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Objective To investigate the influence of nonalcoholic fatty liver disease (NAFLD) on the antiviral response of patients with chronic hepatitis B (CHB), and to provide a reference for clinical treatment of such patients. Methods A total of 187 patients who attended Shenzhen Third People's Hospital from January 2011 to December 2017 were enrolled and divided into CHB group with 43 patients, NAFLD group with 41 patients, and CHB+NAFLD group with 103 patients. Related indices were measured at enrollment different time points of follow-up, including body height, body weight, alanine aminotransferase (ALT), aspartate aminotransferase, four blood lipid parameters, four indicators of liver fibrosis, aspartate aminotransferase-to-platelet ratio index, HBsAg, HBeAg, anti-HBe, and HBV DNA quantification, and the CHB patients and the CHB+NAFLD patients receiving antiviral therapy were compared in terms of treatment outcome at weeks 12, 24, 48, 72, and 96 of antiviral therapy. The Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups, and the Wilcoxon rank-sum test was used for comparison between two groups; the chi-square test was used for comparison of categorical data between groups. Results Compared with the NAFLD group at baseline, the CHB group and the CHB+NAFLD group had significantly lower platelet count, ALT, gamma-glutamyl transpeptidase (GGT), alkaline phosphatase, and right lobe of liver oblique diameter (all P 0.05). At week 12 of antiviral therapy, there were no significant differences in liver fibrosis markers and inflammatory indices between the CHB group and the CHB+NAFLD group (all P > 0.05); compared with the CHB+NAFLD group at weeks 24 and 48, the CHB group had significantly greater reductions in ALT ( Z =-2.128 and -3.055, both P < 0.05) and GGT ( Z =-2.025 and -1.631, both P < 0.05); at week 48, the CHB group and the CHB+NAFLD group had a significant reduction in HBV DNA ( Z =-6.445 and -4.415, both P < 0.001), and the CHB group had a significantly greater reduction. The CHB+NAFLD group had a significantly lower HBV DNA clearance rate than the CHB group at different time points of antiviral therapy ( χ 2 =14.237, 13.961, 15.226, 10.462, and 13.030, all P < 0.05). At week 48 of antiviral therapy, the CHB+NAFLD group had a significantly lower HBeAg clearance rate than the CHB group ( χ 2 =5.309, P =0.021), while there was no significant difference between the two groups at week 96 ( χ 2 =0.117, P =0.732). At weeks 24, 48, 72, and 96 of antiviral therapy, the CHB+NAFLD group had a significantly lower ALT normalization rate than the CHB group ( χ 2 =12.049, 5.287, 11.407, and 11.375, all P < 0.05). Conclusion NAFLD reduces the antiviral response of CHB patients and prolongs the duration of antiviral therapy.
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To screen strains with antibacterial and antitumor activity, pregnenolone was used as the sole carbon source for screening bacteria from soil. Based on bacteriostatic activity assay, Pseudomonas aeruginosa HBD-12 was found to be effectively inhibiting the growth of Escherichia coli, Bacillus thuringiensis, Penicillium digitatum and Penicillium italicum, and its fermentation broth was separated and purified using column chromatography. Then, structure of the obtained monomeric compounds was analyzed by spectrum analysis, and their antitumor activity was measured using HTRF kinase detection kit. The isolated monomeric compounds 1-hydroxy-9,10-phenanthroline and 3-hydroxy-9,10-dihydrophenanthroline had significant antitumor activity. At 20 μg/mL, 1-hydroxy-9,10-phenanthroline and 3-hydroxy-9,10-dihydrophenanthroline inhibited 78.39±2.29% and 60.34±8.35% Aurora kinase A, respectively. Therefore, the secondary metabolites of Pseudomonas aeruginosa HBD-12 have the potential to develop antibacterial and antitumor drugs.
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Antibacterianos/farmacología , Pruebas de Sensibilidad Microbiana , Penicillium , Pseudomonas aeruginosaRESUMEN
Objective:To investigate the effect of early debridement and open reduction combined with internal and external fixation on open fracture of tibia and fibula.Methods:The clinical data of 82 patients with open tibiofibular fractures admitted to the 901st Hospital of the Joint Logistic Support Force of the Chinese People′s Liberation Army from June 2017 to May 2018 were retrospectively analyzed. There were 42 males and 40 females, aged 20-62 years, with an average age (34.8±16.1) years. According to different surgical methods, they were divided into control group ( n=32) and observation group ( n=50). The patients in the control group received early debridement and limited internal fixation, the patients in the observation group received early debridement and open reduction combined with internal and external fixation. The operation time, blood loss, healing time, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, white blood cell count (WBC), excellent rate and complication rate were observed in both groups. The measurement data were expressed as mean±standard deviation( Mean± SD), comparison between groups was analyzed using independent sample t test, count data were expressed as percentage (%), comparison between groups was performed using chi-square test. Results:The operative time (98.35±15.14) min in the observation group were higher than those in the control group (79.26±13.22) min, blood loss (120.53±41.66) mL and healing time (16.84±5.07) min in the observation group were significantly lower than those in the control group [(79.26±13.22) min, (210.59±56.60) mL, (19.48±5.46) min]. The difference was statistically significant ( t values were 5.85, 7.76, 2.20, P<0.05). Compared with control group, the level of ESR (18.91±2.70) mm/h, CRP (39.20±3.13) ng/L, WBC (7.04±1.12)×10 3/L were significantly lower than control group [(27.36±3.28) mm/h, (45.63±4.06) ng/L, (11.06±1.51)×10 3/L]. The difference was statistically significant ( t values were 12.17, 7.63, 12.95, P<0.05). Compared with control groups′s excellent and good rate, the excellent and good rate of observation group was higher, but the difference was not statistically significant ( P>0.05). The incidence of complications in the observation group (6.00%, 3/50) was significantly lower than that in the control group (31.25%, 10/50) ( P<0.05). Conclusions:Early debridement and open reduction combined with internal and external fixation is an effective method for the treatment of open fracture of tibia and fibula. Compared with internal fixation, it has the advantages of shorter healing time, less blood loss and lower incidence of complications. And it can also reduce the inflammatory response of patients.
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Objective To explore the effect of 3d digital reconstruction and printing technology on the teaching of complex orthopedics. Methods A total of 90 interns in the Second Affiliated Hospital of Inner Mongolia Medical University from September 2016 to September 2017 were selected as research subjects. According to the different teaching methods, they were divided into control group (n=45) and experimental group (n=45). The former received traditional teaching;the latter used three-dimensional digital reconstruction and printing technology to print out complex fracture models of patients, digitally reproduced fracture classification, developed scientific surgical plans through fracture models, and simulated surgical fixation methods. Examination was divided into clinical skills and written exam according to exam outline requirements; Self-cognitive ability score included professional interest, fracture understanding, etc. The satisfaction of the medical students in the experimental group was determined using self-made questionnaires. t test was used to compare data between groups. Results Experimental groups' scores for surgical skills (84.36 ±0.28) and theoretical knowledge (87.55 ±0.44) were higher than the control group, and the differences were statistically significant (P<0.05). The professional interest of the experimantal group was higher than that of the control group, and the difference was statistically significant (P<0.05). The students' classroom atmosphere was significantly better compared with the control group, and the difference was statistically significant (P<0.05). Conclusion Using 3 d digital reconstruction and printing technology to establish modes in complex orthopedics teaching process can effectively improve interns' surgical skills and theoretical knowledge, and promote student satisfaction.
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Objective To evaluate the biomechanical effects of lateral meniscus posterior root (LMPR) tears fixed at different suture positions, so as to investigate the optimal suture method for repairing LMPR tears. Methods Eight fresh cadaveric knees were used. Each knee was tested under 6 conditions: intact knee, ruptur of LMPR, suture of LMPR to the center point of root insertion, suture of LMPR posterior, interior and later 5 mm to the center point of root insertion, respectively. The peak contact pressure, the average contact pressure and contact area were evaluated using a Tek-scan sensor positioned between the meniscus and tibial plateau, under 1 kN compressive loading, at 0 degree knee extension. Results In the lateral compartment, the average contact pressure and peak pressure significantly increased under rupture of LMPR compared with the intact state (P0.05). Conclusions The average contact pressure, the peak contact pressure and the contact area between the lateral meniscus and the tibial plateau changed obviously due to the LMPR tears. When the suture position was 5 mm lateral to the center point of root insertion, similar biomechanical function with the intact knee could be obtained.
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The prevalence of non-alcoholic fatty liver disease (NAFLD) is increasing gradually. The pathological changes of NAFLD can progress from simple hepatic steatosis to steatohepatitis , and to advanced liver fibrosis ultimately. Accurate diagnosis and identification of nonalcoholic steatohepatitis (NASH) and fibrosis patients are necessary for the treatment and management of NAFLD. The traditional gold standard--liver biopsy is an invasive procedure that is not suitable for clinical practice and clinical trials. Some non-invasive markers for NAFLD based on serological testing will be a new direction for the diagnosis of NAFLD. This article reviews the laboratory tests, clinical parameters, genomic and metabolomics-related NAFLD non-invasive serological markers.
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Nonalcoholic fatty liver disease (NAFLD) has become the most prevalent liver disease in China and the world. However, heterogeneity exists in the pathogenesis, pathology, and clinical phenotype of NAFLD. Metabolism/obesity and gene polymorphisms are involved in the pathogenesis of NAFLD. As for pathology, NAFLD in adults manifests as atypical fibrosis and sinus fibrosis, while NAFLD in children manifests as fibrosis in the portal area and lobular fibrosis in early stage. As for clinical phenotype, some patients may have diabetes or obesity. Such heterogeneity suggests that there are different strategies and methods for clinical diagnosis, treatment, and outcome evaluation.
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Objective To explore the morphological characteristics and change rule of thoracic joint angles in children aged from 10 to 12 years through thinner CT scanning and 3D reconstruction,and to provide theoretical basis for early diagnosis,treatment and prevention.Methods Totally 30 normal cases aged from 10 to 12 years were admitted into this study.There was no bone destruction,deformity,fractures,tumors and spine surgery involved.DICOM 3.0 data of multi-slice spiral CT (0.625 ～ 1.25 mm),ranging from T1 to T12,were used for 3D reconstruction,measurement and statistical analysis.Results The difference between left and right sagittal section angle of zygopophysis was less than 10°.There was no significant differences between T1,T11,and T12for sagittal section angle of upper zygopophysis (P ＞ 0.05).So was it between T3,T4,T9,T10 and T11 for sagittal section angle of lower zygopophysis (P ＞ 0.05).While there were significant differences between others(P ＜ 0.05).The was no significant difference between left and right coronal plane angle of zygopophysis (P ＞ 0.05).Coronal plane angle of lower and upper zygopophysis tended to be ‘ spike-like’,and the maximum points were at T7 to T9.For horizontal plane angle,left and right upper zygopophysis made significant differences between T2,T4,T8,T10 and T12 only,so did T7 lower zygopophysis (P ＜ 0.05).Horizontal angle of upper zygopophysis tended to be stable in the upper thoracic both in the left and right side,while a decreasing trend was shown in lower thoracic.Horizontal angle of lower zygopophysis showed a decreasing trend generally except individual vertebrae.Both upper and lower zygopophysis showed negative angle at T11 and T12 levels.Conclusion Thoracic joint angles(coronal,sagittal and horizontal angle) in children aged from 10 to 12 years can directly reflect the developmental regularity with growth,and it verified the tendency that horizontal facet joints of the cervical spine gradually changes to coronal facet joints thoracic spine and then changes to sagittal facet joints of lumbar spine.And the left and right side facet joints are basically symmetrical with the angle difference less than 10°.
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BACKGROUND:With the change of modern living habits, the incidence of cervical disease and cervical related diseases is increasingly at younger age. Based on this feature, the discussion of the relationship between the cervical spine and vertebral body as wel as regular feature can provide theoretical basis for early diagnosis, prevention and treatment of cervical spondylosis. OBJECTIVE:To analyze the correlation structure of the cervical vertebra uncinate process with the vertebral body and intervertebral foramen among adolescents. METHODS:A total of 66 cases without injuries, neurological symptoms or signs of 6 to 20 years old were scanned with multi-row thin-slice spiral CT from C1-T1. The original data were loaded in DICOM format into three-dimensional reconstruction software for measurement and statistical analysis. RESULTS AND CONCLUSION:(1) In addition to uncinate process height and vertebral body height, the uncinate process spacing, uncinate base width and diameter between the vertebrae and a uncinate process base radius vector length and vertebral bodies were positively correlated (P<0.05). (2) Uncinate high uncinate base long uncinate base width and height between the foramen in addition to the uncinate process had a positive correlation with the length of the substrate (P<0.05). (3) In conclusion, there is a certain correlation in juvenile cervical uncovertebral joint between the uncinate process and vertebral body and intervertebral foramen. With the growth of age, cervical activity is increased and the uncinate hyperplasia, trauma, and fracture can oppress spinal nerve within the intervertebral foramen to cause corresponding nerve root type of cervical spondylosis.
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Objective The correlation analysis was proceeded between youth cervical hook and transverse foramen by using imaging scanning and three-dimensional reconstruction method,which can provide theoretical basis for early diagnosis,treatment and prevention of ju-venile cervical spondylosis.Methods A total of 66 teenagers who had no trauma,neurological symptoms or signs were selected with aged from 6 to 20 years old,who were scanned by multi slice spiral CT,ranged from C1 to T1 .The original data in DICOMformat to import 3D re-construction software was related index measurement and subsequent statistical analysis.Results There was a correlation between hook height,base width,base length of luschca joint and transverse diameter,longitudinal diameter.Conclusion Hook vertebral meridian of lus-chca joint and transverse foramen has a close contact.Factors such as fracture and hyperplasia of luschca joint,vertebral artery of transverseforamen can be oppressed that cause corresponding vertebral artery type of cervical spondylosis.
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Objective To perform digital 3D measurement of anatomic parameters associated with vertebral units fixed by ribs and pedicle fixation of T4-T10,providing evidence for clinical application.Methods Spiral CT scan of T4-T10 vertebrae was conducted in 15 normal adults without spinal disorder.The data were imported into computer to establish units and disc models of thoracic and rib vertebrae T4-T10 using Mimics 16.0 software and Ansys 11.0 finite element software.The following data were measured in the vertebral pedicle-rib unit fixation group (group A) by software:transverse diameter of vertebral pedicle-rib unit,length of the outside pedicle screw,inclination angle of pedicle screw,and maximum and minimum inclination angles of pedicle screw;the following data were also measured in the pedicle fixation group (group B) by software:pedicle transverse diameter,length of pedicle screw,inclination angle of pedicle screw,and maximum and minimum inclination angles of pedicle screw.The corresponding parameters were compared between groups A and B.Results In both groups,the transverse diameters and screw lengths gradually increased with the increase in the vertebral sequence while the inclination angle of pedicle screw,and maximum and minimum inclination angles of pedicle screw decreased with the increase in the vertebral sequence.All the parameters in groups A were significantly larger than the corresponding ones in group B (P ＜ 0.05).Conclusions Of the spinal segment of T4-T10,the rib vertebral unit fixation can provide greater safe screw angles and screw diameters for clinical surgery.This is of vital significance for reducing the surgical complexity and improving screw prehension.
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Objective To study the developmental patterns and aging characteristics of anterior intervertebral disc and spinal canal based on anatomy CT scan and three dimensional reconstruction imaging measurement in the adolescents ages from 12 ~18 years old,and to provide the anatomical basis for the treatment and prevention of disc herniation diseases.Methods A total of 30 adolescents,who were with normal spines and without any the problems of nervous system,were selected to do CT scan of lumbosacral vertebrae through dual-source 64-slice spiral CT.CT original data of lumbosacral,which were translated into DICOMformat,were measured and analyzed statistically with Mim-ics software.Results There was no significant difference among the intervertebral disc and the superior sagittal diameter of the spinal canal, which were not influenced by gender (P >0.05).The intervertebral disc and the superior sagittal diameter of the spinal canal would increase with age with wavy trends,and there were some significant differences(P <0.05).Conclusion The anatomy parameters of lumbosacral disc and spinal changed regularly.In order to achieve satisfactory results of the lumbosacral disease treatment,it must be combined with individual radiographic findings,biomechanics and materials science,etc.
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BACKGROUND:Artificial knee joint replacement is the main surgical method for the treatment of severe knee joint deformation, but due to the limited existing knee prosthesis type. The stature of Fujian population in southeast China was shorter than that of the north. The size of artificial knee joint usual y did not fit for patients in clinic. The substitution effect was poor. OBJECTIVE:To measure the geometric parameters of proximal surface and cross-section of adult female tibia in southeastern area of Fujian Province of China, and provide basic data for design and replacement of artificial knee joint in females. METHODS:We chose 85 cases of dry female skeleton in southeastern area of Fujian Province of China, measured tibial plateau width, medial tibial plateau width and anteroposterior diameter, lateral tibial plateau width and anteroposterior diameter. We col ected clinical normal proximal tibial CT data of 36 patients (38-65 years old), with scan range of 30 cm (intercondylar eminence 30 cm) and layer thickness of 0.625 mm. Mimics 16.0 three-dimensional reconstruction software was used to measure above indexes and cut the reconstructed models with thickness of 3 mm, total y 10 layers. We divided its widest distance into four equal parts, and measured tibial anteroposterior diameter on three points. Statistical software was used to analyze the linear relationship between the data. RESULTS AND CONCLUSION:The experiment has successful y obtained geometric parameters of tibial specimens of adult females in southeastern area of Fujian province of China. Tibia platform inside and outside diameters were greater than the width inside and outside;inside and outside diameter and inside and outside width were similar. Ten segment planes of tibia, inside and outside diameters were always less than middle anteroposterior diameter. Three groups of data increased firstly, and then reduced. There were positive correlations between tibia length and width of the medial tibia platform, the lateral tibia platform width and anteroposterior diameter, the medial tibia platform width and anteroposterior diameter, and the lateral tibia platform width and anteroposterior diameter (P<0.05). These results suggested that relevant parameters of tibial plateau adult women in southeastern area of Fujian province of China showed some regular changes. Our results may provide quantitative reference data for the design and operation of artificial tibial plateau.
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BACKGROUND:Traditional distal femoral fixation plate screw breakage is relatively common. Designing good anatomical and attached fixation system is the key for clinical application. OBJECTIVE:To perform finite element analysis in two states of motion of the minimal y invasive distal femoral fixation system, compare stress distribution of different parts in the same fixed way, different fixed methods and the same fixed parts of different motion states. METHODS:Imaging data of a 34-year-old male patient weighing 68 kg with 33-C1 type fracture of distal femur were selected. CT data were input into Mimics 16.0 for reconstruction. PRO-E software was used to establish minimal y invasive internal fixation system with distal femoral locking plate. Data were introduced into reconstructed models of distal femur fracture in Mimics for grid division. Data were introduced into Ansys products 11.0 to construct finite element model, fix the surface of distal femur, and loaded 340 N on greater trochanter of femur. Stress distribution of each plate, screw hole and screw tail was analyzed in each group. Stress at the same region was compared in flexion and extension movement states. RESULTS AND CONCLUSION:(1) Finite element models of anatomic locking plate for distal femur fracture fixation were successful y established, total y 43 536 units, 41 256 nodes. (2) With the steel segment gradual y down (S1-S5), the stress gradual y increased. A1-A5 with the increase in the number of screws, the stress gradual y increased, but A6 suddenly decreased. (3) According to the cloud atlas of stress, these were wel distributed except A1. From distal end to extremity of screw, the stress of screws increased. Among corresponding segments, significant differences in stress around the nail holes and steel segment stress were detected. Moreover, the steel stress was greater than the stress of corresponding segment of screw hole. (4) Results suggest that using anatomical locking plate and minimal y invasive internal fixation system for distal femur fracture in a variety of fixed modes and moving conditions, the stress of each part is less than the yield strength of the titanium al oy screw, so the fixed system wil not produce instantaneous deformation or fracture.
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Objective To provide regional anatomical data for clinical application through observing the type, length and diameter of variation in the medial cubital vein of upper limb. Methods Dissected the medial cubital vein of upper limb in 35 (70 sides) adult cadavers (male 38, female 7), and observed the morphological structure. The length and vessel diameter of the medial cubital vein were measured. Results The variation of the medial cubital vein of upper limb was divided into six type. TypeⅠincluded 29 cases (41. 43%) of male and 8 cases (11. 43%) of female;Type Ⅱ included 14 cases (20. 00%) of male and 4 cases (5. 71%) of female;Type Ⅲ included 7 cases (10. 00%) of male and 2 cases (2. 86%) of female;TypeⅣincluded 3 cases (4. 29%) of male and 0 cases of female;TypeⅤincluded 2 cases (2. 86%) of male and 0 cases of female;TypeⅥincluded 1 cases (1. 43%) male and 0 cases of female. Conclusion This study enriched anthropology data of the medial cubital vein and it has the role of guiding in clinical applications.
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BACKGROUND:At present,there is lack of relevant biomechanical model for the T6-T7-T8 rib-vertebral fix unit.In addition,there is no support of parameters of basic studies on reasons and reasonable explanation of screw breakage,poor quality of bone fusion and adjacent segment degeneration.OBJECTIVE:To develop a three-dimensional finite element model of bone graft with vertebral tuberculosis debridement and posterior rib-vertebral unit fixed system through tuberculosis of thoracic spine (T6-8),and to analyze the stress so as to improve it.METHODS:Spiral CT data of one male patient (172 cm,71 kg,39-year-old) with T7 vertebral tuberculosis were imported into computer to develop a three-dimensional finite element model of bone graft with vertebral debridement and posterior vertebral unit fixed system through tuberculosis of T6-8 by Mimics 13.0 and Ansys 11.0 finite element software.500 N pressure and 10 N?m torque were loaded to the vertebral body by 3 kinds of physiological loads which simulated flexion,extension and lateral bending.The stress distribution of fixation devices under different loads was compared.RESULTS AND CONCLUSION: At the positions of anteflexion and extension,the stress mainly concentrated to screw tail,and the stress of upper screw was greater than the middle and lower screws.For connecting rods,the stress of the middle was always less than the lower middle and the middle stress was zero.At lateral bending position,the stresses of upper and middle screw tail were quite,and the unilateral stress of connecting rod was also equivalent.For three different dynamics at the same point,the stress of middle connecting rod increased in the lateral bending motion,and the stress of lower screw tail was equivalent.These data suggested that it is prone to fatigue fracture at upper screw tail by bone graft with vertebral tuberculosis debridement and posterior rib-vertebral unit fixed system through tuberculosis of thoracic spine (T6-8) at the three positions of anteflexion,extension and lateral bending.The lower connecting rod at the positions of anteflexion and extension and the middle connecting rod at the position of lateral bending easily cause fatigue fracture.
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Objective To evaluate the value of application of the digital 3-D reconstruction pelvic on anatomical teaching. Methods The digital 3-D from 1 case non-pelvic-disease CT imaging were reconstructed, and name of structure were marked. A total of 90 students were randomly selected from two classes of clinical medical undergraduates of Grade 2011, and were randomly divided into experiment group (EG) and control group (CG), with 45 students in each group. Digital 3-D recon-struction pelvic and traditional teaching methods were applied in EG, while only traditional teaching methods were applied in CG, and the teaching effect was evaluated through questionnaires and the results of the examination. The questionnaires included how students grasped knowledge and whether or not they were interested in class and satisfied with the teaching methods etc., and the examination included identification specimen test(20 points) and theoretical knowledge examination on pelvic bone knowledge points(80 points). Comparison between two groups was performed using two sets of com-pletely randomized design t test. Results Clear three-dimensional reconstruction of the angular orien-tation of the various models of the pelvis was made. Experimental class' survey results were better than the control class’ and the differences were statistically significant(P<0.05). EG's scores of experimental test and theoretical knowledge examination were (18.69 ±1.32) points and (60.35 ± 5.12) points, respectively, while CG's scores were(17.23±1.52) points and (56.32±6.25) points. Difference be-tween the two groups was statistically significant(P<0.05). Conclution The application of digital 3-D reconstruction pelvic on anatomical teaching can increase the performance record of students, and it can be applied to anatomical teaching as a new method.
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Objective To investigate the C1q expression in the patients with pulmonary tuberculosis (TB) and its mechanism on the anti-TB role of macrophages .Methods Each 30 cases of active pulmonary TB ,tuberculous pleurisy ,latent Mycobacterium tu-berculosis infection and healthy controls were selected .Peripheral venous blood 10-20 mL was collected on the next day of admis-sion or on the time for physical examination .Pleural fluid 50 mL was extracted in the patients with hydrothorax and the lung tissue specimens 1 cm × 1 cm × 1 cm was taken in the operative patients .The real-time quantitative PCR(RT-PCR) was adopted to detect the express C1q in peripheral macrophages and the C1q expressing in macrophages of the lung tissue was detected by immunohisto-chemical staining .Results The peripheral blood C1qA expression level in the active pulmonary TB group and the tuberculous pleu-risy group was significantly higher than that in the healthy control group and the latent TB infection group (P<0 .05) .The C1qA expression level in hydrothorax in the tuberculous pleurisy group was higher than that in the active pulmonary TB group (P<0 .05) ,and the C1q expression in hydrothorax in these two groups was higher than that in peripheral blood (P<0 .05) .C1q was strongly expressed in macrophage cytoplasma in the active pulmonary TB group and the TB pleurisy group ,but weakly expressed in the multinuclear macrophages .Conclusion The peripheral blood C1qA expression level in the active pulmonary TB group and the tuberculous pleurisy group was significantly higher than that in the healthy control group and the latent TB infection group (P<0 .05) .The C1qA expression level in hydrothorax in the tuberculous pleurisy group was higher than that in the active pulmonary TB group (P<0 .05) ,and the C1q expression in hydrothorax in these two groups was higher than that in peripheral blood (P<0 .05) . C1q was strongly expressed in macrophage cytoplasma in the active pulmonary TB group and the TB pleurisy group ,but weakly ex-pressed in the multinuclear macrophages .
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The eighteen incompatible medicaments is the incompatibilities in traditional Chinese medicine (TCM). However, in some special occasion, the incompatible medicaments can also be used in one prescription in the clinical applications. In order to reveal the theoretical basis for applications of incompatible medicaments in prescriptions, we analyzed ancient prescriptions and found that there are contrary Chinese herbal nature combina-tions (CHNCs) which have the same meridian tropism as well as the opposite nature and taste in prescriptions. In clinical applications, one of the non-contrary CHNCs was selected as the main response to syndrome differentia-tion. The contrary CHNCs in the same meridian tropism were used to restrict each other and therefore have the protective effects. The features found in this paper will be beneficial to further research on the rational applica-tion of incompatible medicaments.
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Objective To investigate the clinical characteristics in chronic severe hepatitis B patients with HbeAg-positive and HbeAs-negative.Methods A total of 95 chronic severe hepatitis B cases were retrospectively analyzed.The clinical information,hepatic function,hepatic fibrosis and HBV DNA in HBeAg-negative and HBeAgpositive groups were analyzed.Results of the 95 cases,54(57% ) were HBeAg-negative and 41(43% ) were HBeAg-positive.No significant differences were found on age,ALB,TB,CHE,indexes of hepatic fibrosis and the ratio of complications between HBeAg-negative group and HBeAg-positive group.Compared with HBeAg-positive group,there were significantly higher levels of ALT(198.25±215.37)U/L vs(400.37±413.59)U/L],AST[(254.78±269.16)U/L vs(578.14±600.23)U/L] and lower level of HBV DNA[(6.17×10~6±8.24×10~1)copies/ml vs (2.39×10~5±6.75×10~1) copies/ml] in HBeAg-negative group(P<0.05).The anteroposterior diameter of the left liver and the thickness of right liver were(65.12±12.43)mm and(95.37.±12.69)mm in the HBeAg positive fatal chronic severe hepatitis B before the terminal phase,vs(56.78±11.04)mm and(89.34.±9.23)mm in the HBeAg negative group,and the former is longer than the later(P<0.05).Conclusion Tissue injury is more serious and the level of HBV DNA is lower in HBeAg-negative patients than HBeAg-positive patients.Liver size of HBeAg negative group reduces more significantly than HBeAg positive group before terminal phase.