Different rapid maxillary expansion methods in the treatment of adult patients with obstructive sleep apnea hypopnea syndrome / 中华口腔医学杂志

Obstructive sleep apnea hypopnea syndrome (OSAHS) is a common sleep respiratory disorder characterized by upper respiratory collapse during sleep, with a high prevalence and potentially fatal complications. Currently, maxillary transverse deficiency are considered to be an important pathogenic factor of OSAHS. For patients with poor compliance with positive airway pressure therapy, rapid maxillary expansion can increase the volume and ventilation of the upper respiratory tract, which is an alternative treatment. This paper reviewed the current research on surgically assisted rapid palatal expansion, miniscrew assisted rapid palatal expansion, and distraction osteogenesis maxillary expansion in the treatment of adult OSAHS. By comparing the indications, contraindications, complications, efficacy and long-term stability of the three treatment methods, it provided reference for treatment of patients with OSAHS.

Clinical Characteristics and Risk Factors for 30-Day Mortality in Patients with Hematologic Diseases Infected by Carbapenem-Resistant Organisms / 中国实验血液学杂志

OBJECTIVE@#To explore the clinical characteristics of hospitalized patients with hematologic diseases complicated with carbapenem-resistant organisms (CRO) infection and analyze the risk factors of 30-day all-cause mortality.@*METHODS@#The clinical data and laboratory test data of 77 hospitalized patients with hematologic diseases complicated with CRO infection in department of hematology of the Third Hospital of Shanxi Medical University from January 2015 to December 2020 were retrospectively analysed, the risk factors of 30-day all-cause mortality after CRO infection were analyzed by multivariate logistic regression.@*RESULTS@#Among the total of 77 patients with hematologic diseases complicated with CRO infection, 29 died and 48 survived within 30 days of infection, with a case fatality rate of 37.66%. A total of 93 strains of CRO were isolated from these patients, of which Acinetobacter baumannii had the highest detection rate (25.81%, 24/93), followed by Pseudomonas aeruginosa (18.28%, 17/93). The lung was the most common site of CRO infection. The detected pathogens were highly resistant to carbapenems, and 64.52% (60/93) of the pathogens were resistant to imipenem with minimum inhibitory concentration (MIC)≥16 μg/ml. The results of the univariate analysis showed that albumin concentration <25 g/L (P =0.048), serum creatinine concentration≥120 μmol/L (P =0.023), age-adjusted Charlson comorbidity index (ACCI) (P =0.037) and primary treatments (supportive treatment, immunosuppressive therapy, chemotherapy, HSCT) (P =0.048) were significantly associated with 30-day all-cause mortality after infection. The results of multivariate logistic regression analysis showed that when CRO infection confirmed, albumin concentration <25 g/L (P =0.014, OR=6.171), serum creatinine concentration≥120 μmol/L (P =0.009, OR=10.867) were independent risk factors for 30-day mortality of patients with hematologic diseases complicated with CRO infection.@*CONCLUSION@#The mortality rate of CRO-infected patients with hematologic diseases is high. The detected pathogenic bacteria are highly resistant to imipenem. The albumin concentration <25 g/L and the serum creatinine concentration≥ 120 μmol/L at diagnosis of CRO infection were independent risk factors for 30-day mortality of the patients with hematologic diseases.

Interaction of polycyclic aromatic hydrocarbon DNA adducts and telomere length on missed abortion / 中华预防医学杂志

Objective: To analyze the contribution and interaction of polycyclic aromatic hydrocarbons (PAH)-DNA adducts and changes of telomere length (TL) on missed abortion. Methods: From March to December 2019, patients with missed abortion in the First Hospital of Shanxi Medical University and pregnant women with normal pregnancy but voluntary abortion in the same department during the same period were selected and divided into a case group and a control group. Questionnaire was used to investigate the general situation and the pregnancy situation of the subjects. The abortion villi were collected and the content of PAH-DNA adducts and TL was detected. Logistic regression model was used to analyze the associated factors of missed abortion. R epiR package and Mediation package were used to analyze the effect and relationship between PAH-DNA adducts and TL on missed abortion. Results: The age of the subjects was(29.92±5.69)years old. The M(Q1,Q3)of PAH-DNA adducts was 453.75(404.61, 504.72) pg/ml. The M(Q1,Q3)of TL was 1.21(0.77, 1.72). The content of PAH-DNA adducts in the case group was higher than that in the control group (Z=-2.10, P=0.036), while the TL was lower than that in the control group (Z=-4.05, P<0.001). Multivariate logistic regression showed that low, medium and high levels of PAH-DNA adducts (OR=3.17,95%CI:1.41-7.14;OR=2.85,95%CI:1.25-6.52;OR=2.46,95%CI:1.07-5.64), and long, medium and short levels of TL (OR=2.50,95%CI:1.11-5.63;OR=3.32,95%CI:1.45-7.56;OR=3.22,95%CI:1.42-7.26) were all risk factors for missed abortion. The medium level of PAH-DNA adducts had a 2.76-fold higher risk of shortened TL than those with the lowest level, and no mediating role of TL was found. The stratified analysis showed that when the TL level was longer (>1.21), the low and high levels of PAH-DNA adducts were associated with missed abortion (all P<0.05); when the TL level was shorter (<1.21), the medium level of PAH-DNA adducts was associated with abortion (P=0.025). At lower levels of PAH-DNA adducts, no effect of TL on missed abortion was observed, while, at higher levels, TL was strongly associated with missed abortion (OR=7.50,95%CI:1.95-28.82;OR=6.04,95%CI:1.54-23.65;OR=9.05,95%CI:2.34-35.04). The interaction analysis found that the AP was 0.72 (95%CI: 0.46-0.99), and the SI was 5.21 (95%CI: 2.30-11.77). Conclusion: The high level of PAH-DNA adducts and shortened TL may increase the risk of missed abortion, and there may be a positive additive interaction between the two factors on missed abortion.

Analysis of risk factors for hemorrhage in patients with acute poisoning treated with hemoperfusion / 中华劳动卫生职业病杂志

Objective: To explore the clinical characterist ics and risk factors of hemorrhage complicated by hemoperfusion therapy in patients with acute poisoning. Methods: In January 2021, the clinical data of 196 patients with acute poisoning who received hemoperfusion therapy in the Second Affiliated Hospital of Air Force Military Medical University from January 2018 to December 2020 were analyzed, and the patients were divided into bleeding group and non-bleeding group according to whether the patients were complicated with bleeding. Multivariate logistic regression was used to analyze the independent risk factors for hemorrhage in patients treated with hemoperfusion. Results: A total of 21 patients in the bleeding group and 175 patients in the non-bleeding group were included. There was no significant difference in general data such as gender, age, and body mass index between the two groups (P>0.05) . Organophosphorus pesticides (χ(2)= 4.56, P=0.030) , HA230 perfusion device (χ(2)=4.12, P=0.042) , platelet count (t=-2.33, P=0.009) and activated partial thromboplastin time (t=14.53, P<0.001) at 2 h of perfusion were the influencing factors of hemorrhage in patients with acute poisoning treated with hemoperfusion. Among them, organophosphorus pesticides, 2 h perfusion activated partial thromboplastin time ≥35 s and other factors were independent risk factors forcomplicated bleeding (P<0.05) . Conclusion: Patients with acute poisoning, especially organophosphorus pesticide poisoning, are at greater risk of bleeding during hemoperfusion therapy. Monitoring of changes in activated partial thromboplastin time should be strengthened and the dose of anticoagulants should be adjusted in time to reduce the risk of bleeding.

Application and effect assessment of Mini-CEX in clinical teaching of pediatrics of Chinese medicine / 中华医学教育探索杂志

Objective:To evaluate the application effect of mini-clinical exercise assessment (Mini-CEX) in clinical teaching of pediatrics of Chinese medicine, further optimize Mini-CEX scale with characteristics of pediatrics of Chinese medicine, and improve teachers' understanding of its connotation.Methods:A total of 50 pediatric clinical practice undergraduates were randomly divided into Mini-CEX group and control group, 25 in each group, with a total of 4 weeks of practice. The application effect of Mini-CEX was evaluated by clinical comprehensive ability assessment, and the students' evaluation on the introduction of Mini-CEX in clinical teaching was understood through questionnaire survey on the recognition, advantages and existing problems of various contents of Mini-CEX. SPSS 17.0 was used for t test and chi-square test. Results:Total scores and sub-item scores of clinical comprehensive ability examination in Mini-CEX group were higher than those in control group ( P < 0.05), and the satisfaction with teaching in Mini-CEX group was significantly higher than that in control group ( P < 0.05). Through the questionnaire, it was found that the students had a high degree of recognition for the items in the improved Mini-CEX scale, and thought it was more suitable for the internship study and effect evaluation of pediatrics of Chinese medicine, especially in the aspects of clinical communication skills and humanistic care. Conclusion:Mini-CEX has many advantages, such as improving the clinical comprehensive ability of undergraduates, teaching effect, flexible teaching methods, objective evaluation methods and focusing on the cultivation of doctor-patient communication skills, which is worthy of clinical promotion.

SNP of AHSA2 gene in three cattle breeds using snapshot technology

Droughtmaster is a tropical breed of beef cattle that can survive in hot climates and easily adapt to torrid environments. These traits are important in livestock breeding. In this study, we genotyped five single-nucleotide polymorphisms (SNPs) of the AHSA2 gene from 190 cattle belonging to three different breeds (Droughtmaster, Angus and Simmental) by using snapshot technology. This work aimed to identify the valuable molecular marker of heat resistance in cattle. Results showed that Droughtmaster exhibited higher expected heterozygosity and polymorphic information content compared with the two other breeds. The AHSA2-1 locus deviated from the Hardy– Weinberg equilibrium in the Droughtmaster breed (P \ 0.05). Two SNPs in Droughtmaster diverged significantly from Angus and Simmental. The SNPs were identified as AHSA2-3 and AHSA2-4, which were closely linked to the three breeds based on pair-wise FST. AHSA2-4 involved a missense mutation. In summary, the GG genotypes in AHSA2-3 and AHSA2-4 may be candidate genotypes associated with heat resistance traits and may serve as valuable genetic markers for breeding of heat-tolerant beef cattle in the future.

Allelopathic Effect of Water Extracts from Rhizosphere Soil of Three Medicinal Plants on Polygala tenuifolia Seeds and Their Seedlings / 中国实验方剂学杂志

Objective:To investigate the allelopathic effects of water extracts from rhizosphere soil of three medicinal plants Rehmannia glutinosa，Pinellia ternata and Isatis indigotica on seed germination and seedling growth of Polygala tenuifolia， screen the stubble varieties suitable for crop rotation with P. tenuifolia， and provide some scientific basis for continuous cropping obstacles of P. tenuifolia. Method:The bioassay method was used to study the effects of rhizosphere soil water extracts from three medicinal plants Rehmannia glutinosa，Pinellia ternata and Isatis indigotica at concentrations of 0.3，0.6，0.9 g·mL-1 on the germination of P. tenuifolia seed and seedling growth. Result:The rhizosphere soil water extracts of Rehmannia glutinosa and Pinellia ternata showed basically low-promotion and high-inhibition concentration effects on the final germination rate，germination potential，and germination index of P. tenuifolia seeds，while the water extract of Isatis indigotica showed significant allelopathic inhibition effect. All three rhizosphere soil water extracts showed significant allelopathic inhibition effects on the growth index of P. tenuifolia seedlings. Among them，the rhizosphere soil water extract of Rehmannia glutinosa showed lower inhibitory effect on the plant height and root length of P. tenuifolia seedlings than the other two water extracts. The photosynthetic pigment content，proline（Pro） content，and soluble sugar content of P. tenuifolia chinensis seedlings were the highest under 0.3 g·mL-1 soil water extract of Rehmannia glutinosa， with relatively higher content of soluble protein， and relatively lower content of hydrogen oxide（H2O2）. Under the treatment of 0.9 g·mL-1 soil water extract of Rehmannia glutinosa，P. tenuifolia seedlings had the highest peroxidase（POD） and superoxide dismutase（SOD） activities，low catalase（CAT） activity，and lowest content of malondialdehyde（MDA）. Conclusion:Based on the comprehensive analysis of the above experimental data and allelopathic effects，the water extract of rhizosphere of Rehmannia glutinosa can promote the germination of P. tenuifolia seeds to a certain extent，and lay the foundation for seedling resistance to biochemical stress. Therefore， Rehmannia glutinosa is more suitable for crop rotation with P. tenuifolia.

Circumcision reduces the incidence of human papillomavirus infection in men / 中华男科学杂志

<p><b>Objective</b>To investigate the association of circumcision with the incidence of human papillomavirus (HPV) infection in men.</p><p><b>METHODS</b>We collected the samples from the surface of the coronal sulcus, glans penis, penile shaft and scrotum of 351 males examined for HPV infection in our hospital from January 2016 to August 2017, of whom 118 had received circumcision while the other 233 had not. We compared the incidence rate of HPV infection between the circumcision and non-circumcision groups and analyzed the association of the age of circumcision with the incidence of HPV infection.</p><p><b>RESULTS</b>HPV infection was found in 135 (38.46%) of the males, 29 (24.58%) in the circumcision group and 106 (45.49%) in the non-circumcision group, significantly lower in the former than in the latter (χ² = 14.48, P < 0.01). The incidence rate of HPV infection was also remarkably lower in the males circumcised at ≤17 years (13.16% ［5/38］) than in those circumcised at >17 years of age (30.0% ［24/80］) (χ² = 3.942, P = 0.047).</p><p><b>CONCLUSIONS</b>Male circumcision helps reduce the incidence rate of HPV infection in men and earlier surgery may achieve even better effect.</p>

Clinical and cytogenetic study in a child with de novo chromosome 9 abnormality / 中国当代儿科杂志

This study aimed to analyze the clinical phenotype of chromosome 9p deletion or duplication and its relationship with karyotype. A patient, female, aged 6 months, visited the hospital due to motor developmental delay. Karyotype analysis identified abnormalities of chromosome 9 short arm, and high-throughput sequencing found 9p24.3-9p23 deletion and 9p23-9p13.1 duplication. Her parents had a normal karyotype. Karyotype analysis combined with high-throughput sequencing is of great significance for improving the efficiency of etiological diagnosis in children with motor developmental delay or multiple congenital deformities and mental retardation.

Rapid determination of nine components in the first extraction process of Xingnaojing injection by using ultraviolet spectroscopy / 中国中药杂志

In this study, an analytical method based on ultraviolet spectroscopy was established for the rapid determination of nine components including isophorone, 4-methylene-isophorone, curcumenone, curcumenol, curdione, curzerenone, furanodienone, curcumol and germacrone in the first extraction process of Xingnaojing injection. 166 distillate samples of Gardeniae Fructus and Radix Curcumae were collected in the first extraction process of Xingnaojing injection. The ultraviolet spectra of these samples were collected, and the contents of the nine components in these samples were determined by high performance liquid chromatography. Least squares support vector machine and radial basis function artificial neural network were used to establish the multivariate calibration models between the ultraviolet spectra and the contents of the nine components. The results showed that the established ultraviolet spectrum analysis method can determine the contents of the nine components in the distillates accurately, with root mean square error of prediction of 0.068, 0.147, 0.215, 0.319, 1.01, 1.27, 0.764, 0.147, 0.610 mg•L⁻¹, respectively. This proposed method is a rapid, simple and low-cost tool for the monitoring and endpoint determination of the extraction process of Xingnaojing injection to reduce quality defects and variations.

Study on efficacy and visual sensitivity of long-term masking therapy for children with ametropic amblyopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To investigate the efficacy and visual sensitivity of occlusion therapy combined training for children with ametropic amblyopia.METHODS:Totally 85 children (85 eyes) with anisometropic amblyopia treated in our hospital from January 2013 to January 2015 were selected.All patients were given occlusion therapy combined training.Statistical analysis of clinical efficacy and visual sensitivity changes were taken,and the changes of visual acuity,AULCSF,S Frmax were analyzed.RESULTS:The visual acuity after therapy was significantly better than that before treatment (1.12±0.29 vs0.45±0.25,P＜0.01);AULCSF,Smax and Frmax all increased,the difference between the two groups was statistically significant (P＜ 0.05).The sensitivity of the same spatial frequency was significantly higher than that before treatment,the difference was statistically significant (P ＜ 0.05),and the contrast sensitivity decreased gradually with the increase of spatial frequency.There were statistical differences in the total effective rate of different refractive degrees after treatment (P=0.001).Mild group and moderate group had no significant difference on the total clinical efficiency difference (x2=3.091,P=0.079);between mild group and severe group total effective rate was significantly different (x2 =11.471,P =0.001);the moderate and severe groups total clinical efficiency were no significantly different (x2 =3.359,P=0.067).In addition,the total efficiency rate of wearing glasses under the age of 6 was significantly higher than that after 6 years old (95％ vs 77％),statistical difference between the two groups was significant (P＜0.05).CONCLUSION:Masking therapy combined with comprehensive training,in the treatment of children with ametropic amblyopia,and wearing a corrective spectacles,is desirable,especially for children under 7 years of age.

Therapeutic effects of trimetazidine combined atorvastatin calcium on chronic heart failure / 心血管康复医学杂志

Objective:To explore therapeutic effects of trimetazidine combined atorvastatin calcium on chronic heart failure (CHF) .Methods:According to random number table ,a total of 80 CHF patients were randomly and equally divided into routine treatment group and combined treatment group (received trimetazidine and atorvastatin calcium based on routine treatment group) .NYHA class improvement ,6min walking distance (6MWD) ,left ventricular ejection fraction (LVEF) , left ventricular end‐systolic dimension (LVESd ) , plasma levels of brain natriuretic peptide (BNP ) , C reactive protein (CRP) and adverse drug reactions (ADR) were compared between two groups before and six months after treatment .Re‐sults:Compared with routine treatment group after treatment ,there was significant rise in total effective rate of heart function improvement (77.5% vs .95.0% ) in combined treatment group , P=0.023. Compared with routine treatment group ,there were significant rise in 6MWD [ (346.6 ± 47.3) m vs .(396.4 ± 49.2) m] and LVEF [ (44.5 ± 4.8)% vs . (49.3 ± 5.4)% ] ,and significant reductions in LVESd [ (54.2 ± 4.1) mm vs .(51.1 ± 4.3) mm] ,plasma levels of BNP [ (348.4 ± 61.3) pg/ml vs .(251.4 ± 53.6) pg/ml] and CRP [ (9.1 ± 2.2) mg/L vs .(6.4 ± 1.6) mg/L] in combined treatment group , P<0.05 or <0.01. No severe ADR was found in two groups .Conclusion:Trimetazidine combined ator‐vastatin calcium can significantly improve cardiac function and exercise capacity ,improve quality of life and ventricular re‐modeling in CHF patients ,it's safe and reliable ,which is worth extending .

Epidemic and clinical characteristics of measles in Northeast China in 2014：an analysis of 1 401 cases / 中华临床感染病杂志

Objective To investigate the epidemiological and clinical characteristics of measles in patients of different age groups in Northeast China in 2014.Methods The clinical data of patients with measles in ten hospitals of infectious diseases in Northeast China from January 2014 to June 2014 were collected.Patients were divided into <16 age group and ≥16 age group, and the epidemiology , clinical characteristics, treatment and prognosis of all patients were retrospectively reviewed .SPSS 17.0 was used for data analysis.Results There were 1 401 patients with measles, in which 402 were <16-year old, and 999 were ≥16-year old.Clinical manifestations were mainly maculopapule (100.0%), fever (84.58%), cough (85.80%), Koplik’ s spot (73.23%), pharyngeal hyperemia (71.23%), diarrhea (43.97%), expectoration (40.97%), tears (39.40%) and runny nose (30.55%).The incidences of Koplik’s spot, sputum, pharyngeal hyperemia and diarrhea in <16 age group were lower than those in ≥16 age group (χ2 =8.364, 29.768, 10.953 and 6.701, P<0.05 or <0.01); while the incidence of runny nose was higher than that in ≥16 age group (χ2 =6.703, P<0.05).Abnormalities were found in blood routine examination, C-reactive protein (CRP), liver and kidney function, serum electrolyte levels, myocardial enzymes, and so on.Increasing in WBC, PLT and creatine kinase isoenzyme (CKMB), and decreasing in WBC were observed in 38(9.45%), 122(30.35%), 279(69.40%) and 105(26.12%), patients in <16 age group, which were higher than those in ≥16 age group [45(4.5%), 14(1.40%), 347(34.73%) and 202(20.22%)], and the differences were of statistical significance (χ2 =12.593, 274.033, 139.385 and 5.830, P<0.05 or P<0.01).Increasing in alanine aminotransferase (ALT), CRP, total bilirubin level (TBil), creatine kinase (CK), and decreasing in albumin (Alb), K+, Na+, Cl-were observed in 70(17.41%), 7(1.74%), 38(9.45%), 7(1.74%), and 214(53.23%), 59(14.68%), 45(11.19%), 94(23.38%) patients in <16 age group, which were lower than those in ≥16 age group [668(66.87%), 89(8.91%), 277(27.73%), 714(71.47), and 268(26.83%), 339(33.93%), 642(64.26%), 450 (45.05%)], and the differences were of statistical significance (χ2 =281.230, 23.073, 50.687, 159.740, and 14.674,114.286, 44.268, 271.546, P<0.01).Laryngitis and pneumonia were the most common complications.The incidence of laryngitis in <16 age group was 12.69% (51/402), which was higher than that in ≥16 years group (93/999, 9.31%,χ2 =3.545, P<0.05);while the incidence of spot shadows demonstrated by X-ray in <16 years group ( 72.89%, 121/166 ) was higher than that in ≥16 years group (265/445, 59.55%,χ2 =9.249, P<0.01).Conclusions There are differences in clinical features of measles in patients between <16 age group and ≥16 age group.Basic immunization in children and revaccination in adults should be enhanced to control the epidemics of measles .

Non-invasive method for assessment of liver fibrosis in clinically diagnosed chronic hepatitis B viruscarriers / 中华传染病杂志

Objective To verify the value of routine laboratory markers for assessment of liver fibrosis status in chronic hepatitis B virus (HBV) carriers.Methods A total of 196 patients who were clinically diagnosed with chronic HBV carriers with liver biopsy and routine laboratory test were included in this study. The data of complete blood count, aspartate aminofransferase/alanine aminotransferase (AST/ALT),aspartate aminotransferase to platelet ratio index (APRI) and ageplatelet index (API) were collected and calculated.Patients were divided into group S0 (n=112) and group S1- S3 (n =84) based on liver fibrosis stages.Measurement data were analyzed by Wilcoxon rank sum test and enumeration data were analyzed by chi square test.Results All 196 enrolled HBV carriers were HBV DNA positive,with 156 (79.6％) HBeAg-positive.Age,ALT,AST,AST/ALT,APRI and API were all significantly higher in group S1- S3 than those in group S0 (statistic value=7.705,6.33,7.095,4.977,11.059,8.936,respectively; all P＜0.05).However,PLT level was lower in the former group compared to that in the latter group (statistic value=10.196,P＜0.05 ).The area under receiver operating characteristic curve (AUROC) of APRI and API were 0.827and 0.829,respectively.The highest sensitivity and negative prediction value (NPV) were 70.46 ％and 71.43 ％ respectively when using API.The best specificity and positive prediction value (PPV)was 92.94％ and 92.86％,respectively when using APRI.When APRI≥0.30 was used as the cut-off of liver fibrosis,97.62 ％ of 119 patients were diagnosed with liver fibrosis; when API≥4.0 was used as the cut-off of liver fibrosis, 96.43％ of 112 patients were diagnosed with liver fibrosis.Conclusion APRI and API are two simple and feasible non-invasive biochemical markers that can be used to determine liver fibrosis status in chronic HBV carriers.

Clinical analysis of chronic hepatitis B virus carriers and chronic hepatitis B diagnosed through pathology / 中华传染病杂志

Objective To compare the clinical data of patients with chronic hepatitis B virus (HBV) carriers and chronic hepatitis B so that to provide pathological evidence for management of chronic HBV carriers with different alanine aminotransferase (ALT) levels.MethodsLiver biopsies were performed in totally of 292 cases of chronic HBV infection.The subjects were divided into HBV carrier group (G0-G1 and S0-S1) and hepatitis group (G＞ 1 and/or S＞ 1) according to the pathological diagnosis. The relationships between different age subgroups, different ALT level subgroups and pathological diagnosis were analyzed. Meanwhile,other clinical,biochemical,and iconographic indexes which were possibly related to the pathology diagnosis were compared. The multivariate analysis was done by Logistic regression equation (withdrawal method, maximum likelihood method) to definite the independent influencing factors of pathologically diagnosed with chronic HBV carrier.ResultsAmong the 292 patients,140 (47.9％) were pathologically diagnosed with chronic HBV carries and 152 (52.1％)were chronic hepatitis B. There were statistical differences between ≤35 years group and 36-40 years,＞40 years group (x2 =3.936 and 8.534,respectively; P =0.047 and 0.003,respectively). There were statistical difference among patients with ALT＜0.5×upper limit normal (ULN),(0.5-1.0) ×ULN,(1.1-1.5) ×ULN,(1.6-2.0) ×ULN and ＞2.0 × ULN (x2 =55.314,P＜0.01),while there was no significant difference between (1.1-1.5) × ULN and ＞2.0 × ULN (x2 =3.810,P=0.051). Multivariate analysis indicated that course of disease,alcohol consumption,ALT,HBV DNA level and the surface of liver (smooth or not smooth)detected by ultrasonography were independent influencing factors of pathological diagnosis of chronic HBV carriers (OR =0.995,0.224,0.516,1.308 and 0.270,respectively; P=0.005,0.007,0.000,0.025 and 0.001,respectively).ConclusionLiver biopsy is much meaningful in patients with age ＞35 years old and ALT (1-2)× ULN.

Value of liver biopsy in diagnosis of chronic hepatitis B / 中华传染病杂志

Objective To explore the value of liver biopsy in diagnosis of the severity of chronic hepatitis B (CHB).Methods The liver biopsy, laboratory examination and imaging were performed in 176 CHB patients. The clinical and histological diagnoses were compared. Biochemical indexes of liver function were also compared between patients with histological inflammation activity ＜G2 and≥G2 or the patients with fibrosis score ＜S2 and ≥S2. Rank sum test and χ2 test were used in univariate analysis. Binary Logistic regression was used in multivariate analysis. Results Among 176patients, the clinical diagnosis of CHB and cirrhosis were established in 171 patients and five patients,respectively. Among 171 CHB patients, the clinical diagnosis was consistent with histological diagnosis in 102 (59.6%) patients. The clinical diagnosis was more severe than histological diagnosis in 60 (35.1%) patients and the clinical diagnosis was less severe than histological diagnosis in nine (5.3%) patients. Among 44 patients with histological grade G2, 41 (93.2 %) patients had alanine aminotransferase (ALT)≥2 × upper limits of normal (ULN). According multiple Logistic regression analysis, age, overt symptom, ALT level, cholinesterase (CHE), albumin (Alb), total bile acid (TBA) and ultrasonic appearance of non-smooth liver surface were independent risk factors for the diagnosis of fibrosis score ≥S2. Conclusions The CHB diagnosis based on clinical evidences doesn't show acceptable consistency with the diagnosis based on histological evidences. G2 and S2 may be more reliable criteria for diagnosing moderate and severe CHB.

The correlations between liver histological fibrosis stage and serum fibrosis markers in patients with chronic hepatitis B / 中华传染病杂志

Objective To investigate the relationship between hepatic fibrosis stage and clinical serum fibrosis markers in patients with chronic hepatitis B (CHB).Methods Liver puncture biopsy was performed in 189 CHB patients.The serum levels of hyalyronic acid (HA),laminin (LN),procollagen Ⅲ (PCⅢ),collagen Ⅳ (Ⅳ C),liver function and peripheral blood routine were detected simultaneously. The comparison, correlation and regression analysis were performed based on different fibrosis stages (S).Results From SO to S4 group,levels of PC Ⅲ,γ-glutamyl transpeptidase (γ-G-T),total bilirubin (TBil),protein electrophoresis γ-globulin (Ely-γ) and prothrombin time (PT) were progressively elevated,the differences were statistically significant (F value was 3.325,6.218,2.958,10.160 and 7.028,P＜0.05),while cholinesterase (CHE),total protein (TP),albumin (Alb) and platelet (PLT) were progressively declined,the differences were also statistically significant (F value was 15.984,3.768,14.919 and 4.737,P＜0.05).The differences of LN,IVC,ALT and AST between groups were statistically significant (F value was 4.618,2.795,2.649 and 3.199,P＜0.05).Fibrosis stages (s) was positively correlated with LN,PCIII,ALT,AST,TBil,γ-GT,Ep-γand PT (r=0.200,0.306,0.172,0.273,0.153,0.402,0.415,0.269,respectively);while it was negatively correlated with CHE,TP,Alb and PLT (r=-0.502,-0.208,-0.413,-0.390,respectively);I.N,AI.T,CHE,PLT and Ep-γ were the independent risk factors which affecting hepatic fibrosis stages.Conclusions Liver fibrosis stage in histopathology was correlative in certain degree with the serum markers of hepatic fibrosis,liver function,and blood routine examination.Combined analysis of clinical data may be used to early diagnose hepatic fibrosis non-invasively.

Inhibition of bFGF gene expression and tumor angiogenesis of orthotopic implantation of human gastric carcinoma by N-desulfated heparin / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the effect of N-desulfated heparin on tumor metastasis, tumor angiogenesis and basic fibroblast growth factor(bFGF) gene expression of orthotopically implanted human gastric carcinoma in NOD-SCID mice.</p><p><b>METHODS</b>Human gastric cancer SGC-7901 tissues were orthotopically implanted into the stomach of the NOD-SCID mice. Twenty mice were randomly divided into two groups which received either intravenous injection of 0.9% NaCl solution(0.9%NaCl solution group) or 10 mg/kg N-desulfated heparin (N-desulfated heparin group) twice a week for three weeks. Mice were sacrificed six weeks after tumor implantation. Tissues from stomach and other organs were obtained for histopathological evaluation. The intratumoral microvessel density (MVD) in tumor was evaluated immunohistochemically. Real time PCR was used to detect bFGF mRNA expression.</p><p><b>RESULTS</b>The tumor metastasis rates were 9/10 in 0.9% NaCl solution group and 2/10 in N-desulfated heparin group(P<0.05).MVD was 9.1+/-3.4 in 0.9% NaCl solution group and 4.7+/-1.8 in N-desulfated heparin group (t=3.617,P<0.05). bFGF mRNA expression was lower in N-desulfated heparin group(2.60+/-0.56%)than that in 0.9% NaCl solution group(30.65+/-6.84%).</p><p><b>CONCLUSION</b>N-desulfated heparin can inhibit the metastasis of gastric cancer through inhibiting tumor bFGF gene expression and tumor angiogenesis with no obvious anticoagulant activity.</p>

Comprehensive study on the risk factors of hepatitis B virus intrauterine infection / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the risk factors of hepatitis B virus (HBV) intrauterine infection.</p><p><b>METHODS</b>Risk factors of HBV intrauterine infection were analyzed by nested case control study.</p><p><b>RESULTS</b>Data from univariate analysis revealed that risk factors of HBV intrauterine infection were positive results on HLA-DR3 (OR = 4.71, 1.62-13.66), HBV DNA (OR = 6.59, 2.72-15.97) and HBeAg (OR = 4.53, 1.93-10.64) in pregnant women, HLA-DR3 (OR = 3.91, 1.18-12.94) in newborn, HLA-I) R3 (OR = 5.96, 1.14-31.15) both in pregnant women and her newborns and HBV infection in placentas (OR = 2.51,1.12-5.60). Results from Multivariate unconditional logistics regression analysis showed that the risk factors of HBV intrauterine infection were positive in both HLA-DR3 (OR = 4.65, 1.44-15.05) and HBV DNA (OR = 6.56, 2.65-16.23) in pregnant women. However, there was no interaction between the two factors. The exposure rate of other factors did not reveal the difference in the two groups. With the increase of HBV DNA in pregnant women, the risk of HBV intrauterine infection was rising (chi2 = 16.74, P < 0.05).</p><p><b>CONCLUSION</b>Risk factors of HBV intrauterine infection were HLA-DR3 positive and HBV DNA positive in pregnant women but there was no interaction between the two factors. The risk of HBV intrauterine infection was increased along with the increase of HBV DNA in pregnant women.</p>