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.

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.

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

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.

Objective To evaluate the association between cold spells and nonaccidental mortality from 2001 to 2011 in the Jiang'an District of Wuhan, China. Methods We collected mortality data for December 2001 to 2010 and January to March 2002 to 2011 in the study area. According to the International Classification of Diseases, we stratified the mortality data into three cause-specific categories:nonaccidental mortality, cardiovascular mortality, and respiratory mortality. We also obtained meteorological data (from the China Meteorological Administration) and ambient pollution data (from the Wuhan Environmental Monitoring Center) during the same periods. In the present study, a cold spell was defined as 5 or more consecutive days with daily average temperatures below the 5th percentile of daily mean temperatures (2.58℃) from January to December in 2001-2011. A distributed lag nonlinear model (DLNM) was applied to assess the acute effect of cold spells on daily nonaccidental mortality. Results During the study period, the total number of nonaccidental deaths was 17 119, including 9 403 (75.5%) among individuals aged over 65 years; 7 968 (46.5%) people died of cardiovascular disease. According to this definition, there were a total of 13 cold spell events and 111 days of duration in Wuhan during the study period. Study days were divided into three periods: non-cold spell days, 2008 cold spell days, and cold spell days in other years. Average daily mean temperatures of the above three periods were(8.2±4.5),(-0.7±1.4), and(0.8±1.2)℃, respectively, corresponding to average daily deaths of 14.0 ± 4.2, 18.2 ± 4.5, and 14.9 ± 4.9 for nonaccidental mortality. After adjusting for long-term trends, seasonal trends, weekdays, holidays, and relative humidity, analysis by the DLNM revealed that cold spells were associated with increased mortality risk, with a cumulative relative risk (RR) of 1.56 (95%CI:1.36-1.79) at lag 0-27 days in 2008, higher than that in other years with 1.23 (95%CI:1.08-1.41). Cold spells were not significantly associated with respiratory mortality and people under 65 years of age;however, during the 2008 cold spell RR increased to 1.96 (95%CI:1.62-2.37) and 1.67 (95%CI: 1.43-1.95) for cardiovascular mortality and older adults (≥65 years old), respectively;both males and females had high mortality risk, with RRs of 1.60 (95%CI:1.33-1.92) and 1.50 (95%CI: 1.23-1.84), respectively. The association between cold spells and mortality remained nearly unchanged with and without adjustment for ambient pollutants (PM10, SO2, and NO2) in the DLNMs. Conclusion In Wuhan, both the 2008 cold spell and cold spells in other years were significantly associated with increased nonaccidental mortality. People with cardiovascular disease and elderly adults may be more susceptible to the impact of cold spells on mortality.

Objective To evaluate the association between cold spells and nonaccidental mortality from 2001 to 2011 in the Jiang'an District of Wuhan, China. Methods We collected mortality data for December 2001 to 2010 and January to March 2002 to 2011 in the study area. According to the International Classification of Diseases, we stratified the mortality data into three cause-specific categories:nonaccidental mortality, cardiovascular mortality, and respiratory mortality. We also obtained meteorological data (from the China Meteorological Administration) and ambient pollution data (from the Wuhan Environmental Monitoring Center) during the same periods. In the present study, a cold spell was defined as 5 or more consecutive days with daily average temperatures below the 5th percentile of daily mean temperatures (2.58℃) from January to December in 2001-2011. A distributed lag nonlinear model (DLNM) was applied to assess the acute effect of cold spells on daily nonaccidental mortality. Results During the study period, the total number of nonaccidental deaths was 17 119, including 9 403 (75.5%) among individuals aged over 65 years; 7 968 (46.5%) people died of cardiovascular disease. According to this definition, there were a total of 13 cold spell events and 111 days of duration in Wuhan during the study period. Study days were divided into three periods: non-cold spell days, 2008 cold spell days, and cold spell days in other years. Average daily mean temperatures of the above three periods were(8.2±4.5),(-0.7±1.4), and(0.8±1.2)℃, respectively, corresponding to average daily deaths of 14.0 ± 4.2, 18.2 ± 4.5, and 14.9 ± 4.9 for nonaccidental mortality. After adjusting for long-term trends, seasonal trends, weekdays, holidays, and relative humidity, analysis by the DLNM revealed that cold spells were associated with increased mortality risk, with a cumulative relative risk (RR) of 1.56 (95%CI:1.36-1.79) at lag 0-27 days in 2008, higher than that in other years with 1.23 (95%CI:1.08-1.41). Cold spells were not significantly associated with respiratory mortality and people under 65 years of age;however, during the 2008 cold spell RR increased to 1.96 (95%CI:1.62-2.37) and 1.67 (95%CI: 1.43-1.95) for cardiovascular mortality and older adults (≥65 years old), respectively;both males and females had high mortality risk, with RRs of 1.60 (95%CI:1.33-1.92) and 1.50 (95%CI: 1.23-1.84), respectively. The association between cold spells and mortality remained nearly unchanged with and without adjustment for ambient pollutants (PM10, SO2, and NO2) in the DLNMs. Conclusion In Wuhan, both the 2008 cold spell and cold spells in other years were significantly associated with increased nonaccidental mortality. People with cardiovascular disease and elderly adults may be more susceptible to the impact of cold spells on mortality.

Graphene,as a new type of two-dimensional nanomaterial,has unique physical and chemical properties,which make it characterized by low resistivity,large specific surface area,good biocompatibility,and high chemical stability.It is expected to develop into an ideal material for highly sensitive electrochemical sensors.With the development of electrochemical sensor technology,graphene based electrochemical sensors with high sensitivity,specificity,speed,and convenience can be used to detect various infectious disease patho-gens.This article summarizes the application of electrochemical sensor detection technology based on graphene nanomaterials in the detection of respiratory pathogens,mosquito borne infectious disease pathogens,intestinal infectious disease pathogens,and other infectious disease pathogens,providing new ideas for achieving rapid detection technology and methods for early detection and diagnosis of infectious diseases.