In order to investigate the mutation of HBV polymerase gene reverse transcription conserved region (P region) in chronic hepatitis B (CHB) patients, 212 CHB patients who took antiretroviral treatment with nucleotide analogues were chosen. The drug resistance mutations of HBV P region and HBV genotype were detected by Pyrosequencing. Sequence analysis showed that the drug resistance sites of HBV P region located at sites 173; 180; 181; 184; 204; 236 and 250. The main site of HBV P region drug resistance was 204 and 180, accounting for 35.8% and 23.5%, respectively. There were significant differences in the mutation rate of site 180 among different age groups. There were also significant differences in the mutation rate of site 204 among younger than 30 age group, 41 to 50 age group and 51 to 60 age group. (P < 0.05, P < 0.01). The mutation rate of site 180 combined with site 204 was 66.6%. The mutation rate of site 181 combined with site 236 was 23.3%. The age of C genotype infected patients was significantly older than B genotype infected patients (P < 0.01). M204V/I mutation mostly existed in the form of joint L180M mutation, the mutation rate was age-related. The detection of HBV genotypes and drug resistance sites of HBV P region have important clinical implications for the treatment and prognosis of patients with CHB.
Adult ; Aged ; Antiviral Agents ; pharmacology ; China ; Drug Resistance, Viral ; Female ; Gene Products, pol ; genetics ; Genotype ; Hepatitis B virus ; classification ; drug effects ; enzymology ; genetics ; Hepatitis B, Chronic ; drug therapy ; virology ; Humans ; Male ; Middle Aged ; Mutation, Missense ; Young Adult

Objective To compare complication,nutritional status and quality of life between total gastrectomy and jejuna interposition after proximal radical gastrectomy in patients with advanced proximal gastric carcinoma.Methods Eighty-five patients with proximal stomach cancer were enrolled from Jan.2002 to Dec.2008,total gastrectomy group(Control group) had 40 cases,jejuna interposition after proximal radical gastrectomy(Experimental group) included 45 cases.Nutritional status,incidence of reflux esophagitis and cholecystolithiasis,5-year survival rate,quality of life were investigated.Results There was no significant difference in 5-year survival rate between two groups(P ＞ 0.05).Incidence of reflux esophagitis in Experimental group was significantly lower than that in Control group(P =0.042).Incidence of cholecystolithiasis in Experimental group was significantly lower than that in Control group (P =0.038).Hemoglobin,albumin,vitamin B12 and ferritin in Experimental group were significantly higher than those in Control group[(142.2 ±8.6) vs (128.4 ±8.4),(41.3 ±5.8) vs (35.9 ±3.8),(271.5 ± 49.7) vs (184.5 ± 24.6),(220.2 ± 59.7) vs (170.2 ± 27.6),P =0.036,0.024,0.032,0.026].Diet and labor in Experimental group were better than those in Control group (P =0.042,0.048).Conclusion Jejuna interposition after proximal radical gastrectomy decrease incidences of reflux esophagitis and cholecystolithiasis,improve nutritional status and quality of life.

Primary hepatic carcinoma (PHC) is one of the most common cancers worldwide and is the leading cause of death in China. Multidisciplinary treatment is widely accepted as the way to improve the prognosis of PHC, and non-surgical therapy now plays a more and more important role. The purpose of this article is to review the current status and progress of non-surgical treatments of PHC, such as TACE, local ablation, radiotherapy and systemic therapy.

Objective: To evaluate the biocompatibility of self made nitinol alloy ventricular septal defect occluder. Methods: Six nitinol alloy ventricular septal defect occluder were implanted in the ventricular septum by catheter in 6 normal anaesthetized open chest pigs, and the animals were observed for 45 to 120 d(2 animals). Results: One deaths resulted from hemorrhage and another from embolization of occluder in abdominal aorta during the placement procedure. Successful placement of the occluder was achieved in 4 animals. Four animals were killed at 45, 60 and 120 d. Postmortem gross and microscopic examination of 4 devices 45 to 120 d after placement showed that both the right and left ventricular discs of the occluder were completely covered by a smooth, shiny, glistening thin layer of neoendocardium, and the surface of neoendocardium was covered by a monolayer of endothelium like cells. The inflammatory infiltrate around the occluder was found at 45 d, and disappeared and fibrosis formed at 120 d. These appeared as a repair process of the injury. Embolization in lung,liver, spleen, kidney, intestinal and colon were not found. Conclusion: These suggest that the self made nitinol alloy ventricular septal defect occluder has good biocompatibility. [

Objective To explore the clinical value of using pectoralis major myocutaneous flap in surgery with various adverse factors for advanced oropharyngeal cancer.Methods 15 patients who presented with advanced oropharyngeal cancer were performed for radical surgery,and pectoralis major myocutaneous flaps were applied for immediate reconstruction of surgical defect.In all cases,various adverse factors(advanced age,diabetes,cardiovascular disease,radiation damage,etc.)were existed.The effect of reconstruction was observed.Results All surgeries were successful,and all patients tided over perioperative period.The average time of operation was 5 hours with a range of 4 to 6 hours.The average time cost for flap preparation was 40 minutes with a range of 40 to 55 minutes.The completely survival rate of flaps was 93%.Partial skin necrosis occurred in 1 case(7%);and submandibular fistula occurred in another one(7%).Two patients(13%)developed wound infection.All of them were healed by symptom-atic treatment.Conclusion For the patients with advanced oropharyngeal cancer and various adverse factors of sur-gery,pectoralis major myocutaneous flap can be used as salvage measure in reconstruction of surgical defect,which is more secure than free flap.

10.3969/j.issn.1000-8179.2013.12.012

Objective To study the clinical feature,diagnosis,treatment and prognosis of hepatocellular adenoma(HA).Methods The clinical data of 10 patients confirmed pathologically with HA,were retrospectively analyzed.Results There were four females and six males,aging from 25 to 71 years(mean:42.6 years).Among these 10 patients,6 cases were discovered to have no clinical symptom.Tumors were located in the right lobe of the liver in 4 cases,and in the left lobe in 6 cases.Uhrasonography was performed in all cases.Six cases underwent CT examination and three cases experienced MRI as well as angiography was conducted in one case.All cases were confirmed by complete excision and pathology.All of them were followed up for 5 months to 9 years without tumor recurrence.Conclusion The combination of imaging data is helpful in the diagnosis of HA.Surgery is the best treatment with satisfactory results,and its prognosis is fairly good.

Objective To investigate the effectiveness of surgical resection for metastatic liver cancer in patients of gastric carcinoma, and evaluate the prognosis. Methods Clinical data of 24 gastric cancer cases undergoing hepatectomy for hepatic metastatic tumor were collected retrospectively. There were 18 cases of synchronous resection and 6 cases of heterochronous resection. The prognostic values of clinicopathological factors were assessed by univariate and multivariate analyses. Results Postoperatively all cases were followed up until the death of the patietns. Counting from the time of liver resection the 1-,3- and 5-year survival rate was 67%, 21% and 13% respectively. Univariate analysis showed lymph node involved, tumor size of hepatic metastases, vascular invasion and R0 margin as significant prognostic factors;Multivariate analysis indicated that tumor size of hepatic metastases and vascular invasion were independent prognostic factors influencing the survival. Conclusion These results suggest that for patients with liver metastasia from gastric cancer, better prognosis can be obtained by surgical treatment.

Ablation Techniques ; adverse effects ; Animals ; Bone and Bones ; pathology ; Disease Models, Animal ; Extremities ; Swine

BACKGROUND: Defatting is to reduce the special cell surface antigens by clearing fat and lipoprotein, so as to decrease immunological rejection, improve the biocompatibility of allograft bone, and increase osteogenic potential. However, the effect of defatting on biomechanical performance of bone remains controversial.OBJECTIVE: To explore the influence of defatting on the biomechanics of bovine cortical bone samples.DESIGN, TIME AND SETTING: Randomized, self-controlled observation was performed in Futian People's Hospital of Guangdong Medical College between 2006 and 2008.MATERIALS: Eight pairs of healthy adult bovine femora were used. Bone blocks, 50 mm long and 10 mm wide, were selected from each pair of femora, and burnished into 24 pairs of 7 mm×7 mm×40 mm rectangular bovine cortical bone samples.METHODS: The 24 pairs of cortical bone samples were randomly divided into two groups (n=12). One of each pair was selected as test group sample, and the other as control group sample. The samples of test group were defatted In 500 mL chloroform and methanol mixture (1:1) for 24 hours, while control samples were immerged in deionized water for 24 hours. Six samples from each group were selected for axial compressive test and three-point bending test.MAIN OUTCOME MEASURES: Load and deflection of every sample.RESULTS: Axial compressive test showed that the maximum load and the maximum strain of defatted samples were significantly decreased compared with control group, but the fragility and elastic modulus were increased (P < 0.05). In three-point bending test, the maximum load and the maximum stress of defatted sampled were significantly decreased, the maximum deflection was decreased, and the elastic modulus was increased (P < 0.05).CONCLUSION: The mechanical strength of cortical bone decreased but the fragility increased after defatting.