OBJECTIVETo investigate the efficacy and safety of secreted interferon in treatment of chronic hepatitis B.

METHODSA multi-center randomized open-label controlled clinical trial was carried out. The patients of the study group were treated by secretory human interferon alpha-2a, and the patients of the control group were treated with an ordinary interferon.

RESULTSALT normalization rate in the secreted interferon group was 48.3% and it was higher at the end of treatment than that of the control group, but there was no difference between the two groups at the end of the follow-up. HBV DNA dropped more in the study drug group, but there was no difference in the normalization rate between the two groups. HBeAg seroconversions in secreted interferon group and in the control interferon group were 19.0% and 18.4% respectively. The safety of the two types of interferon was satisfactory.

CONCLUSIONSSecreted interferon was superior to ordinary interferon in ALT normalization and HBV DNA drop at the end of treatment in chronic hepatitis B patients, but there was no difference at the end of the follow-up. There was also no difference in HBeAg negative and HBeAg seroconversion between the two groups.

Adolescent ; Adult ; Antiviral Agents ; adverse effects ; therapeutic use ; DNA, Viral ; blood ; Follow-Up Studies ; Hepatitis B virus ; isolation & purification ; Hepatitis B, Chronic ; therapy ; Humans ; Interferon-alpha ; adverse effects ; therapeutic use ; Middle Aged ; Recombinant Proteins ; Treatment Outcome

It is an important morphological research method to reconstruct the 3D imaging from serial section tissue images. Registration of serial images is a key step to 3D reconstruction. Firstly, an introduction to the segmentation-counting registration algorithm is presented, which is based on the joint histogram. After thresholding of the two images to be registered, the criterion function is defined as counting in a specific region of the joint histogram, which greatly speeds up the alignment process. Then, the method is used to conduct the serial tissue image matching task, and lies a solid foundation for 3D rendering. Finally, preliminary surface rendering results are presented.
Algorithms ; Image Processing, Computer-Assisted ; methods ; Imaging, Three-Dimensional ; Microtomy ; methods

BACKGROUNDAlthough the computer tomography (CT) or magnetic resonance imaging (MRI) findings of alveolar echinococcosis (AE) have been well documented, the consecutive imaging changes of this disease in each PNM stage (parasite lesion, neighboring organ invasion, metastases) were not described accurately. The aim of this study was to analyze the correlation between imaging type and PNM stage and diameter of AE lesions, and to explore the development features of this disease.

METHODSA total of 87 patients with AE were examined using CT and MRI before medical management. Imaging features including the maximum diameter, calcification pattern, and imaging type of lesion were retrospectively assessed. The correlation of imaging type with PNM stage, diameter and calcification pattern was analyzed.

RESULTSLesions (n=111) in 87 patients were divided into three types based on imaging characteristics; solid type (33.3%, 37/111, a solid lesion without liquid necrosis or only small patches of necrosis), mixed type (41.4%, 46/111, solid component surrounding large and/or irregular liquid necrosis area), and pseudo-cystic type (25.2%, 28/111, large cyst without visible solid component). Lesion calcification in the alveolar echinococcosis was categorized into three patterns; mild calcification (45.1%, 50/111, i.e. inconspicuous calcification or punctuate scattered calcification), moderate calcification (46.8%, 52/111, coastline calcification located at the periphery of the lesion, with or without the central dot-calcification) and abundant calcification (8.1%, 9/111, large calcified deposits). Significant differences were found between pseudo-cystic type and other two types in PNM stage, maximum diameter and calcification (P <0.05), but there was no significant difference between solid type and mixed type in those mentioned aspects (P >0.05). No correlation was observed between calcification patterns and maximum diameter (P >0.05).

CONCLUSIONSSolid and mixed type lesions showed some similarities during the course of the disease and accounted for the major form of advanced AE. Pseudo-cystic type represented neither earlier nor advanced stage of AE, but a special presentation during AE development.

Adolescent ; Adult ; Aged ; Echinococcosis, Hepatic ; diagnostic imaging ; pathology ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Tomography, X-Ray Computed ; Young Adult

BACKGROUND: Recombinant human bone morphogenetic protein-2 (rhBMP-2) has been widely used on clinic; however, there are still few reports addressing rhBMP-2-induced osteogenesis in intervertebral disc.OBJECTIVE: To verify the effect of rhBMP-2 to induce interbody fusion in rabbits.DESIGN, TIME AND SETTING: Randomized controlled animal study and multi-level evaluation, which was performed in Affiliated Hospital of Medical College of Qingdao University from February to July 2007.MATERIALS: 24 adult New-Zealand rabbits weighing 3.5-4.5 kg were used to expose L4-5 and L5-6 intervertebral disc; rhBMP-2 (1 mg/ampoule, purity≥95%) was provided by Beijing Bailingke Biological Products Co., Ltd.METHODS: 24 rabbits were randomly divided into experimental group and control group with 12 rabbits for each. In the experimental group, saline (20 μL, containing 200 μg rhBMP-2) was injected into nucleus pulposus of L4-5 intervertebral disc; equivalent saline was inserted into nucleus pulposus of L5-6 intervertebral disc as controls. Rabbits in the control group were injected with saline (20 μL) into nucleus pulposus of L4-5 intervertebral disc.MAIN OUTCOME MEASURES: Morphological changes of injected segments were observed by hand-feeling check together with histological and imaging tests at 10, 30, 60, and 90 days postoperatively.RESULTS: 24 rabbits were included in the final analysis. ①In the experimental group, the motion range of L4-5 segment was not limited at 10 days postoperatively, and lightly limited at 30 days, but severely limited at 60 days postoperatively; L4-5 segment was fixed tightly at 90 days postoperatively. Moreover, motion range of L5-6,segment and articular motion range in the control group were not changed remarkably. ② L4-5 interbedy space was narrowed at 10 days or even disappeared at 90 days postoperatively, and then osteogenesis fusion was formed. Transmittance of intervertebral space in the L5-6 segment and in the control group was not changed obviously. ③ Nucleus pulposus was gradually shrunk at 10 days postoperatively; partial cartilage endplate transformed into mature woven bone, and collagen fiber structure of annulus fibrosus gradually disappeared at 90 days postoperatively. A lot of mesenchymal cells were aggregated surrounding annulus fibrosus at 10 and 30 days postoperatively. Moreover, mature woven bone was formed in annulus fibrosus near to cartilage endplate at 90 days postoperatively. However, histological and morphological changes were not found in the control group at those four time points.CONCLUSION: rhBMP-2 can induce intervertebral disc osteogenesis so as to achieve interbody fusion.

Objective To present our initial experience in laparoscopic radical prostatectomy performed through an umbilical incision using a home-made multichannel port. Methods From August 2009 to March 2010, we performed single-port laparoscopic radical prostatectomy in 11 patients with localized prostate cancer. A home-made multichannel port was inserted extraperitoneally through a 3-cm umbilical incision. The single port extraperitoneal procedures included obturator fossa lymphadenectomy, radical prostatectomy and urethro-vesical anastomosis, while the urethro-vesical anastomosis was performed by a slip-knot running suture technique. Data were collected and analyzed prospectively. Results All cases were completed successfully, without conversion to a standard laparoscopic approach or open surgery except adding an additional port in one case. The average operative time was 256 minutes (range195-315), and the mean blood loss was 90 ml (range 20- 180), without any blood transfusion. The postoperative hospital stay was 15.4 days (range13- 24), and the Foley catheter was removed 12 days after surgery. No intraoperative complications occurred. One patient developed a vesico-rethralanastomosis leakage, 2 had lymphatic leakage and 1 had urinary tract infection,all of the cases were managed successfully with conservative treatment. Histopathological results showed negative surgical margine and negative lymph node dissection. All patients had no biochemical relapse after an average follow-up of 7 months. Conclusions Single-port laparoscopic radical prosta tectomy is feasible, cosmetic and minimally invasive with a low complication rate and good short-term outcome. Additional investigation is needed to evaluate the long-term safety and oncologic adequacy of this new approach.

BACKGROUNDRecently, bilateral transpedicular kyphoplasty with a single balloon was performed for osteoporotic vertebral body compression fractures (OVCFs) to reduce the fees of the operation, but the time of operation and radiation exposure are longer. The aim of this study was to determine the safety and effectiveness of a single balloon cross-midline expansion via unipedicular approach in kyphoplasty for OVCFs.

METHODSThirty-six patients with painful OVCFs (61 vertebrae) were enrolled in this research. Unilateral transpedicular puncture was performed under the fluoroscopy monitoring of an oblique angle down the pedicle. A single balloon was introduced through unipedicular approach. The final balloon position was in the midline of the vertebral body with the balloon cross-midline expansion and bone cement filled. Clinical outcomes were determined by comparison of the preoperative and postoperative visual analogue scale (VAS) and Oswestry disability index (ODI). Radiographic assessment included restoration of vertebral height and correction of kyphosis. Follow-up was conducted for 6 - 12 months (mean 9.2 months).

RESULTSThirty-six consecutive patients with 61 vertebrae were successfully operated on with a mean operation time of 37.4 minutes per vertebra. All patients had dramatic pain relief and functional recovery within 96 hours after the procedure with no surgery or device-related complications. VAS score improved from 7.27 +/- 1.02 preoperatively to 2.71 +/- 0.75 postoperatively (P < 0.01). ODI score was decreased from (71.14 +/- 10.94)% preoperatively to (26.56 +/- 6.35)% postoperatively. The average loss of anterior body height was (14.33 +/- 2.76) mm before procedure and (10.03 +/- 1.83) mm after procedure (P < 0.01), while the average loss of middle body height was (10.15 +/- 2.70) mm before procedure and (5.89 +/- 1.83) mm after procedure (P < 0.01). The kyphotic deformity was corrected from (23.43 +/- 5.00) degree to (16.16 +/- 2.77) degree (P < 0.01). The pain relief and functional recovery were substantial and maintained to the last follow-up without any re-collapse or adjacent level fracture.

CONCLUSIONSA single-balloon cross-midline expansion via unipedicular approach in kyphoplasty for OVCFs is an effective and safe procedure with less cost, less operation time and less radiation exposure when compared with the conventional kyphoplasty technique.

Aged ; Aged, 80 and over ; Female ; Fractures, Compression ; surgery ; Humans ; Male ; Middle Aged ; Osteoporosis ; complications ; Spinal Fractures ; surgery ; Treatment Outcome ; Vertebroplasty ; methods

OBJECTIVETo investigate the distribution of virulent genes of Yersinia enterocolitica (Y. enterocolitica) in Ningxia Hui autonomous region and the characteristics of the molecular patterns of Y. enterocolitica.

METHODS283 strains of Y. enterocolitica were isolated in Ningxia Hui autonomous region between year 1997 and 2010. The genes ail, ystA, ystB, yadA and virF were analyzed by PCR method; the chromosomal DNA of Y. enterocolitica was digested by restriction endonucleases NotI and processed by pulsed-field gel electrophoreses (PFGE); and then the cluster analysis were conducted by BioNumeric computer software towards the above results.

RESULTSOf all, 209 strains of serotypes O:3 and O:9 Y.enterocolitica showed positive virulence of genes ail, ystA, yadA and virF; 97.6% (204/209) of which, the ystB virulence were negative. The virulence of all genes in serotype O:8 and serum-unclassified strains were negative. 9 out of 11 strains of serotype O:5 Y. enterocolitica showed negative virulence of the above five genes. By PFGE, according to the NotI Macrorestriction Map on chromosomal DNA, the 29 strains of serotype O:3 Y. enterocolitica were divided into 12 PFGE patterns, 2 of which were dominant patterns which could be found in over 5 strains; and the 180 strains of serotype O:9 Y. enterocolitica were divided into 13 patterns, 4 of which were dominant patterns which existed in over 10 strains; which were isolated individually from pigs and house mouse, pigs and dogs as well as pigs and wild rabbits.

CONCLUSIONY.enterocolitica serotypes O:3 and O:9 were pathogenic in Ningxia, and serotype O:3 becomes predominant gradually. O:5, O:8 and serum-unclassified serotypes were non-pathogenic.

Animals ; Bacterial Toxins ; genetics ; DNA, Bacterial ; genetics ; Dogs ; Electrophoresis, Gel, Pulsed-Field ; methods ; Genes, Bacterial ; Mice ; Rabbits ; Sus scrofa ; Virulence ; Yersinia Infections ; microbiology ; Yersinia enterocolitica ; genetics ; isolation & purification ; pathogenicity

OBJECTIVETo examine the distribution and trends of hospitalization rates for coronary heart disease (CHD) from 2007 to 2009 in Beijing.

METHODSWe calculated hospitalization rates for CHD using data from Beijing Hospital Discharge Information System. Information of census registered population in Beijing was obtained from Beijing Municipal Bureau of Statistics. CHD includes acute myocardial infarction, unstable angina and other forms of CHD. Age-standardized hospitalization rates for CHD per 100 000 population aged 25 years or more were calculated.

RESULTSDuring 2007 - 2009, a total of 248 049 patients aged 25 years or more hospitalized in Beijing with the primary discharge diagnosis of CHD were enrolled, of whom 73.7% were permanent registered Beijing citizens. The average hospitalization rate for CHD in 2007 - 2009 was 651.2/100 000 for the permanent residences in Beijing (741.2/100 000 in men, 560.9/100 000 in women). The highest average hospitalization rate (671.9/100 000) was seen in exurban area compared to other areas in Beijing. The average hospitalization rate for acute myocardial infarction, unstable angina, and other CHD was 126.4/100 000, 226.4/100 000 and 298.4/100 000, respectively. The hospitalization rate for CHD increased 18.1% from 2007 to 2009 (from 598.1/100 000 to 706.5/100 000). The same trend was seen in women (20.2%) and men (16.6%). The hospitalization rates of CHD in the urban, suburban, and exurban areas of Beijing all increased in the three years, and the greatest increase (36.6%) was found in exurban area. Hospitalization rates of acute myocardial infarction and unstable angina increased 24.5% and 55.3%, respectively, in the three years, while hospitalization rates of other CHD decreased 5.7%.

CONCLUSIONSThe hospitalization rate of CHD is higher in men than in women in Beijing. The hospitalization rates for CHD increased from the observation period, especially in those living in exurban area. Awareness of the magnitudes and trends of CHD hospitalization rates is of great importance in evaluating the burden of cardiovascular disease, allocating and utilizing health care resources, and estimating the health insurance for Beijing.

Adult ; Aged ; Aged, 80 and over ; Angina, Unstable ; epidemiology ; China ; epidemiology ; Coronary Artery Disease ; epidemiology ; Coronary Disease ; epidemiology ; Female ; Hospitalization ; statistics & numerical data ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; epidemiology

OBJECTIVETo introduce a modified surgery for total auriculoplasty and the experience in one hundred and forty-six cases (155 ears).

METHODSThe procedure was a two-stage operation. The first stage involved fabrication and grafting of a costal cartilage framework. A U-shaped skin incision was made on the posterior edge of the lobule and the remnant ear cartilage was removed completely. The area for the insertion of the cartilage framework was undermined. Skin flaps were sutured after insertion of the cartilage framework. The second-stage surgery was usually performed six months after the first-stage operation. The reconstructed auricle was elevated, and a costal cartilage block was fixed to the posterior part of the auricle. A temporoparietal fascia flap was then used to cover the costal cartilage block. Finally, the posterior aspect of the projected auricle was covered with a spit-thickness skin graft.

RESULTSThe incisions healed in one hundred and forty-one patients (150 ears) after the first stage operation. Partial necrosis of the postauricular flap was observed in five cases (5 ears) after the first stage operation, but no exposure or absorption of the cartilage took place. The skin grafts survived in one hundred and thirty-nine cases (147 ears) after the second-stage surgery. Partial necrosis of the skin graft was observed in seven cases (8 ears), but healed after one-week of dressing changes. Ninety-four cases (97 ears) were followed up, but fifty-two cases (58 ears) were lost to follow up. The follow-up at six months to two years showed satisfactory contour and projection of the constructed ears.

CONCLUSIONThis two-stage surgery is simple and ideal for auricloplasty with few complications.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Ear Auricle ; surgery ; Ear, External ; surgery ; Female ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods ; Surgical Flaps ; Young Adult

OBJECTIVETo investigate the role of focal adhesion kinase (FAK) in adhesion and migration of hepatic stellate cells (HSC).

METHODSTwo recombinant plasmids expressing short hairpin RNAs (shRNAs) targeting FAK were constructed and one plasmid substantially suppressing FAK expression in HSC was selected. Real-time PCR and Western blot were used to detect the knockdown effects of FAK gene. After 48-hour treatment with FAK shRNA, toluidine blue colorimetric assay was used to detect the cell adhesion. Wound-healing assay and improved Boyden double-chamber were used to detect the cell migration induced by FN.

RESULTSThe recombinant plasmid expressing FAK shRNA was successfully constructed and transfected into HSC. Compared with the controls, the expression of FAK mRNA and protein in HSC treated with FAK shRNA was markedly down-regulated by 76.82% and 72.53%, respectively. The expression of p-FAK (Tyr397) protein was also decreased by 62.71% 48 h posttransfection. The adhesion of HSC was inhibited by 58.69% at 48 h after shRNA transfection. FAK gene silencing could also dramatically inhibit FN-stimulated HSC migration, and the cell migration distance and the cell number of crossing membrane were decreased by 58.27% and 83.70%, respectively.

CONCLUSIONSFAK gene silencing suppresses adhesion and migration of HSC, and FAK may be a potential target for novel anti-fibrosis therapies.

Animals ; Blotting, Western ; Cell Adhesion ; Cell Line ; Cell Movement ; Down-Regulation ; Fibronectins ; Focal Adhesion Kinase 1 ; genetics ; metabolism ; Genetic Vectors ; Hepatic Stellate Cells ; cytology ; enzymology ; Liver Cirrhosis ; pathology ; prevention & control ; Plasmids ; genetics ; Polymerase Chain Reaction ; RNA Interference ; RNA, Messenger ; genetics ; metabolism ; Rats ; Transfection