Objective To explore the prevalence and clinical significance of metabolic disorder of lipids, glucose and uric acid at different fibrosis stages of patients with chronic hepatitis B (CHB).Methods From January 2006 to December 2014, 1 812 CHB patients in Department of Infectious Diseases, Shunde Hospital of Southern Medical University were retrospectively enrolled and analyzed.All biochemistry indexes were obtained by automatic biochemical instrument.Polymerase chain reaction was used for detecting serum hepatitis B virus (HBV) DNA, and particles immune detection kit was used for detecting hepatitis B e antigen (HBeAg).In statistical analyses, chi-square test, nonparametric test and Logistic analysis were used.Results The metabolic disorder prevalence in 1 812 CHB patients was as follows, 455 cases (25.1%) with decreased high density lipoprotein, 435 cases (24.0%) with increased uric acid, 342 cases (18.9%) with increased total cholesterol, 254 cases (14.0%) with increased triglyceride, 171 cases (9.4%) with decreased apolipoprotein A, 165 cases (9.1%) with increased apolipoprotein B, 162 cases (8.9%) with increased low density lipoprotein and 117 cases (6.5%) increased fasting blood glucose.Patients who had mild liver fibrosis tended to have metabolic disorders of uric acid (26.4%), total cholesterol (22.8%) and high density lipoprotein cholesterol (20.5%).Patients who had moderate liver fibrosis tended to have metabolic disorders of high density lipoprotein (27.2%) and uric acid (20.9%).Patients who had severe liver fibrosis tended to have metabolic disorders of high density lipoprotein (33.6%) and uric acid (22.2%).Multivariate Logistic regression analysis showed that inflammation activty (OR=17.31, 95% CI: 13.410-22.336, P=0.001), age (OR=1.019, 95%CI:1.005-1.035, P=0.010), sex (OR=1.497, 95% CI: 1.061-2.111, P=0.022), apolipoprotein A (OR=0.50, 95% CI: 0.281-0.892, P=0.019) and HBV DNA (OR=0.904, 95% CI: 0.858-0.952, P=0.001) may be independent predictors of moderate and severe liver fibrosis.Conclusions CHB patients with mild liver fibrosis tend to have metabolic disorders of uric acid, total cholesterol and high density lipoprotein cholesterol;patients with moderate liver fibrosis tend to have metabolic disorders of high density lipoprotein and uric acid;and patients with severe liver fibrosis tend to have metabolic disorders of high density lipoprotein and uric acid.

Objective To explore the characteristics and the long-term trend of suicidal deaths among the rural population in Hubei province. Methods Data on suicide deaths from 1984 through 2008 were released from Macheng Death Registration System and analyzed by year, gender and age. Results The suicidal death rates were decreasing during the last 25 years in Macheng city, with the standardized suicide mortality rapidly decreasing from 113.29/100 000 in 1984 to 20.11/100 000 in 2008. The proportion of suicide deaths in the total deaths caused by injuries were declining but not obviously. Suicide was still the leading cause of deaths among all the deaths due to injuries.Number of suicidal deaths among females was outnumbered the males during the last 25 years,representing 50%-60% in total suicide deaths annually. The proportion of suicide deaths among the elderly aged 65 and over had significantly increased in the recent years, which accounting for 46.81% of all the suicidal deaths in 2008. Conclusion Suicide remained the leading cause of injury deaths among the population in this area, especially in females. Attention should be paid to the females and the elderly aged 65 and over,in the rural areas.

OBJECTIVE: To detect the activation pattern of the thalamus in human by the functional magnetic resonance imaging (fMRI) with the electrical stimulation of different intensities, and to explore the mechanism of this area in pain modulation. METHODS: Ten healthy right-handed volunteers were given different electrical stimulations of 1-, 2-, and 3- times pain threshold respectively. The whole-brain was scanned simultaneously by GE 1.5T magnetic resonance imaging system. The data were postprocessed by analysis of functional neuroimages (AFNI) to establish the regional activity maps of the thalamus. RESULTS: Patterns of functional activity showed a positive linear relationship between the activation signals and stimulation intensity in bilateral thalamus, whereas the BOLD signal of bilateral medial thalamus demonstrated that the curve was similar to the exponential function. Meanwhile, the activation in the contralateral lateral thalamus (cThl), but not the contralateral medial thalamus (cThm), was prominent compared with the corresponding ipsilateral subregions, and only the lateral thalamus displayed a contralateral biased representation while the medial thalamus lacked this property. CONCLUSION Thalamus is one of the vital components in the pain modulation network, which can present spatial segregation activations with unique characteristics of stimulation intensity-response in each subregion. All the results are helpful to understand the crucial role of thalamus in processing the pain information.
Adult ; Electric Stimulation ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Pain ; physiopathology ; Pain Threshold ; Thalamus ; physiology

Biopsy ; Humans ; Liver

OBJECTIVETo evaluate the efficacy and safety of video-assisted thoracoscopic (VATS) esophagectomy in the treatment of esophageal cancer.

METHODSFrom June 2004 to October 2007, video-assisted thoracoscopic esophagectomy was performed in 36 patients, including 29 men and 7 women with median age of 58.9 years old. The cancer located at upper segment in 5 cases, middle 25 cases and lower 6 cases. VATS approach was used to mobilize the intrathoracic esophagus and stomach was mobilized by open approach. Esophagogastric anastomosis was performed in the left neck.

RESULTSThe mean operative time was 250 minutes (190-330 min) and average time of VATS was 70 minutes. The mean hospital stay was 8.7 days. Mean lymph node harvest was 14.3 nodes. Post-operative complications occurred in 11 patients(30.6%), but no perioperative death occurred.

CONCLUSIONVideo-assisted thoracoscopic esophagectomy is technically feasible and safe with lower morbidity and shorter hospital stay as compared to open procedure, and may replace the open esophagectomy in selected patients.

Esophageal Neoplasms ; surgery ; Esophagectomy ; methods ; Female ; Humans ; Male ; Middle Aged ; Thoracic Surgery, Video-Assisted

Objective To observe the effects of loading doses of rosuvastatin in treatment of acute cerebral infarction and influence on cerebral hemodynamics.Methods One hundred and twenty-six patients of acute cerebral infarction who were admitted into hospital from January 2014 to June 2016 were selected and randomly divided into the observation group(63 cases,loading doses of rosuvastatin,40 mg per day at the first time,and then 20 mg per day)and the control group(63 cases,routine doses of rosuvastatin,10 mg per day),and one course lasted for 3 months.The NIHSS scores and Barthel index before treatment,1 month and 3 months after treatment were compared,as well as the clinical effects and cerebral hemodynamics changes 3 months after treatment.Results The NIHSS scores of the observation group at 1 month and 3 months after treatment were respectively lower than those of control group with statistical significance(P<0.05),and scores of the Barthel index of the observation group were higher than those of the control group with statistical significance(P<0.05).The total effective rate in the observation group was 88.89%,which was higher than that of the control group(77.78%),but the difference was not statistically significant(P>0.05).After the treatment,bilateral pulsation index(PI)of the observation group were lower than those of the control group (P<0.05).Systolic blood flow velocity(Vs)and mean blood flow velocity(Vm)were higher than those in the control group(P<0.05). The difference of adverse reaction between 2 groups was not statistically significant(P>0.05).Conclusion Loading doses of rosuvastatin can achieve better curative efficacy in treatment of patients with acute cerebral infarction and better improvement of cerebral hemodynamics.

OBJECTIVETo evaluate the effects of the combination of basic fibroblast growth factor (bFGF), transforming growth factor-Β1 (TGF-Β1), bone marrow mesenchymal stem cells (BMSCs), and temperature-responsive chitosan hydrogel (TCH) gel on the repair of degenerative intervertebral disc in rat models.

METHODSRat models of intervertebral disc degeneration were established by acupuncture. The degenerative effects were observed under magnetic resonance imaging (MRI). The BMSCs was cultured in vitro and then transfected by adenovirus with enhanced green fluorescent protein to make it carry the gene of enhanced green fluorescent protein,which functioned as fluorescence labeling. The SD rat models of intervertebral disc degeneration were divided into four groups: group A, treated with the combination of bFGF, TGF-Β1,BMSCs,and TCH gel; group B, treated with the combination of BMSCs and TCH gel;group C, treated with the combination of bFGF,TGF-Β1, and TCH gel;and group D, treated with PBS buffer solution. After the corresponding reagents were injected into the degenerative intervertebral discs of each group, the rats were cultivated for another four weeks and then the repair effects of the intervertebral discs were observed under MRI. Furthermore,the intervertebral discs of each group were taken out and observed by HE and Masson staining. The nucleus pulposus was aspirated and the expressions of aggrecan,collagen 2,Sox-9,and collagen I of nucleus pulposus of each group were tested by reverse transcription polymerase chain reaction and Western blot.

RESULTSThe transplanted BMSCs survived in the intervertebral disc and differentiated into nucleus pulposus-like cells. MRI showed that:the signal intensity of the nucleus pulposus of group A was much higher than that of the rest groups, the signal intensity of group B was higher than that of group C, and the signal intensity of group D was the lowest,in which the dura mater spinalis was in compression and the spinal cord changed in beaded shape. The differences of the Pfirrmann grading among the four groups had statistical significance (P<0.05). The results of the HE and Masson stains showed:the intervertebral disc of group A was well-structured,the quantity of nucleus pulposus cells was larger than that of the other three groups,and the boundary between the nucleus pulposus and the annulus fibrosus was clearly defined;the quantity of the nucleus pulposus cells of group B was larger than that of group C, and the broken annulus fibrosus was not observed in group B, while the broken annulus fibrosus could be observed in group C; and, the nucleus pulposus cells of group D were replaced by fibrous tissue. The results of the reverse transcription polymerase chain reaction and Western blot tests showed that,in terms of the expressions of aggrecan,collagen 2 and Sox-9,group A was the highest, followed by group B,group C,and group D (P<0.05); in terms of the expression of collagen 1,there was no obvious difference among these four groups (P>0.05).

CONCLUSIONSThe transplanted BMSCs can survive in the degenerative intervertebral disc and differentiate into nucleus pulposus-like cells. The combination of bFGF, TGF-Β1, BMSCs,and TCH gel has obvious repair effect on the degenerative intervertebral discs. The effect of the combination of BMSCs and TCH gel on transplantation therapy of the degenerative intervertebral discs is better than that of the combination of bFGF, TGF-Β1 and TCH gel but worse than that of the combination of bFGF, TGF-Β1, BMSCs, and TCH gel.

Animals ; Bone Marrow Cells ; Bone Marrow Transplantation ; Cell Differentiation ; Collagen ; Disease Models, Animal ; Fibroblast Growth Factor 2 ; Hematopoietic Stem Cells ; Intervertebral Disc ; Intervertebral Disc Degeneration ; Rats ; Rats, Sprague-Dawley ; Transforming Growth Factor beta1 ; Wound Healing

OBJECTIVES: To investigate the risk factors for neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture and establish a nomogram model for predicting the risk of neonatal asphyxia. METHODS: A retrospective study was conducted with 613 cases of neonatal asphyxia treated in 20 cooperative hospitals in Enshi Tujia and Miao Autonomous Prefecture from January to December 2019 as the asphyxia group, and 988 randomly selected non-asphyxia neonates born and admitted to the neonatology department of these hospitals during the same period as the control group. Univariate and multivariate analyses were used to identify risk factors for neonatal asphyxia. R software (4.2.2) was used to establish a nomogram model. Receiver operator characteristic curve, calibration curve, and decision curve analysis were used to assess the discrimination, calibration, and clinical usefulness of the model for predicting the risk of neonatal asphyxia, respectively. RESULTS: Multivariate logistic regression analysis showed that minority (Tujia), male sex, premature birth, congenital malformations, abnormal fetal position, intrauterine distress, maternal occupation as a farmer, education level below high school, fewer than 9 prenatal check-ups, threatened abortion, abnormal umbilical cord, abnormal amniotic fluid, placenta previa, abruptio placentae, emergency caesarean section, and assisted delivery were independent risk factors for neonatal asphyxia (P<0.05). The area under the curve of the model for predicting the risk of neonatal asphyxia based on these risk factors was 0.748 (95%CI: 0.723-0.772). The calibration curve indicated high accuracy of the model for predicting the risk of neonatal asphyxia. The decision curve analysis showed that the model could provide a higher net benefit for neonates at risk of asphyxia. CONCLUSIONS The risk factors for neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture are multifactorial, and the nomogram model based on these factors has good value in predicting the risk of neonatal asphyxia, which can help clinicians identify neonates at high risk of asphyxia early, and reduce the incidence of neonatal asphyxia.
Infant, Newborn ; Humans ; Male ; Pregnancy ; Female ; Nomograms ; Retrospective Studies ; Cesarean Section ; Risk Factors ; Asphyxia Neonatorum/etiology*

OBJECTIVE: To evaluate clinical characteristics and treatment response of 100 patients with pure red cell aplasia(PRCA).METHODS: We retrospectively analyzed the clinical data of 100 adult patients with acquired PRCA from October2009 to July 2019, and compared the difference in efficacy between idiopathic and secondary patients.RESULTS: 100 patients were evaluated, including 60 idiopathic patients and 40 secondary patients.The most common reasons for secondary PRCA were large granular lymphocytic leukemia(LGLL)(28 cases,70.0%)and thymoma(6 cases, 15.0%). The remission induced regimens included corticosteroids(CS), cyclosporine A(CsA), or other agents, and the response rate were 66.7%,71.4% and 50%, respectively(P=0.336). Secondary PRCA was less effective than idiopathic PRCA(52.5%,78.3%,P=0.007). PRCA related to large granular lymphocytic leukemia was also less effective compared to idiopathic PRCA(46.4%,79.3%,P=0.003). When treated by CsA, idiopathic PRCA was more effective than secondary PRCA and LGLL related PRCA(P=0.001, P=0.000). Logistic regression analysis showed that lower response rate was related to secondary PRCA and LGLL related PRCA.CONCLUSION: The response rate were similar by different induced regimens. Idiopathic PRCA could acquired better response to CsA than secondary, LGLL related PRCA was less effective to treatment.

Objective: To explore the relationship of physical activity and sedentary leisure time with muscle mass, strength, and quality in Chinese adults. Methods: Based on the second resurvey of China Kadoorie Biobank (CKB) in 2013-2014, logistic regression models were used to analyze the correlation of physical activity and sedentary leisure time with low muscle mass, grip strength, and muscle quality. Results: A total of 24 245 participants were included in the analysis. The average daily physical activity level was (18.3±13.8) MET-h/d, and the sedentary leisure time was (4.4±1.9) hours. We took the lowest physical activity quartile as the reference and found that the participants' physical activity was negatively correlated to low muscle mass, strength, and quality. The ORs (95%CIs) of low appendicular skeletal muscle mass index (ASMI), low total skeletal muscle mass index (TSMI), low grip strength and low arm muscle quality (AMQ) were 0.68 (0.60-0.77), 0.66 (0.58-0.75), 0.82 (0.72-0.94) and 0.84 (0.74-0.95), respectively. The subtypes of physical activity, including those related to work, transportation, housework, and leisure, also showed negative correlations with low muscle mass, strength, and quality to varying degrees. Compared with participants with the shortest sedentary leisure time, those who had the longest were more likely to have low TSMI (OR=1.13, 95%CI: 0.99-1.30). Conclusions: Physical activity was negatively correlated with a lower risk of low muscle mass and strength, while longer sedentary leisure time positively correlated with low muscle mass.
Adult ; China ; Exercise ; Humans ; Leisure Activities ; Muscles ; Sedentary Behavior