Purpose To investigate the relation of Epstein-Barr virus ( EBV) infections and malignant lymphoma. Methods EBV-co-ded RNA ( EBER) was detected by in situ hybridization in tumor tissue of 81 cases of malignant lymphoma in oral, maxillofacial and neck regions, with analysis of the clinical pathological features. Results The detection frequencies of EBER was 44. 44%. The posi-tive detection of EBER in Hodgkin′s lymphomas was 40% and that in non-Hodgkin lymphomas was 45. 1%, including 75% in T cell lymphomas, 87. 5% in NK/T cell lymphomas and 2. 9% in B-cell lymphoma. The positive rates of EBER in T cell lymphomas and NK/T cell lymphomas were significantly higher than that in B-cell lymphoma (P<0. 05). There was a significant difference in the pos-itive rates of EBER between intra-nodal ( 17. 9%) and extra-nodal ( 58. 5%) lymphomas ( P<0. 05 ) . But there was no significant difference the positive rates of EBER between in lymphoma patients over 50 years of age and under the age of 50 patients (55. 9%) (P>0. 05). Conclusion Oral and maxillofacial and neck lymphoma is closely associated with EBV infection in Guangxi region, espe-cially, in which NK/T cell lymphoma most typically occurs in extra-nodal diffuse lymphoid tissues.

Objective:To study the expression of MMP-9 in nasal NK/T cell lymphoma, HIF-1a and its relationship with the clinical and pathologic characteristics. Methods:46 cases ( case group) of paraffin block specimens from patients with pathologically confirmed nasal NK/T cell lymphoma were collected from the Affiliated Hospital of Youjiang Medical College For Nationalities,the same period endoscopy turbinate mucosa were confirmed by pathology in 20 cases of chronic inflammation of mucosa specimens ( control group) , respectively HE staining and immunohistochemistry handle two specimens, observation of the expression differences of two groups of specimens of pathological morphology, MMP-9 and HIF-1a, and to analyze its relationship with the clinical and pathological features of the patients. Results: Case group HIF-1a expression rate 67. 39% (31/46), expression was 6. 52% (3/20) in control group. , the HIF-1a case group were significantly higher than control group (P<0. 05). Case group MMP-9 expression rate 71. 74%(33/46), in the control group expression was 6. 52% (3/20), MMP-9 expression in the case group was significantly higher than control group (P<0. 05). HIF-1a and MMP-9 in positive expression in Ann Arbor staging (Ⅲ-Ⅳ), lymph node metastasis, vascular invasion in patients with nasal NK/T cell lymphoma tissue appeared a high expression ( P< 0. 05 ) . Conclusion: Nasal NK/T cell lymphoma tissue of patients with HIF-1a, MMP-9 presented high expression, and there was a certain relationship between Arbor Ann stage (Ⅲ-Ⅳ) , lymph node metastasis and vascular invasion.

Objective: To investigate the protective effects of matrine combined with glycyrrhizic acid on chronic liver injury induced by carbon tetrachloride, and explore the protective mechanism from the points of energy metabolism and CYP enzyme.Methods: The chronic hepatic injury model of rats was induced by CCl4.The changes of activity of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in serum were measured to observe the protective effect of the two drugs and their combination.The contents of glutamate dehydrogenase (GLDH) in serum and adenine nucleoside three phosphate (ATP), adenosine diphosphate (ADP) and adenine monophosphate (AMP) in liver tissue were determined to evaluate the regulation effect on hepatic energy metabolism and mitochondrial function.The levels of CYP1A2, CYP2E1 mRNA and protein in liver tissue were detected by real-time PCR and Western Blot to evaluate the two drugs and their combination on the regulation function of liver CYP enzyme.Results: Matrine (72.8 mg×kg-1)and glycyrrhizic acid(43.4 mg·kg-1)could decrease the serum activities of ALT and ALT in chronic hepatic injury model, and the combination (matrine 36.4 mg·kg-1+glycyrrhizic acid 21.7 mg·kg-1) had the most significant protective effect (P＜0.05).Matrine (72.8 mg·kg-1)and glycyrrhizic acid(43.4 mg·kg-1)could decrease GLDH in serum,and restore the content of ATP in liver (P＜0.05).Matrine (72.8 mg·kg-1) had no effect on the expression of CYP1A2 and CYP2E1mRNA, and glycyrrhizin (43.4 mg·kg-1) could inhibit the expression of CYP1A2, CYP2E1mRNA and protein (P＜0.05).Conclusion: Matrine combined with glycyrrhizin has obvious regulation effect on mitochondrial function and liver protective effect in chronic hepatic injury model.

OBJECTIVE: To investigate the feasibility of a drill template for the placement of guided template of middle and upper thoracic percutaneous vertebroplasty in thoracic pedicle approach on digital design and 3D printing technology. METHODS: The preoperative CT images of 20 patients with thoracic fracture were collected retrospectively. With the 3D soft tissue printing technology, the data was reconstructed by 3D imaging reconstruction software to produce 1∶1 three dimensional soft tissue model. The pedicle screw channel and the digital template were designed by the 3-matic module of Mimics15.0 software. After guide template was printed by 3D printer and three dimensional template was fixed on the model, 2.0 mm Kirschner was placed and the accuracy of a drill template was observed by CT scans, bone cement was injected through the puncture tube and verified with images. The time of nail guide design, guide template production and cost were recorded. RESULTS: The effectiveness of three dimensional thoracic model and digital guided template of middle and upper thoracic percutaneous vertebroplasty of thoracic fractures in thoracic pedicle approach was confirmed. Kirschner was placed and the accuracy of screw placement was confirmed with CT scanning. Template and the corresponding anatomical landmark fitted well, bone cement had showed good filling. The average printing time of upper thoracic spine model with soft tissue, the mean time of nail guide design, guide template production and cost were (719.00±3.03) min, (12.30±1.01) min, (55.50±10.30) min and RMB 3 150 yuan on average respectively. CONCLUSION By means of individual design and 3D soft tissue printingtechnology, accurate placement of guided template of middle and upper thoracic percutaneous vertebroplasty could be realized.
Humans ; Pedicle Screws ; Printing, Three-Dimensional ; Retrospective Studies ; Surgery, Computer-Assisted ; Vertebroplasty

Objective:To explore the effects of different approaches for second-trimester multifetal pregnancy reduction on pregnancy outcome in women with dichorionic triamniotic (DCTA) triplet.Methods:A retrospective study was performed on 51 women with DCTA triplet pregnancies who were referred to Guangdong Women and Children Hospital for second-trimester multifetal pregnancy reduction from January 2014 to January 2020. All participants were divided into either preventive group ( n=39) or treatment group ( n=12) according to the indication for multifetal pregnancy reduction, and they were further allocated to three subgroups based on different reduction methods, which were reduction to dichorionic twin by radiofrequency ablation (RFA) (RFA subgroup), reduction to monochorionic singleton (KCl-singleton subgroup) or monochorionic twin (KCl-twin subgroup) by cardiac injection of potassium chloride. Pregnancy loss rate, neonatal birth weight, gestational age at delivery, incidence of intrauterine death, and neonatal death were compared and analyzed between different groups using t-test, analysis of variance, Chi-square test, Fisher's exact test and Bonferroni correction. Results:(1) The mean gestational week at operation in the treatment group was significantly later than that in the preventive group [(18.5±3.1) vs (15.0±2.3) weeks, t=-4.209, P<0.001]. In the preventive group, the mean gestational week at operation in the RFA subgroup was later than the KCl-singleton and KCl-twin subgroup[(17.2±1.6) vs (13.8±1.5) and (12.7±1.0) weeks, t=6.630 and 3.875, respectively, both P<0.05]. (2) The postoperative pregnancy loss rate in the preventive group was decreased compared with the treatment group [10.3%(4/39) vs 5/12, Fisher's exact test, P<0.05], and the live birth ratio was increased [ 85.7%(48/56) vs 10/18, χ2=5.640, P=0.018]. No live birth infants with birth weight <1 500 g was reported in the KCl-singleton subgroup in preventive group, and the statistical significance was observed in the intra-group differences ( P<0.05) rather than the pairwise comparison differences in the preventive group. For the proportion of live births, there was a statistically significant difference in the intra-group comparison in the treatment group, which was higher in the RFA subgroup than that in the KCl-twin subgroup (6/6 vs 1/6, P=0.045). No significant difference was revealed among pregnancy loss rate, gestational weeks at delivery, the mean birth weight, premature delivery <32 gestational weeks, and full-term birth rate among three different approaches within the two groups. (3) No monochorionic twin complications or perinatal death occurred in any RFA or KCl-singleton subgroups in the two groups. In the KCl-twin subgroups including five cases with ten fetuses, including three live birth, four miscarriage, three intrauterine death occured, while no neonatal death was reported. One case with selective fetal uterine growth restriction in the preventive group delivered two live births, and one case with twin-to-twin transfusion syndrome in the treatment group had intrauterine death in one fetus and one survival neonate. Conclusions:The pregnancy outcome of multifetal pregnancy reduction to dichorionic diamniotic twins by RFA or reduction to singleton by cardiac injection of potassium chloride are comparative in women with DCTA triplet, regardless of whether it is a preventive or therapeutic reduction.

Objective To analyze the infectious status and genotype characteristics of group A rotavirus (RV) in children with diarrhea in Hangzhou city in 2017, and to provide information for the disease surveillance, epidemic control as well as vaccine development.Methods Fecal samples from children with acute diarrhea at Children's Hospital of Zhejiang University were collected from Jan to Dec in 2017. All samples were tested for RV antigen by emulsion technique. The antigen-positive samples were further detected by reverse transcription polymerase chain reaction (RT-PCR) and sequencing to determine the G and P genotypes. The RV positive rates in different genders, ages and months were compared by chi-square test. Results A total of 20895 fecal samples were collected from 12389 male patients and 8506 female patients. The gender ratio was 1.46:1. In 5012 (23.99％) RV antigen positive samples, 2964 (23.92％) were from male patients and 2048 (24.08％) were from female patients. There was no gender difference in RV positive rate (χ2=0.049, P>0.05). In the study, RV could be detected in the whole year. January, February and December were peak months, and the RV positive rates were significantly different in different months (χ2=2654.681, P<0.05). The highest RV positive rate was in 18-24 months age group and the lowest in<6 months age group, respectively. Children under 2 years old accounted for 76.56％RV positive cases, and those under 5 years old accounted for 98.72％ RV positive cases. The RV positive rates were also significantly different in all age groups (χ2=1013.832, P<0.05). A total of 116 samples were selected from each month, following the random stratified sampling principle, for PCR amplification, sequencing, and genotyping according to VP7 (G genotype) and VP4 (P genotype). A total of 4 G genotypes were detected and G9 (85.3％) was the predominant one. In the two detected P genotypes, P[8] (96.6％) was predominant. The 4 G/P combination genotypes were G9P[8] (85.3％), G3P[8] (9.5％), G2P[4] (3.5％), and G1P[8] (1.7％). Conclusions RV was a common pathogen in pediatric patients with acute diarrhea in Hangzhou city in 2017. Children under 5 years old, especially 18 months to 2 years old infants was the main infected population. The study showed RV infection had obvious seasonality and winter was the peak period. The G9 genotype was predominant in G genotypes, P[8] genotype was predominant in P genotypes, and G9P[8] genotype was predominant in G/P combination genotypes, respectively.

Objective:To compare the consistency and detection capability of seven 2019-nCoV nucleic acid detection kits, and provide reference for detection method selection of clinical laboratory and diagnosis of new coronavirus pneumonia.Methods:Two batches of pharyngeal swab samples were collected from tenpatients with confirmed infection of 2019-nCoV and 10 suspected patients with negative 2019-nCoV test results during January 29 to February 5, 2020 in Shenzhen Luohu People′s Hospital. Seven kinds of kits were labeled as ato g and used for nucleic acid detection respectively to evaluate the consistency of the test results of the clinical samples. A 2019-nCoV positive specimen was selected and diluted to 5-concentration gradient plates (Level-1 to 5) with RNase-free water. The positive detection rate and intra-batch repeatability of different brands of kits were compared.Results:The negative and positive coincidence rates of twenty clinical samples tested by six kinds of kits were 100%, and the positive and negative coincidence rate was 8/10 and 10/10 for the other kit, respectively. The results of intra-batch repeatability showed the CVs of viral loads tested by these seven kits were all less than 5%. In the concentration range of Level-1 to 3, the detection capability for open reading frame (ORF)1ab gene of Kit b,d and f was lower than Kit a,c,e and g, and the detection capability of kit e and g was the highest (14/15). The detection capability for N gene of Kit a (15/15) was higher than the other 5 kits. The comprehensive analysis of the detection capability for ORF1ab and N gene showedthat Kit d had the lowest detection capability (ORF1ab:40%,N:53%), and there was no significant difference in the detection capability of Kit a, b, c, e, and f.Conclusions:There was no significant difference in the accuracy and repeatability of the seven kits for positive samples with high viral loads, and the detection performance was good; but some kits had poor detection capability for weak positive samples. It is suggested that the weak positive samples should be rechecked by at least two manufacturers′ kits to ensure the accuracy of the results.

OBJECTIVE: To assess the clinical effects of percutaneous endoscopic surgery through two different approaches for stable degenerative lumbar spondylolisthesis. METHODS: Sixty-four patients with stable degenerative lumbar spondylolisthesis who underwent percutaneous endoscopic procedures between January 2016 and December 2019 were divided into transforaminal approach group and interlaminar approach group according to surgical approaches, 32 patients in each group. There were 16 males and 16 females in transforaminal approach group, aged from 52 to 84 years old with an average of (66.03±9.60) years, L₂ slippage in 4 cases, L₃ slippage in 5, and L₄ slippage in 23. There were 17 males and 15 females in interlaminar approach group, aged from 46 to 81 years old with an average of (61.38±9.88) years, L₃ slippage in 3 cases, L₄ slippage in 15, and L₅ slippage in 14. Operative time, intraoperative fluoroscopy times, and postoperative bedtime were compared between two groups. Anteroposterior displacement values, interbody opening angles, and the percentage of slippage were measured on preoperative and postoperative 12-month dynamic radiographs. Visual analogue scale (VAS) of low back pain and lower extremity pain, and the Japanese Orthopaedic Association (JOA) score before and after surgery were observed, and clinical effects were evaluated according to the modified MACNAB criteria. RESULTS: All operations were successfully completed, and patients in both groups were followed up for more than 1 year, and without complications during follow-up period. ①There was no significant difference in operation time between two groups(P>0.05). Intraoperative fluoroscopy times were longer in transforaminal approach group than that in intervertebral approach group(P<0.05). Postoperative bedtime was shorter in transforaminal approach group than that in intervertebral approach group (P<0.05).② No lumbar instability was found on dynamic radiography at 12 months postoperatively in both groups. There were no significant differences in anteroposterior displacement values, interbody opening angles, and the percentage of slippage between two groups postoperative 12 months and preoperative 1 day(P>0.05). ③There was no significant difference between two groups in VAS of low back pain at 3 days and 1, 12 months after the operation compared with the preoperative(P>0.05), but the VAS of the lower extremity pain was significantly improved compared with the preoperative(P<0.05). Both of groups showed significant improvement in JOA score at 12 months compared with preoperatively(P<0.05). There was no significant difference in VAS of low back pain, lower extremity pain and JOA scores between two groups during the same period after surgery(P>0.05). According to modified Macnab criteria, excellent, good, fair and poor outcomes were 21, 7, 3 and 1 in transforaminal approach group respectively, and which in intervertebral approach group were 20, 7, 5 and 0, there was no significant difference in clinical effect between the groups(P>0.05). CONCLUSION Intervertebral approach may reduce intraoperative fluoroscopy times and transforaminal approach can shorten postoperative bedtime, both approaches achieve satisfactory results in the treatment of stable degenerative lumbar spondylolisthesis with no progression of short-term slippage.
Male ; Female ; Humans ; Middle Aged ; Aged ; Aged, 80 and over ; Spondylolisthesis/surgery* ; Low Back Pain/surgery* ; Treatment Outcome ; Lumbar Vertebrae/surgery* ; Spinal Fusion/methods* ; Retrospective Studies

Objective: To study the relationship between human cytomegalovirus (HCMV) envelope glycoprotein gene H and clinical features of children with congenital cytomegalovirus infection. Methods: A cohort study was conducted. Newborns diagnosed with congenital cytomegalovirus infection, hospitalized in the Department of Neonatology and Neonatal Intensive Care Unit (NICU) of the Children′s Hospital, Zhejiang University School of Medicine, were included from July 2013 to December 2015.HCMV-DNA gH typing in urine, sputum or blood was conducted. Patients then were divided into gH1 group and gH2 group according to gH genotypes. Patients′ data during hospitalization in newborn and 3-5 years of follow-up were collected.The relationships between gH genotype and clinical manifestations, laboratory examinations, hearing loss and neurological prognosis were analyzed by chi-square test, t test and non-parametric test. Results: A total of 21 cases were enrolled as congenital HCMV infection and followed-up for 3-5 years. Among them, 14 (67%) were gH1 type and 7 (33%) were gH2 type. No mixed infection was found. In the two groups, there were no significant differences in the ratio of males (9/14 vs. 3/7,P=0.397), or birth weight ((2 609±686) vs. (3 021±451) g, t=-1.436, P=0.167). Gestational age of gH1 group was younger than that of gH2 group (38 (29-40) vs. 39(38-40) weeks, Z=-2.18, P=0.029). Moderate to severe hearing loss detected by neonatal auditory brainstem response were found in 40 ears (20 cases). It was higher in gH1 group than that in gH2 group (4/22 vs.0/18, χ²=5.145, P=0.023). In the imaging examination of the nervous system, the Alarcon score of gH1 group was lower than that of gH2 group (0.4±0.3 vs. 1.3±1.1, t=-2.459,P=0.024).No significant statistical difference was found in the probability of motor or language development lag in gH2 group and gH1 group (4/7 vs.4/14, P=0.346). Conclusions Compared with gH2 infection, gH1 infection in children has a younger gestational age. The major type of hearing loss in neonatal period is gH1 infection. Children with gH2 congenital infections are more likely to suffer from nervous systems damage.