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Objective:To investigate the clinical efficacy of radical resection of rectal cancer with different surgical approaches and influencing factors of postoperative complications.Methods:The retrospective study was conducted. The clinicopathological data of 3 418 patients who underwent radical resection of rectal cancer in the Second Affiliated Hospital of Harbin Medical University from July 2011 to September 2020 were collected. There were 2 060 males and 1 358 females, aged (61±11)years. Patients meeting the requirements of radical resection and surgical indications underwent surgeries choosing from open radical colorectal cancer surgery, laparoscopic radical colorectal cancer surgery, and natural orifice specimen extraction surgery (NOSES). Observation indicators: (1) intraoperative and postoperative conditions of patients undergoing different surgical approaches; (2) comparison of preoperative clinical characteristics in patients undergoing different surgical approaches; (3) comparison of postoperative histopathological characteristics in patients undergoing different surgical approaches; (4) postoperative complications of patients undergoing different surgical approaches; (5) analysis of influencing factors of postoperative complications. Measurement data with normal distribution were represented as Mean± SD. Measurement data with skewed distribution were represented as M(range), and comparisons between groups was analyzed using the Kruskal-Wallis rank test. Comparison of ordinal data was analyzed using the non-parameter rank sum test. Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test. Multivariate analysis was conducted using the Logistic regression model. Results:(1) Intraoperative and postoperative conditions of patients undergoing different surgical approaches. Of the 3 418 patients, 1 978 cases underwent open radical colorectal cancer sur-gery, 1 028 cases underwent laparoscopic radical colorectal cancer surgery and 412 cases underwent NOSES, respectively. The operation time, volume of intraoperative blood loss, cases with permanent stoma, preventive stoma or without fistula, time to postoperative first flatus, time to postoperative liquid food intake, cases transferred to intensive care unit after surgery, duration of postoperative hospital stay were 145(range, 55?460)minutes, 100(range, 30?1 000)mL, 435, 88, 1 455, 72(range, 10?220)hours, 96(range, 16?296)hours, 158, 10(range, 6?60)days, respectively, in patients undergoing open radical colorectal cancer surgery. The above indicators were 175(range, 80?450)minutes, 50(range, 10?800)mL, 172, 112, 744, 48(range, 14?120)hours, 72(range, 38?140)hours, 17, 9(range, 4?40)days, respectively, in patients undergoing laparoscopic radical colorectal cancer surgery and 180(range, 80?400)minutes, 30(range, 5?500)mL, 0, 45, 367, 48 (range, 14?144)hours, 72(range, 15?148)hours, 1, 6(range, 3?30)days, respectively, in patients undergoing NOSES. There were significant differences in the above indicators among the patients undergoing different surgical approaches ( H=291.38, 518.56, χ2=153.82, H=408.86, 282.97, χ2=78.66, H=332.30, P<0.05). (2) Com-parison of preoperative clinical characteristics in patients undergoing different surgical approaches. The gender, age, body mass index, cases with diabetes, cases with hypertension, cases with coronary heart disease, cases with anemia, cases with hypoproteinemia, cases with intestinal obstruction, tumor location, preoperative carcinoembryonic antigen, preoperative CA19-9 showed significant differences among patients undergoing open radical colorectal cancer surgery, laparoscopic radical colorectal cancer surgery and NOSES ( P<0.05). (3) Comparison of postoperative histopathological characteris-tics in patients undergoing different surgical approaches. Tumor histological type, tumor differentiation degree, tumor diameter, number of lymph node detected, nerve invasion, vascular invasion, lymph node invasion, tumor T staging, tumor N staging, tumor M staging, tumor TNM staging showed significant differences among patients undergoing open radical colorectal cancer surgery, laparos-copic radical colorectal cancer surgery and NOSES ( P<0.05). (4) Postoperative complications of patients undergoing different surgical approaches. Cases with postoperative complications as anastomotic leakage, abdominal infection, intestinal obstruction, anastomotic bleeding, incision complications, pulmonary infection, other complications were 52, 21, 309, 8, 130, 51, 59, respectively, in patients undergoing open radical colorectal cancer surgery. The above indicators were 33, 17, 75, 3, 45, 58, 9, respectively, in patients undergoing laparoscopic radical colorectal cancer surgery and 13, 4, 8, 0, 11, 10, 15, respectively, in patients undergoing NOSES. There were significant differences in the intes-tinal obstruction, incision complications, pulmonary infection, other complications among patients undergoing different surgical approaches ( χ2=122.56, 13.33, 20.44, 15.59, P<0.05) and there was no significant difference in the anastomotic leakage, abdominal infection, anastomotic bleeding among patients undergoing different surgical approaches ( χ2=0.96, 2.21, 3.08, P>0.05). (5) Analysis of influencing factors of postoperative complications. ① Analysis of influencing factors of intestinal obstruction in patients with radical resection of rectal cancer. Age as 20?39 years and 40?59 years, surgical approach as laparoscopic radical colorectal cancer surgery and NOSES were independent protective factors of intestinal obstruction in patients with radical resection of rectal cancer ( odds ratio=0.46, 0.59, 0.43, 0.13, 95% confidence interval as 0.21?1.00, 0.36?0.96, 0.33?0.56, 0.06?0.27, P<0.05). ② Analysis of influencing factors of incision complications in patients with radical resection of rectal cancer. Body mass index as 24.0?26.9 kg/m 2, surgical approach as laparoscopic radical colorectal cancer surgery and NOSES were independent protective factors of incision complications in patients with radical resection of rectal cancer ( odds ratio=0.24, 0.63, 0.46, 95% confidence interval as 0.11?0.51, 0.44?0.89, 0.24?0.87, P<0.05). ③ Analysis of influencing factors of pulmonary infection in patients with radical resection of rectal cancer. The surgical approach as laparoscopic radical colorectal cancer surgery was an independent risk factor of pulmonary infection in patients with radical resection of rectal cancer ( odds ratio=2.15, 95% confidence interval as 1.46?3.18, P<0.05), and tumor TNM staging as 0?Ⅰ stage was an independent protective factor ( odds ratio=0.10, 95% confidence interval as 0.01?0.88, P<0.05). ④ Analysis of influencing factors of other complica-tions in patients with radical resection of rectal cancer. Age as 20?39 years, 40?59 years, 60?79 years, body mass index as <18.5 kg/m 2, 18.5?23.9 kg/m 2, 24.0?26.9 kg/m 2, 27.0?29.9 kg/m 2, surgical approach as laparoscopic radical colorectal cancer surgery were independent protective factors of other complications in patients with radical resection of rectal cancer ( odds ratio=0.10, 0.29, 0.37, 0.08, 0.22, 0.35, 0.32, 0.29, 95% confidence interval as 0.01?0.81, 0.13?0.64, 0.17?0.78, 0.02?0.40, 0.09?0.52, 0.15?0.83, 0.12?0.89, 0.14?0.59, P<0.05). Conclusions:Compared to laparoscopic radical colorectal cancer surgery and NOSES, open radical colorectal cancer surgery has wide indication and short operation time, but less perioperative treatment effect. Laparoscopic radical colorectal cancer surgery and NOSES can achieve better surgical result and less postoperative complication when patients meeting surgical indications.
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The prognostic nutritional index (PNI) is an immune-nutritional index that contains both albumin and lymphocytes. The use of PNI to investigate the nutritional and immune status of patients before surgery to predict postoperative complications, prognosis and recurrence of colorectal cancer has important clinical significances. This review summarizes the application value of PNI in prognostic assessment after radical resection of colorectal cancer.
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Smart wearable devices play an increasingly important role in physiological monitoring and disease prevention because they are portable, real-time, dynamic and continuous.The popularization of smart wearable devices among people under high-altitude environment would be beneficial for the prevention for heart and brain diseases related to high altitude. The current review comprehensively elucidates the effects of high-altitude environment on the heart and brain of different population and experimental subjects, the characteristics and applications of different types of wearable devices, and the limitations and challenges for their application. By emphasizing their application values, this review provides practical reference information for the prevention of high-altitude disease and the protection of life and health.
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Humanos , Altitude , Encefalopatias , Coração , Monitorização Fisiológica , Dispositivos Eletrônicos VestíveisRESUMO
Objective:To analyze the composition differences of intestinal microbiota in patients with colon cancer and rectal cancer.Methods:The fecal samples of 72 patients in the Second Affiliated Hospital of Harbin Medical University from July 2018 to January 2019 were collected, and they were divided into colon cancer group and rectal cancer group, 36 cases in each group. DNA from fecal samples was extracted, and then high-throughput sequencing was performed on DNA. Bioinformatics was used to analyze the diversity and composition differences of intestinal microbiota between the two groups, and the potential cancer-promoting mechanisms of the differential flora were also discussed.Results:From high-throughput sequencing, 2 356 560 original sequences and 32 730 high-quality sequences were obtained from 72 samples. The average length of the sample sequence was mainly in the interval of 401-460 bp. And 1 409 operational taxonomic units (OTU) were acquired after OTU species taxonomy annotation of all the sequences. Alpha diversity analysis showed that Shannon index of the rectal cancer group and the colon cancer group was 2.61±0.56 and 2.43±0.67, respectively, and the difference was statistically significant ( t = 1.229, P = 0.223); Simpson index of the rectal cancer group and the colon cancer group was 0.17±0.09 and 0.21±0.16, respectively, and the difference was statistically significant ( t = 1.449, P = 0.151). Differences analysis of both groups and linear discriminant analysis (LDA) showed at the phylum level, Firmicutes were more abundant in the intestine of patients with rectal cancer (LDA = 4.67, P = 0.014), while Proteobacteria were more abundant in the gut of colon cancer patients (LDA = 4.49, P = 0.042). From the perspective of class level, the abundance of Gammaproteobacteria was higher in the intestine of patients with colon cancer (LDA = 4.50, P = 0.033), while the abundance of Erysipelotrichia was higher in the intestine of patients with rectal cancer (LDA = 3.50, P = 0.035). At the order level, the abundance of Erysipelotrichales was higher in the intestine of patients with rectal cancer (LDA = 3.50, P = 0.035); at the family level, the abundance of Porphyromonadaceae was higher in the intestine of patients with rectal cancer (LDA = 3.97, P = 0.033). Conclusion:The compositions of intestinal microbiota in patients with colon cancer and rectal cancer are significantly different, indicating that the different floras may contribute to the progression of colon cancer and rectal cancer.
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Objective@#To analyze the status of domestic surgical treatment of synchronous peritoneal carcinomatosis from colorectal cancer in China.@*Methods@#Clinicopathological data of patients who underwent surgery from October 2003 to October 2018 in 16 domestic medical centers was retrospectively analyzed. Excel database was created which covered 77 fields of 7 parts: baseline information of patients, laboratory tests, imaging tests, chemoradiotherapy information, intra-operative findings, postoperative pathology and follow-up data. The Wilcoxon rank-sum test was used for comparison of the measurement data between groups. The χ2 test was used for comparison of the categorical data between groups. The survival curve was calculated by the Kaplan-Meier method.@*Results@#Of the 1 003 patients, there were 575 male and 428 female patients with the age of (58.5±14.1) years (range: 18 to 92 years). In a total of 920 patients, the carcinoma of sigmoid colon was performed in 292 cases (31.8%) with the highest ratio. The proportion of patients with liver metastasis and lung metastasis were 27.9% (219/784) and 8.3% (64/769). Preoperative detection of carcino-embryonic antigen level was the most common method in China (87.74%, 880/1 003), and the positive rate was 64.5% (568/880). The correct rate of preoperative imaging tests was 40.7% (280/688). The ratio of peritoneal carcinomatosis index (PCI) scores between 0 and 10 was the highest (59.6%, 170/285). Two hundred and sixty-two (27.0%) patients were performed by totally laparoscopic operation in 971 patients. The resection of primary tumor was performed in 588 of the 817 patients (72.0%). In a total of 457 cases, 253 (55.4%) patients were performed cytoreduction which group scored completeness of cytoreduction (CCR) 0. The postoperative hyperthermic intraperitoneal chemotherapy was implemented in 70 of the 334 cases (21.0%). Among 1 003 cases, 562 cases (56.03%) had complete follow-up data and the median overall survival was 15 months. The primary tumor resection and the CCR scores were affected by the PCI scores. The patients underwent primary tumor resection (187/205 vs. 26/80, χ2=105.085, P=0.000) and the patients were performed cytoreduction which scored CCR 0 or CCR 1 (162/204 vs. 8/78, Z=-10.465, P=0.000) had significant difference between the groups of PCI<20 and ≥20. There was a close correlation between the surgical method and the CCR scores (Z=-3.246,P=0.001).When the maximum degree of tumor reduction was planned, most surgeons would choose laparotomy. The overall survival time was longer in patients with primary tumor resection (P=0.000). The median survival time was 18.6 months in the group of primary tumor resection.@*Conclusions@#It is difficult to diagnose the synchronous peritoneal carcinomatosis from colorectal cancer before the operation. Primary tumor resection has an obvious effect to prolong the survival time. It is necessary to standardize the treatment of peritoneal metastasis.
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With the improvement of living standard and the change of diet structure,the incidence of multiple primary carcinoma has increased significantly,which is related to the improvement of diagnosis level.In clinical work,multiple primary carcinoma was easily misdiagnosed with metastatic cancer.Many patients lost their best time to treat,because principles and prognosis of them were distinctly different.Strengthen the understanding of multiple primary carcinoma,in order to detect,diagnose and treat earlier,is beneficial to improve the survival of patients.Based on this background,this article reviewed the epidemiology,etiology,pathogenesis,diagnosis and treatment strategies of multiple primary carcinoma,aiming at improving the prognosis of patients.
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Objective To explore the 5-aminolevulinic acid (5-ALA) mediated photodynamic therapy (PDT) for proliferation and apoptosis of gastric cancer cell line MKN-45.Methods The human gastric cancer cell line MKN-45 was cultured in vitro.The MTT method was used to detect fixed lighting processing (laser radiation dose fixed for 25.00 J/cm2,5-ALA photosensitizer concentrations were 0 mmol/L,0.25 mmol/L,0.50 mmol/L,1.00 mmol/L,2.00 mmol/L),fixed photosensitizer concentration treatment (5-ALA photosensitizer concentrations fixed to 1.00 mmol/L,laser radiation dose were 0 J/cm2,6.25 J/cm2,12.50 J/cm2,25.00 J/cm2,50.00 J/cm2,100.00 J/cm2) of the cell apoptosis rate,and then fixed 5-ALA photosensitizer 1 mmol/L and selected the control group,5-ALA group,pure illumination group and PDT group.The promoting effect on cell apoptosis was determined by MTT,electron microscope and flow cytometry.The activity of human gastric cancer cells MKN-45 apoptosis related proteins p65 and the downstream gene regulatory protein bcl-2,bax,caspase-3 and caspase-9 were detected by using Western blot method.Results When laser radiation dose was fixed,5-ALA photosensitizer concentrations in promoting gastric cancer cell apoptosis was positively related to the dominant (P ＜ 0.01).When 5-ALA photosensitizer concentration was fixed,laser radiation dose effect had no longer dominant after 25.00 J/cm2 positive correlation (P =0.613).When 5-ALA photosensitizer concentration was fixed in 1 mmol/L,compared to control group,5-ALA group and pure illumination group,the inhibition of the MKN-45 cell proliferation in PDT group was more apparently,apoptosis rate increased obviously,signal pathways in cell apoptosis protein involved in the NF-kappa B p65 expression was reduced,the downstream gene regulation of target protein bcl-2,caspase-3 and caspase-9 expression were reduced,and bax protein expression was increased.Conclusions 5-ALA mediated photodynamic has a strong inhibitory effect on the growth of gastric cancer cell line MKN-45 in vitro.It can significantly increase the apoptosis rate of gastric cancer cells,and the effect may be carried out by activating the NF-kappa B pathway.
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Objective To analyze the clinical distribution ,antimicbial resistance and Staphylococcal cassette chromosome mec (SCCmec) genotype characteristics of 346 methicillirrresistant Staphylococcus aureus (MRSA) clinical isolates in the hospital . Methods A total of 784 strains of Staphylococcus aureus isolated from January 2014 to January 2015 in the hospital ,MRSA identi-fication and the SCCmec genotype was conducted by PCR assay .Results 346 strains of MRSA (44 .13% ) were isolated from 784 strains of Staphylococcus aureus ,the detection rate of MRSA from sputum accounted for 43 .06% ,the secretion accounted for 48 .55% .MRSA was resistant to penicillin ,levofloxacin and erythromycin ,sensitive to vancomycin ,linezolid and teicoplanin .SCC-mec genotyping result showed that SCCmecⅡ was identified in 130 ,SCCmecⅢ in 196 ,SCCmecⅣ in 11 ,SCCmecⅤ in 9 .Conclusion SCCmecⅢ is the main genotypes of MRSA from our Hospital ,all of the MRSA strains are multi-resistant to tested antibiotics , but sensitive to vancomycin and teicoplanin .
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Objective To evaluate the significance of the expression of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) as prognostic indicators for patients with stage Ⅱ colorectal cancer. Methods A total of 285 patients with stage Ⅱcolorectal cancer who underwent potentially curative surgery were enrolled in the study. A high CEA level was defined as a level exceeding 5 ng/ml and a high CA19-9 level was defined as a level exceeding 37 U/ml. Patients were followed up every 3 months to review CEA and CA19-9 levels. Two years later, the chest and abdominal CT examination were performed every 3 months, and then every 6 months until 5 years. Results Out of these 285 patients, 99 (42.60%) patients had high CEA levels, 25 (8.77 %) patients had high CA19-9 levels, and 12 (4.21 %) patients had both high CEA and CA19-9 levels. The overall survival rates of patients with both high CEA and CA19-9 levels were significantly worse than those of others (P< 0.05). During the study, 51 recurrences were diagnosed. There were 22 hepatic recurrences, 10 pulmonary recurrences, 9 local recurrences, 8 lymph node recurrences, and 2 peritoneal recurrences. CT, CEA and CA19-9 were the first abnormal examinations in 30, 5 and 8 recurrent patients, respectively. In 27 % of recurrent patients, the recurrence was detected earlier by CEA and CA19-9 than that by CT. Conclusions The detection of preoperative CEA and CA19-9 levels is useful for predicting the prognosis after potentially curative surgery in patents with stage Ⅱ colorectal cancer. For early detection of occult recurrence of colorectal cancer, tumor markers are relevant.
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It is important for patients with colorectal cancer to receive standard and reasonable treatment. There are many clinical practice guidelines for diagnosis and treatment of colorectal cancer. However, the most influential guidelines are NCCN, ESMO and NICE guidelines. NCCN guidelines are the most world-renowned guidelines from National Comprehensive Cancer Network of the United States; ESMO guidelines are promulgated by the European Society for Medical Oncology; NICE guidelines are guidance of diagnosis and management for colorectal cancer issued by the National Institute for Health and Care Excellence of the United Kingdom. They are very similar in case management and treatment principles. However, there are still some differences in indications for drugs, treatment of hereditary colorectal cancer, laparoscopy indication and management of ileus. Here we discuss some of these differences and provide a reference for standardization of colorectal cancer treatment in China.
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Objective To assess the feasibility and short-term effect of transanal everted extraction of laparoscopic rectal excision without abdominal incision.Methods Eleven patients were operated by transanal everted extraction of laparoscopic rectal excision without abdominal incision.Results All the operations were accomplished successfully,the average operative duration was (189.5±25.2) min,the intra-operative blood loss volume was (25.4±9.4) ml,the average time to flatus was (38.9±8.6) h,the average postoperative hospital stay was (12.7±2.5) d,and the number of lymph nodes harvested was 13.5±4.1.There were no post-operative complications.Conclusion The technique of transanal everted extraction of laparoscopic rectal excision without abdominal incision is safe and feasible,but the long-term effects need more observation.
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As the improved understanding of the biological behavior of colorectal cancer and the development of diagnosis and surgical techniques,the prognosis of patients with locally advanced colorectal cancer has been improved significantly.Locally advanced colorectal cancers are best treated with multivisceral resections,but the procedure is high technique-demanding and the indications for the procedure should be strictly followed.In this article,the procedure of right colectomy combined with pancreatoduodenectomy for colon cancer was described in detail in order to share the experiences and skills with surgeons.
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ObjectiveTo study the expression of growth factor receptor binding protein 2(GRB2) in bladder transitional cell carcinoma (BTCC),and clarify the role of GRB2 in the development and progression of BTCC.MethodsThe GRB2 expression of BTCC tissue from 60 patients who first got BTCC (BTCC group) and adjacent normal bladder from 30 patients(control group) were detected by SP immunohistochemical method.ResultsThe GRB2 positive expression rate of BTCC group [81.7％(49/60)] was significantly higher than that of control group [30.0％(9/30)] ( X2 =12.122,P ＜0.05).According to tumor histological grade,the GRB2 positive expression rate was grade Ⅰ[66.7％( 16/24)] ＜gradeⅡ [89.3％(17/19)] ＜grade Ⅲ [94.1％(16/17)],grade Ⅰ and grade Ⅱ,Ⅲ had significant difference (P ＜0.05),but grade Ⅱ and grade Ⅲ had no significant difference(P ＞0.05).The GRB2 positive expression rate in the clinical stage was stage T1 [63.0％ (17/27)]＜ stage T2 [95.7％ (22/23)] ＜ stage T3[ 100.0％(10/10) ],stage T1 and stage T2,T3 had significant difference (P ＜ 0.05 ),but stage T2 and stage T3 had no significant difference (P ＞0.05).The GRB2 expression among different gender and age had no significant difference (P ＞0.05).ConclusionsGRB2 has high expression in BTCC tissues.GRB2 expression is related to tumor histological grade andclinical stage.GRB2 plays an important role in the process of BTCC cell proliferation and differentiation.
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ObjectiveTo investigate the clinical difference of ondansetron,metoclopramide and haloperidol in the prevention of postoperative nausea and vomiting after neurosurgery.MethodsNinety patients with neurosurgery were divided by random digits table method into four groups:control group ( 18 cases ) treated with 10 ml 0.9％ sodium chloride ;ondansetron group(24cases ) received ondansetron 4 mg;metoclopramide group (24 cases) with metoclopramide 10 mg and haioperidol group (24 cases) with haloperidol 2.5 mg.The efficacy and adverse reaction were compared among four groups.Results Compared with control group,ondansetron,metoclopramide and haloperidol could obviously inhibit the occurrence of postoperative nausea and vomiting after neurosurgery,the difference had statistical significance (P＜ 0.05).Total effective rate of ondansetron group [79.2％( 19/24)] was significantly higher than that of metoclopramide group [ 58.3％ ( 14/24 ) ] and haloperidol group [ 54.2％ ( 13/24 ) ] (P ＜ 0.05 ).And total effective rate of metoclopramide group and haloperidol group had no significant difference (P ＞ 0.05 ).The occurrence rate of adverse reaction of metoclopramide group [ 16.7％(4/24)] had no statistical significance compared with that of ondansetron group[8.3％(2/24)] and haloperidol group[ 12.5％(3/24)] (P ＞ 0.05).ConclusionsOndansetron,metoclopramide and haloperidol can obviously inhibit the occurrence of postoperative nausea and vomiting after neurosurgery,and the effect of ondansetron is significantly better than that of metoclopramide and haloperidol.Therefore,it is necessary to use drugs for preventing postoperative nausea and vomiting for patients during neurosurgery.
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Objective To summarize the current status and development of therapy for anal canal cancer. Methods Application of Medline database and CHKD database, with "anal canal cancer", "chemotherapy", "radiotherapy", "abdominoperineal resection" as key words search literature about anal canal cancer published from January 1996 to June 2009. Retrieval criteria: the epidemiology of anal canal cancer; the etiology of anal canal cancer; the clinical manifestation and classification of anal canal cancer; strategies and development of therapy for anal canal cancer. Sixty-seven of them met the retrieval criteria, while finally 22 related papers were analyzed. Results Over the last 30 years, treatment of anal canal cancer has undergone a profound evolution. Combined-modality treatment combined with chemoradiotherapy (CRT), including three-dimensional conformal radiation therapy (3D-CRT), intensity modulated radiation therapy (IMRT), novel anti-tumor agent and salvage surgery, had resulted in a 5-year survival rate of approximately 80 %. Conclusion Anal canal cancer is a rare tumor. CRT has replaced surgery as the first choice of anal canal cancer. The development of molecular biology will likely lead to further proposals for trials of anal canal cancer.
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OBJECTIVE To study the mutation profiles of hepatitis B virus(HBV) in the core regions.METHODS Based on the sequence alignment of all HBV genotypes,specific primers targeting all HBV genotypes were designed to amplify the core region of HBV followed by sequence analysis on the sequencing data available.RESULTS Among the 34 cases,23 cases showed mutations in the core region.According to the mutation profiles,the most common mutations were the A1762T(50.0%) and G1764A(52.9%) in the basic core promoter(BCP) regions,and it always showed as double mutations.The L60V in core gene regions was the secondary common mutations(17.6%).Among all patients,there were 18,6 and 10 cases showed mutations in BCP,pre-core,and core gene regions,respectively.The most common mutations in BCP,pre-core,and core gene regions were the double mutations at A1762T and G1764A(94.7%),G1896A(83.3%),and L60V(50.0%),respectively.CONCLUSIONS The most common mutations in the core region of HBV are the double mutations at A1762T and G1764A.Analysis on the mutation profiles of HBV core regions might be helpful for the prognosis and prediction of HBV infections.
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300 ?m ) damage when the islets are rewarmed to 37 ℃ . These novel findings may help to understand the pathophysiology of early loss of islet tissue after transplantation,and may provide a new strategy to improve graft function in the clinical setting of islet transplantation.
