Objective:To analyze the effect of different hepatitis B virus DNA (HBV DNA) loading on liver function in patients with hepatitis B-related hepatocellular carcinoma (HCC).Methods:From February 2017 to August 2018, 78 patients with HCC who underwent radical hepatectomy in the Second Affiliated Hospital of Guangxi University of Science and Technology were enrolled retrospectively.According to the difference of preoperative serum HBV DNA load, there were 30 cases in the high copy group and 48 cases in the low copy group.The positive rates of HBV DNA load in patients with hepatocellular carcinoma were compared 3 days before operation, 7 days and 6 months after operation.Repeated measurement ANOVA was used to observe the liver function of the two groups 3 days before operation, 7 days and 6 months after operation, and the adverse reactions of the two groups were compared.Results:There was no significant difference in the positive rate of HBV DNA load between 3 days before operation, 7 days after operation and 6 months after operation ( P>0.05). The levels of alanine aminotransferase in high copy group were (60.25±28.22), (201.35±69.12), (250.52±74.76) U/L 3 days before operation, 7 days and 6 months after operation, and those in low copy group were (57.24±20.83), (144.50±49.25), (200.21±51.66) U/L.The results of repeated measurement ANOVA showed that Fintra-group=20.429, P<0.01, Finter-group=7.119, P<0.01, Finteraction=27.547, P<0.01.There were significant differences between 7 days, 6 months and 3 days before operation (all P<0.01), between 7 days and 6 months after operation (all P<0.05), and between 7 days and 6 months after operation (all P<0.05). The aspartate aminotransferase levels were (53.14±24.23), (300.30±63.85), (352.36±60.38) U/L in the high copy group 3 days before operation, 7 days and 6 months after operation, and (57.74±23.13), (232.56±53.08), (254.56±58.78) U/L in the low copy group.The results of repeated measurement ANOVA showed that Fintra-group=41.476, P<0.01, Finter-group=50.211, P<0.01, Finteraction=8.736, P<0.01.The difference between 7 days and 6 months after operation and 3 days before operation within the group was statistically significant (all P<0.01). The difference between 7 days after operation and 6 months after operation was statistically significant (all P<0.05). There were statistically significant differences between the groups at 7 days and 6 months after operation (all P<0.05). The plasma albumin of high copy group was (38.13±13.14), (24.22±8.56), (20.31±5.37) g/L 3 days before operation, 7 days and 6 months after operation, and that of low copy group was (37.93±12.54), (29.77±9.32), (25.32±6.43) g/L.The results of repeated measurement ANOVA showed that Fintra-group=12.836, P<0.01, Finter-group=3.608, P<0.05, Finteraction=16.444, P<0.01.There were significant differences between 7 days, 6 months and 3 days before operation (all P<0.01), between 7 days and 6 months after operation (all P<0.05), and between 7 days and 6 months after operation (all P<0.05). The total bilirubin of high copy group was (27.56±6.12), (37.78±9.45), and (46.56±10.22)% at 3 days before surgery, 7 days and 6 months after surgery, and that of low copy group was (25.82±6.38), (31.11±8.65), (38.26±9.23)%, respectively.The results of repeated measurement ANOVA showed that Fintra-group=10.281, P<0.01, Finter-group=8.832, P<0.01, Finteraction=19.114, P<0.01.There were significant differences between 7 days, 6 months and 3 days before operation (all P<0.01), between 7 days and 6 months after operation (all P<0.05), and between 7 days and 6 months after operation (all P<0.05). In addition, the recovery time of liver function in the high copy group was (13.22±2.21) d, and that in the low copy group was (10.34±2.53) d. The difference between the two groups was statistically significant ( t=5.128, P<0.01). The incidence of adverse reactions was 46.67% (14/30) in the high copy group and 16.67% (8/48) in the low copy group, and the difference was statistically significant ( P=0.008). Conclusion:There was no significant change of HBV DNA load in HCC patients before and after operation, while the recovery ability of liver function in HCC patients with high copy HBV DNA was significantly reduced, the incidence of adverse reactions was higher, and the prognosis was poor.

Objective To analyze the dynamic changes of immunoregulatory factors and tumor markers before and after chemotherapy in patients with advanced gastric cancer.Methods From October 2015 to February 2018,58 patients with chemotherapy AGC in our hospital were selected as gastric cancer group.According to the efficacy of chemotherapy they were divided into effective group, stable group and ineffective group.Meanwhile,30 healthy persons were selected as normal group.The immunoglobulins (IgA, IgG,IgM), T lymphocyte subsets ( CD3+, CD4+, CD8+, CD4+／CD8+) and related tumor markers ( CEA, CA199,CA242) were compared before and after chemotherapy.Results The levels of IgA((2.11±0.89) g／L),IgM((10.65±4.61) g／L),IgG((1.25±0.45) g／L),CD8+((28.12±3.56)%),CEA((40.33 ±16.24) μg／L),CA199((76.34±21.56) kU／L) and CA242((29.34±9.57)k U／L) in the gastric cancer group were significantly higher than those in the normal group IgA((0.93±0.36) g／L),IgM((6.46±3.59) g／L),IgG((0.65±0.32) g／L),CD8+(( 25.02± 4.78)%),CEA((1.81± 0.55) μg／L),CA199((7.51 ±2.67) kU／L),CA242((3.35±1.21) kU／L) (t＝6.958,3.600,6.495,3.435,12.952,17.370,14.773, P＜0.05),while CD3+(( 64.12± 5.12)%),CD4+(( 34.12 ± 4.10)%),CD4+／CD8+( 1.09 ± 0.28) were lower than the normal group (CD3+(71.23±7.14)%,CD4+( 39.78±5.20)%,CD4+／CD8+( 1.47±0.40)) (t＝5.376,5.592,5.192,P＜0.05).The total effective rate of AGC patients in gastric cancer group was 79.31 %(46／58),and the ineffective rate was 20.69%(12／58).IgA,IgG,IgM,and CD8+in the effective group were significantly lower than those before chemotherapy (t＝3.925,3.745,4.036,2.661,P＜0.05), while CD3+,CD4+, CD4+／CD8+ were significantly higher than before chemotherapy ( t＝3.520, 3.077, 3.218,P＜0.05).The subcellular level of protein and T lymphocytes was significantly better than that of stable group and ineffective group (P＜0.05).The levels of tumor markers CEA,CA199 and CA242 in the effective group and stable group were significantly lower than those before chemotherapy ( P＜0.05), and significantly lower than the ineffective group ( P＜0.05).Conclusion The levels of immunoglobulins, T lymphocyte subsets and tumor markers in patients with AGC have significant changes after chemotherapy,and their levels can guide the efficacy of chemotherapy.

Objective To study the effect of lithium chloride on the gap junction in the myocardium under chronic hypoxia.Methods Twenty-five C57BL/6J mice were randomly divided into normoxia group,hypoxia group,normoxic control group,hypoxia + saline group and hypoxia + lithium chloride group.Hypoxia group was treated with 10％ oxygen concentration for 4 weeks.Hypoxia + saline group and hypoxia + lithium chloride group were intraperitoneal injection of saline and lithium chloride.Electrophysiology and cardiac catheterization were used to assess arrhythmias,heart rate and ejection fraction.The expression of Cx43,phosphorylated glycogen synthase kinase 3β(p-GSK-3β) and glycogen synthase kinase 3β (GSK-3β) were detected by Western blot.Results Compared with the normoxia group,the hypoxia group had a faster heart rate [(448 ± 18) bpm vs.(401 ± 13) bpm,P＜0.05),and the ejection fraction was decreased [(56±5)％ vs.73±4)％,P＜0.05],arrhythmia score increased [(3.4±0.5)％ vs.(0.6±0.5)％,P＜0.05],Cx43 expression was decreased.Compared to hypoxia + normal saline group,the heart rate decreased[(412±11)bpm vs.(454±18)bpm,P＜0.05],ejection fraction increased[(69±3)％ vs.(55±4)％,P＜0.05],the score of arrhythmia decreased [(1.8±0.4) ％ vs.(3.0±0.7)％,P＜0.05] in hypoxia + lithium chloride group,the expression of Cx43 and the rate of p-GSK-3β to GSK-3β were increased.Conclusion During the chronic hypoxia,lithium chloride can sustain the gap junction through inhibition of GSK-3β signaling way,which can also reduce the rate of arrhythmia.

Objective:To study the learning curve of percutaneous patent foramen ovale (PFO) occlusion guided solely by transthoracic echocardiography (TTE), as well as the success rate and safety of the learning curve.Methods:To retrospectively analyze these patients with indications for PFO occlusion admitted in our department from April 2021 to April 2022, and obtained 100 samples the author's initial cases guided solely by TTE, including 25 men and 75 women, with a mean age of (48.22±10.44) years old.Analyze preoperative baseline data: gender, age, height, weight, body mass index, the tunnel length and size of the PFO measured by transesophageal echocardiography, the grade of contrast-transcranial doppler test, combined atrial septal aneurysm, etc.Operation time, success rate, and complications were analyzed in all patients.Results:With the accumulation of cases, the operation time gradually shortened, accumulated to about 50 cases, the operation time has significantly shortened ( P<0.05), and the learning curve was leveled off after 50 cases ( P<0.05), there was statistical difference.The comparison of the success rate and complication of cases within the learning curve and those after completing the learning curve was no statistical significance( P>0.05). Conclusion:The learning curve of percutaneousc closure of patent foramen ovale guided solely by TTE is long, requiring about 50 cases to complete the learning curve. The success rate and safety of the learning curve are high. This procedure is worth popularizing.

Objective    To compare the effects of transthoracic device closure and surgical closure on ventricular septal defect systemically. Methods    A systematic literature search was conducted using the PubMed, EMbase, The Cochrane Library, VIP, CNKI, CBM, Chinese Clinical Trial Register, ClinicalTrials. gov and Wanfang Database up to July 31, 2016. Quality was assessed and data of included articles were extracted. The meta-analysis was conducted using RevMan 5.0 and Stata 14.0 software. Results    Eleven studies were identified, including 5 RCTs and 6 cohort studies involving 2 504 patients. For success rate, there was no statistical difference between the transthoracic closure group and the surgical closure group in RCT (RR=0.99, 95%CI 0.96 to 1.03, P=0.70); the success rate in the transthoracic closure group was lower than that in the surgical closure group in the cohort study (OR=0.21, 95%CI 0.08 to 0.55, P=0.002). Both  results of RCTs and cohort studies showed that compared with surgical closure, transthoracic device closure reduced duration of the operation (RCT MD=–79.38, 95%CI –95.00 to –63.76, P<0.000 01; cohort study MD=–66.26, 95%CI –71.20 to –61.31, P<0.000 01) and hospital stay (RCT MD=–2.10, 95%CI –2.65 to –1.55, P<0.000 01; cohort study MD=–3.99, 95%CI –6.03 to –1.94, P=0.000 1), and the patients with blood transfusion (RCT RR= 0.04, 95%CI 0.01 to 0.11, P<0.000 01; cohort study OR=0.01, 95%CI 0.00 to 0.13, P=0.001). In the transthoracic closure group the risk of postoperative arrhythmia reduced (RCT RR=0.20, 95%CI 0.13 to 0.32, P<0.000 01; cohort study OR=0.46, 95%CI 0.31 to 0.67, P<0.000 1). In the transthoracic closure group a higher postoperative valvular regurgitation risk in RCT induced (RR=1.45, 95%CI 1.07 to 1.96, P=0.02) and the rate of postoperative valvular regurgitation in cohort study reduced (OR=0.43, 95%CI 0.20 to 0.92, P=0.03). However, there was no statistical difference in postoperative residual shunt (RCT RR=0.96, 95%CI 0.57 to 1.62, P=0.89; cohort study OR=0.52, 95%CI 0.12 to 2.25, P=0.38). Conclusion    Transthoracic device closure can shorten duration of the operation, hospital stay and reduce the patients with blood transfusion and post- and intraoperative arrhythmia risk. Therefore, transthoracic device closure may be a better approach for some ventricular septal defect patients.

Objective 聽 聽To investigate the influence of mechanical and biological valves on clinical benefits of elderly patients with valvular heart disease. Methods 聽 聽We retrospectively analyzed the clinical data of 280 elderly patients with valvular heart disease treated by valve replacement between 2008 and 2014 year. The patients were divided into two groups by tendency score matching including a group A with biological valves and a group B with mechanical valves. Finally, there were 96 patients in each group. There were 43 males and 53 females at age of 64.41卤6.52 years in the group A, 44 males and 52 females at age of 64.07卤6.20 years in the group B. Results 聽 聽The bleeding rate of skin and mucosa of the group B was significantly higher than that of the group A (P<0.05). There was no statistical difference in mortality within 30 days after operation, all-cause mortality, re-hospitalization rate, re-valve replacement rate, combined atrial flutter/atrial fibrillation ratio, drug use, incidence of cerebral infarction, cerebral hemorrhage, new peripheral vascular embolism and visceral hemorrhage, heart function (NYHA) classification, the cumulative survival rate of all the patients during follow-up (P=0.63), or the cumulative survival rate of the patients with no thrombus/hemorrhage (P=0.75) between the two groups (P>0.05). Conclusion 聽 聽Mechanical valve replacement and bioprosthetic valve replacement in the treatment of valvular heart disease in the elderly can achieve similar clinical benefits and both have clinical application value.