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1.
Zhonghua Wai Ke Za Zhi ; 59(11): 912-917, 2021 Nov 01.
Artigo em Chinês | MEDLINE | ID: mdl-34743453

RESUMO

Objective: To examine the clinical application effects of two-complex and one-plane technique for the renal artery dissected location in transperitoneal laparoscopic radical nephrectomy(LRN). Methods: Clinical data of patients diagnosed as renal tumor between January 2016 and December 2019 that treated with transperitoneal LRN and the two-complex and one-plane technique was performed to locate and dissect the renal arteries were analyzed retrospectively. A total of 206 qualified patients were enrolled, included 71 cases from Kaifeng Central Hospital and 135 cases from the First Affiliated Hospital of Zhengzhou University. There were 126 males and 80 females with median age of 54 years (range: 35 to 82 years). Renal tumor lived at left kidney in 102 cases and at the right in 104 cases, with a maximum tumor diameter of (6.8±2.5)cm (range: 3.0 to 12.7 cm). During the procession of transperitoneal LRN, The genital veins was followed to locate renal veins, soon the renal vein complex and renal lower pole complex and psoas major muscle plane that named as "two-complex and one-plane"anatomical markers were applied to the dissected location of renal arteries. The established application of two-complex and one-plane technique for renal artery location, and the anatomical features along with its locational time of renal artery, as well as vascular-related complications were recorded and analysed. The χ2 test or t test was used to compare the results of different lateral operations. Results: The surgical procedures were successful in all 206 patients. The operation time was (54.4±13.6) minutes (range:22 to 116 minutes), no injury to liver, spleen or intestine. Two-complex and one-plane technique was used to complete renal arteries location of 206 patients that accompanied with one or more arterial branch in the procession of transperitoneal LRN. Single renal artery branch was found in 163 cases, two or more renal artery branches were found in 43 cases, and 60 branches of accessory renal artery that in addition to the main trunks were detected in 14 cases (13.7%, 14/102) on left-side and 29 cases (27.9%, 29/104) on the right(χ²=6.251, P=0.012).The main branch of renal artery that directly been located inferior or posterior to renal vein in 165 cases, and the other 41 cases that born with higher-position of main branch been located through an upper"window-opening"of renal veins complex. Of the 60 accessory renal artery, 46 branch (76.6%, 46/60) been located inferior or posterior to renal veins, and the other 14 branch with higher-position (23.3%, 14/60) been located by a"window-opening"technique. The renal artery dissected location time was (21.2±9.4) minutes (range:11 to 43 minutes) in left-side and (17.5±9.3) minutes (range:9 to 32 minutes) in the right (t=2.840, P=0.005).The intraoprative bleeding was (51.8±25.2) ml (range:20 to 400 ml). There were 4 cases of vascular injury occured and treated with laporoscopy, only one need blood transfusion. Conclusions: The anatomical markers of renal vein complex and renal lower pole complex and psoas major muscle plane that can apply to locate various anatomical position types of renal artery in transperitoneal LRN effectively. The exactly application of two-complex and one-plane technique that could shorten the operational time of renal artery location and reduce the complications of vascular injury.


Assuntos
Neoplasias Renais , Laparoscopia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Neoplasias Renais/cirurgia , Masculino , Pessoa de Meia-Idade , Nefrectomia , Artéria Renal/cirurgia , Estudos Retrospectivos
2.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 56(11): 1150-1157, 2021 Nov 07.
Artigo em Chinês | MEDLINE | ID: mdl-34749453

RESUMO

Objective: To compare the recovery and quality of life of patients with oral and oropharyngeal tumors treated with three kinds of free soft tissue flaps. Methods: The clinical data of 103 patients, including 66 males and 37 females, aged 26-74 years, who underwent primary repair of defects after resection of oral and oropharyngeal tumors in Sichuan Tumor Hospital from July 2014 to August 2020 were analyzed. Anterolateral thigh flap (ALTF) was used in 43 patients, radial forearm free flap (RFFF) in 45 patients, and lateral arm free flap (LAFF) in 15 patients. Postoperative qualities of life of patients were evaluated by the university of Washington quality of life questionnaire and oral health impact scale (HIP-14 Chinese edition). SPSS 23.0 software was used for statistical analysis. Results: The T staging of RFFF or LAFF group was significantly lower than that of ALTF group (P<0.05). There was no significant difference in mean flap areas between ALTF group ((55.87±27.38) cm2) and LAFF group ((49.93±19.44) cm2), while RFFF group had smaller mean flap area ((33.18±6.05) cm2) than ALTF group (t=5.311, P<0.001) and LAFF group (t=3.284, P=0.005). In terms of oral functions including swallowing, mastication, taste and spitmouth, there were no significant differences between LAFF group and RFFF group (P>0.05), but both groups had better oral functions than ALTF group (P<0.05). There was no significant difference in appearance scores between LAFF group (75(75, 75)) and ALTF group (75(75,75) vs.75(75,75),Z=-1.532, P=0.126), and both groups had higher scores than RFFF group (50(50, 75),Z values were -3.447 and -3.005 respectively, P<0.05). RFFF group had higher speech score (100(67, 100)) than LAFF group (67(50, 76),Z=-2.480, P<0.05) and ALTF group (67(33, 67),Z=-5.414, P<0.05). ALTF group had lower mean score of quality of life than RFFF group [72(56,77) vs.79(69, 89),Z=-3.070, P<0.05), but there was no statistical difference in the mean scores of qualities of life between ALTF group and LAFF group (Z=1.754, P=0.079). According to the evaluation of oral health impact scale (HIP-14 Chinese version) 1 year after surgery, individual item scores and the average score of all items in ALTF group were lower than those in RFFF and LAFF groups (P<0.05), with no significant difference between RFFF group and LAFF group (P>0.05). Conclusions: RFFF has unique advantages for small tissue defects, while ALTF is suitable for large tissue defects, such as buccal penetrating defect, whole tongue and near whole tongue defect, and LAFF is a compromise choice between ALTF and RFFF. ALTF is inferior to RFFF and LAFF in oral functional reconstruction, including swallowing, chewing, taste and spittle. ALTF and LAFF are superior to RFFF in postoperative appearance.


Assuntos
Retalhos de Tecido Biológico , Neoplasias Orofaríngeas , Procedimentos Cirúrgicos Reconstrutivos , Feminino , Antebraço/cirurgia , Humanos , Masculino , Neoplasias Orofaríngeas/cirurgia , Qualidade de Vida , Coxa da Perna/cirurgia
3.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 33(5): 457-463, 2021 Oct 27.
Artigo em Chinês | MEDLINE | ID: mdl-34791842

RESUMO

OBJECTIVE: To evaluate the impact of water pollutants, water levels and meteorological factors on the Oncomelania hupensis density in Eastern Dongting Lake regions, so as to provide insights into schistosomiasis control. METHODS: O. hupensis snails were surveyed using a systematic sampling method in snail-infested marshlands in Eastern Dongting Lake regions from 2007 to 2014, and data pertaining to water pollutants, water levels and meteorological factors were collected. The duration of submergence and the date of the start of submergence were calculated. The snail density and its influencing factors were descriptively analyzed, and a linear mixed model was generated to examine the impacts of variables on the snail density. In addition, smooth curves were fitted to investigate the relationship between snail density and variables. RESULTS: The snail density appeared a fluctuation in Eastern Dongting Lake regions during the period from 2007 to 2014, with the highest density on October, 2010 (52.79 snails/0.1 m2) and the lowest density on January 2009 (2.15 snails/0.1 m2). Linear mixed-model analysis showed that permanganate index, total phosphorus and the date of the start of submergence affected the snail density (t = 6.386, -2.920 and -3.892, all P values < 0.01). Smooth curve analysis revealed that the associations of the snail density with the permanganate index and total phosphorus appeared an approximately quadratic curve. After the end of April, the earlier date of the start of submergence resulted in a higher snail density. CONCLUSIONS: Permenganate index, total phosphorus and the date of the start of submergence affect the O. hupensis snail density in Eastern Dongting Lake regions.


Assuntos
Lagos , Esquistossomose , Animais , China , Caramujos , Água
4.
Br Poult Sci ; 2021 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-34797186

RESUMO

1. This study investigated the effects of dietary betaine supplementation on growth performance, meat quality, muscle fatty acid composition and antioxidant ability in slow-growing broiler chickens.2. In total, 400, one-day-old female Xueshan broiler chicks were randomly divided into five groups with eight replicates of ten chickens each for 102 days. Broilers were fed a basal diet supplemented with 0, 125, 250, 500 or 1,000 mg/kg betaine.3. Broilers fed betaine had better feed conversion efficiency and weight gain (P<0.05) and increased meat redness and yellowness 24 h after slaughter. Supplementation linearly decreased cooking loss and drip loss from breast muscle (P<0.05). Muscular resilience was improved and tenderness increased (P<0.05). Intra-muscular saturated fatty acids decreased, while total monounsaturated fatty acids and polyunsaturated fatty acids increased (P<0.05). Betaine increased activities of glutathione peroxidase (GPx) and total superoxide dismutase (SOD), glutathione (GSH) level, ratio of reduced glutathione/oxidised glutathione, and activity of scavenging hydroxyl radicals. It increased the activity of total antioxidant capacity (T-AOC) in the breast muscle (P<0.05). Moreover, supplementation up-regulated (P<0.05) mRNA expression levels of blood and antioxidant markers.4. In conclusion, 1000 mg/kg betaine can be recommended as a supplement for slow-growing, Xueshan chicken.

5.
Zhonghua Wei Chang Wai Ke Za Zhi ; 24(11): 962-968, 2021 Nov 25.
Artigo em Chinês | MEDLINE | ID: mdl-34823296

RESUMO

Objective: Radiotherapy is one of the standard treatments for pelvic malignant tumors. However, researches associated with intestinal radiation injury and the quality of life (QoL) of patients receiving radiotherapy were lacking in the past. This study aims to analyze the occurrence of radiation-induced rectal injury after adjuvant radiotherapy for pelvic malignant tumors and call for more attention on this issne. Methods: A retrospectively observational study was conducted. Case data of cervical cancer patients from the database of STARS phase 3 randomized clinical trial (NCT00806117) in Sun Yat-sen University Cancer Center were analyzed. A total of 848 cervical cancer patients who received adjuvant radiation following hysterectomy and pelvic lymphadenectomy in Sun Yat-sen University Cancer Center from February 2008 to August 2015 were recruited. The pelvic radiation dosage was 1.8 Gy/day or 2.0 Gy/day, five times every week, and the total dosage was 40-50 Gy. Among 848 patients, 563 patients received radiation six weeks after surgery, of whom 282 received adjuvant radiation alone and 281 received concurrent chemoradiotherapy (weekly cisplatin); other 285 patients received sequential chemoradiotherapy (paclitaxel and cisplatin). Acute adverse events, chronic radiation damage of rectum, and QoL were collected and analyed. The digestive tract symptoms and QoL were evaluated based on EORTC QLQ-C30 questionnaires at one week after surgery (M0), during adjuvant therapy period (M1), and at 12 months and 24 months after the completion of treatments (M12 and M24), respectively. Higher scores in the functional catalog and overall quality of life indicated better quality of life, while higher scores in the symptom catalog indicated severe symptoms and worse QoL. Chronic radiation rectal injury was defined as digestive symptoms that were not improved within three months after radiotherapy. Grading standard of acute adverse events and chronic radiation rectal injury was according to the gastrointestinal part of National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0 (NCI-CTCAE Version 4.0). Results: The mean total radiation dosage of 848 patients was (47.8±4.6) Gy. During adjuvant therapy, the common symptoms of acute intestinal dysfunction were nausea (46.0%, 390/848), vomiting (33.8%, 287/848), constipation (16.3%, 138/848) and abdominal pain (10.3%, 87/848). At M12 and M24, the number of 0 QLQ-C30 questionnaires collected was 346 and 250, respectively. QLQ-C30 questionnaires showed that the scores of nausea or vomiting, appetite decrease, diarrhea, constipation, etc. were improved obviously at M12 or M24 compared with those at M0 or during M1 (all P<0.05). As the extension of the follow-up time, the score of the overall QoL of patients gradually increased [M0: 59.7 (0.0-100.0); M1: 63.1 (0.0-100.0); M12: 75.2 (0.0-100.0); M24: 94.1 (20.0-120.0); H=253.800, P<0.001]. Twelve months after the completion of treatments, the incidence of chronic radiation rectal injury was 9.8% (34/346), mainly presenting as abdominal pain, constipation, stool blood, diarrhea, mostly at level 1 to 2 toxicity (33/34, 97.1%). One patient (0.3%) developed frequent diarrhea (>8 times/d), which was level 3 toxicity. Twenty-four months after all treatments, the incidence of chronic radiation rectal injury was 9.6% (24/250), which was not decreased significantly compared to that in the previous period (χ(2)=0.008, P=0.927). The symotoms of one patient with level 3 toxicity was not relieved. Conclusions: The common symptoms of patients with pelvic maligant tumors during postoperative adjuvant radiotherapy include nausea, vomiting, constipation, abdominal pain and diarrhea. These symptoms are alleviated obviously at 12 and 24 months after adjuvant radiotherapy, and the QoL is significantly improved. However, a few patients may develop chronic radiation rectal injury which is not improved for years or even decades, and deserves attention in clinical practice.


Assuntos
Neoplasias Pélvicas , Lesões por Radiação , Feminino , Humanos , Neoplasias Pélvicas/radioterapia , Qualidade de Vida , Dosagem Radioterapêutica , Radioterapia Adjuvante , Reto/cirurgia , Estudos Retrospectivos
6.
Zhonghua Wei Chang Wai Ke Za Zhi ; 24(11): 984-990, 2021 Nov 25.
Artigo em Chinês | MEDLINE | ID: mdl-34823299

RESUMO

Objective: To observe the incidence and treatment of radiation rectal injury complicated with anxiety, depression and somatic symptom disorder. Methods: A cross-sectional survey research method was carried out. Patients with radiation rectal injury managed by members of the editorial board of Chinese Journal of Gastrointestinal Surgery were the subjects of investigation. The inclusion criteria of the survey subjects: (1) patients suffered from pelvic tumors and received pelvic radiotherapy; (2) colonoscopy showed inflammatory reaction or ulcer in the rectum. Exclusion criteria: (1) patient had a history of psycho-somatic disease before radiotherapy; (2) patient was unable to use a smart phone, unable to read and understand the questions in the questionnaire displayed on the phone; (3) patient refused to sign an informed consent form. According to the SOMA self-rating scale, PHQ-15 self-rating scale, GAD-7 and PHQ-9 self-rating scale, the electronic questionnaire of "Psychological Survey of Radiation Proctitis" was designed. The questionnaire was sent to patients with radiation rectal injury managed by the committee through the WeChat group. Observational indicators: (1) radiation rectal injury symptom assessment: using SOMA self-rating scale, radiation rectal injury symptom classification: mild group (≤3 points), moderate group (4-6 points) and severe group (> 6 points); (2) incidence of anxiety, depression and physical disorder: using GAD-7, PHQ-9 and PHQ-15 self-rating scales respectively for assessment; (3) correlation of radiation rectal injury symptom grading with anxiety, depression, and somatic symptom disorder. Results: Seventy-one qualified questionnaires were collected, of which 41 (56.9%) were from Guangzhou. Among the 71 patients, 6 were males and 65 were females; the mean age was (55.7±9.3) years old and 48 patients (67.6%) were less than 60 years old; the median confirmed duration of radiation rectal injury was 2.0 (1.0, 5.0) years. (1) Evaluation of symptoms of radiation rectal injury: 18 cases of mild (25.4%), 27 cases of moderate (38.0%), and 26 cases of severe (36.6%). (2) Incidence of anxiety, depression and somatic disorder: 12 patients (16.9%) without comorbidities; 59 patients (83.1%) with anxiety, depression, or somatic disorder, of whom 2 patients only had anxiety, 1 patient only had depression, 9 only had somatic disorder, 2 had anxiety plus depression, 4 had anxiety plus somatic disorder, 2 had depression plus somatic disorder, and 40 had all three symptoms. (3) correlation of radiation rectal injury grading with anxiety, depression, and somatic symptom disorder: as compared to patients in mild group and moderate group, those in severe group had higher severity of anxiety and somatic symptom disorder (Z=-2.143, P=0.032; Z=-2.045, P=0.041), while there was no statistically significant difference of depression between mild group and moderate group (Z=-1.176, P=0.240). Pearson correlation analysis revealed that radiation rectal injury symptom score was positively correlated with anxiety (r=0.300, P=0.013), depression (r=0.287, P=0.015) and somatic symptom disorder (r=0.344, P=0.003). Conclusions: The incidence of anxiety, depression, and somatic symptom disorder in patients with radiation rectal injury is extremely high. It is necessary to strengthen the diagnosis and treatment of somatic symptom disorder, so as to alleviate the symptoms of patients with pelvic perineum pain and improve the quality of life.


Assuntos
Depressão , Qualidade de Vida , Idoso , Ansiedade , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reto , Inquéritos e Questionários
7.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(5): 941-947, 2021 May 10.
Artigo em Chinês | MEDLINE | ID: mdl-34814493

RESUMO

Infectious diseases are still one of the leading causes of morbidity and death globally, affecting public health and life, social and economic development, and even national security. Early detection focuses on detecting the abnormal information of infectious disease outbreaks or epidemics in a timely and sensitive way to conduct field investigation and verification. It is also a precursor to effective surveillance and early warning system. The effective surveillance and early warning system can fully and accurately understand the real conditions, driving forces, and transmission chain of the occurrence of a specific infectious disease outbreak and epidemic and put forward scientific and effective prevention and control strategies and measures. Due to the measurement of the resources support and the particular data collection value, it is not easy to obtain epidemiological, etiological, and other data information in a timely, complete and accurate manner. This paper summarized the theory and technology on early detection, effective surveillance, and early warning information on infectious diseases. It also integrated and utilized the multi-source data, including effective infectious disease surveillance and the country's early warning system, to better understand the outbreak epidemic, causes, risks, processes, and driving forces. Thus, it is possible to set up a sensitive, specific staging measurement innovative technical system to monitor, early warning, and timely respond to acute infectious diseases through multidisciplinary cooperation in China. It provides the basis for strengthening the surveillance and early warning of new emerging and major infectious diseases and public health emergencies, avoiding the spread of inadequate response to infectious disease, and preventing the resources waste of over-response.


Assuntos
Doenças Transmissíveis , Epidemias , China/epidemiologia , Doenças Transmissíveis/diagnóstico , Doenças Transmissíveis/epidemiologia , Surtos de Doenças , Humanos , Vigilância da População
8.
Lett Appl Microbiol ; 2021 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-34822723

RESUMO

Tomato yellow leaf curl disease which is caused by Tomato yellow leaf curl virus (TYLCV) is economically important and a widely spread tomato disease in China. Rapid and accurate detection methods are important in the control TYLCV. Here, a rapid method was developed to identify TYLCV on the basis of recombinase polymerase amplification (RPA) that can be visualized in 5 min using lateral flow dipsticks. The sensitivity and the specificity of this method were evaluated. This method can detect 0.5 pg DNA after 30 min at 37°C without any expensive instrumentation. In addition, it showed higher sensitivity than a PCR method when purified DNA was used. Moreover, the TYLCV was specifically detected, whereas other viruses infecting tomato produced negative results. The crude tomato extracts used in this assay has potential application in minimally equipped plant clinic laboratories. This method will facilitate the early and rapid detection of TYLCV for timely application of control measures.

9.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(11): 1989-1993, 2021 Nov 10.
Artigo em Chinês | MEDLINE | ID: mdl-34818845

RESUMO

Objective: To understand the incidence of HIV infections and associated factors among men who have sex with men (MSM) in Jiangsu province. Methods: Based on national AIDS sentinel surveillance in 2019, MSM from 13 cities in Jiangsu were recruited for questionnaire interview and laboratory testing during April to July, 2019. Seropositive samples were tested with Limiting-antigen avidity enzyme immunoassay to detect recent HIV infections. The incidence of HIV infection in MSM were calculated according to the formula and parameters from China CDC. Multivariable logistic regression analysis was used to identify factors associated with recent infection of HIV. Results: A total of 4 469 MSM were subjects and the incidence of HIV infection were 4.5% (95%CI: 3.4%-5.5%).Multivariate logistic regression analysis results showed that compared with these aged ≥40 years, recruitment ways from MSM venues, awareness of AIDS knowledge, non-unprotected anal sex in the past 6 months and non-syphilis infection, those who aged 18-24 years (aOR=2.083,95%CI:1.087-3.990), recruitment ways from VCT clinics (aOR=2.125,95%CI:1.175-3.843), unawareness of AIDS knowledge (aOR=2.456,95%CI:1.109-5.437), unprotected anal sex in the past 6 months (aOR=3.553,95%CI:2.143-5.889) and syphilis infection (aOR=2.414,95%CI:1.033-5.462) were higher risk of HIV infection. Conclusion: The new infection rates of HIV were high in MSM in Jiangsu province. Health education, condom use and HIV/syphilis screening promotions should therefore be top priority in the prevention and control of HIV infection in MSM.


Assuntos
Infecções por HIV , Minorias Sexuais e de Gênero , Sífilis , China/epidemiologia , Estudos Transversais , Infecções por HIV/epidemiologia , Homossexualidade Masculina , Humanos , Masculino , Prevalência , Fatores de Risco , Comportamento Sexual , Inquéritos e Questionários , Sífilis/epidemiologia
10.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 56(10): 992-997, 2021 Oct 09.
Artigo em Chinês | MEDLINE | ID: mdl-34619893

RESUMO

Objective: To evaluate the effect of extraction treatment on orthodontic patients with Stage Ⅳ/Grade C periodontitis. Methods: Eight orthodontic patients with Stage Ⅳ/Grade C periodontitis (3 males, 5 females, 25~38 years old) who had finished extraction treatment during January 2003 and December 2013 were included in the study. The patients accepted periodontal treatment and extraction orthodontic treatment in the Department of Periodontology and Department of Orthodontics at Peking University School and Hospital of Stomatology. Clinical examination records and periapical films of 34 teeth adjacent to extraction sites (TAES) and 34 teeth non-adjacent to extraction sites (TNES) were evaluated and compared. Probing depth (PD) and relative bone height (RBH) before and after orthodontic treatment were also compared. Results: No significant difference was found between PD of TAES and that of TNES (P>0.05). After orthodontic treatment, RBH of TAES was increased by 8.19% (-3.36%,14.01%) (P<0.05). RBH of TAES far from extraction sites was elevated by 7.73% (-1.52%, 21.55%)(P<0.05). Tooth resorption rate of TAES was 13.1% (1.3%, 23.9%)and TNES was 4.3% (-8.19%, 12.5%) after orthodontic treatment, and the difference was statistically significant. Conclusions: Under proper combined periodontal and orthodontic treatment, stability of periodontal status in patients with Stage Ⅳ/Grade C periodontitis can be maintained. Relative bone height of extraction sites can be elevated after orthodontic treatment.


Assuntos
Periodontite , Dente , Adulto , Assistência Odontológica , Feminino , Humanos , Masculino , Periodontia , Periodontite/terapia
11.
Zhonghua Yan Ke Za Zhi ; 57(10): 777-783, 2021 Oct 11.
Artigo em Chinês | MEDLINE | ID: mdl-34619949

RESUMO

Objective: To explore the incidence and age distribution of fundus abnormalities in pediatric patients aged 0-3 years in northwest China. Methods: A retrospective study of the clinical data of 8808 pediatric patients aged 0-3 years who underwent fundus examination with a wide-filed digital retinal imaging system and an indirect ophthalmoscope in our hospital from January 2008 to December 2019 were performed. There were 5092 males and 3716 females, with a median age of 1 month (range, 3 days to 3 years), a mean gestational age of 34.32 (SD 2.92) weeks (range, 24 to 42 weeks) and a mean birth weight of 2006.92 (SD 709.23) g (range, 490 to 5500 g), from Shaanxi Province (7415 cases, 84.18%), Gansu Province (770 cases, 8.74%), Ningxia Hui Autonomous Region (94 cases, 1.07%), Qinghai Province (53 cases, 0.60%), Xinjiang Uygur Autonomous Region (14 cases, 0.16%) and other neighboring areas (462 cases, 5.25%). The fundus condition of the enrolled pediatric patients was documented to calculate the annual detection rate. The joinpoint regression model was drawn to estimate the annual percent change and average annual percent change. The constituent ratios and age distribution of different types of fundus abnormalities were finally analyzed. Results: Fundus abnormalities were detected in 2 531 cases (28.74%). During the 12 years, the number of pediatric patients undergoing fundus examination each year in our center increased rapidly in the first 7 years, and then kept almost stable, while the number of fundus abnormality cases increased year by year. The positive detection rate showed an overall upward trend with an average annual percent change of +7.2%, and it was +30.09% from 2016 to 2019. Among all the pediatric patients with fundus abnormalities, there were 1 678 cases with developmental diseases (66.30%), 232 cases with hereditary diseases (9.16%), 140 cases with ocular tumor (5.53%), 64 cases with ophthalmic manifestations of systemic diseases (2.53%), 31 cases with ocular trauma (1.23%), 12 cases with infectious diseases or inflammation (0.48%) and 438 cases with other ocular abnormalities (17.31%). The top 5 abnormalities were retinopathy of prematurity (ROP; 1477 cases, 58.36%), gray patchy retinopathy (225 cases, 8.89%), retinal hemorrhage (157 cases, 6.20%), retinoblastoma (137 cases, 5.41%) and familial exudative vitreoretinopathy (77 cases, 3.04%). Fundus abnormalities varied with age. ROP, developmental diseases other than ROP, hereditary diseases, ocular trauma and infectious diseases were mostly detected in pediatric patients at 0-6 months old, while tumors were mostly detected after 1 year old. Conclusions: The detection rate of fundus abnormalities in the Department of Ophthalmology of Xijing Hospital of Air Force Medical University, a tertiary referral center in northwest China, increased notably year by year. The abnormalities were mainly developmental and hereditary lesions as well as of certain age distribution. They occurred with the highest frequency between birth and 6 months of age, in which ROP was in the ascendancy. Meanwhile, the detection rate of other developmental, hereditary and neoplastic disorders increased with age. Therefore, a comprehensive and objective understanding of the fundus disease in infants is essential. (Chin J Ophthalmol, 2021, 57: 777-783).


Assuntos
Doenças Retinianas , Criança , Pré-Escolar , China/epidemiologia , Feminino , Fundo de Olho , Idade Gestacional , Humanos , Lactente , Recém-Nascido , Masculino , Doenças Retinianas/diagnóstico por imagem , Doenças Retinianas/epidemiologia , Estudos Retrospectivos
12.
Artigo em Chinês | MEDLINE | ID: mdl-34624957

RESUMO

Nighteen people at a restaurant experienced dizziness headaches and other discomforts in six days. According to the description method, the time and location distribution were found to be concentrated. A second Investigation was conducted at the same time as the onset of the case, the test found that the carbon monoxide concentration of second floor up to 539 mg/m(3). The on-site testing found that when 2 steam generator in snack room on the first floor turned on, the carbon monoxide concentration on the top of elevator on the second floor was 1225.0 mg/m(3). After the accident, the restaurant replaced a steam generator, the carbon monoxide concentration on the top of the new and old steam generator were 350 mg/m(3) and >1 000 mg/m(3), respectively. After the steam generators were fitted with exhaust smoke pipe and exhasust hood, the carbon monoxide concentrations of on the top of the vegetable transfer elevator and the room on the second floor were both 0.4 mg/m(3), and there were no cases of recurrence. It was determined that this was a carbon monoxide poisoning incident caused by a high concentration of carbon monoxide emitted by the steam generators, which spread to the second floor of the private room through the vegetable transfer elevator.


Assuntos
Intoxicação por Monóxido de Carbono , Acidentes , Intoxicação por Monóxido de Carbono/epidemiologia , Intoxicação por Monóxido de Carbono/etiologia , Cefaleia , Humanos , Fumaça
13.
Phys Rev Lett ; 127(15): 152702, 2021 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-34678013

RESUMO

Fluorine is one of the most interesting elements in nuclear astrophysics, where the ^{19}F(p,α)^{16}O reaction is of crucial importance for Galactic ^{19}F abundances and CNO cycle loss in first generation Population III stars. As a day-one campaign at the Jinping Underground Nuclear Astrophysics experimental facility, we report direct measurements of the essential ^{19}F(p,αγ)^{16}O reaction channel. The γ-ray yields were measured over E_{c.m.}=72.4-344 keV, covering the Gamow window; our energy of 72.4 keV is unprecedentedly low, reported here for the first time. The experiment was performed under the extremely low cosmic-ray-induced background environment of the China JinPing Underground Laboratory, one of the deepest underground laboratories in the world. The present low-energy S factors deviate significantly from previous theoretical predictions, and the uncertainties are significantly reduced. The thermonuclear ^{19}F(p,αγ)^{16}O reaction rate has been determined directly at the relevant astrophysical energies.

14.
Int J Radiat Oncol Biol Phys ; 111(3S): e233, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34700976

RESUMO

PURPOSE/OBJECTIVE(S): Thoracic radiotherapy combined with PD-1 inhibitor can promote the activation of T cell and improve the treatment outcomes of patients with chest cancer. However, it also increases the risk of myocardial injury. A mouse model was used to observe the effects of PD-1 inhibitors on myocardial immune microenvironment and radiation induced injury, and to explore the potential mechanism of PD-1 inhibitors aggravating myocardial injury using. MATERIALS/METHODS: Totally 20 C57BL/6 mice were randomly divided into 4 groups, including group A as normal control, group B receiving intraperitoneally injected with anti-PD-1 antibody, group C receiving full thoracic x-ray irradiation with 15 Gy in one fraction, D group receiving anti-PD1 as the same as B group and full thoracic x-ray irradiation as C group. At 1 months after irradiation, mice were killed under anesthesia. Hematoxylin-eosin staining and Mason staining were used to observe myocardial injury and fibrosis. The levels of CD3+, CD3+CD4+, CD3+CD8+ lymphocyte and cytokines (IL-4, IL-6, IL-17A, TNF-α, TGF-ß1, INF-γ) in myocardium were detected by flow cytometry. The apoptosis rate of myocardial cells was detected by TUNEL assay. RESULTS: Mason staining showed that no obvious myocardial fibrosis in group B, and collagen fibers were distributed in the myocardial interstitium in groups C and D. The results of semi-quantitative analysis showed that the myocardial collagen volume fraction (CVF) of each group A, B, C and D were (1.97 ± 0.36)%, (2.83 ± 1.03)%, (5.39 ± 0.77)% and (7.72 ± 1.43)%, respectively. The CVF of group A was similar to that of group B (P = 0.314). There were statistically significant differences in CVF among other groups (P < 0.05). Compared with group A, the absolute value and percentage of CD3+T lymphocytes in groups B, C and D were increased (P < 0.01), and those in group D were higher than those in group B and C (P < 0.01). The absolute value and percentage of CD3+CD4+T lymphocytes in groups A, C, B and D were similar (P > 0.05). The absolute value and percentage of CD3+CD8+T lymphocytes in group D were higher than those in groups A, B and C (P < 0.001). The levels of IL-6, IL-17A and TGF-ß1 in group D were higher than those in groups A, B and C (P < 0.001). The apoptotic index of groups A, B, C and D increased gradually, and the difference of apoptotic index among all groups was statistically significant (P < 0.001). CONCLUSION: PD-1 inhibitors can aggravate radiation-induced myocardial injury by promoting myocardial immunoinflammatory response.

15.
Int J Radiat Oncol Biol Phys ; 111(3S): e445, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34701471

RESUMO

PURPOSE/OBJECTIVE(S): The purpose of this study was to evaluate the efficacy of dynamic 18F-FDG total body PET imaging as a predictive maker of induction chemo-immunotherapy followed by concurrent chemoradiotherapy (CCRT) response in locally advanced non-small cell lung cancer (LA-NSCLC) by a prospective study. MATERIALS/METHODS: Stage IIIA-IIIC NSCLC patients were prospectively enrolled in a prospective total body PETCT study (NCT04654234, GASTO-1067) and a randomized phase II clinical trial (NCT04085250) between September 2020 and December 2020. Patients underwent a dynamic total-body 18F-FDG PET/CT scan before any treatment, after 2 cycles of induction chemo-immunotherapy (docetaxel + cisplatin + nivolumab), then after CCRT. The primary lung tumor, metastatic regional lymph node and inflammatory lymph node before and after treatment were manually delineated by a nuclear medicine physician and a radiation oncologist. Total Body PET was acquired between 0 - 60 mins after the injection of FDG from the subject's feet. Patients was separated into high dynamic FDG metabolic (H-DFM) group and low DFM(L-DFM) group by the scatter plot of SUV-mean and Ki-mean of baseline scan for primary lung tumor. We compared lesion heterogeneity and different image-derived PET metrics including the metabolic tumor volume (MTV), SUV total lesion glycolysis (SUV-TLG), Patlak-derived influx rate constant (Ki) TLG (Ki-TLG). RESULTS: Fifteen patients completed three scans (before treatment, after induction chemo-immunotherapy, after CCRT). Eight patients were in H-DFM group and 7 in L-DFM group by baseline scan. Patients in H-DFM group had significant decreased levels of MTV (P < 0.001), SUV-TLG (P < 0.001) and Ki-TLG (P < 0.001) both in primary lung tumor and metastatic lymph node by the induction chemo-immunotherapy and CCRT. However, patients in L-DFM group only had a significant reduction of MTV in primary lung tumor (P < 0.05). There was no significant difference in the MTV of metastatic lymph node (P > 0.5), the SUV-TLG (P > 0.5) and Ki-TLG (P > 0.5) of primary lung tumor and metastatic lymph node during the treatment course in L-DFM group. CONCLUSION: Patients in H-DFM group had the better treatment response of induction chemo-immunotherapy and CCRT with significant decreased levels of MTV, SUV-TLG and Ki-TLG. Dynamic 18F-FDG Total body PET Imaging could be regarded as a potential predictive marker of induction chemo-immunotherapy and CCRT response in the setting of LA-NSCLC.

16.
Int J Radiat Oncol Biol Phys ; 111(3S): e462-e463, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34701511

RESUMO

PURPOSE/OBJECTIVE(S): Adrenal metastases are commonly identified in the context of primary lung cancer. Recent literature has shown stereotactic body radiation therapy (SBRT) to improve progression free survival (PFS) in the setting of oligometastatic disease. Multiple studies have shown the efficacy and safety of adrenal SBRT. However, patient selection criteria are not well defined. We investigated the various patient selection criteria for adrenal SBRT and their associations with PFS. MATERIALS/METHODS: We examined a cohort of patients with stage IV oligometastatic primary lung cancer with adrenal metastases who were consecutively treated with 5-fraction SBRT (n = 19). Multiple characteristics were selected for examination prior to data collection and PFS calculation. We considered 1) age 2) performance status 3) size greater than 4cm 4) presence of other metastases at adrenal metastasis diagnosis 5) presence of brain metastases at adrenal metastasis diagnosis 6) time to adrenal metastasis progression from primary diagnoses. RESULTS: Eighteen patients completed their treatments of 5-fraction adrenal SBRT with a median dose of 4500 cGy (range from 3500 cGy to 500 cGy). One patient had a course of SBRT to each adrenal gland. Completion rate was 100% and there was no grade two or higher acute toxicities. Small bowel 0.03cc max dose ranged from 230 cGy to 3410 cGy with a median dose of 2350 cGy. Median PFS was 4.7 months. PFS was the same for patients with and without brain metastases at adrenal progression (P = 0.133). There were also no significant differences found in PFS when observing patients with adrenal progression within one year and greater than one year of initial diagnosis (P = 0.474). Similarly, PFS did not change when comparing patients with adrenal lesions greater than 4cm to patients with adrenal lesion less than or equal to 4cm (P = 0.477). PFS trended towards significance for patients older than 70 compared to patients who were 70 or younger (6.6 months vs 12.4 months, P = 0.09). Additionally, PFS was significant for patients with ECOG 2 or higher compared to patients with ECOG less than 2 (1.4 months vs 11.5 months, P = 0.027). Patients without additional metastatic disease at the time of progression had better PFS than patients with additional metastatic disease (18 months vs 7 months, P = 0.016). CONCLUSION: Patients with an ECOG score of 0 or 1 who did not have additional metastases at the time of adrenal metastasis exhibited a higher progression free survival rate after adrenal SBRT. Despite the small sample size, this study showed that appropriate patient selection for adrenal SBRT can lead to good long-term progression free survival with very minimal toxicity if any.

17.
Int J Radiat Oncol Biol Phys ; 111(3S): e86-e87, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34701986

RESUMO

PURPOSE/OBJECTIVE(S): Host immune status plays an important role in treatment outcome prediction and prognosis in patients with various cancers. However, the relationship between circulating immune cell and tumor control has not been well studied in hepatocellular carcinoma (HCC) after stereotactic body radiation therapy (SBRT). MATERIALS/METHODS: Patients with recurrent HCC received liver SBRT were eligible. Patients must be deemed surgically unresectable, and had Trans Arterial Chemotherapy Embolization (TACE). The local tumor control was defined as no disease progression by treatment response assessment CT or MRI around 3 months, largely according to mRECIST. Complete metabolic responses were defined either with no enhancement on MRI or no FDG activity. The risk factors of our interest included demographics factors, liver disease history, Child Pugh score, pathology stage, and prior treatments. The counts of whole leukocytes, lymphocyte and neutrophil pre- and post-SBRT were recorded from clinical laboratory. Leukopenia was graded according to CTCAE v 5.0. The associations of variables with in-field treatment response were analyzed using Chi-square test and one-way ANOVA. RESULTS: A total of 22 patients enrolled between August 2015 and September 2020. All patients had disease progression after TACE treatment and received 5 fractions of SBRT. Twenty patients received a definitive dose of 40-50 Gy. The local tumor was controlled in 86.4% (19/22), and increased to 90% (18/20) after excluding 2 patients receiving lower doses of palliative SBRT. There were 2 (10%), 5 (25%) and 13 (65%) defined as progressive disease, stable disease, partial response, and complete metabolic response, respectively. Large tumor/multiple tumor (P = 0.003), vascular invasion (P = 0.042), surgery history (P = 0.023), and BCLC stage (P = 0.040) were significantly associated with the tumor control, while age, gender, family history, heavy drinking, smoking history, BMI, ECOG, hepatitis, cirrhosis, Child Pugh score, portal vein tumor emboli, TNM, tumor size, and radiation dose were not. In 20 patients with complete blood testing peri-SBRT and uninterrupted radiation treatment, 17 (85%), 18 (90%), 13 (65%) and 9 (45%) patients had reduction in leukocyte, lymphocyte, neutrophil and monocyte after SBRT, respectively. Post-SBRT leukocyte counts (P = 0.036), pre-monocyte (P = 0.029), pre-lymphocyte (P = 0.073) and post- lymphocyte (P = 0.092) were associated with tumor control. The pre-RT leukocyte, neutrophil, post-RT neutrophil and monocyte were not. CONCLUSION: This limited study suggests that SBRT may provide excellent local tumor control for patients with recurrent HCC after surgical resection and TACE with no local treatment options. The significance in post-SBRT circulating immune cell suggest a role of immune function on radiation tumor control and a potential value of improving SBRT technique to decrease damage of immune cells. Further validation study with large sample size and longer follow-up is needed.

18.
Zhonghua Yu Fang Yi Xue Za Zhi ; 55(2): 200-206, 2021 Feb 06.
Artigo em Chinês | MEDLINE | ID: mdl-34645180

RESUMO

Objective: To evaluate consistency between 2-fold serial and 4-fold serial diluted neutralization tests against Enterovirus A71 (EV-A71) in estimating titer, Geometric mean titer (GMT), seroprevalence, and seroincidence. Methods: Based on a prospective cohort of 1-9 years old children, mothers and infants established in Anhua County, Hunan Province, during 2013-2018, from which 92 participants with a total of 386 blood specimens were sampled and tested with a 2-fold serial dilution and a 4-fold serial dilution neutralization tests against EV-A71 at the same time. Agreement was estimated using the Bland-Altman method. Stratified analysis was conducted to estimate effect dilution approach on GMT, seroprevalence and seroincidence. Results: The mean difference (0.04, 95%CI:-0.02-0.10) between the two dilution approaches was not significant. However, the limits of agreement (LOA) (-1.12-1.21), with the 95% confidence interval of upper LOA (1.10-1.31) and of lower LOA (-1.22--1.02), significantly exceeded the Clinic accept interval (-1, 1) indicating insufficient agreement between the two approaches in practice. While the dilution approaches did not affect estimates of GMT of the total population and the positive population, and seroincidence with seroconversion only, the differences were 2, 6 and 2%, respectively (P>0.05). Estimates of seroincidence with at least 4-fold increase and seroconversion/4-fold increase were significantly higher using a 4-fold dilution neutralization test compared to the 2-fold dilution neutralization test with 8% (95%CI: 1%-12%) and 9% (95%CI: 1%-17%), respectively. Conclusion: The 2-dilution and 4-dilution neutralization tests yielded comparable results when estimating the population's GMT; however, the difference between the two is not negligible when assessing the seroincidence.


Assuntos
Enterovirus Humano A , Infecções por Enterovirus , Enterovirus , Doença de Mão, Pé e Boca , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Estudos Prospectivos , Estudos Soroepidemiológicos
19.
Zhonghua Yu Fang Yi Xue Za Zhi ; 55(2): 239-244, 2021 Feb 06.
Artigo em Chinês | MEDLINE | ID: mdl-34645186

RESUMO

Objective: To investigate the clinical characteristics of ureaplasma urealyticum(UU) pneumonia in preterm infants less than 32 weeks. Methods: Preterm infants with gestational age <32 weeks who were hospitalized in neonatal intensive care unit (NICU) of Peking University Third Hospital from January 2018 to December 2019 were retrospectively analyzed. There were 105 premature infants, 63 males and 42 females. After the first diagnosis of pneumonia during hospitalization, the airway secretions were collected for UU nucleic acid detection. They were divided into UU positive group and UU negative group. Perinatal factors, comorbidities, antibiotic treatment and clinical outcomes were compared between the two groups. SPSS24.0 statistical software was used for statistical analysis. T test or chi-square test was used to compare the two groups, and logistic regression was used for multivariate analysis. Results: Among 105 cases of preterm pneumonia, 37 cases (35.2%) were diagnosed with UU pneumonia and 68 cases (64.8%) were negative for UU test. There was no significant difference in gestational age [28(27,30) weeks vs 29(28,30)weeks,Z=-0.98, P>0.05] and birth weight[(1 282.03±292.49)g vs (1 196.62±322.89)g,t=1.34, P>0.05] between the two groups. In UU pneumonia group, the rate of singleton (86.5% vs 50%,χ2=12.15), chorioamnionitis (10.8% vs 1.55%,χ2=4.61), premature rupture of membranes>12 h (32.4% vs 11.8%,χ2=5.37) and vaginal delivery rate(59.5% vs 35.3%,χ2=4.75) were higher than UU negative group (P<0.05). Further multivariate logistic regression analysis showed that vaginal delivery was an independent risk factor for UU (OR = 2.694, 95%CI: 1.113-6.525). WBC count in UU positive group was significantly higher [12.85×109/L (9.32×109/L,17.22×109/L) vs 9.06×109/L (7.06×109/L,13.37×109/L), Z=-3.01, P<0.05], and oxygen consumption time was prolonged[ (46.8±19.8)d vs (37.8±20.7)d, t=2.177,P<0.05]. The incidence of hemodynamically significant patent ductus arteriosus (29.7% vs 57.4%,χ2=6.265) and respiratory distress syndrome (54.1% vs 75.0%,χ2=4.801) in UU positive group was significantly lower than that in UU negative group (P<0.05). There was no significant difference in bacterial infection(62.2% vs 50.0%, χ2=8.826) and antibiotic(48.6% vs 47.1%,χ2=1.352) between the two groups(all P>0.05). After azithromycin treatment, the time for UU negative was (9.00±3.14) days. There was no significant difference in the incidence of bronchopulmonary dysplasia(73.0% vs 69.1%,χ2=0.036), retinopathy of prematurity(10.8% vs 26.5%,χ2=2.665), neonatal necrotizing enterocolitis(2.7% vs 1.5%,χ2=0.195), intraventricular periventricular hemorrhage (69.4% vs 72.1%,χ2=0.003) and periventricular leukomalacia (8.1% vs 8.8%,χ2=0.016) between the two groups (P>0.05). Conclusions: If premature rupture of membranes >12 h, combined with chorioamnionitis, and vaginal delivery, preterm infants less than 32 weeks are likely to have an increased risk of UU infection. UU pneumonia in preterm infants less than 32 weeks old was characterized by prolonged oxygen consumption and increased white blood cell count. Oral azithromycin treatment could effectively remove UU and improve prognosis.


Assuntos
Pneumonia , Ureaplasma urealyticum , Feminino , Idade Gestacional , Humanos , Lactente , Recém-Nascido , Recém-Nascido Prematuro , Masculino , Gravidez , Estudos Retrospectivos
20.
Zhonghua Gan Zang Bing Za Zhi ; 29(9): 837-843, 2021 Sep 20.
Artigo em Chinês | MEDLINE | ID: mdl-34638201

RESUMO

Objective: To compare the baseline difference in the quantitative hepatitis B core antibody levels (qAnti-HBc) between non-response and response group in children with HBeAg-positive chronic hepatitis B (CHB) who received antiviral therapy, and further explore the proportion and functional activity of CD8 + memory T lymphocyte subsets with different qAnti-HBC levels in peripheral blood of children. Methods: The baseline anti-HBc quantification (qAnti-HBc) levels of 85 children with HBeAg-positive CHB who visited the Department of Infectious Diseases, Children's Hospital of Chongqing Medical University from June 2018 to December 2020 were detected retrospectively. The relationship between the baseline qAnti-HBc level and HBeAg serological response in 37 children who received antiviral therapy was analyzed. The proportion of CD8(+) memory T lymphocyte subsets and the secretion levels of interferon (IFN) γ, and tumor necrosis factor (TNF) α in peripheral blood of 59 children at baseline were detected by flow cytometry. The relationship between qAnti-HBc level and the proportion and functional activity of CD8(+) memory T lymphocyte subsets was analyzed. Pearson's Chi-square test was used to compare the count data. Mann-Whitney U test or Kruskal-Wallis test was used to compare measurement data between two or more groups, and Spearman's rank correlation analysis was used for the correlation between continuous variables. Results: Among 37 children who received entecavir (ETV, 21/37 cases) or pegylated interferon (Peg-IFN, 16/37 cases), 18 cases had developed HBeAg seroconversion (10/ 21 cases in the ETV group, 8/16 cases in the Peg-IFN group). The baseline qAnti-HBc level was significantly higher in the response group [4.71 (4.64~4.81) log(10)IU/ml] than the non-response group children [4.54 (4.45~4.64) log(10)IU/ml, Z = -3.316, P = 0.001]. The proportion of CD8(+) Tem, CD38(+)CD8(+) Tem, CD38(+)CD8(+) Temra cells and the levels of IFNγ and TNFα secreted by CD8(+) T lymphocytes were significantly higher in the high-qAnti-HBc group than the low-qAnti-HBc group (P < 0.05). The proportion of CD8(+) Tem, CD38(+)CD8(+) Tem and CD38(+)CD8(+) Temra cells was significantly higher in ALT > 1× upper limit of normal value (ULN) group than ALT≤1×ULN group (P < 0.05). However, there were no significant differences in the levels of IFNγ and TNFα secreted by CD8(+) T lymphocytes between the two groups (P > 0.05). Spearman's correlation analysis showed that qAnti-HBc was positively correlated with the proportion of CD8(+) Tem, CD38(+)CD8(+) Tem, CD38(+)CD8(+) Temra cells and the level of IFNγ secreted by CD8(+)T lymphocytes (P < 0.05). Additionally, ALT was only positively correlated with the proportion of CD38(+)CD8(+) TEM and CD38(+) CD8(+) Temra cells (P < 0.05). Conclusion: Raised baseline qAnti-HBc level is related to the HBeAg serological response to antiviral therapy in children with CHB. Peripheral blood effector CD8+ T lymphocytes of CHB children with higher qAnti-HBc show stronger phenotype and functional activation characteristics, which may shed some light on the underlying immune mechanism related to antiviral therapy efficacy in children with CHB.


Assuntos
Hepatite B Crônica , Antivirais/uso terapêutico , Criança , Anticorpos Anti-Hepatite B , Antígenos E da Hepatite B , Hepatite B Crônica/tratamento farmacológico , Humanos , Estudos Retrospectivos
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