The effects of gambogenic acid on proliferation and apoptosis of CAL27 cell xenograft tumor in nude mice / 实用口腔医学杂志

Objective:To investigate the effects of gambogenic acid(GNA)on the proliferation and apoptosis of CAL27 cell xenograft tumor in nude mice.Methods:18 SPF nude mice were randomly divided into 3 groups(n=6).All nude mice were inoculated with CAL27 cells at logarithmic growth stage to establish subcutaneous transplanted tumor models.The mice in low and high dose GNA groups were treated with GNA of 8.0 mg/kg iv.and 16.0 mg/kg iv.every other day,respectively,and those in the control group was given the same amount of normal saline.The tumor growth curve was plotted during drug administration.2 weeks later,the nude mice were sacrificed,the tumor tissue was removed and the tumor inhibition rate was evaluated by the tumor size measurements.TUNEL as-say was used to detect the apoptosis of transplanted tumor cells in the groups.The expression levels of AKT,Bcl-2 and PI3K proteins in tumor tissue were detected by immunohistochemistry(IHC).The toxicity and side effects of GNA on normal tissues were detected by HE staining.Results:The transplanted tumors in low and high dose GNA groups grew slowly,and the tumor weight and volume were significantly lower than those in the control group(P＜0.05),the tumor inhibition ratio of low and high dose groups was 57.58％and 83.68％respectively.TUNEL results showed that the apoptosis index of GNA low and high dose groups was higher that of control group(P＜0.05).IHC results showed that the expression of AKT,Bcl-2 and PI3K in the tumor tissues of nude mice in low and high dose GNA groups was lower than that in the control group(P＜0.05).HE results showed that GNA had not effect on normal tissues and or-gans(P＜0.05);Conclusion:GNA may induce CAL27 cell apoptosis by regulating the expression of AKT,Bcl-2 and PI3K,and in-hibites the development of human tongue squamous cell carcinoma with little effect on normal tissues and organs.

Comparative analysis of cerebrospinal fluid laboratory test results between multiple sclerosis and Guillain-Barré syndrome / 中华检验医学杂志

Objective:To compare the characteristics of cerebrospinal fluid (CSF) oligoclonal band electrophoresis examination results between patients with multiple sclerosis (MS) and Guillain-Barré syndrome (GBS), and to provide a basis for the differential diagnosis of the two types of neurological demyelinating diseases.Methods:Case analysis.The retrospective study method was used, and the patients who visited Beijing Tiantan Hospital, Capital Medical University from January 2020 to August 2023 were selected as the research subjects, including 70 MS patients[19 males and 51 females, aged 34 (28, 44) years] and 70 GBS patients [44 males and 26 females, aged 50 (36, 61) years]. The oligoclonal band electrophoresis and immunoglobulin G(IgG) index (IgG I) were performed on the clinical specimens from MS and GBS patients, and CSF routine, CSF biochemistry (glucose, chloride, protein), lactate, interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor-α (TNF-α), antibodies to herpes simplex virus (HSV), cytomegalovirus (CMV), rubella virus (RV), toxoplasma gondii (TOX), Epstein-Barr virus (EBV), and coxsackievirus were detected simultaneously. The enumeration data were treated with the chi-square test. The measurement data didn′t accord with normal distribution, and were treated with the Mann-Whitney U test. Results:The positive rate of oligoclonal band (OCB) electrophoresis in MS and GBS patients were 80.00% (56/70) and 4.29% (3/70), respectively. The positive rate in MS patients was significantly higher than that in GBS patients (χ 2=82.289, P<0.001). The white blood cells count [5.50 (3.00, 11.00)/μl] and the level of chlorine [127 (125, 128) mmol/L] in CSF of MS patients was higher than that of GBS patients [3.50(2.00, 7.00)/μl, 126(124, 128) mmol/L] ( U=-2.245, P<0.05; U=-2.028, P<0.05), while the levels of CSF protein [33.40(27.61, 39.17)mg/L], glucose [3.59(3.36, 3.88) mmol/L], and lactate [1.55(1.40, 1.73) mmol/L] of MS patients were lower than those of GBS patients [6.71(43.78, 138.30) mg/L, 3.97(3.55, 4.54) mmol/L, 1.80(1.60, 2.00) mmol/L]( U=-6.747, P<0.001; U=-3.651, P<0.001; U=-4.531, P<0.001). The levels of IL-6 [3.36(2.34, 5.02) pg/ml], IL-8 [55.40(46.75, 66.40) pg/ml], and TNF-α [5.63(4.25, 6.63) pg/ml] in CSF of MS patients were lower than those of GBS patients [6.12(3.61, 11.73) pg/ml, 120.00(74.90, 187.80) pg/ml, 6.57(5.25, 8.03) pg/ml]( U=-3.463, P<0.05; U=-5.225, P<0.001; U=-2.785, P<0.05). The positive rates of CMV IgG, TOX IgG, and EBVCA IgG in CSF of MS patients were 36.36% (24/66), 0 and 0, respectively,and the positive rates of those of GBS patients were 85.71% (54/63), 30.16% (19/63), and 19.05% (12/63), respectively. The positive rates of CMV IgG, TOX IgG, and EBVCA IgG in CSF of MS patients were significantly lower than those of GBS patients (χ 2=32.839, P<0.001; χ 2=23.343, P<0.001; χ 2=13.861, P<0.001). Conclusions:The MS patients mainly showed the higher positive rates of OCB. The GBS patients showed elevated CSF protein levels but no significant increase in white blood cell count, namely albuminocytologic dissociation in CSF. Meanwhile, the GBS patients showed elevated levels of intrathecal immunity and inflammation indicators, and a higher positive rate of pathogen antibodies.

Visual transient elastography combined with liver steatosis analysis for assessing liver function injury after ablation / 中华超声影像学杂志

Objective:To investigate the value of a novel technique called visual transient elastography (ViTE) and liver steatosis analysis (LiSA) in assessing liver function injury in hepatitis B virus-related hepatocellular carcinoma (HBV-related HCC) patients after ablation therapy.Methods:A total of 129 HBV-related HCC patients in Harbin Medical University Cancer Hospital from January 2022 to August 2023 were retrospectively analyzed.ViTE and LiSA examinations were applied to record the liver stiffness E value and LiSA value before ablation. An albumin-bilirubin (ALBI) score was constructed using laboratory indicators. Spearman correlation analysis was used to assess the correlation between E value, LiSA value and ALBI score, body mass index (BMI). According to the change of ALBI grade in perioperative period, the patients could be divided into two groups: liver function unchanged group and liver function injury group. Univariate and multivariate statistical methods were used to analyze related factors affecting changes in liver function after ablation, followed by establishing a predictive model.Results:Spearman analysis showed a strong positive correlation between E value and ALBI score ( rs=0.686, P<0.001), and LiSA value was weakly positively correlated with BMI ( rs=0.338, P<0.001). There were no significant correlations between E value and BMI, LiSA value and ALBI score (all P>0.05). Univariate analysis showed that differences of age, BMI, ablation parameters, E value, and LiSA value in the two groups were statistically significant (all P<0.05). Multivariate analysis showed that E value, LiSA value, and ablation time were independent predictors of hepatic dysfunction after ablation (all P<0.05). AUC was 0.892 indicating high accuracy in the predictive model based on above indicators. Conclusions:Under the real-time ultrasound guidance, a non-invasive liver function injury prediction model based on ViTE and LiSA technology can offer personalized predictions for ablative perioperative changes in liver function among HBV-related HCC patients.

Advances in research on radiation-induced brain injury / 中华放射医学与防护杂志

Radiotherapy can cause functional and morphological changes in the brain tissues of patients with primary or metastatic malignant brain tumors, leading to radiation-induced brain injury. However, the pathogenesis of radiation-induced brain injury has not yet been unanimously determined, and its research advances and treatment protocols are yet to be elucidated and improved. In this study, we explore the pathogenesis of radiation-induced brain injury from the perspective of vascular injury, inflammatory reactions, neuronal dysfunction, glial cell injury, and gut microbiota and reviewed the advances in research on its treatment and prevention. The purpose is to provide a reference and theoretical basis for the research and clinical diagnosis and treatment of radiation-induced brain injury.

Influence of Helicobacter pylori infection on anxiety and depression in patients with chronic gastritis / 中华消化杂志

Objective:To evaluate the influence of Helicobacter pylori ( H. pylori) infection on anxiety and depression in patients with chronic gastritis. Methods:From December 1 2020 to June 30 2021, 387 patients with chronic gastritis who visited the outpatient Department of Gastroenterology, the First Hospital Affiliated to Air Force Medical University were continuously recruited. According to the status of current H. pylori infection, the patients were divided into H. pylori uninfected group and H. pylori infected group. The general demographic information of patients was collected. Hamilton anxiety scale, Hamilton depression rating scale-24, Pittsburgh sleep quality index (PSQI) and gastrointestinal symptom rating scale (GSRS) were filled in. The detection rates of anxiety and depression were compared between the H. pylori uninfected group and the H. pylori infected group according to demographic characteristics. Chi-square test and multiple logistic regression analysis were used for statistical analysis. Results:Finally, 360 patients with chronic gastritis were enrolled, including 200 patients in H. pylori uninfected group and 160 patients in H. pylori infected group. The detection rates of anxiety and depression of the H. pylori infected group were both higher than those of the H. pylori uninfected group (48.1%, 77/160 vs. 30.0%, 60/200; 25.0%, 40/160 vs. 12.5%, 25/200), and the differences were statistically significant ( χ2=12.39 and 9.39, P<0.001 and=0.002). The detection rate of anxiety of male patients in the H. pylori infected group was higher than that in the H. pylori uninfected group (45.1%, 32/71 vs. 24.5%, 27/110); the detection rate of depression of female patients in the H. pylori infected group was higher than that in the H. pylori uninfected group (30.3%, 27/89 vs. 11.1%, 10/90), and the differences were statistically significant ( χ2=8.27 and 10.09, P=0.004 and 0.001). The detection rates of anxiety and depression of patients less than 48 years old in the H. pylori infected group were both higher than those in the H. pylori uninfected group (46.2%, 37/80 vs. 21.9%, 21/96; 20.0%, 16/80 vs. 7.3%, 7/96), and the differences were statistically significant ( χ2=11.73 and 6.20, P=0.001 and 0.013). The detection rates of anxiety and depression of the patients with high school education and below in the H. pylori infected group were higher than those in the H. pylori uninfected group (56.5%, 48/85 vs. 31.7%, 38/120; 32.9%, 28/85 vs. 14.2%, 17/120), and the differences were statistically significant ( χ2=12.57 and 10.24, P<0.001 and =0.001). The results of multivariate analysis showed that H. pylori infection, history of hypertension, PSQI score ≥8, GSRS score ≥7, chronic superficial gastritis and chronic atrophic gastritis were independent risk factors of anxiety in patients with chronic gastritis( P<0.001, =0.013, =0.001, <0.001, =0.036, =0.021), and the risk of anxiety of patients with H. pylori infection was 2.509 times as much as that in uninfected patients (95% confidence interval 1.512 to 4.163). H. pylori infection, PSQI score ≥8, GSRS score≥7, and having overnight dish ≥3 times per week all were independent risk factors of depression in patients with chronic gastritis( P=0.004, =0.002, <0.001, =0.001). The risk of depression in patients with H. pylori infection was 2.563 times as much as that in uninfected patients (95% confidence interval 1.356 to 4.846). Conclusion:H. pylori infection is correlated to anxiety and depression in patients with chronic gastritis, and it is an independent risk factor of anxiety and depression in patients with chronic gastritis.

The mechanism of the severe exacerbation and chronicity of hepatitis E virus infection / 临床肝胆病杂志

‍Hepatitis E virus （HEV） infection is the most common cause of acute viral hepatitis worldwide， and over the past ten years， studies have shown that HEV can not only cause acute self-limiting hepatitis， but also lead to severe and chronic infection. Pregnant women or patients with underlying liver disease may progress to liver failure after HEV infection， resulting in a relatively high mortality rate， and patients receiving solid organ transplantation may progress to chronic hepatitis after HFV infection. This article introduces the diagnosis， clinical features， transmission， prevention， and treatment of severe and chronic HEV infection， discusses the features of immune response， inflammatory response， and the virus itself during the severe exacerbation and chronicity of HEV infection， and summarizes the mechanism in promoting the progression of HEV. Nevertheless， there are still large gaps between current studies and clinical application， and there is still a lack of effective diagnosis and treatment regimens for severe and chronic HEV infection. It is necessary for clinical researchers to conduct research on the pathogenesis of hepatitis E and systematic cohort studies and improve the level of clinical nursing， thereby achieving the goal of preventing hepatitis E and improving the prognosis of patients with hepatitis E.

Analysis on the Current Situation and Influencing Factors of Ethical KAP among Clinical Researchers / 中国医学伦理学

【Objective:】 To understand the current situation and influencing factors of ethical knowledge, attitude, and practice (KAP) among clinical researchers, enhance their ethical awareness, and improve the quality of clinical researches. 【Methods:】 A self-designed questionnaire was used to conduct a convenient sampling survey of medical staff who have participated in clinical study. 【Results:】 A total of 6,021 subjects were investigated, with males accounting for 28.46% and females accounting for 71.53%. The average age of them was (37.47±11.46) years old. The total score of ethics and the mean scores of the three dimensions of knowledge, attitude and practice were (70.62±12.99), (59.63±12.50), (79.55±19.62) and (74.92±18.29), respectively. Multiple linear regression analysis showed that researchers with male, tertiary hospitals, doctors, ethics-related part-time jobs, postgraduate education, associate senior title or above, and training experience scored higher (P<0.05). 【Conclusion:】 Ethical attitudes have a significant mediating effect between knowledge and practice, accounting for 62.72% of the total effect. Researchers recognize the importance of ethics, but it is urgent to strengthen their knowledge learning and practical application.

Analysis of family mutation type and two-hit hypothesis of a familial VHL Syndrome patient / 现代泌尿外科杂志

【Objective】 To explore the mutation type, clinical characteristics, molecular genetics and the two-hit type of a patient with familial Von Hippel Lindau (VHL) syndrome. 【Methods】 The data of the patient were collected. DNA was extracted from the peripheral blood and renal cell carcinoma sample. The VHL gene germline mutation site was detected with high throughput sequencing next generation sequencing (NGS). The two-hit site was identified with UCSCXena database, methylation-specific PCR (MSP) and microsatellite stability detection. 【Results】 The mutation site of the embryo line was located in c.500G>A R167Q mutation. The patient had single nucleotide polymorphism, but no clear loss of heterozygosity, methylation or system mutation. 【Conclusion】 The germline mutation in exon 3 is the basis for the clinical features of this familial renal cell carcinoma proband. The identification of the two-hit site is key to the occurrence of the disease, which is significant for the diagnosis and treatment. The use of the databases can guide the screening of mutations and methylation sites in familial renal cell carcinoma.

Experimental study on the therapeutic effect of different bleaching methods on white-spot lesions of the enamel using optical coherence tomography / 口腔医学

Objective@#To investigate the efficacy of different bleaching methods on white-spot lesions of the enamel using optical coherence tomography and to evaluate its feasibility for monitoring the therapeutic effects on white-spot lesions. @*Methods@#Forty-eight sound premolars extracted for orthodontic reasons were selected and cut for 4 mm×4 mm×2 mm enamel blocks in buccal surfaces of the crowns. The samples were covered with acid-resistant varnish (except for the buccal surfaces) and immersed in demineralization solution for 18 days to establish the white-spot lesion models of the enamels. Samples were randomly divided into four groups (n=12). Group A was given demineralization only. Specimens in Group B, C and D were treated with 40% hydrogen peroxide, resin infiltration and 40% hydrogen peroxide combined with resin infiltration, respectively. Eight samples in each group were randomly selected. OCT was applied to observe the optical changes of the enamel surface and according to the OCT scanning results, the demineralization depth of enamel samples in each group was calculated. Then, the enamel blocks were embedded in epoxy resins, except the buccal surfaces, and measured for the microhardness values of the enamel surface by a microindentation hardness tester. Four samples in each group were cut longitudinally, and the ultrastructural changes of enamel samples in each group were observed by scanning electron microscope. @* Results@#OCT showed that the light scattering characteristics of enamel surface changed in all groups, and the bright layer was formed, but the thickness of bright layer in Group C and D was significantly lower than that in Group A and B (P<0.05). The microhardness values (kg/mm2) of the samples in Group A-D were (214.99±31.70), (250.66±33.64), (312.42±18.01) and(286.53±26.65), respectively. The microhardness of enamel surfaces in Group C and D was significantly higher than that in Group A and B (P<0.05), and the ultrastructure of enamel surfaces in Group C and D were more flat and dense in SEM observation (P<0.05). @*Conclusion@#The methods of resin infiltration therapy or 40% hydrogen peroxide combined with resin infiltration could effectively improve white-spot lesions of the enamel and the non-invasive OCT can be used as a better evaluation method for the diagnosis and treatment of white-spot lesions of the enamel.

Comparison of clinical features of Omicron and Delta cases / 西安交通大学学报(医学版)

【Objective】 To compare the clinical features of Omicron and Delta cases, so as to provide scientific basis for the prevention and treatment of COVID-19. 【Methods】 The case-control study method was used to retrospectively analyze the clinical data of the Omicron cases admitted to the designated hospital for the treatment of COVID-19 in Xi’an from December 2021 to January 2022. and the Delta cases admitted during the same period were used as the control group. The demographic data, epidemiological history, vaccination status, clinical characteristics, laboratory tests, nucleic acid and antibody levels, and outcomes of patients in the two groups were collected and compared. 【Results】 A total of 21 patients were included in the study, 5 were Omicron patients and 16 were Delta cases. The mean age of the patients in the two groups were (38.20±15.07) and (37.69±10.39) years, respectively.The time interval between the last vaccination and the diagnosis was (145.40±77.92) days and (159.00±99.74) days, respectively. For the initial symptoms, the patients with Omicron were mainly characterized by throat discomfort (3, 60%), cough and sputum (2, 40%), and the patients with Delta were mainly characterized by throat discomfort (5, 31.25%), fatigue (5, 31.25%), cough and sputum (4, 25%). On admission, laboratory tests showed that 60% of Omicron patients had low lymphocytes and elevated erythrocyte sedimentation rate, and 50% of patients in the delta group had elevated hemoglobin. The Ct values of ORFlab gene, N gene and E gene with Omicron were lower than those with Delta. And the difference of E gene between the two groups was statistically significant (t=-2.711, P=0.024). IgG antibody levels increased in both groups.The time for nucleic acid to turn negative with Omicron was (28.20±5.89) days, and it was (18.50±7.73) days with Delta, and the difference between the groups was statistically significant (t=2.565, P=0.019). The length of hospitalization with Omicron was (30.60±4.88) days, and that with Delta was (22.13±7.81) days, and the difference was statistically significant (t=2.270, P=0.035). 【Conclusions】 The initial symptoms of Omicron patients are mainly throat discomfort, cough and sputum. The clinical manifestations are generally mild. The nucleic acid test Ct value is lower. The time for nucleic acid to turn negative and the time for hospitalization are longer, and the potential infectiousness is stronger. Those eligible for vaccination should complete the full course of vaccination and booster vaccination as soon as possible. At the same time, the management of "early detection, early reporting, early isolation, and early treatment" should be implemented.

Progress in regulatory effects of thymic stromal lymphopoietin on immune cells / 中华微生物学和免疫学杂志

Thymic stromal lymphopoietin (TSLP), as a pleiotropic cell growth factor, not only participants in the processes of human skin fibrosis, epidermal proliferation and angiogenesis, but also plays a critical role in regulating a variety of immune cells in immune-related diseases (such as respiratory diseases and allergic diseases). TSLP regulates various innate immune cells (such as dendritic cells, mast cells, macrophages, eosinophils, basophils, natural killer T cells and innate lymphocytes) and adaptive immune cells (T lymphocytes and B lymphocytes) mainly through JAK/STAT, NF-κB and other signal pathways mediated by TSLP receptor. This paper summarized the progress in the regulatory roles of TSLP in the proliferation, differentiation and function of various immune cells.

Analysis of the anxiety and depression in patients with gallbladder polyps, gallbladder stones and post-cholecystectomy / 中华消化杂志

Objective:To investigate the anxiety and depression in patients with gallbladder polyps, gallbladder stones and post-cholecystectomy.Methods:From December 2020 to August 2021, consecutive patients who visited the Department of Gastroenterology, First Affiliated Hospital of Air Force Medical University, were enrolled and divided into normal gallbladder group, gallbladder polyp group, gallbladder stone group and post-cholecystectomy group, with 100 patients in each group. Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) were used to evaluate patients′ anxiety or depression. Quality of life, sleep quality and severity of gastrointestinal symptom were assessed by short form 36 (SF-36), Pittsburgh sleep quality index (PSQI) scale and gastrointestinal symptom rating scale (GSRS) respectively. The incidence of anxiety or depression of patients in the 4 groups were compared, and the related risk factors of anxiety and depression were analyzed. Chi-square test and multiple logistic regression were used for statistical analysis.Results:Among 400 patients, 89 patients (22.2%) suffered from anxiety; and the incidences of anxiety of normal gallbladder group, gallbladder polyp group, gallbladder stone group and post-cholecystectomy group were 9.0% (9/100), 19.0% (19/100), 25.0% (25/100) and 36.0% (36/100) respectively. There was statistically significant difference in the incidence of anxiety among the 4 groups ( χ2=22.12, P<0.001). The incidence rates of anxiety of the gallbladder polyp group, gallbladder stone group and post-cholecystectomy group were all higher than that of the normal gallbladder group, and the differences were all statistically significant ( χ2=4.15, 9.07 and 20.90, P=0.042, 0.003 and <0.001). The incidence of anxiety of post-cholecystectomy group was higher than that of gallbladder polyp group, and the difference was statistically significant ( χ2=7.25, P=0.007). Among the 400 patients, 70 patients (17.5%) suffered from depression. The incidence rates of depression of the normal gallbladder group, gallbladder polyp group, gallbladder stone group and post-cholecystectomy group were 5.0% (5/100), 10.0% (10/100), 24.0% (24/100) and 31.0% (31/100) respectively. There was statistically significant difference in the incidence of depression among the 4 groups ( χ2=30.27, P<0.001). The incidences of depression of the gallbladder stone group and post-cholecystectomy group were both higher than that of the normal gallbladder group and gallbladder polyp group, and the differences were statistically significant ( χ2=14.56, 22.90, 6.94 and 13.53, P<0.001, <0.001, =0.008 and <0.001). The results of multivariate analysis showed that history of cholecystectomy, history of coronary heart disease, consumption of overnight food ≥3 times per week, PSQI score ≥ 8 and GSRS score ≥9 were independent risk factors for anxiety ( OR, 95%confidence interval: 4.02, 1.60 to 10.13; 10.01, 2.15 to 46.68; 4.15, 1.87 to 9.19; 4.69, 2.58 to 8.52; 3.02, 1.64 to 5.58; P=0.003, 0.003, <0.001, <0.001, and <0.001). Gallbladder stones history of cholecystectomy, consumption of overnight food ≥3 times per week, consumption of fresh fruit < 200 g/d, PSQI score ≥8 and GSRS score ≥9 were independent risk factors for depression ( OR, 95%confidence interval: 4.40, 1.38 to 14.06; 4.97, 1.54 to 16.12; 4.23, 1.61 to 11.08; 3.78, 1.32 to 10.85; 5.59, 2.78 to 11.27, 4.19, 1.94 to 9.04; P=0.012, 0.007, 0.003, 0.014, <0.001 and <0.001). Conclusions:The incidences of anxiety and depression in patients with gallbladder stones or post-cholecystectomy are higher than that of people with normal gallbladder. A history of cholecystectomy is the independent risk factor for anxiety and depression. Gallbladder stones is the independent risk factor of depression. Clinical attention should be paid to the mental state of patients with gallbladder polyps, gallbladder stones, especially post-cholecystectomy.

Application of upper sternal mini-incision with debranching technique in Stanford B aortic dissection involving the arch / 中华胸心血管外科杂志

Objective:To investigate the safety and early and mid-term efficacy of upper sternal mini-incision with debranching technique in B aortic dissection involving the arch.Methods:18 patients with B aortic dissection involving the arch who were admitted into our center from November 2017 to January 2019 were enrolled, to evaluate the intraoperative and postoperative conditions, including special intraoperative treatment, time of operation、poseoperative drainage、time of use ventilators, time of staying in ICU, complications etc, 12-24 months follow-up were performed after operation.Results:No death occurred, 1 case with acute renal failure, 1 case with type I endoleak, 1 case with paraplegia occurred during hospitalization, 1 patient with sudden vomiting of blood 30 days after discharge from hospital who was found aortoesophageal fistula, underwent emergency surgery to replace thoracic aortic and repair esophageal fistula, all of them were cured and discharged, the rate of complication was 22.2%(4/18). none of the other patients had any phenomena such as agnail、distal rupture、twisted or displaced of the stents、ischemic of coronary artery、cerebrovascular accident, etc.Conclusion:The result of upper sternal mini-incision with debranching technique in B aortic dissection involving the arch is satisfied, the early and mid-term survival rate is significantly improved, the patient's prognosis are improved.

Research Progress of High-dose Dual Therapy in Eradication of Helicobacter pylori Infection / 胃肠病学

In the era of increasing of antibiotic resistance, Helicobacter pylori (Hp) eradication rates of traditional triple and quadruple therapy are gradually declining. High-dose dual therapy (HDDT) containing proton pump inhibitors and amoxicillin may be a new breakthrough in eradicating Hp infection. Current research shows that HDDT, whether used as a first-line regimen or a rescue regimen, has a high eradication rate and a low incidence of adverse reactions. It has the potential to become a new first-line eradication therapy or rescue therapy for Hp infection in clinical practice. This article reviewed the research progress of HDDT in eradication of Hp infection.

Investigation of radiation dose in CT scanning for adult patients in Ningxia / 中华放射医学与防护杂志

Objective To investigate the current status of CT radiation dose to adults in Ningxia, and provide basic data for developing the first diagnostic reference level of adults from CT scanning. Methods Stratified cluster sampling method was used to investigate the in-service status of CT scanners with various brands and different models in different grades of hospital in Ningxia. Interval sampling method was used to obtain everyday' s scanning parameters and radiation dose values from different types of scanning examinations in surveyed hostipitals. Basic information was collected include hospitals, CT scanner, scanning types and patients. CT scanning parameters, CTDIvol and DLP values were recorded, with effective dose values calculated. The data were statistically analyzed by examination types and comparation was made with the DRL values recommended by other countries. Results Finally, there were 45 medical institutions in this study, including 10 public tertiary A hospitals, 5 public tertiary B hospitals, 23 public secondary A hospitals, 5 private hospitals and 2 physical examination centers. 58 CT scanners from 6 manufacturers and 4952 adult patients were investigated. The 75th percentile (P75) of CTDIvol, DLP, and E values of common scanning examinations were listed as follows: 65.67 mGy, 860.74 mGy·cm, and 1.64 mSv in skull scanning;29.32 mGy, 490. 00 mGy·cm, and 2.83 mSv in neck scanning;36. 92 mGy, 954. 42 mGy·cm, and 4. 87 mSv in neck enhanced scanning; 11. 50 mGy, 382.06 mGy·cm , and 5.68 mSv in chest scanning; 45.80 mGy, 1713.22 mGy·cm, and 25.01 mSv in chest enhanced scanning; 20. 10 mGy, 506. 59 mGy·cm, and 7. 75 mSv in upper abdominal scanning;50. 07 mGy, 1434. 19 mGy·cm, and 21. 94 mSv in upper abdominal enhanced scanning; 14. 33 mGy, 670.78 mGy·cm, and 10. 26 mSv in abdominal-pelvic scanning; 48. 00 mGy, 2294. 00 mGy·cm, and 35.10 mSv in abdominal-pelvic enhanced scanning;16.10 mGy, 471.58 mGy·cm, and 6.08 mSv in pelvic scanning;31.04 mGy, 1138. 78 mGy·cm, and 14. 69 mSv in pelvic enhanced scanning. Conclusions The CT scanning radiation doses to skull, neck, chest and pelvis in Ningxia are slightly lower than, or similar to, in other countries, but the abdominal scanning dose is significantly higher than that in other countries. It is necessary to optimize the abdominal CT scanning protocol.

The application of deep hypothermic circulatory arrest in the surgical treatment of complex thoracoabdominal aortic aneurysm / 中华胸心血管外科杂志

Objective To discuss the application of deep hypothermic circulatory arrest in surgical treatment of complex thoracoabdominal aortic aneurysms and its near-midterm effect.Methods The clinical data of 34 cases of thoracoabdominal aortic aneurysm in the center from August 2009 to June 2018 were analyzed retrospectively.All the patients underwent surgery under deep hypothermic circulatory arrest.There were 23 males and 11 females; aged 23 -67 years, mean(42.26 ±10.96) years old; Crawford type Ⅰ in 12 cases and Crawford type Ⅱ in 22 cases; aneurysms with a maximum diameter of 50 -120 mm, mean(65.26 ±16.09) mm;Marfan syndrome 15 cases, atherosclerosis 14 cases, aortic coarctation in 5 cases;22 cases of hypertension;28 cases of first aortic surgery, 6 cases of re-aortic surgery.Surgical transthoracic and abdominal incision, ext-racapsular approach, femoral artery and inferior vena cava intubation, deep hypothermic circulatory arrest technique to complete proximal anastomosis, arterial tube reconstruction of intercostal artery, abdominal organ blood supply artery and four The bifur-cated vessels were anastomosed, and the bifurcated vessels were anastomosed with the "Y"type artificial blood vessel trunk. The bilateral radial arteries were end-to-end anastomosis in the 10 mm artificial blood vessels of the "Y"type artificial blood vessels.Results There were no complications of cranial nerve system in the whole group , deep hypothermic circulatory arrest (17.68 ±4.88) min, ventilator assist time(34.88 ±16.04) hours, postoperative renal failure in 5 cases, after CRRT treat-ment After recovery, 1 case of paraplegia after operation, muscle strength recovered after cerebrospinal fluid drainage and de-compression, and 1 case died in the whole group, and died of multiple organ failure.The patients were followed up for 3 months to 5 years, and the results were satisfactory.The survivors did not die.The survivors did not die.However, 5 patients underwent thoracic aortic replacement under deep hypothermic circulatory arrest for the first time , and 4 patients underwent reo-peration because of distal vasodilation.The reconstructed intercostal artery occlusion occurred in 4 patients, but no paraplegia occurred.Conclusion When cross clamping the aorta is not feasible,it is safe to perform proximal anastomosis with deep hy-pothermic circulatory arrest.

Influence of pregnancy on the natural history of chronic hepatitis B virus infection / 临床肝胆病杂志

Chronic hepatitis B virus (HBV) infection is still a serious public health problem in China, and the HBsAg carrying rate reaches 6.0%-7.8% in pregnant women. Maternal immune system is suppressed during pregnancy, which may affect the natural history of HBV infection. At present, no consensus has been reached on the influence of pregnancy on the natural history of HBV infection. The article reviews the research advances in the influence of pregnancy on the natural history of HBV infection from the aspects of maternal immunosuppression during pregnancy and the effect of pregnancy on viral replication, HBeAg seroconversion, liver function, and liver disease progression. Pregnant women with chronic HBV infection should be closely monitored in clinical practice in terms of virological examination and liver function examination during pregnancy and postpartum.

Clinical analysis of female urethral diverticulum resection and reconstruction under Jacknife position / 中华泌尿外科杂志

Objective To explore the clinical efficacy of female urethral diverticulum resection and reconstruction under the folding position.Methods Retrospective analysis of 22 female patients with urethral diverticulum was performed from September 2010 to December 2018.There were 12 cases of simple diverticulum,6 cases of horseshoe diverticulum,4 cases of circumferential diverticulum,aged from 26 to 72 years,with an average of 46.2 years,whose BMI ranged from 24.2 to 34.8 kg/m2,with an average of 30.4 kg/m2.Eleven cases (50％) presented with dysuria,10 cases (45.5％) with repeated urinary tract infections,7 cases (31.2％) with difficulty of voiding,10 cases (45.5％) with urethral secretion,9 cases (40.1％) with difficulty of sexual intercourse,and 4 cases (18.2％) without symptoms.Unlike the traditional surgical procedure under the lithotomy position,the folding position was used to expose the vagina and separate the vaginal mucosa by longitudinal incision,and the diverticulum was completely removed to the neck.The peri-operative complications and efficacy were recorded.Results All 22 cases underwent successful procedures,and were followed up for 25.2 months on average (ranged 8 to 42 months).One of them suffered from weak stream 2 months after operation,with residual urine volume of 100ml by ultrasonography.Her symptoms improved after dilatation of the urethra.Two cases suffered from different degrees of lower urinary tract storage symptoms 1 month after the operation (1 case of mild dysuria and 1 case of urinary tract infection),who improved after oral administration of levofloxacin tablets for 3-5 days.All patients had no urethral diverticulum recurrence 3 months later by ultrasonography,half a year by cystoscopy,and every six months by ultrasonography.Conclusions Surgical treatment is still the best choice for patients with urethral diverticulum.The success rate of transvaginal urethral diverticulum reconstruction with a Jackknife position is high,postoperative recurrence rate is low,and postoperative complications are few.

Investigation of radiation dose in CT scanning for adult patients in Ningxia / 中华放射医学与防护杂志

Objective@#To investigate the current status of CT radiation dose to adults in Ningxia, and provide basic data for developing the first diagnostic reference level of adults from CT scanning.@*Methods@#Stratified cluster sampling method was used to investigate the in-service status of CT scanners with various brands and different models in different grades of hospital in Ningxia. Interval sampling method was used to obtain everyday′s scanning parameters and radiation dose values from different types of scanning examinations in surveyed hostipitals. Basic information was collected include hospitals, CT scanner, scanning types and patients. CT scanning parameters, CTDIvol and DLP values were recorded, with effective dose values calculated. The data were statistically analyzed by examination types and comparation was made with the DRL values recommended by other countries.@*Results@#Finally, there were 45 medical institutions in this study, including 10 public tertiary A hospitals, 5 public tertiary B hospitals, 23 public secondary A hospitals, 5 private hospitals and 2 physical examination centers. 58 CT scanners from 6 manufacturers and 4 952 adult patients were investigated. The 75th percentile (P75) of CTDIvol, DLP, and E values of common scanning examinations were listed as follows: 65.67 mGy, 860.74 mGy·cm, and 1.64 mSv in skull scanning; 29.32 mGy, 490.00 mGy·cm, and 2.83 mSv in neck scanning; 36.92 mGy, 954.42 mGy·cm, and 4.87 mSv in neck enhanced scanning; 11.50 mGy, 382.06 mGy·cm , and 5.68 mSv in chest scanning; 45.80 mGy, 1 713.22 mGy·cm, and 25.01 mSv in chest enhanced scanning; 20.10 mGy, 506.59 mGy·cm, and 7.75 mSv in upper abdominal scanning; 50.07 mGy, 1 434.19 mGy·cm, and 21.94 mSv in upper abdominal enhanced scanning; 14.33 mGy, 670.78 mGy·cm, and 10.26 mSv in abdominal-pelvic scanning; 48.00 mGy, 2 294.00 mGy·cm, and 35.10 mSv in abdominal-pelvic enhanced scanning; 16.10 mGy, 471.58 mGy·cm, and 6.08 mSv in pelvic scanning; 31.04 mGy, 1 138.78 mGy·cm, and 14.69 mSv in pelvic enhanced scanning.@*Conclusions@#The CT scanning radiation doses to skull, neck, chest and pelvis in Ningxia are slightly lower than, or similar to, in other countries, but the abdominal scanning dose is significantly higher than that in other countries. It is necessary to optimize the abdominal CT scanning protocol.

Clinical analysis of female urethral diverticulum resection and reconstruction under Jacknife position / 中华泌尿外科杂志

Objective@#To explore the clinical efficacy of female urethral diverticulum resection and reconstruction under the folding position.@*Methods@#Retrospective analysis of 22 female patients with urethral diverticulum was performed from September 2010 to December 2018. There were 12 cases of simple diverticulum, 6 cases of horseshoe diverticulum, 4 cases of circumferential diverticulum, aged from 26 to 72 years, with an average of 46.2 years, whose BMI ranged from 24.2 to 34.8 kg/m2, with an average of 30.4 kg/m2. Eleven cases (50%) presented with dysuria, 10 cases (45.5%) with repeated urinary tract infections, 7 cases (31.2%) with difficulty of voiding, 10 cases (45.5%) with urethral secretion, 9 cases (40.1%) with difficulty of sexual intercourse, and 4 cases (18.2%) without symptoms. Unlike the traditional surgical procedure under the lithotomy position, the folding position was used to expose the vagina and separate the vaginal mucosa by longitudinal incision, and the diverticulum was completely removed to the neck. The peri-operative complications and efficacy were recorded.@*Results@#All 22 cases underwent successful procedures, and were followed up for 25.2 months on average (ranged 8 to 42 months). One of them suffered from weak stream 2 months after operation, with residual urine volume of 100ml by ultrasonography. Her symptoms improved after dilatation of the urethra. Two cases suffered from different degrees of lower urinary tract storage symptoms 1 month after the operation (1 case of mild dysuria and 1 case of urinary tract infection), who improved after oral administration of levofloxacin tablets for 3-5 days. All patients had no urethral diverticulum recurrence 3 months later by ultrasonography, half a year by cystoscopy, and every six months by ultrasonography.@*Conclusions@#Surgical treatment is still the best choice for patients with urethral diverticulum. The success rate of transvaginal urethral diverticulum reconstruction with a Jackknife position is high, postoperative recurrence rate is low, and postoperative complications are few.