Hepatitis B is a serious hazard to human health.This paper describes the current clinical use of several nucleoside antiviral drugs combination,and introduces the candidate drugs which are able to effectively inhibit the hepatitis B virus replication in vivo and in vitro in two years,which provides reference for the research and development of new anti-HBV drugs.

?AIM: To discuss the application of anterior segment optic coherence tomography ( AS-OCT ) in the diagnosis of corneal ulcer.?METHODS: The cross linear scan was used in 88 patients ( 88 eyes ) with corneal lesion by AS-OCT to gather the image data, observe the pathological changed tissue by measuring all layers for patients with initial inspection, providing important visual images and data for treatments. All the patients were followed up for 2mo.?RESULTS:Clear images with structure of all layers were obtained. It can provide the intuitive image data and scan the same position and show the changes during the treatment.?CONCLUSION: AS-OCT can discover the important condition immediately. It also can monitor course of disease dynamically, provide the intuitive image data for clinical treatment.

Adolescent ; Adult ; Blood Transfusion ; Child ; Child, Preschool ; Female ; Humans ; Male ; Middle Aged ; Pesticides ; poisoning ; Poisoning ; therapy ; Treatment Outcome

Objective To investigate the effect of trichostatin A (TSA) and 5-azacitidine (5-AzaC) on pancreatic β-cells impaired by cytokine,via measuring the proliferation,apoptosis,and function of pancreatic β-cells.Methods RIN-m5f was impaired by interleukin-1β and interferon-γin vitro,and treated with TSA and 5-AzaC.Experiment groups included blank control group,cytokine induction group,0.05/0.10 μmoL/L TSA group,0.63/1.25 μmoL/L 5-AzaC group,and0.10 μmol/L TSA plus 1.25 μmol/L 5-AzaC group.The viability of RIN-m5f cells was detected by MTT assay.Apoptotic rate was determined by Annexin V-fluorescein isothiocyanate (FITC) /propidium iodide flow cytometry.Insulin secretion was measured by enzyme-linked immunosorbent assay.Results The viability of RIN-m5f cells in 0.05/0.10 μmoL/L TSA group,0.63/1.25 μmol/L 5-AzaC group,and 5-AzaC plus TSA group was 70.1％/79.2 ％,67.3 ％/82.9 ％,and 89.1％ respectively,being higher than that in the cytokine group (33.9％,P＜0.05) ; the apoptosis rate was 10.3％/10.5％,7.9％/9.6％,and 8.2％,being lower than that in the cytokine group (16.6％,P＜0.05) ; the capacity of glucose-stimulated insulin secretion of all the treated groups was higher than that in the cytokine group (P＜0.05).Conclusion TSA and 5-AzaC might promote the proliferation of pancreatic β-cells impaired by cytokines,inhibit its apoptosis and recover its insulin secretion.

Objective To evaluate the effect of the esophagus invert stripping without opening the thoracic cavity on carci- noma in the inferior pharynx, cervical esophagus or the cardia. Method Eighteen patients with carcinoma in the inferior pharynx, cervical esophagus or the cardia were treated surgically with invert stripping of the exophagus without opening the thoracic cavity. Ten patients received antidromic esophagus invert stripping and the other 8 underwent orthodromic esophagus invert stripping. The esophagus of these patients were replaced with either the stomach (in 15 cases) or the colon (in 3 cases), and complete removal of the pharynx and larynx were performed in 2 cases, both of which received permanent fistulization. Result No death occurred during the operation and the complications included anastomotic leakage (2 cases), injury of the recurrent laryngeal nerve (2 cases), pulmonary infection (3 cases), and incision infection (1 case). The follow-up survey showed that the 1-year, 3-year and 5-year survival rates were 77%, 44% and 22%, respectively. Conclusions This surgical approach reduces the damage of the cardiopulmonary function, which can be meaningful for senior patients and those with cardiac or pulmonary problems. The carcinoma in the inferior pharynx or cervical part of the esophagus should be treated surgically to improve the survival rate, but this approach should be avoided in patients with carcinoma in thoracic part of the esophagus.

Objective To evaluate the effect of the esophagus invert stripping without opening the thoracic cavity on carci- noma in the inferior pharynx, cervical esophagus or the cardia. Method Eighteen patients with carcinoma in the inferior pharynx, cervical esophagus or the cardia were treated surgically with invert stripping of the exophagus without opening the thoracic cavity. Ten patients received antidromic esophagus invert stripping and the other 8 underwent orthodromic esophagus invert stripping. The esophagus of these patients were replaced with either the stomach (in 15 cases) or the colon (in 3 cases), and complete removal of the pharynx and larynx were performed in 2 cases, both of which received permanent fistulization. Result No death occurred during the operation and the complications included anastomotic leakage (2 cases), injury of the recurrent laryngeal nerve (2 cases), pulmonary infection (3 cases), and incision infection (1 case). The follow-up survey showed that the 1-year, 3-year and 5-year survival rates were 77%, 44% and 22%, respectively. Conclusions This surgical approach reduces the damage of the cardiopulmonary function, which can be meaningful for senior patients and those with cardiac or pulmonary problems. The carcinoma in the inferior pharynx or cervical part of the esophagus should be treated surgically to improve the survival rate, but this approach should be avoided in patients with carcinoma in thoracic part of the esophagus.

Objective: To investigate the correlation of MDM2 SNP309 polymorphism with breast cancer risk in Chinese women. Methods: The polymorphism of MDM2 SNP309 was detected by PCR-restriction frag-ment length polymorphisms assay (PCR-RFLP) in 698 women with primary breast cancer and 525 healthy controls. Results: Compared with the T/T genotype, the G allele (T/G or G/G) was not associated with an in-creased risk of breast cancer in the entire population studied (T/G, adjusted OR=1.2, 95% CI: 0.8-1.6, P=0.30; G/G, adjusted OR=1.0, 95% CI: 0.7 ～ 1.5, P=0.88). Among postmenopausal women, the G allele (T/G or G/G) was significantly associated with an increased risk of breast cancer (T/G, adjusted OR=1.8, 95% CI:1.2～3.0, P=0.011; G/G, adjusted OR=1.9, 95% CI: 1.2～3.3, P=0.014). But this association was not ob-served among premenopausal women. Conclusion: MDM2 SNP309 heterozygous T/G genotype and homozy-gous mutant GIG genotype increase breast cancer risk in postmenopausal Chinese women.

Aim To evaluate the effectiveness and safety of remimazolam tosylate for administering general anesthesia in morbidly obese patients.Methods This clinical trial was conducted at a single center from De-cember 2021 to October 2023.It assessed 108 morbid-ly obese patients(body mass index,BMI≥40)who underwent laparoscopic sleeve gastrectomy.Patients were randomly assigned to either the remimazaolam group(Group R)or the propofol group(Group P)for general anesthesia induction and maintenance.The primary outcome was to compare the incidence of ad-verse events and postoperative recovery characteristics between the two groups.Results During induction pe-riod,the incidence of adverse events was higher in group P,including hypotension(P＜0.01),hypox-emia(P＜0.05),bradycardia(P＜0.01),and in-creased vasopressor requirement(P＜0.05).The time to loss of consciousness and BIS falling to 60 was shor-ter in group P than in group R(P＜0.01).There were no statistically significant differences between the two groups in terms of postoperative quality of recovery(QoR-40 score),24-hour postoperative pain visual an-alogue scale(VAS)scores and morphine consump-tion.In conclusion,remimazolam tosylate,utilized for anesthesia induction in morbidly obese patients,signif-icantly reduced hypotension and hypoxemia compared to propofol,while it could also maintain similar postop-erative recovery quality.Conclusions Remimazolam is effective in reducing the incidence of hypotension and hypoxaemia during the induction period of general anaesthesia in morbidly obese patients and it is compa-rable to propofol in terms of quality of postoperative re-covery.

OBJECTIVETo design a device for direct vision intracardiac operation without cardiopulmonary bypass, and assess its applicability preliminarily.

METHODSThe device was designed according to the clinical needs of intracardiac operation and used in operations for repairing atrial septal defect in 5 ex vivo porcine heart models. The practical applicability of this device was thoroughly tested and the results of the operations were evaluated.

RESULTS AND CONCLUSIONDirect vision operation for repairing atrial septal defect was successfully performed using this device, which can be a well applicable in some intracardiac operations, but its clinical effects need further evaluation.

Animals ; Cardiac Surgical Procedures ; instrumentation ; methods ; Cardiopulmonary Bypass ; Heart Septal Defects, Atrial ; surgery ; In Vitro Techniques ; Swine

OBJECTIVETo explore the impact of 5-fluorouracil (5-FU) on glucose metabolism and pancreatic pathology.

METHODSTwenty Wistar rats were divided into 5-FU group(n=10, chemotherapy was administered intraperitoneally to animals at a dose of 20 mg/kg daily for continuous 5 days) and control group (n=10, sodium chloride was administered intraperitoneally to animals with the same dose at the same time ). Glucose tolerance was evaluated 2 and 7 days following 5-FU treatment by serial measurement of blood glucose before and after an oral glucose load. Plasma insulin concentration was determined by radioimmunoassay. Pancreatic pathology was examined with morphological method and the ultrastructural changes of β cells were observed by transmission electron microscope.

RESULTSFasting blood glucose level was significantly higher in the 5-FU group than that in the control group [(7.6±0.9) mmol/L vs. (4.6±0.6) mmol/L at day 2; (8.9±1.0) mmol/L vs. (4.7±0.6) mmol/L at day 7, P<0.01]. Insulin releasing test indicated that the early phase insulin response to glucose load was significantly diminished in animals treated with 5-FU at day 2. Insulin level was significantly lower in the 5-FU group than that in the control group at 30 min (P<0.01). The peak secretion time of plasma insulin in 5-FU group was at 60 min, similar to the control group; and plasma insulin level decreased more slowly. Plasma insulin level was higher in 5-FU groups than in control groups on 120 min and 180 min. At day 7, Insulin level was lower in the 5-FU group than that in the control group on 60 min, and the peak secretion time of plasma insulin was delayed to 120 min. Plasma insulin level was significantly increased in 5-FU group than that in control group on 180 min(P<0.01). No gross histopathological damage to the pancreas was observed at day 2 and 7 following administration of 5-FU. The structural changes of mitochondria were mainly the quantities of secretory granule diminished at day 7 under transmission electron microscope. Dilated rough endoplasmic reticula, swollen mitochondria, and the presence of adipose drops in lysosomes were found in few cells.

CONCLUSIONS5-FU-induced hyperglycemia appears to be mediated in part by a relatively deficient insulin secretion to glucose stimulation. A relative deficiency in insulin secretion following 5-FU treatment appears to be related to β cells function impairs with islet cell ultrastructural changes induced by 5-FU.

Animals ; Blood Glucose ; drug effects ; metabolism ; Female ; Fluorouracil ; pharmacology ; Insulin ; blood ; Male ; Pancreas ; drug effects ; pathology ; Rats ; Rats, Wistar