Chronic hepatitis B(CHB)is one of the most commom cause of liver fibrosis. Accurate assessment of liver fibrosis is essential for the strategy of treatment and judgement of prognosis . Liver biopsy is the gold standard for staging fibrosis,but it is invasive with high cost,low reproducibility and poor acceptance by patients. Therefore,it is urgent to explore a noninvasive modality for the assessment of liver fibrosis. Recent evidence highlights that elastographic techniques, biochemical markers and the diagnostic model consisted of several serum markers have the potential for the diagnosis of liver fibrosis. This article reviewed the progress in noninvasive assessment of liver fibrosis in patients with CHB.

BACKGROUND:It has been shown thatChuanglingye has good anti-inflammatory effects, inhibits platelet aggregation and thrombus and improve wound healing. OBJECTIVE:To investigate the effects ofChuanglingye-loaded colagen on regulating inflammation and healing process of chronic wounds. METHODS: Forty rats were selected to make chronic wound models and randomly divided into four groups at 3 days after modeling: control group, colagen group,Chuanglingye group,Chuanglingye-loading colagen group, 10 rats in each group, respectively treated with 0.2 mL normal saline, 0.2 mL Chuanglingye, colagen and Chuanglingye-loaded colagen. The size of wounds was measured when modeling and at 3, 7 and 15 days after modeling. Amount of white blood cels, interleukin-6 level and tumor necrosis factor-α level in wound exudates were detected. The levels of hydroxyproline and matrix mentaloproteases (MMPs), including MMP-1, MMP-2, MMP-9, in the granulation tissue, were also detected. RESULTS AND CONCLUSION:At 3, 7, 15 days after modeling, the amount of white blood cels and levels of interleukin-6, tumor necrosis factor-α, MMP-1, MMP-2, MMP-9 were significantly lower in the Chuanglingye-loaded colagen group andChuanglingye group compared to the control group and colagen group (P < 0.01, P < 0.05). But there was no significant difference betweenChuanglingye-loaded colagen group and
Chuanglingye group. The level of hydroxyproline in the granulation tissue was significantly higher in the Chuanglingye-loaded colagen group than the other three groups at 3, 7, 15 days after modeling (P < 0.05), and the size of wound in theChuanglingye-loaded colagen group was significantly lower than that in the other three groups at 15 days after modeling (P < 0.01). In addition, no significant difference was found among the four groups at 15 days after modeling. These findings indicate thatChuanglingye-loaded colagen can significantly depress proliferation and infiltration of inflammatory cels on the wound surface, decrease levels of inflammatory factors and MMPs in wound exudates, and thus promote the healing of chronic wounds.

Objective To analyze the outcomes of renal transplantation from donation after citizen death (DCD) in our single center.Method We retrospectively investigated the recipient outcomes of renal allografts from DCD.Between November 2010 and 31st December 2014,our institution performed 242 renal transplants from DCD.Outcome variables (survival of recipients/allografts and adverse events) and characteristics of marginal donor transplants were analyzed.Result There were 139 males and 44 females in the enrolled 183 donors,and the range of age was from 2 days to 68 years.183 donors included 102 cases of donation after brain death (category Ⅰ),22 cases of donation after circulatory death (category Ⅱ) and 59 cases of donation after brain death followed by circulatory death (category Ⅲ).Utilizing these renal allografts,we performed 242 kidney transplantations including 237 single kidney transplants and 5 pediatric en bloc kidney transplants.The age of recipients ranged from 12 to 64 years.The data indicated that the 1-year recipient/allograft survival rate was 93.8％ and 90.5％,respectively.The rate of delayed graft function (DGF) was 33.1 ％,higher than that from executed prisoners allografts (23.6％,P＜0.05).However,the rate of 1-year acute rejection,interstitial pneumonia and the other adverse events (urinary fistula,ureteral obstruction and cardiac and cerebral vascular accident,etc.) was similar to that from executed prisoners allografts.In addition,good results from pediatric and elder donor renal transplantation were shown in our data,even though the discard rate of elder donor kidney was high.Conclusion By comprehensive evaluation,strictly screening donors and enhancing the rnanagenent of donors,the long-term survival of recipients may be prolonged and the incidence of DGF and primary graft non-function (PNF) may be decreased.The marginal donors from pediatric and elder DCD donors could be utilized in clinical transplantation safely and effectively as long as reasonable evaluation was carried out.

Objective To investigate and evaluate the curative effect of radioimmunological targeting drug on nude mice bearing breast cancer. Methods The anti-CEA monoclonal antibody C50 was combined with ~ 131 I to produce radioimmunological targeting drug. 16 nude mice inoculated subcutaneously with breast cancer cell MCF-7 with tumor diameter about 0.5 cm were randomly into 4 groups(n=4): group Ⅰ, injected in part with ~ 131 I-C50 18.5 MBq; group Ⅱ, injected in part with ~ 131 I-C50 3.7 MBq; group Ⅲ, injected in part with ~ 131 I-mIgG 18.5 MBq; group Ⅳ, injected in part with C50 0.75 ?g. The size of tumor volume and inhibitory rate (IR) after treatment for six weeks were calculated and compared with the control group. Results The tumor volume and curves for tumor growth and tumor weight had significant differences between group Ⅰ and the group Ⅲ as well as group Ⅱ (P0.05). Conclusion Anti-CEA monoclonal antibody C50 labeled with radionuclide ~ 131 I could inhibit the growth of the tumor when given locally. ~ 131 I-C50 has a potential value of clinical application

Objective To analyze and evaluate neoadjuvant chemotherapy's value and significance in combining with surgical treatment for limited small cell lung cancer(LD-SCLC).Methods A total of 94 LD-SCLC patients underwent complete resections combined with chemotherapy between January 2000 and January 2011 in Shanghai Pulmonary Hospital.Among these cases,initial two cycles of neoadjuvant chemotherapies were performed for all pathologically confirmed patients (Group A),and initial operations followed by adjuvant chemotherapy were administered to patients without pathology (Group B).The survival rate was analyzed by log-rank test and Kaplan-Meier method.Multivariate analysis of the prognostic factors was performed using Cox's regression model.Results Group A included 43 cases and Group B included 51 cases.The mean age was (56.37 ± 10.18) years.According to the 6th edition of Tumor,Node,Metastasis(TNM) classification of lung cancer,54 cases were at stage Ⅰ or Ⅱ,40 cases were at stage Ⅲ.Overall 5-year survival(5-YS) was 27％.The 5-YS for patients with stage Ⅰ-Ⅱ was notably better than that of stage Ⅲ (34％ vs 20％,P =0.033).For patients with stage Ⅲ,the 5-YS of Group A was significantly better than that of Group B(34％ vs 12％,P =0.020),besides median overall survival for Group A and Group B were 46 and 15 months(P =0.009).Furthermore,the results of multivariate analysis showed that neoadjuvant chemotherapy,surgery and histopathology of SCLC were independent factors that strongly affected survival and prognosis.Conclusion In combined surgical treatment for LD-SCLC,neoadjuvant chemotherapy obviously improved the prognosis of patients with stage Ⅲ.Therefore,it was very important and necessary that pre-surgical neoadjuvant chemotherapy was administered to resectable stage Ⅲ LD-SCLC patients.

Objective Women with gestational diabetes mellitus (GDM) are at risk to develop Type 2 diabetes mellitus ( DM2).The aim of this study is to compare the effect of three diagnostic criteria on the prevalence of GDM.Methods 2864 pregnant women receiving obstetric care at 24 to 28 weeks of gestation at Peking University First Hospital,underwent the 75 g oral glucose tolerance test for routine GDM screening.The pregnancies were evaluated bythe American Diabetes Association (ADA 2004) Cuideline,the new criteria which was proposed by the International Association of Diabetes and Pregnancy Study Groups (IADPSG 2010) based on the HAPO study,not by the criteria of American College of Obstetricians and Chinese Obstetrics and Gynecology (6th edition 2005).Venous plasma glucose was measured by the IDMS-traceable glucose oxidase method.Results The mean age of the women was 30 years.590 women were diagnosed with GDM using the IADPSG criteria.According to the IADPSG standard,GDM diagnostic rate reached 20.6％.The diagnostic rate of new criteria was increased by 307％ and 199％ compared with the Chinese Obstetrics and Gynaecology (6th edition) and the old ADA standard,respectively.If increasing the number of abnormal glucose values in the IADPS standard to 2 or more,the number of positive cases dropped to 227 people.The diagnostic rate of GDM plummeted to 7.93％,similar with that of the old ADA diagnostic criteria (6.8％).Conclusions The diagnosis rate of GDM was significantly higher using the IADPSG criteria,due to more stringent glucose abnormality recommended by the IADPSG.

Objective To assess the incidence and prognosis of the bronchial anastomosis complications following lung transplantation.Methods Between January 2003 and July 2016,all 81 cases after lung transplantation at Department of Thoracic Surgery of Shanghai Pulmonary Hospital,Tongji University were retrospectively analyzed.We analyzed the incidence and prognosis of postoperative complications of bronchial anastomosis in lung transplant recipients.Results The overall incidence of bronchial anastomotic complications was 30.9％,including anastomotic infection (18.5 ％),anastomotic fistula (4.9 ％),stenosis (6.2 ％),and bronchomalacia (1.2 ％).One case died of infection,and 3 cases died of anastomotic fistula.Conclusion The main bronchial anastomosis complications occurred early,and the prognosis was acceptable.

Objective:To investigate the feasibility of replacing the femoral prosthesis and implanting antibiotic calcium sulfate carriers in a two-stage revision for periprosthetic infection following total knee arthroplasty (TKA).Methods:Between May 2017 and January 2020, 35 patients were admitted to Department of Orthopaedic Surgery, The First Affiliated Hospital to Zhengzhou University for periprosthetic infection after TKA. They were 12 males and 23 females, aged from 49 to 84 years (average, 67.9 years). The two-stage revision for periprosthetic infection was performed for all of them and replacement of femoral prosthesis and implantation of antibiotic calcium sulfate carriers were carried out in stage-one revision. Recorded were postoperative culture of micro-organisms, white blood cell count (WBC), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) before stage-one and stage-two revisions; the Hospital for Special Surgery (HSS) knee score, range of motion (ROM) and American Knee Society Score (KSS) were compared between preoperation and the last follow-up.Results:Postoperative negative culture was found in 22 cases (62.9%), and positive one in 13 cases (37.1%) of which 4 were caused by Staphylococcus aureus, 2 by Staphylococcus epidermidis, 2 by Candida glabrata, 2 by Candida parapsilosis, one by Candida albicans, one by Mycobacterium tuberculosis and one by Escherichia coli. WBC, ESR and CRP decreased on average from 13.67×10 9/L, 49.71 mm/h and 45.13 mg/L before stage-one revision to 6.44×10 9/L, 18.79 mm/h and 7.82 mg/L before stage-two revision. All patients were followed up for an average of 22.4 months (from 8 to 41 months). At the last follow-up, ROM, HSS and KSS were significantly increased from preoperative 73.2°±15.9°, 59.5±14.6 and 36.1±6.0 to 105.6°±13.2°, 84.3±10.0 and 86.1±5.6, respectively ( P<0.05). None of the patients showed any sign of re-infection at the last follow-up. Conclusion:For patients with periprosthetic infection following total knee arthroplasty, replacing femoral prosthesis and implantation of antibiotic calcium sulfate carriers can well control infection, facilitating recovery of range of motion and function after surgery.

Objective　To investigate the effect of breast milk and some other kinds of infant foods on the adhesion of EPEC to Hela cells and intestinal mucosa so as to understand the possible protective mechanism of breast-feeding in the intestine of infants. Methods　The adhesion of EPEC to Hela cells and intestinal mucosa were examined by cell culture, bacterial adherence test, light and electron microscopy in the mediums that contain breast milk, cow's milk and formula milk or contain ecal filtrate of the infants fed by breast milk and formula milk respectively. Results　Adhesive index for EPEC to Hela cells was significantly lower in the medium containing breast milk than in control and so did in the fecal medium containing breast fed infants than artificial feeding infants. Conclusion　Breast milk may inhibit the adhesion of EPEC to infant intestine.

Objective To investigate the role of staging nutrition(SN) in the treatment of severe acute pancreatitis(SAP). Methods One hundred patients with SAP treated in our hospital since 1997 were randomly divided into two groups: Total parenteral nutrition group(TPN group,50 cases) and staging nutrition group (SN group,50 cases). The curative effects and complications between two groups were analyzed and compared. Results The incidences of total complications,incubation complication,double infection,hepatic function injury,abdominal cavity infection and hospital stay in SN-group were significantly lower than those in TPN-group(all P