Objective To investigate the clinical value of detection of fluorescence quantitative PCR in detection of HBV DNA and HBV markers.Methods 653 hepatitis B patients in our hospital from 2013 April to 2013 December were selected.First ELISA method using HBV-M model for qualitative detection of the blood samples,the detection order:Hepatitis b virus surface antigen (HBsAg),Hepatitis B surface Antibody(HbsAb),Hepatitis B e Antigen(HbeAg),hepatitis Be antibody(HbeAb),hepatitis B core antibody(HbcAb);Then the FQ-PCR method for the quantitative detection of HBV-DNA,different HBV-m model test results were compared..Results Big 3 this world[1(+)、3 (+)、5 (+)model]and[1 (+)、3 (+)model ]of the HBV-DNA positive rate was 97.97%,94.74% was significantly higher than that in other mode(P<0.05).Big 3 this world[1(+)、3(+)、5(+)model]HBV-DNA expression level is the highest(5.59 ×106 ±2.42 ×105 )copies/mL was significantly higher than that in other mode(P<0.05).Conclusion Combined with qualitative and quantitative detection of HBV-DNA HBV-M,which is of great value to clinical early diagnosis and therapy.

We analyzed the whole genome coding sequence of Volvariella volvacea to study the pattern utilization of codons by Codon W 1.4.2. As results, 24 optimal codons were identified. Moreover, the frequency of codons usage was calculated by CUSP program. We compared the frequency of codons usage of V. volvacea with other organisms including 6 modal value species (Homo sapiens, Saccharomys cerevisiae, Arabidopsis thalian, Mus musculus, Danio rerio and Drosophila melanogaster) and 4 edible fungi (Coprinopsis cinerea, Agaricus bisporus, Lentinula edodes and Pleurotus ostreatus). We found that there were less differences in 3 edible fungi (excluding Pleurotus ostreatus) than 6 modal value species, comparing with the frequency of codons usage of V. volvacea. With software SPSS16.0, cluster analysis which showed differences in the size of codon bias, reflects the evolutionary relationships between species, which can be used as a reference of evolutionary relationships of species. This was the first time for analysis the codon preference among the whole coding sequences of edible fungi, serving as theoretical basis to apply genetic engineering of V. volvacea.
Agaricales ; genetics ; Animals ; Arabidopsis ; genetics ; Cluster Analysis ; Codon ; DNA, Fungal ; genetics ; Drosophila melanogaster ; genetics ; Humans ; Mice ; Saccharomyces cerevisiae ; genetics ; Software ; Volvariella ; genetics ; Zebrafish ; genetics

INTRODUCTION: Airway management outside the operating room can be challenging, with an increased risk of difficult intubation, failed intubation and complications. We aim to examine airway practices, incidence of difficult airway and complications associated with airway code (AC) activation. METHODS: We conducted a prospective audit of AC activations and adverse events in two tertiary hospitals in Singapore. We included all adult patients outside the operating room who underwent emergency intubation by the AC team after AC activation. Adult patients who underwent emergency intubation without AC activation or before the arrival of the AC team were excluded. Data were collected and documented by the attending anaesthetists in a standardised survey form shortly after their responsibilities were completed. RESULTS: The audit was conducted over a 20-month period from July 2016 to March 2018, during which a total of 224 airway activations occurred. Intubation was successful in 218 of 224 AC activations, giving a success rate of 97.3%. Overall, 48 patients (21.4%) suffered an adverse event. Thirteen patients (5.8%) had complications when intubation was carried out by the AC team compared with 35 (21.5%) by the non-AC team. CONCLUSION Dedicated AC team offers better success rate for emergency tracheal intubation. Non-AC team attempted intubation in the majority of the cases before the arrival of the AC team. Increased intubation attempts are associated with increased incidence of adverse events. Equipment and patient factors also contributed to the adverse events. A multidisciplinary programme including the use of supraglottic devices may be helpful to improve the rate of success and minimise complications.

Objective To investigate status of internet addiction and circadian typology in college students and to explore the relationship between circadian typology and internet addiction. Methods A total of 3 572 college students including freshmen and juniors was enrolled in the study. Circadian typology and internet addiction were assessed by morningness-eveningness questionnaire(MEQ) and internet addiction test (IAT) respectively. All questionnaires were self-reported. Results The score of IAT was (38. 46±11. 84) points and incidence of internet addiction was 41. 7%. Freshmen and juniors were significantly different in distribution of circadian typology and IAT scores(χ2=10. 51,P<0. 05; t=5. 90,P<0. 01). Proportion of the evening type and scores of IAT of juniors(33. 0%,(39. 66±12. 71)points) were both higher than those of freshmen(28. 3%,(37. 32±10. 82)points). For freshmen,IAT scores of evening type students((40. 79± 11. 33)points) was higher than those of intermediate type students((36. 54±10. 27)points) and morning type students((32. 27±9. 66)points),and the differences were statistically significant(F=51. 81,P<0. 01). For juniors,IAT scores of evening type students((42. 90±13. 02)points) was higher than those of intermedi-ate type students((38. 61±12. 19)points) and morning type students((34. 06±11. 92)points),and the differences were statistically significant(F=37. 80,P<0. 01). After adjusting for gender,age,grade and par-ents’ educational level by analysis of covariance,IAT scores were still statistically different in circadian ty-pology(F=93. 53,P<0. 01). Results from ordinal logistic regression showed that grade(juniors compared to freshman,OR=1. 42,P<0. 01) and circadian typology (evening type compared to morning type,OR=3. 82,P<0. 01; intermediate type compared to morning type,OR=1. 97,P<0. 01) were independent factors influen- cing internet addiction. Conclusion Internet addiction of college students is at a high level and different in grades. Compared with junior students,senior students are at a higher level of internet addiction. College students with evening type are more likely to be internet addicted.

Hepatocellular carcinoma (HCC) accounts for approximately 75%-85% of primary liver cancer cases and is one of the most frequently diagnosed malignancies worldwide. Immunotherapy is currently considered to be the most promising treatment to prevent the progression and postoperative recurrence of HCC. At present, the treatment strategies of immunotherapy for HCC are classified as active immunotherapy and passive immunotherapy, including tumor vaccine therapy, immune checkpoint inhibitors, and adoptive cell therapy. Here we review the current clinical progression and discuss the future perspective on immune therapy for HCC.

INTRODUCTION: Post-anaesthesia care unit (PACU) delirium is a potentially preventable condition that results in a significant long-term effect. In a multicentre prospective cohort study, we investigate the incidence and risk factors of postoperative delirium in elderly patients undergoing major non-cardiac surgery. METHODS: Patients were consented and recruited from 4 major hospitals in Singapore. Research ethics approval was obtained. Patients older than 65 years undergoing non-cardiac surgery >2 hours were recruited. Baseline perioperative data were collected. Preoperative baseline cognition was obtained. Patients were assessed in the post-anaesthesia care unit for delirium 30-60 minutes after arrival using the Nursing Delirium Screening Scale (Nu-DESC). RESULTS Ninety-eight patients completed the study. Eleven patients (11.2%) had postoperative delirium. Patients who had PACU delirium were older (74.6±3.2 versus 70.6±4.4 years, P=0.005). Univariate analysis showed those who had PACU delirium are more likely to be ASA 3 (63.6% vs 31.0%, P=0.019), had estimated glomerular filtration rate (eGFR) of >60mL/min/1.73m2 (36.4% vs 10.6%, P=0.013), higher HbA1C value (7.8±1.2 vs 6.6±0.9, P=0.011), raised random blood glucose (10.0±5.0mmol/L vs 6.5±2.4mmol/L, P=0.0066), and moderate-severe depression (18.2% vs 1.1%, P=0.033). They are more likely to stay longer in hospital (median 8 days [range 4-18] vs 4 days [range 2-8], P=0.049). Raised random blood glucose is independently associated with increased PACU delirium on multivariate analysis.
Aged ; Anesthesia ; Anesthesia Recovery Period ; Delirium/etiology* ; Humans ; Incidence ; Postoperative Complications/etiology* ; Prospective Studies ; Risk Factors

INTRODUCTION: Post-anaesthesia care unit (PACU) delirium affects 5%-45% of patients after surgery and is associated with postoperative delirium and increased mortality. Up to 40% of PACU delirium is preventable, but it remains under-recognised due to a lack of awareness of its diagnosis. The nursing delirium screening scale (Nu-DESC) has been validated for diagnosing PACU delirium, but is not routinely used locally. This study aimed to use Nu-DESC to establish the incidence and risk factors of PACU delirium in patients undergoing non-cardiac surgery in the surgical population. METHODS: We conducted an audit of eligible patients undergoing major surgery in three public hospitals in Singapore over 1 week. Patients were assessed for delirium 30-60 min following their arrival in PACU using Nu-DESC, with a total score of ≥2 indicative of delirium. RESULTS: A total of 478 patients were assessed. The overall incidence rate of PACU delirium was 18/478 (3.8%), and the incidence was 9/146 (6.2%) in patients aged > 65 years. Post-anaesthesia care unit delirium was more common in females, patients with malignancy and those who underwent longer operations. Logistic regression analysis showed that the use of bispectral index (P < 0.001) and the presence of malignancy (P < 0.001) were significantly associated with a higher incidence of PACU delirium. CONCLUSION In this first local study, the incidence of PACU delirium was 3.8%, increasing to 6.2% in those aged > 65 years. Understanding these risk factors will form the basis for which protocols can be established to optimise resource management and prevent long-term morbidities and mortality in PACU delirium.
Female ; Humans ; Delirium/epidemiology* ; Postoperative Complications/etiology* ; Singapore/epidemiology* ; Prospective Studies ; Anesthesia/adverse effects* ; Risk Factors ; Neoplasms