Objective To explore the feasibility of virtual touch tissue quantification(VTQ) technique in noninvasive assessment of transjugular intrahepatic portosystemic stent shunt (TIPSS).Methods Twenty-four patients were enrolled in this study.Shear wave velocity(SWV) of the liver and spleen were obtained by VTQ technique on one day before TIPSS insertion and one week after TIPSS placement,and the portal vein pressure was measured while placing the TIPSS.The correlation between SWV of the liver and spleen and portal venous pressure were analysed.In addition,fourteen patients were followed up for one month after TIPSS placement.Results There was significant difference in portal vein pressure pre [(27.82 ± 4.07) mm Hg] and post [(16.26-± 3.10) mm Hg] TIPSS insertion.The SWV of the liver in patients pre and post TIPSS measured (2.43 ± 0.37)m/s and (2.40 ± 0.34)m/s,respectively.The SWV of the spleen in patients pre and post TIPSS were (3.49 ± 0.40)m/s and (3.08 ± 0.39)m/s,respectively,there was significant difference (P =0.000).However,SWV of the liver pre and post TIPSS placement was no significant difference(P =0.130).And as well as the patients which were followed up for one month after TIPSS placement.A significant,direct,linear correlation(r =0.602,P =0.000) was found between SWV of the spleen and portal vein pressure,but liver SWV was not correlated with the portal venous pressure.Conclusions SWV of the spleen measured by VTQ technique has a significant correlation with portal vein pressure.Hence,the spleen SWV based on VTQ technique can be used as a non-invasive method for quantitatively in monitoring the portal vein pressure as the function of the TIPSS.However,evidence to support a similar role for liver stiffness is lacking.

The anti-hepatitis B virus (HBV) effects and its mechanisms of the ethanol extracts of Hypericum perforatum L. (EHP) in vitro were explored. HepG2 2.2.15 cells, a stable HBV-producing cell line, were cultured as the model system to observe the anti-HBV effect. The viral antigens of cellular secretion, HBsAg and HBeAg, were determined by enzyme linked immunosorbent assay (ELISA). The quantity of HBV-DNA released in the supernatant was assayed by real-time PCR. In order to understand the mechanisms of the suppression of HBV replication, all HBV promoters (Cp, Xp, S1p, S2p and Fp) with luciferase reporter gene were transfected into HepG2 cells respectively. Then the activities of viral promoters were examined by luciferase reporter assay. It was found EHP effectively suppressed the secretion of HBsAg and HBeAg from HepG2 2.2.15 cells in a dose-dependent manner, as well as the extracellular HBV DNA. And EHP could selectively inhibit the activity of HBV promoter Fp. Our data suggest that EHP exerts anti-HBV effects via inhibition of HBV transcription, which helps to elucidate the mechanism underlying the potential therapeutic value of EHP.

Objective To evaluate the performance of virtual touch tissue quantification (VTQ)technique in noninvasive assessment of esophageal varices (EV) in patients with hepatitis B cirrhosis.Methods One hundred and thirty-five patients were enrolled in this study.Liver shear wave velocity (LSWV) and spleen shear wave velocity (SSWV) were obtained by VTQ technique,and the detection of EV was performed by upper endoscopy per patient.The severity of EV was staged on a G1-G3 scale.Liver function was also tested.ResultsThe mean value of LSWV in patients with cirrhosis was (2.48±0.50)m/s,LSWV was not correlated with the stage of EV.The mean value of SSWV was (3.25 ± 0.44) m/s,a significant,direct,linear correlation ( r =0.66,P＜0.001 ) was found between SSWV and the stage of EV.The cut-off value of SSWV for predicting the presence of EV was 3.16 m/s and the area under ROC curve was 0.83,with the sensitivity and specificity of 0.83 and 0.80,respectively.The cut-off value of SSWV for predicting severe EV was 3.39m/s and the area under ROC curve was 0.84,with the sensitivity and specificity of 0.83 and 0.77,respectively.ConclusionsIn cirrhotic patients infected with hepatitis B virus,SSWV measured by VTQ technique can be used as a noninvasive method for determining the presence and the severity of EV,however evidence to support a similar role for LSWV is lacking.

0.05).There was significant difference in the 3-year survival rate between A and C group. Conclusions The 3-year survival rate was dramatically increased with combined therapy mainly by cisplatin, the dose of 60～80mg is tolerant for the elderly aged above seventy years, and perioperation complications can be cured.

BACKGROUNDIn cardiology, it is controversial whether different therapy strategies influence prognosis after acute coronary syndrome. We examined and compared the long-term outcomes of invasive and conservative strategies in patients with non-ST-segment elevation myocardial infarction (NSTEMI) and characterized the patients selected for an invasive approach.

METHODSA total of 976 patients with acute NSTEMI were collected from December 2006 to October 2012 in the First Affiliated Hospital of Dalian Medical University Hospital. They are divided into conservative strategy (586 patients) and invasive strategy (390 patients) group. Unified follow-up questionnaire was performed by telephone contact (cut-off date was November, 2013). The long-term clinical events were analyzed and related to the different treatment strategies.

RESULTSThe median follow-up time was 29 months. Mortality was 28.7% (n = 168) in the conservative group and 2.1% (n = 8) in the invasive management at long-term clinical follow-up. The secondary endpoint (the composite endpoint) was 59.0% (n = 346) in the conservative group and 30.3% (n = 118) in the invasive management. Multivariate analysis showed that patients in the conservative group had higher all-cause mortality rates than those who had the invasive management (adjusted risk ratio [RR] = 7.795; 95% confidence interval [CI]: 3.796-16.006, P < 0.001), and the similar result was also seen in the secondary endpoint (adjusted RR = 2.102; 95% CI: 1.694-2.610, P < 0.001). In the subgroup analysis according to each Thrombolysis in Myocardial Infarction risk score (TRS), log-rank analysis showed lower mortality and secondary endpoint rates in the invasive group with the intermediate and high-risk patients (TRS 3-7).

CONCLUSIONSAn invasive strategy could improve long-term outcomes for NSTEMI patients, especially for intermediate and high-risk ones (TRS 3-7).

Acute Coronary Syndrome ; mortality ; pathology ; therapy ; Aged ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; mortality ; pathology ; therapy ; Prognosis ; Retrospective Studies

The anti-hepatitis B virus(HBV)effects and its mechanisms of the ethanol extracts of Hypericum perforatum L.(EHP)in vitro were explored.HepG2 2.2.15 cells,a stable HBV-producing cell line,were cultured as the model system to observe the anti-HBV effect.The viral antigens of cellular secretion,HBsAg and HBeAg,were determined by enzyme linked immunosorbent assay(ELISA).The quantity of HBV-DNA released in the supernatant was assayed by real-time PCR.In order to understand the mechanisms of the suppression of HBV replication,all HBV promoters(Cp,Xp,S1p,S2p and Fp)with luciferase reporter gene were transfected into HepG2 cells respectively.Then the activities of viral promoters were examined by luciferase reporter assay.It was found EHP effectively suppressed the secretion of HBsAg and HBeAg from HepG2 2.2.15 cells in a dose-dependent manner,as well as the extracellular HBV DNA.And EHP could selectively inhibit the activity of HBV promoter Fp.Our data suggest that EHP exerts anti-HBV effects via inhibition of HBV transcription,which helps to elucidate the mechanism underlying the potential therapeutic value of EHP.

Objective To examine the association between pregnancy-induced hypertension(PIH) and small-for-gestational-age babies(SGA)in a Chinese population.Methods Subjects were women who delivered a singleton baby(gestational weeks:equal to or greater than 28,and less than 42)in four cities or counties in Jiangsu and Zhejiang provinces,China,during the period of 1995-2000.A total number of 93 743 women were included.Incidence of SGA was calculated and compared between women with or without PIH and between groups with different severities of PIH.Multiple logistic regression was used to address the relationship between PIH and SGA while controlling for maternal age,occupation,education,parity,BMI,anemia,premature rupture of membranes and fetal sex.The association between PIH and SGA was also examined according to preterm or term delivery.Results The incidence of SGA in women with PIH(6.0%)was higher than women without(4.5%),and the incidence increased with severities of PIH.The adjusted relative risk rates(95%CI)of SGA in women with mild,moderate and severe PIH were 1.17(1.01-1.34),1.69(1.33-2.14),and 3.50(2.57-4.77),respectively,when confounders were controlled for.The risk ratios of SGA in women with PIH among women who delivered a preterm baby wete higher than those among women who delivered a term baby.Conclusion There seemed a statistical association between PIH and SGA,and women with PIH having higher incidence of SGA than those withont PIH.

China ; Genetic Testing ; Glucosephosphate Dehydrogenase ; genetics ; Glucosephosphate Dehydrogenase Deficiency ; genetics ; prevention & control ; Humans ; Mutation

OBJECTIVETo investigate the association between third trimester hemoglobin (Hb) concentrations and the risk of low birth weight and preterm delivery in a Chinese population.

METHODSSubjects were women who delivered in four cities/counties in Jiangsu and Zhejiang provinces, China, during the period of 1995 - 2000. Incidence of low birth weight and preterm delivery was calculated and compared among groups of women with different levels of Hb during the third trimester. Multiple logistic regression was used to address relationships between Hb levels and the risk of preterm delivery and low birth weight while controlling for potential confounding factors.

RESULTSThe overall prevalence of anemia during third trimester of pregnancy was 48.2% , mainly consisting of mild and moderate anemia. Mild and moderate anemia did not increase the risk of preterm delivery and low birth weight statistically. The lowest incidence of preterm delivery and low birth weight was found among pregnant women with Hb levels at 90-99 g/L. The risk for preterm delivery and low birth weight increased with either increasing or decreasing hemoglobin concentrations. However,there was no remarkable elevation of the risk when Hb was in the range of 70-119 g/L. Women with severe anemia (Hb< 70 g/L) had 80% higher risk (95% CI:1.0-3.3) of preterm delivery and a 4.0-fold higher risk (95 % CI :2. 1-7.5) of low birth weight compared with women with an Hb value of 90-99 g/L. In addition, women with a high Hb concentration (Hb> 130 g/L) had 20% higher risk (95 % CI: 1..0-1.4) of preterm delivery and 50 % higher risk (95 % CI: 1.2-1.9) of low birth weight.

CONCLUSIONA U-shape relationship was found between Hb concentration and the risk of preterm delivery and low birth weight. Severe anemia and high hemoglobin concentration were both associated with increased risk of preterm deliveries and low birth weight.

Adult ; Delivery, Obstetric ; Female ; Hemoglobins ; metabolism ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Pregnancy ; Pregnancy Trimester, Third ; Premature Birth ; blood ; epidemiology ; Risk Factors ; Young Adult

OBJECTIVETo summarize clinical characteristics, diagnosis and treatment of infants with urinary calculus and acute renal failure developed after being fed with melamine tainted formula milk.

METHODSData of infant patients with urinary calculus and acute renal failure due to melamine tainted formula milk admitted to the Beijing Children's Hospital affiliated to the Capital Medical University and the Xuzhou Children's Hospital in 2008 were used to analyze the epidemiological characteristics, clinical manifestations, image features as well as effects of 4 types of therapies.

RESULTSAll the 34 infants with urinary calculus were complicated with acute renal failure, their blood urea nitrogen (BUN) was (24.1 +/- 8.2) mmol/L and creatinine (Cr) was (384.2 +/- 201.2) micromol/L. The chemical analysis on the urinary calculus sampled from 14 of the infants showed that the calculus contained melamine and acidum uricum. The time needed for the four types of therapies for returning Cr to normal was (3.5 +/- 1.9) d for cystoscopy group, (2.7 +/- 1.1) d for lithotomy group, (3.8 +/- 2.3) d for dialysis group, and (2.7 +/- 1.6) d for medical treatment group, which had no statistically significant difference (P = 0.508). Renal failure of all the 34 infants was relieved within 1 to 7 days, averaging (3.0 +/- 1.8) d.

CONCLUSIONMelamine tainted formula milk may cause urinary calculus and obstructive acute renal failure. It is suggested that firstly the patients with urinary calculus complicated with acute renal failure should be treated with dialysis or medication to correct electrolyte disturbances, in particular hyperkalemia, and then relieve the obstruction with available medical and surgical methods as soon as possible. It is observed that the short term prognosis is satisfactory.

Acute Kidney Injury ; diagnosis ; epidemiology ; therapy ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Infant Food ; Male ; Triazines ; toxicity ; Urinary Calculi ; diagnosis ; epidemiology ; therapy