Objective To investigate the clinical and pathologic features of primary hepatic carcinoma(PHC) associated with hepatitis B virus,HBV). Methods 200 cases of the patients with PHC were diagnosed by histopathologic examination and surgery. The history of HBV infection, its infective patterns and abnomal liver function were obtained from the medical history, and the tests of liver function and HBV five markers. The pathologic features of PHC associated with HBV were determined by analysis of histopathologic changes and views of surgery. Results The markers of HBV were positive in 181 out of 200 cases with PHC, and the positive rate of HBV infection was 90.5%. The postitive rate of HBsAg, anti-HBe and anti-HBc was the highest among the five markers of HBV (50.83%). The positive rate of HBsAg and HBeAg and anti-HBc was only 4.97%. The PHC patients without history of HBV infection and asymptomatic carriers of HBV accounted for 61.33% and 6.63%, respectively. The cases with cured hepatitis and no relapse accounted for 8.29%. The cases with chronic hepatitis B and with liver cirrhosis accounted for 22.10% and 1.66%, respectively. Liver functions were slightly abnomal in approximately one-half patients with PHC. Histopathologic features were as following: HCC accounted for 91.95%, and nodular type, macro-type and small hepatic carcinomas accounted for 55.25%, 30.94% and 13.81%,respectively. The distributions of PHC were mainly in right lobe of liver. The incidence of venous cancer embolism was 12.71%. The incidence of liver cirrhosis was 83.32%. Conclusions ⑴There was relationship between HBV and PHC. The main infective pattern of HBV was the positive HBsAg, anti-HBe and anti-HBc;⑵Pathologic lesion of liver was hidden after infection of HBV;⑶The incidence of active cirrhosis was high; and ⑷There were many pathologic features in patients with PHC associated with HBV.

Objective To analyze risk factors for the perioperative heart failure following hip fracture surgery in the aged patients.Methods The present study included 186 elderly patients(≥ 65 years)who had received hip fracture surgery from August 2009 to Janurary 2014 in our department.Their clinical data were analyzed to define risk factors for perioperative heart failure.Results Factors significantly affecting the perioperative heart failure included age,gender,hypertension,time from injury to operation,general health before injury,pain score,perioperative blood transfusion,perioperative human serum albumin transfusion,fluid infusion during operation,perioperative balance between daily fluid intake and output,perioperative temperature changing and heart diseases.A multivariate Logistic regression analysis revealed that the independent risk factors for perioperative heart failure included general health before injury (OR =21.967,P=0.000),perioperative balance between daily fluid intake and output (OR =19.349,P =0.005),heart diseases (OR =6.009,P =0.006).Conclusions In aged patients undergoing hip fracture repair operations the independent risk factors for perioperative heart failure include general health before injury,perioperative balance between daily fluid intake and output,heart diseases.Perioperative risk assessment and prevention are the keys of better prognosis.

Objective:To understand the etiology and clinical characteristics of hospitalized severe community-acquired pneumonia(SCAP) in Changchun, and provide scientific basis for its etiology diagnosis and targeted treatment.Methods:The study subjects included 618 children with clinical diagnosis of SCAP who were hospitalized from January 2016 to December 2019.We collected pharyngeal swabs and alveolar lavage fluid from children.Virus isolation, bacterial culture, time-of-flight mass spectrometry, PCR/RT-PCR, colloidal gold method and Optochin test were used to detect the antigen, nucleic acid and protein profiles in the specimen.Results:There were more boys than girls in hospitalized children with SCAP.The peak age of onset was 7 to 12 months.Most cases occurred in winter and spring.The highest detection rate of SCAP virus was 56.15%(347/618); 73.49%(255/347) were positive for one virus, among which the top five were respiratory syncytial virus (27.8%), influenza A virus (23.9%), influenza B virus (16.1%), rhinovirus (12.2%) and metapneumovirus (10.2%). Two viruses were positive for 19.88%(69/347); three viruses were positive for 4.32%(15/347); four viruses were positive for 2.31%(8/347). Atypical microbial infections were 29.77%(184/618), of which Mycoplasma pneumoniae accounted for 95.65%(176/184). Bacterial infections were 17.31%(107/618), mainly Streptococcus pneumoniae(39.25%, 42/107) and Staphylococcus aureus(24.30%, 26/107). The mixed infection of multiple pathogens was 7.61%(47/618), among which the mixed infection rates of Mycoplasma pneumonia with Streptococcus pneumoniae, virus were 40.43% and 34.04%, respectively.High fever, faster breathing, and perioral cyanosis were risk factors for SCAP, with OR and 95% CI of 7.71 and 4.56-13.04, 2.43 and 2.02-2.93, 3.53 and 2.56-4.86, respectively.Viral co-infection occurred in 36.96%(34/92) of complications such as heart failure, toxic encephalopathy, and myocardial damage; Mycoplasma pneumoniae and other pathogens co-infected 35.29% of children with pleural effusion. Conclusion:The pathogens of SCAP in Changchun are mainly viruses notably, respiratory syncytial virus is the dominant pathogen, followed by Mycoplasma pneumoniae.The bacterial pathogen is mainly Streptococcus pneumoniae.High fever, faster breathing, and cyanosis around the mouth are risk factors for severe pneumonia.Multi-pathogen mixed infection is prone to serious complications.