Objective:To follow up the hepatitis B recurrence post liver transplantation using the combination of lamivu dine and high-dose intravenous/intramuscular hepatitis B immunoglobulin.Methods:Fifty-two consecutive patients who underwent liver transplantation were included in this analysis.All patients were administered lamivudine combined with hepatitis B immunoglobulin intravenous(V group)or intramuscular(M group)injection prophylaxis.Dosages of hepatitis B immunoglobulin were 4 000 U during anhepatic phase,2 000 U/d during the first six days after operation,2 000 U/week at 2-4 weeks after operation and 2 000 U/month at 2-6 months after operation.The dosages of hepatitis B immunoglobulin were decided by blood concentrations at 6 months after transplantation in both groups(HBsAb titer≥200 U/L during the 6-12 months after operation;100-200 U/L one year after operation).The negative-conversion rates of serum HBsAg,serum HBsAb levels and hepatitis B recurrence rate at the 6th month,1 year after transplantation and at the end of this study were investigated.Results:The daily average negative-conversion rate of serum HBsAg was significantly faster in V group than that of M group within the first 4 postoperative days(P ＜ 0.05).The 100% of serum HBsAg negative-conversion rate was obtained in two groups after one week of operation.No recurrence was found in two groups.And the ease of death was independent on HBV recurrent during the follow-up.Conclusion:Lamivudine combined with hepatitis B immunoglobulin intravenous/intramuscular injection prophylaxis was effective protocol for the hepatitis B recurrence after the liver transplantation.

0.05) between two groups.Conclusion Two surgicel porcedures offer smilar results in the surgical treatment of primary spontaneous pneumothorax.Both techniques are equally safe,small traumatic,pain controllable,and there are little postoprerative complications and the relapse rate is very low.

Objective To evaluate the effectiveness and safety of 25G illumination aided scleral buckling surgery for treatment of rhegrmatogenous retinal detachment (RRD).Methods This is a retrospective case control study.Fifty-seven RRD patients (57 eyes) were enrolled in this study.There were 35 males (35 eyes) and 22 females (22 eyes).The patients were randomly divided into ophthalmoscope group (29 patients,29 eyes) and illumination group (28 patients,28 eyes).There was no differences in the data of gender,age,onset time,logarithm of the minimum angle of resolution (logMAR) best corrected visual acuity(BCVA) and information of retinal tears between the two groups (P＞0.050).The patients in the ophthalmoscope group received operation of conventional scleral buckling with binocular indirect ophthalmoscope.The patients in the illumination group received scleral buckling surgery with the aid of intraocular illumination and noncontact wide-angle viewing system.The follow-up was ranged from 6 to 12 months.The BCVA,intraocular pressure,fundus examination and complications were observed and recorded.Results The difference of operation time between two groups was significant (t=2.124,P=0.031).In the ophthalmoscope group,26 eyes (89.7％) achieved retinal reattachment,3 eyes (10.3％) failed in retinal reattachment.In the illumination group,26 eyes (92.8％) achieved retinal reattachment,2 eyes (7.2％) failed in retinal reattachment.There was no difference of retinal reattachment rate (P=I.000).Five eyes failed in retinal reattachment,3 eyes received sclera buckling surgery,2 eyes received vitrectomy with silicone oil tamponade.The final reattachment ratios were both 100％.BCVA increased in both groups compared with pre-surgery BCVA (t=4.529,5.108;P＜0.001).The difference of BCVA between two groups was not significant (t=0.559,P=0.458).There was no significant difference of intraocular pressure and complications before and after surgery in both two groups (t=-1.386,-1.437;P=0.163,0.149).The difference of intraocular pressure between two groups was not significant (t=0.277,P=0.730).Subretinal hemorrhage occurred in 1 eye in the ophthalmoscope group.There was no iatrogenic retinal break,choroidal hemorrhage and endophthalmitis in the two groups.Conclusion 25G intraocular illumination aided buckling surgery for treatment of RRD is fast,safe and effective.

Objective: The influence on the blood glucose,ALB,LYM,K+,Na+,Cl-,TG,TC and so on after the use of different nutrition formula was observed in patients with cerebrovascular disease and type 2 diabetes.Methods: 40 patients who suffered from cerebrovascular diseases and type 2 diabetes were divided into two groups: one group using the ordinary formula and the others using special-purpose formula of diabetes.The levels of blood glucose,ALB,LYM,K+,Na+,Cl-,TG,TC were monitored.Results: The patient's blood glucose after use of ordinary formula rised obviously and insulin or the oral drug for decreasing blood glucose was used.The blood glucose in special-purpose diabetes formula group didn' t increase obviously,and there was not the need of using insulin(P

Objective To investigate the therapeutic effects and relative mechanisms when constraint-induced movement therapy (CIMT) is used in patients with upper extremity disorders after head injury, and to compare the effects of CIMT with those of traditional rehabilitation (TR). Methods Thirty-six hemiparesis patients were randomly divided into a CIMT group and a TR group. Patients in the CIMT group were treated with intensive shaping training for 5 h a day for 3 weeks, as well as having their unaffected arms constrained. Meanwhile, the patients in the TR group were treated with traditional rehabilitation with no constraint of their unaffected arms. Motor activity logs (MALs) were compiled, and the Wolf Motor Function Test ( WMFT) and Barthel Index ( BI) were used to evaluate the therapeutic effects before treatment and at 0 d, 1 month and 3 month after treatment. Results Compared with the scores before treatment, the therapeutic effects were significant in the CIMT group, and the effect lasted to the follow-up period. Significant differences were also found between the CIMT group and the TR group in the improvement of dexterity by means of WMFT, and the usage of unaffected upper extremity as recorded in the MAL. There were no significant differences in therapeutic effects between the 2 week and 3 week treatments in the CIMT group. Conclusion CIMT significantly improved upper extremity function and ability in the activities of daily living ( ADL) of hemiplegia patients in the subacute period. The effectiveness of CIMT is superior to that of traditional rehabilitation methods.

Objective To evaluate the factors that may influence the possibility of early hemorrhage after vitrectomy with silicon oil tamponade for proliferative diabetic retinopathy (PDR).Methods Sixty-seven eyes of 60 patients of PDR who received vitrectomy and silicon oil filled in Department of Ophthalmology,China-Japan Friendship Hospital during January 2014 and May 2017 were included in this study.There were 34 males and 26 females,with the mean age of 51.3 ± 12.5 years.Groups were divided depending on the degree of postoperative hemorrhage in 3 days:non-hemorrhage group (NH group) and hemorrhage Group (H group) composed of two sub-group that were called slight hemorrhage (SH) and massive hemorrhage (MH) group.The treatment was conventional 25G or 27G pars plana vitrectomy combined with silicon oil tamponade.Forty eyes received phacoemulsification.The follow-up ranged from 8 to 16 months,with the mean follow-up of 11.2± 5.6 months.The possible related factors of early hemorrhage after vitrectomy with silicon oil tamponade were analyzed.Independent t test,x2 test and Fisher test were used in this study.Results 55 eyes of 48 patients were in the NH group,while 12 eyes of 12 patients were in the H Group.There were statistical significances on the difference of age (t=-3.552,P=0.001),gender (P=0.052),hypertension (P=0.021),HbA1c (t=2.187,P=0.033)and presence of neovascularization of iris (x2=6.414,P=0.011),but there was no difference on diabetes duration (t=-0.451,P=0.654).Of the 12 patients in the H group,7 were in the SH group and 5 were in the MH group.The MH group had a significantly higher HbA1c level (7.8± 1.1)％ compared with the SH Group (9.7±0.7)％,the difference was statistical significant (t=-3.256,P=0.009).Higher systolic blood pressure of MH group 186± 7 mmHg (1 mmHg=0.133 kPa) acquired during operation was observed compared with S H Group 153± 18 mmHg,the difference was statistical significant (t=-3.894,P=0.003).There was no statistical significances on the difference of age (t=1.954),gender,hypertension duration (t=-1.787),diabetes duration (t=-1.079),fasting blood-glucose (t=-0.361),diastolic blood pressure during operation (t=-0.811) between the two groups (P＞0.05).Conclusions Younger age,history of hypertension,presence of neovascularization of iris,higher level of HbA 1 c may predict greater possibility to cause early hemorrhage after vitrectomy with silicon oil tamponade for PDR.The patients with high level of HbA1c and high systolic pressure during the operation are more likely to undergo massive hemorrhage and secondary glaucoma.

Objective To evaluate the early diagnostic value of circulating microRNA-1 (miR-1) on acute myocardial infarction (AMI). Methods A prospective cohort study was conducted. The patients with chest pain admitted to the Second People's Hospital of Wuxi from November 2012 to June 2015 were enrolled. According to AMI diagnostic criteria, the patients were divided into AMI group and non-AMI group, and healthy individuals during the same period were served as heath controls. The venous samples of the onset patients were collected within 3 hours after admission. The plasma miR-1 was determined by real-time quantitative reverse transcription-polymerase chain reaction (RT-PCR), and the levels of plasma cardiac troponin I (cTnI) and MB isoenzyme of creatine kinase (CK-MB) were measured by electrochemiluminescence. The correlation between plasma miR-1 and cTnI as well as CK-MB was performed by Spearman analysis. The early diagnostic performance of plasma miR-1, cTnI, and CK-MB for AMI was estimated by receiver operating characteristic (ROC) curve analysis. Results There were 127 patients in AMI group, and 107 in non-AMI group, including 82 patients with angina pectoris, 2 with pulmonary embolism, 3 with aortic dissection, 2 with acute pericarditis, 3 with myocarditis, 13 with acute heart failure, and 2 with peptic ulcer. Ninety volunteers were served as healthy controls. There was no difference in clinical characteristics including gender and hyperlipidemia between AMI group and non-AMI group. The expressions of plasma miR-1, cTnI and CK-MB were significantly increased in AMI patients as compared with those of the healthy controls [miR-1 (2-ΔΔCt): 4.32±2.60 vs. 1.44±0.75 and 0.98±0.18, cTnI (μg/L): 3.23 (0.63, 10.70) vs. 0.02 (0.00, 0.17) and 0.00 (0.00, 0.00), CK-MB (U/L): 32.40 (14.20, 95.40) vs. 14.40 (11.20, 17.10) and 8.90 (8.28, 9.50), all P < 0.01]. The expression of plasma miR-1 had a significantly positive correlation with cTnI and CK-MB in AMI patients (r1 = 0.395, r2 = 0.490, both P < 0.000). It was demonstrated by ROC curve analysis that the area under ROC curve (AUC) for the diagnostic value of miR-1 on AMI was 0.905 [95% confidence interval (95%CI) = 0.860-0.950, P = 0.000], the sensitivity was 86.6%, and the specificity was 95.4%; the AUC for cTnI was 0.908 (95%CI = 0.870-0.946, P = 0.000), the sensitivity was 81.9%, and the specificity was 95.9%; the AUC for CK-MB was 0.795 (95%CI = 0.736-0.854, P = 0.000), the sensitivity was 63.0%, and the specificity was 92.9%. Conclusions Plasma miR-1 has the capacity in early diagnosis of AMI, superior to CK-MB, and equal to cTnI. It can provide additional diagnostic information beyond cTnI. The diagnostic accuracy for early AMI can be improved with the combination of plasma miR-1 and cTnI.

Objective:To study the tonifying Qi and producing blood mechanism of Jianpi Shengxue tablets. Methods: SD rats were randomly divided into the normal group,FeSO4group, and low, medium and high dosage groups(0.65,1.3,2.6 g·kg-1). All the groups except the normal group received low iron diet,to induce anemia. After the two-week intragastric administration, real-time PCR was carried out to identify the changes of Hepcidin mRNA expression, while western blot was applied to test the changes of DMT-1 protein expression. Results:The medium and high dosage groups could significantly increase the DMT-1 expression compared with the normal group,while FeSO4 could reduced the DMT-1 expression. The Hepcidin expression in liver was increased along with the in-crease of the dosage. Conclusion:The Chinese medicine ingredients in Jianpi Shengxue tablets is beneficial to the expression of DMT-1 protein and the expression of Hepcidin mRNA in liver, which can finally improve the iron supply in the body.

Objective To discuss the feasibility and effectiveness of transcatheter implantation of double-ring aortic valve stent through puncturing the tip of the heart under thoracotomy.Methods A novel double-ring aortic valve stent was independently designed by the authors.Three healthy goats were selected for this study.A small incision on the left anterolateral thoracic wall was made to expose the cardiac apex,than the puncturing of the left ventricular apex was performed to establish the working pathway.Guided by fluoroscopy,along a hard guide wire a double-ring aortic valve stent was inserted through a 22-French sheath to the site above the aortic valve.By utilizing the opened outer ring of the stent,the double-ring aortic valve stent was accurately placed at the bottom of the aortic valve sinus.Then,the balloon was inflated and the stent was released to substitute the original aortic valve of the experimental goat.The experiment results were evaluated immediately after the procedure.Results Transcatheter aortic valve implantation (TAVI) was successfully accomplished in all the three experimental goats.DSA was performed immediately after the procedure and anatomy evaluation indicated that the position of the implanted artificial aortic valve was satisfactory,which could replace the work of original valve.Conclusion It is technically feasible and clinically effective to use this novel double-ring aortic valve stent to perform TAVI through transapical route by puncturing the left ventricular apex.

Objective: To investigate the clinicopathological characteristics and prognostic factors in breast carcinoma patients with bone-only metastasis (BOM). Methods: A total of 967 patients with metastatic breast cancer treated in Tianjin Medical University Insti-tute and Hospital between January 2009 and December 2016 were screened, and the case data were retrospectively analyzed. These data involve 180 cases in the BOM group and 787 cases in the non-BOM group. We performed univariate analysis and Cox regression model multivariate analysis of prognostic factors in patients with BOM. Subgroup analysis was performed according to the hormone re-ceptor (HR) status, number of bone metastases, and treatment approaches. Results: Patients in the BOM group had a median progres-sion-free survival (PFS) of 19.4 months, and non-BOM patients had a median PFS of 10.0 months. Patients in the BOM group had a me-dian overall survival (OS) of 45.6 months. The proportions of patients with HR positivity were 81.7% (147/180) in the BOM group and 64.7% (509/787) in the non-BOM group (P<0.001). Cox regression model multivariate analyses found that HR status, location of bone metastases, number of bone metastases, and treatment approach were independent factors influencing the prognosis of patients with BOM. Among patients with HR-positive BOM, the prognosis of patients receiving endocrine therapy (P=0.004) or combinatory therapy (P<0.001) was significantly better than that of patients receiving chemotherapy alone. The number of bone metastases and endocrine therapy were independent prognostic factors in patients with HR-positive BOM. Patients with single bone metastases who received en-docrine therapy (P=0.004) or combinatory therapy (P=0.002) had better prognosis than patients who received chemotherapy alone. Patients with multiple bone metastases who received combinatory therapy had better prognosis than patients who received endo-crine therapy (P=0.04) or chemotherapy alone (P<0.001). Conclusions: For HR-positive BOM patients, especially those with single me-tastases, endocrine therapy can obtain satisfactory outcomes. For patients with multiple metastases, combinatory therapy can be con-sidered.