OBJECTIVETo review the development, mechanism, necessity and limitation of antiviral therapy in decompensated hepatitis B virus-related cirrhosis.

DATA SOURCESMost information was pulled from a literature search (Pubmed 2000 to 2011) using the keywords of antiviral and decompensated hepatitis B virus-related cirrhosis. Relevant book chapters were also reviewed.

STUDY SELECTIONWell-controlled, prospective landmark studies and review articles on antiviral therapy in decompesated hepatitis B virus-related cirrhosis were selected.

RESULTSSpecific antiviral agents not only control viral replication, which permits liver transplantation, but also improve liver function so significantly that patients could be removed from the transplant waiting list. However, the emergence of drug-resistant mutants can result in treatment failure. Combination therapy is a save-strategy in drug-resistant.

CONCLUSIONSAlthough the treatment of end-stage liver disease is still a challenge worldwide, antiviral therapy has altered the natural history of hepatitis B patients with decompensated cirrhosis. The approval of the new generation of antivirals is opening new perspectives for finding the optimal antiviral treatment for patients with decompensated cirrhosis and preventing antiviral resistance. A combination of antivirals may be one of the future strategies for fulfilling these goals.

Antiviral Agents ; therapeutic use ; Hepatitis B virus ; drug effects ; pathogenicity ; Humans ; Liver Cirrhosis ; drug therapy ; virology

Objective： This study was designed to evaluate the clinical, endoscopic, and pathologic characteristics of primary gastric malignant lymphoma(PGML). Methods： Thirty patients with PGML were retrospectively reviewed and analyzed in the aspects of elinical, roentgenography, and endoscopic status. Results： The clinical presentations including abdominal pain, loss of weight, fever, and upper gastrointestinal hemorrhage were invariably found. Most lesions were in the body of stomach(73.3％ ). All patients were examined by endoscopy with protruding, infiltrative, and ulcerative lesions accounting for 46.7％ (14/30), 40.0％ (12/30), and 13.3％ (4/30) ,respectively. The pathological coincidence rate of endoscopic biopsy with resected operation was 80.0％ . The tumor might originate from the following organisms： B cell of 90.0％ (27/30)(19 of them are mucosa-associated lymphoid tissue lymphoma) and T cell of 10.0％ (4/30). The operative resectability of these PGML remained higher and these PGML were sensitive to chemotherapy and radiotherapy. Conclusion： PGML is very likely to be misdiagnosed or neglected due to its rarity and specificity. Gastroscopy remains to be valuable to correct diagnosis of PGML. Better prognosis is often expected if followed by operative resection, chemotherapy and/or radiotherapy.

Objective To explore the associations between fasting serum lipids and high-sensitivity C-reactive protein ( hsCRP).Methods Serum triglyceride ( TG),high-density lipoprotein cholesterol (HDL-C) and hsCRP were measured in residents of Chengdu,China.Subjects with potential factors which might influence lipids and hsCRP were excluded,580 subjects [ mean age ( 62.3 ± 6.6 ) years ; male:58.7％ ] were finally recruited by random sampling methods.Results There was a weak positive relationship between TG and hsCRP ( r =0.108,P =0.01 ) and a weak negative relationship between HDLC and hsCRP (r =- 0.197,P ＜ 0.001 ),this was also true in the sub-group with BMI ＜ 24 kg/m2 ( r =0.236,-0.140 respectively,all P ＜0.001 ).In subjects with BMI ＜24 kg/m2,the hsCRP concentration was significantly higher in subjects with higher TG or lower HDL-C ( all P ＜ 0.05 ).hsCRP increased in proportion with the degree of dyslipidemia.After adjusting for gender,age,TC,LDL-C,fasting blood glucose,systolic blood pressure,diastolic blood pressure,history of hypertension and diabetes,smoking and alcohol drinking,logistic regression analysis showed that the odds ratio for increased hsCRP was 1.970 in subjects with either increased TG or lower HDL-C (P =0.105) and 9.098 in subjects with both higher TG or lower HDL-C levels (P =0.031 ).However,the observed relationship between TG,HDL-C and hsCRP in subjects with BMI ＜ 24 kg/m2 could not be observed in subjects with subjects with BMI ＞ 24 kg/m2despite significant more cardiovascular risk factors in these subjects.Conclusions A weak positive correlation between TG and hsCRP as well as a weak negative correlation between HDL-C and hsCRP was evidenced in the whole cohort suggesting dyslipidemia might be related to enhanced inflammatory status.However,this relationship is not observed in subjects with BMI ＞ 24 kg/m2 despite existence of more cardiovascular risk factors in these subjects.

Objective To detect the distribution of resistance-nodulation (RND)efflux pump system of Acineto-bacter baumannii (AB),and explore the relationship between its’expression and antimicrobial resistance.Methods Fifty-nine strains of multidrug-resistant AB isolated from clinical specimens in The First Affiliated Hospital of Nan-chang University were identified and performed antimicrobial susceptibility analysis,distribution of RND efflux sys-tem of AB was detected by polymerase chain reaction(PCR),expression of efflux pump genes in different drug-re-sistant phenotypes of AB was compared,relationship between the expression level and drug resistance was analyzed, amplified products of RND efflux system were sequenced.Results Resistance rates of AB to ampicillin/sulbactam, imipenem,gentamicin,ciprofloxacin,and levofloxacin were 93.2%,94.9%,88.1%,96.6%,and 52.5% respec-tively.PCR detection results of efflux pump and integron genes of 59 AB strains revealed that the carrying rates of adeR,adeS,adeB,adeJ,and adeG genes were 81.4%,91.5%,93.2%,100.0%,and 61.0% respectively.The expression of efflux pump genes in different strains was different,expression levels of ade B and adeJ genes among gentamicin,imipenem,ampicillin/sulbactam resistant AB group and non-resistant AB group were significantly dif- ferent (all P＜0.05).There was no mutation or insertion sequence in the base sequences of regulatory genes ade R and ade S of adeABC efflux pump.Conclusion RND efflux pump system is universally present in AB,the expres-sion upregulation of ade B and ade J genes in RND efflux pump system is related with antimicrobial resistance of bacteria to gentamycin,imipenem,and ampicillin-sulbactam.

OBJECTIVETo study the effects of Salvia miltiorrhiza on treatment of Chlamydia trachomatis salpingitis (CTS) and fibrosis.

METHODA mouse model for CTS was estahlished in C3H/He by intravaginal inoculation. after 3 weeks mice were randomly divided into 3 groups. Only Azithromyxin was given orally, Azithromyxin and early S. miltiorrhiza given, or Azithromyxin and later S. miltiorrhiza given. After 10 weeks, observe the change of oviduct of mice, observe the histopathologic change and analysis collagen histochemical index.

RESULT3 Treatment groups induce tubal occlusion and hydrosalpinx decreased and the collagen histochemical index decreased significantly than those of no treatment given (P < 0.05). Early S. miltiorrhiza given group induce tubal occlusion and hydrosalpinx decreased and the collagen histochemical index decreased significantly than only Azithromyxin group or later S. miltiorrhiza given group (P <0.05).

CONCLUSIONWhen we treat CTS genital infection with Azithromyxin, if we can give S. miltiorrhiza treatment as early as possible, it may decrease tubal occlusion and hydrosalpinx. significantly inhibit fibrosis maybe one of its pharmacologic mechanismin.

Animals ; Chlamydia Infections ; complications ; drug therapy ; microbiology ; Chlamydia trachomatis ; drug effects ; Drugs, Chinese Herbal ; isolation & purification ; therapeutic use ; Fallopian Tube Diseases ; etiology ; prevention & control ; Fallopian Tubes ; drug effects ; pathology ; Female ; Fibrosis ; Mice ; Mice, Inbred C3H ; Phytotherapy ; Plants, Medicinal ; chemistry ; Random Allocation ; Salpingitis ; complications ; drug therapy ; Salvia miltiorrhiza ; chemistry

This study examined the value of volume rendering (VR) interpretation in assessing the growth of pulmonary nodular ground-glass opacity (nGGO).A total of 47 nGGOs (average size,9.5mm; range,5.7-20.6 mm) were observed by CT scanning at different time under identical parameter settings.The growth of nGGO was analyzed by three radiologists by comparing the thin slice (TS) CT images of initial and repeat scans with side-by-side cine mode.One week later synchronized VR images of the two scans were compared by side-by-side cine mode to evaluate the nGGO growth.The nodule growth was rated on a 5-degree scale:notable growth,slight growth,dubious growth,stagnant growth,shrinkage.Growth standard was defined as:Density increase ≥ 30 HU and (or) diameter increase (by 20％ in nodules ≥10 mm,30％ in nodules of 5-9 mm).Receiver operating characteristic (ROC) was performed.The results showed that 32 nGGOs met the growth criteria (29 nGGOs showed an increase in density; 1 nGGO showed an increase in diameter; 2 nGGOs showed an increase in both diameter and density).Area under ROC curve revealed that the performance with VR interpretation was better than that with TS interpretation (P＜0.01,P＜0.05 and P＜0.05 for observers A,B and C respectively).Consistency between different observers was excellent with both VR interpretation (κ=0.89 for observers A&C,A&B,B&C) and TS interpretation (κ=0.71 for A&B,κ=0.68 for A&C,κ=0.74 for B&C),but time spending was less with VR interpretation than with TS interpretation (P＜0.0001,P＜0.0001 and P＜0.05for observers A,B and C,respectively).It was concluded that VR is a useful technique for evaluating the growth of nGGO.

OBJECTIVETo investigate the reconstruction of wide vermilion and orbicularis oris muscle defect with satisfactory outcome of aesthetics, sensation, and function.

METHODSThe buccal musculomucosal flap based on the anterior buccal branches of the facial artery was used to reconstruct wide defect of vermilion and orbicularis oris muscle on upper or lower lip.

RESULTS7 patients were treated. 5 cases had no postoperative complication. Partial mucosal necrosis on the tip of the flaps happened in 2 cases, but the underlying muscle survived and was re-mucosalized spontaneously. No other complication was observed. The sensation of cold, heat and touch could be detected on the first postoperative day. Electromyographic and electron microscopic studies confirmed innervation of the muscle in the flap.

CONCLUSIONSThe buccal musculomucosal flap is a reliable reconstruction option for wide defect of vermilion and orbicularis oris muscle which can' t be reconstructed with conventional method. Satisfactory aesthetic and functional results can be achieved with the buccal musculomucosal flap.

Adolescent ; Adult ; Cheek ; Facial Muscles ; pathology ; transplantation ; Female ; Follow-Up Studies ; Humans ; Lip ; pathology ; Male ; Middle Aged ; Mouth Mucosa ; transplantation ; Mouth Neoplasms ; pathology ; surgery ; Neoplasm Staging ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps ; Young Adult

BACKGROUND: The osteotomy and prosthesis placement of the traditional total knee arthroplasty is mostly done by visual measurement and lacks more precise measurements. OBJECTIVE: To identify rotational alignment of tibial prosthesis using preoperative calculation of tibial anteroposterior axis by CT scan and to compare the clinical efficacy of tibial prosthesis placement in traditional total knee arthroplasty. METHODS: Data of 50 patients with knee osteoarthritis who underwent primary total knee arthroplasty in Department of Orthopedics, Renmin Hospital of Wuhan University from January 2014 to April 2015 were retrospectively analyzed. All patients were randomly divided into two groups: 23 cases (25 knees) received preoperative CT to measure the tibial anteroposterior axis in CT assistant group; 27 cases (29 knees) received the method of medial 1/3 of the tibial tubercle in traditional surgery group. We recorded operative time and hospital time, pre- and post-operative Hospital for Special Surgery score, patellar score, knee range of motion and Visual Analogue Scale score. At 3 days after surgery, X-ray images were obtained to measure tibial valgus β and tibial slope valgus θ. All operations were performed by the same team. RESULTS AND CONCLUSION: (1) All patients were followed up. There was no significant difference between two groups in the general information (P > 0.05). (2) Operative time, tibial valgus β and tibial slope valgus θ assessed in CT assistant group were better than in traditional surgery group (P < 0.05); there was no significant difference in hospital time between the two groups (P > 0.05). (3) There was no significant difference in Hospital for Special Surgery score, patellar score, range of motion, and Visual Analogue Scale score between the two groups pre-operatively, 1 and 3 months after operation (P > 0.05). However, above indexes were better in the CT assistant group than in the traditional surgery group at 6 months after operation (P < 0.05). (4) Results indicated that the tibial anteroposterior axis measured by CT for guiding tibial prosthesis position was more precise than the traditional surgery to make the femur prosthesis and the tibial prosthesis have better rotating alignment.

OBJECTIVETo investigate the association of the micronucleus (MN) formation in lymphocytes from patients with the malignant degrees of colorectal cancer.

METHODSThe MN test in capillary blood lymphocytes was conducted in 112 patients randomly selected from in-hospital patients before therapy. Experimental data were analyzed by SPSS (v.10.1) software.

RESULTSThe differences in the frequency of MN between 7 pathological types of colorectal cancers and controls were statistically significant (P<0.01). The frequency of MN increased with the decrease of the histological differentiation in colorectal cancer, and the statistically significant differences were seen between low differentiation group and the other differentiation groups in colorectal cancers.

CONCLUSIONThere is a significant correlation between MN formation and the malignant degrees of colorectal cancer, and MN formation will be a useful biomarker for the identification of malignant degrees of colorectal cancer before operation or for the screening of high risk subgroup.

Adult ; Aged ; Aged, 80 and over ; Colorectal Neoplasms ; blood ; genetics ; pathology ; Female ; Humans ; Lymphocytes ; metabolism ; pathology ; Male ; Micronucleus Tests ; methods ; Middle Aged

OBJECTIVEThis paper presents the experience in using the reverse buccinator musculomucosal flap for repairing the defect following excising inverted papilloma of the nose.

METHODSAfter the inverted papilloma of the nose was excised through an endonasal approach, the reverse buccinator musculomucosal flap supplied by the retrograde blood flow of the anterior buccal artery was harvested and sutured to the defect through the ora-nasal tunnel. The procedure was performed on three patients.

RESULTSThe postoperative course was uneventful. All the flaps survived completely.

CONCLUSIONSThe technique provides the solution to prevent nasal stricture from cicatricial contracture after excising inverted papilloma. In the operation, excising the inverted papilloma and repairing the defect was performed simultaneously, saving another operation for the secondary deformity. The technique is also applicable to the treatment of existing cicatricial stricture of the nose.

Humans ; Male ; Middle Aged ; Mouth Mucosa ; transplantation ; Nose Neoplasms ; pathology ; surgery ; Papilloma, Inverted ; pathology ; surgery ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps