OBJECTIVETo elucidate the relationship between HBV core promoter mutation and clinical features as well as its effects on serum e system and viral replication.

METHODSSemi-nested mutation specific PCR (msPCR) was employed for detecting core promoter mutation at nt 1 762-1 764 in 97 patients with HBV infection.

RESULTSThe msPCR method was demonstrated to be specific and reliable for the mutation detection by sequencing the PCR products. The detection ratio of the mutation in patients with acute hepatitis, mild, moderate and severe chronic hepatitis and liver cirrhosis was 2/5, 7/43, 10/31, 1/3 and 7/15, respectively. The detection rate of the mutation in liver cirrhosis was significantly higher than that in light chronic hepatitis (P < 0.025). In 92 patients with chronic HBV infection, HBeAg positive rate in wild (25/92), mutant (42/92) and mixed (25/92) strain infection was 80.0%, 56.0% and 64.3%, HBV DNA level was (4.4 +/- 8.5) x 10(8), (1.1 +/- 1.6) x 10(9) and (1.4 +/- 1.8) x 10(9) copies/ml, the rate of abnormal ALT was 44.0%, 52.0% and 42.6%; ALT level was (58.6 +/- 79.0), (57.1 +/- 75.2) and (62.6 +/- 90.3) IU/L, respectively (P > 0.05).

CONCLUSIONSThe msPCR method for detecting core promoter mutation at nt 1 762-1 764 is specific and reliable. Core promoter mutation is associated with the severity of liver disease, but neither related to the status of e system in serum nor to the virus replication.

Adolescent ; Adult ; Aged ; Child ; DNA, Viral ; blood ; genetics ; Enzyme-Linked Immunosorbent Assay ; Female ; Hepatitis B ; blood ; pathology ; virology ; Hepatitis B Core Antigens ; blood ; genetics ; Hepatitis B virus ; genetics ; isolation & purification ; physiology ; Host-Pathogen Interactions ; Humans ; Male ; Middle Aged ; Mutation ; Polymerase Chain Reaction ; Promoter Regions, Genetic ; genetics ; Virus Replication ; Young Adult

OBJECTIVETo observe the differences in the clinical efficacy on depression in comparison among the alliance of acupuncture and Chinese herbal medicine, simple herbal medicine and flupentixol and melitracen tablets.

METHODSTwo hundred and twenty-seven cases were randomized into a Chinese medicine group(75 cases), an acupuncture + medication group(78 cases) and a western medicine group(74 cases). In the Chinese medicine group, Shugan Jianwei Anshen Decoction was prescribed, in which Radix Bupleuri and Radix Paeoniae Alba were the monarch herbs, one dose a day. In the acupuncture + medication group, on the basic treatment of Chinese medicine, acupuncture was combined every day at Baihui (GV 20), Sishencong (EX-HN 1), Shenmen (HT 7), Lingdao (HT 4), Daling (PC 7), Laogong (PC 8), Yongquan (KI 1), etc. In the western medicine group, deanxit was taken orally, 1 tablet after getting up in the morning and after lunch respectively. The treatment lasted for 8 weeks in the three groups. The change of Hamilton depression scale (HAMD) score and clinical efficacy were observed before and after treatment.

RESULTSIn 8 weeks of treatment, in the acupuncture + medication group, 19 cases were cured, 35 cases were markedly effective, 14 cases were effective and 10 cases failed, the effective rate was 87.2%; in the western medicine group, 11 cases were cured, 32 cases were markedly effective, 18 cases were effective and 13 cases failed, the effective rate was 82.4%; in the Chinese medicine group, 5 cases were cured, 14 cases were markedly effective, 35 cases were effective and 21 cases failed, the effective rate was 72.0%. HAMD assessment was done in 8 weeks of treatment, which was (5.71 +/- 4.32) scores in the acupuncture + medication group, (6.09 +/- 3.78) scores in the western medicine group and (9.24 +/- 3.49) in the Chinese medicine group, the differences were significant in the Chinese medicine group compared with the western medicine group and the acupuncture + medication group (both P < 0.05). The differences in the scores after treatment were not significant statistically between the acupuncture + medication group and the western medicine group (both P > 0.05), but the cured and markedly effective rate in the acupuncture + medication group was superior to that in the western medicine group (P < 0.05).

CONCLUSIONThe alliance of acupuncture and medication achieves the definite efficacy on depression, characterized as less adverse reactions and better safety.

Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Combined Modality Therapy ; Cooperative Behavior ; Depression ; drug therapy ; psychology ; therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

In this study, the rat type 2 diabetes mellitus (T2DM) model was established through tail vein injection with low dose of streptozotocin (STZ) and high fat diet for 8 weeks, and then treated with Jiaotai Pill. The oral glucose tolerance test (OGTT), fasting serum insulin (FINS), free fatty acid(FFA) levels and blood lipid were assayed. HOMA-IR was calculated. Pancreatic pathology was performed. And pancreatic triglyceride (TG) content was examined by the lipid extraction method. Pancreatic islet cell apoptosis were detected by terminal dexynucleotidyl transferase (TdT)-mediated dUTP nick end labeling (TUNEL). According to the results, the model group showed abnormal OGTT, increased FINS, HOMA-IR, FFA, lipid disorder, obvious fat accumulation and significantly increased TG content in pancreatic tissues, and enhanced pancreatic islet cell apoptosis. Compared with the model group, the Jiaotai Pill group displayed improved OGTT, reduced FINS, HOMA-IR, FFA, recovered lipid disorder, decreased fat accumulation and significantly declined TG content in pancreatic tissues, and lowered pancreatic islet cell apoptosis. In summary, Jiaotai pill could effectively treat type 2 diabetes in rats. Its mechanism may be related to the reduction in pancreatic fat accumulation and islet cell apoptosis.
Animals ; Apoptosis ; drug effects ; Diabetes Mellitus, Type 2 ; drug therapy ; metabolism ; physiopathology ; Drugs, Chinese Herbal ; administration & dosage ; Fats ; metabolism ; Glucose Tolerance Test ; Humans ; Islets of Langerhans ; cytology ; drug effects ; Male ; Pancreas ; drug effects ; metabolism ; Rats ; Rats, Wistar

Objective To examine the clinical manifestations and pulmonary radiological features in patients with triphosgene poisoning.Methods Clinical manifestations,laboratory tests and CT scans were analyzed retrospectively in 17 patients with triphosgene poisoning.We focused on the severity,development and repair of pulmonary impairment.Results Plain film and CT scans in five mild cases demonstrated bilateral scattered pulmonary patchy shadows.Of 12 cases with moderate to severe diseases,three showed bilateral multiple pulmonary patchy shadows and nodules with confluence of part of the lesions on plain film and CT scans;bilateral lungs were involved in nine cases with imaging findings of bilateral disseminated pulmonary round or ovary nodules with different size,ill-defined and partly-confluent patchy shadows and thickening of both interlobular septum and the wall of bronchus.Of clinical interests,imaging findings were closely correlated with clinical course and laboratory results.Conclusion Radiological examinations with plain films and CT scans could reveal the severity,evolvement of pulmonary edema in patients with triphosgene poisoning,and these are of clinical benefit in the early management and prognostic evaluation of patients with triphosgene poisoning.

OBJECTIVETo evaluate the efficacy and safty of photoselective vaporization of prostate (PVP) in the treatment of benign prostatic hyperplasia with obstruction within 5 years.

METHODSFrom December 2004 to December 2009, there were 782 cases have been except for neurogenic bladder dysfunction and prostate cancer, who received PVP surgical treatment of BPH. The surgical conditions and postoperative follow-up data were recorded and the follow-up cut-off time for surgery after 5 years.

RESULTSA total of 782 patients with BPH who underwent PVP were included in this retrospective study. The operation in 740 cases was successfully completed at one time. But in other 42 cases, the twice operation was performed. The mean operation time was (85 ± 38) minutes, and the mean energy delivery was (355 ± 124) kJ. The mean catheterization and postoperative hospitalization time was (2.3 ± 1.7) days and (5.2 ± 2.6) days, respectively. No severe intraoperative complications were observed. The mean follow-up was (44.1 ± 19.3) months. The shortest follow-up was 6 months. The longest follow-up was 5 years. Complete follow-up data were available for 398 of the 782 patients. Of the 398 patients followed up for 5 years, the mean international prostate symptom score after 5 years was 12.8 ± 6.9, quality of life score was 2.2 ± 1.6, maximal flow rate was (14.5 ± 2.4) ml/s, and residual urine volume was 58 ml (M50). The retreatment rate because of BPH was 2.3% (9/398). Urethral stricture and bladder neck contracture were observed in 1.5% and 0.5% of the patients, respectively.

CONCLUSIONSPVP has demonstrated remarkably consistent results for objective and subjective voiding parameters. Its late complication is rare and retreatment rate is low.

Aged ; Follow-Up Studies ; Humans ; Lasers, Solid-State ; Male ; Prostatic Hyperplasia ; surgery ; Retrospective Studies ; Transurethral Resection of Prostate ; Treatment Outcome

OBJECTIVETo investigate the therapeutic efficacy of standard antiviral therapy applied after interferon (IFN) treatment failure in patients with chronic hepatitis C (CHC).

METHODSCHC patients who completed a 48-week course of IFN therapy (pegylated (Peg)-IFNa-2a at 180 mug, qw, ih with or without ribavirin (RBV) at 15 mg/kg/w) in our hospital between January 2009 and June 2012 but who showed no response (at week 48) or who relapsed (at week 72) were enrolled in the study. Prior to initiating the 48-week course of retreatment therapy (Peg-IFNa-2a plus RBV as above), the hepatitis C virus (HCV) genotype was detected and the viral load measured (baseline) by PCR of HCV RNA. Each patient's response to therapy was classified as follows: baseline vs. week 4 (rapid virological response, RVR), vs. weeks 12 and 24 (early virological response, EVR), vs. week 48 (end of treatment virological response, ETVR) and vs. week 72 (sustained virological response, SVR).

RESULTSOf the total 235 cases administered retreatment therapy, 60.0% (n = 140) achieved RVR, 77.4% (n = 182) achieved EVR, 83.8% (n = 197) achieved ETVR, 68.0% (n = 68%) achieved SVR, and 15.7% (n = 37) relapsed. Stratification analysis of recurrence (n = 158) and non-responsive (n = 77) sub-groups showed that the recurrence group experienced significantly higher rates of RVR, EVR, ETVR and SVR, but a significantly lower rate of relapse. Stratification analysis of genotype 1b carrier (n = 206) and non-1b carrier (n = 29) sub-groups showed that the 1b carriers had significantly lower rates of RVR, EVR, ETVR and SVR, but a significantly higher rate of relapse. Finally, the patients who achieved RVR (vs. non RVR, n = 95) and EVR (vs. non-EVR, n = 53) showed higher rates of SVR and ETVR.

CONCLUSIONCHC patients who fail to respond to the initial course of standard IFN-based therapy may achieve SVR upon retreatment, especially those infected with the HCV genotype 1b.

Adult ; Antiviral Agents ; administration & dosage ; therapeutic use ; Female ; Genotype ; Hepacivirus ; genetics ; Hepatitis C, Chronic ; drug therapy ; Humans ; Interferon-alpha ; administration & dosage ; therapeutic use ; Interferons ; therapeutic use ; Male ; Middle Aged ; Polyethylene Glycols ; administration & dosage ; therapeutic use ; Recombinant Proteins ; administration & dosage ; therapeutic use ; Retreatment ; Ribavirin ; administration & dosage ; therapeutic use ; Treatment Failure

OBJECTIVEIn order to figure out how and to what degree the social and economic development and control strategy influencing the epidemics of tuberculosis and to provide reference for tuberculosis prevention and control in China.

METHODSBased on the data from the nationwide random surveys on tuberculosis in 1979, 1984/1985, 1990 and 2000 and the indexes on social and economic development of China, correlation coefficient was used to analyze the relationship of three factors including (1) the change of epidemic situation of tuberculosis from 1979 to 2000; (2) the level of social and economic development; (3) the implementation of Health V Project.

RESULTSThe prevalence rate of smear positive tuberculosis was significantly correlated to per capita net income of rural population, consumption level of city population, per capita GDP, density of population, and proportion of rural population. Among which the correlation with per capita net in come of rural population, consumption level of city population, per capita GDP, or density of population showed negative, correlation but the proportion of rural population showed positive. The range of GDP increase was similar in both areas with or without the implementation of Health V Project from 1990 to 2000 (77.2% and 77.8%). However, the ranges of the decline of prevalence rate were quite different (44.4% and 12.3%) in the two areas. In the western part of China, the range of GDP increase was similar in the areas with or without the implementation of Health V Project. However, the prevalence rate declined in the area that implementing the project but increased in other areas without the project.

CONCLUSIONThe level of social and economic development had influenced the prevalence rate of tuberculosis, but the implementation of tuberculosis control project played an important role in the reduction of tuberculosis prevalence rate from 1979 to 2000 in China.

China ; epidemiology ; Female ; Humans ; Income ; statistics & numerical data ; Male ; Prevalence ; Rural Population ; Socioeconomic Factors ; Tuberculosis ; epidemiology

OBJECTIVETo explore the prediction of the site for microsurgical vasoepididymostomy (VE) in the treatment of epididymal obstructive azoospermia (OA).

METHODSThis study involved 56 infertile men with confirmed OA whose obstruction was suspected to be in the epididymis. Based on their medical history and results of preoperative physical examination and ultrasonography, we predicted the sites for VE. We performed surgical scrotal exploration for the status of epididymal obstruction, conducted palpation and microscopic observation for the epididymal tubules to be anastomosed, and finally decided on the sites for VE by making sure of the presence of motile sperm in the epididymal fluid of the patients. After surgery, we followed up the patients for the rate of pregnancy.

RESULTSAll the patients received bilateral scrotal ultrasonography and surgical scrotal exploration, totaling 112 procedures, including 98 VE procedures. The accuracy rate of the predicted sites for VE was 80.5% (153/190) by medical history and physical examination, 80.3% (90/112) based on the results of ultrasonography, and 87.4% (90/103) according to the first selected epididymal tubules. Of the 28 patients followed up for more than 12 months, motile sperm were found in 19 (67.9% ) at 2 to 12 months and spontaneous pregnancies were achieved in 10 (35.7%), all with the anastomotic sites in the corpus or cauda.

CONCLUSIONMedical history and physical examination contribute to the selection of anastomotic sites and non-invasive scrotal ultrasonography is effective and practical for positioning epididymal obstruction. The epididymal tubules with motile sperm for anastomosis could be easily obtained from the most dilated ones in indurated epididymides.

Azoospermia ; surgery ; Body Fluids ; Epididymis ; diagnostic imaging ; surgery ; Female ; Humans ; Male ; Microsurgery ; methods ; Pregnancy ; Pregnancy Rate ; Scrotum ; diagnostic imaging ; Ultrasonography ; Vas Deferens ; diagnostic imaging ; surgery

OBJECTIVEThe aim of this study was to observe the coexistence of periodontal bacteria DNA (Actinobacillus actinomycetemcomitans, Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia, Tannerella. forsythensis) in coronary atheromatous plaques and subgingival plaques in patients scheduled for coronary artery bypass graft.

METHODSCoronary atheromatous plaque and subgingival plaque samples were obtained from 51 patients and examined by polymerase chain reaction (PCR) technique with specific primers for periodontal bacteria.

RESULTSP. gingivalis (33%), T. forsythensis (31%), P. intermedia (18%) and F. nucleatum (12%) were detected while A. actinomycetemcomitans was negative and not found in coronary atheromatous plaques; T. forsythensis (84%), F. nucleatum (78%), P. intermedia (59%), P. gingivalis (39%) and A. actinomycetemcomitans (22%) were detected in subgingival plaque samples. Coexistence of periodontal bacteria DNA in coronary atheromatous and subgingival plaque samples was evidenced in 32 patients.

CONCLUSIONSThe coexistence of T. forsythensis, F. nucleatum, P. intermedia, P. gingivalis in coronary atheromatous plaques and the subgingival plaque samples in CAD patients could suggest a potential role for periodontal pathogenic bacteria in atherosclerosis disease process.

Adult ; Aged ; Bacteroides ; isolation & purification ; Coronary Artery Bypass ; Coronary Artery Disease ; microbiology ; surgery ; DNA, Bacterial ; analysis ; Dental Plaque ; microbiology ; Female ; Fusobacterium nucleatum ; isolation & purification ; Gingiva ; microbiology ; Humans ; Male ; Middle Aged ; Polymerase Chain Reaction

OBJECTIVETo compare the effects of the point-to-point needling and perpendicular needling of auricular acupuncture for rapid analgesia on the patients with lumbar disc hernia, and find which method is better for this disease.

METHODSNinety two patients were paired according to the three factors as sex, age and degree of pain, and then randomly divided into the point-to-point needling group and perpendicular needling group. The methods of point-to-point needling through the skin and perpendicular needling towardS the skin were respectively applied at bilateral lumbar areas as auricular acupuncture, and added acupoints following the change of symptom. All patients accorded with the demands of McGill pain questionnaire (MPQ), before treatment, 5 and 30 min after treatment, the accumulated score of pain was recorded respectively for observing the difference of the effects in both groups.

RESULTSAfter 5 min treatment, the effect of analgesia on the male patients in the point-to-point needling group was better than that of in the perpendicular needling group (P<0.05), but there was no difference on the female patients in both groups (P>0.05). After 30 min treatment, the effect of analgesia in the point-to-point needling group was better than that of the perpendicular needling group (P<0.05). Besides the patients with light degree pain, there was no significant difference between the two groups after 5 min treatment as score of pain (P>0.05), paired t-test showed that the effects of analgesia on the patients with lumbar disc hernia in the point-to-point needling group was better than that of perpendicular needling group (P<0.05).

CONCLUSIONThe point-to-point needling method can rapidly relieve patients' lumbar disc hernia of pain, which is better than the perpendicular needling method.

Acupuncture Analgesia ; Acupuncture, Ear ; Adult ; Aged ; Female ; Humans ; Intervertebral Disc Displacement ; therapy ; Male ; Middle Aged ; Pain Management ; Pain Measurement ; Treatment Outcome ; Young Adult