Objective To find ways to reduce vascular crisis of the patients undergoing replantation of severed fingers by pain, adverse analgesics and sleep quality with auricular seeds pressing. Methods 310 digital replantation patients were divided into 2 groups according to admission time. There were 155 cases in the traditional group treated with routine postoperative care ,while 155 cases in the controlled group treated with routine postoperative care plus auricular seeds pressing. Results The scores of pain, adverse analgesics and sleep quality in two groups were statistically significant ( P<0.05). The rate of vascular crisis of the traditional group [18.06%(28/155)] was much more higher than the controlled group [5.16%(8/155)], the difference was significant, χ2=12.571, P < 0.01. Conclusion In digital replantation, auricular seeds pressing was effective to pain relieving, constipation and reduce adverse reactions, and could significantly improve sleeping time and survival rate of the severed fingers.

BACKGROUNDTo elucidate relationship between amino acid sequence of non-structural protein 5A (NS5A) and outcome of HCV (1 b) patients after interferon (IFNa) therapy.

METHODSSera of 24 patients were collected before, during and after IFNa therapy. Pretreatment RNA levels and the sequences of HCV NS5A interferon sensitivity determining region (ISDR) were determined. NS5A full-length sequences of 5 HCV isolates from 3 patients with different response types were also analyzed. Phylogenetic tree analysis and protein secondary structure prediction were undertaken.

RESULTSPretreatment RNA levels of sustained response group were significantly lower than that of non-response group and relapse group (4.50X104 copies/ml versus 1.82X107 copies/ml, P < 0.01).ISDR sequences of NS5A from pretreatment sera were compared with HCV-J strain (prototype). Thirteen of 24 isolates were wild type,11 of 24 were intermediate type and none of them was mutant type. 3 of 6 sustained responders were infected with wild-type isolates, the rest with intermediate type isolates. Phylogenetic tree based on NS5A full-length sequences classified 5 isolates with 3 different response types into 3 groups. Non-response isolates belonged to the same group as HCV-J. Secondary structure prediction of 5 isolates revealed significant differences existing in 2 255- 2 289. This region was partly overlapped with PKR-binding domain.

CONCLUSIONSLow HCV RNA levels in serum are associated with favorable outcome of IFNa therapy. ISDR sequence alone could not predict outcome of IFN treatment. Combination of determination of HCV RNA levels in serum with sequence analysis of PKR-binding domain may be helpful in predicting the efficacy of IFN therapy.

Amino Acid Sequence ; Antiviral Agents ; therapeutic use ; Hepacivirus ; drug effects ; genetics ; Hepatitis C, Chronic ; drug therapy ; virology ; Humans ; Interferon-alpha ; therapeutic use ; RNA, Viral ; blood ; Viral Nonstructural Proteins ; genetics