Objective To evaluate the effectiveness and safety of partial splenic embolization using polyvinyl alcohol versus gelfoam to treat hypersplenism in cirrhotic patients.Methods A literature search was performed in databases which included PubMed,Embase,Cochrane library,Sinomed,CNKI,Wangfang data and VIP for trials on partial splenic embolism using PVA or gelfoam to treat hypersplenism in cirrhotic patients.The study was censored in May 2016.After data extraction and assessment of quality,a meta-analysis was performed using the RevMan 5.3 software.Results Five studies which involved 197 patients were selected in this study.Included into the PVA group were 92 patients and the gelfoam group 105 patients.On Meta-analysis,the PVA group had a higher value of WBC a month after PSE (WMD =0.4,95％ CI:0.05 ～ 0.75,P ＜ 0.05),higher values of WBC (WMD =0.39,95％ CI:0.06 ～ 0.71,P ＜0.05) and PLT (WMD =8.08,95％ CI:1.65 ～ 14.51,P ＜ 0.05) on month 6 post-embolization.The degree of post-embolization pain was more severe (RR =1.32,95％ CI:1.14 ～ 1.54,P ＜ 0.05) and the length of painful time was longer (RR =2.01,95％ CI:1.36 ～ 2.66,P ＜0.05) in the PVA group.There were no significant differences in the values of PLT,fever and complications (all P ＞ 0.05).Conclusions PSE using PVA achieved better short-term and long-term results in hematological indicators than gelfoam.However,the degree and extent of duration of pain were significantly longer.

Objective To evaluate the analytical performance of a novel HBV DNA assay based on automated DNA extraction and real-time fluorescence quantitative PCR .Methods Analytic verification studies.Accuracy and lower limit of detection were assessed by determining a panel of HBV standard plasma of WHO.HBV standard plasma (genotype A, B, C and D) at 6 different concentrations were measured 18 times to evaluate precision and reproducibility .Pseudo-viral particles at high HBV DNA concentration were serially diluted to assess linear range .One hundred and forty-four clinical specimens were quantified for HBV DNA so as to evaluate the correlation between the new test and COBAS ? system. Results Quantification of HBV standard plasma showed acceptable accuracy , with each deviation between observed and expected values within ±0.35 lg IU/ml (-0.17-0.32 lg IU/ml).Intra-assay coefficients of variation ( CV) for genotype A , B, C and D were 3.87% -6.32%, 0.45% -14.68%, 0.16% -8.36% and 0.64%-13.01%respectively, and the inter-assay CV were 5.67%-9.69%, 1.28%-15.68%, 0.36%-9.05%and 1.69%-13.65%, separately.Linearity assessment exhibited an excellent dynamic range of linear quantification from 20 to 1.0 ×1010 IU/ml ( r =0.998, P <0.001 ) .And the satisfactory results obtained at 3 levels of HBV DNA concentration (10, 20, 50 IU/ml, respectively) confirmed the claimed lower limit of detection with 5/5 detectable rate at 20 IU/ml.Furthermore, good correspondence was observed between the new HBV DNA assay and the COBAS ? system with 100% ( 144/144 ) qualitative coincidence and significant correlation based on 104 positive data ( r=0.984, P<0.000 1).Conclusions The novel fully-automated real-time PCR assay displayed good analytical and clinical performance for highly sensitive detection of HBV DNA.It was well suited for monitoring antiviral responses as well as drug resistance according to current clinical practice guidelines for the management of chronic HBV infection .

Objective:To observe the mechanism of electroacupuncture on nerve repair in mice with neuropathic pain based on the protein kinase C(PKC)-purinergic receptor P2X ligand-gated ion channel 3(P2X3)signal pathway.Methods:A total of 48 mice were randomly divided into sham group,model group,acupuncture group and electroacupuncture group,with 12 mice in each group.Except the sham group,the other mice were constructed with chronic constriction injury(CCI)model.On the 8th day after operation,acupuncture group and electroacupuncture group received acupuncture and electroacupuncture interventions for 7 days.Mechanical withdrawal threshold(MWT)and thermal withdrawal latency(TWL)were measured before operation and 3rd,5th,7th,10th,12th and 14th day after operation.All mice were killed 15 days after operation.The histomorphology of sciatic nerve was ob-served by HE staining.The levels of IL-1β and TNF-α in spinal cord were detected by ELISA.PKC and P2X3 levels in spinal cord tis-sue were detected by Western blot.PKC and P2X3 expressions in spinal cord neurons were detected by Immunofluorescence.Results:In the sham group,the neuronal cells were of different sizes,the cell membrane was intact,the cytoplasm was fine and granular,the nucleus was large and round,and the nucleolus was clearlyvisible in the middle.Atrophic neurons could be seen in the model group,myelinated nerve fibers were disordered,axons were swollen,and spaces were formed between neurons.Compared with the model group,the number of atrophic neurons decreased in the acupuncture group and the electroacupuncture group(P<0.05),the arrange-ment of myelinated nerve fibers improved and the improvement in the electroacupuncture group was more obvious than that in the acu-puncture group.Compared with the sham group at the same time point,on the 3rd,5th,7th,10th,12th and 14th day after opera-tion,the MWT and TWL values of the model group,acupuncture group and electroacupuncture group decreased significantly(P<0.05),while the expressions of IL-1β,TNF-α,PKC,P2X3,the numbers of PKC and P2X3 positive cells and the average optical den-sity increased(P<0.05).Compared with the model group,the values of MWT and TWL in the acupuncture group and electroacupunc-ture group increased significantly on the 10th,12th and 14th day after operation(P<0.05),while the expression of IL-1β,TNF-α,PKC,P2X3,the number of PKC and P2X3 positive cells and the average optical density decreased(P<0.05).Compared with the acu-puncture group,the values of MWT and TWL in the electroacupuncture group increased significantly on the 10th,12th and 14th day after operation(P<0.05),while the expressions of IL-1β,TNF-α,PKC,P2X3,the numbers of PKC and P2X3 positive cells and the average optical density decreased(P<0.05).Conclusion:Electroacupuncture can reduce the neuroinflammatory reaction of CCI model mice,reduce the expression levels of PKC and P2X3,improve the morphology of sciatic nerve cells and the arrangement of myelinated nerve fibers,reduce the gap between neurons,increase the values of MWT and TWL,and relieve the degree of neuropathic pain.

Purpose/Significance To explore the feasibility of applying blockchain technology to the current healthcare system of hos-pitals,and to achieve the purpose of protecting patients'privacy to the greatest extent possible at a lower cost.Method/Process 505 questionnaires are randomly distributed and collected from people of different age groups in Beijing,Tianjin,Shanghai and Shenzhen who have a certain degree of understanding of blockchain technology,and the results are analyzed.Result/Conclusion Different age groups are highly concerned about personal privacy and privacy protection,and are willing to accept blockchain as an emerging technology.There is a greater demand and acceptance for the application of blockchain technology in the primary health care systems.

Objective To investigate vascular remodeling and low-density lipoprotein(LDL)deposition,the growth and development trends of lateral branch plaques in bifurcated vessels,and the potential locations of subsequent plaque growth due to the presence of plaques.Methods An idealized model of bifurcated vessels was established and the distribution of wall shear stress before and after the growth of edge-branch plaques was obtained using computational fluid dynamics.Seven sections were intercepted in the areas of low shear stress:planes 1-3 were the low shear stress areas on the lateral branch before plaque formation,planes 4-5 were the proximal and distal edges of the plaque,and planes 6-7 were the lower shear stress areas of the plaque.Vascular remodeling and LDL deposition in the cross section were simulated.The growth and development trends of plaques are also discussed.Results Among planes 1-3,plane 2 produced obvious negative remodeling and the highest concentration of LDL deposition(102.266 mmol/L),thereby indicating that this was the initial location of the atherosclerotic plaque.Compared to plane 4,plane 5 produced more pronounced vascular remodeling,lumen narrowing,and the highest deposition concentration(110.17 mmol/L)after plaque formation,which indicated that the patch had a tendency for eccentric growth downstream.Compared to plane 6,plane 7(blood flow separation reattachment site)produced more negative remodeling and the highest deposition concentration(93.851 mmol/L),thereby indicating the possibility of new plaque formation near the reattachment point of blood flow separation.Conclusions Obvious vascular remodeling at low shear stress in the lateral branches leads to lumen stenosis and high LDL deposition,thus,forming atherosclerotic plaques.The lateral wall of the bifurcated blood vessels is the initial location of atherosclerotic plaque growth.After growth,the plaque tends to develop downstream,and subsequent plaques may form at the flow separation and reattachment points.