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Objective:To study the effects of plan-do-check-action (PDCA) cycle in quality improvement of neonatal resuscitation.Methods:From 2016 to 2020, the clinical data of neonates born in our hospital were analyzed. Neonates born during 2016 to 2017 were pre-PDCA group and neonates born during 2018 to 2020 were post-PDCA group. PDCA quality improvement included step-by-step, high-frequency and low-dose training, strengthening teamwork and adding equipment.Results:A total of 7 728 live-birth neonates were delivered before PDCA with 319 cases (4.1%) of asphyxia. 10 174 live-birth neonates were delivered after PDCA with 422 cases (4.1%) of asphyxia. The asphyxia rates showed no significant difference between the two groups ( P>0.05). The incidences of severe asphyxia before and after PDCA were both 0.8% without significant difference ( P>0.05). The success rates of resuscitation for severe asphyxia before and after PDCA was 27.9% and 44.9%, respectively, and the differences were statistically significant ( P<0.05). The mortality rates within 7 d before and after PDCA were 0.5‰ and 0.1‰ respectively, without significant differences ( P>0.05). Conclusions:The implementation of PDCA cycle and step-by-step, high-frequency, low-dose neonatal resuscitation training can effectively improve the success rate of resuscitation in newborns with severe asphyxia.
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The presence of replication-competent HBV DNA in the liver and/or serum of HBsAg-negative individuals is a sufficient and necessary condition for the diagnosis of occult hepatitis B virus infection (OBI). In recent years, Chinese scholars have proposed what is considered a more "rigorous" definition, i.e., on this basis, HBV window period (WP) infection is excluded, which corresponds to a serum HBV DNA level of below the lower limit of detection or a low positive value (< 200 IU/mL). As the definition of WP for HBV infection remains unclear and its duration is highly variable, "HBV DNA < 200 IU/mL" is not the only criterion in OBI patients. Therefore, it is believed that there is still a lack of sufficient basis and operability for the definition of OBI based on "the exclusion of HBV WP infection" and "HBV DNA < 200 IU/mL" as "rigorous" conditions for the diagnosis of OBI.
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Objective:To explore the necessity of lowering the cut-off value of alanine aminotransferase (ALT) in identifying chronic HBV infection patients with significant liver histological changes.Methods:The clinical data of 123 chronic HBV infection patients with normal ALT according to domestic criteria who underwent liver biopsy in the Department of Hepatology of Taizhou People’s Hospital from June 2016 to March 2021 were analyzed retrospectively. According to the cut-off ALT values recommended by 2018 version of AASLD guidelines (male 35 U/L, female 25 U/L), the patients were divided into two groups: high normal value group (HNALT, ALT≥AASLD and<domestic standard) and normal low value group (LNALT, ALT<AASLD value). The cases with significant liver histological changes (G/S≥2) were compared between the two groups. Univariate and multivariate Logistic regression analysis were used to explore the risk factors of G/S≥2.Results:There were 68(68/123, 55.3%) cases with significant liver histological changes (G/S≥2) in this series. Among 83 patients in the LNALT group, there were 35 case of G≥2 (42.2%), 26 cases of S≥2 (31.3%) and 39 cases of G/S≥2 (47.0%); while among 40 patients in the HNALT group, there were 27 cases of G≥2 (67.5%), 21 cases of S≥2 (52.5%), and 29 cases of G/S≥2 (72.5%), respectively. There were significant differences between the two groups ( χ2=6.928, 5.126 and 7.107, all P values <0.05). Univariate analysis showed that ALT at high normal values ( χ2=7.107), albumin levels ( t=2.248), glutamyltransferase ( Z=-2.885) and international normalized ratio (INR) ( t=-3.152) were significantly associated with liver histological changes in patients ( P<0.05 ro <0.01). Multivariate Logistic regression analysis showed that ALT at high normal value ( OR=3.492, 95% CI 1.369-8.907) and INR ( OR=1.529, 95% CI 1.054-2.218) were independent risk factors of significant liver histological changes. Conclusion:Lowering the cut-off value of ALT may contribute to identify patients who potentially need antiviral treatment. It is recommended that patients with high normal value of ALT according to domestic criteria should undergo liver biopsy or non-invasive liver fibrosis examination to evaluate the histological changes of the liver and treat them if necessary.
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Objective:To compare the effects of the fracture line direction in the sagittal profile on the Gartland type Ⅲ supracondylar humerus fractures in children.Methods:A total of 153 cases of Gartland type Ⅲ supracondylar humerus fractures treated in the Department of Pediatric Orthopedics, Qilu Hospital of Shandong University (Qingdao) from January 2017 to April 2019 were retrospectively analyzed.They were categorized into the traditional oblique type (the fracture line went downward in the front and upward in the back), transverse type (the fracture line went horizontally) and reverse oblique type (the fracture line went upward in the front and downward in the back). Gender, age, injury side, cause of injury, ecchymosis before elbow, preoperative neurological symptoms, operation time, incision ratio, and Flynn scores of the elbow joint at the last follow-up were compared among the 3 groups.Results:Patients were followed up for (8.65±2.47) months (6-15 months). There were 60, 64 and 29 patients in the traditional oblique type, transverse type and reserve oblique type groups, respectively.There were no differences in the gender, injury side, and injury causes among the 3 groups (all P>0.05). The age of the traditional oblique type, transverse type and reverse oblique type group were (4.76±2.51) years, (4.71±2.09) years and (6.32±1.98) years, respectively, which was significant different among the 3 groups ( F=5.826, P<0.05). There were 10, 7 and 11 cases of preoperative elbow ecchymosis occurred in children of the traditional oblique type, transverse type and reverse oblique type groups, respectively, which was significant different ( χ2=9.902, P<0.05). No significant differences were found in preoperative neurological symptoms of the 3 groups ( P>0.05). The operative time for the traditional oblique type, transverse type and reverse oblique type group were (43.28±24.25) min, (40.95±27.41) min and (58.66±34.08) min, which was significant different ( F=4.337, P<0.05). The traditional oblique type and transverse type groups had 1 failure case of closed reduction, respectively, and the incision was performed during the operation.There were 4 cases in the reverse oblique type group who underwent the open reduction.The reduction rate was significantly different among 3 groups ( χ2=6.883, P<0.05). There was no significant difference in the excellent to good rate of traditional oblique type (96.67%, 58/60 cases), transverse type(95.31%, 61/64 cases)and reserve oblique type (93.10%, 27/29 cases) among 3 groups ( P>0.05). Conclusions:The reverse oblique Gartland type Ⅲ supracondylar humerus fractures are relatively rare in clinical practice, which involves more severe soft tissue damages and more obvious antecubital ecchymosis.The conventional reduction methods seem to be ineffectual for the reverse oblique supracondylar humerus fractures.
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Objective:To establish the method for detecting lower respiratory infections (LRIs) bacterialpathogens using nanopore sequencing, and evaluate the feasibility of this method.Methods:Bronchoalveolar lavage fluid (BALF) samples from 33 patients with LRIs who visited the Department of Respiratory and Critical Care Medicine of Beijing Hospital from July 2019 to September 2020 were collected.Nanopore 16S amplicon sequencing were performed on these samples. In order to evaluate the clinical value of the nanopore sequencing, χ 2 test was used to analyze the pathogen differences between the detection rate and pathogen types results found with using the nanopore 16S sequencing and the results found with bacterial culture. Results:The process and method of nanopore sequencing used in the detection of the LRIs pathogens were established. The pathogen detection rate of the 16S sequencing was higher than that of the traditional bacterial culture (75.8% [25/33], 45.5% [15/33], χ2=5.140, P<0.05). From the 25 positive samples found with nanopore 16S sequencing, 16 pathogens were detected, including Haemophilus parainfluenzae, Haemophilus influenzae, Streptococcus pneumoniae, Streptomonas maltophilia, Acinetobacter baumannii, and Acinetobacter junii, Staphylococcus aureus, Klebsiella pneumoniae, Enterococcus faecalis, Enterococcus gallinarum, Corynebacterium striatum, Mycobacterium paraintracellulare, Serratia marcescens, Achromobacter insuavis, Citrobacter murliniae and Mycoplasma pneumoniae. More than 6 pathogens were tested in clinical culture, including Haemophilus parainfluenzae, Acinetobacter baumannii, Pseudomonas aeruginosa, Staphylococcus aureus, Klebsiella pneumoniae and Streptomonas maltophilia (χ2=7.949, P<0.05). 16S sequencing aligned to species level sequences accounted for 80.0 (60.0, 86.0)% of the genus level. The results obtained by using16S sequencing and bacterial culture were consistent in 11 (33.3%) samples. Conclusions:Nanopore 16S amplicon sequencing can quickly identify pathogenic bacteria from BALF in LRIs patients. Nanopore 16S amplicon sequencing has a high detection rate, it can detect more pathogens than traditional bacterial culture, and it can also identify most bacteria to the species level. This technology is a very promising platform with broad application prospects.
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To investigate whether the laboratory specimens preserved in Beijing Hospital Biobank during a specific period had been contaminated by SARS-Cov-2 through a cross-sectional study, and to establish a retrospective biobank safety screening system. Laboratory specimens were collected from the Department of Respiratory and Critical Care Medicine and the Fever Clinic of Beijing Hospital from November 1, 2019 to January 22, 2020, nucleic acid and serological antibody testing were performed for SARS-CoV-2 in these specimens (including 79 serum, 20 urine, 42 feces and 21 bronchoalveolar lavage fluid specimens). The safety of the stored samples during this period was defined by negative and positive results. Both the nucleic acid test and serological antibody test showed negative for SARS-CoV-2, indicating that these specimens were safely stored in the biobank. High-risk specimens collected in our hospital during the early stage of the COVID-19 outbreak are free of SARS-CoV-2, and a safety screening strategy for the clinical biobank is established to ensure the biosafety of these samples.
Subject(s)
Humans , Biological Specimen Banks , COVID-19 , Cross-Sectional Studies , Hospitals , Retrospective Studies , SARS-CoV-2ABSTRACT
Objective To investigate the incidence of postoperative pancreatic fistula (POPF) and its risk factors after radical gastrectomy.Methods The prospective study was conducted.The clinicopathological data of 2 089 patients who underwent radical gastrectomy in 22 medical centers between December 2017 and November 2018 were collected,including 380 in the Zhongshan Hospital of Fudan University,351 in the Renji Hospital of Shanghai Jiaotong University School of Medicine,130 in the Ruijin Hospital of Shanghai Jiaotong University School of Medicine,139 in the Peking University Cancer Hospital,128 in the Fujian Provincial Cancer Hospital,114 in the First Hospital Affiliated to Army Medical University,104 in the First Affiliated Hospital of Nanchang University,104 in the Affiliated Hospital of Qinghai University,103 in the Weifang People's Hospital,102 in the Fujian Medical University Union Hospital,99 in the First Affiliated Hospital of Air Force Medical University,97 in the Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine,60 in the Hangzhou First People's Hospital Affiliated to Zhejiang University School of Medicine,48 in the Fudan University Shanghai Cancer Center,29 in the First Affiliated Hospital of Xi'an Jiaotong University,26 in the Lishui Municipal Central Hospital,26 in the Guangdong Provincial People's Hospital,23 in the Jiangsu Province Hospital,13 in the First Affiliated Hospital of Sun Yat-Sen University,7 in the Second Hospital of Jilin University,4 in the First Affiliated Hospital of Xinjiang Medical University,2 in the Beijing Chao-Yang Hospital of Capital Medical University.Observation indicators:(1) the incidence of POPF after radical gastrectomy;(2) treatment of grade B POPF after radical gastrectomy;(3) analysis of clinicopathological data;(4) analysis of surgical data;(5) risk factors for grade B POPF after radical gastrectomy.Measurement data with normal distribution were represented as Mean±SD,and comparison between groups was analyzed using ANOVA.Count data were described as absolute numbers or percentages,and comparison between groups was analyzed using the chi-square test.Univariate analysis was conducted using the t test or chi-square test based on data excluding missing data of clinicopathological and surgical data.Multivariate analysis was conducted using the Logistic regression model based on factors with P＜0.20 in univariate analysis.Results There were 2 089 patients screened for eligibility,including 1 512 males,576 females and 1 without sex information,aged (62± 11)years.The body mass index (BMI) was (23±3) kg/m2.(1) The incidence of POPF after radical gastrectomy:the total incidence rate of POPF in the 2 089 patients was 20.728％(433/2 089).The incidence rates of biochemical fistula,grade B pancreatic fistula,and grade C pancreatic fistula were 19.627％(410/2 089),1.101％(23/2 089),0,respectively.(2) Treatment of grade B POPF after radical gastrectomy:2 of 23 patients with grade B POPF after radical gastrectomy had drainage tube placed for more than 21 days and received anti-infective therapy.Four of 23 patients with grade B POPF after radical gastrectomy had ascites detected by imaging examination,of which 2 received peritoneal drainage guided by ultrasound,1 received failed puncture drainage,1 received no puncture drainage,and they were given anti-infective therapy.Eleven of 23 patients with grade B POPF after radical gastrectomy had no ascites detected by imaging examinations,and they were given anti-infective therapy and inhibitors of pancreas secretion for clinical manifestation as fever or elevated white blood cells.Six patients with no typical clinical manifestations were given somatostatin to inhibite pancreas secretion and prolonged duration of abdominal drainage tube placement (with a median time of 7 days).All the 23 patients recovered well after treatment,without reoperation.(3) Analysis of clinicopathological data:for the 2 089 patients,BMI,cases with or without neoadjuvant therapy were (23±3) kg/m2,1 487,160 of patients without pancreatic fistula,(23±3)kg/m2,386,22 of patients with biochemical fistula,and (24±3)kg/m2,22,1 of patents with grade B pancreatic fistula,showing significant differences between the three groups (F=5.787,x2 =8.269,P＜0.05).(4) Analysis of surgical data:for the 2 089 patients,cases with open surgery,laparoscopic assisted surgery,totally laparoscopic surgery (surgical method),cases with D1 lymph lode dissection,D2 lymph lode dissection,and other lymph lode dissection (range of lymph lode dissection),cases with no omentectomy,partial omentectomy,and total omentectomy (range of omentectomy),cases with no usage of energy facility,usage of CUSA,LigaSure,LigaSure+CUSA as energy facility,cases with or without biological glue,the number of lymph node dissection were 737,624,292,24,1 580,51,418,834,381,63,1 530,23,16,1 431,201,33±14 of patients without pancreatic fistula,146,189,74,11,389,9,110,171,128,35,359,6,9,378,31,31± 14 of patients with biochemical fistula,and 14,5,4,0,20,3,6,13,4,2,18,1,2,22,1,37±16 of patients with grade B pancreatic fistula,showing significant differences between the three groups (x2=15.578,9.397,15.023,28.245,8.359,F=4.945,P＜ 0.05).(5) Risk factors for grade B POPF after radical gastrectomy:results of univariate analysis showed that usage of energy facility was a related factor for grade B POPF after radical gastrectomy (x2=9.914,P＜0.05).Results of multivariate analysis showed that laparoscopic assisted surgery,combined evisceration,application of LigaSure + CUSA,the number of lymph lode dissection were independent factors for for grade B POPF after radical gastrectomy (odds ratio=0.168,3.922,9.250,1.030,95％ confidence interval:0.036-0.789,1.031-14.919,1.036-82.602,1.001-1.059,P＜0.05).Conclusions The incidence of grade B POPF after radical gastrectomy is relatively low.Laparoscopic assisted surgery,combined evisceration,application of LigaSure + CUSA,and the number of lymph lode dissection are independent risk factors for grade B POPF.Trial Registration:This study was registrated at ClinicalTrial.gov in United States with the registration number of NCT03391687.
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Objective@#To investigate the incidence of postoperative pancreatic fistula (POPF) and its risk factors after radical gastrectomy.@*Methods@#The prospective study was conducted. The clinicopathological data of 2 089 patients who underwent radical gastrectomy in 22 medical centers between December 2017 and November 2018 were collected, including 380 in the Zhongshan Hospital of Fudan University, 351 in the Renji Hospital of Shanghai Jiaotong University School of Medicine, 130 in the Ruijin Hospital of Shanghai Jiaotong University School of Medicine, 139 in the Peking University Cancer Hospital, 128 in the Fujian Provincial Cancer Hospital, 114 in the First Hospital Affiliated to Army Medical University, 104 in the First Affiliated Hospital of Nanchang University, 104 in the Affiliated Hospital of Qinghai University, 103 in the Weifang People′s Hospital, 102 in the Fujian Medical University Union Hospital, 99 in the First Affiliated Hospital of Air Force Medical University, 97 in the Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine, 60 in the Hangzhou First People′s Hospital Affiliated to Zhejiang University School of Medicine, 48 in the Fudan University Shanghai Cancer Center, 29 in the First Affiliated Hospital of Xi′an Jiaotong University, 26 in the Lishui Municipal Central Hospital, 26 in the Guangdong Provincial People′s Hospital, 23 in the Jiangsu Province Hospital, 13 in the First Affiliated Hospital of Sun Yat-Sen University, 7 in the Second Hospital of Jilin University, 4 in the First Affiliated Hospital of Xinjiang Medical University, 2 in the Beijing Chao-Yang Hospital of Capital Medical University. Observation indicators: (1) the incidence of POPF after radical gastrectomy; (2) treatment of grade B POPF after radical gastrectomy; (3) analysis of clinicopathological data; (4) analysis of surgical data; (5) risk factors for grade B POPF after radical gastrectomy. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was analyzed using ANOVA. Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test. Univariate analysis was conducted using the t test or chi-square test based on data excluding missing data of clinico-pathological and surgical data. Multivariate analysis was conducted using the Logistic regression model based on factors with P<0.20 in univariate analysis.@*Results@#There were 2 089 patients screened for eligibility, including 1 512 males, 576 females and 1 without sex information, aged (62±11)years. The body mass index (BMI) was (23±3)kg/m2. (1) The incidence of POPF after radical gastrectomy: the total incidence rate of POPF in the 2 089 patients was 20.728%(433/2 089). The incidence rates of biochemical fistula, grade B pancreatic fistula, and grade C pancreatic fistula were 19.627%(410/2 089), 1.101%(23/2 089), 0, respectively. (2) Treatment of grade B POPF after radical gastrectomy: 2 of 23 patients with grade B POPF after radical gastrectomy had drainage tube placed for more than 21 days and received anti-infective therapy. Four of 23 patients with grade B POPF after radical gastrectomy had ascites detected by imaging examination, of which 2 received peritoneal drainage guided by ultrasound, 1 received failed puncture drainage, 1 received no puncture drainage, and they were given anti-infective therapy. Eleven of 23 patients with grade B POPF after radical gastrectomy had no ascites detected by imaging examinations, and they were given anti-infective therapy and inhibitors of pancreas secretion for clinical manifestation as fever or elevated white blood cells. Six patients with no typical clinical manifestations were given somatostatin to inhibite pancreas secretion and prolonged duration of abdominal drainage tube placement (with a median time of 7 days). All the 23 patients recovered well after treatment, without reoperation. (3) Analysis of clinicopathological data: for the 2 089 patients, BMI, cases with or without neoadjuvant therapy were (23±3)kg/m2, 1 487, 160 of patients without pancreatic fistula, (23±3)kg/m2, 386, 22 of patients with biochemical fistula, and (24±3)kg/m2, 22, 1 of patents with grade B pancreatic fistula, showing significant differences between the three groups (F=5.787, χ2=8.269, P<0.05). (4) Analysis of surgical data: for the 2 089 patients, cases with open surgery, laparoscopic assisted surgery, totally laparoscopic surgery (surgical method), cases with D1 lymph lode dissection, D2 lymph lode dissection, and other lymph lode dissection (range of lymph lode dissection), cases with no omentectomy, partial omentectomy, and total omentectomy (range of omentectomy), cases with no usage of energy facility, usage of CUSA, LigaSure, LigaSure+ CUSA as energy facility, cases with or without biological glue, the number of lymph node dissection were 737, 624, 292, 24, 1 580, 51, 418, 834, 381, 63, 1 530, 23, 16, 1 431, 201, 33±14 of patients without pancreatic fistula, 146, 189, 74, 11, 389, 9, 110, 171, 128, 35, 359, 6, 9, 378, 31, 31±14 of patients with biochemical fistula, and 14, 5, 4, 0, 20, 3, 6, 13, 4, 2, 18, 1, 2, 22, 1, 37±16 of patients with grade B pancreatic fistula, showing significant differences between the three groups (χ2=15.578, 9.397, 15.023, 28.245, 8.359, F=4.945, P<0.05). (5) Risk factors for grade B POPF after radical gastrectomy: results of univariate analysis showed that usage of energy facility was a related factor for grade B POPF after radical gastrectomy (χ2=9.914, P<0.05). Results of multivariate analysis showed that laparoscopic assisted surgery, combined evisceration, application of LigaSure + CUSA, the number of lymph lode dissection were independent factors for for grade B POPF after radical gastrectomy (odds ratio=0.168, 3.922, 9.250, 1.030, 95% confidence interval: 0.036-0.789, 1.031-14.919, 1.036-82.602, 1.001-1.059, P<0.05).@*Conclusions@#The incidence of grade B POPF after radical gastrectomy is relatively low. Laparoscopic assisted surgery, combined evisceration, application of LigaSure + CUSA, and the number of lymph lode dissection are independent risk factors for grade B POPF. Trial Registration: This study was registrated at ClinicalTrial.gov in United States with the registration number of NCT03391687.
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Objective To investigate the expression of thyroid cancer-1 (TC1) and β-catenin in cervical carcinoma and precancerous lesions and their significance. Methods Immunohistochemical methods were used to examine the expression of TC1 and β-catenin in80 cervical squamous cell carcinoma (CSCC) tissues, 40 high-grade squamous intraepithelial lesions (HSIL), 40 low-grade squamous intraepithelial lesions (LSIL), and 30 normal cervical tissues. Results Although TC1 expression in CSCC was significantly higher than that in LSIL (P = 0.002) and normal cervical tissues (P ＜ 0.001), it was similar to that in HSIL (P = 0.576). TC1 expression was positively correlated with poor differentiation (P = 0.005) and advanced FIGO stage (P = 0.004) in CSCC. β-catenin expression in CSCC was significantly higher than that in LSIL (P ＜ 0.001) and normal cervical tissues (P ＜ 0.001), but was similar to that in HSIL (P = 0.907). The abnormal β-catenin expression was also correlated with poor differentiation (P = 0.025) and advanced FIGO stage (P = 0.001) in CSCC. TC1 expression was positively correlated with the abnormal β-catenin expression in CSCC (r = 0.294, P = 0.008) and cervical squamous intraepithelial lesions (r = 0.549, P ＜ 0.001). Conclusion TC1 and β-catenin expression in CSCC and HSIL was significantly higher than that in LSIL and normal cervical tissues. TC1 expression correlated with the abnormal β-catenin expression, and with poor differentiation and advanced FIGO stage of CSCC.
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Objective To investigate the distribution characteristics of nasal cavity and maxillary sinus microbiota in aged patients with chronic maxillary sinusitis.Methods A total of 15 aged patients with chronic unilateral maxillary sinusitis who received surgical treatment between January 2017 to June 2018 in Beijing Hospital were enrolled and analyzed retrospectively.Their lavage samples from nasal cavity(N)and maxillary sinus(M)were collected and the samples were labeled according to the location(N and M groups,n=15 each).The high-throughput sequencing was used for sequencing all bacterial 16S rRNA genes in the samples.The composition of nasal cavity and maxillary sinus microbial communities was obtained,and the distribution features of nasal cavity and maxillary sinus microbiota were analyzed.Results A total of 8 bacterial phyla and 34 bacterial genera were found in nasal cavity and maxillary sinus microbiota.The most widely distributed phyla in nasal and sinus groups were Bacteroidetes,Fusobacteria,Frimicutes,Spirochaetes and Proteobacteria.The abundance of Bacteroidetes was higher in group M(60.0 ％,51 762/86 301)than in group N(42.9 ％,37 999/88 576)with statistically significant difference(P ＜0.05).The most widely distributed bacteria genera were Prevotella,Fusobacterium,Alloprevotella,Treponema,Parvimonas,Streptococcus,Filifactor,Phocaeicola,Campylobacter,Prevotella-7 and Lentimicrobiaceae.The abundance of Prevotella was higher in group M(47.7％,41 252/86 414)than in group N(33.5％,29 680/88 598) with statistically significant difference(P ＜ 0.05).Conclusions In the aged patients with chronic maxillary sinusitis,the distribution of bacteria in the nasal cavity and maxillary sinus is partly consistent.The abundance of the anaerobes distribution is higher in maxillary sinus than in nasal cavity in aged patients with chronic maxillary sinusitis.
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Objective To determine the predictive factors for antiviral therapy in hepatitis B e antigen (HBeAg)-negative chronic hepatitis B virus (HBV) infection [HBeAg(-) CHBI] patients with HBV DNA＜4.3 lg IU/mL.Methods A total of 179 HBeAg (-) CHBI patients were retrospective analyzed.Histology activity index (HAI) and fibrosis (S) were scored according to the Knodell HAI scoring system,and HAI＞3 and/or S≥3 was adopted as indications for treatment.Univariate and multiple regression analysis were used to assess factors associated with treatment indications.Receiver operating curves (ROC) and area under curve (AUC) were used to determine the predictive value of relevant factors.Results There were 81 cases with HAI＞3 (45.3％) and 72 with S≥3 (40.22％),and the proportion of patients with indications for treatment was 54.7 ％.Multiple regression analysis showed that age,γ-glutamyl transpeptadase (γ-GT),platelet (PLT) and albumin (Alb) were the predictive factors for the severity of liver damage and indication for treatment (all P＜0.05).The AUC for age,PLT,γ-GT and Alb were 0.655,0.657,0.726 and 0.65,respectively,and the corresponding Yoden index for age,PLT,γ-GT,and Alb were 0.297,0.426,0.03 and 0.012,respectively,the sensitivities of predicting HBeAg (-CHBI for treatment indications were 0.643,0.842,0.705 and 0.653,respectively.Conclusions This study shows that 54.7％ of HBeAg(-)CHBI patients with HBV DNA＜4.3 lg IU/ml have significant liver histological changes and require antiviral treatment.Older age,higher γ-GT,lower PLT and lower Alb levels are the predictive factors for treatment.
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Objective To investigate whether emodin suppresses angiogenesis in pancreatic cancer.Methods A nude mouse pancreatic cancer xenograft model was established with SW1990 human pancreatic cancer cells by surgical orthotopic implantation.Different doses of emodin were injected into the abdominal cavities of the tumor-bearing mouse models and controls 3 times weekly for 2 weeks.The expression of CD34 was detected by immunochemistry,and microvessel density was calculated.Quantitative RT-PCR and Western blot were performed to determine the mRNA and protein expressions of TGF-β1 and Smad4.Results A negative dose-dependent association was found among emodin treatments about the weight of tumors.Emodin was associated with lower levels of TGF-β1 mRNA and protein,and higher levels of the mRNAs and proteins Smad4.Conclusion Emodin may repress angiogenesis in pancreatic cancer by altering activities of the TGF-β1 and Smad4.
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Objective To investigate the differential expression of circular RNA ( circRNA ) in patients with chronic HBV infection of different stages.Methods Seven patients with chronic HBV infection admitted in Taizhou People's Hospital from October 2014 to October 2015 were enrolled, including 4 with chronic hepatitis B ( CHB ) and 3 chronic HBV carriers;3 healthy subjects served as controls. Peripheral blood mononuclear cells (PBMCs) were separated,and the expression of circRNA molecules in PBMCs were detected by new generation of circRNA microarray and validated by fluorescent quantitative PCR.The interaction sites between circRNA and miRNA were predicted with Arraystar miRNA target prediction software.Target genes regulated by the circRNA related to miRNA were analyzed by Gene oncology (Go) and Kyoto encyclopedia of genes and genomes (KEGG) analysis.SPSS 17.0 software was used for statistical analysis.Results Compared with the healthy controls , 137 circRNA molecules of differential expression were found in patients with chronic hepatitis B , of which 89 were up-regulated and 48 were down-regulated; while 444 circRNA molecules of differential expression , of which 130 were up-regulated (>5 fold in 34 ) and 314 down-regulated , were found in chronic HBV carriers.Compared with chronic HBV carriers , 1041 circRNA molecules of differential expression were found in CHB patients , including 663 up-regulated and 378 down-regulated (>5 fold in 54).There were many miRNA responsive elements which complementary with seed regions on miRNA in different circRNA molecules.Target gene analysis demonstrated that 533 target genes regulated by hsa_circ_0038646 were related to miRNAs , 249 target genes found in hsa_circ_0087354 were related to microRNAs.GO analysis showed that function of target genes regulated by hsa_circ_0038646 related to miRNA mainly enriched in activin binding.Function of target genes regulated by hsa_circ_0087354 related to miRNA mainly enriched in armadillo repeat domain binding.KEGG analysis showed that hsa_circ_0038646 molecules related to miRNA mainly involved in T cell receptor , estrogen receptor signaling pathway and so on.Hsa_circ_0087354 molecules related to miRNA mainly involved in adherens junction , MAPK signaling pathway and so on. Conclusion There are differential expressions of circRNA in patients at different clinical stages of chronic HBV infection , which might be involved in immune regulation of chronic HBV infection through the regulation of multiple target genes and signaling pathways.
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The pivot shift test is the most specific physical examination to assess the rotatory laxity of knee joint following anterior cruciate ligament injury.It is also one of the most important physical examinations to assess the stability and recovery of the knee joint after anterior cruciate ligament reconstruction.The following anterior lateral structures of knee joint contribute to the grade of the pivot shift,including the lateral meniscus,anterolateral capsule,iliotibial band and the morphology of tibial plateau.Lateral meniscus is a secondary stabilizer to rotatory loads in the anterior cruciate ligament deficient knee.Anterolateral capsule controls anterior tibial translation and internal rotation.Iliotibial band is an important secondary restraint to anterior tibial translation and internal rotation at high flexion angles.Posteroinferior slope of the tibial plateau results in increased anterior tibial translation during pivot shift.The size of the lateral tibial plateau is also associated with the grade of poivt shift.The integrity destruction of the anterolateral soft tissue in the anterior cruciate ligament deficient knee leads to higher grade of poivt shift.The morphological features of the tibial plateau can also affect the stability of the knee joint.However,there is still a paucity of knowledge about the anatomical and morphological features responsible for a high grade pivot shift.Higher grade pivot shift indicates the injury of anterolateral structures and the abnormality of tibial plateau.In order to restore the integrity of anterolateral soft tissue,the injury of lateral meniscus and iliotibial band should be repaired via anterior cruciate ligament reconstruction surgery with an addition of a lateral extraarticular reconstruction when the anterior cruciate ligament deficiency combined with injuries to anterolateral capsule.
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Objective:To investigate the baseline levels of 25-hydroxy-vitamin D [25-(OH) D] in 3340 hospitalized children, analyze the 25-( OH) D levels in children with different diseases, age and gender in different seasons, and study the correlation between the 25-( OH) D levels and the clinical indicators. Methods:Totally 3340 hospitalized children were randomly selected, the 25-( OH) D levels were detected by an ELISA method, and Pearson correlation analysis of 25-( OH) D levels and clinical indicators such as liver function, myocardial enzymes, immunoglobulins, lymphocyte subtypes and thyroid function was performed. Results: The serum 25-(OH) D level in 3340 cases (1850 male, 1490 female) was (33. 00 ± 13. 42) ng·m1 -1, and that in those with neonatal diseases was the lowest followed by those with primary nephrotic syndrome, Henoch-schordeinpurpura and juvenile idiopathic arthritis. The ser-um 25-( OH) D levels in the premature was higher than that in full term infant. Except the newborn, the level of serum 25-( OH) D gradually reduced along with the age increase, while the percentage of insufficiency gradually increased. The serum 25-( OH) D level between the male and the female had no significant difference. The 25-( OH) D levels of hospitalized children were the highest in sum-mer. The serum level of 25-( OH) D was positively correlated with body mass index ( BMI) , alanine transaminase ( ALT) , aspartate transaminase (AST), creatine kinase (CK), creatine-phosphokinase (CK-MB), lactate dehydrogenase(LDH), free T4 (FT4) and free T3 (FT3), and negative correlation with alkaline phosphatase(ALP), immunoglobulin E (IgE) and immunoglobulin M (IgM). Conclusion:The incidence of vitamin D insufficiency is high in hospitalized children. The level of vitamin D is different among various diseases. The level of serum 25-( OH) D may have certain relevance with BMI, allergies, myocardial damage and thyroid function.
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Objective To investigate the potential tigecycline resistance of Klebsiella pneumoniae during treatment.Methods The minimum inhibitory concentrations (MICs) and the mutant prevention concentrations (MPCs) of tigecycline were determined for K.pneumoniae isolates with four different resistant profiles.Corr.elations between MICs and MPCs were analyzed.We combined with the pharmacokinetic parameters of tigecycline to estimate the potential of emerging resistance to tigecycline monotherapy in K.pneumoniae.Results The MPCs of tigecycline for the carbapenem-and fluoroquinolone-resistant isolates were found to be 8-fold higher than those for carbapenem-and quinolones-susceptible isolates.Our data showed that the MPCs range and MPC90 values of tigecycline were 4-512 mg/L and 64 mg/L,respectively,which were much higher than the therapeutic concentrations of tigecycline in serum and tissues.Conclusions Long-term tigecycline monotherapy may predispose the emergence of resistance in K.pneumoniae,which is not recommended.It is desirable to carry out ongoing monitoring of K.pneumoniae susceptibility and tigecycline treatment effect.
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The pivot shift test is the most specific physical examination to assess the rotatory laxity of knee joint following anterior cruciate ligament injury.It is also one of the most important physical examinations to assess the stability and recovery of the knee joint after anterior cruciate ligament reconstruction.The following anterior lateral structures of knee joint contribute to the grade of the pivot shift,including the lateral meniscus,anterolateral capsule,iliotibial band and the morphology of tibial plateau.Lateral meniscus is a secondary stabilizer to rotatory loads in the anterior cruciate ligament deficient knee.Anterolateral capsule controls anterior tibial translation and internal rotation.Iliotibial band is an important secondary restraint to anterior tibial translation and internal rotation at high flexion angles.Posteroinferior slope of the tibial plateau results in increased anterior tibial translation during pivot shift.The size of the lateral tibial plateau is also associated with the grade of poivt shift.The integrity destruction of the anterolateral soft tissue in the anterior cruciate ligament deficient knee leads to higher grade of poivt shift.The morphological features of the tibial plateau can also affect the stability of the knee joint.However,there is still a paucity of knowledge about the anatomical and morphological features responsible for a high grade pivot shift.Higher grade pivot shift indicates the injury of anterolateral structures and the abnormality of tibial plateau.In order to restore the integrity of anterolateral soft tissue,the injury of lateral meniscus and iliotibial band should be repaired via anterior cruciate ligament reconstruction surgery with an addition of a lateral extraarticular reconstruction when the anterior cruciate ligament deficiency combined with injuries to anterolateral capsule.
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Objective To investigate the effect of tripterygium on the grow th ,invasion and angiogenesis of melanoma A375 and its action mechanisms .Methods MTS was used to test the effect of tripterygium on proliferation of A375 melanoma;the nude mouse subcutaneous melanoma xenograft model was used to detect the effect of tripterygium on tumor growth ;the Transwell ex‐periment was used to determine the effect of tripterygium on invasion of A 375 melanoma;the tubule formation experiment was used to determine the effect of tripterygium on tumor angiogenesis ;ELISA was used to detect the influence of tripterygium on A 375 cel‐lular secretion factors ,such as VEGF ,bFGF ,TGF‐βand IL‐8 .Results The in vitro proliferation and in vivo growth of A375 mela‐noma cells after tripterygium treatment were significant inhibited ,the invasion ability of A375 melanoma cells was significant weak‐ened compared with the control group ;tripterygium could inhibit tumor cell‐induced vessel formation by down‐regulating the ex‐pression of VEGF ,bFGF and IL‐8 proteins ,but it had no influence on expression of TGF‐βprotein .Conclusion Tripterygium has anti‐growth and anti‐invasion effects on A375 melanoma ,its potential mechanisms may associated with the inhibition of tumor an‐giogenesis of A375 melanoma .
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Objective To investigate the effect of microRNA (miRNA )‐548ah targeting histone deacetylase‐4 (HDAC4) on the replication and expression of hepatitis B virus (HBV) .Methods HepG2 , 2 ,15 cells were transfected by mimics and inhibitors . The expressions of miRNA‐548ah and HDAC4 before and after transfection were detected by fluorescent quantitative polymerase chain reaction (PCR) . The expression of HDAC4 protein in HepG2 ,2 ,15 cells was detected by Western blotting .The target gene of miRNA‐548ah was analyzed by bioinformatics methods .3′UTR dual‐luciferase expression vector containing candidate HDAC4 target genes was built to test the luciferase activity .The levels of hepatitis B e antigen (HBeAg) and hepatitis B surface antigen (HBsAg) in the supernatant of cultured HepG2 ,2 ,15 cells were detected by enzyme‐linked immunosorbent assay (ELISA) .The level of HBV DNA in the supernatant of HepG2 ,2 ,15 cells was detected by fluorescent quantitative PCR .The t‐test was used for comparison between two groups ,SNK‐q tests were used for multiple groups comparisons .Results The expressions of miRNA‐548ah in HepG2 ,2 ,15 and HepG2 cells were 5 .74 ± 0 .02 and 2 .96 ± 0 .40 , respectively (t= 11 .89 ,P< 0 .01) ,and the expressions of HDAC4 mRNA were 9 .38 ± 0 .39 and 18 .13 ±0 .34 ,respectively (t = 29 .39 , P < 0 .01) . The expression of miRNA‐548ah in HepG2 ,2 ,15 cells was inhibited by transfection of miRNA‐548ah inhibitors (1 .01 ± 0 .13 ,t= 15 .48 , P< 0 .01) .Compared with control group ,the levels of HBsAg ([6 .45 ± 0 .46 ] IU/mL vs [2 .60 ± 0 .20 ] IU/mL , t = 7 .48 , P <0 .01) ,HBeAg ([5 .49 ± 0 .27] NCU/mL vs [4 .15 ± 0 .34 ] NCU/mL , t = 3 .10 , P < 0 .05 ) and HBV DNA ([3 .93 ± 0 .06] lg copy/mL vs[2 .04 ± 0 .07] lg copy/mL ,t = 18 .89 , P< 0 .01) in the supernatant of cultured HepG2 ,2 ,15 cells significantly decreased in inhibitor group . The expression of HDAC4 in HepG2 ,2 ,15 cells significantly decreased after transfection of miRNA‐548ah mimics (2 .98 ± 0 .94) ,but significantly increased after transfection of miRNA‐548ah inhibitors (23 .77 ± 6 .74 ) , with statistical significance (F= 9 .34 , P< 0 .01) .The expression of HDAC4 protein was also significantly inhibited after transfection of miRNA‐548ah mimics (0 .53 ± 0 .14 vs 0 .23 ± 0 .02 , t = 3 .58 , P = 0 .02) .The activity of luciferase was significantly inhibited by transfection of miRNA‐548ah mimics (7 .62 ± 0 .45 vs 6 .65 ±0 .27 ,t = 3 .18 , P = 0 .03 ) .Conclusion miRNA‐548ah may promote the replication and expression of HBV through the regulation of target gene HDAC4 .
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Smear is the classic method for pathogen dectection,and it is the most direct,simplest and the fastest identification method.The conscientious and standardized operation of smears can effectively determine the quality of specimen,the proportion of bacteria,and even identify the suspicious pathogen directly,which provide valuable information for clinical diagnosis and treatment In addition,morphological examination can also become supplementary approach for the validation,calibration of modern equipment The staff working in the laboratory of microbiology should notice the important value of smear test.