OBJECTIVETo investigate the distribution of hepatitis B virus (HBV) genotype in Guizhou and to study the relationship between the genotype and the progression of liver disease.

METHODS786 patients with chronic HBV infection, from 4 cities of Guizhou, including 346 asymptomatic carriers (ASC), 313 chronic hepatitis (CH), 77 liver cirrhosis (LC), 50 hepatocellular carcinoma (HCC) were examined. HBV genotype was determined by restriction fragment length polymorphism analysis and the subtypes were determined by direct sequencing of PCR product in 94 patients with HBV B genotype, the relationship between HBV genotype and the progression of liver disease was studied by multifactor analysis such as HBeAg positivity, HBV DNA load and ALT level.

RESULTSOf the 786 patients, 7 (0.89%), 497 (63.23%), 275 (34.99%), and 7 (0.89%) belonged to genotype A, B, C, D, respectively. There was statistically significant difference in the distribution of genotype B among Kaili (96.04%), Zunyi (78.79%), Duyun (64.52%) and Guiyang (53.14%) (P< 0.01). Genotype C was more prevalent in Guiyang than in other three cities (P < 0.01, or P < 0.05). Out of 94 genotypes B, 93 (98.94%) belonged to subtype Ba, only one was subtype Bj. There were statistically significant difference in the distribution of genotype B and C among various stage of liver disease (P < 0.05 or P < 0.01). Genotype B showed a gradual decrease from ASC, CH, LC to the HCC group while in contrast, genotype C showed a gradual increase in the same order. The ALT levels and the mean age were significantly higher and older in patients with genotype C than those in genotype B (P < 0.01 or 0.05). The HBeAg positivity was significantly lower in genotype C than that in genotype B (P < 0.025).

CONCLUSIONData showed that there were genotype A, B, C and D existing in Guizhou. Genotype B was the major one but genotype C was more commonly seen. In genotype B, subtype Ba appeared to be predominant. The geographic distribution of genotype B and C were different in some cities of Guizhou. Compared to genotype B, genotype C was associated with the development of more severe liver damage.

Carcinoma, Hepatocellular ; pathology ; virology ; DNA, Viral ; analysis ; Disease Progression ; Genotype ; Hepatitis B virus ; classification ; genetics ; Hepatitis B, Chronic ; genetics ; pathology ; Humans ; Liver ; pathology ; Liver Cirrhosis ; pathology ; virology ; Liver Neoplasms ; pathology ; virology ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length

Objective To explore the influence to nursing efficiency using exposed wound care ( EWC) at different time point after finger replantation. Methods 60S patients after finger replantation were recruited according to selection criteria and were randomly divided into 4 groups. 136 cases in group A were treated with EWC without gauze dressing cover 1 to 2 hours after operation. 183 cases in group B were treated with EWC 6 to 8 hours after operation. 159 cases group C were treated with EWC 12 to 24 hours after operation. 127 cases in group D were treated with gauze dresssing cover all the time until taking the stiches out ( 14 days). Blood circulation, wound infection, finger survival rate, medical costs were observed and compared among 4 groups. Results Compared with the other 3 groups, group B had better outcomes including blood circulation, wound infection, survival rate and medical costs of replanted finger. The EWC therapy could decrease expenditures of inpatient, length of stay, and incidence of complications. Conclusions The EWC therapy should be used 6 to 8 hours after operation when dressing oozing did not dry completely. That therapy can decrease the incidence of blood vessel crisis of replanted finger, reduce medical expenditures and improve survival rate of replanted finger.

Objective To explore the rehabilitation effect of mapping method on the rehabilitation training among around the Knee Joint Fracture patients.Methods The clinical data were retrospectively analyzed and compared from 90 cases with knee fractures between July 2011 and December 2011,who were treated with operation.Forty-five patients who injuried between October and December were as experimental group that received routine nursing and the health education by mapping method and other 45 cases were as control group that only received routine nursing.Rehabilitation effect indexes that we observed were HSS score and compliance.Results After 12 weeks of operation,the HSS score of experimental group was significantly higher than that of control group [(84.3 ± 3.8) vs (76.8 ± 4.3); t =8.77,P ＜ 0.01].And significant difference was found in the patients' compliance (U =53.10,P ＜ 0.01)and the rank of HSS score between experimental group and control group (x2 =8.0,P ＜ 0.01).Conclusions Good clinical outcomes could be obtained with mapping nursing.

Objective To observe the effect and safety of intravenous morphine and epidural combination of morphine and bupivacaine in children after pelvic triple osteotomy and discuss postoperative nursing methods.Methods 48 children who had received pelvic triple osteotomy from January 2011 to March 2012 in Shanghai 6th Hospital were chosen and randomly divided into the intravenous morphine group (Group A),epidural combination of morphine and bupivacaine group (Group B) and the control group (Group C).OPS was used to record analgesic effect 2,4,8,12,24 and 48 hours after operation as well as the incidence rate of adverse events.Results There were no statistically significant differences in analgesic effect 4,8,12,24 and 48 hours after operation between Group A and Group B (x2 =1.000,0.356,0.356,1.000,1.000,respectively;P ＞0.05).And the effect in both groups were obviously better in that in Group C (P ＜0.05).The incidence rate of adverse events was 81.2％ in Group A,12.5％ in Group B,50.5％ in Group C,and the differences were statistically significant (z =14.877,P ＜ 0.01).The rate in Group A was higher than that in both Group B and Group C,and the differences were statistically significant (x2 =14.710,5.073,respectively;P ＜ 0.05).Conclusions Epidural combination of morphine and bupivacaine has better analgesic effect on children after pelvic triple osteotomy and lower incidence rate of adverse events.Nurses should provide safe and effective analgesic nursing to promote their recovery and improve the satisfaction rate of children and their parents.

Objective To study the incidence of anxiety and depression among patients with osteosarcoma so as to analyze its influencing factors.Methods Between January 2010 and December 2011,94 hospitalized patients with osteosarcoma were investigated with self-rated anxiety scale ( Self-rating Anxiety Scale,SAS) and self-rated depression scale (Self-rating Depression Scale,SDS),then analyzed the influencing factors.Results And the incidence of anxiety and depression was 27.7％ and 44.7％,respectively.The total score of SAS and SDS of patients with osteosarcoma (44.95 ± 11.11) and (50.22 ± 12.40),was significantly higher than that of the national norm[ ( 33.80 ± 5.90 ),(41.85 ± 10.57 ) ; t =6.878,4.629,respectively;P＜0.01].Logistic analysis showed that gender,disease stage and education were the influencing factors for anxiety and depression of patients with osteosarcoma.Conclusions Patients with osteosarcoma are easily have the mental problems of anxiety and depression,so psychological interventions,social support and necessary medicine treatment are necessary for osteosarcoma patients with anxiety and depression.

Female ; Humans ; Mass Screening ; Polysomnography ; Pregnancy ; Sleep Apnea, Obstructive/diagnosis*

Objective: This study aims to investigate the sleep quality of pregnant women in Xuhui District, Shanghai, and the related factors of sleep disturbances during pregnancy. Methods: From February 2019 to February 2021, we used online integrated sleep questionnaire (including PSQI, BQ, ESS, AIS) in Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, The International Peace Maternity and Child Health Hospitals of China Welfare Institution, and Shanghai Eighth People's Hospital, to investigate the sleep quality across pregnancy. We also collected maternal physical examination results, childbearing history, sociodemographic, and other clinical data. The prevalences and related factors of various sleep disturbances in pregnant women were analyzed, including insufficient/excessive nighttime sleep, low sleep efficiency, difficulty falling asleep, poor sleep quality, insomnia, daytime sleepiness, and high risk of sleep-disordered breathing (SDB). Results: This study includes 1 898 cases in the first trimester (T1), 3 099 cases in the second trimester (T2), and 1 539 cases in the third trimester (T3). Poor sleep quality (38.6%), daytime sleepiness (mild 41.9%, moderate 17.7%, severe 2.1%), and suspicious insomnia (32.3%) are most prevalent among women in T1 (P<0.01). In comparison, short sleep time (2.7%), long sleep time (8.6%), difficulty falling asleep (12.2%), poor sleep efficiency (35.4%), very poor sleep quality (6.7%), clinical insomnia (21.8%), and high-risk SDB (6.4%) are most prevalent among women in T3 (P<0.05). During pregnancy, late gestation (OR=1.016, 95%CI: 1.006-1.025) and multiple induced/drug abortions (OR=1.329, 95%CI: 1.043-1.692) are risk factors for poor sleep quality (PSQI>5), while multiple full-term deliveries (OR=0.800, 95%CI: 0.675-0.949) is its protective factor. Advanced maternal age (OR=0.976, 95%CI: 0.956-0.997), multiple full-term deliveries (OR=0.808, 95%CI: 0.680-0.959), late gestation (OR=0.983, 95%CI: 0.974-0.992) and hypertension (OR=0.572, 95%CI: 0.401-0.814) are protective factors for daytime sleepiness (ESS>6). The high-risk pregnancy category (OR=9.312, 95%CI: 1.156-74.978) is a risk factor for insomnia (AIS≥4), while multiple full-term deliveries (OR=0.815, 95%CI: 0.691-0.961) is its protective factor. High BMI (OR=1.334, 95%CI: 1.270-1.402) and hypertension (OR=4.427, 95%CI: 2.539-7.719) are risk factors for high-risk SDB in pregnant women. Conclusions: The prevalences of various sleep disturbances are high throughout pregnancy. Noticeably, symptoms of maternal SDB develop along with pregnancy. Different types of sleep disturbances are associated with different factors. Women of high-risk pregnancy category, in late gestation, with high BMI, hypertension, a history of induced/drug abortion, or without a history of full-term delivery can be at high risk of sleep disturbances during pregnancy.
Child ; China/epidemiology* ; Cross-Sectional Studies ; Female ; Humans ; Pregnancy ; Pregnancy Complications/epidemiology* ; Pregnant Women ; Sleep ; Sleep Quality