Objective To evaluate the performance of aspartate aminotransferase to platelet ratio index (APRI) in the assessment of fibrosis in chronic hepatitis B virus (HBV) infection patients with transaminase level less than two times of upper limits of normal (ULN),and to analyze the clinical utility in antiviral therapy.Methods A total of 349 clinically diagnosed chronic HBV infection with alanine aminotransferase (ALT) and aspartate aminotransferase (AST) level less than 2 × ULN were enrolled.Liver biopsy and routine laboratory tests were performed to calculate the ratio of AST to platelet (PLT),namely the APRI,and to compare the relationship between liver fibrosis and APRI.Diagnostic performance of APRI model was assessed by using receiver operating characteristic (ROC) curves and area under the ROC curve (AUC) analysis.Correlation between APRI and liver fibrosis was determined by Spearman rank correlation analysis.Results The AUC of APRI≥0.273 for significant liver fibrosis was 0.641 with sensitivity of 48.3％,specificity of 75.7％ and positive predictive value of 73.9％.The AUC of APRI≥0.311 for cirrhosis was 0.771 with sensitivity of 68.6％,specificity of 76.8％,and negative predictive value of 93.5％.In patients with HBV DNA level ranging from 1 × 103 to 1 × 105 copy/mL,the optimal cut-off value of APRI was 0.179 for significant fibrosis (P＝0.00) and 0.283 for cirrhosis (P=0.00).By Spearman rank correlation analysis,APRI was positively correlated with histologic stages of fibrosis (r=0.370,P＜0.01).Conclusions APRI can be utilized to assess liver fibrosis in HBV infection with ALT and AST level less than 2 × ULN.APRI≥0.273 (pathologic stages of fibrosis ≥S2) has obvious hepatic fibrosis,which may help physician to select the optimal time for antiviral therapy.APRI may serve as a potential tool for assessing liver fibrosis according to HBV DNA levels.

Objective:To evaluate the efficiency of high-tech medical equipment of county-level hospitals in Guangxi Zhuang Autonomous Region, and to provide a scientific foundation for high-tech medical equipment configuration planning for county-level hospitals.Methods: DEA model was used to evaluate the relative efficiency of 40 county-level hospitals in Guangxi.Results: 4 among 40 hospitals (10.00%) could be categorized as effective hospitals, and pure technical efficiency is not high in 30 hospitals (75.00%). The returns to scale decreased in 20 hospitals (50.00%), and 16 hospitals (40.00%) increased. The average number of the overall efficiency, pure technical efficiency and scale efficiency of the 40 hospitals were 0.684, 0.753 and 0.908 respectively. Conclusion: Departments concerned should set reasonable evaluation index to ensure that the evaluation is scientific. Hospitals should strengthen the internal management of high-tech medical equipment to improve the utilization rate of the equipment. Departments concerned are supposed to curb or enlarge the number of the high-tech medical equipment to improve the scale efficiency of the equipment.

OBJECTIVE To obtain the statistics of the resistance of Staphylococcus spp to 12 antibacterial agents. METHODS The clinical non-repeated isolates of Staphylococcus aureus and coagulase negative Staphylococcus(CNS) were collected in September 2004 in 13 hospitals of Anhui Province.According to National Committee for Clinical Laboratory Standards(NCCLS) of America(2004),agar dilution method was performed to determine the MICs of 12 antimicrobial agents against the isolates. RESULTS All S.aureus and 92.9% of CNS were resistant to penicillin respectively.Multi-resistance to antibiotics such as macrolides,and fluoroquinolones were found in these strains,and all the isolates of Staphylococcus spp were susceptible to vancomycin. CONCLUSIONS Staphylococcus spp exhibit some degrees of resistance to antimicrobial agents in Anhui Province.Therefore,the drug resistance of surveillance must be imposed,and we must emphasize on reasonable option of antimicrobial agents in clinical therapy in our area.

Objective To investigate the levels of HBsAg and HBV DNA in different clinical stages. Methods Serum samples of 246 patients, without accepting antiviral therapy, from the second affiliated anhui medical univrsity were collected from 2012.1 to 2013.5. Among the enrolled patients, 41 cases with chronic HBV-carrier (ASC), 99 cases with chronic hepatitis B patients (CHB), 70 cases with liver cirrhosis (LC), and 36 cases with primary liver cancer (HCC) were included. Results Levels of HBsAg in the group of ASC, CHB, LC, HCC were 135 280.00 (1 788.80 ~ 51 820.00) IU / mL, 8 218.00 (1 644.60 ~ 266 700.80) IU / mL, 1 280.38 (265.70~2 375.00) IU / mL, and 925.10(135.05 ~ 2 381.8) IU / mL, respectively. Positive correlations were observed between HBsAg tire and HBV DNA levels (rs = 0.332, P = 0.000), and negative correlations were doserved between HBsAg leve and age(rs = -0.496,P = 0.000). Conclusions The level of HBsAg in serum decreased progressively from the group of ASC to CHB, LC and HCC, the positive correlation between levels of HBsAg and HBV DNA, and the negative correction between HBsAg level and age were demonstrated.

Objective To investigate the cachexia morbidity among hospitalized patients with digestive system cancer and evaluate its impact on clinical outcomes.Method By analyzing the clinical data of 5 118 hospitalized patients with digestive system cancer in Zhongshan Hospital,Fudan University from January 2012 to December 2013,we investigated the cachexia morbidity and compared the clinical outcome between cachectic patients and noncachectic patients.Results The overall cachexia morbidity of hospitalized patients with digestive system cancer was 15.7％ (803/5 118).The highest cachexia morbidity was 34.0％ (89/173),found in patients with pancreatic cancer.In cachectic group and non-cachectic group,the overall completion rate of radical resection was 67.1％ (539/803) and 74.5％ (3 214/4 315),respectively (P =0.000).Compared to the non-cachectic group,the cachetic group had significantly longer postoperative hospital days [(11.5 ±6.2) d vs (9.4 ±4.9) d,P =0.003],slower postoperative recovery of bowel function [(3.4 ±0.9) d vs (3.2 ±0.8) d,P =0.013],longer postoperative time to intake semifluid [(4.4 ± 1.5) d vs (3.9 ± 1.3) d,P =0.002],and more postoperative complications in 28 days after surgery [8.9％ (48/539) vs 5.8％ (186/3 214),P=0.006].After surgery,131 patients in the cachectic group were transferred to the ICU,and 646 patients in non-cachectic group transferred to the ICU (24.3％ vs 20.0％,P=0.026).Compared to the non-cachecic group,the reoperation rate [3.2％ (17/539) vs 1.5％ (48/3214)],ventilator support rate [8.0％ (43/539) vs 5.7％ (184/3 214)],and mortality [2.4％ (13/539) vs 1.1％ (35/3 214)] of the cachectic group were all significantly higher (P =0.006,0.042,0.011).Conclusions Cachexia is common in hospitalized patients with digestive system cancer,especially in patients with pancreatic cancer.Cachexia has negative impact on the clinical outcomes.

Adielectrophoresis-basedmicrofluidicchipappliedtocellspatterningisdesignedandfabricated, and it demonstrates non-contact and batch manipulation of cells. The microfluidic chip employs a PDMS microchannel and two ITO electrodes, which are designed as astep shape. The distribution of electric field caused by the microelectrodes is simulated by finite element simulation software, COMSOL. The position of the maximum intensity of electric field is also determined. The ITO microelectrodes and the PDMS microchannel are fabricated using MEMS fabrication process. After oxygen plasma surface treatment, the PDMS microchannel and glass substrate with the ITO microelectrodes are aligned and bonded to form experimental microfluidic chip. Through DEP experiment with the varying frequencies, DEP response of yeast cells is examined, and the electric field frequency of the both positive and negative DEP responses are confirmed. The results showed that yeast cells in solution conductivity of 60 μS/cm had negative DEP movement at the frequency of 1 kHz to 10 kHz, positive DEP movement at the 500 kHz to 10 MHz, and no DEP movement at the 50 kHz. Under the condition of the sinusoidal potential of 8Vp-p and the electric field frequency of 5 MHz, the yeast cells were aligned into chains along the step edge of microelectrodes.

OBJECTIVETo investigate cachexia in hospitalized patients with digestive system cancer and evaluate its impact on clinical outcomes.

METHODSBy analyzing the clinical data of 5118 hospitalized patients with digestive system cancer in Zhongshan Hospital of Fudan University from January 2012 to December 2013, cachexia was investigated and clinical outcomes between cachexia patients and non-cachexia patients was compared.

RESULTSThe total cachexia rate of hospitalized patients with digestive system cancer was 15.7%(803/5118). The highest rate of cachexia was 34.0%(89/262) in patients with pancreatic cancer followed by gastric cancer 22.4%(261/1164), colon cancer 21.7%(146/672), and rectal cancer 20.1%(117/581). In cachexia group and non-cachexia group, the overall completion rate of radical resection was 67.1%(539/803) and 74.5%(3214/4315) respectively(P<0.05). Compared to the non-cachexia group, the cachexia group was associated with longer postoperative hospital stay [(11.5±6.2) d vs. (9.4±4.9) d, P<0.05], slower postoperative recovery of bowel function [(3.4±0.9) d vs. (3.2±0.8) d, P<0.05], longer postoperative time to intake of semifluid [(4.4±1.5) d vs. (3.9±1.1) d, P<0.05], and more postoperative complications within 28 days after radical surgery [8.9%(48/539) vs. 5.8%(186/3214), P<0.05]. After radical surgery, the ICU admission rate of the cachexia group [24.3%(131/539)] was higher than that of the non-cachexia group [20.1%(646/3214)] with significant difference(P<0.05). Compared to non-cachexia group, the reoperation rate [3.2%(17/539) vs. 1.5%(48/3214), P<0.05], ventilator support rate [8.0%(43/539)vs. 5.7%(184/3214), P<0.05] and mortality [2.4%(13/539) vs. 1.1%(35/3214), P<0.05] in the cachexia group were all significantly higher(all P<0.05).

CONCLUSIONSCachexia is commen in patients with digestive system cancer. Cachexia has significant adverse effects on clinical outcomes in hospitalized patients with digestive system cancer.

Cachexia ; etiology ; Colonic Neoplasms ; complications ; Defecation ; Humans ; Postoperative Complications ; Rectal Neoplasms ; complications ; Reoperation ; Stomach Neoplasms ; complications

OBJECTIVETo evaluate the safety and short-term outcomes of laparoscopic-assisted surgery for rectal cancer by comparing the efficacy of laparoscopy and open surgery.

METHODSClinical data of patients with rectal cancer treated by laparoscopy or open surgery in Zhongshan Hospital from April 2011 to June 2012 were analyzed retrospectively, and the clinical outcomes between the two groups were compared.

RESULTSNinety-six rectal cancer patients undergoing laparoscopic surgery(LS) were enrolled. A total of 216 rectal cancer patients underwent open surgery(OS). There was no operative death in both groups. In LS and OS group, the overall completion rates of TME were 86.4%(83/96) vs. 89.3%(193/216)(P>0.05) respectively, and the overall anal reservation rates were 78.1%(75/96) vs. 75.0%(162/216)(P>0.05) respectively. The mean distance to proximal resection margin and distal resection margin respectively were (10.3±4.1) cm vs.(10.0±4.3) cm(P>0.05) and (3.4±0.9) cm vs. (3.6±1.4) cm(P>0.05) respectively. The mean number of harvested lymph nodes respectively were (12.8±5.2) vs.(13.7±6.4)(P>0.05). Compared to OS, LS presented less blood loss [(98.0±28.7) ml vs. (175.0±41.0) ml, P<0.05], shorter postoperative hospital stay [(9.4±4.9) d vs.(11.6±6.2) d, P<0.05], quicker postoperative recovery of bowel function[(2.7±0.9) d vs. (3.4±0.9) d, P<0.05], shorter postoperative time to intake semi-solid[(3.7±1.2) d vs. (4.4±1.5) d, P<0.05], less postoperative complications(15.6% vs. 25.9%, P<0.05), but longer operative time[(155.7±48.4) min vs. (120.0±26.7) min, P<0.05]. Postoperative follow-up was 6 to 24 months, and the local recurrence of LS and OS was 2.1% and 2.3%(P>0.05).

CONCLUSIONLaparoscopic surgery can obtain the same radical efficacy for rectal cancer as compared to open surgery.

Anal Canal ; Digestive System Surgical Procedures ; Humans ; Laparoscopy ; Lymph Nodes ; Neoplasm Recurrence, Local ; Operative Time ; Postoperative Complications ; Rectal Neoplasms ; surgery ; Retrospective Studies ; Treatment Outcome

Chronic obstructive pulmonary disease （COPD） is susceptible to systemic complications. Especially，sarcopenia is an independent risk factor for COPD patients that can exacerbate respiratory muscle fatigue，lead to a higher risk of falls and fractures，and lower the quality of life. The pathogenesis of sarcopenia involves such aspects as mitochondrial dysfunction，insulin resistance，changes in skeletal muscle fiber types，and an imbalance in protein synthesis and breakdown. As nutrition support and exercise rehabilitation therapy frequently have limited effectiveness，it is urgent to find a way to slow the progression of COPD with sarcopenia. Numerous studies conducted in recent years have discovered a potential link between pulmonary microbiome disorders and the gut microbiota of COPD patients. Furthermore，a wide range of functions of gut microbiota and its metabolites have been demonstrated，such as regulating inflammation and immunity，glucose and lipid metabolism，and mitochondrial function. According to the Zangxiang theory in Chinese medicine， there are intimate connections between the spleen， intestine，and muscle，and gut microbiota may be the most essential part of ameliorating "spleen governing muscle" and increasing muscle mass and strength. This study aims to expound on the effect mechanism of gut microbiota in slowing the progression of COPD with sarcopenia，thereby furnishing novel perspectives and recommendations for forthcoming investigations and therapeutic applications.