ObjectiveTo identify the differences in clinicopathological features between HBeAg-positive and HBeAg-negative chronic hepatitis B (CHB). MethodsA total of 665 CHB patients who were admitted to Ningbo No. 2 Hospital during June 2002 and January 2010 were enrolled, in which 428 were HBeAg-positive and 237 were HBeAg-negative. HBV DNA loads, live histological inflammation grades and fibrosis stages were compared between two groups. SPSS 1 1. 5 was used for statistical analysis.For measurement data, t (for normal distribution) or Mann-Whitney U (for skew distribution) was performed; for enumeration data, Chi-square test was performed; and Pearson correlation analysis was conducted. ResultsLiver inflammatory grade and fibrosis staging in HBeAg-negative CHB patients were more severe than those in HBeAg-positive patients (x2 = 7.92 and 10.35, P ＜ 0. 01 ). The ratio of serum HBV DNA levels ＜ 3, ≥3- ＜ 5 log10 copies/mL in HBeAg-negative CHB patients were significant higher than those in HBeAg-positive patients (x2 = 105.16 and 36.92 ,P ＜0.01 ) ; and the ratio of HBV DNA ≥7 log10 copies/mL in HBeAg-negative group was lower than that in HBeAg-positive group (x2 = 110. 18, P ＜0. 01 ). With the rising of serum HBV DNA levels, liver inflammatory grade and fibrosis staging in HBeAg-positive patients had a descending tendency (r =-0. 287 and-0. 224, P ＜0.01 ), while those in the HBeAg-negative group were ascending (r = 0. 360 and 0. 303, P ＜ 0. 01 ). ConclusionCompared with HBeAg-positive CHB patients, liver inflammation and tissue damage in HBeAg-negative patients are more severe, which need close monitoring.

Objective To compare image quality and radiation dose of the new imaging plate (IP) with the used IP on computed radiography (CR),and to investigate the using principle in the two kinds of IP. Methods The dark noise, uniformity and erasure thoroughness of the new and the used IP were measured respectively.Based on threshold contrast-detail detectability(TCCD) technique,the phantom T0.16 photography was done at 75 kV,and with the two kinds of IP respectively.Three observers scored each image sequence using double blind method,calculated the threshold detection index (HT).The volunteers were randomly divided into three groups:the knee joint group,the chest group and the lumbar group.Each group had 50 cases and checked with the same condition as the phantom.Three radiologists using double blind method evaluated the imaging quality of knee joint,chest and lumbar.Results The physical characteristic indexes of the new and the used IP were similar to each other.Under the same condition,the detection ability of the new IP was better than that of the used one.When the dose of exposure was raised about 20%,the detection ability of the used IP was close to that of the new one.Conclusions The dose of exposure can be raised to keep the same imaging quality with the increase times of IP used.The detection ability of IP can decrease with the same dose as before,and the image quality decreases too.

Objective To investigate the clinical significance of HBV pre-core and basal core promoter mutations in chronic hepatitis B using Gene-chip technique.Methods Four spot mutations of 1896,1814 dots in pre-core region and 1762,1764 dots in basal core promoter region were detected in 95 patients with chronic hepatitis B using gene chips.Serum HBV DNA level was measured using fluorescent quantitation polymerase chain reaction(FQ-PCR).Results In the 95 patients with chronic hepatitis B, HBV pre-core or basal core promoter mutations were detected in 91 patients,and the positive rate was 95.8%.The mutation rate of G1896A,A1762T associated with G1764A,and G1896A plus A1762T plus G1764A were 36.3%,70.3% and 24.2% respectively.No A1814C mutant was detected in these patients.Compared with no mutation group,the serum HBV DNA quantity was lower in G1896A plus A1762T and G1764A mutation group,and no significant changes was found in other groups.Conclusion Several different variant sites of HBV can be detected at one time using gene chip technique.HBV pre-core and basal core promoter mutations have effect on the serum HBV DNA level in chronic hepatitis B patients to a certain extent.

Objective:To study the surgical approach to the orbital floor and infraorbital rim.Method:15 cases of fractures of the orbital floor and infraorbital rim were treated with the transconjunctival approach.Result:All fractures of the orbital floor and infraorbital rim were repositioned and fixed through transconjunctival approach. Except for 1 case with mild canthal malposition, no other complication was observed.Conclusion:The transconjunctival approach can provide adequate exposure of the infraorbital rim and orbital floor without scar formation in the face.

OBJECTIVE To evaluate the results of superficial parotidectomy with preservation of the Steven’s duct. METHODS 27 cases of superficial parotidectomy with preservation of the Steven’s duct were reviewed retrospectively. Complications and treatment outcomes were analyzed. RESULTS Almost all cases investigated resulted in satisfactory outcomes. CONCLUSION Superficial parotidectomy with preservation of the Steven’s duct is a possible alternative for some patients, especially those with benign parotid tumour.

Objective To investigate the reproducibility and influencing factors of relative quantification of phosphorus metabolites with two-dimensional chemical shift imaging (2D CSI) in rabbit liver. Methods Using 2D CSI MRS, 500 ml phosphate (NaH2PO4) solution phantom with 0. 05 mol/E concentration and one healthy rabbit were scanned 30 times respectively in one day and rescanned 30 times in the next day, and the stability of MR scanner and reproducibility of within-run and between-days in the same individual were analyzed. Each of thirty rabbits was scanned and rescanned one time respectively in different days, and the reproducibility of between-days in one group was analyzed. The data were statistically analyzed with t tests. Results (1) Phosphate solution phantom had a good reproducibility of within-run with the coefficient variation (CV) of 4. 92% and 5. 12% respectively in different two days. No significant change of phosphorus metabolites was detected in between-days, which was 16. 68 ± 0. 82 and 16. 56 ± 0. 85 respectively(t = 0. 665, P > 0. 05 ). (2) The CV of metabolites in one healthy rabbit ranged from 8. 04% to 34. 13%. Among the metabolites, β-ATP had the best reproducibility with the CV less than 10%. PME was 0. 88 ± 0. 28 and 0. 88 ± 0. 30, PDE was 4. 35 ± 0. 66 and 4. 35 ± 0, 66, Pi was 0. 95 ± 0.30 and 0.97±0.28, α-ATP was 5.58±0.60 and 5.61±0.61, β-ATP was 2.70±0.22 and 2.71± 0. 22, γ-ATP was 2. 20±0. 63 and 2. 18±0.44 respectively, no significant changes of metabolites were detected in between-days( P >0. 05 ). (3) The CV of metabolites in 30 healthy rabbits ranged from 8.48% to 36. 21%. Among the metabelites, β-ATP had the best reproducibility with CV less than 10%. PME was 0. 84 ± 0. 30 and 0. 79 ± 0. 28, PDE was 4. 29 ± 0.72 and 3.94 ± 0. 84, Pi was 0. 91 ± 0. 28 and 0. 92 ± 0. 31, α-ATP was 5.65±0. 66 and 5. 36±0. 60, β-ATP was 2. 71±0. 23 and 2. 66±0. 25, γ-ATP was 2. 07±0. 29 and 1.99±0. 37 respectively, no significant changes of metabolites were detected in between-days (P > 0. 05). Conclusions The relative quantification of hepatic β-ATP may be most reliable among the phosphorus metabolites for rabbit liver because of its good reproducibility and small CV. The quantification of phosphorus metabolites by 31p MRS with 2D CSI in rabbit liver is affected by many factors.

Objective To investigate the effect of progesterone pretreatment of focal cerebral ischemic and reperfusion injury (fCIRI) and underlying molecular mechanisms.Methods A single intraperitoneal injection of progesterone (8 mg/kg) given 1 h,48 h and 96 h before fCIRI was established in male Sprague-Dawley rats.The number of survival of neurons in hippocampal CA1 region of the ischemiaside,as well as spatial memory function,was detected on days 3-8 after fCIRI.Extracellular-signalregulated kinase 1/2 phosphorylation (p-ERK1/2) and nuclear translocation of p-ERK1/2 in hippocampal CA1 region were examined using western blot.Results The number of survival of neuronal cells was significantly increased in ischemic groups treated with progesterone at 1 h and 48 h pre-fCIRI (164.3 ± 11.0,218.5 ± 9.1 and 142.7 ± 12.1,F =29.4,P ＜ 0.01) compared with fCIRI group treated with vehicle.Likewise,the escape-latency to reach the hidden-platform recorded in day 5 of Morris water maze test was reduced markedly in fCIRI-treatment groups compared with the vehicle group(10.3 ± 11.1,19.2 ±9.6 and 32.4 ± 14.3 ;F =35.8,P ＜0.01).The level of p-ERK1/2 was elevated notably during 24 h to 48 h postprogesterone by western blot,while restored to the baseline at 96 h post-progesterone.Improved nuclear translocation of p-ERK1/2 was observed from 2 h to 48 h post-progesterone.The progesterone receptor antagonist RU486 blocked the exaltation of either intracellular level or nuclear translocation of p-ERK1/2,which was induced by progesterone.Conclusions The pretreatment with progesterone exerts a neuroprotective effect against the ischemia-induced neuronal death and ameliorates the deficits in spatial memory through enhancing the activation of ERK1/2.The neuroprotection derived from pretreatment with progesterone achieves a time window of not less than 48 h,which is progesterone receptor-mediated ERK1/2 signaling pathway-dependent.

Objective:To investigate the levels of periphreal blood free carnitine and amino acids in healthy pregnant women in the third trimester and their association with maternal, fetal, and neonatal cardiac function and structure.Methods:This prospective descriptive study included healthy singleton pregnancies who underwent routine obstetric examination and delivered in two district maternal and child health hospitals (one in the urban and one in the suburb an area) in Beijing from June 2017 to February 2018. All recruiters had serology Down's syndrome screening test at (18±1) gestational weeks. Besides measurement of amino acids and free carnitine levels in whole blood and urine samples by liquid chromatography-tandem mass spectrometry, all cases underwent maternal and fetal echocardiography at (35±1) weeks of gestation. And neonatal echocardiography was performed after delivery to assess the heart function and structure. Antenatal factors were also collected, including maternal education background, age at first marriage and conception, gravidity, and folic acid supplement in early pregnancy. Statistical analysis was performed using t-test, ANOVA, Chi-square test, Pearson correlation coefficient, and Kappa test. Results:A total of 493 mother-neonate dyads were enrolled in this study. Blood free carnitine levels in the healthy pregnant women in the third trimester ranged from 5.09 to 59.17 μmol/L (reference value: 10.00-50.00 μmol/L) with an average value of (13.03±3.87) μmol/L. None was found with structural abnormalities by cardiac ultrasound, showing an average left ventricular end diastolic diameter (LVEDD) and end systolic diameter (LVESD) of (45.70±3.08) mm and (29.17±3.12) mm, respectively, and left ventricular ejection fraction (LVEF) of all cases were over 55%. No cardiac malformation was detected by the third-trimester fetal echocardiography. The average birth weight of the 493 newborns was (3 340±313) g. Those whose birth weight <2 500 g and >4 000 g were accounted for 1.0% (5 cases) and 3.0% (15 cases) with the average maternal blood free carnitine level of (13.25±2.17) μmol/L (10.46-19.21 μmol/L) and (12.64±2.50) μmol/L (8.78-17.73 μmol/L) ( t=0.42, P>0.05). The average LVEDD and LVESD of the 493 newborns were (17.21±1.27) mm and (11.03±1.30) mm, respectively. For the 64 newborns (13.0%) whose LVEF<60%, the maternal blood free carnitine level was (12.93±2.78) μmol/L (7.34-22.13 μmol/L), showing no statistical difference ( t=-0.29, P>0.05) with those 59 neonates (12.0%) whose LVEF over 75% and maternal carnitine level of (13.09±3.24) μmol/L (8.66-27.49 μmol/L). All cases were divided into four groups based on the quartiles of maternal blood free carnitine level and no significant difference in maternal or neonatal LVEDD or LVEF was observed among these groups (all P>0.05). Conclusions:Blood free carnitine concentration in healthy pregnant women in the third trimester is at the lower limit of normal range, and no significant effect on maternal cardiac function and fetal cardiac structure is seen. However, the effect of low maternal carnitine level in the third trimester on children's myocardial function and whether carnitine should be supplemented in the third trimester are worthy of further investigation with larger sample size.

Objective To investigate acute CT radiation injury on rabbit liver after the whole body CT scans with high-dose abdominal CT scan model.Methods The forty-six New Zealand white rabbits were randomly assigned into 3 groups.High-dose CT scanning groups included one-off CT scanning group(group 1)and repeated CT scanning group (group 2)with high-dose abdominal CT scan modes,and 18 rabbits in each group.The other two groups were routine-dose CT scanning group(n=5)and control group(n=5).Rats in both group 1 and 2 were divided into 6 subgroups(n= 3).Four to twenty-four times of continuous or discontinuous CT scans with 240 mAs and 140 Kv were performed on every rabbit.The liver samples of every animal were eoUected at 48 h or 24 h after CT scans and pathological examination and immunohistochemistry assay of Cpp32 and Bax expression were performed.Results(1)Light microscope showed①in group 1,slight hepatic injury occurred at 6 times of continuous CT scanning;after 6～18 times of continuous CT scanning,hepatocytes were slight swelling at first,followed by hydropic or fatty degeneration,constriction or emphraxis of hepatic sinuses,puncture necrosis of hepatocytes,and local hepatic hemorrhage;②in group 2:slight hepatic injury occurred at 8 times of CT scanning,and after 8～24 times of CT scanning,hepatocytes were slight or mild swelling at first,followed by moderate or diffuse swelling,hydropic degeneration,and dispersed karyopyknosis of hepatocytes near central vein.(2)Immunohistochemistry assay showed:①in group 1,positive expressions of the apoptosis-inducing protein Bax and Cpp32 were observed in part of liver samples,the expressions of Bax and Cpp32 were correlated with CT radiation dose;②in group 2,positive expressions of the apoptosis-inducing protein Bax and Cpp32 were found in every subgroup,but the expression was not correlated with CT scan times.(3)The hepatic tissues of routine-dose CT scanning group were normal under the light microscope and immunohistochemistry assay.Conclusion Routine-dose CT scanning on liver is very safe,but high-dose CT scanning with non-routine scan times may cause acute pathological hepatic injury and hepatocyte apoptosis.

Objective:To explore the clinical characteristics, treatment and prognosis of primary cardiac tumors in infants and children.Methods:The clinical information for 21 patients with primary cardiac tumor in the Department of Pediatric Cardiology, Beijing Anzhen Hospital Affiliated to Capital Medical University from May 2010 to August 2018 were analyzed retrospectively.Their median age was 7 months (gestational age 26 weeks-15 years old, and 6 cases were found in fetal phase) and 10 cases of them were male, 11 cases were girl.The clinical features, treatment methods and prognosis were summarized.Results:Among the 21 patients, 8 cases had an atypical heart murmur, 2 cases with chest tightness and chest pain, 2 cases with congestive heart failure, 1 case with dizziness and amaurosis, 1 case with cerebral artery embolism, 1 case with higher inflammatory index, and 9 cases were asymptomatic.Totally, 13 cases underwent surgical resection.All of them were confirmed as benign tumors, including 4 cases of rhabdomyoma, 3 cases of myxoma, 3 cases of fibroma and 2 cases of inflammatory myofibroblastic tumor (IMT) and 1 case of teratomas.There was no death during perioperative period.Follow-ups were performed from 3 months to 7 years, and 3 cases had recu-rrence (2 cases with myxomas and 1 cases with IMT). There were 8 cases without treatment, of which 7 cases were clinically diagnosed as transverse leiomyoma.During the follow-up, 3 cases disappeared, 1 case became small, 2 cases had no obvious change, and 1 case was lost to follow-up.One case was considered to be malignant tumor, and died within half a year.Conclusions:Primary cardiac tumors in children are mostly benign, especially transverse leiomyoma, and their clinical manifestations are diverse.Pathological examination is the golden standard for diagnosis.Surgical treatment is a radical method for most cardiac tumors, some benign tumors can be treated with drug adjuvant therapy, while the prognosis is poor for malignant cardiac tumor patients.