Objective To investigate the association of hepatitis B virus(HBV) S gene quasispecies with the outcome of HBV infection.Methods Serum samples were collected from three chronic HBV carriers, three chronic hepatitis B and three chronic severe hepatitis B patients.All subjects were male and with HBV genotype C.HBV S gene was amplified, and 20 clones of HBV fragment were randomly selected and sequenced from each sample.SPSS 15.0 software was adopted for analysis.Results Quasispecies complexity of HBV S gene in chronic HBV carriers and chronic hepatitis B tended lower than that of the severe chronic hepatitis B, but the difference was not of statistical significance (P＞0.05).In T cell epitope 45, 47, 85 amino acid sites of the HBV S gene, the constitution of quasispecies in the chronic hepatitis B was more complex than that of the HBV carriers (P=0.01), but compared with the severe chronic hepatitis, the difference was not significant (P=0.06).The computer model showed that both the dominant clones and the non dominant clones could effectively bind to the receptors of cytotoxic T lymphocytes.Conclusion Quasispecies in some T cell epitopes of HBV S gene may be related with the clinical outcome of hepatitis B.

Objective To characterize serum hepatitis B virus(HBV)full-length genome quasispecies and to investigate its ralationship with severe exacerbation of chronic hepatitis B(CHB).Methods HBV full-length genome was amplified and cloned from four treatment naive CHB patients and four treatment naive CSHB patients.Fourteen to sixteen clones per sample were selected,sequenced and analyzed by bioinformatics software.The measurement data was compared by independent-samples t test and count data was analyzed by x2 test. Results Totally 120 HBV fulllength genome sequences were obtained.All the patients had either genotype B or C virus monoinfection.One hundred percent clones(60/60)from CSHB patients showed mutations including G1896A,A1762T/G1764A(one patient even carried A1762T/G1764A/C1766T mutations),T1753C/G and start codon mutations in preS2,preS1,which were more common than those from CHB patients(46/60,76.7%;x2=15.85,P<0.01).The quasispecies complexity and diversity were higher in CSHB patients than CHB patients within full-length genome,S,X,P genes and reverse transcriptase region,but lower within C gene at both nucleotide and amino acid levels.But the difference were not statistically significant in all regions.Conclusion The mutation frequency and quasispeeies heterogeneity in HBV genome are higher in CSHB patients than in CHB patients,which may play a role in the severe exacerbation of CHB and needs further investigation in large scale studies.

Objective To characterize the profile and clinical significance of hepatitis B virus (HBV) quasispecies in patients infected with hepatitis B virus based on the sequence of reverse transcriptase (RT) region.Methods Fifty HBV infected treatment-naive patients were enrolled and divided into three groups,asymptomatic carriers (ASC) group (10 cases),chronic hepatitis B (CHB) group (30 cases) and liver cirrhosis (LC) group (10 cases).HBV genomes were extracted from serum samples.The sequence of RT region was amplified by polymerase chain reaction (PCR) and cloned into vectors.Fifteen to thirty clones per sample were selected,sequenced and analyzed by bioinformatics software.The mean values among groups were compared by analysis of variance.The median values among groups were compared by nonparametric statistics.The enumeration data were analyzed by x2 test.Results Totally 1221 HBV RT region nucleotide sequences were obtained (152from ASC patients,780 from CHB patients and 289 from LC patients).Genotype distribution showed no difference among three groups.However,the quasispecies complexity showed significant differences among the three groups,LC group ＞CHB group＞ ASC group (F=33.400,P＜0.05).The quasispecies diversity was LC group ＞CHB group＞ ASC group,and that of LC group was significantly different from the other two groups (F=18.070,P＜0.05),while there was no significant difference between CHB and ASC patients.Conclusions The HBV isolated from patients in immune clearance phase have higher variability than those isolated from patients in immune tolerance phase.The longer the infection persists and the more severe the disease is,the more variable HBV quasispecies are.

ObjectiveTo explore the effect of synthesized rehabilitation on detoxification addicts.Methods100 detoxification addicts were randomly divided into the rehabilitation group and control group with 50 cases in each group. Cases of the rehabilitation group were treated with "ten-step" rehabilitation treatment, but that of the control group did not. The rehabilitating treatment included cognitive psychotherapy, behavioral therapy, family treatment, social skill training and etc. The effects of two groups were evaluate with Symptom Checklist-90 (SCL-90) scale.ResultsExcept hostility, other factorial scores of the rehabilitation group including positive items, somatization, obsession, interpersonal sensitivity, depression, phobia, paranoid and psychotic factors were significantly higher than that of the control group (P<0.05～0.01).ConclusionThe synthesized rehabilitation can obviously improve the psychology of detoxification addicts.

ObjectiveTo investigate the Character of Symptom Checklist 90 (SCL-90) in detoxification addicts in reeducation center.Methods100 detoxification addicts in reeducation center were evaluated.ResultsThe results showed that the mean scores of all factors in detoxification addicts were higher than those of normal population, and there was difference between different drug dependence addicts.ConclusionThe detoxification addicts shows serious psychological disorders.

Objective:To screen risk factors of postoperative venous thromboembolism (VTE) in patients in department of spinal surgery and establish a risk prediction model and conduct external validation.Methods:This study was a case-control study. Using the convenient sampling method, a total of 93 patients with VTE who underwent spinal surgery from May 2019 to April 2021 in the Second Xiangya Hospital of Central South University were selected as as the thrombosis group, while 100 patients who underwent spinal surgery without VTE during the same period were selected as the control group. A self-designed questionnaire about the risk factors of VTE in patients undergoing spinal surgery was used to investigate the patients. Binomial Logistic regression was used to analyze the risk factors of postoperative VTE in patients with spinal surgery and R software was used to establish a nomogram prediction model. A total of 46 patients (23 patient with VTE and 23 patients without VTE) from Department of Spinal Surgery from May and June 2021 were selected to verify the prediction model.Results:Age ( OR=1.603, 95% CI: 1.036-2.483) , operation time ( OR=0.253, 95% CI: 0.123-0.518) , use of internal fixation ( OR=0.128, 95% CI: 0.043-0.384) , application of bone cement ( OR=0.176, 95% CI: 0.048-0.652) , D-dimer ( OR=0.360, 95% CI: 0.147-0.884) and plasma fibrinogen degradation product ( OR=0.024, 95% CI: 0.006-0.091) were risk factors for VTE in spinal surgery patients. The prediction model was established according to the risk factors. The prediction agreement rate of the model was 0.865 and the sensitivity was 0.742. The model was externally validated with a sensitivity of 0.761, a specificity of 0.565 and an area under the receiver operating characteristic curve of 0.810. Conclusions:Age, operation time, use of internal fixation, application of bone cement, D-dimer and plasma fibrinogen degradation products are risk factors for postoperative VTE in patients with spinal surgery. Predictive models based on risk factors can predict the risk of VTE in spinal surgery patients.