Hepatitis B virus(HBV)will become reactive in non-active HBsAg carriers when they are in the immunosuppression status,which is often caused by cytotoxic drugs in chemotherapy or immunosuppressants.Liver damage will be induced in such patients and even liver failure in some patients.Nucleoside analogues could be used in early phase as prophylaxis for reactivation of hepatitis B in immunosuppression and to improve clinical prognosis.

Hair ; Hair Follicle ; Humans ; Neoplasms ; diagnosis

Objective To investigate the effect of virtual simulation teaching method in the comprehensive experimental teaching.Methods In experimental teaching of nursing,simulation medical records were compiled,plans were implemented,experiment guidance materials were preliminarily formed and teaching effect was evaluated.Results The application of virtual simulation teaching in nursing comprehensive experiments reflected the comprehensiveness of teaching content,and the comprehensiveness of knowledge,ability and capacity.It could train students creative ability,exploring spirit,enhance the sense of professional and humane care consciousness,train the communication skills and strain capacity,make active teaching atmosphere,improve the quality of teaching.Conclusions This teaching method can make students achieve mastery through a comprehensive multi-disciplinary knowledge,improve the ability of solving practical problems,help nurses to develop the comprehensive professional quality.

Objective To investigate the value of CT spectral imaging in differential diagnosis of atypical pheochromocytoma and adrenal adenoma.Methods The energy spectrum CT data of 13 cases of atypical pheochromocytoma and 15 cases of adrenal cortical adenoma confirmed by surgery pathology were retrospectively analyzed.All images processed by spectrum software.The CT value of different energy levels (40-140 keV) in arterial,venous and delayed phase,energy spectrum curve and spectrum curve type,base material of concentration (water-iodine,grease-iodine,blood-iodine) were obtained,and the CT value of different energy were standardize in the same period.Data were compared with samples t test.Results For arterial phase,the standardization CT values of pheochromocytoma on monochromatic images of 40 keV,70 keV to 140 keV had statistical difference with those of adenoma (all P＜0.05).For venous phase,the standardization CT values of pheochromocytoma on monochromatic images of 70 keV to 140 keV had statistical difference with those of adenoma (all P＜0.05).For delayed phase,the standardization CT values of the two tumors on monochromatic image of 40 keV to 140 keV had significant difference (all P＜0.05).Both the energy spectrum of the three periods of type curve was falling,pheochromocytoma always located above compared with adenoma.The standardization concentration of base materials including water (iodine),fat (iodine) and blood (iodine) of pheochromocytoma were higher than those of adenoma in three phases (all P＜0.001).The standardization concentration of base materials including iodine (water),iodine (fat) and iodine (blood) had no significant difference in three phases between pheochromocytoma and adenoma (all P＞ 0.05).Conclusion Atypical pheochromocytoma and adrenal adenoma have different spectral curve and spectrum characteristics of the material content.Spectral CT imaging provides a method of multiple parameters to identify atypical adrenal pheochromocytoma and adenoma.

Objective To investigate the value of multipoint and multidirectional ultrasound-guided fineneedle aspiration cytology (US-FNAC) in preoperative diagnosis of papillary thyroid microcarcinoma (PTMC).Methods From Jan.2012 to Jan.2013,multipoint and multidirectional US-FNAC were performed in 177 patients with 233 nodules suspected as PTMC,and the cytopathological findings were compared with surgical pathological results and clinical follow-up results.Results Of the 233 biopsies,the cytology were classified as malignant for 146 lesions,suspicious for malignancy for 43 lesions,benign for 24 lesions,follicular lesions for 4 lesions and inadequate sample for 16 lesions.After the second multipoint and multidirectional US-FNAC,only 1 case did not have sufficient cells for diagnosis,and the puncture failure rate was 0.43％.Actually there were 189 malignant and 44 benign lesions confirmed by clinical follow-up and pathological results.The sensitivity,specificity,and accuracy of multipoint and multidirectional US-FNAC was 99.5％,81.8％ and 96.1％ respectively.Conclusions Multipoint and multidirectional US-FNAC has definite value in increasing puncture qualified rate and positive diagnosis rate before operation.

Objective·To analyze the choice of smoking cessation methods and its influencing factors in moderate-to-severe nicotine-dependent population.Methods·A retrospective clinical analysis was conducted for170 moderate-to-severe nicotine-dependent smoking-quitters (Fagerstr(o)m scale ≥ 4).Different smoking cessation methods (pharmacotherapy and non-pharmacotherapy) and abstinence rates of the selected population (7 d point prevalence abstinence rates and sustained abstinence rates 1,3,and 6 months after treatment) were compared and possible influencing factors were analyzed.Results·The differences in choosing the smoking cessation method in moderate-to-severe nicotine-dependent population with different ages,levels of education,and employment status were statistically significant (P=0.000).The Logistics regression analysis showed that the level of education was the major factor for choosing the smoking cessation method (P=0.006).The 7 d prevalence abstinence rate was much lower for pharmacotherapy than for non-pharmacotherapy 1 month after treatment (P=0.000) and was much higher for pharmacotherapy than for non-pharmacotherapy 3 and 6 months after treatment (P=0.000).The sustained abstinence rate was much higher for pharmacotherapy than for non-pharmacotherapy 3 and 6 months after treatment (P=0.002,P=0.000).Conclusion·For moderate-to-severe nicotine-dependent smoking-quitters,attention should be paid to the formulation and implementation of personalized strategies.The choice of smoking cessation methods depends on the age,level of education,and employment status.Reasonable pharmacotherapies can significantly increase the abstinence rate.

Objective To assess the contrast-enhanced ultrasound (CEUS) characteristics of pleomorphic adenoma (PA) and carcinoma ex pleomorphic adenoma (CXPA).Methods A retrospective analyse was made from the contrast-enhanced ultrasonic features of 42 PA and 8 CXPA.The features included tumor size,echotexture,boundary,shape and blood flow richness on conventional US imaging and rise time (RT),time to peak (TP),peak intensity(PI),time from peak to one half(HT),mean transit time (MTT),and area under the curve(AUC) on contrast-enhanced ultrasound.Results All of PA and CXPA were hypoechoic,but there was no difference between them in shape and blood flow richness (P ＞0.05).37.5％ CXPA has hetergeneous echotexture with the presence of anechoic area,but it appeared in only 4.8％ PA(P ＜0.05).The following findings were observed from a perfusion kinetics of CEUS in all of PA and CXPA:slow in,centripetal,heterogeneous enhancement,with no enhancement area.Well-defined margins were presented in 42 PA and in 7 CXPA(P ＜0.05).Their time-intensity curves showed RT,TP,HT and MTT in CXPA group were obviously higher than those in the PA group(P ＜0.05).However there was no statistical difference in PI and AUC between both groups (P ＞ 0.05).Conclusions Conventional US and CEUS perfusion patten provide limited diagnostic information for distinguishing PA from CXPA.CXPA could be diagnosed by ill defined margins,more internal anechoic area and poorly defined margins.But CEUS quantitative analysis can significantly promote the differentiation.

Objective To study the clincial effectiveness and safety of endoscopic sphincteropapillotomy combined with balloon dilation for decompensated cirrhosis accompanied with choledocholithiasis.Methods Data of 79 cases of decompensated cirrhosis patients with choledocholithiasis who underwent limited endoscopic sphincterotomy plus endoscopic papillary balloon dilation (ESBD,the ESBD group) and 42 cases who underwent endoscopic papillary balloon dilation(EPBD,the EPBD group)were retrospectively analysed and compared for complete stone clearance rate,one-time stone clearance rate and complications.Results The rate of complete stone clearance and one-time stone clearance were 94.9％ (75/79) and 77.2％ (61/79)in ESBD group,and those were 88.1％ (37/42) and 59.5％ (25/42) in EPBD group respectively.The rate of complete stone clearance was a little higher in ESBD group than that in EPBD group.In ESBD group,ERCP-related bleeding occurred in 3 patients (3.8％),post-ERCP hyperamylasemia in 3 (3.8％)and post-ERCP pancreatitis in 2 (2.5％) ; while in EPBD group,post-ERCP hyperamylasemia occurred in 8 patients(19.0％),post-ERCP pancreatitis in 6(14.3％) and ERCP-related bleeding did not occur.There were no significant difference in ERCP-related bleeding between ESBD group and EPBD group (P =0.551).However,the rates of post-ERCP pancreatitis and hyperamylasemia in ESBD group were significantly lower than those in EPBD group(P ＜ 0.05).Conclusion ESBD is a safe and effective procedure for choledocholithiasis accompanied by decompensated cirrhosis,with several advantages over EPBD in terms of higher one-time stone clearance rate,reduced risk of post-ERCP pancreatitis and hyperamylasemia,and without noticeable increase in the risk of bleeding related to ERCP.

Objective:To investigate the role of C3a,C5a and their receptors in the pathogenesis of IgA nephropathy (IgAN). Methods:A total of twenty-eight 6-8 weeks old female BALB/c mice were investigated.And they were negative control group , WT group,C3aR-/-group,C5aR-/-group(the latter three groups were named as experimental groups ),seven mice in each group.All the mice were infected through respiratory tract with infectious SV (experimental groups) or PBS(negative control group),combined with tail vein challenge to make IgAN animal model.Testing 24 h total urinary protein , serum urea nitrogen ( BUN ) and creatinine ( Cr ) , using direct immunofluorescence to test the renal deposition of IgA and C 3,observing renal pathologic lesion under PAS staining with light microscopy.RT-qPCR was used to test the relative mRNA expression of TNF-α,TGF-β,IL-1β,IL-6,MCP-1.Results: After 15 weeks,the level of UTP in experimental group was significantly higher than negative control group ,and the same results as WT group than C3aR-/-group and C5aR-/-group.There was no significant difference among groups for BUN and Cr.Combined with negative control group , experimental groups had significant renal pathological lesions , and the changes of WT group was more severe than C3aR-/-group and C5aR-/-group.The results of relative mRNA expression of TNF-α,TGF-β,IL-1β,IL-6,MCP-1 was the same as the level of 24 h UTP,at the same time,the relative mRNA expression of IL-1β,IL-6,MCP-1 in C3aR-/-group was significantly less than C5aR-/-group.Conclusion:The deficiency of C3a/C5a receptors can protect kidney from injury in IgAN ,and C3a receptor has more significant role in protect kidney from injury in IgAN.

Objective:To explore the effect of revision endoscopic sinus surgery (RESS) on quality of life in the patients with chronic rhinosinusitis with nasal polypsis (CRSwNP).Method:To survey and evaluate 60 cases of RESS patiens (treatment group) and 120 normal ones with physical examination (Control group) through the medical outcomes survey short form questions (MOS SF-36) and the Sino-Nasal Outcome Test-20 (SNOT-20), and comparison and analysis of the two groups results which we got were carried out.Result:With SF-36 scales for evaluation of quality of life, the results show that: the scores of CRSwNP patients (treatment group) without surgical treatments with RESS were significantly lower than that of the control group(P<0.05); while use of SNOT-20 scales in evaluation of the properative treatment group patients, the results were significantly higher than that of the control group(P<0.05). While the CRSwNP patients with surgical treatments with RESS for 6 monthes, not only with SF-36 scales but also with SNOT-20 scales,there was no significant difference between the two groups(P>0.05 ).Conclusion:RESS may obviously improve the clinical symptom of CRSNP patients. The SF-36 and SNOT-20 assessment scales could reflect the patient's QoL change.