[Twelve-week of sofosbuvir/velpatasvir therapeutic regimen for chronic hepatitis C patients in northwest region of China: a real-world multicenter clinical study].

Objective: To study the real-world outcome of China FDA-approved Sofosbuvir (SOF)/Velpatasvir (VEL) in Northwest China. Methods: In this multicenter, prospective, real-world cohort study, we recruited patients from 10 sites from Northwest China, who were chronically infected with HCV GTs 1-6 from 06/2018 to 09/2019. Patients received SOF (400mg)/VEL (100mg) for 12 weeks, and with ribavirin 900-1200 mg for GT3 cirrhosis and for any genotype decompensated cirrhosis. The primary endpoint was sustained virological response at 12-weeks post-treatment (SVR12) and safety. The secondary endpoint was the change of liver function after the achievement of SVR12. Results: Totally, 143 patients were enrolled in the study, four patients were lost to follow-up and one died during the follow-up, 138 patients were included in per-protocol analysis. Of the 138 patients, the mean age 53 years, 53.6% male, 94.2% Han nationality, 53.6% liver cirrhosis, 10.1% HBsAg(+), 6.5% renal dysfunction, 5.1% treatment-experienced, and 16.7% patients received ribavirin treatment. The genotype distribution was as follows: 35.5% GT1, 42.8% GT2, 15.9% GT3, and 5.8% un-typed. The SVR12 rate was 96.5% (138/143, 95%CI: 93.5%-99.6%) for intention-to-treat analysis, and in per-protocol analysis, all 138 patients obtained SVR12 (100%). Compared with baseline, the serum total bilirubin, ALT and AFP levels decreased (all P < 0.05), as well as increased ALB and platelet count (all P < 0.001) at post-treatment 12-weeks. Overall adverse events (AEs) rate is 29.0%, and the most common AEs were anemia (14.5%) and fatigue (8.0%). Severe side effects (edema and fatigue) occurred in 2 patients, one of whom needed a short-term interruption of treatment due to fatigue. Conclusion: In this real-world cohort study, 12-week SOF/VEL regimen with or without ribavirin achieved high SVR12 rates (96.5%-100% overall) with excellent safety profile among patients with HCV GT1/2/3 infection including patients with GT3 and cirrhosis, and led to improvement of liver function.

[Effect of perforator flap of the proper digital artery of the ulnar or radial side of finger in the treatment of webbed scar contracture of the same finger in child].

Objective: To explore the effect of the perforator flap of the proper digital artery on the ulnar or radial side of the finger in the treatment of webbed scar contracture of the same finger in child. Methods: From January 2012 to January 2016, 26 children who were treated with dressing change after burn of finger and then had webbed scar contracture along with growth and development were hospitalized in our unit, involving a total of 50 fingers. There were 14 males and 12 females among the children aged from 2 to 14 years. After the scar was dissected and released, the wound area ranged from 1.6 cm×1.0 cm to 5.0 cm×2.6 cm. The perforator flap of the proper digital artery of the ulnar or radial side of the same finger was used to repair the wound. The flap area ranged from 1.8 cm×1.0 cm to 4.6 cm×1.8 cm. The donor sites were sutured directly. The residual wounds in donor and recipient sites were repaired by full-thickness skin graft collected from inguinal area/adjacent area or adjacent perforator flap. The postoperative development and function of the fingers were followed up and observed. The range of motion of the fingers was evaluated according to the Chinese Medical Association Hand Surgery Society's upper limb functional evaluation trial standard, the Kantor Scar Cosmesis Assessment and Rating Scale was used to score the scar of finger, and the latest data were recorded. Results: The flaps and skin grafts survived successfully after operation. The patients were followed up for 6 to 24 months. The perforator flaps of the proper digital artery on the ulnar or radial side of the finger survived well at the latest follow-up, with good color and texture and a two-point discrimination distance of 9 to 12 mm. There was no contracture of the fingers, a little pigmentation in the skin graft area, no flexion deformity of the fingers, no lateral bending of the fingers to the flap-harvesting side, and no scar contracture at the webs of the fingers. Compared with that of healthy side, the development of finger was not obviously abnormal. The range of motion of the fingers was excellent in 38 fingers and good in 12 fingers, and the scar score of the fingers was 2-3 points in 31 fingers, 4-7 points in 15 fingers, and 8-10 points in 4 fingers. Conclusions: The efficacy of perforator flap of the proper digital artery of the ulnar or radial side of finger in the treatment of the webbed scar contracture of the same finger in child is reliable, with high postoperative survival rate of the flap, better color and texture, and fewer complications, which can avoid the risk of re-contracture of the finger in a short period after operation, and does not affect the growth and development of the finger.

[Clinical value of diffusion tensor imaging parameter value in evaluating the prognosis of spinal cord injury in acute cervical spinal cord injury].

Objective: To evaluate the clinical application value of diffusion tensor imaging (DTI) parameter in evaluating the prognosis of spinal cord injury in acute cervical spinal cord injury. Method: From October 2012 to December 2015, a total of 23 patients with acute cervical spinal cord injury were examined by routine MRI-T2WI high signal DTI examination, according to the American Spinal Injury Association (ASIA) damage standard. One month later according to the functional outcome of the spinal cord, all patients were divided into non improvement group (group A) 4 cases (2 cases of ASIA-A, 2 cases of grade B) and improvement group (group B) 19 cases (13 cases of ASIA-C, 5 cases of grade D, 1 case of grade B), 15 cases of healthy volunteers as the normal group (group C ). The FA value, ADC and axial eigen value[λ∥=λ1], radial eigen value[λ⊥=(λ2+ λ3)/2]of before and after the treatment in group A and group B were compared by paired t test respectively. Single factor analysis of variance (ANOVA) was used to analyze the differences of DTI among the group A, group B and group C, and LSD test was used to compare the differences among the groups.Before and after treatment, the DTI measurement area was consistent.Changes of nerve fiber bundles in group A and group B before and after treatment were displayed in DTT. Results: After the treatment , the FA value of group A decreased , ADC value and λ⊥ value increased than that of before treatment(t=3.037, -4.183, -4.805, all P<0.05), λ∥ value increased(t=-1.160, P>0.05). After the treatment , the FA value and ADC value of group B increased , λ⊥ value decreased than that of before treatment(t=-3.344, -3.642, 4.694, all P<0.05), λ∥ value increased(t=-0.596, P>0.05). After treatment, there were statistical differences in FA values, λ⊥ value , ADC values and λ∥ values among three groups (F=71.958, 70.432, 75.902, 22.521, all P<0.01). Conclusion: The changes of FA value, λ⊥ value are the two most sensitive indicators of acute cervical spinal cord injury of spinal cord function prognosis.It suggests the poor prognosis of spinal cord function when FA value decreases and λ⊥ value continues to increase.DTT can visually display subtle changes in the nerve fiber bundle.

[GABA initiates the acrosome reaction and fertilizing ability in human sperm].

The present study was undertaken to investigate whether GABA induced the acrosome reaction (AR) and fertilizing ability, as well as its possible mode of action in human spermatozoa. Spermatozoa from fifteen health fertile men isolated by the swim-up technique were preincubated in a modified BWW with 0.35% BSA for 1-11 h under 5% CO2 in 95% air at 37 degrees C. Aliquots of spermatozoa were collected at 0, 1, 3, 5, 7, 9 and 11 h of incubation for evaluation of the AR by chlortetracycline (CTC) staining. The sperm penetration assay (SPA) was carried out by using the zona-free hamster oocyte test. Intracellular calcium ([Ca2+]i) concentrations were determined by means of fluorescent probe Frua-2/AM. GABA at 1.25 mumol/L significantly induced the AR in human spermatozoa preincubated for 3 h, with a maximal response in preincubated for 9 h, and the effect changed in a concentration-dependent manner. The maximal stimulatory effect was observed with 1.25 mumol/L GABA, and the AR then decreased markedly with further increase of GABA concentration to 10 mumol/L. Exposure of preincubated spermatozoa to GABA in combination with progesterone resulted in a higher proportion of the AR as compared with that obtained with each agonist applied alone. In addition, GABA prompted a rapid increase in interacellular [Ca2+]i. Furthermore, the AR induced by GABA was prevented by inclusion of 1 mmol/L EGTA or 100 mumol/L La3+. Also, GABA enhanced significantly the ability of spermatozoa penetrating zona-free hamster oocytes and the index of fertilization. These results indicate that GABA may be involved in the modulation of the AR and the fertilization process in capacitated human spermatozoa through a calcium mediated mechanism, thus opening up possibilities for studies of signal transductions through activation of the GABAA receptor present on the sperm surface.