Objective To explore the recurrence of chronic hepatitis B(CHB) after stopping nucleoside (acid) analogue(NAs) and the impact of residual amount of serum hepatitis B virus(HBV) DNA on recurrence. Methods Seventy-nine CHB patients, who received treatment of NAs and achieved standard withdrawal were enrolled in this study. According to lab examination, there were 47 hepatitis B e antigens (HBeAg)-positive patients and 32 HBeAg-negative patients. Meanwhile, 33 CHB patients received lamivudine treatment (LAM group), 27 CHB patients received adefovir treatment (ADV group), and 19 CHB patients received entecavir treatment (ETV group). The biochemical and virological indicators of CHB patients′recurrence would be recorded after 48 weeks. Results There were 43 CHB patients (54.4%), whose indicators of HBV DNA turned positive after discontinuity of treatment with NAs of 48 weeks. There were 27 CHB patients (55.3%), the HBV DNA of whom turned positive among 47 HBeAg-positive patients, and 17 patients(53.1%) among 32 HBeAg-negative patients, and there was no significant difference (P>0.05). In addition, the positive conversion rate after stopping treatment with NAs of 48 weeks in LAM group, ADV group and ETV group had no significant difference:54.5%(18/33), 51.9%(14/27), 11/19, P > 0.05. Moreover, there were 36 patients (45.6%) whose index of alanine aminotransferase(ALT) increased again after discontinuity of treatment with NAs of 48 weeks . There were 20 CHB patients (42.6%) in HBeAg-positive patients, and 16 patients (50.0%) in HBeAg-negative patients, and there was no significant difference (P>0.05). The rate of ALT increase again in LAM group, ADV group and ETV group had no significant difference: 48.5%(16/33), 40.7%(11/27), and 9/19, P >0.05. According to the results of serum samples of 79 CHB patients with Roche reagent when stopping using NAs, in 35 CHB patients (44.3%) serum HBV DNA>12 × 103 U/L was detected. However, serum HBV DNA>5 × 105 U/L was detected in 25 CHB patients (71.4%)among 35 patients with serum HBV DNA > 12 × 103 U/L after 48 weeks, and merely in 18 CHB patients (40.9%) among 44 patients with serum HBV DNA < 12 × 103 U/L, and there was significant difference (P < 0.01). Conclusions The CHB patients with standard withdrawal still have high recurrence rate after stopping treating, whatever medicine was used. Then, residual amount of serum HBV DNA is an important indicator for predicting relapse of CHB. Meanwhile, the retreatment of these patients should be researched further.

The placement of the flexible ureteroscopic sheath during lithotripsy may injure the ureter. We have developed a double-tube flexible ureteral access sheath. Thirteen patients with renal calculi were treated with double-tube and flexible sheath in one stage. CT examination of 13 cases showed that the ureter was normal. The double-tube flexible ureteral access sheath makes the operation of sheathing easy, safe and effective.

Objective To explore the correlation between gait parameters at 14 days and knee function and quality of life at 3 months after total knee arthroplasty (TKA). Methods Eighteen patients who underwent TKA were analyzed by using three-dimensional gait analysis system to observe their gait parameters. Knee joint function and life quality of the patients at 3 months after TKA were evaluated with WOMAC (Western Ontario and McMaster Universities Arthritis Index) and SF-36 (short form 36-item health survey scores) assessment scale and their correlations were analyzed simultaneously. Results At 14 days after TKA, single support time (SST) and peak knee flexion at swing (PKF) of the operated side of the leg were significantly smaller than those of the healthy side of the leg. The knee flexion angle at mid-stance (MKF) and knee valgus angle at mid-stance (MKV) of the operated side of the leg were significantly larger than those of the healthy side of the leg. There was a moderate negative correlation between the spatiotemporal parameters of the operated side of the leg and the WOMAC score during gait, while a high correlation between the WOMAC score and peak knee flexion at swing (PKF), MKF and MKV. Except for the step length and forward velocity, the other gait parameters were significantly correlated with SF-36 life quality score. The single support time (SST) and PKF had a highly positive correlation, while the MKF and MKV had a moderate negative correlation with SF-36 life quality score. Conclusions The SST, MKF, MKV and PKF in postoperative early gait analysis (14 days) results can be used as the effective indicators to judge postoperative knee function and rehabilitation efficacy of life quality after TKA surgery.