With the appearance and development of ultrasonic surgical installation, ultrasonic therapy enters on a new epoch. High-amplitude and high-power ultrasonic vibration produced during the operation, ultrasonic surgical installation can be used to decrease the amount of bleeding or stop bleeding according to the acoustic properties of different tissues. The part where pathological changes happen can be excised selectively by ultrasonic surgical installation. This article introduces the principle, structure, classification and clinical application of ultrasonic surgical installation in detail.

OBJECTIVETo study the efficacy of Xiaoyao Powder (XYP) combined with interferon alpha (IFN-alpha) in treating HBeAg positive chronic hepatitis B (CHB) patients and the effect on their quality of life (QOL).

METHODSTotally 193 patients with HBeAg-positive CHB confirmed by liver biopsy were randomly assigned to 2 groups, Group A (94 cases) and Group B (99 cases). IFN-alpha1b was subcutaneously injected to patients in Group A at the dose of 50 microg, thrice per week. Those in Group B additionally took XYP. The therapeutic course for all was 24 weeks. Clinical efficacy was observed by assessing ALT restoration rate, HBeAg negative rate, HBeAg conversion rate, HBV DNA negative rate, complete response rate, partial response rate, and symptoms integral. The evaluation of QOL was performed by using chronic liver disease questionnaire (CLDQ) score. Adverse reaction occurrence rate was observed in the two groups.

RESULTSBetter effects were obtained in Group A on ALT restoration rate, HBeAg negative rate, HBV DNA negative rate, complete response rate, partial response rate, TCM symptoms integral, the total effective rate of TCM sysmptoms, CLDQ score, and adverse reaction rates, showing statistical difference when compared with Group B (P < 0.05, P < 0.01).

CONCLUSIONXYP could elevate the efficacy of TCM symptoms of HBeAg-positive CHB patients and anti-viral effect, improve their QOL, and reduce adverse reaction of IFN-alpha.

Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Hepatitis B e Antigens ; Hepatitis B, Chronic ; drug therapy ; Humans ; Interferon-alpha ; therapeutic use ; Male ; Quality of Life ; Treatment Outcome

Objective To investigate the effect of long-term antiviral treatment on clinical outcome and liver histology in patients with hepatitis B virus ( HBV)-related compensated cirrhosis .Methods A total of 61 patients with HBV-related compensated cirrhosis receiving antiviral therapy were enrolled from Taizhou Hospital of Zhejiang Province during September 2010 and March 2015, including 26 HBeAg-positive cases and 35 HBeAg-negative cases .Thirty-nine patients were treated with entecavir ( ETV ) and 22 were treated with adefovir dipivoxil ( ADV ) .Biochemical , serological and virological markers were examined every 3 months during treatment, and Child-Turcotte-Pugh (CTP) scores were calculated.All the patients underwent liver biopsy before and 144 weeks after antiviral treatment .Metavir scoring system was used to evaluate the liver histological activity ( A) and fibrosis score ( F) .Wilcoxon rank sum test and paired t-test were used for the evaluation of liver histopathology and liver function before and after treatment , respectively.Results After 144 weeks of antiviral treatment , HBV DNA was reduced and below the lower limit of detection in 58 patients (95.1%), HBeAg disappeared in 14 patients (14/26, 53.8%), and HBeAg seroconversion was observed in 10 patients (10/26, 38.5%); alanine aminotransferase ( ALT), aspartate amino transaminase (AST), total bilirubin (TBil) and CTP score decreased (t=7.489, 8.259, 14.000 and 6.026, all P<0.01), prothrombin time (PT) was shortened (t=9.777, P<0.01), and serum albumin (Alb) increased (t=3.446, P<0.01).Improvements in both liver histologic activity and fibrosis score were observed (Z=5.716 and 6.657, all P<0.01).Liver histological activity decreased from A1 to A0 in 16 cases, from A2 to A0 in 9 cases, from A2 to A1 in 15 cases, from A3 to A0 in 1 case, from A3 to A1 in 5 cases, and from A3 to A2 in 5 cases.Fibrosis score at the baseline was F 4 for all patients, while after treatment, there were 7 patients with F1, 22 with F2, 20 with F3, and F4 remained in rest 12 patients.Conclusion Both clinical and histological improvements can be obtained after long-term antiviral treatment for patients with HBV-related compensated cirrhosis .

Objective To clinically observe and verificate the advantages of treating infantile anorexia of spleen-dysfunction in transportation with infantile massage and Chinese medicine based on the thought of “invigo-rating spleen and nourishing qi”. Methods Multi-central large-sample randomized controlled trial was carried out in Guangzhou, Shenzhen, and Foshan. Five hundreds cases of infantile anorexia of spleen-dysfunction in transportation were randomized into infantile massage group, Chinese medicine group, infantile massage combined with Chinese medicine group and Western medicine group and two sessions of treatment were required in each group. Separately, during the enrollment, after 2 sessions of treatment, infantile anorexia signs and symptoms scale , the related therapeutic effect criterion from clinical guideline of new drugs for traditional Chinese medicine, the expression level of hemoglobin and blood zinc were adopted for efficacy assessment. Results A mong 4 groups , the recovery rate and the total effective rate of infantile massage combined with Chinese medicine group were better than those of other groups (P < 0.05). The expression level of hemoglobin and blood zinc of 4 groups both increased obviously (all P < 0.01), but more improvement was found in infantile massage combined with Chinese medicine group (both P < 0.05). Conclusion The treatment of infantile anorexia with infantile massage and Chinese medicine based on the thought of invigorating spleen and nourishing qi has a significant effect.

To observe whether plasma levels of lysophosphatidic acid (LPA) can be decreased in patients with cerebrovascular diseases after the treatment with aspirin. Methods:A total of 1,400 patients were recruited. Among them,803 patients were diagnosed as probable ischemic stroke,and 343 patients were diagnosed as ischemic stroke. Thirty-four health volunteers were used as control subjects. The levels of LPA were measured by chromatography with the combination of inorganic phosphorus quantitative method. Results: The levels of LPA in the ischemic cerebrovascular group (3.11 ± 1.55 μmol/L) were significantly higher than those in the control group (1.77 ± 1.04 μmol/L) (P < 0.001). Taking aspirin (80 mg,qd) for one month significantly decreased the levels of LPA. After stopping aspirin for one month,the level of LPA re-elevated (3.90 ± 1.09 μmol/L),was higher than that during administration of aspirin (1.93 ±0.85 μmol/L(P <0.001). Conclusions: There are close correlations between the increased levels of LPA and the platelet activation. Aspirin decreases the level of plasma LPA;this may be one of the mechanisms of aspirin in prevention against ischemic stroke.

Vip3A, a novel insecticidal protein, is secreted by Bacillus thuringiensis (Bt) during vegetative growth. Vip3A protein possesses insecticidal activity against a wild spectrum of lepidopteran insect larvae. Since the first cloning of vip3A gene from Bt, many other vip3A genes have been isolated. To investigate vip3A genes contribution to Bt and reflect the revolution relationships, the strains containing vip3A genes were screened and gene similarity was analyzed. 114 wild-type Bacillus thuringiensis (Bt) strains isolated from different regions and 41 standard Bt strains from the Institute of Pasteur were screened for the vip3A genes using PCR amplification. 39 strains including B. thuringiensis subsp. kurstaki (Btk) HD-1 were found to contain the vip3A genes. Because acrystallerous strain Cry- B derived from Btk HD-1 was proved not to contain vip3A gene, it suppose that the vip3A gene may be located at the plasmids. Vip3A proteins expressed in these strains were detected with polyclonal antibody by Western blot and 4 strains among them were shown not to express the Vip3A proteins. The vip3A genes amplified from wild-type Bacillus thuringiensis strains S101 and 611 with different levels of activity against lepidopteran insect larvae were cloned into pGEM-T Easy vector. Alignment of these 2 putative Vip3A proteins with 6 others (Vip3A (a), Vip3A(b), Vip3A-S, Vip3A-S184, Vip83 and Vip3V) in the GenBank data base and 2 reported Vip3A proteins (Vip14 and Vip15) showed that vip3A genes are highly conservative. The plasmids pOTP-S101 and pOTP-611 were constructed by in- serting 2 vip3A genes (vip3A-S101 and vip3A-611) into the expression vector pQE30 respectively and were transformed into E. coli M15. E. coli M15 cells harboring the pOTP plasmids were induced with 1 mmol/L IPTG to express 89 kDa protein. Experiments showed that the level of soluble proteins of Vip3A-S101 in E. coli M15[pOTP-S101] and Vip3A-611 in E. coli M15 [pOTP-611] were about 48% and 35% respectively. Bioassay showed that each of these Vip3A proteins had similar toxicity against neonate Spodoptera litura larvae, indicating that some amino acids change had little effect on the insecticidal activity of proteins. Although vip3A genes are conservative, the unknown insecticidal spectrum is still to be brought out. Vip3A genes can be used for the construction of the Bt engineered strains and transgenic plants. In addition, vip3A genes are excellent candidates for delay of the pest resistance due to the difference of the action model from that of Bt delta-endotoxins.
Animals ; Bacillus thuringiensis ; genetics ; isolation & purification ; metabolism ; Bacterial Proteins ; genetics ; metabolism ; toxicity ; Blotting, Western ; Electrophoresis, Polyacrylamide Gel ; Insecticides ; metabolism ; toxicity ; Larva ; drug effects ; Models, Biological ; Polymerase Chain Reaction ; Spodoptera ; drug effects ; Toxicity Tests

BACKGROUND:The rabbit model of osteonecrosis of the femoral head (ONFH) has been successfully established by glucocorticoid combined with lipopolysaccharide.OBJECTIVE:To observe the dynamic changes of bone mass in the early steroid-induced ON FH.METHODS:Twenty-four adult New Zealand white rabbits were randomly divided into experimental and control groups (n=12 per group).Rabbits in the experimental group were injected with lipopolysaccharide and glucocorticoid to establish the model of ONFH,while those in the control group given the same volume of normal saline.The changes in the femoral head structure,morphology and distribution of the trabecular bone at 5,1 0,15 and 20 days after modeling were observed through multi-slice spiral CT,micro-CT and hematoxylin-eosin staining;the bone mineral density and rate of empty lacunae were detected.RESULTS AND CONCLUSION:The imaging examinations showed that the rabbit femoral head was intact and smooth in both groups;on days 15 and 20,in the experimental group,the cortical bone became thinner,the trabecular bone became sparse and discontinuous,and the bone mineral density,tissue mineral density and bone volume/total volume were significantly lower than those in the control group (P ＜ 0.01).The histological observation indicated that there were more empty lacunae and adipocytes,as well as less osteocytes and hematopoietic cells in the experimental group;the rate of empty lacunae in the experimental group was significantly higher than that in the control group on days 15 and 20 (P ＜ 0.01).These findings suggest that in the early stage of ONFH,necrotic osteocytes increase in number,accompanied by trabecular micro-fractures,which leads to a decrease in bone mineral density,eventually resulting in bone remodeling disturbance.

Objective To explore the effect of hypertension on the life quality in elderly.Methods A cohort of 1847 elderly in community in Beijing was recruited.Blood pressur,body structural and mental heath,cognition, activity and life satisfaction were evaluated by physical examination,CES-D scale,MMSE,and ADL,IADL scale.Results The life quality of the elderly hypertension was worse than those of normotensive;the morbidi- ties of chronic disease related to hypertension were higher and the cognitive ability worse with the duration of hy- pertension.The prevalence of depression was higher and the vitality was decreased as the rising of blood pres- sure.Conclusion Prevention and control hypertension improve life quality in elderly hypertension.

Objective To explore the depression status of hypertension and analyze the associated factors in the elderly population in a community of Beijing.Methods This cohort of 1064 elderly people in the community were screened with Centerfor Epidemiology Scale(CES-D). Results Those who lived in rural(21.6% vs city 7.3%),illiterate(19.9% vs literate 11.2%),mateless(19.7% vs mate 12.4%),lower income(21.9% vs high in- come 9.8%),life accidents(23.2% vs without life accidents 8.6%),sleep disorder(31.0% vs sleep good 8.7%) and lower living abilities(26.7% vs high living ability 9.0%)had higher incidence of depression(all P

Objective To investigate the feasibility of determining the breast cancer extension with diffusion-weighted imaging(DWI)and the apparent diffusion coefficient(ADC).Methods Fifty-nine lesions(57 patients)were studied by using DWI and ADC measurement before surgical excision.The cancer extension was investigated on ADC maps with different b values(b=500 and 1000 s?mm~(-2))according to the threshold values discussed before.The lesion extension on dynamic enhanced images and on DWI was used for comparison.The tumor extension was determined by calculating two lines.Line one:the maximum diameter of lesion.Line two:perpendicular line crossing the midpoint of line one.All measurement was compared with the pathologic specimen.Results(1)There were 48 invasive ductal carcinomas,6 ductal carcinomas in situ with small invasive foci,3 mucinous carcinomas,and 2 medullary carcinomas.(2)The low ADC value on ADC maps at b=500 and 1000 s?mm~(-2)was described as cancer extension.The measurement results were compared to pathologic figures and the pattern of correlation was categorized into 3 groups:Group 1,the area of low ADC values was almost the same as the pathological tumor extension; Group 2(overdiagnosis),the area of low ADC values was wider and more than 20% larger than the area of tumor extension;Group 3(false negative),no area of low ADC value was observed.There were no significant difference between DWI with b of 500 and b of 1000 s?mm~(-2)(X~2=0.160,P=0.689;X~2= 0.172,P=0.679)in Groups 1 and Group 3.There were 2 lesions in Group 2,which were consistent in DWI with b of 500 and b of 1000 s?mm~(-2).There were 14 misdiagnosed lesions,including overdiagnosis in 2 lesions and false negative in 12 lesions.Eight lesions measured at DWI with b of 500 and b of 1000 s? mm~(-2)were not consistent.Five lesions were diagnosed correctly at DWI with b of 500 s?mm~(-2),three of them were duetal carcinomas in situ with small invasive foci.(3)The extension of lesion on dynamic enhanced imaging was measured at 4 minutes after enhancement,and was compared with the extension measured at the same slice on DWI map.Pathologic figures were regarded as the gold standard.The extension of 47 lesions(80%)on enhanced images accorded with DWI.The abnormal area on DWI,which was consistent with pathologic figures,was wider than the area on enhanced images in 8 lesions.Of them,3 lesions were mucinous carcinomas and 5 lesions were grade 3 invasive ductal carcinomas.Conclusion DWI and ADC value have the potential in evaluating the cancer extension.The accuracy of extension measured on DWI map was better than that on dynamic enhanced images for some kinds of breast cancers.