Objective To investigate the relevance between relapse and course of treatment in genotype 1 chronic hepatitis C (CHC)pa-tients with slow virologic response.Methods Totally 157 genotype 1 CHC inpatients or outpatients were selected from the Third People′s Hospital of Jiaozuo and the People′s Hospital of Jiaozuo from April 2010 to March 2013.The patients were treated with interferon α-1b in conjunction with ribavirin.At 6 months of the initial treatment,5 1 patients with slow virologic response were randomly divided into groups A (24 cases)and B (27 cases),which received continued treatment for another 6 and 12 months,respectively.A 1 -year follow-up of pa-tients was performed after withdrawal of treatment.Adverse reactions in patients receiving the antiviral therapy were assessed.Furthermore, group comparisons were performed on the clearance rate of hepatitis C virus (HCV)RNA and normalization rate of alanine aminotransferase (ALT)at withdrawal of treatment,as well as the CHC relapse rate and ALT normalization rate at 6 months and 1 year after withdrawal of treatment.Continuous data were compared using t test,and categorical data were compared usingχ2 test.Results The rate of adverse reac-tions in patients receiving antiviral therapy had no significant difference between groups A and B (P>0.05 ).At withdrawal of treatment, there were no significant differences between groups in terms of HCV RNA clearance rate (95.65%vs 92.59%)and ALT normalization rate (95.65% vs 88.89%)(χ2 =0.02 and 0.13,respectively,both P>0.05).At 6 months and 1 year after withdrawal of treatment,the CHC relapse rate in group B was significantly lower than that in group A (20.00% vs 50.00%,χ2 =4.69,P <0.05;36.00% vs 68.18%,χ2 =4.85,P<0.05);the ALT normalization rate in group B was nonsignificantly higher than that in group A (84.00% vs 59.09%,χ2 =3.63,P>0.05;72.00% vs 50.00%,χ2 =2.40,P>0.05).Conclusion To extend the 6 -month course of treatment can significantly reduce the relapse following slow virologic response in patients with genotype 1 CHC.

Objective 　To investigate the anatomic characteristics of optic canal in chinese adults. Methods　Twenty chinese cadaveric speciments fixed in formalin of chinese patients without intracranial and intraorbital disease. We measured the width and height of the intracranial opening and the intraorbital opening of the optic canal of all cases. The length of roof, floor, medial and lateral wall of the optic canal, and the width, the height of the middle protion were also measured after unroofing the canal with high-speed drilling. The degree of pneumatization of ethmoidal and sphenoidal sinuses was recorded. Results　The intracranial opening of the optic canal was a horizontal oval shape. The width of it was (5.05±0.42) mm and the height was (4.61±0.27) mm. The length of optic roof, optic floor, medial wall and lateral wall of the optic canal was (9.67±1.51) mm, (5.41±0.84) mm, (9.58±0.72) mm and (9.26±0.66) mm, respectively. The intraorbital opening of the optic canal was a vertical oval shape, the height and width of it was (5.30±0.64) mm and (5.62±0.83) mm respectively. Conclusions　The wall of the optic canal is thinner and there is a narrow portion in the middle of it. Depending on the degree of the pneumatization of sphenoidal and ethmoidal sinus, three types were divided into: 1. reversal U shape, 2. C shape, 3. D shape. The dura fold of the optic canal is long and its edge is sharp.

Objective To explore the new preservation method of cornea by evaluating the structure and function of rabbit's endothelia on the condition of whole-eye preservation with aqueous removed and recipient's serum tamponaded. Methods Forty New Zealand big white rabbits (80 eyes) were random divided into two groups, 40 eyes in group A (control group) and 40 eyes in group B (experimental group). The vitality of endothelial cell on the condition of tow corneal preservation methods which were the moist chamber preservation (group A) and the whole-eye preservation with aqueous removed and recipient's serum tamponaded (group B) was compared. At the 2nd day, the 5th day, the 7th day, the 10th day, the vitality of endothelial cell was appraised through ultra-microstructure by scanning electron microscope and the trpan biuealizarin red stain. The corneal thickness was measured, and corneal endothelial cells density was calculated, and cell size was observed by image analysis system. Result In group B, the corneas remained transparent for 7 days , and the rate of vitality was 90% for7 days and that was over 80% for 10 days. In group A, the corneas remained transparent for 2 days, and the endothelial cell losing and dying were found after 5 days. Cell vitality, cell density and cell size had no statistical difference between Group B for 7 days and group A for 2 days. (all P＞0. 05). In group A, at the 5th day, the 7th day ,the 10th day, the average corneal thickness were (0.64 ± 0.04) mm, (0. 79 ± 0. 03) mm , (1.06 ± 0. 03) mm. In the group B, at the 5th day, the 7th day ,the l0th day, the average corneal thickness were (0. 55 ±0.03)mm, (0.65 ±0. 02) mm , (0. 85 ± 0. 05) mm. The average corneal thickness had significant difference between group A and group B (all P ＜ 0. 05). Conclusion Recipient serum had the function with supporting the structure and function of rabbit's corneal endothelial cell, and it could prolong the storage time with the moist chamberstorage at the same time.

Objective To seek the evidence-based medicine (EBM) evidences of curative effects of intravitreous injection with triamcinolone acetonide (TA) for macular edema. Methods All articles of intravitreous injection TA for macular edema published in English or Chinese were picked up from databases of MEDLINE and CNKI and then evaluated according to EBM standard. The data in accord with research standard were selected by using excluding and including criteria, and classified according to the appraisal standard of clinical therapeutic documents. Results In the selected papers, none in gradeⅠevidence; 1 in gradeⅡevidence; 7 in grade Ⅲ evidence; 24 in grade Ⅳ evidence; and 19 in gradeⅤevidence. Forty-two papers reported that intravitreous injection with TA had significant effect for macular edema within 3 months, and the improvement of visual acuity was recorded in these papers. Regression of macular edema was recorded in 23 papers. Among 20 papers, side-effect was found in 93 eyes (31.41%) and the serious side-effect in 4 eyes (1.35%). Conclusions Intravitreous injection with TA has some curative effects for macular edema in short term, but the quality of current study has not been encouraging. There are no grade I document and lack of the study of validity in long term and essentiality and validity of retreatment. The special attention should be payed on the increasing persistency of efficacy and preventing the serious side-effects in the future investigation.

Objective To evaluate the effect of ultra-filtration extract from Danggui Buxue Decoction (DBD) on immune function of H22 bearing mouse and explore the mechanism through observing the effect of ultra-filtration extract from DBD on the secretion of the cytokines (IL-2,IFN-?).Methods We used membrane separation technique to extract DBD.The content of IL-2 and IFN-? in splenocyte culture supernatant was detected by enzyme-linked immunosorbent assay (ELISA),and the mRNA expression of cytokines (IL-2,IFN-?) in splenocytes was assayed by reverse transcription-polymerase chain reaction ( RT-PCR).Results The content of IL-2 and IFN-? in splenocyte culture supernatant was increased in ultra-filtration extract from DBD groups,significantly in high-dose group (P

OBJECTIVE: To explore the diagnostic value of the proposed thyroid imaging reporting and data system (TI-RADS) classification in thyroid nodules, and to investigate interobserver variability among different observers using TI-RADS classification for ultrasound. METHOD: We reviewed 667 thyroid nodules conventional ultrasound image data from 532 patients who were confirmed by Pathological diagnosis. Those ultrasound images were reviewed by 4 experienced sonographers who can independently assessed the sonographic characteristics and analyzed according to the TI-RADS classification. It is to assess the diagnostic sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the TI-RADS classification. The multirater kappa statistics were used to assess the interobserver agreement among different observers. RESULT: The overall sensitivity, specificity, negative predictive value (NPV) and Accuracy were 94%, 79%, 97% and 81%, respectively. Positive predictive values (PPVs) for categories 4 and 5 were 55% and 92%. There was substantial interobserver agreement for categories 3, 4B and 5 (Kappa = 0.62, 95% CI, 0.58-0.65), and was moderate agreement for category 4A (Kappa = 0.57) and 4B(Kappa = 0.60). CONCLUSION The diagnostic criteria of TI-RADS for differentiating between benign and malignant thyroid nodules have a high diagnostic value. There was substantial interobserver agreement in different experienced sonographers. The TI-RADS diagnostic criteria have a high diagnostic value and has great practical value in making a proper and further treatment plan.
Humans ; Observer Variation ; Predictive Value of Tests ; Sensitivity and Specificity ; Thyroid Nodule ; classification ; diagnostic imaging ; Ultrasonography

AIM:To observe the protective effect of allitridi on hippocampal neuron of rats with cerebral ischemia-reperfusion (I/R) injury and to investigate its effects on P53 expression in hippocampus.METHODS: The global cerebral ischemia-reperfusion models were established by 4-vessel occlusion. Allitridi at doses of 10, 20 or 30 mg/kg was injected through rat’s tail vein, half dose at 30 min before brain ischemia and another half dose at 10 min after reperfusion were injected, respectively. The hippocampus of rat was removed 24 h after reperfusion. Toluidine blue staining was applied to estimate morphologic changes. Flow cytometry was used to evaluate neuronal apoptosis rate of hippocampus. Immunohistochemistry was used to observe the expression of P53 protein.RESULTS: Compared with sham group, survival neuronal density in I/R group was significantly depressed. The rate of neuronal apoptosis and the expression of P53 protein were significantly increased. Allitridi significantly increased the number of survival neurons in hippocampus compared to I/R group. Meanwhile, allitridi remarkably inhibited the rate of neuronal apoptosis and the expression of P53 protein.CONCLUSION: Allitridi has protective role against brain ischemia reperfusion injury. The mechanism may be involved in blocking P53 protein expression in hippocampus of rats with ischemia-reperfusion.

BACKGROUND: Whether the injured peripheral nerve in a late stage has repairing value still remains a problem. If irreversible changes happen in substance P and calcitonin gene-related peptide, the feeling function will lose even after repairing.OBJECTIVE: To quantitatively study the changes of substance P(SP) and calcitonin gene-related peptide(CGRP) in the spinal dorsal horn 24 weeks after peripheral nerve injury.DESIGN: A self-controlled quantitative experiment.SETTING: Institute of Orthopaedics of the Fourth Military Medical University of Chinese PLA.MATERIALS: This experiment was performed in the Institute of Orthopaedics of the Fourth Military Medical University of Chinese PLA from October 2002 to May 2003. Totally 55 SD rats were divided into 11 groups according to time points(1, 2, 3, 4, 6, 8, 10, 12, 16, 20 and 24 weeks after sciatic nerve transection).INTERVENTIONS: Sciatic nerve injury model was set up by transecting one side of sciatic nerve and ligating the proximal stump of sciatic nerve; the other side was set as the control side. Computer-assisted image analysis was used to measure the immunologic reaction areas of substance P and CGRP.MAIN OUTCOME MEASURES: Changes of the distribution of the positive fibres of SP and CGRP in rat spinal dorsal horn in each group.RESULTS: Fifty-five rats entered the result analysis. The distributions of SP immunoreactivity in the spinal dorsal horn following sciatic nerve injury showed a significant reduction during 2-6 weeks, followed by a slow rate of increase,and reached almost complete restoration at 16 weeks after deafferentation. No obvious advanced changes happened at 20 and 24 weeks. The ratios for ipsilateral and cotralateral sides of positive fibre and distribution area injury in spinal dorsal horn CGRP were 1.14 at week 1, 1.13 at week 6, and 0. 29 at week 24. The ratios were similar at each time point( P ＞ 0. 05).CONCLUSION: At the late stage of peripheral nerve injury, neurons in the spinal dorsal horn and dorsal root ganglion still remain their functions to synthesize and secrete SP and CGRP. Spinal dorsal horn remains at a balanced status and still has the neurologic basis to recover the sensory function.

Objective To assess the impact of additional cycles of temozolomide on the survival of glio-blastoma(GBM)patients after 6 months of maintenance temozolomide(TMZ)following concurrent TMZ chemo-therapy and radiation therapy. Methods Data of 51 GBM patients from 2009 to 2015 were retrospectively studied and the therapeutic effect was assessed according to whether receiving long-term treatment with TMZ. Results Sev-enteen of fifty-one GBM patients received 8 or more cycles and prolonged treatment improved progression-free sur-vival(P=0.011)and overall survival(P=0.004). Conclusions Extended use of TMZ is safe to GBM patients , which may improve response OS and PFS compared to conventional regimen. Prospective studies in larger popula-tions are needed to better-define the population to whom it can be proposed and its optimal duration.

Objective To survey the incidence of sleep disorders among patients with industrial injuries and analyze the relevant factors.MethodsA total of 112 depressed patients ( male 106,female 6; aged 22-79 years,course of disease 35 d-25 years) were assessed by a professional psychologist using life satisfaction index A,the type A behavior pattern scale,the Pittsburgh sleep quality index (PSQI) and the Barthel index.ResultsThe incidence of disordered sleep was 40.18％ (45/112),of whom mildly depressed patients were 34.29％,moderately depressed patients 42.86％ and severely depressed patients 85.71％.The incidence of sleep disorders increased with increasing depression severity.The incidence of disordered sleep was significantly higher among the severely depressed patients than among those mildly or moderately depressed,but there was no significant difference in incidence between moderately and mildly depressed patients.PSQI scores among the severely and moderately depressed patients were significantly higher than among those mildly depressed,but there was no statistically significant difference in average PSQI scores between the severely and moderately depressed patients.The sleep disorder group suffered significantly poorer sleep quality and took significantly longer to get to sleep.There were no significant differences in average age,educational level,marital status,social relations,family and social support,gender distribution or course of disease between the two groups.There were,however,significant differences in family income,life satisfaction,character type and disease species between the groups.ConclusionThe incidence of disordered sleep among depressed patients after industrial injury is correlated with the severity of depression,family income,life satisfaction,the type of injury and the patient's character.