Objective To investigate the value of detecting hepatitis B virus (HBV) YMDD variants by matrix-assisted laser de-sorption time of flight mass spectrometry (MALDI-TOF MS). Methods The assay is based on polymerase chain reaction (PCR) amplifica-tion and mass measurement of oligonucleotides containing sites of mutation of the YMDD motif. Result The MALDI-TOF MS-based genoty-ping assay was sufficiently sensitive to detect as few as 100 copies of HBV genome per milliliter of serum, and this method had superior spe-cificity for determining mixtures of wild-type and variant viruses. When sera of 40 patients were analyzed, the MALDI-TOF MS-based assay correctly identified known viral variants and additional viral quasi-species not detected by previous methods, as well as their'relative abun-dance. Conclusion The sensitivity, specificity and amenability to high-throughput analysis make MALDI-TOF MS-based assay suitable for mass screening of HBV infected patients who are receiving lamivudine.

Objective To explore the effect of the cystoscope indwelling double J tube for the treatment of pregnancy with ureteral calculi,and to observe and analyze the prognosis,and provide the basis for clinical therapy. Methods 46 pregnant women with ureteral calculi were selected.All patients were treated by cystoscope indwelling double J tube.Observation indexes were the follow -up complications after a week of operation time,operation situa-tion,Visual analogue scale (VAS)was used to evaluate the degree of pain operation before and after treatment 48 h. To observe the pregnant women with double J tube placement and delivery status.Results 46 patients were success-fully catheter,the average operation time was (29.14 ±3.27)min.37 patients with lumbar cramps and fever and other symptoms were relieved after treatment.6 patients with replacement of double J tube 2 months later.After treatment, VAS score was (1.16 ±0.83)points,which was lower than (6.93 ±1.02)points before treatment,the difference was statistically significant (t =9.64,P <0.05).After treatment,the infection rates of hydronephrosis and urinary tract were 4.35% (2 /46)and 0% (0 /46),which were lower than before treatment [(15 /46,32.61%)and 19.57%(9 /46)],the differences were statistically significant (χ2 =8.33,9.05,all P <0.05);46 cases of pregnant women were smooth production,no abortion complications.The average indwelling double J tube time was (5.08 ± 1.16)months.Conclusion Cystoscope indwelling double J tube for the treatment of ureteral calculi in pregnancy has less invasion,high stone clearance rate,less postoperative complications and high safety,the prognosis was good,and it is a safe and effective method.

[Objective] To study the mechanism of Ruangan Granule (RG) in counteracting the experimental liver fibrosis and cirrhosis in SD rats. [Methods] As compared with colchicines, effect of RG in small and large dosages on serum transforming growth factor ? (TGF ?1 ), hydroxyproline (Hyp), collagen Ⅰ and Ⅲ , hepatic function and hepatic pathology were observed in rats. [ Results ] Both RG and colchicines could decrease serum levels of alanine aminotransferase (ALT) and alkaline phosphatase (AKP) and increase serum levels of total protein and albumin in rats with liver fibrosis induced by bovine serum albumin (P 0.05). Effect of large-dosage RG in improving hepatic pathology was better than that of colchicines. [Conclusion] RG has an inhibitory effect on the formation of liver fibrosis and cirrhosis. Its mechanism may be related to the improvement of hepatic function, decrease of serum TGF ft , collagen Ⅰ and Ⅲ and Hyp levels.

Objective To study the Sheng Mai San on the levels of cell factors induced by lipopolysaccharide in acute liver failure rats. Methods The models of chronic liver failure were constructed by injecting CCl4 in the abdomen of rats. The serum levels of lipopolysaccharide and cell factors were determined after treating with LPS and Sheng Mai San for 2 hours. Results The serum level of IL-6［(64.50±18.79)pg/ml vs (4.79±0.57)pg/ml］, ICAM-1［(25100.00±5258.85)pg/ml vs (4215.50±942.79)pg/ml］ and TNF-α［(17.55±2.39)pg/ml vs (10.92±5.02)pg/ml］ was increased by CCl4 (P＜0.05), but there is no effect on the serum level of LPS in rats ［(0.058±0.007)EU/ml vs (0.040±0.002)EU/ml,P＞0.05］. Sheng Mai San can significantly reduce the serum level of IL-6, ICAM-1 and TNF-α in rats with acute liver failure induced by CCl4 ［(17.20±3.12)pg/ml,(9490.00±2725.78)pg/ml,(3.00±1.00)pg/ml,P＜0.05］. After treating with LPS for 2 hours, the serum level of LPS, TNF-α, IL-6, ICAM-1 markedly increased ［(0.501±0.019)EU/ml,(19750.00±9655.17)pg/ml,(5615.00±490.50)pg/ml,(41000.00±589.88)pg/ml,P＜0.01］. Sheng Mai San could reduce the serum levels of LPS, TNF-α, IL-6, ICAM-1 and in rats with chronic liver failure (P＜0.01). Conclusions SD Rats in the state of chronic liver fail-ure, existing serious serum endotoxin, can induce the levels of cell factors by diversification inflammation reaction and. ShengMaiSan can regulating the levels of cell factors in rats with chronic liver failure.

Objective To investigate the effects of "a determinant variants in chronic hepatitis B(CHB)patients on the expression of hepatitis B surface antigen(HBsAg) and anti-HBs antibodies (HBsAb). Methods Eight hundred sixty-six chronic hepatitis B patients were enrolled, which HBs Ag carriage was beyond a 6 month period.77 patients(8.9%)concomitantly carried both HBs Ag and anti-HBs antibodies,789 patients(91.1%)were only HBs Ag positive. Selection criteria for patients with both HBs Ag and anti-HBs were mainly focused on anti-HBs titers at least three times above the analytical threshold of the technique(10 U/L)on at least three consecutive visits.14 patients were selected from77 patients, who presented both markers(group Ⅰ),and 12 patients from another 789 patients who positive for HBs Ag only(group Ⅱ)were randomly selected as controls. The HBs Ag-encoding gene was amplified and cloned, and at least 15clones per patient were sequenced and analyzed. Results The number of residue changes within the S protein group Ⅰ was 2.7 times more frequently than that in group Ⅱ patients, and "a" determinant of the major hydrophilic region(MHR)occurred mostly. Ten patients (71%)from group Ⅰ and three patients(25%)from group Ⅱ presented at least two residue changes in the MHR. The most frequent changes in group Ⅰ patients were located at positions s145,s129,s126,s144, and s123 as described for immune escape variants. Conclusions In CHB patients, the coexistence of HBsAg and HBsAb is associated with an increase of "a" determinant variability, suggesting a selection of HBV immune escape mutants during chronic carriage. The consequences of this selection process play an important role in vaccine efficacy, diagnosis and clinical therapy.

Objective To study the effects of tonifying kidney therapy on pathology in chronic hepatitis B virus carriers.MethodsWith the multi-center, randomized, double-blinded and placebo-controlled methods, 600 cases of chronic hepatitis B virus carriers were divided intoBushen Qingtou group,Bushen Jianpi group and control group, 200 cases in each group, and were treated withBushen Qingtou prescription,Bushen Jianpi prescription and placebo prescription respectively for 52 weeks. The pathological changes of the liver biopsy were observed by liver biopsy examination before and after treatment. Inflammatory active degree and fibrosis were scored with Knodell HAI and Ishak.Results The number of decreasing more than 2 points on Knodell HAI inBushen Qingtou group,Bushen Jianpi group and control group was 21, 18, and 6 respectively (P<0.05); the number of increasing more than 2 points on Knodell HAI in three groups was 3, 2, and 8 respectively (P<0.05). The curative effect ofBushen Qingtou prescription,Bushen Jianpi prescription were significantly obviously better than control group, without statistical significnce between the two treatment groups (P>0.05). The number of decreasing more than 1 points on Ishak in Bushen Qingtou group,Bushen Jianpi group, and control group was 13, 12, and 9 respectively (P>0.05); the number of increasing more than 1 points on Ishak inBushen Qingtou group,Bushen Jianpi group and control group was 8, 3, and 11 respectively, with statistical significance betweenBushen Jianpi group and controlled group (P<0.01), without statistical significance betweenBushen Qingtou group and control group (P>0.05), which meantBushenJianpi prescription could prevent the deterioration of liver tissue fibrosis more significantly than placebo prescription did. ConclusionTonifying kidney therapy, includingBushen Qingtou prescription andBushen Jianpi prescription, can inhibit the inflammatory activity and slow down the fibrosis progression of the chronic HBV carriers.

ObjectiveTo investigate the risk factors for contrast-induced nephropathy (CIN) after endovascular therapy in patients with peripheral arterial diseases and to evaluate the conformance of serum cystatin C (Cys C) and serum creatinine in diagnosis of CIN. Methods In this prospective,single center study,in-hospital patients with peripheral arterial diseases undergoing non-emergency endovascular therapy from July 2010 to April 2011 in our hospital were enrolled.CIN was defined asScr increase ≥25％ after angiography.General clinical characteristics and blood biochemical parameters were compared between the non-CIN and CIN groups.Logistic regression analysis was performed to determine risk factors.Changes compared to baseline level in serum creatinine and Cys C at predefined time-points were evaluated.Results A total of 367 patients were enrolled in the study.The proportions of patients with diabetes mellims and treatment with diuretics before angiography,contrast-media dosage were significantly higher in the CIN group than those in non-CIN group (P＜0.05,＜0.01,＜0.01).Logistic regression analysis indicated that diabetes mellitus,contrast-media dosage were risk factors for CIN.Several serum Cys C increase criteria at 24 hours after contrast media exposure all had low sensitivity for predicting a Scr increase ≥25％.Only small overlapped regions were found in Venn diagram between several increasing criteria according to serum Cys C and serum creatinine criterion. Conclusions Diabetes mellitus,contrast-media dosage are independent risk factors for CIN.The results of several increasing criteria according to serum Cys C in evaluating contrast-induced AKI are not coincident well with that of serum creatinine criterion.

Objective To explore the evolution of research themes and trends in China's nursing college education during the last decade.Methods A co-word analysis of keywords was performed in the research literatures around nursing college education from two Chinese databases,VIP China Science and Technology Journal Database and CKNI Periodical Full-text Database,between 2003 and 2012.The analysis was based on two different periods (phase Ⅰ from 2003 to 2007 and phase Ⅱ from 2008 to 2012).Results A total of 646 articles were included,with 287 articles published in phase Ⅰ and 359 articles in phase Ⅱ.Sixteen high-frequency keywords were identified during the phase Ⅰ,with seventeen during the phase Ⅱ.Two research themes,nursing student-training model and construction and reform of curriculum,were presented in both phases.However,some differences in research sub-themes exited between phase Ⅰ and phase Ⅱ.Conclusions Hot research topics in nursing college education seemed no change in the past ten years.School-hospital collaboration newly emerged as a hot topic in the field of nurse education research.The research on construction and reform of curriculum change its focus to nursing courses and humanities courses.The academic studies of nursing college education were mostly influenced and pushed by reforming and developing of nursing education.

Objective:To summarize the early and intermediate outcomes of second-grade false-lumen endovascular occlusive repair (FLEVOR) for aortic dissection.Methods:The clinical data of 12 patients undergoing second-grade FLEVOR after proximal repair of aortic dissection at our center from Aug 2016 to Aug 2019 was retrospectively analyzed.Results:The mean age was (51.3±14.9) years old. Four patients received open repair due to Stanford type A aortic dissection previously, the other 8 patients underwent thoracic endovascular aortic repair for Stanford type B aortic dissection. The time to the proximal repair varied from 3 months to 16 years. The technical success rate was 100%. Visceral ischemia, early spinal cord ischemia and in-hospital death did not occur perioperatively. The mean follow-up time was 16.7 months. Persistent false lumen perfusion was found in 3 patients, complete thrombosis of false lumen was achieved in the other 8 patients. The maximum diameter of abdominal aorta decreased in 8 (72.7%) patients.Conclusions:FLEVOR could block the blood flow from the false lumen and induce the thrombosis of false lumen, which promotes the aortic remodeling. Meanwhile, FLEVOR could protect the blood supply of spinal cord and viscera, and reduce the risk of type Ⅱ endoleaks.

Objective To observe the effects of serum with drug Penthorum chinense Pursh extractum on transforming growth factor (TGF)-β1 and collagen I secretions of activated hepatic stellate cells. Methods Twenty male SD rats were divided into 2 groups, and were administered with 0.9% sodium chloride solution and Penthorum chinense Pursh extraetum via gastrogavage for 3 days respectively and then sacrificed. Serum samples of these rats were collected. HSC-T6 cells were divided into the normal group and the treatment group. The cells of the normal group were incubated in Dulbecco's modified eagle medium (DMEM)with sera of normal rats, while those of the treatment group were incubated in DMEM with sera from Penthorum chinense Pursh extractum treated rats. The HSC-T6 viability was observed by AlamarBlue assay, while the toxicity of Penthorum ehinense Pursh extractum was measured by 3-(4, 5-Dimethyhhiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assay. The expression of collagen I and TGF-β1 mRNA were determined by real timepolymerase chain reaction (real time PCR). The protein expressions of collagen I and TGF-β1 were analyzed by Western blotting. The data were analyzed by single factor analysis of variance and pairwise comparison was done by q test. Results Different concentrations of sera from Penthorum chinense Pursh extractum treated rats could all inhibit HSC-T6 proliferation, especially when the sera concentration were 10% and the HSC-T6 cells were incubated for 24 h (P＜0.01 ). MTT assay indicated that sera from Penthorum chinense Pursh extractum treated rats showed no obvious toxicity to HSC-T6 compared with those from normal rats (P ＞0.05). After 24 h incubation, 10% sera from Penthorum chinense Pursh extractum treated rats could significantly down-regulate mRNA expression of TGF-β1 and collagen I compared with normal group (TGF-β1 2.790±0.174 vs 9. 827 ± 1.429, P＜0.01 ; collagen I 1.213 ± 0.099 vs 4.053 ± 1.005, P＜0.01 ). Mcanwhile, the protein expressions of TGF-β1 and collagen I were also obviously inhibited in drug treated group compared with normal group (P＜0.01). Conclusions Serum from Penthorum chinense Pursh extractum treated rats can significantly decrease TGF-β1 and collagen I secretions of activated hepatic stellate cells, which provides the experimental evidence for liver fibrosis treatment.