Objective To evaluate the factors associated with recurrence of chronic hepatitis B (CHB) after nucleoside analogs (NAs) withdrawal.Methods A literature search from PubMed,Wanfang data,CQVIP,CNKI,Duxiu and SinoMed was conducted to identify studies on the recurrence of CHB after NAs withdrawal.Meta-analysis was performed using RevMan 5.3.Random-effects or fixed-effects model was performed based on the heterogeneity.Weighted mean difference (WMD) was used to assess the continuous data,and odds ratio (OR) was used to assess the dichotomous data.Publication bias was evaluated with Egger' s regression test using Stata SE 11.0.Results A total of 20 case-control studies were included in this analysis.The recurrence rates were 21.0％,30.4％,33.2％ in HBeAg-positive CHB patients,and 26.5％,34.1％,50.1％ in HBeAg-negative patients after NAs withdrawal for 3 months,6 months and 1 year,respectively.For patients treated with lamivudine,the recurrence rates of CHB were 21.0％,28.0％,34.3％ at 3-,6-and 12-month after NAs withdrawal.Meta analysis demonstrated that among HBeAg-positive CHB patients,the average age (WMD =7.36,95％ CI:5.72-9.00,Z =8.81,P ＜0.01) and baseline HBV DNA level (WMD =0.26,95％ CI:0.05-0.46,Z =2.44,P =0.01) were higher in recurrence group,while antiviral treatment duration was shorter in recurrence group (WMD =-3.12,95％ CI:-4.56--1.68,Z =4.26,P ＜ 0.01),and the rate of recurrence was higher in patients with liver cirrhosis (OR =2.59,95％ CI:1.33-5.04,Z =2.79,P ＜ 0.01).Among HBeAg negative patients,the average age of patients in recurrence group was higher than that in non-recurrence group (WMD =5.90,95％ CI:1.57-10.23,Z =2.67,P ＜ 0.01),and no difference was observed in other factors between recurrence and non-recurrence patients.Among patients treated with lamivudine,the average age (WMD =7.68,95％ CI:5.02-10.34,Z =5.66,P ＜0.01) and baseline HBV DNA level (WMD =0.26,95％ CI:0.05-0.46,Z =2.44,P =0.01) were higher,while antiviral treatment duration was shorter in recurrence group (WMD=-2.11,95％CI:-3.85--0.38,Z=2.39,P＜0.01),and the rate of recurrence was higher in patients with liver cirrhosis (OR =2.59,95％ CI:1.33-5.04,Z =2.79,P ＜ 0.05).Conclusion Among HBeAg-positive and lamivudine-treated patients,age,baseline HBV DNA level,antiviral treatment duration and liver cirrhosis are associated with the recurrence of CHB after NAs withdrawal; while for HBeAg-negative patients,age is the only risk factor.

Objective To investigate a method that perfect imaging could be obtained and minimal contrast media was used. Methods The 5 cases with enhanced CT images were measured at each slice, then the Hu of aim-position was obtained and the Hu-time curve was got. At last, the valid enhanced period would be found. Results According to the experience, the enhancement threshold of aorta, portal vein and hepar were set at 70 HU. The onset and ending time of enhancement threshold were found. Conclusion The dose of contrast media should be extenuatory when new type spiral CT was operated, and the correlative parameters, such as flow rate, delay time etc. should be adjusted according to the objective condition.

Objective To investigate the pathologic base of breast cancer malignant halo.Methods The status of margin of 80 cases confirmed breast nonspecific invasive ductal cancer by pathology were determined preoperatively.80 cases were divided into two groups:malignant halo group and non malignant halo group.The estrogen receptor (ER),progesterone receptor (PR),human endothelial growth factor receptor (CerB-2),nuclear protein antibodies (Ki-67) expression were detected by immunohistochemical method.The histological grade,mitotic count and documented tumor size,patient age and the number of lymph node metastases,breast cancer margin on pathology were observed.Halo tissue were drawn from specimens and the tissue structure were observed.Results Ki-67 expression in malignant halo group were significantly lower than those in non malignant halo group.The observing results of the margin status of breast cancer on ultrasound and pathology were consistent.Halo tissue was mainly composed of fatty tissue and scattered clumps of cancerous tissue,fibrous tissue,normal lobular and tubular.Conclusions Malignant halo is a special manifestation of breast cancer on gray-scale ultrasound.

Objective A new mechanical thrombectomy instrument with preliminary clinical application were introduced. Methods Four cases (3 men and one woman; 61-71 years of age, mean age 66) consisting six legs with subacute or chronic occlusion of the femoropopliteal arteries having a course of 75 days to 10 months, were included in this study. All patients were treated with Straub Rotarex System (Straub Rotarex, patent pending. Straub medical, Wangs, Switzerland). Among them 2 cases were caused by atherosclerosis, 1 by emboli and 1 by diabetes mellitus. The lengths of the occluded segments were 3.8-56 cm. Results The thrombi were removed, and the arteries were undergone recanalization. The blood loss was low, amounting to 5-180 ml. Distal emboli formation in 3 legs were treated successfully by thrombsuction or thrombolysis. Conclusion Straub Rotarex System is a new safe and effective mechanical thrombectomy instrument.

Objective To analyze the safety and clinical efficacy of three types stents of transjugular intrahepatic portosystemic shunt (TIPS) in treatment of cirrhosis with portal hypertension.Methods Totally 1 086 patients with cirrhotic portal hypertension underwent TIPS for the first time.All patients were divided into bare stent group (group A),covered stent-group (group B) and combined stents group (group C).The rates of symptom improvement,shunt insufficiency,re bleeding,survival and major complications in 2 years after TIPS were analyzed and compared.Results Totally 1 690 stents were placed in 1 086 patients.The overall technical success rate was 100％;2.53％ (10/396) emergency patients dead due to uncontrolled gastrointestinal bleeding,and 2.78％ (11/396) emergency patients,0.84％ (5/593) bleeding stopped patients dead with acute liver funtional failure.In 2-year following-up,the overall survival rate of group A,group B,group C were 83.78％ (186/222),88.36％ (281/318),96.34％ (526/546),and the difference was statistical significant (x2=4.15,P=0.04).The shunt insufficiency rates of group A,group B,group C were 39.64％ (88/222),22.33％ (71/ 318),11.17％ (61/546),and the difference was statistical significant (x2 =4.15,P=0.04),The rates of rebleeding of group A,group B,group C were 31.53％ (70/222),16.89％ (54/318),7.14％ (39/546),and the difference was statis tical significant (x2 =9.91,P=0.01).The rates of hepatic encephalopathy of group A,group B,group C were 21.62％ (48/222),22.96％ (73/318),19.23％ (105/546),and the difference had no statistical significant (x2 =1.00,P=0.06).Conclusion TIPS is an effective way to relieve portal hypertension and complications in patients with cirrhosis.The safety and clinical efficacy can be improved by 8 mm shunt with double stent technique.

Objective To study the expression of IL 1?,TNF ? and nitric oxide (NO) in the cervical intervertebral disc and their roles in the pathogenesis of cervical spondylotic myelopathy (CSM). Methods Fifteen cervical discs were obtained from patients of CSM undergoing anterior disc surgery. Six cervical discs specimens were obtained in the surgical operation with patients with traumatic cervical injury served as the control. The specimens were analyzed for IL 1?、TNF ? by use of ELISA method, NO was measured by optical density assays. Results The contents of IL 1?,TNF ? and NO in disc of CSM patients increased significantly when compared with the control group. Conclusion The results of the present study indicated that IL 1?,TNF ? and NO may be involved in the pathogenesis of CSM.

Objective:To study on mechanisms of wrist-ankle acupuncture for prevention and treatment of peripheral neuritis complicated by diabetes.Methods:Ninety cases of peripheral neuritis complicated by diabetes were treated respectively by wrist-ankle acupuncture and body acupuncture,with western medicine routine treatment used as control group,30 cases in each group.The therapeutic effects and laboratory results were compared.Results:Therapeutic effects in wrist-ankle acupuncture group and body-acupuncture group were significantly superior to that in control group,with no significant difference between wrist-ankle acupuncture and body-acupuncture group.Conclusion:Wrist-ankle acupuncture can improve blood glueose and metabolism blood lipids,decrease blood viscosity and recover function of peripheral nerve cells and it has a definite effect on diabetic peripheral neuritis.

Objective: TO study the change of substance P(SP) level in Plasma and its relationship with ankylosing spondylitis(AS).Method: Radioimmunoassay. Results: The author observed that the level of SP in Plasma of AS is singificantly higher than that of healthy controls. SP level in AS patients during active stage is higher than in those during inactive stage. Conclusion: Increased SP may play an importantrole in the pathogenesis Of AS.

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0bjective To summarize the experience of postoperative and mid-term echocardiographic evaluation of modified Blalock-Tasussig(BT)shunts. Methods During 2003-2006,thirty five consecutive patients received modified BT shunts and survived postoperative 6 months were enrolled in this study.Transthoracic echocardiography was utilized to evaluate the patency of shunts and the change of pulmonaryarteries(PA)and left ventricle(LV). Results Three patients received the emergence surgery for the intervention for the BT shunts. The follow-up was (21.2±11.3) months. During the follow up,the obstruction of shunts occurred in 7 cases. After the placement of shunts,the mean size of PA increased by 31.2%,meanwhile,the size of LV increased by 25.6%. Nineteen patients received the followed definitive repair or palliative operations. Compared with the patients still waiting for the growth of PA,the patients who receiving the second staged procedure achieved the more appropriate PA growth. Furthermore,for the above patients,there was no significant difference between the angiographic and echocardiographic evaluation for the PA size. Conclusions Echocardiography could accurately diagnose the patency of shunts and record the growth of PA and LV following BT shunts. Echocardiography is a highly reliable noninvasive approach for the perioperative evaluation and mid-term follow-up for the modified BT shunts.