1.The survival analysis of chronic severe hepatitis B with antivirus treatment
Guangming XIAO ; Kaiyin HE ; Chunliang LEI ; Zhan YANG
Chinese Journal of Infectious Diseases 2009;27(7):423-425
Objective To analyse the effect of antivirus treatment on the survival time of chronic severe hepatitis B retrospectively.Methods one hundred and twenty-one patients with chronic severe hepatitis B and positive HBV DNA were divided into 3 groups:42 patients in entecavir(ETV)group,34 patients in lamivudine(LVD)group and 45 patients in control group.The primary data were recorded and followed.The survival curve was described using Kaolain-Maier method.The comparison of survival rate among groups was done using Logrank test.Results The baseline characteristics were well balanced among 3 groups.When the follow-up ended,the mean survival time of ETV group,LVD group and control group was(49.4±5.8)weeks,(51.6±6.7)weeks,(32.8±5.7)weeks;the total survival rate was 0.567,0.557,0.318 respectively,there was a statistical difference between ETV group and control grouP(χ2=5.742,P<0.05),or between LVD group and control group (χ2=5.472,P<0.05).There was not statistical difference between ETV group and LVD group in the week of 2,4,8,12,24,48.Conclusion ETV and LVD can improve the survival rate of chronic severe heoatitis B,and ETV iS not different from LVD.
2.Changes of tongue and pulse parameters in the patients with chronic hepatitis B after pegylated interferon alpha-2a treatment
Kaiyin HE ; Guangming XIAO ; Chunlan ZHANG ; Huimin FAN ; Xinghua TAN
Chinese Journal of Primary Medicine and Pharmacy 2016;(4):504-508
Objective To observe the changes of tongue and pulse parameters in the patients with chronic hepatitis B(CHB)after pegylated interferon alpha-2a(PEG-IFNα-2a)treatment,to investigate its value in evaluation clinical efficacy of PEG-IFNα-2a treatment.Methods 120 patients with CHB who confirmed to the standard received PEG-IFNα-2a antiviral therapy for 48 weeks,and followed up for 24 weeks.The tongue and pulse parameters were detected by DS01-A type digital tongue and pulse presentation analyzer.The changes of liver function,serum HBV markers,HBV DNA,tongue and pulse parameters were observed before and after treatment.Results 113 patients completed the course of treatment,46 cases received complete response(response rate 40.7%).The response rate of liver stagnation and spleen deficiency group was higher than that of blood stasis group(95%CI:0.010-0.677,P <0.05).The baseline of tongue and pulse parameters had no significant difference between response group and non response group(h3 /h1,t =1.799,P =0.074;h4 /h1,t =1.383,P =0.169;h5 /h1,t′=0.461,P >0.05;W/t,t′=0.688,P >0.05;R,t =1.317,P =0.190;G,t =0.346,P =0.729;B,t =1.720,P =0.088).After 48 weeks treat-ment,and followed up for 24 weeks,the tongue and pulse parameters of response group and non response group were compared with baseline,h3 /h1,h4 /h1 decreased,R value and G value increased,the differences were statistically sig-nificant(Response group:h3 /h1,t =3.004,P =0.003;h4 /h1,t =2.702,P =0.008;R,t′=2.258,P <0.05;G,t′=3.052,P <0.05.Non response group:h3 /h1,t =1.978,P =0.049;h4 /h1,t =2.487,P =0.014;R,t′=2.661,P <0.05;G,t′=2.318,P <0.05).But there were no significant differences between the response group and no response group after treatment(h3 /h1,t′=0.191,P >0.05;h4 /h1,t =0.390,P =0.697 2;h5 /h1,t′=0.957,P >0.05;W/t,t =0.149,P =0.881;R,t =1.343,P =0.181;G,t =0.994,P =0.322;B,t =0.565,P =0.572).Conclusion The changes of tongue and pulse parameters have improved after treatment with PEG-IFNαin patients with CHB. However,the value in predicting the efficacy of antiviral therapy may be limited.
3.Prognostic factors for patients with acquired immunodeficiency syndrome-related lymphoma
Kaiyin HE ; Yaozu HE ; Feilong XU ; Xiejie CHEN ; Weiping CAI ; Xiaoping TANG ; Linghua LI
Chinese Journal of Infectious Diseases 2016;34(8):475-479
Objective To explore the risk factors for the prognosis of acquired immunodeficiency syndrome (AIDS)-related lymphoma (ARL).Methods A total of 32 patients with ARL were enrolled in this study from Guangzhou Eighth People's Hospital during August 2011 and July 2014,who were followed up for 2 to 48 months (median 9 months).The risk factors for the prognosis of ARL were analyzed by Logistic regression analysis.Results A total of 32 patients were included,among whom 27 were males and the rest were females,with a mean age of (42.8± 13.5) years (ranging from 4 to 70 years).Regarding the clinical staging at the initial diagnosis,6 cases (18.8 %) were classified as stage Ⅰ,4 cases (12.5%) stage Ⅱ,5 cases (15.6%) stage Ⅲ,and 17 cases (53.1%) stage Ⅳ.As for international prognostic index (IPI) score,4 cases (12.5%) were in the low risk group (IPI 0-1),5 cases (15.6%) in the low-middle group (IPI 2),8 cases (25.0%) in the middle-high risk group (IPI 3),and 15 cases (46.9 %) in the high risk group (IPI 4-5).According to the pathological diagnosis,26 cases (81.2%) were B cell non-Hodgkin lymphoma (NHL),4 cases (12.5%) were T cell NHL,and 2 cases (6.2%) were Hodgkin lymphoma (HL) nodular sclerosis.In total,23 cases (71.9%) had received highly active antiretroviral therapy (HAART) before the first hospital visit or within one month after the diagnosis of lymphoma.Sixteen (50.0%) cases received standard chemotherapy regimen formulated by the oncology specialists.A total of 17 patients died,with the mortality rate of 53.1%.By univariate analysis,the prognostic factors included age (OR=0.915,P=0.012),high lactate dehydrogenase (OR=1.006,P=0.021) value at baseline,receiving HAART (OR =12.444,P=0.011),and standard chemotherapy regimen (OR=13.000,P=0.001).By multivariate Logistic regression,receiving standard chemotherapy regimen (OR=0.035,P=0.022) was the only prognostic factor of ARL.Conclusions The mortality of ARL is high and the most common pathological type was NHL.The prognosis could be improved by standard chemotherapy regimen on the basis of HAART.
4.Clinical features of acquired immunodeficiency syndrome patients complicated with peripulmonary occupational lesions
Feilong XU ; Xizi DENG ; Xiejie CHEN ; Linghua LI ; Yun LAN ; Qingqing LI ; Kaiyin HE
Chinese Journal of Infectious Diseases 2021;39(3):152-156
Objective:To analyze the clinical features of acquired immunodeficiency syndrome (AIDS) patients complicated with peripulmonary occupational lesions.Methods:Fifty-five AIDS patients with peripulmonary occupational lesions treated in Guangzhou Eighth People′s Hospital from January 2012 to January 2019 were included, and the clinical data of patients were retrospectively analyzed. According to the results of lung biopsy, the patients were divided into Mycobacterium infection group, fungal infection group and tumor group. The clinical characteristics, the proportion of different CD4 + T lymphocyte counts and chest computed tomography (CT) features of the three groups were compared. Chi square test was used for comparison among the three groups, and Bonferroni method was used to correct the test level for pairwise comparison. The significance level was 0.016 7 because of three pairwise comparisons. Results:Among 55 AIDS patients complicated with peripulmonary occupational lesions, pulmonary biopsy showed 14 cases with Mycobacterium infection, 12 cases with fungal infection and 15 cases with tumor lesions. Mixed diseases were found in 11 patients, including seven cases with Mycobacterium and fungus coinfection, four with tumor complicated with fungus and (or) Mycobacterium. Three with chronic interstitial pneumonia. The main clinical manifestations of 55 patients were fever, expectoration, fatigue, weight loss and superficial lymph node enlargement. There were no significant differences in symptoms/signs, white blood cell counts, hemoglobin levels, alanine transaminase and creatinine among Mycobacterium infection group, fungal infection group and tumor group (all P>0.05). There was significant difference in anti-retroviral therapy (ART) acceptance among the three groups ( χ2=15.165, P<0.01). However, the results of pairwise comparison between groups showed that there was significant difference between fungal infection group and tumor group ( χ2=7.514, P<0.016 7), while there was no significant difference between Mycobacterium infection group and tumor group, Mycobacterium infection group and fungal infection group ( χ2=0.255 and 5.306, respectively, both P>0.016 7). There were significant differences in clinical outcomes among the three groups ( χ2=15.119, P<0.01), and the pairwise comparison between the Mycobacterium infection group and the tumor group, and the fungal infection group and the tumor group showed significant differences ( χ2 =10.311 and 9.095, respectively, both P<0.016 7). The cases with CD4 + T lymphocyte count ≤50/μL, 51-<200/μL and ≥200/μL in Mycobacterium infection group were three cases, one case and 10 cases, respectively; those in fungal infection group were 10 cases, two cases and 0 case, respectively, and those in tumor group were one case, two cases and 12 cases, respectively. The difference was statistically significant ( χ2=21.284, P<0.01). Chest CT showed that there was significant difference in the types of space occupying lesions among the three groups ( χ2=13.308, P=0.003), and pairwise comparison between the two groups showed that there was significant difference between the Mycobacterium infection group and the tumor group ( χ2=11.312, P<0.016 7), while there were no significant differences between the Mycobacterium infection group and fungal infection group ( χ2=0.931, P>0.016 7), and the fungal infection group and the tumor group ( χ2=7.053, P>0.016 7). There was significant difference among the three groups in calcification focus ( χ2=8.524, P=0.004), while there was no difference between the Mycobacterium infection group and fungal infection+ tumor group ( χ2=10.982, P<0.016 7). Conclusions:Mycobacterium infection, fungal infection and tumor are the main types of peripulmonary occupational lesions in AIDS patients. The differential diagnosis could be made by combining with chest CT features, ART acceptance and CD4 + T lymphocyte level.
5.Progress and challenges in optical cochlear implant.
Kaiyin ZHANG ; He GUO ; Shan WU ; Yanning WU ; Shutao ZHAO ; Qiuling WANG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2016;51(1):73-77
Optical cochlear implant has been occuring as a new cochlear implant which utilizes laser pulses to stimulate hearing. Compared to electronic cochlear implant, it has demonstrated higher spatial selectivity and less radiation scattering, which could lead to higher fidelity cochlear prostheses. At present, most investigations have focused on experiments in vivo. Although a lot of exciting results have been obtained, the mechanisms of laser stimulation is still open. In this paper, a brief review on the recent new findings of optical cochlear implant is given, and possible mechanisms are discussed. In the end, new experimental proposals are suggested which could help to explore the mechanisms of laser-cochlea stimulation.
Cochlear Implantation
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Cochlear Implants
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Hearing Loss
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rehabilitation
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Humans
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Lasers
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Optics and Photonics
6.Artificial ascites assisted ultrasound guided fusion virtual MRI navigation radiofrequency ablation for hepatocellular carcinoma adjoining hollow viscera
Ning PENG ; Songqing HE ; Yiwen TAO ; Kaiyin XIAO ; Hong YANG ; Lequn LI
Chinese Journal of General Surgery 2019;34(6):512-515
Objective To evaluate ultrasound assisted virtual MRI guided radiofrequency ablation (RFA) in the treatment of hepatocellular carcinoma (HCC) adjacent to gastrointestinal tract with artificial ascites.Methods A total of 33 HCC lesions in 32 patients adjacent to gastrointestinal tract in our hospital were collected.After the establishment of artificial ascites,they were treated with radiofrequency ablation guided by ultrasound-guiding fusion and virtual MRI navigation.The curative effect and complication rate were compared with the control group (non-hollow GI tract abutting HCC lesions).Results All 33 lesions were completely ablated without residual.After 1 month and 3 months follow-up,the reexamination of contrast-enhanced ultrasound and MRI showed no activity and no new lesions.All cases had no serious complications such as gastrointestinal injury.There were no statistically significant differences in tumor complete inactivation rate,complication rate and recurrence rate between the two groups.Conclusion Ultrasound-guiding fusion and virtual MRI guided radiofrequency ablation with artificial ascites is safe and effective in the treatment of liver cancer adjacent to gastrointestinal tract.
7.Intercostal trocars and transthoracic trocars facilitated laparoscopic resection of lesions in liver segments 7 and 8 : a report of 20 cases
Banghao XU ; Zhang WEN ; Jingqing SONG ; Ya GUO ; Minhao PENG ; Bin CHEN ; Kaiyin XIAO ; Tao PENG ; Songqing HE
Chinese Journal of Hepatobiliary Surgery 2018;24(4):231-234
Objective To evaluate the use of intercostal trocars (ICS) and transthoracic trocars in laparoscopic resection of liver segments 7 and 8.Method From November 2015 to June 2017,20 patients who underwent laparoscopic S7 or 8 segmentectomy for liver tumors in the Department of Hepatobiliary Surgery,the First Affiliated Hospital,Guangxi Medical University were analyzed retrospectively.Results Ports were inserted at the 8th or 9th ICS,respectively,in addition to the conventional abdominal ports.The mean operation time was 225.0 min (110.0 ~ 486.0 min).Anatomical resection was completed in 1 patient,and non-anatomical resection in 19 patients.The conversion rate was 0%.Pringle's maneuver was used in 9 patients.The mean blood loss was 85.0 (25.0 ~410.0) ml,and the mean length of hospital stay was 7.0 (5.0 ~ 12.0) days.The complication rate was 10.0%.Pathologic findings revealed that 17,2,1 patient(s) had HCC,hemangioma,and inflammatory nodule,respectively.The mean tumor size and tumor free margin were 33.8 (15.0 ~ 74.0) mm;and 15.0 (1.0 ~ 30.0) mm,respectively.There was no HCC recurrence on follow-up,expect for one patient who developed tumor recurrence at 20 months after laparoscopic liver resection.Conclusions In selected patients,laparoscopic liver resection using intercostal trocars was useful and safe for tumors located in liver segments 7 and 8.The long-term oncologic outcomes need to be further evaluated.