In the present study, the genomic sequence characteristics of HN-JY40 strains of the hepatitis E virus (HEV) isolated from pigs in Henan Province, China, were analyzed and the evolutionary relationship between HN-JY40 and other sequenced strains examined. The whole genome of HN-JY40 was sequenced and analyzed by reverse transcription-polymerase chain reaction, 3' rapid amplification of cDNA ends (3' RACE) and 5' RACE. Bioinformatic analyses were carried out with Megalign, Expasy, clustal x, and MEGA 4 software. The genome of HN-JY40 was 7 223 bp in size upon removal of polyA sequences. Sizes were 9 bp and 69 bp at 5' and 3' noncoding regions, respectively. The genome of HN-JY40 was predicted to contain three open reading frames (ORFs): ORF1 (5 124 bp) encoding 1 707 amino acids; ORF2 (2 025 bp) encoding 674 amino acids; ORF3 (345 bp) encoding 114 amino acids. Phylogenetic-tree analyses indicated that HN-JY40 is a typical type-IV virus that belongs to a new subgenotype of HEV genotype 4. We sequenced and analyzed the whole genome of HN-JY40. This strategy elicited the genomic characteristics of the HEV isolated from pigs in Henan Province as well as the evolutionary relationships between HN- JY40 and other HEV isolates from pigs. We revealed that the ORF1 of HN-JY40 (153-432 nt) and human HK 104-2004 had high similarity, which offers molecular evidence for uncovering the interspecies transmission of the HEV.
Amino Acid Sequence ; Animals ; Base Sequence ; China ; Cloning, Molecular ; Genome, Viral ; Hepatitis E ; veterinary ; virology ; Hepatitis E virus ; classification ; genetics ; isolation & purification ; Humans ; Molecular Sequence Data ; Open Reading Frames ; Phylogeny ; Sequence Homology, Amino Acid ; Swine ; Swine Diseases ; virology

Objective To investigate the correlation between ABCD2 scores and vertebrobasilar artery stenosis in patients with posterior circulation transient ischemic attack (TIA).Methods The patients with posterior circulation TIA who performed cerebral angiography were enrolled in the study,and their ABCD2 scores and imaging data were analyzed.Results A total of 108 patients with posterior circulation TIA were enrolled.There were significant differences in the main trunk stenosis degree of vertebrobasilar artery with different ABCD2 scores in patients with posterior circulation TIA (P =0.005).The overall degree of stenosis increased with the increase of ABCD2 score (P =0.000).After adjustment for other vascular risk factors,ABCD2 score had significant predictive ability for whether had posterior circulation stenosis (odds ratio [OR]1.771,95％ confidence interval [CI] 1.234-2.542; P =0.002) and moderate to severe stenosis (OR 2.083,95％ CI 1.336-3.176; P =0.001).Its receiver operating characteristic area under the curve was 0.693(95％ CI 0.586-0.800) and 0.755 (95％ CI 0.661-0.849) respectively.When the ABCD2 score was ≥3,the sensitivity and specificity of predicting posterior circulation stenosis were 62.6％ (95％ CI 53.4％-71.7％) and 70.6％ (95％ CI62.0％-79.1％) respectively,and the sensitivity and specificity of predicting posterior circulation stenosis ＞ 50％ were 78.7％ (95％ CI 70.9％-86.4％) and 67.5％ (95％ CI58.7％-76.3％) respectively.Conclusions In patients with posterior circulation TIA,the stenosis degree of vertebrobasilar arterial trunk increases with the increase of ABCD2 score.In a certain extent,ABCD2 score may predict whether the main trunk of the posterior circulation has stenosis and whether has moderate to severe stenosis.

Objective Identification of anatomic structures are essential for totally thoracoscopic anatomic pulmonary segmentectomies, however sometimes the procedure are difficulty.This study was to assess whether three-dimensional computed tomography angiography(3D-CTA) could contribute to the preoperative arrangement of thoracoscopic complex segmentectomy.Methods Between September 2012 and August 2014, 29 patients were performed thoracoscopic complex segmentectomies under the guidance of preoperative 3D-CTA.The segmentectomies pattern were based on the nodules' diameter, location,and pathology.The targeted vessels and bronchus were marked in preoperative simulated segmentectomies.Results Of the 29 cases, 9 right upper lobe segmentectomies, 13 left upper segmentectomies, and 7 bibasilar segmentectomies were achieved, among which 6 subsegmentectomies were also inclued.The mean lesion diameter, operative time and intraoperative blood loss were(1.35 ± 0.80) cm, (190.53 ± 50.83) min, and (26.90 ± 32.24) ml respectively.Under the guidance of preoperative 3D-CTA , 8(27.5％) nodules were detected accurately, moreover 2(6.9％) aberrant arteries and 1 (3.4％) aberrant bronchus were observed.According to the marked vessels and bronchus preoperatively, 27 (93.1％) arteries, 25 (86.2％)veins,and 29(100％) bronchus were identified and dissected in the operation.Three cases converted to unplanned segmentectomies.No serious complications or death occurred.Conclusion 3D-CTA is an effective tool to enhance security and efficiency in thoracoscopic complex anatomical segmentectomy.

Objective To report the surgical approach for the treatment of giant or extensive skin lesions due to the infection of human papilloma virus (HPV). Method Surgical treatment was performed for 10 patients with verruca vulgris, 20 with condyloma acuminatum, and 8 with epidermodyplasia verruciformis, whose giant or extensive lesions were poorly responsive to routine non-surgical therapy. Results Recurrence of lesions was found in 2 of 10 patients with verruca vulgris and 5 of 20 condyloma acuminatum in 6 months after operation, with a total recurrent rate of 25%. The extensive skin lesions were removed and the functions of affected limbs were recovered in patients with epidermodyplasia verruciformis after operation, however, the long-term topical retinoids was needed to control the recurrence of the lesions. Conclusion Surgical approach is effective for the treatment of the giant or extensive skin lesions due to HPV infection.

Objective To observe the treatment outcome of different surgical strategies in nevus-like benign melanocytic tumors with various size and shape in the head and face. Methods A total of 180 cases with nevus-like benign melanocytic tumors received surgical treatment from February 2005 to February 2008.The following surgical strategies were selected, including direct excision, partial excision, skin grafting, skin soft tissue expanding and application of local flaps (inter-flap, diamond-shaped flap, A-T flap, kite flap, etc),to treat skin lesions in the head, nose, cheek and eyelid. All patients were followed up for 3 to 6 months. Results The incisions for direct and partial excision were well healed without infection or recurrence. Of those cases treated with local flaps or expander, 3 (1 on the face and 2 on the head) experienced recurrence, 2 on the head suffered from post-operational infection. Conclusion To select different surgical strategies according to lesion size, sites and shape may lead to a favorable cosmetic result in the treatment of nevus-like benign melanocytic tumors in the head and face.

OBJECTIVE: To test the reliability and validity of Health Scale of Traditional Chinese Medicine (HSTCM) by means of questionnaires. METHODS: A cross-sectional survey was conducted at Liwan Community of Guangzhou, Old People's Home in Guangzhou and Outpatient Department of the Second Affiliated Hospital of Guangzhou University of Chinese Medicine. A total of 652 Chinese individuals (over 18 years old) were assessed with the 88-item version of HSTCM and World Health Organization Quality of Life Measure-Abbreviated Version (WHOQOL-BREF), which were randomly delivered to them. Some socioeconomic characteristics were registered. RESULTS: A test-retest reliability (15-day interval) was found among the 76 persons who completed the questionnaires by themselves. Intra-class correlation coefficient (ICC) was 0.93. Associated 95% confidence interval (CI) was 0.89-0.96. Split-half reliability was 0.79. Inter-investigator reliability (0.93) was also good, and the ICC of HSTCM was 0.90 (95%CI 0.67-0.97). The correlation between HSTCM and WHOQOL-BREF was -0.66. The correlations of HSTCM and questionnaire deliver order, investigator, interview date and interview time were 0.06, -0.12, -0.17 and 0.20 respectively. The correlation between HSTCM and self-rated health (0.46) was greater than that between HSTCM and chronic illness (0.28). Divided by individuals with or without chronic illness, area under the ROC (receiver operator characteristic) curve for HSTCM was 0.67 (95%CI 0.63-0.71). CONCLUSION: It indicates that the HSTCM is conceptually valid with satisfactory psychometric properties and forms a basis for further applications in clinical research of traditional or integrative medicine.

Evaluation Studies as Topic ; Humans ; Medicine, Chinese Traditional ; Publishing ; standards ; Quality Control ; Randomized Controlled Trials as Topic ; standards

Objective To validate the therapeutic effect of Centella Triterpenes after surgical excision and X-ray irradiation.Methods Surgical excision was performed on one hundred and six patients with keloid,after operation superficial X-ray irradiation was given to the patients.Then,they were divided into three groups:36cases in group A treated with higher dose of Centella Triterpenes;39cases in group B treated with lower dose of Centella Triterpenes;31cases took placebo as controls.All patients were followed up for12months after treatment.Results All patients were healed completely after operation.The effective rate was significantly higher in Centella Triterpenes groups than that in the control group(P

Objective To investigate the related factors of early adverse outcomes in young patients with ischemic stroke.Methods From January 2006 to June 2016,685 young patients (18-45 years old) with acute ischemic stroke admitted to the Department of Neurology,Nanjing General Hospital of Nanjing Military Command were enrolled retrospectively.They were diagnosed as the first onset with head CT or MRI.According to the modified Rankin scale (mRS) at 90 d,the patients were divided into a favorable outcome (mRS 0-2) group (n=554) and a poor outcome (mRS 3-6) group (n=131).The collection of clinical data were completed on the day of admission,including the risk factors for cerebrovascular disease (oral contraceptives,etc),the National Institutes of Health stroke scale (NIHSS) score on admission,the mean systolic blood pressure (>140 mmHg was analyzed) and laboratory examination.The stroke subtypes were classified with the trial of org 10172 in acute stroke treatment (TOAST) classification criteria.Univariate analysis was used to analyze the difference of clinical data between groups,and multivariate logistic regression analysis was used to analyze the risk factors for early poor outcomes.Results Compared with the favorable outcome group,the patients with the ratio of mean systolic pressure >140 mmHg in the first 3 d after hospitalization (37.4% [49/131] vs.21.7% [120/554],χ2=14.131),NIHSS score on admission (10.0 [7.0,14.0] vs.1.5 [0,3.0],Z=-15.300),white blood cell count (7.5 [6.0,9.0] ×109/L vs.6.8 [5.7,8.2] ×109/L,Z=-3.157),fasting glucose (4.9 [4.6,6.0] mmol/L vs.4.8 [4.4,5.3] mmol/L,Z=-2.726),higher fibrinogen level (2.8 [2.3,3.4] g/L vs.2.6 [2.3,3.2] g/L,Z=-2.018,blood uric acid level (291[220,346] mmol/L vs.315 [261,374] mmol/L,Z=-3.443),and plasma albumin level (43.1[40.0,45.9] g/L vs.44.8 [42.4,47.4] g/L,Z=-4.708) were decreased in the poor outcome group.There were significant differences between the two groups (all P<0.05).TOAST classification comparison:the proportion of the patients with cardioembolism in the poor outcome group was higher than that in the favorable outcome group.There was significant difference between the two groups (6.9% [9/131] vs.2.5% [14/554];χ2=4.893,P<0.05).There were no significant differences in the remaining clinical data between the two groups (all P>0.05).Multivariate logistic regression analysis showed that the higher NIHSS score on admission (OR,1.474,95%CI 1.378-1.576,P<0.01),the mean systolic pressure >140 mmHg at the first 3 d after admission (OR,2.134,95%CI 1.210-3.764,P=0.009) and the cardioembolism(OR,4.902,95%CI 1.073-22.222,P=0.040) were the risk factors for early poor outcome,and the elevated plasma albumin level (OR,0.902,95%CI 0.850-0.956,P=0.001) was a protective factor of early favorable outcome.Conclusion The higher NIHSS score at admission,the cardioembolism and the increased mean systolic blood pressure in the first 3 d after admission may result in early poor outcome in young patients with ischemic stroke,while the elevated plasma albumin level is beneficial to the early outcome.

Objective To investigate the possible formation mechanism and imaging features of the hyperintense vessel sign (HVS) on fluid attenuated inversion recovery (FLAIR) in patients with ischemic stroke or transient ischemic attack (TIA).Methods The baseline data of the patients with middle cerebral artery (MCA) ischemic stroke or TIA with digital subtraction angiography (DSA) showing the lesions of MCA M1 segment in clinical practice were retrospectively retrieved from Nanjing Stroke Registry Program from January 2010 to July 2011.FLAIR was used to observe HVS,and DSA was used to evaluate the degree of vascular stenosis and cerebral collateral circulation.Results A total of 101 patients were enrolled,76 (75.2％) were males,and their mean age was 53.94 ± 13.47 years; 90 patients (89.1％) with ischemic stroke and 11 patients (10.9％) with TIA; 55 patients (54.5％) were HVS negative and 46 (45.5％) were HVS positive.Among the patients whose MCA stenosis ＜50％,50％-70％,70％-90％ and ≥90％,the positive rates were 0％ (0/8),25.0％ (3/12),17.6％ (3/17),and 62.5％ (40/64),respectively.There were significant differences (Z=-4.479,P＜ 0.001).The leptomeningeal collateral circulation of the HVS positive group was significantly more than that of the HVS negative group (Z =-6.196,P ＜ 0.001).Multivariate logistic regression analysis showed that the degree of MCA stenosis was an independent risk factor for influencing the formation of HVS (odds ratio 3.943,95％ confidence interval 2.03-7.659; P ＜0.001).Conclusions The formed intracranial leptomeningeal colhteral circulation after severe intracranial vascular stenosis or occlusion is a major pathophysiological basis of HVS formation on FLAIR sequences in patients with ischemic stroke or TIA.