ObjectiveTo identify the differences in clinicopathological features between HBeAg-positive and HBeAg-negative chronic hepatitis B (CHB). MethodsA total of 665 CHB patients who were admitted to Ningbo No. 2 Hospital during June 2002 and January 2010 were enrolled, in which 428 were HBeAg-positive and 237 were HBeAg-negative. HBV DNA loads, live histological inflammation grades and fibrosis stages were compared between two groups. SPSS 1 1. 5 was used for statistical analysis.For measurement data, t (for normal distribution) or Mann-Whitney U (for skew distribution) was performed; for enumeration data, Chi-square test was performed; and Pearson correlation analysis was conducted. ResultsLiver inflammatory grade and fibrosis staging in HBeAg-negative CHB patients were more severe than those in HBeAg-positive patients (x2 = 7.92 and 10.35, P ＜ 0. 01 ). The ratio of serum HBV DNA levels ＜ 3, ≥3- ＜ 5 log10 copies/mL in HBeAg-negative CHB patients were significant higher than those in HBeAg-positive patients (x2 = 105.16 and 36.92 ,P ＜0.01 ) ; and the ratio of HBV DNA ≥7 log10 copies/mL in HBeAg-negative group was lower than that in HBeAg-positive group (x2 = 110. 18, P ＜0. 01 ). With the rising of serum HBV DNA levels, liver inflammatory grade and fibrosis staging in HBeAg-positive patients had a descending tendency (r =-0. 287 and-0. 224, P ＜0.01 ), while those in the HBeAg-negative group were ascending (r = 0. 360 and 0. 303, P ＜ 0. 01 ). ConclusionCompared with HBeAg-positive CHB patients, liver inflammation and tissue damage in HBeAg-negative patients are more severe, which need close monitoring.

Objective To investigate the clinical effect of the treatment of acute radiation dermatitis caused by radiotherapy in nasopharyngeal carcinoma patients treated with hydrogen. Methods Selected from January 2014 to January 2016 for nasopharyngeal carcinoma in the first hospital of Ningbo radiotherapy lead to acute radiation dermatitis patients were studied, by drawing lots method were divided into treatment group and control group with 40 cases in each. The patients in the control group were given conventional treatment, iodine inunction, treatment group given routine treatment, hydrogen card grease rubbed. Comparison of two groups of treatment effect. Results After 10 days of treatment, the treatment group the score RISRAS significantly lower than the control group (P < 0.05). Conclusion Combination of hydrogen and conventional therapy in the treatment of acute radiation dermatitis induced by radiotherapy in nasopharyngeal carcinoma patients, can significantly shorten the treatment time.

Bone Neoplasms ; Chondrosarcoma ; Female ; Humans ; Middle Aged ; Nasal Septum

Objective:To evaluate the clinical value and the prognostic factors of postoperative radiotherapy in type B3 thymoma pa-tients. Methods:A total of 159 patients with thymoma were treated by surgery and postoperative radiotherapy. According to Masaoka staging system, 12, 33, 62, and 52 patients had stageⅠ,Ⅱ,Ⅲ, andⅣlesions, respectively. Myasthenia gravis existed in 38 patients. Altogether 58 patients underwent chemotherapy. Overall survival, disease-free survival, and local control rates were calculated by Ka-plan-Meier method. Prognostic factors were analyzed by Cox regression model. Results:With a median follow-up of 52 months (8-125 months), the overall 5-year survival rate was 81.6%. The 5-year progression-free survival rate was 76.2%. The 5-year local control rate was 82.6%. The recurrence rate was 32.6%, and the metastatic rate was 9.3%. In the univariate analysis, tumor size, Masaoka stage, re-section margin, radiotherapy, and chemotherapy were significantly associated with 5-year overall survival and progression-free surviv-al (P<0.05). In the multivariate analysis, Masaoka stage, resection margin, and radiotherapy were independent prognostic factors of 5-year progression-free survival (P<0.05). Radiotherapy could improve the regional control rate and the overall survival of patients in Ma-saoka stagesⅢ-Ⅳ. Conclusion:The major failure mode for type B3 thymoma is the recurrence of pleure. Radiotherapy can improve the regional control rate and the overall survival of patients in advanced stages. Masaoka staging, surgical margin, and radiotherapy are the independent prognostic factors for type B3 thymoma treated by postoperative radiotherapy.

BACKGROUND:It has been demonstrated to be effective for the improvement of heart function after acute myocardial infarction with intravenous or intramyocardial administration of bone marrow mesenchymal stromal cels. However, little is known regarding the effect of the combination of intravenous and intramyocardial administration of mesenchymal stromal cels on the heart function of a chronic myocardial infarction model. OBJECTIVE:To study the effect of intravenous and intramyocardial administration of bone marrow mesenchymal stromal cels on the heart function of a rat chronic myocardial infarction model and the relevant mechanism. METHODS:Bone marrow mesenchymal stromal cels isolated from Lewis rats were expandedex vivo. BrdU-labeled bone marrow mesenchymal stromal cels (3×106) were administeredvia the femoral vein and the myocardial surface respectively into rat models of chronic myocardial infarction in cel transplantation group. The equal volume of PBS was injected into the same place in control group. Four weeks after injection, echocardiography was performed to evaluate the heart function, and then the heart tissues were harvested for immunohistochemistry examination. The total blood vessel density in the scar area was evaluated. RESULTS AND CONCLUSION:At 4 weeks after cel implantation, the left ventricular function was not improved in the two groups. The immunohistochemistry staining showed that (1) the mesenchymal stromal cels in the myocardium did not differentiate to myocardial cels; (2) there was no significant difference in the total blood vessel density in the scar area between the cel transplantation and control groups. Taken together, the combined intravenous and intramyocardial administration of bone marrow mesenchymal stromal cels cannot improve heart function in a rat chronic myocardial infarction model.

Adult ; Endoscopy ; Ethmoid Sinus ; surgery ; Humans ; Lipoma ; surgery ; Male ; Orbital Neoplasms ; surgery ; Paranasal Sinus Neoplasms ; surgery

Objective:To confirm the safety and feasibility of totally thoracoscopic repair with leaflet folding, multiple artificial chordae implantation and ring annuloplasty for mitral regurgitation(MR) in Barlow disease.Methods:From June 2018 to December 2019, 10 consecutive Barlow’s disease patients underwent totally thoracoscopic repair with leaflet folding, multiple artificial chordae implantation and ring annuloplasty. The safety and feasibility of this technique was evaluated by its early clinical outcomes.Results:8 males and 2 females. The mean age was(33.5±11.0) years.There was no operative death and related complications. The mean cardiopulmonary bypass(CPB) time was(142±26)(112-194)min, and the aortic clamping time was(96±18)(78-128) min. The average number of artificial chordae implantation was(3.4±0.7)(2-4) pairs/case. Intraoperative transesophageal echocardiography(TEE) showed the mean mitral valve coaptation length and transvalvular pressure gradient was(1.2±0.2)(0.8-1.5) cm and(1.2±0.4) mmHg(1 mmHg=0.133 kPa), respectively, without MR or systolic anterior motion(SAM). During a follow-up of 1-18 months, there were 7 cases with no MR and 3 with trace MR, with a mean transvalvular pressure gradient of( 1.5±0.6 )mmHg.Conclusion:Totally thoracoscopic repair with leaflet folding, multiple artificial chordae implantation and ring annuloplasty was a safe and effective procedure with satisfied early clinical outcomes for MR in Barlow’s disease. However, further randomized and long-term follow-up studies were warranted to determine its clinical effects.

Objective To assess the clinical significance of reverse trendelenburg position in preventing postoperative nausea and vomiting(PONV)in thyroid surgery.Methods 110 patients with papillary thyroid carcinoma(PTC) admitted from Feb.2013 to Mar.2014 were prospectively divided into experimental group and the control group according to whether reserve trendelenburg position was adopted.Univariate and multivariate method were used to analyze relations between PONV and surgical position,gender,age,body mass index,hypertension,surgical time,ASA classification,anesthesia,and motion sickness.Results Of the 110 cases of PTC,the incidence of PONV was 16.28％ (7/43) in the experimental group while it was 37.31％ (25/67) in the control group.The difference had statistical significance(P ＜ 0.05).Statistical analysis showed that PONV was related to patients'gender,surgical position,surgical time,and motion sickness,while only surgical position and motion sickness was the independent risk factors.Conclusion Reverse trendelenburg position surgery can help to prevent PONV and promote recovery.

Objective To assess clinical significance of the right side lymph node dissection behind recurrent laryngeal nerve (RLN) in papillary thyroid carcinoma (PTC).Methods Clinical data of 111 cases of PTC adimitted in our hospital (Department of Vascular and Thyroid Surgery,the Union Hospital of Fujian Medical University) from Feb.2013 to Mar.2014 were retrospectively analyzed.Central lymph node metastasis was analyzed.Univariate and multivariate analysis were made to analyze relations between the right side lymph node (Ⅵ b2) metastasis behind RLN and gender,age,tumor size,capsule infiltration and so on.Results Among 111 cases of PTC,71 had central lymph node metastasis (63.96％).Total metastasis number of the right side lymph node behind recurrent laryngeal nerve (Ⅵ b2) was 2.720±2.037,and the transfer rate was 27.03％ (30/111) (P＜0.05),all lower than those of Ⅵ bl.The one-way ANOVA results showed that metastasis of the right side lymph node behind RLN (Ⅵ b2) was related with age,lateral neck dissection,and Ⅵ b1 lymph node metastasis (P＜0.05) while Ⅵ bl lymph node metastasis was the only independent risk factor for metastasis of the right side lymph node behind RLN(Ⅵ b2) in PTC.Conclusion For patients with right PTC,the metastasis rate of Ⅵ b2 is high,thus dissection of this area is favorable and can accurately reflect lymph node metastasis and further to guide tumor staging and postoperative treatment.

Objective To analyze the prevalence status and the genetic characterizations of influenza B viruses isolated in Hunan Province after pandemic influenza A (H1N1) 2009,and to explore possible reasons for the prevalence.MethodsThroat swabs were collected from outpatients with influenza-like illness in 23 sentinel hospitals of Hunan Province in 2010.Influenza viruses were isolated with Madin-Darby canine kidney (MDCK) cells and identified by haemagglutination inhibition test.The genomes of 10 selected influenza B viruses were sequenced and analyzed for phylogenetic and molecular characterization.ResultsWith the reduction of isolation of pandemic influenza A (H1N1)2009 viruses,influenza B virus became the predominant isolated strain in the first half of 2010.Epidemic viruses mainly belonged to the B/Victoria lineage,and both two lineages co-circulated.Seven out of 11 influenza outbreaks caused by type B.Ten strains were filled into 2 branches of BV and BY which were classified by their lineage types in polymerase (PB2,PB1,PA),hemagglutinin (HA),neuraminidase (NA),NB,membrane protein (M1),influenza B virus membrane protein M2 (BM2),and non-structural protein (NS1,NS2) phylogenetic trees except the NP phylogenetic tree in which 10 strains were all in the BY branch.Compared with World Health Organization (WHO) vaccine strains,the amino acid identity of 11 proteins of the 10 strains was high (97.2％-100.0％).However,some amino acid point mutations were found.No mutation was found in drug resistance mutation sites.Some mutations in NA,NB,PB1,PB2 and NS2 molecules were found in 2 strains isolated from outbreaks compared with strains from sentinel surveillance.Conclusions The point mutations,insertions and genetic reassortment indicate viruses sustaining evolution,which is probably the reason for predominant influenza B viruses after pandemic influenza A (H1N1) 2009 in Hunan Province.