ObjectiveTo observe the effect of neural mobilization based on shoulder control training on shoulder pain and upper limb function in stroke patients with hemiplegia. MethodsFrom January, 2020 to November, 2021, 43 patients with hemiplegia after stroke in the Second People's Hospital of Nantong were randomly divided into control group (n = 21) and treatment group (n = 22). The control group received shoulder control training, while the treatment group received neural mobilization in addition. Before and after four weeks of treatment, they were evaluated with the Numeric Rating Scale (NRS) of pain and Fugl-Meyer Assessment-Upper Extremities (FMA-UE). ResultsOne case dropped off in the control group and two cases dropped off in the treatment group. After treatment, the NRS score and FMA-UE score improved in both groups (|t| >7.898, P < 0.001), and they were better in the treatment group than in the control group (|t| >2.337, P < 0.05). ConclusionNeural mobilization based on shoulder control training can significantly alleviate shoulder pain and improve upper limb motor function in stroke patients with hemiplegia.

Objective:To explore the pathogenesis and prognostic factors of brain metastasis of hepatocellular carcinoma(HCC)after liver transplantation(LT).Methods:Retrospective review was performed for 17 HCC cases with brain metastasis after liver transplantation from 2000 to 2020.All cases were diagnosed as hepatitis B cirrhosis complicated with HCC.All of them were beyond the Milan Criteria.The immunosuppressive regimen consisted of baliximab + mycophenolate mofetil + calcineurin inhibitors(CNIs)+ corticosteroids in early postoperative period with a gradual tapering of corticosteroids and mycophenolate mofetil.Three patients received sirolimus immunotherapy after tumor recurrence and withdrew CNIs.One of three cases received sorafenib.Results:Other organ involvements included lung metastasis( n=16, 94.1%), bone metastasis( n=5, 29.4%)and liver metastasis( n=6, 35.3%). The median survival time after brain metastasis was 7 months and the 1-year cumulative survival rate 29.4%.The median survival time post-LT was 14 months and the 1-year cumulative survival rate 64.7%.Among 7 patients with a resection of brain metastasis, two deaths at Month 1 post-operation were due to cerebral hemorrhage.The longest survival time was 214 months and the median survival time 9 months. Conclusions:The prognosis of brain metastasis post-LT remains poor.However, early detection and reasonable treatment can prolong patient survival time and even achieve long-term survival.Most brain metastases are accompanied by lung metastases.And the finding of lung metastatic tumor hints at a presence of intracranial lesions.

Objective:To analyze the epidemiological and etiological characteristics of a dengue fever outbreak in Hunan province in 2018.Methods:Real-time PCR assay was performed for the laboratory diagnosis of 8 suspected dengue fever cases. Etiological surveillance was performed in 186 suspected dengue fever cases and fever cases who had close contacts with dengue fever patients. C6/36 cells was used for the virus isolation from acute phase serum. By sequencing the full length of E genes of 15 dengue virus strains, phylogenetic analysis was performed based on the sequences obtained, including reference sequences from the NCBI GenBank database, the serotypes and gene subtypes of the virus were analyzed to trace the possible source of transmission. An emergency monitoring of vector density and a retrospective survey of sero-epidemiology in healthy population were conducted in the epidemic area.Results:In the serum samples of 8 suspected patients, 6 were dengue virus RNA positive, and 4 were NS1 antigen positive. In 186 suspected patients, 96 were dengue virus nucleic acid, NS1 antigen or antibody positive in etiological test. A total of 64 dengue virus strains were isolated. The phylogenetic analysis showed that all the dengue virus strains belonged to type 2, which might be from Guangdong or Zhejiang provinces. The Bretub index was up to 65, indicating an extremely high risk of transmission. The positive rate of the dengue virus IgG antibody was 0.53%(2/377) in retrospective survey of 377 healthy people.Conclusion:The field epidemiologic and the molecular genetics analyses showed the outbreak of dengue fever in Hunan in 2018 was caused by imported cases and dengue virus 2.

Objective: To understand the infection status and genetic characteristics of Norovirus from foodborne diseases in sentinel hospital of Ma′anshan city. Methods: The 911 stool samples and epidemiological data of the patients with foodborne disease were collected from three hospitals of Ma′anshan city during January 2015 to June 2018. The G Ⅰ and G Ⅱ Norovirus were detected by real-time reverse transcription PCR. Some of the positive specimens were amplified by conventional reverse transcription PCR, and the PCR products were sequenced for sequence alignment and phylogenetic analysis. Results: The positive rate of Norovirus was 14.7% (134/911), in which 7 strains were G Ⅰ, 124 strains were G Ⅱ and 3 strains were mixed infection. Norovirus can be detected throughout the year, with high positive rate from December to April of the next year [24.4%(20/82)-45.3%(24/53)]. The 78 males (15.5%) and 55 females (13.7%) were positive for Norovirus (χ²=0.58,P=0.448). There was no significant difference in different age groups (χ²=9.55, P=0.089). A total of 79 strains were successfully sequenced, 4 strains were G Ⅰ group(5.1%), 75 strains were G Ⅱ group (94.9%). The predominant strains were GⅡ.17 and GⅡ.4, aud the number were 35 and 15 respectively. The predominant strains were different in different years. The main strain was GⅡ.17 in 2015 (30, 68.2%),GⅡ.4 in 2016 (5/9) and 2017 (8/16), but GⅡ.3 in 2018 (3/6). Conclusion Norovirus diarrhea was popular in Ma′anshan city throughout the year,especially in winter and spring. The prevalent strain was GⅡ,genotypes were diversified distribution,the dominant strains were GⅡ.17 and GⅡ.4. The predominant strains were different in different years.

OBJECTIVE: To review the development of adult and pediatric liver transplantation in Tianjin First Center Hospital, and to enhance academic exchanges, improve technological innovation, and jointly promote the progress and maturity in the field of liver transplantation. METHODS: The development of liver transplantation in Tianjin First Center Hospital was analyzed. The clinical data of adult and pediatric liver transplantation from September 1998 to September 2018 were collected. The important events and technological innovation achievements of liver transplantation during the 20 years were summarized. RESULTS: The first clinical liver transplantation was attempted in Tianjin First Central Hospital in April 1980. The first long-term survival adult liver transplantation in China was completed in 1994 (11 years survival after the operation). The specialized team of liver transplantation was formally established in September 1998. The 20-year clinical exploration and progress reflected the characteristics of era changes and technological innovation during the rapid development of liver transplantation in China. Our center performed liver re-transplantation in January 1999, reduced-size pediatric liver transplantation in August 2000. In May 2001, we organized the formulation for the preventive and treatment plan for hepatitis B recurrence after liver transplantation. We performed combined liver and kidney transplantation in July 2002, split liver transplantation (SLT) in April 2004, the first domino liver transplantation (DLT) in August 2005. Pediatric living donor liver transplantation (LDLT) was initiated in October 2006, adult LDLT was carried out in August 2007. In September 2007, the first living donor combined liver and kidney transplantation from the same donor in Asia was performed. The first domino+living donor double grafts liver transplantation in the world was performed in January 2009. In March 2011, we performed laparoscopically assisted right hepatic lobe liver transplantation (LDLT) with middle hepatic vein. In May 2014, living donor laparoscopic left lateral lobe procurement was successfully established. In April 2016, simultaneous liver, pancreas and kidney multi-organ transplantation was completed. Domino donor-auxiliary liver transplantation was performed in February 2017. In December 2017, extracorporeal membrane oxygenation (ECMO)-supported liver transplantation in a patient with severe pulmonary hypertension was successfully completed. Liver transplantation combined with partial splenectomy was established in April 2018. Cross-domino liver transplantation (hypersensitive kidney transplantation with auxiliary liver transplantation+pediatric liver transplantation) was performed in May 2018. During the 20 years, the team has performed or assisted other centers in Beijing, Shanghai, Guangzhou and Shenzhen to carry out more than 10 000 cases of liver transplantations. A total of 7 043 cases of various types of liver transplantation were performed in the single center of the hospital (6 005 adult liver transplantations and 1 038 pediatric liver transplantations). Concerning adult liver transplantation, the cumulative 1-year, 3-year and 5-year survival rate from September 1998 to March 2003 were 83.1%, 73.0% and 69.0%, from April 2003 to March 2009 were 85.3%, 76.2% and 72.1% and from April 2009 to September 2018 were 87.5%, 79.2% and 75.1%, respectively. The cumulative 1-year, 3-year and 5-year survival rate for pediatric liver transplantation were 93.5%, 92.2% and 90.2%, respectively. The nucleoside (acid) analogue combined with low dose hepatitis B immunoglobulin (HBIG) was developed to prevent the recurrence of hepatitis B after liver transplantation, this plan has reduced the recurrence rate of hepatitis B and the 5-year re-infection rate of hepatitis B virus (HBV) after liver transplantation significantly. The risk assessment system for tumor recurrence after liver transplantation was established and individual treatment method was established based on this assessment system. Continuous exploration and improvement of liver transplantation for liver cancer, liver re-transplantation, liver transplantation with portal vein thrombosis, SLT, DLT and multi-organ combined transplantation have significantly improved the clinical efficacy of patients and the post-operative survival rate. CONCLUSIONS The liver transplantation team of Tianjin First Center Hospital has carried out a scientific and technological exploration on the key problems and technical difficulties of clinical liver transplantation. This work strongly has initiated and promoted the rapid development of liver transplantation in China. The restrictive barrier of hepatitis B recurrence after liver transplantation has been overcome. The risk prevention and control system of tumor recurrence after liver transplantation has been established. A series of innovative achievements that can be popularized have been achieved in the field of complex liver transplantation and expansion of donor liver source. The iterative progress and sustainable development of liver transplantation have been realized.
China ; Humans ; Liver Transplantation

Objective To understand the infection status and genetic characteristics of Norovirus from foodborne diseases in sentinel hospital of Ma′anshan city. Methods The 911 stool samples and epidemiological data of the patients with foodborne disease were collected from three hospitals of Ma′anshan city during January 2015 to June 2018. The GⅠ and GⅡ Norovirus were detected by real?time reverse transcription PCR. Some of the positive specimens were amplified by conventional reverse transcription PCR, and the PCR products were sequenced for sequence alignment and phylogenetic analysis. Results The positive rate of Norovirus was 14.7% (134/911), in which 7 strains were GⅠ, 124 strains were GⅡ and 3 strains were mixed infection. Norovirus can be detected throughout the year, with high positive rate from December to April of the next year [24.4%(20/82)-45.3%(24/53)]. The 78 males (15.5%) and 55 females (13.7%) were positive for Norovirus (χ2=0.58, P=0.448). There was no significant difference in different age groups (χ2=9.55, P=0.089). A total of 79 strains were successfully sequenced, 4 strains were GⅠ group (5.1%), 75 strains were GⅡ group (94.9%). The predominant strains were GⅡ. 17 and GⅡ. 4, aud the number were 35 and 15 respectively. The predominant strains were different in different years. The main strain was GⅡ.17 in 2015 (30, 68.2%),GⅡ.4 in 2016 (5/9) and 2017 (8/16),but GⅡ.3 in 2018 (3/6). Conclusion Norovirus diarrhea was popular in Ma′anshan city throughout the year,especially in winter and spring.Theprevalent strain was GⅡ,genotypes were diversified distribution,the dominant strains were GⅡ.17 and GⅡ.4. The predominant strains were different in different years.

Objective To understand the infection status and genetic characteristics of Norovirus from foodborne diseases in sentinel hospital of Ma′anshan city. Methods The 911 stool samples and epidemiological data of the patients with foodborne disease were collected from three hospitals of Ma′anshan city during January 2015 to June 2018. The GⅠ and GⅡ Norovirus were detected by real?time reverse transcription PCR. Some of the positive specimens were amplified by conventional reverse transcription PCR, and the PCR products were sequenced for sequence alignment and phylogenetic analysis. Results The positive rate of Norovirus was 14.7% (134/911), in which 7 strains were GⅠ, 124 strains were GⅡ and 3 strains were mixed infection. Norovirus can be detected throughout the year, with high positive rate from December to April of the next year [24.4%(20/82)-45.3%(24/53)]. The 78 males (15.5%) and 55 females (13.7%) were positive for Norovirus (χ2=0.58, P=0.448). There was no significant difference in different age groups (χ2=9.55, P=0.089). A total of 79 strains were successfully sequenced, 4 strains were GⅠ group (5.1%), 75 strains were GⅡ group (94.9%). The predominant strains were GⅡ. 17 and GⅡ. 4, aud the number were 35 and 15 respectively. The predominant strains were different in different years. The main strain was GⅡ.17 in 2015 (30, 68.2%),GⅡ.4 in 2016 (5/9) and 2017 (8/16),but GⅡ.3 in 2018 (3/6). Conclusion Norovirus diarrhea was popular in Ma′anshan city throughout the year,especially in winter and spring.Theprevalent strain was GⅡ,genotypes were diversified distribution,the dominant strains were GⅡ.17 and GⅡ.4. The predominant strains were different in different years.

Objective To establish the reference intervals of 20 dry biochemical items in different age periods among healthy population in Chengdu to providing better support and service for clinical diagnosis and treatment .Methods The stratified random‐ized cluster method was used to collect healthy children and adults in 4 age periods(1 month-3 years old ,>3-7 years old ,>7-18 years old and >18 years old) .Totally 1 495 healthy people (740 males and 755 female) were screened out as the research sub‐jects by the questionnaire ,physical examination and laboratory screening .Fasting venous blood samples were collected from these cases ,then the VITROS 5600 dry biochemistry analyzer was used to detect 20 biochemical items .The obtained results were statisti‐cally analyzed .Results In different groups according to sex and age ,except the conjugated bilirubin (BC) was constant 0 μmol/L , the other items had statistical differences (P<0 .05) .After merging the different groups without statistically significant difference , the obtained reference intervals had significant differences compared with the reference intervals provided by the manufacturer .Con‐clusion Laboratory should establish the different reference intervals aiming at different age and gender populations according to the special character of hospital visiting populations in order to meet the clinical requirements .

Objective To discuss the clinical value of high sensitivity C‐reactive protein(hs‐CRP) ,fibrinogen(Fib) and D‐dimer (D‐D) measurement for patients with acute myocardial infarction(AMI) before and after the treatment with the anticoagulation and thrombolysis therapy .Methods 110 patients with AMI were recruited in the study and the plasma hs‐CRP ,Fib ,D‐D and myocardi‐al damage markers were measured before and after the treatment .Results 66 of the 110 patients′plasma hs‐CRP ,Fib ,D‐D concen‐trations elevated(higher than the threshold) before treatment and after treatment within 24 h ,while 44 patients′plasma hs‐CRP , Fib concentrations increased ,but D‐D didn′t .Conclusion The measurement of hs‐CRP is helpful for the diagnosis and treatment of AMI .Hs‐CRP is another good myocardial injury marker ,and the plasma hs‐CRP concentration after treatment for 24 -48 h could reflect the severity and prognosis of AMI better than after treatment within 12 h .Fib decreases relatively slowly after the treat‐ment ,so it cannot be used for curative effect observation for AMI patients;D‐D concentration dosen′t have the determined negative predictive value for the diagnosis of AMI ,so it cannot be used as screening out indicator for AMI ,but D‐D concentration can be used as therapeutic effect monitoring indicator for AMI patients with D‐D positive .

Objective To evaluate the effect of aged cadaveric donor liver on long-term survival of liver transplant recipients.Methods Patients who underwent first time liver transplantation from cadaveric donor aging above 40 years were studied.Those patients were divided into donor age ＜ 50 group and age ≥ 50 group.Data for donor graft,recipient perioperative condition as well as long-term survival of recipients were compared between the two groups.Results There were 21 recipients receiving liver graft from a donor aging ≥ 50 (54.6-± 3.9) years.58 cases were given a liver graft from a donor aging ＜ 50 years (42.6 ± 2.9).The overall donor graft conditions were not different between the two groups (P ＞ 0.05).However,the median amount of operation time in donor age ≥50 group was longer than that in age ＜ 50 group (9.5 h vs.8.0 h,Z =-1.994,P =0.046).Median red blood cell (RBC) transfusion volume was greater in the age ≥50 group than that in age ＜50 group (1 000 ml vs.800 ml,Z =-2.593,P =0.010).During the follow-up,graft survival rates in 1,3 and 5 years were 74％,55％,55％ in donor age ≥50 group and 87％,66％,63％ in donor age ＜ 50 group,respectively (Z =0.903,P =0.342).Conclusions Use of aging cadaveric donor liver expandes donor pool,and is as well as safe,not hindering in graft's long term functions.