Objective To explore the application value of enzyme linked immunosorbent assay for detection of hepatitis B PreS1 antigen and antibody in the diagnosis of hepatitis B.MethodsSeveral common patterns in the results of hepatitis Btwo halfcheck were selected from August 2014 to August 2016 for the sample, the use of hepatitis Btwo half7 commonly used detection model for 140 cases of PreS1 antigen, antibody detection.Enzyme linked immunosorbent assay for detection of PreS1 antigen and antibody.ResultsIn patients with HBeAg in PreS1 antigen positive rate was 87.5%, in patients with positive PreS1 antigen positive rate was 8.6%, HBsAg, HBcAb in patients with positive PreS1 antigen positive 13.3%, in a pure HBsAg in patients with positive PreS1 antigen 4.3%.There was no significant difference in the total positive rate of HBV-DNA and the total positive rate of PreS1, and the total coincidence rate was higher.PreS1 antigen positive correlated with HBsAg, HBeAg and HBcAb positive(P<0.05), and has nothing to do with HBsAb, HBeAb positive.ConclusionHepatitis B PreS1 antigen and antibody detection, can effectively complement the diagnosis of hepatitis B, early detection of hepatitis B infection.

Stab wounds are the main cause of large-vessel injuries in the neck and they have a fairly good prognosis when the patient receives expeditious and appropriate management. The objective of this study is to present the experience of managing patients with large-vessel injuries in the neck. A retrospective study was carried out involving 22 cases with vessel injuries in the neck over the past 10 years. Stab wounds accounted for 77% of this series (17 of 22 patients). All 22 cases were treated operatively. The overall survival rate was 95%. One patient died on the operating table because of torrential haemorrhage into the chest. Complications included one thrombosis of the right subclavian artery, and five cases of haemothorax, all of which resolved. Successful salvage of patients with major vessel injuries in the neck depends on familiarity with the anatomy, accurate and timely clinical diagnosis and expedient surgical intervention. Patients with haemodynamic instability, rapidly expanding cervical haematomas or uncontrollable bleeding require immediate operative intervention, forgoing any diagnostic study. Stable patients may undergo radiological studies to detect occult injuries that may result in late morbidity such as false aneurysms and arteriovenous fistulae.
Physical trauma ; Neck ; seconds ; Mores ; Large

Objective To discuss nursing of patients with esophageal cancer surgery by early feeding of homemade non-factor enteral nutrition.Methods 70 patients of esophageal cancer surgery were accepted homemade non-factor enteral nutrition.Results We got better results in nitrogen balance recovery and the enteral function in intestinal nutrition group than those in apenteric nutrition group after the operation.Conclusion The nutritional status of patients had been markedly improved by application of homemade non-factor feeding after carefully nursing of nasal feeding tube and other tubes,reasonable preparation,maintaining the pipeline opening,observation of illness,oral care,complications of observation and caring etc.The complications have been reduced the quality of life of the patients wag significantly improvad.

Objective To evaluate the feasibility and safety of peroral direct cholangioscopy (PDCS) by freehand intubation using routine straight-view endoscope for diagnosis and therapy of biliary diseases.Methods Patients with bile duct dilation underwent standard ERCP and native papilla was dilated using EST and/or endoscopic papillary large balloon dilation,according to the size of the papilla.Then peroral direct cholangioscopy was performed by freehand intubation using routine straight-view endoscope.General data of patients,procedure of ERCP,diagnosis of PDCS and complications were recorded.Results A total of 5 patients underwent PDCS.Indications included common bile duct stones (n =2),intraductal papillary neoplasm of bile buct (n =2) and benign biliary stricture after removable metal stent placement (n =1).The diameter of common bile duct ranges from 1.2 cm to 2.4 cm.EST or/and EPLBD was required in 3/5 patients to facilitate PDCS.Freehand PDCS intubation of the bile duct was successful in all procedures (1 case into distal common bile duct,4 cases into proximal common bile duct).Complications were cholangitis managed with intavenous antibiotics (n =1).No procedure related death occurred.Conclusion Freehand PDCS is technically feasible and safe,and may be clinically useful for diagnostic and therapeutic purposes in managing select biliary tract diseases.

Objective To investigate the reversal effect of triazole antifungal itraconazole,fluconazole combined with adriamycin on multidrug resistance in leukemia cells.Methods Human chronic myelogenous leukemia adriamycin resistant cell lines K562/ADR cells were incubated with itraconazole,fluconazole,or PSC833 (positive control) combined respectively with adriamycin.CCK-8 assay was used to assess cell proliferation of K562/ADR.The mean fluorescence intensity of intracellular ADR was measured by flow cytometry.The marker of DNA damage γH2AX was detected by Western blot.Results 1 μg/ml itraconazole and 0.5 μg/ml PSC833 can decrease K562/ADR IC50 of adriamycin from 38.30 μg/ml to 8.59 μg/ml and 24.64 μg/ml in a dose-dependent manner.K562/ADR cells were incubated with 1 μg/ml itraconazole or 0.5 μg/ml PSC833 combined respectively with adriamycin for 3 h and 6 h,the mean fluorescence intensity of intracellular ADR were increased 1.54-fold (3 h),1.50-fold (6 h) or 5.97-fold (3 h),5.83-fold (6 h).Itraconazole or PSC833 combined with adriamycin significantly increase the expression of γH2AX in K562/ ADR cells.Conclusion Itraconazole can recover adriamycin sensitivity of K562/ADR by increasing the concentration of intracelullar adriamycin and synergistically increasing DNA damage,but not for fluconazole.

Objective To investigate the effects of alprostadil injection on IL-6, IL-8, TNF-αand insulin resistance in diabetic patients.Methods 90 patients with diabetes mellitus in our hospital from January 2014 to May 2016 were selected,and randomly divided into observation group and control group,45 cases in each groups.The control group received conventional western medicine , the observation group was treated with alprostadil injection.The levels of serum IL-6, IL-8, TNF-α, insulin and insulin resistance index were compared before and after treatment in both two groups. Results After treatment,the total effective rate of treatment group was 91.11%,which was significantly higher than the control group 71.11%( P<0.05).Before treatment,the levels of IL-6,IL-8,TNF-α,insulin and insulin resistance index of two groups were had no statistical significance,after treatment,the levels of IL-6,IL-8,TNF-α,insulin and insulin resistance index were decreased in both groups,and the observation group was significantly lower than the control group,the difference was statistically significant (P<0.05).Conclusion The alprostadil injection can significantly reduce the levels of IL-6,IL-8,TNF-α,and control the level of blood glucose,reduce the effect of insulin resistance.