Objective To explore the sensitivity of a little amount of subarachnoid hemorrhage (SAH) between CT and different MR sequences through animal experiment,to find a more sensitive way to diagnosis SAH.Methods 18 healthy adult white New Zealand rabbits were randomly divided into two experimental groups(group A and group B) and one control group(group C).Rabbit SAH model was established by injecting blood into the cisterna magna one time.All rabbits underwent CT and MR scan at 2 hours,48 hours after operation.The findings on CT and different MR sequences were observed and recorded.Results ①In experimental groups(group A and group B),MR FLAIR sequences in the diagnosis of a little amount of SAH was more sensitive than that on MR T1WI,T2WI and CT in acute phase.And the diagnosis sensitivity between MR FLAIR and CT was statistically significant(P<0.05).②Abnormal signs of SAH could not be found in group C.Conclusion ①Rabbit SAH model was established successfully which will be the foundation for the follow-up study of medical imaging.②MR FLAIR sequence is more sensitive to diagnose a little amount of SAH in acute phase,and may be used in the routine diagnosis of SAH in acute phase.

Objective To investigate the molecular epidemiology of hepatitis B virus(HBV) in child carriers. Methods Blood samples were collected from children under 15 in Jiangsu and Zhejiang provinces. Enzyme immunoassay(EIA) and microparticle enzyme immunoassay(MEIA) were applied to screen hepatitis B surface antigen(HBsAg) positive children. Nested-PCR and real time PCR were used to amplify the HBV S gene and detected HBV DNA loads. S gene sequence and three-dimensional structure were analyzed by the DNASTAR and VMD1.8.6, respectively. SPSS 12.0 software was applied for data processing. Results A total of 64 HBsAg-positive cases were found in the screened children, from which 41 HBV S gene sequences were obtained. The average HBV DNA loads were(4.15±0.79)×10~7 copies/mL in 64 HBV carriers. Among 41 sequences. genotype C, B and B+C accounted for 82.93%(34/41), 12.19%(5/41)and 4.88%(2/41), respectively; and the serotypes were adr(34/39,87.18%), adw(4/39,10.24%) and ayr (1/39, 2.56%) with 2 strains unable to be sub-typed. The most common variants of "a" determinant in HBV S gene were 129 site Q→F(glutamine→phenylalanine), 145 site G→R(glycine→lysine), 131 site S→N(serine→asparagine)and 144 site C→A(cysteine→alanine), and the mutation frequencies were 12.20%(5/41), 4.88%(2/41), 2.27%(1/41)and 2.27%(1/41), respectively . The total mutation frequency was 21.95%(9/41). The S protein spatial structures of 129 site "Q→F" and 145 site "G→R" were entirely different from that of the wild strain. Conclusion Wild strain of HBV(C/adr) is predominant in the children HBV carriers, exhibiting a high replication, and the HBV vaccine should be still effective.

Objective To investigate the clinical features and viral load of persons infected with HCV and the risk factors for severe outcomes.Methods Medical testing and questionnaire survey were conducted on 465 cases who were infected with HCV,20-30 years back.HCV RNA,alanine transaminase (ALT),aspartate transaminase (AST),albumin,globulin and bilirubin were tested for these subjects.Factors as demography,tobacco and alcohol consumption,SNP of rs7453920 and rs2856718 on HLA-DQ gene of subjects with HCV RNA,were analyzed by multiple logistic regression method to explore the risk factors for severe outcomes among the patients.Result Totally,465 subjects had symptoms as hypodynamic (15.70％,73/465),digestive system (17.63％,82/465),and arthrodynia (10.32％,48/465).HCV RNA was positive in 68.60％ (319/465) of the subjects with median viral load as 76.01 × 104 copies/ml (min-max:592 copies/m1-1.08 × 1010 copies/ml).Totally,11.83％ (55/465) of the cases appeared having liver inflammation by routine ultrasound exams.ALT and AST was seen higher than 80 (IU/L) in 12.70％ (59/465) and 11.18％ (52/465) of the subjects,separately.Factors as being male (OR=2.298,95％CI:1.247-4.238),GA genotype compared with AA type in rs2856718 (OR=1.716,95％CI:1.070-2.752),alcohol intake ≥7 times per-week (OR=2.966,95％ CI:0.979-8.988) etc.,were independently related to HCV RNA sustained positivity.Factors as:being male (OR=1.694,95％CI:0.975-2.942),in 50-59 years age group (OR=2.414,95％ CI:1.156-5.042),having other liver diseases (OR=2.592,95％CI:1.105-6.079) and carrying positive HCV RNA (OR=3.479,95％CI:1.648-7.343) etc.were independent risk factors for abnormal liver function.Conclusion High rates of carrying sustained positive HCV RNA and abnormal liver function appeared in subjects who got the HCV infection 20-30 years ago.Factors as being male,in old age,being frequent alcohol taker,GA genotype in rs2856718 and with other liver diseases etc.were related to higher risk for developing severe outcomes.

ObjectiveTo investigate the serological markers associated with posthepatectomy recurrence in patients with hepatocellular carcinoma, and to establish a prognostic model to evaluate whether palliative hepatectomy is suitable for such patients. MethodsA total of 111 patients with hepatocellular carcinoma who underwent hepatectomy in the Affiliated Cancer Hospital of Zhengzhou University from February 2009 to July 2013 and received follow-up were enrolled. Basic clinical data were collected and the patients were divided into recurrence group and non-recurrence group according to whether recurrence was observed during follow-up. The t-test was used for comparison of normally distributed continuous data between two groups and the Wilcoxon rank sum test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. Survival curves were plotted using the Kaplan-Meier method, and survival differences were analyzed using the log-rank test. A Cox regression analysis was used to perform univariate and multivariate analyses, and the area under the ROC curve (AUC) was used to evaluate prediction efficiency. ResultsThe Kaplan-Meier survival curves showed that the patients with low alpha-fetoprotein (AFP), alkaline phosphatase, gamma-glutamyl transpeptidase (GGT), and fibrinogen and high CXCL13 had a longer median time to recurrence (P＜0.05). AFP (hazard ratio ［HR］［95%CI］=1.69(1.03~2.79), P=0.039), GGT (HR［95%CI］=1.89(1.14~3.14), P=0.014), and CXCL13 (HR［95%CI］=0.54(0.33~0.89), P=0.015) were independent factors associated with posthepatectomy recurrence. The prognostic index PI=0.526×AFP+0.637×GGT-0.616×CXCL13 established based on these factors had an AUC of 0.87, a sensitivity of 93.75%, and a specificity of 63.64% in predicting recurrence within 0-3 months after palliative hepatectomy, with a significant reduction in prediction efficiency for recurrence within 0-6 months (AUC=0.68) or a longer period of time. The recurrence prediction efficiency of this model for palliative hepatectomy was significantly higher than that for radical resection. ConclusionThe prognostic model established based on CXCL13, AFP, and GGT can be used to evaluate the risk of early recurrence after palliative hepatectomy and thus helps clinicians to make diagnosis and treatment decisions based on patients’ benefits.

OBJECTIVETo investigate the hepatitis C virus (HCV) infection rate among general population in Jiangsu province and to analyze the main risk factors for HCV infection.

METHODSSubjects in 3 counties were surveyed by stratified cluster random sampling in the National Major Science and Technology Projects demonstration area in Jiangsu province. Interview was carried out with uniformly- designed questionnaires. Blood samples were collected and anti-HCV tested. Data were analysed under SPSS 13.0. Case-control study was conducted on two groups with subjects under 1:4 matching by sex, age, village of residence and status of HCV infection. Cox's proportional hazards regression analysis was then performed to analyze the risk factors for HCV infection.

RESULTSThe positive rate of anti-HCV was higher in females (0.965%, 95%CI:0.899%-1.035%) than in males (0.572%, 95%CI:0.517%-0.632%). Significant differences were noticed among the positive rates of anti-HCV in the three counties (0.131%, 95%CI:0.103%-0.164%;0.316%, 95%CI: 0.268%-0.370%; 2.173% , 95% CI:2.039%-2.315% , respectively). Peak prevalence of anti-HCV (1.577%, 95%CI:1.425%-1.740%) was observed among persons at 50-59 years of age. Bottom rate (0.161%, 95%CI:0.125%-0.204%) was observed below 30 years of age. High anti-HCV positive rate was detected in people with lower education background or belonged to 'floating population'. Factors as having histories of hospitalization (OR = 3.049, 95% CI:1.322-7.036), blood transfusion (OR = 14.319, 95%CI:2.318-88.459) or sharing razor (OR = 3.604, 95%CI:1.096-11.851) were risk factors of HCV infection in the area with the lowest anti-HCV positive rate. In another county, factor as having histories of 'blood products transfusion' (OR = 7.202, 95% CI:1.170-44.310) appeared important while in the third county, having history of 'blood donation' (OR = 7.496, 95%CI:6.121- 9.180); 'blood transfusion' (OR = 2.305, 95%CI:1.578-3.369) and 'invasive physical examination' (OR = 1.258, 95% CI:1.021-1.549) appeared to be important. Age seemed a risk factor for HCV infection. "Sharing razor" was a specifically important risk factor among the 30- year-olds. "Having received acupuncture" was noticed a risk factor only among people at 50-59 years of age while "Having received invasive physical examination" was important in the 50-59 and 60-69 year-olds.

CONCLUSIONHigh anti-HCV positive rate was observed in people at middle of aged population, as well as in those with poor education or under 'floating'. Unsafe blood donation or having received blood-product transfusion might be the risk factors in the last decades. Factors as sharing razor, having received acupuncture or invasive examination might be specifically risky in different populations.

Blood Donors ; Blood Transfusion ; Case-Control Studies ; China ; epidemiology ; Female ; Hepacivirus ; Hepatitis C ; epidemiology ; Humans ; Male ; Prevalence ; Regression Analysis ; Risk Factors

Objective: To establish and evaluate diagnostic efficacy and applicability of serum Golgi protein (GP) 73 based non-invasive diagnostic model with other conventional serological indicators for compensated stage hepatitis B cirrhosis. Methods: 666 cases with chronic hepatitis B (CHB) who had visited to the Fifth Medical Center of People’s Liberation Army General Hospital from January 2010 to December 2017 were selected as the study subjects, and were classified according to compensated stage cirrhosis into clinical and pathological diagnosis group based on whether or not the liver histological examination was performed. A diagnostic model of compensated stage hepatitis B cirrhosis in the clinical diagnosis group was established. The current clinically used diagnostic model of liver cirrhosis, aspartate aminotransferase/platelet ratio index (APRI), fibrosis index (FIB)-4 and liver stiffness measurement (LSM) were compared. Eventually, the diagnostic model was verified step by step by pathological diagnosis group. Results: The area under the receiver operating characteristic curve (AUC) of GP73 and APRI, FIB-4, and LSM for cirrhosis patients in the clinical diagnosis group were 0.842, 0.857, 0.864, and 0.832, respectively. The diagnostic efficiency of the four indicators were of similar (P value > 0.05). A diagnostic model of compensated stage hepatitis B cirrhosis (GAPA) using logistic regression analysis was established: LogitP = 1/ [1 + exp (1.614-0.054 × GP73-0.045 × Age + 0.030 × PLT-0.015 × ALP)]. The AUC of the model was as high as 0.940 and the optimal cut-off value were 0.41. The corresponding diagnostic sensitivity and specificity were 0.92 and 0.82, respectively. The diagnostic efficiency was better than that of APRI, FIB-4, LSM and GP73 alone (P < 0.05). The AUC of GAPA was 0.877 in the pathological diagnosis group, which was similar to the diagnostic efficacy of LSM (0.891) and FIB-4 (0.847) (P > 0.1), but still superior to that of APRI (0.811) and GP73 alone (0.780) (P < 0.001). Conclusion GAPA, a diagnostic model for compensated stage hepatitis B cirrhosis established in this study, has a good diagnostic efficacy in both the clinical and pathological diagnosis group, and has certain auxiliary diagnostic value in the areas where resources are relatively scarce or where LSM has not been developed.

Objective To analyze the process of intercomparison of national personal dose monitoring, evaluate the ability of personal dose monitoring, and ensure the accuracy and reliability of monitoring results in our laboratory. Methods In accordance with the intercomparison protocol for 2019—2021, an energy-discriminant thermoluminescence dosimeter was used for measurement at different doses. The uncertainty of measurement was evaluated and compared with the reference value. Results H_p(10) was measured for intercomparison in 2019—2021. In 2019, the single group performance difference was −0.02 to 0.02 and the comprehensive performance was 0.02. These values were 0.02-0.10 and 0.05 in 2020, and −0.02 to 0.02 and 0.01 in 2021. The intercomparison results were rated as excellent in the three consecutive years. Conclusion The personal dose monitoring system in our laboratory was in good condition, and the monitoring results were accurate and reliable. Improving the knowledge of personnel and cultivating a serious working attitude are important for intercomparison and personal dose monitoring.