Hepatitis B, Chronic ; Humans

Objective:To evaluate the effects of losartan、fosinopril and captopril on the excretion rate of urinary albumin (UAER) and the clearance of endogenous creatinine (Cr-C) in elderly patients. 　　Methods:In this study,162 elderly patients with stage of the 2—3 class hypertension were included,The patients were divided into 3 groups,that were losartan group and the fosinopril group and captopril group,the anti-hypertensive effects and UAER and Cr-C were determined before and after the treatment. 　　Results:The hypertensive effect rates were 94% in losartan group and 93%、93% in fosinopril group and captopril group respectively.Decrease of UAER was observed in 89% of patient in losartan group and 59%、50% in fosinopril group、captopril group.Cr-C were improved in 94%、78% of patient in losartan group and in fosinopril group and 63% in captopril group. 　　Conclusions:Losartan has better effects on UAER and Cr-C than captopril in elderly hypertensive patients.

[Objective ] To investigate the improvement of the surgical treatment effect on cerebral palsy with spastic diplegia by performing modified surgeries since 2004. [Method ] Twenty-three cases of severe cerebral palsy with spastic diplegia were operated, 14 male, 9 female; age 3 ～ 12 years; the average age of 5.7 years; their main symptoms were unable to stand and walk independently, with severe hypermyotonia of both lower extremities, and a scissoring type of gait when standing, hip and knee flexing contracture, ankle and foot equinovarus. Physical examination: there was hypermyotonia of the iliopsoas, adductor musculus, hamstrings, triceps surae, anterior and posterior tibial muscle, flexor pollicis longus and flexor digitorum longus. The muscle tone was 3 ～4 grade according to Ashworth criterion. Treatment: The intramuscular tenotomy, fascial division or sliding elongation were performed, to lengthen the tendon of the joint flexion contracture, the lateral half of anterior tibial muscle tendon was transferred laterally to balance the muscle force at the foot. Finally, both lower extremities were fixed by a new designed external frame, to straigthen the articular genu, keep both ankles and feet in neutral position, both lower extremities abducting 30°, and to correct all joint deformities. Family rehabilitation programs started after the external frame was removed 6 weeks later. [Result] All cases were followed up in 1 ～3 years with the average 2. 2 years. The results were evaluated as excellent, good and ineffective, according to correction of the joint deformities, the ability to stand and walk, and parent's satisfaction to the treatment. Of them 21 cases were excellent, 2 cases good, and no ineffective case. [ Conclusion ] For the severe cerebral palsy with spastic diplegia in children, reasonable release of the tight tendons of the multi-joint flexion contracture, balance of muscle force at the foot, correction of all deformities and fixation of the lower extremities with the new external frame, and long term of family rehabilitation after the surgery, are more effective treatment.

BACKGROUND: Recently,Illizarov external frame is commonly used to treat adult talipes equinovarus.However,its application is limited in infant and child due to amount of components,large volume and heavy weight. OBJECTIVE: A new three-dimensional external mini-frame was designed to observe its therapentical effects for congenital talipes equinovarus in infants. DESIGN,TIME AND SETTING: Retraspectively analysis of the therapentical effects of the three-dimensional external mini-frame for congenital talipes equinovarus in infants at the Department of Pediatric Orthopedics,Third Hospital of Hebei Medical University between January 2004 and June 2007. PARTICIPANTS: 106 infants (130 feet) with congenital talipes equinovarus,76 males and 30 females aged 1.6 years (range 0.5-3 years),including 80 left feet and 50 right feet,24 cases bilateral feet and 82 cases unilateral feet. Eighty-one cases underwent orthosis or cost treatment but were not cured; 10 cases underwent surgery in other hospitals but all failed,the other cases were not given any treatment. The new three-dimensional external mini-frame was designed by the authors and produced by Hebei Hengshui Kangda. METHODS: According to the age,degree of deformity,being operated or not and pathological changeS of the foot,different treatment methods were applied: Corrcetion and fixation of the foot directly with the new external mini-frame; Limited soft tissue release,followed by corrcetion and fixation of the foot with the mini-frame; Corrcetion and fixation of the foot with the mini-frame after more soft tissue realse on interior posterior foot; Corrcetion and fixation of the foot with the mini-frame after soft tissue release,tendon transfer and restore of muscle force balance. The postoperative external fixation lasted for about 3 mouths. MAIN OUTCOME MEASURES: Evaluatoin of therapentical effects according to Garceau standards. RESULTS: All cases were followed up for 2.5 years (range 0.5-3.5 years). Eighty-six cases (94 feet) were excellent: the foot looked near normal,the calcar pedis was erect,with plantigrade foot in walking,the range of the joint motion in foot was near normal. Seventeen cases (32 feet) were good: the foot deformity improved obviously,but a light adduction was remained in the forefoot,with plantigrade foot in walking,the range of joint motion in foot was good. Three cases (4 feet) were effective: the forefoot adduct lightly,with lightly calcaneus varus,the motion of foot was limitted partly. CONCLUSION: The new 3D external mini-frame shows favorable effects for congenital talipes equinovarus in infants.

Objective To compare the quality of Rheum palmatum L. in different areas and ages in Gansu Province by comparing five components in Rheum palmatum L. through fingerprints and QAMS (quantitative analysis of multi-components) methods; To determine the most suitable growing areas and the best development areas in Gansu Province. Methods The water content, total ashes, and water-soluble extract content in 15 batches of Rheum palmatum L. from different areas and ages in Gansu Province were determined according to the approaches listed in the Chinese Pharmacopeia. The contents of five index components were determined through HPLC and the quality of 15 batches of Rheum palmatum L were evaluated by fingerprint and QAMS method. Results The results from 15 batches of Rheum palmatum L. showed that the water content was less than 15％, total ashes less than 10％, and water-soluble extract content less than 25％, conforming to Pharmacopoeia. There were 23 common peaks in the fingerprints of 15 batches of Rheum palmatum L.. Five of them were identified as aloe-emodin, rhein, emodin, chrysophanol and physcion, which showed good linear relationship in the range of 0.0122–0.7344 μg (r=0.9999), 0.00714–5.7120 μg (r=0.9999), 0.0088–0.7040 μg (r=1.0000), 0.1224–3.6720 μg (r=0.9999) and 0.0148–5.9200 μg (r=0.9997), respectively. There was no significant difference between the calculated value and the measured value by using the relative correction factor (RCF), and the reproducibility of RCF was good. The quality of Rheum palmatum L. from different areas and ages in Gansu Province significantly differed (P<0.05). Two year old Rheum palmatum L. from Pingxiang village of Li county and Rushu village of Tanchang county had the best quality, and that of three years old was better than two years old from Tanchang county. Conclusion The established fingerprints and QAMS method is accurate, feasible, and can be used for the quality comparison of Rheum palmatum L. from different areas and ages in Gansu Province. Li County and Tanchang County areas in Gansu Province can be used as suitable planting areas and development industry. Therefore, it is recommended to select more than two yeas old Rheum palmatum L. from Tanchang County and Li County in Gansu Province for medicinal application.

Objective To investigate the relationship between serum soluble growth stimulating expression gene 2 protein(sST2),homocysteine(Hcy)and interleukin(IL)-33 levels and degree of coronary artery ste-nosis and major cardiovascular adverse events(MACE)in patients with acute myocardial infarction(AMI).Methods A total of 139 patients with AMI admitted to a hospital from May 2021 to May 2023 were retro-spectively selected and divided into a good prognosis group(54 cases)and a poor prognosis group(85 cases)according to the occurrence of MACE.Spearman correlation was used to analyze the relationship between ser-um sST2,Hey,IL-33 levels and the degree of coronary artery stenosis in AMI patients.Multivariate Logistic regression was used to analyze the influencing factors of MACE occurrence in patients,and receiver operating characteristic(ROC)curve was plotted to evaluate the predictive value of serum sST2,Hcy and IL-33 levels for MACE occurrence in AMI patients.Results Serum levels of sST2,Hcy and IL-33 in the poor prognosis group were significantly higher than those in the good prognosis group,and the difference was statistically sig-nificant(P＜0.05).Serum levels of sST2,Hcy and IL-33 in patients with severe and moderate stenosis were significantly higher than those in patients with mild stenosis,and the difference was statistically significant(P＜0.05).Spearman correlation analysis showed that serum sST2,Hcy and IL-33 levels were positively cor-related with the degree of coronary artery stenosis(P＜0.05).Serum Hcy,sST2 and IL-33 are risk factors for MACE in AMI patients.ROC curve analysis showed that the area under the curve(AUC)of serum sST2,Hcy and IL-33 levels for predicting the occurrence of MACE in AMI patients was 0.838,0.726 and 0.800,and the sensitivity was 87.1％,80.0％and 84.7％,respectively.The specificity was 77.8％,68.5％and 77.8％,re-spectively.The AUC of the combined prediction value of MACE in AMI patients was 0.906,and the sensitivi-ty and specificity were 88.2％and 90.7％,respectively.Conclusion Serum sST2,Hcy and IL-33 levels have certain predictive value for MACE in patients with AMI.

OBJECTIVETo observe the clinical efficacy and side effects of brentuximab vedotin (BV) plus chlormethine hydrochloride (CH) in patients with relapsed and refractory Hodgkin lymphoma (HL) after failure with BV alone.

METHODSFrom March, 2014 to December, 2014, 6 patients who failed with BV monotherapy were enrolled in this study. The chemotherapy regimen consisted of BV (1.2-1.8 mg/kg, iv. gtt, d1) and CH (6 mg/m2, iv. gtt, d1) was given for 3 weeks as one course, and all patients received about 3-8 courses of chemotherapy, with an median of 4 courses. Clinical efficacy and adverse events were assessed and observed by radiographic examination and serological detection.

RESULTSAmong 6 patients, the overall response rate was 100% with 2 complete remission and 4 partial remission. The main adverse events were grade I (2 patients) and IV (2 patients) bone marrow depression, grade II (2 patients)gastrointestinal reaction, grade I (1 patient) increase of transaminase and myocardial enzyme and grade I (1 patient) mouth ulcers.

CONCLUSIONThe combination of BV and CH in the treatment of relapsed and refractory HL after failure with BV alone was high effective and the toxicities were well tolerable.

Human motion recognition (HAR) is the technological base of intelligent medical treatment, sports training, video monitoring and many other fields, and it has been widely concerned by all walks of life. This paper summarized the progress and significance of HAR research, which includes two processes: action capture and action classification based on deep learning. Firstly, the paper introduced in detail three mainstream methods of action capture: video-based, depth camera-based and inertial sensor-based. The commonly used action data sets were also listed. Secondly, the realization of HAR based on deep learning was described in two aspects, including automatic feature extraction and multi-modal feature fusion. The realization of training monitoring and simulative training with HAR in orthopedic rehabilitation training was also introduced. Finally, it discussed precise motion capture and multi-modal feature fusion of HAR, as well as the key points and difficulties of HAR application in orthopedic rehabilitation training. This article summarized the above contents to quickly guide researchers to understand the current status of HAR research and its application in orthopedic rehabilitation training.

Objective:To investigate the incidence and treatment of gastric cancer in 16 medical centers in Tianjin from 2020 to 2021.Methods:The retrospective and descriptive study was conducted. The clinical data of 3 122 gastric cancer patients who underwent surgery in 16 medical centers, including Tianjin Medical University Cancer Institute & Hospital, et al, in Tianjin from 2020 to 2021 were collected. There were 2 112 males and 1 010 females, aged (64±11)years. Observation indicators: (1) general data of patients; (2) treatment situations; (3) postoperative complications. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range). Count data were descri-bed as absolute numbers or percentages, and comparison between groups was conducted by the chi-square test. Results:(1) General data of patients. From 2020 to 2021, a total of 3 122 gastric cancer patients received surgeries in 16 medical centers in Tianjin, including 2 112 males and 1 010 females. There were 1 443 cases in 2020, including 976 males and 467 females, aged (63±11) years. There were 1 679 cases in 2021, including 1 136 males and 543 females, aged (65±11) years. Of the 3 122 pati-ents, cases in stage Ⅰ, Ⅱ, Ⅲ, Ⅳ were 696, 667, 1 466, 293, accounting for 22.293%(696/3 122), 21.365%(667/3 122), 46.957%(1 466/3 122), 9.385%(293/3 122), respectively. Cases with early gastric cancer, locally advanced gastric cancer, advanced gastric cancer account for 17.265%(539/3 122), 73.350%(2 290/3 122), 9.385%(293/3 122). There were 2 829 patients without distant metastasis and 293 patients with distant metastasis. For the 2 829 patients without distant metas-tasis, cases in stage T1, T2, T3, T4a, T4b accounted for 19.053%(539/2 829), 12.089%(342/2 829), 20.148%(570/2 829), 41.499%(1 174/2 829), 7.211%(204/2 829)respectively, cases in stage N0, N1, N2, N3 account for 37.328%(1 056/2 829), 16.331%(462/2 829), 15.836%(448/2 829), 30.505%(863/2 829). For the 293 advanced gastric cancer patients with distant metastasis, 190 cases had peri-toneal metastasis, 47 cases had lymph node metastasis, 27 cases had ovarian metastasis, 37 cases had liver metastasis, 14 cases had other metastasis (some patients had ≥2 distant metastases). (2) Treatment situations. ① For the 539 with early gastric cancer, cases undergoing endoscopic submu-cosal dissection, laparoscopic surgery, open surgery were 22, 150, 86 in 2020, versus 19, 212, 50 in 2021, showing a significant difference between them ( χ2=19.42, P<0.05). For the 498 patients with early gastric cancer who underwent laparoscopic or open surgery, cases undergoing open surgery including total gastrectomy, distal gastrectomy, proximal gastrectomy were 25, 81, 30, and cases undergoing laparoscopic surgery including total gastrectomy, distal gastrectomy, proximal gastrec-tomy were 18, 309, 35, respectively, showing a significant difference between them ( χ2=40.62, P<0.05). For the 2 290 patients with locally advanced gastric cancer, cases undergoing open surgery and laparoscopic surgery were 446 and 617 in 2020, versus 410 and 817 in 2021, showing a significant difference between them ( χ2=17.75, P<0.05). For the 2 290 patients with locally advanced gastric cancer, cases undergoing open surgery including total gastrectomy, distal gastrectomy, proxi-mal gastrectomy were 336, 377, 143, and cases undergoing laparoscopic surgery including total gastrectomy, distal gastrectomy, proximal gastrectomy were 377, 920, 137, respectively, showing a significant difference between them ( χ2=89.64, P<0.05). Of the 293 patients with advanced gastric cancer, 175 cases underwent surgeries due to hemorrhage, stenosis, perforation, 76 cases under-went surgery after chemotherapy, 42 cases underwent surgery directly. ② For 756 cases of 3 122 pati-ents undergoing total gastrectomy, 357 and 4 cases received open digestive tract reconstruction including Roux-en-Y and other anastomosis, versus 380 and 15 cases with laparoscopic digestive tract reconstruction including Roux-en-Y and other anastomosis, showing a significant difference between them ( χ2=5.57, P<0.05). For 1 687 cases undergoing distal gastrectomy, 84, 160, 158, 55 cases received open digestive tract reconstruction including Billroth Ⅰ anastomosis, Billroth Ⅱ + Braun anastomosis, Roux-en-Y anastomosis, uncut Roux-en-Y anastomosis, versus 154, 489, 417, 170 cases with laparoscopic digestive tract reconstruction including Billroth Ⅰ anastomosis, Billroth Ⅱ + Braun anastomosis, Roux-en-Y anastomosis, uncut Roux-en-Y anastomosis, showing a significant difference between them ( χ2=10.90, P<0.05) . Of the 539 patients with early gastric cancer, 65 cases had lymph node metastasis, in which 18 of 306 stage T1a cases had lymph node metastasis and 47 of 233 stage T1b cases had lymph node metastasis. The number of detected lymph nodes for the 2 290 patients with advanced gastric cancer was 31±15, including ≥16 for 2 059 cases and ≥30 for 1 276 cases. Of the 3 122 patients, cases with neoadjuvant therapy, complete response and incomplete response was 128, 13 and 115 in 2020, versus 250, 49 and 201 in 2021, showing a significant difference between them ( χ2=5.51, P<0.05). (3) Postoperative complications. Of the 3 122 patients, 746 cases had postoperative complications, with an incidence of 23.895%(746/3 122). There were 62 patients with grade 3 or more complications. Reoperation was conducted in 34 patients. There were 14 cases of postoperative death. The duration of postoperative hospital stay and hospital expense were (11±5)days and (98 114±46 598)yuan for the 3 122 patients, (26±14)days and (122 066±68 317)yuan for cases with complications, (40±21)days and (196 926±12 747)yuan for cases with grade 3 or more complications. Conclusion:Compared with 2020, cases undergoing laparoscopic surgery and distal gastrectomy for gastric cancer in Tianjin increases in 2021, and the digestive tract reconstruction also differs. The number of patients with neoadjuvant chemotherapy and complete response rate for advanced gastric cancer increases.

Hepatitis B virus infection and hepatitis C virus infection often progress to end-stage liver diseases such as liver cirrhosis, liver failure, and hepatocellular carcinoma, which endanger the life of patients. Recent studies have shown that gut microbiota are closely associated with chronic viral liver diseases. This article reviews the association of gut microbiota with chronic hepatitis B (CHB), chronic hepatitis C (CHC), and their related liver diseases and the research advances in therapies targeting gut microbiota against CHB and its related liver diseases, in order to provide more ideas for the clinical treatment of CHB, CHC, and their related liver diseases.