Objective: To investigate the knowledge, attitude and practice of hepatitis B prevention and control among junior high school students in Linping District, Hangzhou City, so as to provide insights into management of hepatitis B among adolescents. Methods: Two classes were sampled using a cluster sampling method from grades 2 in 12 public junior high schools in Linping District, and all students in these two classes were enrolled. Students' knowledge, attitude and practice of hepatitis B prevention and control were collected using questionnaire surveys, and factors affecting knowledge, attitude and practice of hepatitis B prevention and control were identified using a multivariable logistic regression model. Results: A total of 1 102 questionnaires were allocated and 1 094 valid questionnaires were recovered, with an effective recovery rate of 99.27%. The respondents included 540 males (49.36%) and 554 females (50.64%), and 542 rural students (49.54%) and 552 urban students (50.46%). The awareness of hepatitis B prevention and control knowledge was 43.60%, and a low awareness rate was seen for the item “use of condom may prevent hepatitis B” (21.12%). The percentage of correct attitudes towards hepatitis B prevention and control was 57.77%, and a low percentage was found for the item “individuals living with hepatitis B will tell others” (38.67%). The percentage of positive practices towards hepatitis B prevention and control was 80.07%, and a low percentage was seen for the item “hepatitis B vaccines have been inoculated in recent five years” (16.54%). Multivariable logistic regression analysis identified gender (females, OR=1.483, 95%CI: 1.159-1.898), household registration (urban, OR=1.300, 95%CI: 1.011-1.670), and parental highest educational level (high school or technical secondary school, OR=0.703, 95%CI: 0.532-0.929) as factors affecting the awareness of hepatitis B prevention and control knowledge among junior high students, and parental highest educational level (high school or technical secondary school, OR=0.705, 95%CI: 0.533-0.934) and serving as class cadres (OR=1.449, 95%CI: 1.128-1.860) were factors affecting the attitudes hepatitis B prevention and control, while household registration (urban, OR=1.566, 95%CI: 1.144-2.143) and route of acquiring hepatitis B control knowledge (internet or magazine, OR=0.473, 95%CI: 0.288-0.776) were factors affecting the formation of practices towards hepatitis B prevention and control. Conclusions The overall awareness of and percentage of attitudes towards hepatitis B prevention and control, and the percentage of hepatitis B vaccination are low among junior high school students in Linping District. Targeted health education pertaining to hepatitis B prevention and control is required to be reinforced and promotion of hepatitis B vaccination is recommended.

Objective To investigate the effect of dexmedetomidine on perioperative cell immune function in patients undergoing hepatoma surgery. Methods Sixty patients (40-65 y/o, 50-80 kg body weight, ASA grad-ing I-II) with hepatoma were allocated into two groups each containing 30 patients:control group (group C) and dex-medetomidine group (group D). 15 minutes before anesthesia induction, a loading dose of dexmedetomidine 0.5μg/kg was injected intravenously, followed by infusion at 0.4μg/(kg · h)until the end of operation in group D. The equal volume of normal saline was administered in group C.Blood samples were obtained from jugular vein before induc-tion of anesthesia (T0), the end of operation(T1) and 24 h after the end of surgery (T2) for detections of the levels of T lymphocyte subsets (CD3+, CD4+, CD8+) and NK cells by flow cytometry. CIM+/CD8+ratio was calculated. Serum IL-2 and IL-10 were detected by ELISA methods. Results When compared with the baseline value (T0), the levels of CD3+, CD4+, CD4+/CD8+ratio and NK cells significantly decreased at T1 and T2 in group C, and the levels of CD3+and CD4+also significantly decreased at T1 and T2 in group D (P<0.05). Compared with group C, the levels of CD3+, CD4+, NK cells and IL-2 at T1 and T2 were significantly higher in group D, and level of IL-10 at T1 and T2 were significantly lower in group D (P < 0.05). Conclusion Dexmedetomidine could improve the postoperative suppression of immune function in patients undergoing hepatoma surgery.

Objective To explore the efficacy of debridement and primary suture for mesh-related infections after tension-free inguinal hernia repair.Methods From January 2007 to December 2013,208 cases with nesh infections following inguinal hernia repairs were treated with debridement in Department of Hernia and Abdominal Wall Surgery of Beijing Chaoyang Hospital,147 cases were treated with primary suture (suture group) and 61 cases were treated with dressing change (open group).Results The mean time of mesh infection was (8.37 ± 6.89) months.The results of bacterial culture in the two groups were similar.First grade healing rate of suture group was 80.95％ (119/147),compared to zero percent in open group.Length of stay [(20.86 ± 7.90) d vs.(31.82 ± 11.50) d,t =3.47,P =0.034] and hospital cost [(3 200 ± 5 800) yuan vs.(26 500 ± 6 600) yuan,t =4.51,P =0.02] in suture group were less than in open group.No patients developed recurrent hernia in suture group compared with one recurrence in open group.Conclusions Debridement and primary suture for mesh-related infections after tension-free inguinal hernia repair could increase the rate of first grade healing,shorten average length of hospital stay and reduce total costs.

OBJECTIVETo prepare insulin-loaded polymeric nanoparticles based on polyethyleneimine-polycaprolactone- polyethylene glycol-polycaprolactone-polyethyleneimine pentablock copolymers and evaluate its in vitro release of insulin.

METHODSPolycaprolactone-polyethylene glycol-polycaprolactone (PCL-PEG-PCL) triblock copolymer was synthesized by ring-opening polymerization method, and the pentablock copolymer was prepared by Michael addition reaction. The copolymers obtained were characterized by Fourier-transform infrared (FT-IR) spectroscopy and (1)H-NMR and their critical aggregation concentration (CAC) was measured by fluorescence technique with pyrene as the probe. Insulin-loaded polymeric nanoparticles based on the pentablock copolymers were prepared by solvent evaporation method that exploited the cationic nature of PEI-PCL-PEG-PCL-PEI to allow the formation of ionic complexes with anionic biomolecules such as insulin. The prepared nanoparticles were further characterized by Malvern laser particle sizer and transmittion electron microscopy (TEM). The drug loading, encapsulation efficiency and in vitro release profile of the nanoparticles were analyzed using Bradford method.

RESULTSUsing copolymer PEI10K-PCL4K-PEG2K-PCL4K-PEI10K as the drug carrier, the spherical nanoparticles prepared with an optimal insulin-coplymer mass ratio of 40% allowed the maximum insulin loading of (18.63∓0.07)% and had an average particle size of 175.30∓19.51 nm. The prepared nanoparticles was capable of sustained release of insulin for as long as 48 h in vitro, and the burst release could be minimized by incorporation of PEI in the triblock copolymer.

CONCLUSIONThe insulin-loaded polymeric nanoparticles based on the pentablock copolymers allow sustained release of insulin in vitro, and PEI can enhance sustained drug release and reduce burst drug release.

Delayed-Action Preparations ; Drug Carriers ; chemistry ; Drug Liberation ; Insulin ; pharmacokinetics ; Nanoparticles ; chemistry ; Particle Size ; Polyesters ; chemistry ; Polyethylene Glycols ; chemistry ; Polymers ; chemistry ; Spectroscopy, Fourier Transform Infrared

This paper summarizes the research situation of the treatment for the periarthritis of shoulder using fire-needle, and summarizes the effective treatment of shoulder periarthritis by using fire-needle method, including the fire-needle with acupuncture or with the cupping therapy, the fire needle combing other methods.Meanwhile. This paper puts forward the problems in the treatment and the clinical study of shoulder arthropoditis.

Afatinib, a second-generation oral tyrosine kinase inhibitor (TKI), is suitable for first-line treatment of advanced non-small-cell lung cancer (NSCLC) and second-line treatment of squamous NSCLC. At present, a large number of strong clinical research data has confirmed the efficacy and safety of afatinib. Therefore, this article reviews the mechanism of action, pharmacokinetic clinical efficacy, combination of drugs, adverse reactions and dose adjustment of afatinib in order to provide ideas for individual rational drug use guidance.

Objective To investigate the clinical efficacy of laparoscopic fundoplication for gastroesophageal reflux disease complicated with Barrett's esophagus.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 12 patients with gastroesophageal reflux disease complicated with Barrett's esophagus who were admitted to Beijing Chao-Yang Hospital of Capital Medical University between July 2012 to July 2016 were collected.Preoperative tests of patients included distal esophageal manometry and 24-hour pH monitoring,gastroscopy and upper gastroenterography.According to preoperative evaluation of patients,laparoscopic Nissen fundoplication was preferred,and laparoscopic Dor fundoplication was used for patients with discordant esophageal peristalsis function.Observation indicators:(1) surgical and postoperative recovery situations;(2) follow-up:① subjective changes of reflux symptoms;② distal esophageal manometry and 24-hour pH monitoring after operation;③ progression of esophageal mucosal lesions.Patients were followed up using outpatient examination and telephone interview with questionnaire at one month after operation and gastroscopy every 6 months up to June 2018.Measurement data with normal distribution were represented as (x)±s and measurement data with skewed distribution were described as M (range).Results (1) Surgical and postoperative recovery situations:of 12 patients,7 underwent laparoscopic Nissen fundoplication and 5 underwent laparoscopic Dor fundoplication.Seven patients complicated with esophageal hiatal hernia underwent laparoscopic repair of esophageal hiatal hernia,without conversion to open surgery.Operation time,volume of intraoperative blood loss and duration of hospital stay were (98±21) minutes,(27± 13) mL,(2.3± 1.2) days.There were no intraoperative and postoperative severe complications in the 12 patients.(2) Follow-up:12 patients were followed up for 20-42 months with a average time of 32 months.① Subjective changes of reflux symptoms:12 patients completed questionnaires at one month after operation.Scores of heartburn in the 12 patients were 0.Acid regurgitation in the 12 patients was relieved,requiring no acid-inhibitory drugs.Upper abdominal dull pain in 3/4 of the patients and retrosternal pain in 2 patients were relieved.Patients had mild dysphagia or abdominal distention at 2 weeks after operation and recovered to normal diet by dietary instruction within 4 weeks.Score of dysphagia was 2 (range,0-4) and no patient need hospitalization or surgical treatment.Score of surgery satisfaction was 9 (range,7-10) in the patients.② Distal esophageal manometry and 24-hour pH monitoring after operation:lower esophageal sphincter pressure and DeMeester score were (12.8 ± 2.8) mmHg (1 mmHg =0.133 kPa) and 11±3 respectively.③ Progression of esophageal mucosal lesions:2 of 9 patients with short Barrett's esophagus were detected complete regression of esophageal mucosal lesions at postoperative one year,1 was detected partial regression of esophageal mucosal lesions at postoperative one year and 6 were detected no change at postoperative 2 years.One of 3 patients with long Barrett's esophagus was detected partial regression of esophageal mucosal lesions at postoperative one year and 2 complicated with mild poor differentiation were detected no change at postoperative 2 years.Conclusion Laparoscopic fundoplication for gastroesophageal reflux disease complicated with Barrett's esophagus can improve subjective symptom and objective markers of patients and provide satisfactory efficacy.

Objective To evaluate the imaging features of nigrosome-1 in Parkinson's disease (PD) with a 3 T scanner by susceptibility weighted imaging (SWI),and to explore its clinical relevance.Methods Thirty-two patients with primary PD diagnosed by neurologists were collected.Healthy controls matched to their age and gender were recruited during the same period (n=20).All subjects underwent routine brain magnetic resonance imaging (MRI) and sensitive weighted imaging (SWI).The SWI images of the subjects were evaluated to evaluate nigrosome-1 by blinded investigators.Then,the correlation between imaging features and clinical data was analyzed.Results In the PD group,21 cases of bilateral "absent swallow-tail sign",five cases of bilateral "indecisive swallow-tail sign",five cases of "absent swallow-tail sign" on one side and "indecisive swallow-tail sign" on the other side,and one case of bilateral "clear swallow-tail sign" were found.The course of the "absent swallow-tail sign" group (56 (54) months) was significantly longer than the "non-absent swallow-tail sign" group (18 (18) months;U=-2.47,P=0.01).The Hoehn-Yahr stage was significantly higher in the "absent swallow-tail sign" group (2.0 (0.5)) than in the "non-absent swallow-tail sign" group (1.5 (0.5),U=-2.21,P=0.03).There was also a statistically significant difference in the Unified Parkinson's Disease Rating Scale score (24 (8),13 (14)) between the two groups (U=-2.91,P=0.01).However,there were no statistically significant differences between the two groups in the Hamilton Depression Scale score (5 (2) vs 5 (7),U=-0.10,P=0.94) and the Hamilton Anxiety Scale score (3.0 (2.5) vs 3.0 (3.0),U=-0.02,P=1.00).Conclusion The images of nigrosome-1 by SWI are closely related to the severity of the condition and motor symptoms of patients with PD,which can reflect the severity of the disease.

Objective:To investigate the application value of ambulatory surgery mode for small and medium abdominal wall hernia repair.Methods:The retrospective and descriptive study was conducted. The clinical data of 33 patients with small and medium abdominal wall hernia who were admitted to Beijing Chaoyang Hospital of Capital Medical University from January 2019 to January 2021 were collected. There were 19 males and 14 females, aged 54(range, 26?85)years. Patients individually underwent Onlay repair, Sublay repair, intraperitoneal onlay mesh repair (IPOM)according to the diagnosis and treatment mode of ambulatory surgery. Observation indicators: catogaries of small and medium abdominal wall hernia, surgical methods, intraoperative measured diameter of hernia ring defect, operation time, volume of intraoperative blood loss, duration of hospital stay, delayed discharge of patients, hospitalization expenses, postoperative follow-up, complications, postoperative visual analogue scale of pain, chronic pain, postoperative satisfaction. Follow-up using telephone interview or outpatient examinations was conducted to detect hernia recurrence, surgical-related complications (wound infection, pain, hematoma or seroma, intestinal leakage, intestinal obstruction) and postoperative satisfaction at postoperative 3 days, 7 days, 1 month, 3 months, 6 months and 12 months. Measurement data with normal distribution were represented as Mean± SD. Measurement data with skewed distribution were represented as M(range), and count data were represented as absolute numbers. Results:Of the 33 patients, 16 cases had umbilical hernia, 14 cases had incisional hernia, 3 cases had lumbar hernia. There were 7 patients treated with Onlay repair, 16 with Sublay repair, and 10 cases with IPOM. The intraoperative measured diameter of hernia ring defect, operation time and volume of intraoperative blood loss of 33 patients were 2.8(range, 1.0?6.0)cm, 51(range, 20?85)minutes, 4.3(range, 1.0?10.0)mL. The duration of hospital stay of 33 patients was 24?48 hours, including 25 cases with duration of hospital stay ≤24 hours, 8 cases with duration of hospital stay >24 hours and ≤48 hours. Of the 8 patients undergoing IPOM with delayed discharge, 5 cases had postoperative pain and 3 cases had dizziness, nausea and vomiting after general anesthesia. They were recovered and discharged from hospital after observation and symptomatic support until the next morning. The hospitalization expenses were 17 139(range, 6404?34 124)yuan. All the 33 patients were followed up regularly after operation. No hernia recur-rence, wound infection, hematoma and seroma, intestinal fistula or intestinal obstruction was observed during the follow-up period. From postoperative 3 days to 12 months, the visual analogue scale of pain was from 2.90±0.10 to 0 for patients with Onlay repair, from 3.10 ±0.10 to 0 for patients with Sublay repair, from 3.50 ±0.20 to 0 for patients with IPOM. No patient suffered from chronic pain after the operation and postoperative satisfaction of patients was 100%. Conclusion:The ambulatory surgery mode has safety and feasibility in small and medium abdominal wall hernia repair.

Objective: To investigate the impact of allergic airway diseases on the risk of attention deficit hyperactivity disorder (ADHD) in school-age children. Method: Used stratified cluster sampling method, school-age children in first to sixth grade in primary schools in 9 randomly selected cities including Shanghai, Guangzhou, Xi′an, and Wuhan were enrolled in the study. Interview of parents with questionnaires, which included school-age individual and family social environment questionnaire (including history of diagnosed ADHD, allergic rhinitis, and bronchial asthma) and Children′s Sleep Habits Questionnaire (CSHQ), were finished and collected during November to December in 2005.Diagnosed allergic rhinitis and asthma by specialist were independent variables and divided into following three categories as no allergic diseases (neither allergic rhinitis nor asthma), single allergic disease (allergic rhinitis or asthma), and combined allergic diseases (allergic rhinitis and asthma). Diagnosed ADHD as dependent variable, binary logistic regress model was used to analyze the risks of ADHD in school-age children. Result: Totally 23 791 questionnaires were handed out, while 22 018 were collected. The children had an average age of (8.8±1.8) years, within which 10 869 were male, and 11 021 were female. The risk ratios of ADHD were 2.197 (95%CI: 1.823-2.648) and 3.150 (95%CI: 2.082-4.760) in children with single allergic disease and combined allergic diseases separately. There was no significant difference after adjusting for the factor of sleep habits, as the risk ratios were 2.055 (95%CI: 1.683-2.508) and 3.140 (95%CI: 2.061-4.784) in children with single and combined allergic airway disease separately. Conclusion Allergic rhinitis and bronchial asthma increased the risk of ADHD, not depending on sleep habits. Hence, allergic airway diseases could be independent risk factors of ADHD.