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Objective:To study the Epstein-Barr virus (EBV) activity and its clinical characteristics in patients with hemorrhagic fever with renal syndrome (HFRS). Methods:From January 2016 to August 2017, patients with HFRS who were hospitalized in the First Affiliated Hospital of Harbin Medical University were routinely tested by EBV serology, and were divided into two groups according to their presence or absence of EBV infection, namely EBV active group and non-EBV active group. The clinical data between the two groups were compared and analyzed by SPSS 18.0.Results:A total of 188 HFRS patients were enrolled, including 73 cases in EBV active group and 115 cases in non-EBV active group. The EBV active rate of HFRS patients was 38.83% (73/188). The incidences of lumbago [57.53% (42/73) vs 42.61% (49/115)], abdominal pain [42.47% (31/73) vs 20.00% (23/115)], skin and mucosa congestion [57.53% (42/73) vs 39.13% (45/115)], and conjunctiva edema [50.68% (37/73) vs 28.70% (33/115)] in EBV active group were significantly higher than those in non-EBV active group (χ 2 = 3.983, 11.008, 6.083, 9.239, P < 0.05). There were 10, 7 and 43 patients with acute kidney injury (AKI) stage 1, 2 and 3 in EBV active group and 5, 13 and 53 patients in non-EBV active group. Degree of AKI in EBV active group was higher than that in non-EBV active group, and the difference was statistically significant (χ 2 = 12.615, P < 0.05). In EBV active group, the proportion of patients whose renal function recovery over 15 days [23.29% (17/73)] and white blood cell count [11.26 (3.39 ~ 54.23) × 10 9/L] were significantly higher than those in non-EBV active group [6.96% (8/115), 10.03 (2.91 ~ 66.99) × 10 9/L], and the differences were statistically significant (χ 2 = 10.330, Z = - 2.003, P < 0.05). Conclusion:HFRS patients may cause latent EBV activity, complicate their clinical features, cause severe renal damage and prolong the recovery time of renal function.
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Objective To explore the effect of nucleos(t)ide analog (NA)antiviral treatment on the pathological differentiation of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC)and the prognostic factors of HCC.Methods Totally 127 patients with HBV-related HCC who were hospitalized and received partial hepatectomy in First Affiliated Hospital of Harbin Medical University from March 2007 to November 2013 were included in this study.Sixteen cases received antiviral treatment before operation and the remaining 111 cases had no history of NA treatment.The differences of histopathological grading were compared between the two groups.Twenty-nine patients received antiviral treatment for the first time after surgery,and the rest 82 patients did not.All these patients were followed up for survival and recurrence.Multivariate analysis was used to explore the prognostic factors for HCC.The categorical variables were analyzed byχ2 test or Fisher exact test.Survival rate was compared with Log-rank test. Univariate or multivariate Cox regression analysis was used to explore the related factors of survival. Results The proportions of well-,moderately- or poorly-differentiated HCC in patients with antiviral treatment before surgery were 18.75 %,68.75 % and 12.5 %,respectively.Whereas the proportions in those without treatment were 16.22%,66.67% and 17.11 %,respectively.There was no significant difference in histopathological grading of HCC between the two groups (χ2=0.224,P =0.885 ).The overall median survival time was 39 months.The 6-month,1-and 2-year survival rates were 91 .7%, 77.5 % and 59.3%,respectively.The 6-month,1- and 2-year survival rate of postoperative antiviral treatment were 96.3%,92.4% and 78.5 %,respectively,which were significantly higher than those of no antiviral treatment group (85 .9%,70.0% and 48.5 %,respectively;χ2= 6.967,P = 0.008 ). Univariate analysis showed that tumor number,size,portal vein transfer,AFP level,postoperative antiviral treatment,histopathological grading,TNM staging,BCLC staging,γ-GT and PTA were prognostic factors for postoperative HCC survival.Multivariate analysis showed that AFP level (HR=1 , 95 %CI :1 .0004—1 .002,P =0.004),postoperative antiviral treatment (HR =0.38,95 %CI :0.38—0.15 ,P =0.04)and BCLC stage (B vs A:HR=1 .55 ,95 %CI :0.76—3.18;C vs A:HR=3.63,95 %CI :1 .31 —10.09,P =0.04)were independent prognostic factors.Conclusions Preoperative antiviral treatment has no impact on the histopathological grading of HCC. BCLC stage, AFP level and postoperative antiviral treatment are independent prognostic factors for HBV-related HCC.
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Objective To analyze the real world status of traditional known cardiovascular risk factors in patients with coronary heart disease ( CHD ) .Methods 6040 in-hospital patients with CHD or suspected CHD undergoing angiography from 01/01/2013 to 02/28/2015 were retrospectively analyzed . According to angiography result , patients with severe coronary artery lesion and undergoing percutaneous coronary intervention (PCI) were enrolled in the PCI group (n=2808) and patients without severe coronary artery lesion and not undergoing PCI or CABG were enrolled in the No-PCI/CABG group (n=3232).Patients in the PCI group were further divided into 3 subgroups which were STEMI group , NSTEMI/UA group and stable angina (SA) group.Results (1) Compared with the No-PCI/CABG group, patients in the PCI group have higher ratio of male patients (75.4% vs.53.1%, P<0.0001), older average age (64.83 ±0.20 vs. 63.39 ±0.18 years old , P <0.0001 ) , and higher existing rates of traditional risk factors including hypertension (66.7%vs.54.7%, P<0.0001 ) , diabetes/impaired glucose tolerance ( IGT ) ( 37.0% vs. 20.8%, P<0.0001), stroke(7.0%vs.5.4%,P=0.0098)and chronic kidney disease (CKD) (4.3%vs. 2.8%, P=0.001 ) , but there was no statistic difference in existing rates of dyslipidemia between the two groups.(2)In the PCI group,female patients had higher prevalence of hypertension (74.1%vs.64.3%, P<0.001), diabetes/IGT (42.5%vs.35.3%, P=0.0007) and stroke (9.4%vs.6.2%, P=0.0054) than the male patients.There were no significant sex difference in these comorbidities as above in No-PCI/CABG group.Female patients had higher prevalence of dyslipidemia than male patients in both PCI and No -PCI/CABG groups.(3) Among all the 3 PCI subgroups, STEMI patients presented with youngest average age (62.54 ±0.45 vs.65.15 ±0.28 vs.66.17 ±0.34 years old, P<0.0001) and highest male patient ratio (83.9%vs.72.9% vs.72.3%, P<0.0001).Patients in the SA subgroup had the highest prevalence of hypertension and prior revascularization including PCI and CABG .Patients in the NSTEMI/UA subgroup had the highest rates of diabetes/IGT.No significant differences were observed in the prevalence of dyslipidemia , CKD and stroke among all the subgroups .Conclusions Hypertension and diabetes are the leading risk factors of coronary artery disease , and prior revascularization is also an important cause of stable angina and NSTEMI /UA undergoing PCI.Patients requiring PCI were found to be more of male gendor , but female patients has higher prevalence of traditional cardiovascular risk factors including hypertension , diabetes/IGT or stroke than male patients.
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Objective To evaluate the effect of the modified balloon dilatation intervention on the pharyngeal constriction function of the brainstem stroke survivors with dysphagia using videofluoroscopy-based digital analysis.Methods Thirty brainstem stroke survivors with pharyngeal dysphagia were recruited and randomly divided into a treatment group and a control group,with 15 in each.The treatment group was treated with the modified balloon dilatation in addition to the routine treatment of 30min,respectively,once a daily,3 days a week,whiled a control group was treated with routine treatment of 30min twice a day,3 days a week.Before and after the treatment,the rate and duration of pharyngeal constriction were measured in both groups.Results After the treatment,the rate of pharyngeal constriction in the treatment group was (0.20 ± 0.030),(0.14 ± 0.05) and (0.15 ± 0.04) when swallowing thin liquid,thick liquid and pasty food,significantly better than before the treatment.The duration of the pharyngeal constriction was (990.34 ±96.14),(1010.47 ± 133.64) and (1180.10 ± 121.27) ms,respectively,also significantly better than before the treatment.In the control group,significant differences were also observed in the rate and duration of pharyngeal constriction before and after the treatment.Conclusions Digital analysis based on videofluoroscopy can be used to quantify swallowing function effectively,and the rate and duration of pharyngeal constriction can be used to evaluate the pharyngeal function before and after treatment.
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Objective To explore the effect of theta-burst stimulation (TBS) of the motor cortex on the suprahyoid muscles and the mechanism through which the bilateral motor cortex regulates the suprahyoid muscles.Methods Continuous TBS (cTBS) was applied to the left motor cortex followed by intermittent TBS (iTBS) applied to the right motor cortex of 24 healthy subjects.The motor-evoked potentials (MEPs) of the suprahyoid muscles on both sides were recorded before the stimulation and after 15 and 30 minutes.The MEP amplitudes of the left and right suprahyoid muscles were analyzed using repeated measures analysis of variance.Results Before stimulation, the average MEP amplitudes of the left and right suprahyoid muscles were (375.29 ± 176.09) μV and (368.17 ± 149.02) μV respectively, significantly lower than the values after the stimulation.Conclusion iTBS can distinctly enhance the excitability of the right motor cortex controlling the suprahyoid muscles and reverse the inhibition caused by cTBS applied to the left motor cortex.Clarifying the effect of TBS on the excitability of the bilateral motor cortex is important for the rehabilitation of dysphagic stroke survivors.
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Objective Proliferative cholangitis (PC) is responsible for stone recurrence and biliary restenosis, this study was to investigate the and-proliferative effect of CDC2 kinase shRNA on PC. Methods The common bile duct of PC rat model was given an intralumenal administration of 0. 5 ml of CDC2 kinase shRNA. Results CDC2 kinase shRNA treatment effectively inhibited the expression of CDC2 kinase,PCNA, and procollagen I , resulting in the inhibition of hyperplasia of biliary epithelium, submucosal gland, and collagen fibers. Also, the lithogenic potentiality of PC decreased due to the inhibition of endogenous β-glucuronidase secretion. Conclusion The anti-proliferative effect of CDC2 kinase shRNA on PC may prevent biliary restenosis and stone recurrence.
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Objective To discuss the influence of anatomical variations of the cystic duct on preoperative diagnosis and operational scheme for cholecystectomy. Methods A 47-year-old woman was admitted to our hospital with diagnosis of cholecystolithiasis. Ultrasonography suggested minimal intra- and extrahepatic ductal dilatation. Laboratory tests showed that serum levels of alanine aminotransferase, aspartate aminotransferase and alkaline phosphatase were 189 IU/L, 366 IU/L and 144 IU/L, respectively. In order to make a certain diagnosis, the patient received both magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP). Results MRCP showed the bile duct slightly dilated with a shuttle shape figure and a lower signal with a strip form in it. MRCP could not confirm the quality of this signal and was doubtful of choledochus diaphragma. Subsequently, ERCP was applied to demonstrate that the cystic duct was collateral with the common hepatic duct when arriving into its left side and converged into the bile duct with a lower position, which was the reason for why MRCP misjudged the formation of choledochus diaphragma in the bile duct. Finally, the patient underwent open cholecystectomy. Conclusion There are some kinds of variations in the cystic duct including course, appearance and location of confluence. Combing MRCP with ERCP can significantly elevate the diagnostic accuracy of the cystic duct before operation, especially in those patients with doubtful diagnosis upon admission. To avoid biliary injury as much as possible, open cholecystectomy is superior to the laparoscopic cholecystectomy (LC)with regard to the patients suffering from cholecystolithiasis complicated with variation of the cystic duct.
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objective To investigate the diagnosis and treatment of hepatic focal nodular hyperplasia(FNH).Methods Twelve cases with hepatic focal nodular hyperplasia from January 2003 to December 2006 in our hospital were reviewed retrospectively. Results Three cases had epigastric discomfort(25%),5 cases with elevated ALT(41.67%),3 cases with elevated AST(25%),2 cases with elevated AFP(16.67%),one patient was of positive HBsAg(8.33%).The rate of preoperative correct diagnosis made by ultrasound,CT and MRI was 0,20%and 25%respectively,there was no significant difference between CT and MRI.Final diagnosis was established by stlrgical resection and pathology in 11 cases and by needle biopsy in one case.All cases recovered and were followed-up with an average of 28 months.No recurrence was found in cases undergoing surgical resection. Conclusion The rate of correct preoperative diagnosis for FNH is low,definite diagnosis depends on pathologic examination.The prognosis is good,however,most patients in this series underwent resection because of possible malignancy especially in eases of cirrhotics.
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Objective To evaluate the effects of high intensity focused ultrasound (HIFU) on hepatic cancer cells spreading in blood.Methods AFP mRNA in peripheral blood of 19 patients with hepatocellular carcinoma was detected before and after HIFU therapy by RT PCR.Results ①Before HIFU therapy, 11 of 19 cases were AFP mRNA positive (57.9%), while the control group were all negative. AFP mRNA was correlated with some clinical parameters such as serum AFP level, tumor size, portal vein embolism and extrahepatic metastasis ( P 0.05). ③After one week of HIFU therapy, the AFP mRNA positive rate of the group with tumor size less than 8 cm was much lower than that of tumor size larger than 8 cm ( P
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Objective To observe the effect of 5 Fluorouracil(5 FU) on the exocrine pancreas. Methods The effects of 5 FU were investigated in 8 patients who had undergone pancreatoduodenectomy. The pancreatic juice was temporarily diverted to the exterior via a pancreatic duct catheter.Ten days after operation,the patients were injected intravenously with 5 FU 500 mg/d for three days. The samples of pancreatic juice were taken for measurement of amylase,pH, HCO 3 -, Na +, K +, Cl -, Ca 2+ and Mg 2+ .Results The amylase, pH, HCO 3 -, Na +, K +, Cl -, Ca 2+ and Mg 2+ did not alteredsignificantly before and after 5 FU injection.Conclusion 5 FU has no short term effect on exocrine pancreas. Therefore, improvement of acute pancreatitis cannot be achieved through inhibiting pancreatic enzymes synthesis.
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Objective To investigate the effect of high intensity focused ultrasound(HIFU) on the immunity of patients with advanced primary liver cancer(PLC).Methods Forty cases of PLC admitted to our institution from Mar.2003 to Dec.2003 were included in this study.Patients were divided into 2 groups and received either HIFU or radio-frequency ablation(RFA) treatment randomly.CD3,CD4,CD8,CD4/CD8,NK,IL-2,TNF were chosen to assess the immune status before and after treatment.The results were compared statistically.(Results The) survival rate after HIFU was 80.0%,61.1%,42.9%,33.3% at 3 months,6 months,9 months and 1 year respectively,which was similar to that after RFA treatment.The changes of immunity parameters of CD3,CD4,CD8,CD4/CD8,NK,IL-2 and TNF were not significant after HIFU treatment.In addition,the differences of those parameters between HIFU group and RFA group were insignificant.Conclusion There are no detrimental effects on immunity in the early period after HIFU treatment.
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Objective To investigate the feasibility, effect and mechanism of chemical bile duct embolization for chemical hepatectomy. Methods Phenol or absolute ethanol plus cyanonacrylate were employed as embolization agents. Histology, Fas and TGF-? 1 measurement were used to evaluate the result. Results Phenol plus cyanonacrylate effectively destroyed and embolized intrahepatic biliary duct, leading to complete disappearance of hepatocytes in the periphery of embolization lobe and thereby achieving the effect of chemical hepatectomy. Expression of Fas and TGF-? 1 in phenol embolism group (88.90?38.10, 185.22?70.39) and ethanol embolism group (72.39?29.51, 163.56?51.75) were higher than those in biliary duct ligated group (26.31?12.07, 74.84?40.73) ( P
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Objective: To study the effect of total flavonoids of astragalus (TFA) on adjuvant arthritic (AA) rats and its mechanism. Methods: The volume of non-injected hind paw of AA rats, serum malondialdehyde (MDA) content, interleukin-1(IL-1) and nitrite (NO - 2) produced from articular synoviocytes were measured. Results: It was obseved that serum levels of MDA and the levels of IL-1 and NO - 2 from synoviocytes increased in AA rats, and the degree of the secondary inflammatory reaction of AA rats appeared to be directly correlated with serum levels of MDA and IL-1. Treatment of whole (d0～27) or partial (d12-18 or d18-24) course of AA rats with TFA (20 mg/kg/d,ig) could not only markedly inhibit the inflammatory reaction in AA rats, but also reduce their enhanced serum lipid peroxides (LPO), IL-1 and NO production from synoviocytes. Conclusion: TFA has significant therapeutic effects on AA rats, which might be related to both of anti-oxidative effect and the reduced production of IL-1 and NO from synoviocytes.