Objective To investigate the therapeutic effect and advantage of laparoscopic appendectomy by concealed three-ports technique. Methods The clinical data of 283 patients received concealed three-ports laparoscopic appendectomy were retrospectively reviewed. Results All the patients were cured after appendectomy,including 5 patients required conversion to operation(because of adhesions around the appendix and difficult to dissect). The surgical time ranged from 25 min to 110 min and the mean time was 38 min. After 8 ～ 12h the patients could move and the average length of postoperative stay was 5d (range 4 ～ 6d). 3 cases had postoperative wound infection. None occurred complications such as postoperative bleeding, abdominal abscess, intestinal fistula, adhesion ileus and incision hernia in 6 months on average (range 1 ～ 18 months)after operation. Conclusion Laparoscopic appendectomy by concealed three-ports technique was a safe and available method and had advantages such as convenience and safety,good cosmetic results,less injury,rapid recovery,less complications,cheap and easy.

Objective To summary the therapy outcome of retroperitoneal laparoscopic treatment on upper ureteral calculi.Methods The retroperitoneal laparoscopic treatment were performed to all cases from Jun.2011 to Jun.2012 in our hospital.All cases were treated with 3-hold method (two 10 mm and one 5 mm ports).The retroperitoneal space was made by a combination of blunt and balloon dissection,and the space was maintained with CO2 Ureteral longitudinal incision was made to remove the stones,and double J catheter was served as stent drainage.Absorbable suture was used to suture ureteral incision.Results A retroperitoneal approach was performed in 12 patients,and another patient was conducted the open surgery because the stone cower in the kidney calices.Operative periods ranged from 55 to 132 min (average was 85 min).There were no significant postoperative complications.Conclusion It is a minimally invasive and effective approach in the therapy of upper urerteral calculi with laparoscopic.

Objective To investigate the expression of PD-1 on CD4 +and CD8 + T cells in patients with HBeAg-positive chronic hepatitis B(CHB)treated with telbivudine.Methods Fifty-six HBeAg-positive CHB patients admitted in the First Affiliated Hospital of Zhengzhou University during January 201 3 and June 201 4 were enrolled in this study.The expression of PD-1 on CD4 +and CD8 + T cells was detected with flow cytometry at baseline,24,48 and 72 wks after telbivudine treatment.The relationship of PD-1 expression with alanine aminotransferase (ALT)level,HBeAg seroconversion and HBV DNA loads was analyzed.t test and completely random variance analysis were used to analyze the data.Results The PD-1 expression on CD4 + and CD8 + T cells at baseline was higher in patients with low ALT levels compared to those with high ALT levels(t =1 2.20 and 9.69,both P <0.01 ),while higher levels of PD-1 expression was also observed in patients with high HBV DNA load (≥5 lgIU /mL)compared to those with low HBV DNA load (t =4.39 and 4.85,both P <0.01 ).PD-1 levels on CD4 + and CD8 + T cells presented a declining trend after telbivudine treatment(F =6.98 and 8.97,both P <0.01 ),PD-1 expression in patients with HBeAg seroconversion showed lower levels compared with baseline values (t =1 8.45 and 1 8.01 ,both P <0.01 ). Conclusion In HBeAg-positive CHB patients,the expression of PD-1 on CD4 + and CD8 + T lymphocytes shows a decreasing trend during the treatment with telbivudine,indicating that antiviral therapy may alleviate the immunosuppression in these patients.

Objective To investigate the diagnostic value of matrix gamma carboxy glutamic acid protein(MGP) for coronary heart disease(CHD) .Methods Enzyme linked immunosorbent assay was performed for the detection of serum MGP level in health‐y subjects and CHD patients with different coronary artery calcium score(CACS) .Receiver operating characteristic(ROC) curve was used to analyze the diagnostic value of MGP for CHD .Results Between CHD patients and healthy subjects ,and CHD patients with different CACS ,the difference of serum MGP level was significant ,and serum MGP level was positively correlated with CACS (P<0 .05) .ROC curve of showed that the area under ROC curve was 0 .667 ,the diagnostic threshold was 70 .69 pg/mL ,the diag‐nostic sensitivity was 58 .80% ,the specificity was 83 .70% and the Youden index was 0 .425 .Conclusion CHD patients might be with abnormal serum MGP level ,which could be positively correlated with CACS .MGP might be with significant value for the diag‐nosis of CHD ,could be useful for the clinical prevention and early diagnosis of CHD .

ObjectiveTo investigate the association of high-density lipoprotein cholesterol (HDL-C) with the prognosis of patients with alcohol-related hepatocellular carcinoma (HCC) after radical treatment. MethodsA retrospective analysis was performed for the clinical data of 43 patients with alcohol-related HCC who were admitted to The Fifth Medical Center of Chinese PLA General Hospital and underwent radical treatment from January 2008 to July 2015, and according to HDL-C level, the patients were divided into normal group with 26 patients and abnormal group with 17 patients. The two groups were compared in terms of basic information, laboratory markers, imaging indices, Barcelona Clinic Liver Cancer tumor stage, and Child-Pugh class of liver function. The t-test test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U 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. The Kaplan-Meier method was used to plot survival curves and the log-rank test was used for comparison between groups. Univariate and multivariate Cox proportional hazards models were used to analyze independent risk factors for prognosis. ResultsThere was a significant difference in prealbumin between the two groups (162.38±60.86 mg/L vs 120.06±64.08 mg/L, t=2.184, P=0.035). Number of tumors (hazard ratio ［HR］=2.839, 95%confidence interval ［CI］: 1.120~7.200,P=0.028), tumor size (HR=2.634, 95%CI: 1.062~6.529,P=0037), and HDL-C level (HR=2.400, 95%CI: 1.040~5.537,P=0.040) were independent risk factors for the overall survival of patients with alcohol-related HCC. There were significant differences in 1-, 3-, and 5-year cumulative survival rates between the normal group and the abnormal group (88.5%/72.4%/55.7% vs 70.6%/43.7%/17.5%, χ2=5.881, P=0.015). ConclusionThe reduction in HDL-C level might indicate poor prognosis of patients with alcohol-related HCC.

Background: Chicken anemia virus (CAV) causes chicken infectious anemia, which results in immunosuppression; the virus has spread widely in chicken flocks in China. Objectives: The aim of this study was to understand recent CAV genetic evolution in chicken flocks in Guangxi Province, southern China. Methods: In total, 350 liver samples were collected from eight commercial broiler chicken farms in Guangxi Province in southern China from 2018 to 2020. CAV was detected by conventional PCR, and twenty CAV complete genomes were amplified and used for the phylogenetic analysis and recombination analysis. Results: The overall CAV-positive rate was 17.1%. The genetic analysis revealed that 84 CAVs were distributed in groups A, B, C (subgroups C1-C3) and D. In total, 30 of 47 Chinese CAV sequences from 2005-2020 belong to subgroup C3, including 15 CAVs from this study. There were some specific mutation sites among the intergenotypes in the VP1 protein. The amino acids at position 394Q in the VP1 protein of 20 CAV strains were consistent with the characteristics of a highly pathogenic strain. GX1904B was a putative recombinant. Conclusions Subgroup C3 was the dominant genotype in Guangxi Province from 2018–2020.The 20 CAV strains in this study might be virulent according to the amino acid residue analysis. These data help improve our understanding of the epidemiological trends of CAV in southern China.

Leptomeningeal metastasis (LM) is one of the serious complications of advanced non-small cell lung cancer (NSCLC), although the incidence is not high, the clinical symptoms are severe and the prognosis is poor. LM is prone to occur in patients with positive driver gene than negative. At present, the treatment of LM mainly includes molecular targeted therapy, systemic chemotherapy, whole brain radiotherapy, intrathecal chemotherapy and immunotherapy. Although there are many treatments, the efficacy of LM is still unsatisfactory. This article reviews the drug therapy of sensitive driver gene positive NSCLC LM.