Objective To explore how to treat open neck trauma in time and with reason in the primary hospital.Methods 57 cases of neck open injury were hospitalized from Aug.1997 to Jan.2()07,and injury cause,mechanism,diagnosis and treatment of them are analyzed retrospectively.Results There were 29 incisal wounds and 23 penetrating wounds and 5 contusing wounds.Among 57 patients there were 12 significant injuries and 55 minor injuries cases.53 patients had been treated with operative exploration and 10 patients had therapeutic exploration.The result of treatment showed that 50 patients were cured,and 4 patients died of head injury,cervical spinal injury and respiratory failure,anoxic encephalopathy from airway obstruction and hemorrhagic shock from combined injuries of common carotid artery and internal jugular vein.Conclusion The mainstay of choice of treatment is the injury mechanism and clinical signs and symptoms of patient.

Objective To explore differences of ultrasoundgraphy and CT guided percutaneous paracentesis for liver abscess and provide references for the paracentesis treating of liver abscess .Methods 68 patients with liver abscess arranged ultrasoundgraphy guided percutaneous paracentesis were regarded as ultrasound group ,and 38 patients accepted CT guided percutaneous paracentesis were considered as CT group .The succeed rate of paracentesis ,operation period ,treatment effectiveness ,complications of the 2 groups were compared .Results The succeed rate of paracentesis in ultrasound group (81 .7% ) was not different obviously to CT group(82 .6% ) (χ2 =0 .016 2 ,P=0 .898 6) .The operation period of ultrasound group(22 .3 ± 5 .6)min was shorten than CT group (25 .6 ± 4 .8)min ,t= 3 .057 4 ,P< 0 .05 .The heal rate of the 2 groups(91 .2% ,92 .1% ) was not different (χ2 = 0 .027 1 ,P=0 .869 3) .There was no different of the complications in the 2 groups(5 .88% ,8 .57% )(χ2 =0 .010 1 ,P=0 .920 1) .Conclusion Either ultrasoundgraphy or CT guided percutaneous paracentes is feasible and safe for liver abscess .Compared to CT ,the ultra-soundgraphy is more convenient and economic .

Objective To evaluate the effects of nucleoside/nucleotide analogue treatment on immunoglobulin and complement in patients with chronic hepatitis B (CHB).MethodsA total of 157 CHB patients were recruited and divided into CHB group,liver cirrhosis (LC) group and severe hepatitis B (SHB) group.There were 50 patients who received oral antiviral treatment (lamivudine 100 mg/d,or entecavir 0.5 mg/d,or telbivudine 600 mg/d).Serum levels of complement 3 and 4 (C3,C4),C-reaction protein (CRP),hemolytic complement (CH50),immunoglobulin G,M,A (IgG,IgM,IgA),hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) were detected by enzyme-linked immunosorbent assay (ELISA) or immunoturbidimetry.Hepatitis B virus (HBV) DNA was quantified by real-time polymerase chain reaction (RT-PCR) before and 1,2,3 and 4 weeks after nucleoside antiviral therapy.Comparison of means was done by t test and Mann-Whitney test.The correlation was analyzed by Pearson correlation coefficient test.ResultsSerum IgA and IgM levels of SHB and LC patients were significantly higher than those of CHB patients (P＜0.01).Levels of C3,C4,CH50 and CRP were significantly different among three groups.Levels of C3,IgM,IgG and HBV DNA in HBeAg positive patients were significantly different from those in HBeAg negative patients.There was a statistically significant difference of IgA,IgM,C3 and CH50 levels between patients with high HBV DNA level and low HBV DNA level in HBeAg-positive patients.While in the HBeAg-negative patients,only the IgA level was significantly different with HBV DNA levels.After anti-viral treatment,immunoglobulin and HBV DNA levels were all decreased in three groups,while the serum complement level was increased compared to baseline,and the differences became significant at week 4 of treatment. HBV DNA level was negatively correlated with C3 (r=-0.78,P=0.021) and HBeAg titer was positively correlated with C3 (r=0.87,P=0.015).ConclusionsThe immunoglobulin,CRP,C3,C4,and C H50 could reflect the inflammatory activity in liver.The changes of C3 level can predict the efficacy of antiviral therapy.

Objective To investigate the susceptibility of bone marrow mesenchymal stem cell (BMSC) to hepatitis B virus (HBV) infection during induction toward hepatocyte and the role of asialoglycoprotein receptor (ASGPR) in BMSC HBV infection. Methods BMSC obtained from hepatitis B patients were tested for HBV infection and then cultured with HBV infectious serum in vitro and induced to differentiate into hepatocyte through exposure to hepatocyte growth factor (HGF), fibroblast growth factor-4(FGF-4), and epidermal growth factor(EGF). Subsequently these cells were determined for the presence of hepatitis B virus e antigen( HBeAg), hepatitis B virus surface antigen(HBsAg) and ASGPR. All experiments were repeated for 3 times in 5 different samples. The results were analyzed by non-parametric test. Results After 6 days of exposure, BMSC-derived hepatocyte-like cells expressed hepatic special genes and proteins, including alpha fetoprotein(AFP),cytokeratin18 (CK18), albumin (Alb), and manifested hepatocyte functions, including glycogen synthesis, urea secretion and albumin synthesis. Expressions of CK18 and Alb were increased, and AFP was decreased with time of induction. The BMSC were resistant to HBV infection both in vitro and in vivo or after induction toward hepatocyte. ASGPR expression level was low in BMSC, which was increased in the induced BMSC but still lower than that of the control HepG2 cells. Conclusions BMSC are resistant to HBV infection both in vitro and in vivo. The low level expression of ASGPR may be a reason for this.

Pregnancy in patients with Eisenmenger syndrome (ES) is associated with high maternal mortality rates of 30%‒50%, or even up to 65% in the case of a cesarean section (Yuan, 2016). Here, we report a case of term pregnancy complicated with ES and severe pulmonary artery hypertension (PAH), which was managed by a multidisciplinary team (MDT) and resulted in an uncomplicated delivery via elective cesarean section. The goal of this study is to emphasize the importance of multidisciplinary approach in the management of pregnancy with ES, which can profoundly improve maternal and infant outcomes.
Female ; Humans ; Pregnancy ; Cesarean Section ; Eisenmenger Complex/therapy* ; Hypertension, Pulmonary/therapy* ; Maternal Mortality ; Pregnancy Complications, Cardiovascular/therapy* ; Pregnancy Outcome