,which differences in the genotypes between various clinical types of HBV infection and liver function and virological markers between various HBV genotyping were analyzed.Results The genotype B,C,BC combinations,D of 2922 patients with HBV infection accounted for 15.9%,83.5%,0.41%,0.21% respectively.The ratio of genotype B in acute hepatitis group was higher(P=0.003),which the ratio of genotype C in the cirrhosis group and the hepatocellular carcinoma group was higher(P=0.000,0.000).The difference in ratio of genotype C was not statistically significant between acute-on-chronic liver failure group and chronic hepatitis group.HBeAg-positive rate,viral load and liver function markers of B,C genotype group in acute hepatitis group and chronic hepatitis group were not significant different.HBeAg-positive rates of genotype C in acute-on-chronic liver failure group,cirrhosis group,hepatoeellular carcinoma group were higher than that of genotype B(P=0.000,0.024,0.003).Viral load of genotype C in hepatocellular carcinoma group was higher than that of genotype B(P=0.025).Cholinesterase levels of genotype C in the acute-on-chronic liver failure group and the hepatocellular carcinoma group was lower than that of genotype B(P=0.0004、0.02).Conclusion There were HBV genotype B,C,B/C combinations and D in Chinese patients with HBV infection,with genotype B and C being the major ones.Compared with HBV genotype B,genotype C in Chinese patients with HBV infection was more likely to chronic infection,evolved to cirrhosis and hepatocellular carcinoma, but genotype difference was not observed in occurrence of acute-on-chronic liver failure.Genotype was not significant effect in acute and chronic hepatitis B,but HBeAg-positive rate/viral load was higher and liver damage was more severe in severe and end-stage genotype C HBV infection patients.     

HBV基因型与HBV感染慢性化、重症化的关系

Objective To explore the association between HBV genotype and chronic/severe liver disease with HBV infection in Chinese patients.Methods Serum samples were collected from 2922 patients with HBV infection.HBV genotyping was performed with type-specific primers polymerase chain reaction,and the virological and biochemical markers were detected,which differences in the genotypes between various clinical types of HBV infection and liver function and virological markers between various HBV genotyping were analyzed.Results The genotype B,C,BC combinations,D of 2922 patients with HBV infection accounted for 15.9%,83.5%,0.41%,0.21% respectively.The ratio of genotype B in acute hepatitis group was higher(P=0.003),which the ratio of genotype C in the cirrhosis group and the hepatocellular carcinoma group was higher(P=0.000,0.000).The difference in ratio of genotype C was not statistically significant between acute-on-chronic liver failure group and chronic hepatitis group.HBeAg-positive rate,viral load and liver function markers of B,C genotype group in acute hepatitis group and chronic hepatitis group were not significant different.HBeAg-positive rates of genotype C in acute-on-chronic liver failure group,cirrhosis group,hepatoeellular carcinoma group were higher than that of genotype B(P=0.000,0.024,0.003).Viral load of genotype C in hepatocellular carcinoma group was higher than that of genotype B(P=0.025).Cholinesterase levels of genotype C in the acute-on-chronic liver failure group and the hepatocellular carcinoma group was lower than that of genotype B(P=0.0004、0.02).Conclusion There were HBV genotype B,C,B/C combinations and D in Chinese patients with HBV infection,with genotype B and C being the major ones.Compared with HBV genotype B,genotype C in Chinese patients with HBV infection was more likely to chronic infection,evolved to cirrhosis and hepatocellular carcinoma, but genotype difference was not observed in occurrence of acute-on-chronic liver failure.Genotype was not significant effect in acute and chronic hepatitis B,but HBeAg-positive rate/viral load was higher and liver damage was more severe in severe and end-stage genotype C HBV infection patients.     

降钙素增强双膦酸盐对绝经后骨质疏松患者慢性腰背痛缓解及生活质量改善的作用

BACKGROUND: Salmon calcitonin or elcatonin has been reported to alleviate acute and severe back pain caused by osteoportic fracture. OBJECTIVE: To evaluate the effects of the combined use of elcatonin and risedronate in the treatment of chronic back pain and the improvement of quality of life in postmenopausal women with osteoporosis. METHODS: Forty-five postmenopausal women with osteoporosis accompanied by chronic back pain persisting for more than 3 months, after excluding women with fresh vertebral fractures within the last 6 months, were randomly assigned to a risedronate group (administration of risedronate alone, n=22) and a combined drug group (combined administration of risedronate and elcatonin, n=23). Pain was evaluated using a visual analogue scale (VAS) and the Roland-Morris questionnaire. Bone mineral density was determined by dual-energy X-ray. Quality of life was assessed using the Medical Outcomes Study 36-Item Short-Form (SF-36) at 6 months after treatment. RESULTS AND CONCLUSION: There were 20 and 19 cases in the risedronate and combined drug groups, respectively included in the final analysis. Significant improvements were found in the combined drug group for VAS and mental health status section scores in the SF-36 at final follow-up compared with baseline and 3-month follow-up, while no change was found in the risedronate group. Bone mineral density was increased significantly in both groups, while no significant difference was found between groups. These findings suggest that the use of elcatonin in addition to risedronate for more than 3 months may reduce chronic back pain in osteoporosis patients. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

Effect of intrathecal clonidine on group I and group II oligosynaptic excitation in paraplegics

We investigated the possibility that a change in transmission in group II pathways contributes to the spasticity of patients with spinal lesions. Thirteen patients were tested by measuring the quadriceps stretch reflex (Ashworth scale), the threshold of the quadriceps H reflex, and the oligosynaptic facilitation of the quadriceps H reflex elicited by volleys to groups I and II afferents in the common peroneal nerve (CPN). All these tests were performed before and after intrathecal injection of clonidine (60 μg). Early group I CPN-induced excitations occurred in 13 patients, and late group II CPN-induced excitations in 12. Both facilitations were, on average, significantly greater than those reported for normal subjects, but these increases were not correlated with the clinically assessed spasticity. Clonidine caused a constant, prolonged and dramatic decrease in spasticity, but did not alter the threshold of the quadriceps H reflex. CPN-induced group I and group II non-monosynaptic excitations of quadriceps motoneurones were significantly decreased, although they did not return to normal values. These results provide a further indication that group II pathways gives rise to the heteronymous late CPN-induced excitation. The pathophysiological role of a change in transmission in group II pathways in spasticity is discussed. Electronic Publication