Chronic infection of hepatitis B virus(HBV)presents one of the serious public health challenges worldwide.Current treatment of chronic hepatitis B(CHB)is limited,and is composed of interferon and nucleoside/nucleotide reverse transcriptase inhibitors(NRTI).Interferon is poorly tolerated and is only responsive in a small fraction of CHB patients and NRTIs often face the problem of emergence of drug resistance during long-term treatment.The current treatment of CHB earl be improved in several ways including genotyping mutations associated with drug resistance before treatment to guide the choice of NRTIs and suitable combinations among NRTIs and interferon.It is important to continue research in the identification of novel therapeutic targets in the life cycle of HBV or in the host immune system to stimulate the development of new antiviral agents and immunotherapies.Several antivirai agents targeting HBV entry,cecDNA,capsid formation,viral morphogenesis and virion secretion,as well as two therapeutic vaccines are currently being evaluated in preclinical studies or in clinical trials to assess their anti-HBV efficacy.

Objective To investigate the association of excessive daytime sleepiness(EDS) and the quality of life in patients with moderate to severe obstructive sleep apnea and hypoventilation syndrome (OSAHS).Methods 123 patients with moderate to severe OSAHS were diagnosed by polysomnography(PSG),and 52 cases ruled out by PSG were controls.Patients and controls were completed the Calgary sleep apnea quality of life index (SAQLI) and the Epworth sleepiness score(ESS).Results There were statistical significance of body mass index (BMI),respiratory disturbance index(RDI),the lowest oxygen saturatioo( LSpO2 ),the longest apnea time( Tmax),the percentage of recording time with oxygen saturation of 90％ or less(T90) between the patients and the controls.Daily Functioning,Social Interactions,Emotional Functioning,Symptoms,and total scores of SAQLI in patients with moderate to severe OSAHS were(3.88 ± 1.05),(4.48 ± 1.39),(4.76 ± 1.59),(2.98 ± 1.10),(3.94 ± 1.22),which were less than that of controls respectively.The ESS scoree of patients with moderate to severe OSAHS were higher than that of controls[ ( 13.98 ± 4.05 ) vs (5.78 ± 2.45) ],( P ＜ 0.01 ).ESS were related to the daily Functioning,social interactions,emotional functioning,symptoms,and total scores of SAQLI in patients with moderate to severe OSAHS,and the coecient of correlation were - 0.52,- 0.48,- 0.40,- 0.48 and - 0.44,respectively,and all p value were less than 0.01.Conclusion Patients with moderate to severe OSAHS have the EDS,which associate with the impairment of quality of life.The higher ESS may indicate the decrease of quality of life in patients with moderate to severe OSAHS.

Objective To explore the relationship between high sensitive C-reactive protein (hsCRP) and renal function among people aged 90 years and over in longevity regions in China.Methods Totally 506 subjects aged 90 years and over in 5 longevity areas from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) 2008-2009 were included in the study.Demographic,behavioral and lifestyle parameters and self-reported chronic diseases were collected by general health-related questionnaire.We conducted the physical examination and also measured serum hsCRP and other indicators of renal function.Logistic regression was used to analyze the relationship between hsCRP and renal function.Results The prevalence of elevated hsCRP was 36.6％ in people aged 90 years and over,43.0％ in male and 34.8％ in female.No significant gender difference was observed among them (x2 =2.4184,P=0.1199).The prevalence of elevated hsCRP were 34.4％ in 90-99 years group and 39.2％ in the centenarian group,and there was no significant difference between the two groups (x2 =1.2425,P =0.2650).We found significant statistical difference in prevalence of elevated hsCRP between declined renal function group (42.0％) and normal group (33.3％) (t=3.8450,P=0.0499).The level of serum creatinine were (89.5±37.4) μmol/L in elevated hsCRP group and (81.5±31.4) μmol/L in the normal hsCRP group among the people aged 90 years and over.Significant difference was found between the elevated and normal hsCRP group (x23.8450,P=0.0161).In the multivariate logistic regression analysis,the risk factors of renal function decline were female,smoking,hypertension,hyperuricemia and elevated hsCRPCOR=1.676 (95％CI:1.091-2.573)].Conclusions Elevated hsCRP increases the risk of renal function decline among people aged 90 years and over in China.

Objective To describe the prevalence of hyperuricemia of centenarians in longevity areas of China and the risk factors were analyzed. Methods All centenarians in 7 longevity areas were selected,and people aged 40 ～, 60 ～, 80 ～ and 90 ～ were selected randomly in the same 7 areas. The data of demographic data, dieting habits and diseases history were collected by questionnaire survey. Hyperuricemia and associated risk factors, physical examination and biochemical tests were collected. Logistic regression was used to analyze the hypemricemia and its relevant factors. Results The highest prevalence of hyperuricemia was found in centenarian men, which was 12.73％, the highest prevalence of hyperuricemia among 90～ women was 18.75％. The hyperuricemia group were more prone to have hypertension, diabetes, renal function decreased, hypercholesterolemia, hypertriglyceridemia, high density lipoprotein. Logistic regression analysis showed that renal function declined, high TG, high density lipoprotein hyperlipidemia, blood urea nitrogen increased, drinking were risk factors for hyperuricemia. Conclusion The prevalence of hyperuricemia in people older than 90 years and above in longevity areas is high. The results suggest that the treatment strategy for hyperuricemia should be a comprehensive one that combines preventive measures with medication interventions.

Objective To assess the prognostic benefits of intraoperative radiotherapy (IORT) with electron beam among patients with unresectable locally advanced pancreatic cancer.Methods Between January 2009 and December 2014,167 patients with unresectable locally advanced pancreatic cancer received IORT with electron beam (10-20 Gy) in our hospital.After surgery,12 patients were treated with external beam radiotherapy,56 patients with chemoradiotherapy (CRT),and 17 patients with chemotherapy.Overall survival (OS),local recurrence,and toxicities were retrospectively analyzed.The Kaplan-Meier method was used to calculate survival rates,the log-rank test was used for survival difference analysis and univariate prognostic analysis,and the Cox model was used for multivariate prognostic analysis.Results The follow-up rate was 100％.The median OS time was 10.3 months,and the 2-year OS rate was 22％.The median progression-fiee survival (PFS) time was 6.3 months,and the 2-year PFS rate was 9.9％.The cancer-specific survival (CSS) time was 11.2 months,and the 2-year CSS rate was 23.6％.In the patients treated with IORT alone at doses of＜15 Gy,15 Gy and＞15 Gy,the median OS times were 6.2 months vs.9.1 months vs.22.2 months,and the 1-year OS rates were 10.0％ vs.39.6％ vs.74.4％ (P=0.000).Among the patients receiving postoperative adjuvant therapy,those treated with IORT+CRT had the best survival,with a median OS time of 11.6 months (P=0.033).The univariate analysis showed that IORT dose (P =0.000),tumor size (P =0.006),and IORT applicator diameter (P =0.007) were prognostic factors.The multivariate analysis showed that IORT dose (P=0.000) and IORT combined with CRT (P=0.006) were independent prognostic factors.Conclusions IORT with electron beam is an effective and safe treatment strategy for unresectable locally advanced pancreatic cancer.After protecting surrounding organs,increasing the IORT dose can improve the survival.IORT combined with CRT should be recommended because it improves survival for unresectable locally advanced pancreatic cancer without increasing toxicities.

OBJECTIVE: To evaluate the effect of different cumulative energy composite parameters on the outcomes of phacoemulsification cataract surgery in patients with type 2 diabetes mellitus. METHODS: A total of 252 patients with cataract (involving 252 eyes) and type 2 diabetes mellitus received phacoemulsification cataract surgery in our hospital between January, 2017 and June, 2019. The patients were divided into group A (150 cases) and group B (102 cases) for cataract phacoemulsification with cumulative energy composite parameters of 8 and 10, respectively, and 90 nondiabetic patients received cataract phacoemulsification with a cumulative energy composite parameters of 10 served as the control. The macular thickness, best corrected visual acuity, visual acuity, and postoperative leakage in the 3 groups were evaluated at 1 week, 1 month, and 3 months after the surgery. RESULTS: The visual acuity was significantly improved after phacoemulsification better in all the 3 groups. At 3 months after the surgery, the proportions of patients with visual acuity ratio < 0.1 or >1.0, macular thickness, best corrected visual acuity and permeability differed significantly between groups A and B ( < 0.05), but not between group A and the control group ( > 0.05). At 1 month and 3 months after the surgery, the proportion of patients with visual acuity ratio < 0.1 was significantly lower and the rate of visual acuity ratio >1.0 was higher in group A than in group B. At 1 month after the operation, the total leakage rate in group A (31.1%) was higher than that in the control group (21.1%) but comparable with that in group B; at 3 months, the total leakage rates were significantly lower in group A than in group B (10.0% 32.4%, < 0.05), and the leakage resulted mainly from local and diffuse permeation. CONCLUSIONS Phacoemulsification can effectively improve the visual acuity of cataract patients especially in non-diabetic patients. A lower cumulative energy composite parameter achieves better outcomes in type 2 diabetic patients with cataract. The macular thickness, local infiltration and diffuse leakage can be used as indicators for assessing visual recovery and stabilization after phacoemulsification.
Cataract ; Cataract Extraction ; Diabetes Mellitus, Type 2 ; Humans ; Phacoemulsification ; Visual Acuity

【Objective】 To investigate the changing trends in etiology and treatment of male urethral stricture in recent 10 years. 【Methods】 A total of 940 male patients with urethral stricture admitted to the Department of Urology of Beijing Jishuitan Hospital during Jan.2013 and Dec.2022 were continually collected.The clinical data were divided into two groups according to the time of admission, namely the group from 2013 to 2017 and the group from 2018 to 2022, for a comparative analysis of the previous and subsequent 5 years.The etiology, location, length and the type of treatment of urethral stricture were retrospectively analyzed. 【Results】 The causes of the 940 cases of male urethral stricture were trauma in 447(47.55%), iatrogenic injury in 220(23.40%), idiopathic causes in 128(13.62%), lichen sclerosus (LS) in 78(8.30%), infection in 46(4.89%), and other causes in 21(2.23%).The treatment methods were urethroplasty in 691(73.51%), direct vision internal urethrotomy (DVIU) in 122(12.98%), urethral dilatation in 86(9.15%), and suprapubic cystostomy in 41(4.36%).Compared with the previous 5 years, in the past 5 years, the proportion of urethral stricture caused by trauma decreased significantly (60.34% vs. 41.71%, P<0.001), while the proportion of iatrogenic injury increased significantly (17.63% vs. 26.05%, P=0.005). In the past 5 years, the proportion of urethroplasty increased from 68.81% to 75.66% (P=0.027), while the proportion of DVIU decreased from 19.66% to 9.92% (P<0.001). In the past 5 years, the proportion of membranous urethral stenosis decreased significantly (26.98% vs. 50.85%, χ²=51.06, P<0.001),the proportion of penile urethral stricture (21.40% vs. 7.80%, χ²=26.37, P<0.001) and meatal stenosis (9.30% vs. 4.75%, χ²=5.80, P<0.001) increased significantly. 【Conclusion】 In the past decade, trauma was the main cause of male urethral strictures, but its proportion showed a decreasing trend.Iatrogenic injury led to a gradual increase in urethral strictures, which was the second leading cause of male urethral stricture.The application of urethroplasty increased significantly, making it the main treatment method for male urethral stricture.