Objective To establish the diagnosis criterion and management protocol for nonalcoholic steatohepatitis(NASH).Methods The data of 75 patients with NASH including 10 chronic hepatitis,10 simple fatty,15 alcoholic liver disease,10 healthy conerol and 40 tpye 2 diabetic patient without viral hepatitis were investigated.Results Among 75 NASH patients,the mean age was 36.8 years,and male were 66(88%);their body mass index(BMI)≥25 were 58 (77.3%).Serum ALT and insulin concentration were elevated in all patients with NASH;60 cases were with hypertriceridemia (80%),30 with normal oral glucose tolerate test (OGTT) (40%),fatty liver was detected in 67 patients (90%)by ultrasonography.The BMI were different between NASH and healthy controls,P

OBJECTIVETo evaluate the effect of orthognathic surgery in the treatment of condylar osteochondroma.

METHODSA total of 12 cases of condylar osteochondroma were treated with Le Fort I osteotomy, intraoral vertical ramus osteotomy, sagittal split ramus osteotomy and genioplasty.

RESULTSNo recurrence of condylar osteochondroma was observed in all 12 cases two years after the treatments. Facial asymmetry was obviously corrected.

CONCLUSIONThe orthognathic surgery methods are advantageous in improving facial figure without scar development in the treatment of condylar osteochondroma.

Bone Neoplasms ; Face ; abnormalities ; Facial Asymmetry ; congenital ; Humans ; Hyperplasia ; Male ; Orthognathic Surgery ; Osteochondroma ; Osteotomy ; Osteotomy, Le Fort ; Osteotomy, Sagittal Split Ramus

Objective To understand the existing deficiency in the work of preventing HIV transmission from mother to child.Methods The diagnostic occasions of 179 HIV positive pregnant women(189 pregnant times)in some counties in Hubei,Shanxi,and Hebei were collected,including measures for prevention.The reasons for the missing prevention for HIV positive pregnant women were analyzed.Results The HIV positive rate in pregnant women in the counties enrolled in this study was 0.26‰.Percentage of HIV pregnant women who were found in antepartum,intrapartum,and postpartum were 66.7%,7.4%,and 25.9% respectively.Some HIV positive pregnant women missed the prevention in all of three periods.In HIV positive pregnant women found antepartum,some rejected prevention.The missing reason for HIV positive pregnant women found intrapartum failed to get ARV drug.HIV positive pregnant women found postpartum missed the prevention.Conclusions There is some progress in the work of preventing HIV transmission from mother to child in China,but some HIV positive pregnant women can not be detected in time,and the percentage of HIV pregnant women who have received comprehensive measures is low.The work of PMTCT therefore needs to be improved.

Objective To investigate the expression of Beclin1,p62 and Atg5 in serous ovarian cancer and its clinical significance.Methods The expression of Beclin1,p62 and Atg5 was detected in 50 serous ovarian cancer tissues by immunohistochemical method,and the relationship between their expression levels and the clinical parameters of serous ovarian cancer patients were analyzed.Results The expression of Beclin1 and Atg5 in serous ovarian cancer tissue was significantly lower than that in normal ovarian tissue,but p62 was significantly higher than that in normal ovarian tissue,and the difference had statistically significance (P＜0.05).The expression of Beclin1 and Atg5 were correlated with degree of cell differentiation and clinical stage (P＜0.05),while the expression of p62 was associated with clinical stages and lymph node metastasis (P＜0.05).Conclusions The abnormal expression of Beclin1,p62,Atg5 in serous ovarian cancer,which can lead to reduced autophagy body formation and autophagy activity,may be involved in the occurrence and development of serous ovarian cancer.

Objection To investigate the spectrum and survival status of HIV positive cancer in HuBei province, China. Methods HIV positive cancer patients were added up and followed up who had registered in Zhongnan Hospital between January 2004 and June 2009. The prognostic features were determined for HIV patients with cancer. Results The average age of HIV positive and HIV negative group who suffered with malignant neoplasm were 42.5±8.8 years and 55.1±13.7 years respectively (P ＜0.05), mean CD4 counts were (220.9±142.3)/μl and (554.4±174.3)/μl, respectively (P ＜0.05), the types of common cancer were NHL, cervical cancer, liver cancer and lung cancer, colon cancer, breast cancer, respectively. Anticancer and/or ART treatment were the important positive prognostic factors. Additional factors such as age and CD4 count were associated with survival of cancer patients with HIV infection. Conclusion Mean age of HIV positive cancer patients is about 42 years old. NHL, cervical cancer and liver cancer are HIV associated malignant tumor. ART and anticancer can effectively prolong the survival of HIV infected patients with cancer.

Objective To evaluate the surgical corrective results of prominent mandibular angle with masseter muscle hypertrophy by using intraoral approach. Methods One hundred and twenty three cases with various degrees of prominent mandibular angle with masseter muscle hypertrophy were treated through intraoral approach. The basic surgical procedures included masseter muscle reduction (type Ⅰ), mandibular angle osteotomy (type Ⅱ) and angle-splitting osteotomy (type Ⅲ). The type Ⅰ was completed in 4 cases, type Ⅱin 16 cases, type Ⅲ + type Ⅰ in 56 cases, type Ⅲ in 19 cases, type Ⅲ + type Ⅰ in 9 cases, type Ⅲ + type II in 12 cases, type Ⅲ + type Ⅱ+ type Ⅰ in 7 cases. Genioplasty was simultaneously performed in 69 cases.Results The overwidth of the lower face was effectively corrected. The cosmetic results, as determined by both patients and surgeons, were good. No complications, such as facial never injury, or inferior alveolar never injury, occurred in any patients. Conclusions In order to reach good cosmetic results at the patients' lateral view and frontal view, considerations should be determined according to the degrees of the deformities and patient's desires, to choose suitable surgical procedures.

Objective To explore the clinical characteristics, pathological features and prognostic factors of patients with acquired immune deficiency syndrome (AIDS) related lymphoma (ARL).Methods The clinical characteristics, treatment regimen and survival status were retrospectively analyzed.At a ratio of 1∶2, 106 general non-Hodgkin lymphoma (NHL) cases were included after matching for demography and clinical characteristics with 53 ARL patients.Chi-square test was used for statistical analysis.Overall survival was analyzed using Kaplan-Meier curves.Cox regression was used for multivariant analysis.Results The predominant pathologic type of ARL was diffuse large B cell lymphoma (60.4%, 32/53).B cell lymphoma accounted for 88.7% (47/53) and T cell lymphoma accounted for 11.3% (6/53).Patients in ARL group (62.3%, 33/53) had lower proportion of receiving radiotherapy or chemotherapy compared with patients in general NHL group (94.3%, 100/106) (χ2=26.58, P<0.05).ARL group had lower hepatitis B surface antigen (HBsAg) positivity rate compared with general NHL group (1.9% vs 26.4%, χ2=14.26, P<0.05).No other characteristic was found significantly different between these two groups.The survival time of ARL and general NHL patients was (6.0±1.3) months and (48.0±10.0) months, respectively (t=8.13, P<0.01).The 1-year, 2-year, 3-year and 5-year survival rates of ARL patients were 39.6%, 32.7%, 27.7% and 20.1%, respectively, while those of general NHL patients were 79.2%, 56.8%, 42.4% and 25.0%, respectively.Of the 33 ARL patients and 100 general NHL patients who received anti-NHL treatment, the 1-year survival rates were 60.6% and 83.0%, respectively (χ2=4.040, P=0.043), the 2-year survival rates were 53.5% and 60.5%, respectively (χ2=0.003, P=0.096), the 3-year survival rates were 48.1% and 45.9%, respectively (χ2=0.288, P=0.59), the 5-year survival rates were 39.1% and 27.5%, respectively (χ2=0.798, P=0.372).Multivariate analysis revealed that anti-NHL therapy and international prognostic index score were independent predictors for prognosis (both P<0.05).Conclusions Diffuse large B cell lymphoma is the predominant pathologic type of ARL.ARL patients has significantly lower survival rate compared with general NHL patients.Combination of anti-HIV therapy and anti-lymphoma therapy in individuals with ARL can prolong their survival time.

Objective To assess the value of magnetic resonance angiography (MRA) and arterial proton spin labeling (ASL) in the internal carotid artery transient ischemic attack. Methods According to TIA seizure frequency, 58 patients clinical diagnosed as TIA were divided into single group (n=12) and the frequent group (n=46). All patients underwent MRA and ASL, then intracranial arterial stenosis and cerebral perfusion were evaluated. Results Vascular stenosis with abnormal ASL were detected in 33 (71.74%) of 46 frequent TIA patients and 1 (8.33%) single TIA patient. The incidence of vascular stenosis with abnormal ASL was higher in frequent TIA than that in single TIA (P＜0.05). Conclusion Vascular stenosis with perfusion abnormality is one of the most risk factors of TIA frequent seizures. Combination of MRA and ASL can make judgment for stenosis and abnormality of cerebral blood flow, being helpful to understand the onset causes and prognosis of TIA.

Objective To investigate the incidence and risk factors of end-stage liver disease (ESLD) in human immunodeficiency virus (HIV) and hepatitis C virus (HCV) co-infected patients after antiretroviral therapy (ART).Methods The demographic and clinical data of HIV-HCV coinfected patients in Zhongnan Hospital,Wuhan University and local Centers for Disease Control and Prevention (CDC) from Jan 2003 to Dec 2010 were analyzed retrospectively. Single factor and multiple factor Logistic regression were used to analyze the correlation between the variables and incidence of ESLD,such as baseline age ≥40,male,previous blood transfusion history,duration of HCV persistent infection,hepatitis B virus (HBV) co-infection (HBsAg positive),HIV RNA≥-1 ×104 copy/mL at last visit,HCV RNA≥ 1.× 105 copy/mL at last visit,CD4 count ＞ 200 / μL at last visit,alanine aminotranferase (ALT) ≥ 2 × upper limit normal (ULN) at last visit,ART containing nevirapine (NVP),follow-up duration,ART duration＞5 years and HCV genotype 1b.The effect of ESLD on the survival of HIV-HCV co-infected patients was analyzed by Kaplan-Meier method.Results Totally 427 HIV-HCV co-infected patients were followed up with average of 3.7 years. Fifty-five patients (12.9％) developed ESLD,and 52 patients (12.2％) died.Factors independently associated with ESLD included baseline age≥40 (OR=2.385,P=0.039),ALT ≥2× ULN (OR=16.374,P=0.000),HBV-coinfection (OR=2.507,P=0.042),duration of ART ＞ 5 years (OR=3.232,P=0.010),and CD4 count ≥200/μL (OR=0.364,P=0.011).The cumulative mortality of HIV-HCV co-infected patients with ESLD was 50.9％,whereas that of HIV-HCV co-infected patients without ESLD was 6.5％ (P=0.000).Conclusion In the ART era,ESLD is common among HIV-HCV co-infected patients in China,which is responsible for reducing the survival time of the patients.

ObjectiveTo investigate the situation of mother to child transmission of HIV after mothers acquired HIV prenatally or before pregnancy and the related factors. Methods Two hundred and seventy-seven mothers who acquired HIV prenatally or before pregnancy and their 322children from Yi-ning city of Xinjiang Uygur autonomous region and some counties of central China were enrolled in this study from January 2000 to December 2009.Subtypes of HIV were determined by detection of Gag sequence,the rate of HIV transmission from mother to child was calculated and its related factors were analyzed by Chi-square test and Logistic regression analysis.ResultsThe HIV subtype of all mothers who were infected through blood (n=174) was B'.The major subtype of mothers who were infected via sexuality (n =58) was recombined subtype CRF01-BC (n=35) and CRF-AE (n=20),accounting for 60.3％ and 34.5％,respectively,and only 3 mothers with B'subtype (5.2％).Twelve infants died before HIV detection,and 108 infants out of the rest 310infants were found to be HIV positive, giving the HIV mother-to-child transmission rate of 34.8％ (95％ CI:29.5％-40.1％).The infection rate of bottle feeding infants was lower than that of breastfeeding infants [12.5％ (6/48) vs 38.9％ (102/262),x2 =12.484,P=0.000].The infection rate of the infants whose mothers' HIV infection ＜7 years was lower than that of the infants whose mothers' HIV infection ≥7 years [28.8％ (46/160) vs 54.2％ (32/59),x2 =12.211,P=0.000].Multi-factor Logistic analysis showed that the duration of maternal HIV infection (OR =1.342,95％ CI:1.189-1.515,P=0.000) and duration of breastfeeding (OR =1.137,95％ CI:1.053-1.227,P=0.001) were risk factors of HIV vertical transmission.ConclusionsThe HIV subtypes might be associated with transmission route.Formula feeding could decrease the vertical transmission rate of HIV,while long duration of maternal HIV infection and breastfeeding might increase the vertical transmission rate of HIV.