Objective To investigate the mutation characteristics and genotype of hepatitis B virus resistance gene in Nantong area,and provide scientific basis for clinical rational drug.Methods A total of 158 cases of chronic hepatitis B (CHB)pa-tients who were received with nucleos (T)ide analogues therapy for at least 2 years as the research object,and 30 cases of CHB patients who were not received nucleos (T)ide analogues for the treatment as the control group.PCR-sequencing method was used to detect the HBV P resistant gene and genotype,meanwhile,observe the relationship between three main mutation model and the levels of ALT and HBV DNA was also investigated.Results B genotype was detected in 42 (26.58%)out of 158 CHB patients,and 116 cases (73.42%)were C genotype.A total of 131 patients with different site mutations in P region,the mutation rate were 82.91%.There were totally 11 HBV mutation sites,including the main muta-tion site:M204I,L180M,M204V,A181V and A181T,the frequency of drug resistance were 41.14%,37.34%,22.15%, 11.39% and 10.13%,respectively.Moreover,11 mutation sites had 21 mutation patterns.In lamivudine (LAM)resistance associated mutations,the L180M and M204V sites were mainly co-occurrence,followed by M204I alone.In adefovir dipivoxil (ADV)resistance associated mutations,A181V was the main mutation site.Whereas,the drug resistance rate of entecavir (ETV)was low.Conclusion The main genotypes of HBV were type B and C in Nantong area,and C type was the dominant genotype.The resistance mutations mainly concentrated in LAM and ADV resistance associated mutations,while the resist-ance rate of ETV was low.Multi-locus drug-resistant mutation detection may help to detect viral resistance and guide clinical treatment better.

Based on the follow-up investigation made on the employment of university graduates in pharmacy,we analyzed the situation of their jobs,salary and their attitude towards pharmacy and suggested some mothods to promote the graduates employment and give the students the career guidance.Up to now,492 students have graduated,the first employment rate was 78%,and last employment rate was 100%.

Objective To explore the effect and the possible mechanisms of silent homo sapiens eukaryotic translation elongation factor 1 alpha 2(EEF1A2)gene on the growth of pancreatic cancer cell in vivo.Methods The pancreatic cancer xenograft models in mice were established.The mice were equally divided into control group,negative control group and EEF1A2 group,which were injected with PBS,negative control siRNA and EEF1A2 siRNA into xenograft tumors respectively.The size and weight of tumors in each group were measured.The expression of EEF1A2 and PCNA in tumor tissue of each group was detected by immunohistochemistry.The cell apoptosis rate in tumor tissue of each group was determined by TUNEL.Results In xenograft nude mice models,since the 17th day of injection,the growth of tumor size in EEF1A2 group was obviously slower than that of negative control group and control group(all P＜0.05).By the end of the treatment,the tumors were cut off and weighted.The weight of tumors in EEF1A2 group(0.27g± 0.06g)were significantly lower than those of control group and negative control group(0.39g± 0.08g and 0.43g± 0.07g,P＜0.05).EEF1A2 mostly expressed in cytoplasm of pancreatic cancer cell.In negative control group and control group,the positive cells distributed densely and the positive rate was(72.58 ± 25.47)％ and (76.75±23.19)％ respectively.The distribution of positive cells in EEF1A2 group was scattered and the positive rate was(34.78±21.36)％,the difference was statisically significant(P＜0.01).The expression of PCNA at protein level in EEF1A2 group was significantly lower those that of control group and negative control group(P＜ 0.01).The result of TUNEL test indicated that the cell apoptosis rate in EEF1A2 group was higher than those of control group and negative control group (P＜0.01).Conclusions The EEF1A2 gene can be effectively silented in vivo,which significantly inhibits the growth of pancreatic cancer cell.It may be related with inhibition of cell proliferation and promotion cell apoptosis.

0.05),but elevated markedly and acutely to a peak level at 24 h after operation (P

Objective To investigate the effects of on-pump and off-pump coronary artery bypass grafting on plasma adrenomedullin (ADM) and endothelin-1 (ET-1) levels before and after operation in elderly patients. Methods Elderly patients aged 60 years and over with coronary artery bypass grafting were enrolled in the study and divided into off-pump group and on-pump group, each group had 20 cases. Blood samples were collected before surgery, immediately after operation and 6,24 hours, 3 days after operation. The plasma levels of ADM and ET-1 were dectecded by radio immunoassay. Results The levels of ADM and ET-1 were significantly increased immediately after operation in 2 groups of on-and off-pump. The levels of ET-1 in on-pump group and off-pump group were (67.59±10.18) ng/L and (58.73±9.64) ng/L respectively. The levels of ADM in on-and off-groups were (284.90±36.24) ng/L and (243.25±25.70) ng/L. This showed that in on-pump group, the plasma levels of ADM and ET-1 increased more significantly(P＜0.05). The plasma levels of ADM and ET-1 began to decline at 6 hours after operation, and continued to 24 hours after operation. On 3 days after operation, the plasma levels of ADM and ET-1 in off-pump group returned to the preoperative level, but they were still maintained at a high level in on-pump group.Conclusions For elderly patients, both on-pump and off-pump coronary artery bypass grafting can cause endothelial dysfunction, increasing plasma levels of ET-1 and ADM. But compared with the on-pump coronary artery bypass grafting, the off-pump coronary artery bypass grafting has less influence.

Objective:To explore the feasibility and clinical efficacy of in situ vessels anastomosis in treatment of severe degloving injury of hand, and long-term follow-up observation of the clinical efficacy.Methods:From January 2016 to December 2018, 11 patients of severe degloving avulsion injuries were treated in the Department of Hand and Microsurgery of Tianjin Hospital. Six patients had right hands injuried and 5 in left hands. The age of patients ranged from 16 to 51 years old, with an average age of 31.5 years old. All injuries accompanied with metacarpal or phalangeal fractures. In situ vascular anastomosis was applied to all patients in the replantation surgery. Long-time follow-ups and observation of postoperative appearance, sensory and hand function recovery were conducted through visits of outpatient clinic.Results:All operations were successful. All degloving tissues survived after replantation in 6 patients. Partial palm skin necrosis and thumb nail bed necrosis occurred in 1 patient, and treated with skin grafting and abdominal flap transfer. Thumb nail bed necrosis occurred in 2 patient, in which 1 patient repaired by abdominal pedicled flap transfer, and the other patient repair by local flap transfer. One patient had dorsal hand skin necrosis, and repaired with free anterolateral thigh flap(ALTF). One patient had palm hand skin necrosis, and repaired with free skin grafting. There were 1 patient had index and middle finger necrosis and 1 with little finger necrosis. And finger amputation was performed later. Mean follow-up period was 22 (15-36) months. According to the Evaluation Standard of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association, 6 patients were in excellent, 3 in good and 2 in fair. According to the standard of British Medical Research Council (BMRC), sensation recovered to S 4 in 5 patients, S 3 in 5 patients and S 2 in 1 patient. Conclusion:Using precise microsurgical techniques to directly anastomose in situ vessels in the treatment of severe hand degloving injuries can achieve satisfactory long-term recovery of hand function.

Since the emergence of CRISPR/Cas9, gene editing technologies have attracted increasing attention, in particular type II systems, in which nucleases consist of only a single protein. The effectors include type II Cas9, type V Cas12 and type VI Cas13, which allow precise genomic DNA or RNA editing. Catalytically inactive CRISPR/Cas9 can also be used as a platform to recruit effectors such as transcription factors, epigenetic factors, and/or base modification enzymes to target gene loci. On the other hand, optogenetics offers spatial, temporal, and reversible control of biological processes. CRISPR and optogenetics can enable precise gene editing in vitro and in vivo at the spatiotemporal level, which has a broad applicability in biology and medicine. This article has provided a review for the research advance in photoactivatable CRISPR systems, with details for the design and application of such tools and a discussion over the limitations of the current methods, which may shed light on this emerging field.
CRISPR-Cas Systems ; DNA ; Gene Editing ; Humans ; Technology

Background: Cardiopulmonary resuscitation (CPR) strategies in COVID-19 patients differ from those in patients suffering from cardiogenic cardiac arrest. During CPR, both healthcare and non-healthcare workers who provide resuscitation are at risk of infection. The Working Group for Expert Consensus on Prevention and Cardiopulmonary Resuscitation for Cardiac Arrest in COVID-19 has developed this Chinese Expert Consensus to guide clinical practice of CPR in COVID-19 patients. Main recommendations: 1) A medical team should be assigned to evaluate severe and critical COVID-19 for early monitoring of cardiac-arrest warning signs. 2) Psychological counseling and treatment are highly recommended, since sympathetic and vagal abnormalities induced by psychological stress from the COVID-19 pandemic can induce cardiac arrest. 3) Healthcare workers should wear personal protective equipment (PPE). 4) Mouth-to-mouth ventilation should be avoided on patients suspected of having or diagnosed with COVID-19. 5) Hands-only chest compression and mechanical chest compression are recommended. 6) Tracheal-intubation procedures should be optimized and tracheal-intubation strategies should be implemented early. 7) CPR should be provided for 20-30 min. 8) Various factors should be taken into consideration such as the interests of patients and family members, ethics, transmission risks, and laws and regulations governing infectious disease control. Changes in management: The following changes or modifications to CPR strategy in COVID-19 patients are proposed: 1) Healthcare workers should wear PPE. 2) Hands-only chest compression and mechanical chest compression can be implemented to reduce or avoid the spread of viruses by aerosols. 3) Both the benefits to patients and the risk of infection should be considered. 4) Hhealthcare workers should be fully aware of and trained in CPR strategies and procedures specifically for patients with COVID-19.