Objective To investigate the characteristics of depression in the chronic hepatitis C (CHC) patients who received pegylated interferon therapy.Methods Clinical data of 218 CHC patients who were treated with pegylated interferon were collected in Huzhou Central Hospital,Zhengjiang from January 2008 to December 2013.The Hamilton Depression Rating Scale (HAMD) was used to assess the patient's depression symptoms during the treatment process.The sustained virological response (SVR) rate was assessed 24 weeks after the completion of treatment.Chi square test was used to compare the effects of treatment,gender,age,different types of interferon during the treatment process on depression,and to analyze the dynamic changes of depression and the effect of depression on SVR.Results Of the 218 CHC patients who completed pegylated interferon treatment,the proportion of patients with HAMD score ≥8 (n=73,33.19％) after treatment was significantly higher than that before treatment (n=20,9.17％;x2=40.321,P＜0.05).The female CHC patients were more prone to have depressive symptoms than the male patients (40.50％o [49/121] vs 24.74％ [24/97];x2 =6.097,P＜0.05).The incidence rate of depression in patients younger than 55 years old was lower than that of over 55 years (27.48％ [36/131] vs42.53％ [37/87];x2=5.271,P＜0.05).The incidence rate was not significant different between pegylated interferon α-2a group and pegylated interferon α-2b group after treatment (35.04％ [41/117] vs31.68％ [32/01];x2=0.275,P＞0.05).At week 8 of treatment,the number of depression patients increased most significantly.Totally 113 (51.83 ％) of 218 patients achieved SVR,including 57.53％ (42/73) of patients with depression and 48.97％ (71/145) of patients without depression,but there was no statistical significance (x2 =1.432,P＞0.05).Conclusion In CHC patients received pegylated interferon treatment,elderly and female patients are more susceptible to develop depression and the incidence of depression peaks at week 8 of treatment.

Fracture problem of orthodontic wires was discussed in this paper. The calculation formulae of bending stress and tensile stress were obtained. All main factors that affect bending stress and tensile stress of orthodontic wires were analyzed and discussed. It was concluded that the main causes of fracture of orthodontic wires were fatigue and static disruption. Some improving proposals for preventing fracture of orthodontic wires were put forward.
Dental Alloys ; Elasticity ; Equipment Failure Analysis ; Mechanics ; Orthodontic Wires ; Tensile Strength

Objective To analyze the effect of single nucleotide polymorphism ( SNP) rs8099917 of interleukin-28B ( IL-28B) on spontaneous virus clearance and the efficacy of antiviral therapy in hepatitis C virus (HCV) infected patients in Huzhou area of Zhejiang Province.Methods A total of 268 HCV-infected patients were enrolled.The high sensitive HCV RNA quantification , HCV genotype and the IL-28B rs8099917 SNP were detected at baseline.One hundred and sixty-three patients received pegylated interferon α-2a ( Peg-IFNα-2a) and ribavirin (RBV) combined antiviral therapy (referred as PR treatment) for 48 weeks, who were followed up for 24 weeks.The remaining 44 patients were treated with sofosbuvir and daclatasvir for 12 weeks. The virological response of patients with different IL-28B rs8099917 genotypes was monitored.The count data was compared by χ2 test.Results The distributions of IL-28B rs8099917 SNP were 84.33%for TT genotype and 15.67%for GT genotype, while the GG genotype was not detected.Of the 135 patients with acute HCV infection, 61 cases had spontaneous viral clearance , 74 cases were converted to chronic infection.The spontaneous clearance rates were 47.11% for TT genotype and 28.57% for GT genotype.There was no significant difference of the spontaneous clearance rate between TT and GT genotype (χ2 ＝1.072, P＝0.30). In 163 chronic hepatitis C (CHC) patients with PR treatment, the rate of sustained virological response (SVR) after 24 weeks follow-up was 86.50%(141 cases).SVR rate in patients with TT genotype was significantly higher than those with GT genotype (91.67%vs 47.36%, χ2 ＝28.212, P＜0.05).There was no statistically significant difference of the SVR rates between genotype 1b and 2a (χ2 ＝1.525, P＞0.05).In 44 patients received sofosbuvir and daclatasvir treatment , both SVR rates of TT genotype and GT genotype were 100%. Conclusions In Huzhou area of Zhejiang Province , there is no significant correlation between IL-28B rs8099917 genotype and spontaneous clearance in patients with acute HCV infection , but the genotype of IL-28B rs8099917 is valuable for the prediction of PR treatment efficacy , the SVR rate of the TT genotype is superior to the GT genotype.The SVR rate can reach 100% in patients received combination therapy of sofosbuvir and daclatasvir independent of polymorphism of IL-28B.

Objective To study the relationship between cleanliness of children′s hands and diminution of Ascaris lumbricoides infection. Methods Before the study all persons positive for ascaris eggs in the preliminary survey were treated with albendazole. Hand washing habit before meal and after defecation was kept in children of experimental group, but not in the control group. Kato thick smear stool examination was done once every two months for one year to compare the new infection rates in children without ascaris infection in the two groups, and the reinfection rates in the cured negative cases were also compared between them in half a month after chemotherapy. Results All the new infection rates as well as reinfection rates of each reexamination in the experimental group were significantly lower than that of the control group ( P

Objective To explore the application value of cone-shaped gastric tube combined with cervical end-to-end anastomosis in thoracoscopic and laparoscopic esophagectomy for esophageal cancer.Methods The retrospective and descriptive study was conducted.The clinical data of 122 patients with esophageal cancer who were admitted to West China Hospital of Sichuan University from December 2016 to December 2017 were collected.There were 89 males and 33 females,aged (61±8)years,with a range from 48 to 81 years.McKeowntype three-incision esophagectomy was performed,and the cone-shaped gastric tube was pulled up to esophagus in left neck for hand-sewn end-to-end anastomosis after the dissection of esophagus and stomach under total thoracoscopy and laparoscopy.Observation indicators:(1) surgical treatment situations;(2) postoperative complications;(3) follow-up.Follow-up using outpatient examination was performed to detect postoperative gastroesophageal reflux,anastomotic stenosis and evaluate anastomotic width at 1,3,6 months and one year postoperatively up to December 2018.Measurement data with normal distribution were represented by Mean±SD.Measurement data with skewed distribution were described by M (P25,P75) or M (range).Count data were expressed by absolute number.Results (1) Surgical treatment situations:122 patients underwent laparocopic McKeown-type three-incision esophagectomy successfully,using cone-shaped gastric tube combined with cervical hand-sewn end-to-end anastomosis as digestive tract reconstruction,with no intraoperative conversion to open surgery.The operation time,cervical anastomosis time,and volume of intraoperative blood loss were (229 ± 49) minutes,(27± 1) minutes,and 50 mL (40 mL,60 mL),respectively.There were 6-8 stations of lymph node dissected,and the number of lymph node dissected were 19 (15,25).Duration of postoperative hospital stay was 10 days (9 days,11 days) in the 122 patients.(2) Postoperative complications:31 of 122 patients had postoperative complications.The primary complications:3 patients with anastomotic fistula were cured by conservative treatment including enteral nutrition through placement of nutritional tube under gastroscope,closed thoracic drainage and anti-infection;6 cases with severe thoracic gastric dilation were cured after gastrointestinal decompression.The secondary complications of 22 patients included 8 cases with hoarseness caused by recurrent laryngeal never injury,5 with arrhythmia,9 with pulmonary infection.They were cured after symptomatic and supportive treatment.No chylothorax occured,and there was no perioperative death.(3) Follow-up:all the 122 patients were followed up for 10-24 months,with a median time of 19 months.During the follow-up,7 cases with anastomotic stenosis including 4 scoring less than grade 2 and 3 scoring more than grade 3 were relieved after dilation through gastroscope.There were 33 of 122 patients without any reflux symptoms,and 89 with reflux symptoms,among which 52 were scored 1,25 were scored 2 and 12 were scored 3.The width of gastroesophageal anastomosis measured by barium radiography at 1 month after operation was (1.2±0.4) cm.Conclusion Coneshaped gastric tube combined with cervical end-to-end anastomosis in digestive tract reconstruction of thoracoscopic and laparoscopic esophagectomy can reduce the incidence of postoperative anastomotic complications and thoracic gastric dilation,and nasogastric tube placement could be abandoned,which demonstrates good safety and universality.

Objective:To analyze the clinical characteristics of brucellosis in Huzhou City, Zhejiang Province, so as to provide basis for clinicians to improve their understanding and diagnosis and treatment of brucellosis.Methods:The data of 10 cases of brucellosis in Huzhou Central Hospital from 2014 to 2019 were collected, and the epidemiological characteristics, clinical manifestations, laboratory examination results, imaging examination results, etiological examination results, diagnosis and treatment process and prognosis were summarized and analyzed by retrospective analysis method.Results:Among the 10 patients with brucellosis, 6 were males and 4 were females, aged from 32 to 71 years old, and 9 patients had a history of contact with goat, and one case was considered as food borne infection. The main clinical manifestations were fever (10 cases), sweating (2 cases), joint pain (7 cases). In imaging examination, 5 cases with splemomegaly, 1 cases with lymphadenopathy, 3 patients presented with spondylitis (including 1 case with paravertebral abscess) and 2 cases with prostatitis; Brucella was cultured in 2 patients and Brucella antibodies were positive in 10 patients. The treatment drugs included doxycycline, rifampicin and levofloxacin in two or three combinations. Eight patients were followed up for more than 1 month to more than 5 years, and the prognosis was good. Conclusions:Brucellosis lacks specificity in clinical features. Most patients with brucellosis are associated with osteoarthritis or urinary system diseases. Physicians should be vigilant, combine epidemiological features, conduct laboratory tests in time, and diagnose as soon as possible.

Since the outbreak of corona virus disease 2019(COVID 19), the epidemic has spread rapidly, which brings great challenge to the surgical diagnosis, treatment and management of lung neoplasm Sichuan International Medical Exchange &Promotion Association organized thoracic surgery experts to sum up experiences from experts in major hospital, and formulated the Guidance suggestion on surgical diagnosis, treatment and management of lung neoplasm during the outbreak of COVID-19 to provide references for thoracic surgeons.

Objective    To explore the safety and feasibility of the modified and improved thoracoscopic surgery for esophageal cancer using the concept of "single-direction" thoracoscopic technique. Methods    The clinical data of 65 patients undergoing this modified minimally invasive esophagectomy based on "single-direction" thoracoscopic system between June 2018 and April 2019 were retrospectively analyzed, including 54 males and 11 females aged 62.5±7.8 years. Results    The thoracoscopic operation time was 133.4±28.6 min, and intraoperative blood loss was 61.9±29.2 mL. No intraoperative blood transfusion was needed. One patient was transferred to open thoracotomy (due to severe pleural adhesion atresia). Major complications included anastomotic leak, pneumonia, chylothorax, incisional infection, recurrent laryngeal nerve paralysis and gastric emptying disorders, which were recovered by conservative treatment. No postoperative death occurred. The median number of lymph nodes and lymph node station harvested was 19 and 10, respectively. The median postoperative hospital stay was 10 days. The volume of chest drainage was 1 117.3±543.4 mL. Conclusion    The minimally invasive operation mode of esophageal cancer based on "single-direction" thoracoscopic system is safe and feasible, and has good field vision and smooth and simplified procedure.

Objective    To investigate the short-term postoperative pain between robot-assisted and thoracolaparoscopic McKeown esophagectomy for esophageal carcinoma. Methods    We prospectively analyzed clinical data of 77 patients with esophageal carcinoma in our hospital between September 2016 and February 2017. The patients were allocated into two groups including a robot group and a thoracolaparoscopic group. The patients underwent robot assisted McKeown esophagectomy in the robot group and thoracolaparoscopic McKeown esophagectomy in the thoracolaparoscopic group. There were 38 patients with 30 males and 8 females at average age of 60.80±6.20 years in the thoracolaparoscopic group, and 39 patients with 35 males and 4 females at average age of 60.90±7.20 years in the robot group. Results    There was no statistical difference between the two groups in terms of the postoperative usage of analgesic drugs. The patients in the robot group experienced less postoperative pain on postoperative day 1, 3, 5, 6 and 7 than the patients in the thoracolaparoscopic group. The mean value of visual analogue scale (VAS) on postoperative day 1, 3, 5, 6 and 7 for the robot group and the thoracolaparoscopic group was 3.20±1.10 versus 2.70±0.90 (P=0.002), 2.75±0.96 versus 2.40±0.98 (P=0.030), 2.68±1.08 versus 2.02±0.8 (P=0.005); 2.49±0.99 versus 1.81±0.88 (P=0.003), 2.27±0.83 versus 1.51±0.61 (P<0.001), respectively. Conclusion    Compared with the thoracolaparoscopic group, patients receiving robot assisted McKeown esophagectomy experience less postoperative short-term pain. However, the long-term postoperative pain for these patients needs to be further studied.

Objective To present the initial clinical experience of robot-assisted thoracoscopic esophagectomy for patients with esophageal cancer and to analyze the short-term outcomes of these patients. Methods Between February 2016 and December 2017, 148 patients with esophageal carcinoma underwent robotic esophagectomy and two-fields lymph node dissection. There were 126 males and 22 females at average age of 62.0±8.0 years. Demographic data, intraoperative characteristics and short-term surgical outcomes were collected and analyzed. Results 106 patients underwent McKeown esophagectomy and 42 patients underwent Ivor-Lewis esophagectomy. The mean operation time was 336.0±76.0 min, the mean intraoperative blood loss was 130.0±89.0 ml, the mean number of lymph nodes removed was 21.0±8.0 and the mean length of postoperative hospital-stay was 12.0±7.2 days. Postoperative complications included anastomotic fistula (n=8, 5.4%), pulmonary infection (n=13, 8.7%), hoarseness (n=23, 15.5%), tracheoesophageal fistula (n=1, 0.7%), chylothorax (n=4, 2.7%) and incision infection (n=2, 1.4%). There was no intra-operational massive hemorrhage or in-hospital mortality. Conclusion Both robot-assisted McKeown and Ivor-Lewis esophagectomy are safe and feasible with good early outcomes.