Objective To analyze and evaluate the relationship between hepoatocelluar carcinoma incidence and hepatitis B e antigen (HBeAg) expression in choronic hepatitis B (CHB) patients with long-term treatment of nucleoside analogue therapy.Methods The clinical data of 56 CHB patients with long-term treatment of nucleoside analogue therapy except for hepoatocelluar carcinoma (experimental group)were summarized retrospectively,and all patients underwent anti-viral therapy with no less than 5 years.The clinical data of 56 CHB patients without anti-viral therapy in the same period (control group) were collected.The risk factors of hepoatocelluar carcinoma were analyzed.Results The incidence of hepoatocelluar caroinoma was 7.14％ (4/56) in experimental group and 19.64％ (11/56) in control group,and there was significant difference (P ＜ 0.05).The incidence of hepoatocelluar carcinoma was 0 in patients with positive HBeAg without cirrhosis (36 cases) in experimental group and 1/8 in patients with negative HBeAg without cirrhosis in experimental group,and there was significant difference (P＜ 0.05).Conclusions Long-term treatment of nucleoside analogue therapy can reduce but bot eliminate the hepatocellular carcinoma risk in patients with CHB,especially in those with negative HBeAg.HBeAg negativity is a significant risk factor for the development of hepallerular carcinoma in CHB patients without liver cirrhosis.

Objective To evaluate the clinical outcomes of emergency intracoronary stenting for senile patients with acute myocardial infarction (AMI). Methods Eighty-four senile patients with AMI underwent emergency intracoronary stenting were compared with eighty-eight non-senile patients with AMI. Results Eighty-six stents were implanted in eighty-four infarction related arteries (IRA), two patients died during hospitalization,the procedural success rate was 97.6% in senile group. Eighty-eight stents were implanted in eighty-eight IRA, one patient died during hospitalization, the success rate was 98.9% in non-senile group. There was no significant difference in characteristic of stents, bleeding complication and LVEF between the senile group and the non-senile group.Conclusion Emergercy intracoronary stenting was an effective and safe therapeutic maneuver for the senile patients with AMI.

BACKGROUND:A large number of studies have shown that bone marrow mesenchymal stem cels (BMSCs) with differentiation ability can be used to treat kidney injury. Epimedium has good anti-inflammatory and immune restoration ability.
OBJECTIVE:To observe the effect of epimedium with BMSC transplantation on rat’s kidney disease caused by adriamycin nephrosis.
METHODS:Fifty rats were equivalently randomized to receive no treatment in control group, tail vein injection of normal saline plus intragastric injection of normal saline in model group, tail vein injection of BMSCs plus intragastric injection of epimedium decoction in combined group, tail vein injection of BMSCs in BMSCs group, and intragastric injection of epimedium decoction in epimedium group. Rat models of adriamycin nephrosis were made in the latter four groups through tail vein injection of doxorubicin hydrochloride, while rats in the control group were only given the same volume of normal saline. Twenty-four hours after modeling, rats in the latter four groups began to be given the corresponding treatments. Epimedium decoction was given in the combined and epimedium groups at a dose of 1 mL/d, for consecutive 1 week.
RESULTS AND CONCLUSION:Compared with the model group, mitigated kidney injury and reduced urinary protein level were found in rats undergoing BMSCs and/or epimedium decoction treatment; the levels of plasma albumin and catalase were significantly increased in the combined group and epimedium group, while the levels of serum cholesterol, triglycerides and malondialdehyde decreased; the mRNA expression of transforming growth factor β1 in the kidney tissues was dramaticaly declined in the combined group and BMSC group. To conclude, the combined use of epimedium and BMSCs is superior to their use alone in the treatment of kidney disease.

Objective To construct DNA vaccine expressing Mycobacterium tuberculosis(Mtb) immunodominant antigen Ag85A and analyze its anti-tuberculosis T cell responses in BCG primed-mice after DNA vaccination boosting.Methods The coding gene of Ag85A mature fragment was amplified by PCR with H37Rv genomic DNA as template,and then cloned into the eukaryotic expression vector pVAX1 to construct Ag85A DNA vaccine.After purification,Ag85A DNA vaccine was injected intramuscularly twice in BCG primed-mice with BCG vaccination and DNA vaccination alone as control.Eight weeks post-vaccination,spleen lymphocytes were separated and were then used to analyze Mtb antigen specific effector T cell response and polyfuntional IFN-γ/TNF-α/IL-2 secreting CD4+ T cell frequencies and intensities,and CD8+T cell responses by IFN-γ ELISPOT assay and intracellular staining,respectively.Results Compared to BCG vaccinated-and DNA vaccinated-mice,Ag85A DNA boosting not only enhanced significantly BCG primed-mice IFN-γ+TNF-α+IL-2+,IFN-γ+ IL-2+,TNF-α+IL-2+ and IL-2+ CD4+ T cell frequencies and IL-2 secretion,but also improved significantly IFN-γ-secreting and IL-2-secreting CD8+ T cell frequencies.Condusion Ag85A DNA vaccine was constructed successfully and was demonstrated to enhance significantly BCG primed-mice Mtb antigen specific CD4+ and CD8+ T cell responses when boosting,which is beneficial to improve BCG immunogenicity and its waning immune protection against Mtb.

0.05). The results have shown that XTR plays a protective role in preventingmyocardial necrosis caused by isoproternal.

Objective To explore the feasibility and the value of ultrasound transient elastography in the estimation of intraocular pressure.Methods Thirty-two cases of glancomatous patients' and twenty-eight healthy subjects'eyeball were examined by using ultrasound transient elastography,meanwhile using Photoshop image analysis software to quantitative analysis of blue gradation ratio of the front wall tissue of eyeball,then intraocular pressure were examined by NCT.The difference of quantitative data of blue gradation ratio of the front wall tissue of eyeball between glancomatous patients and healthy subjects were compared.The relationship of quantitative value of blue gradation ratio and intraocular pressure were established.Results The blue gradation ratio of the front wall tissue of eyeball in glancomatous patients were 0.37± 0.03,while in healthy subjects were 0.33 ± 0.02,there was a significant difference between glancomatous patients and healthy subjects (P < 0.01),and there was a linear relation between blue gradation ratio and intraocular pressure(r = 0.424,P < 0.05).Conclusions The ultrasound transient elastography can be used in estimation of intra-ocular pressure in glancomatous patients,and there is a linear relation in quantitative data between blue gradation ratio and intraocular pressure.

Objective To observe the clinical efficacy of Gastrodin acupoint injection in treating depression.Method Eighty depression patients were randomized into a treatment group and a control group, 40 cases in each group. The treatment group was by gastrodin acupoint injection plus medication, while the control group was by acupuncture plus medication. The Hamilton Rating Scale for Depression (HAMD-17) was observed before and after intervention, and the clinical efficacies were compared. Result Respectively after 2 and 3 treatment courses, the HAMD scores were significantly different from that before intervention in both groups (P<0.05). Respectively after 1, 2, and 3 treatment courses, the HAMD scores in the treatment group were significantly different from that in the control group (P<0.05). The recovery rate and total effective rate were respectively 70.0% and 100.0% in the treatment group, versus 45.0% and 90.0% in the control group, and the between-group differences were statistically significant (P<0.05).Conclusion Gastrodin acupoint injection is an effective approach in treating depression.

Objective To explore the clinical effects of pedicled omentum in preventing anastomotic leakage after resection of colorcctal cancer complicated with intestinal obstruction.Methods The clinicopathologic data and anastomotic leakage rate of 102 patients with colorectal cancer undergoing resection from Dec.2012 to Dec.2015 were analyzed.Results Seven patients in the control group developed anastomotic leakage.Only 1 patient in the experimental group developed anastomotic leakage.The incidence of anastomotic leakage in the control group was 12％,while that in the experimental group was 2％ (x2 =4.250,P =0.039).Of the 7 patients complicating anastomotic leakage in control group,1 died of multiple organ failure,1 was cured with conservative treatment,and 5 were done with diverting stoma.The one leakage in experimental group was cured by conservative treatment.Conclusion Pedicled omentum is useful in the prevention of anastomotic leakage after resection of colorectal cancer in settings of intestinal obstruction.

Objective To investigate the influence of the hematoma involving the aortic arch in endovascular aortic repair of complicated type B intramural aortic hematoma. Methods A total of 69 patients[58men; mean age(58.1±8.9)years; range 38-77]underwent endovascular repair between February 2011 and June 2015 were retrospectively reviewed. Patients with hematoma involving about the left subclavian artery level were categorized as group A(n=28) and patients without hematoma involvement to the aortic arch were categorized as group B (n=41). Results All the patients were treated with coverd aortic stents. The success rate was 97.1％ with complete isolation of lesion in 67 patients. The average follow-up period was(19.6±14.1)months. During perioperative period, no procedure related deaths was recorded. Perioperative complications include paraplegia in 1case(1.4％) in group B and stent graft-induced new entry in 2 cases(2.9％) in group A. During the follow-up period 1 case in group A within 1 month and another 1 case in group B within 1 year developed new entries at proximal end of stents. 1 case (1.4％) in group B had asymptomatic type Ⅰ endoleak 2 years after TEVAR. Conclusions Type B aortic intramural hematoma with arch involvement is not a risk factor of stent-induced new entry in perioperative period after endovascular treatment and further studies are needed. Strict control of blood pressure is essential for the prevention of stent-related complications.

Objective: To establish a scoring system to predict the risk of anastomotic leakage in patients with rectal cancer older than 60 years. Methods: The study included 995 patients (≥ 60 years) with rectal cancer locating 3-12 cm from the anal verge who underwent anterior resection or intersphincteric resection at the Department of General Surgery, Henan Cancer Hospital from January 2012 to December 2016. Potential risk factors for leakage were subjected to univariate analysis. Multivariate logistic regression analysis was used to identify the independent risk factors for anastomotic leakage. The scoring system was developed based on regression coefficient for each significant risk factor. One point was allocated to the risk factor with a regression coefficient β < 1, and two points were allocated to the risk factor with β > 1. The proposed scoring system was tested by the area under curve (AUC) of the receiver operating characteristic curve (ROC) . Results: Surgery was successfully performed in all 995 patients. The incidence of anastomotic fistula was 4.6% (46/995) . Among these 46 patients, 31 recovered after conventional treatment, and 13 patients underwent transverse colostomy, and 2 died of multiple organ failure. Independent risk factors included age (β = 0.643, OR = 1.902, 95%CI: 1.020 - 3.614, P = 0.048) , body mass index (BMI) (β = 1.218, OR = 3.379, 95%CI: 1.607 - 7.105, P = 0.001) , albumin levels (β = 0.986, OR = 2.681, 95%CI: 1.432-5.021, P = 0.002) , and level of anastomosis from the anal verge (β = 1.395, OR = 4.034, 95%CI: 2.086-7.801, P = 0.000) . The scoring system was created base on coefficient β of the independent risk factors (age≥70 years for 1, BMI≥25 kg/m² for 2, albumin levels < 35 g/L for 1, level of anastomosis from anal verge < 4.0 cm for 2) . All the scores were added up, and all patients were divided into the high-risk group (4-6 points, n=71) and intermediate-low-risk group (0-3 points, n=924) based on the scoring system. The incidence of anastomotic leakage in the two groups was 23.9% (17/71) and 3.1% (29/924) , respectively (χ² = 60.092, P = 0.000) . The AUC of age, BMI, albumin levels, and level of anastomosis from the anal verge were 0.598, 0.591, 0.622, and 0.635 respectively. The AUC of the scoring system was 0.656, which was higher than above parameters with a sensitivety of 0.37 and specificity of 0.94. Conclusions The scoring system is effective and accurate for identifying a subgroup at high risk for postoperative anastomotic leakage in rectal cancer patients over 60 years old.