1.Emergence of the pre C and YMDD mutations and its clinical significance during lamivudine treatment
Chuanmiao LIU ; Xinxin ZHANG ; Zhimeng LU
Chinese Journal of Infectious Diseases 2001;0(05):-
Objective To explore pre C and YMDD motif mutant of hepatitis B virus during lamivudine therapy. Methods From five chronic hepatitis B patients with serum HBeAg seroconversion but HBV DNA positive by polymerase chain reaction(PCR) following lamivudine therapy, sequences of the pre C and P genes of hepatitis B virus were analyzed by direct PCR product sequencing methods. Results All the five patients were observed to have G to A variations at nucleotide 1896. However, such mutations were observed only in 2 of the 5 patients before HBeAg seroconversion emerged. Meanwhile YMDD mutations were found in all the five patients during lamivudine therapy three of which were M552I mutants, two were M552I associated with L528M. One of the five patients had no reaction to the therapy, four had HBV DNA breakthrough during therapy. Conclusions The mutants of pre C associated with YMDD mutations may arise in the patients with HBeAg seroconversion and positive HBV DNA during the treatment of lamivudine. HBV DNA should be detected in the patients with HBeAg seroconversion to exclude the pre C mutation.
2.Detection of YMDD mutation during lamivudine therapy by real time fluorimetry PCR
Chuanmiao LIU ; Xinxin ZHANG ; Donghua ZHANG ; Zhimeng LU
Chinese Journal of Laboratory Medicine 2001;0(01):-
Objective Setting up a method to detect YMDD mutation during lamivudine therapy. Methods Two specific fluorescent probes were designed, on the unpaired base can remarkably affect melting temperature when oligonucleotide probe binding to DNA template. 297 patients (354 sera samples) were detected YMDD mutation by real time fluorimetry PCR. Results 156 YMDD mutation were found in 354 sera samples (44.1%), in which the mixed variant species were 34%(53/156). In the same time, nine sera samples wre sequenced. The results of sequencing were fully corresponded to those of fluorimetry PCR. The statistical analysis showed that YMDD variants were obviously correlated with ALT level(P
3.Randomized,Open-label and active controlled study of PEG-IFN?-2a in the treatment of chronic hepatitis C in China
Daozhen XU ; Yao XIE ; Zhimeng LU ; Al ET ;
Chinese Journal of Infectious Diseases 1997;0(04):-
Objective To investigate the efficacy, tolerability and safety profiles of PEG IFN alpha 2a(PEG IFN? 2a) in the treatment of chronic hepatitis C in China. Methods 208 patients with chronic hepatitis C were included, and divided into two groups randomly, PEG IFN? 2a group and IFN? 2a Group respectively. There was no significant difference between two groups in pretreatment HCV RNA, HCV genotype and other clinical data. The main parameters to valuate the efficacy were virological response and biochemical response. The side effects were intensively observed. Results Sustained virological response rate in PEG IFN? 2a group was significantly higher than that in IFN? 2a group (41.51% and 16.67% respectively, P
4.Hepatic transplantation and HBV reinfection.
Chinese Journal of Hepatology 2002;10(1):75-76
5.The application of computer aided technology in the treatment of pelvic malunion
Yu HE ; Dongsheng ZHOU ; Haomin CUI ; Shun LU ; Qinghu LI ; Zhimeng ZHAO
Chinese Journal of Orthopaedics 2015;35(4):307-314
Objective To introduce the application of computer aided technology in the treatment of pelvic malunion and observe the effect of this technique on the operation.Methods Data of 9 consecutive patients with pelvic malunion who were enrolled in our hospital from January 2009 to December 2012 were retrospectively observed.There were 4 patients who had undergone surgery with computer aided technology,including 3 men and 1 woman with an average age of 34 years (computer aided technology,CAT) group.According to the Tile classification,4 cases were all type C.There were 1 case with open pelvic fractures,2 associated with the craniocerebral injury,2 associated with the thoracic injury and 2 associated with the abdomen trauma.There were 5 patients who had undergone surgery without computer aided technology,including 3 men and 2 women with an average age of 32.6 years (conventional group).According to the Tile classification,4 cases were all type C.There were 1 case with open pelvic fractures,2 associated with the craniocerebral injury,3 associated with the thoracic injury and 1 associated with the abdomen trauma.The Majeed score,the visual analogue score (VAS),operation time,blood loss,blood transfusion,intraoperative fluoroscopy,degree of improvement in lower limb length,iatrogenic injury and the complication were all recorded respectively.Results For the CAT group,the operation time was 195-230 min,the blood loss was 800-1 6 00 ml,the blood transfusion was 6-16 U,intraoperative fluoroscopy was 6-11 times and the degree of improvement in lower limb length was 2-3 cm.The Majeed score in the final follow-up was 78-90 points,including 3 excellent cases and 1 good.The VAS after surgery was 0-4 points.For the conventional group,the operation time was 210-330 min,the blood loss was 600-4 500 ml,the blood transfusion was 6-28 U,intraoperative fluoroscopy was 7-18 times and the degree of improvement in lower limb length was 1-3 cm.The Majeed score in the final follow-up was 79-89 points,including 3 excellent cases and 2 good.The VAS after surgery was 1-4 points.Conclusion Surgeons can make full preoperative planning by the computer aided technology before the operation.This technology which reduces the operation time can make the operation more accurately,effectively and safely.
6.Basic characteristics and treatment of aseptic nonunion of femoral shaft in Red Cross Hospital Affiliated to Medical College, Xi'an Jiaotong University from 2013 to 2020
Haobo YE ; Liang SUN ; Lu LIU ; Zhimeng WANG ; Kun ZHANG
Chinese Journal of Orthopaedic Trauma 2022;24(12):1049-1054
Objective:To investigate the basic characteristics and treatment of aseptic nonunion of femoral shaft in Xi'an Red Cross Hospital from 2013 to 2020.Methods:The data were analyzed retrospectively of the patients with aseptic nonunion of femoral shaft who had been treated at Department of Orthopaedics and Trauma, Red Cross Hospital Affiliated to Medical College, Xi'an Jiaotong University from January 2013 to December 2020. The patients' data from 2013 to 2016 were assigned into group A while those from 2017 to 2020 into group B. The data like gender, age and nonunion were statistically analyzed and compared between the 2 groups.Results:A total of 311 patients with aseptic nonunion of femoral shaft were diagnosed and treated during the 8 years, accounting for 54.6% (311/570) of the femur nonunion, 32.8% (311/949) of the lower extremity nonunion, 25.0% (311/1,242) of the extremity nonunion, and 22.7% (311/1,370) of the whole body nonunion. There were 244 males and 67 females; the majority of patients were in the age group of 21 to 50 (67.2%, 209/311). The occupation distribution was the most common in farmers (49.2%, 153/311). Traffic injury was the most common cause for primary fractures (40.8%, 127/311). The most common type of injury was closed injury (89.4%, 278/311); the most common type of nonunion was atrophic nonunion (87.8%, 273/311); intramedullary nailing was the main treatment for primary fractures (54.3%, 169/311); channel osteogenesis was the main treatment for secondary nonunion (62.1%, 193/311); autologous iliac bone grafting was the most common grafting for atrophic nonunion (83.5%, 228/311). Compared with group A, the proportion of aseptic nonunion of femoral shaft in group B increased by 9.2% in the femoral nonunions, by 6.9% in the lower extremity nonunions, and by 6.0% in the extremity nonunions, and by 5.2% in the whole body nonunions, showing statistically significant differences ( P < 0.05). There were significant differences in the types of nonunion, occupational distribution, first-stage fracture treatment, second-stage nonunion treatment, and bone grafting method between the 2 groups ( P < 0.05). Conclusions:The patients with aseptic nonunion of the femoral shaft were more common in young and middle-aged male heavy manual laborers, and the condition was increasing in recent years. The channel osteogenesis technique was still the preferred treatment method in the hospital investigated.
7.A retrospective study of endoscopic submucosal dissection for colorectal tumors
Qingqing LIU ; Zhimeng SHI ; Honggang YU ; Lu WU ; Zhengqiang WANG
Chinese Journal of Digestive Endoscopy 2017;34(12):857-860
Objective To investigate the clinical efficacy of endoscopic submucosal dissection (ESD)for the treatment of colorectal tumors, and to analyze risk factors affecting operation time. Methods A retrospective study was conducted using data of 74 cases with colorectal tumor,who underwent ESD in Department of Gastroenterology of Wuhan University Renmin Hospital from January 2014 to September 2015. The clinical efficacy of ESD, occurrence of complications and follow-up results were summarized,and the risk factors of operation time were analyzed. Results The rate of ESD en bloc resection and histological complete resection was 97.30%(72/74)and 89.19%(66/74), respectively. Among the 8 cases of histological non-curative resection, 2 cases received appended surgical procedures because of deep invasion of tumor(SM2),6 cases were given close follow-up according to the pathological result of adenomas. Among the 74 cases, no acute hemorrhage or pneumoperitoneum occurred. Four cases (5.41%, 4/74)had postoperative delayed bleeding, and were successfully treated by endoscopic hemostasis. Four cases(5.41%, 4/74)had intraoperative perforation, and were successfully treated by endoscope. No recurrence or abnormal lesions occurred during the follow-up of 15-35 months. Multivariate linear regression analysis showed that tumor size was a main risk factor for ESD operation time(P=0.000). Conclusion ESD, as a minimally invasive treatment, is safe and effective for the treatment of colorectal tumors,and the tumor size is a main risk factor of ESD operation time.
8.Effects of surgical revision for humeral shaft nonunion on health-related quality of life
Yao LU ; Zhimeng WANG ; Liang SUN ; Qian WANG ; Teng MA ; Ming LI ; Cheng REN ; Hanzhong XUE ; Zhong LI ; Kun ZHANG
Chinese Journal of Orthopaedic Trauma 2020;22(5):394-399
Objective:To investigate the effects of surgical revision for humeral shaft nonunion on health-related quality of life.Methods:The data of 62 patients were studied retrospectively who had been hospitalized at Department of Orthopaedics and Traumatology, Hong-Hui Hospital for humeral shaft nonunion from March 2013 to September 2018. They were 43 males and 19 females, aged from 20 to 73 years (average, 42.3 years). Their nonunions belonged to the atrophic type in 19 cases, to the ischemic type in 14 cases and to the hypertrophic type in 29 cases. Their demographic and clinical data, imaging manifestations and treatment methods were recorded and analyzed. The 12-item short form health survey (SF-12) and brief pain inventory (BPI) were used to evaluate their health-related quality of life and the Mayo elbow performance score (MEPS) was used to evaluate their elbow function.Results:Upon admission, their physical component summary (PCS) scored 24.3±5.2, mental component summary (MCS) 26.3±3.8, brief pain inventory- severity (BPI-S) 6.5±1.9, and brief pain inventory-interference (BPI-I) 6.7±2.5. At 1-year follow-up, their PCS averaged 43.6±8.1, MCS 34.7±4.4, BPI-S 4.9±1.2, and BPI-I 4.4±1.4. There were statistically significant differences between preoperation and postoperation in the above 4 groups of indicators ( P<0.05). Their MEPS at the last follow-up revealed a 95.2% rate of excellent elbow function (59/62). By comparison with the literature data, their postoperative PCS scores were not significantly different from those for the patients with Barrentt's esophagus, primary hypertension, chronic obstructive pulmonary disease and silicosis ( P>0.05). There was no significant difference either in the postoperative MCS scores between them and stroke patients ( P>0.05). Conclusions:As a destructive chronic disease, humeral shaft nonunion has negative effects on physical and mental health and quality of life of the patients. Although the pain effect on the limb can be alleviated by surgical revision, the entire treatment may cause permanent psychological trauma to the patients.
9. Effect of tranexamic acid combined with temporary clamping of drain in reducing perioperative blood loss of Schatzker V and VI tibial plateau fracture
Zhimeng WANG ; Yao LU ; Jiarui YANG ; Qian WANG ; Teng MA ; Zhong LI ; Kun ZHANG
Chinese Journal of Trauma 2020;36(1):68-74
Objective:
To investigate the safety and effect of tranexamic acid combined with drainage tube clamping to reduce perioperative blood loss of Schatzker V and VI tibial plateau fracture.
Methods:
A prospective case-control study was performed on 87 patients with Schatzker V and VI tibial plateau fracture admitted from March 2018 to January 2019 in Honghui Hospital, including 53 males and 34 females, aged 24 to 69 years [(39.05±2.7)years]. All patients underwent tibial plateau reduction and internal fixation. According to the random number table method, the patients were divided into intravenous group (27 cases), articular cavity group (30 cases) and control group (30 cases). The intravenous group were given a total of 1 g of tranexamic acid intravenously 5-10 minutes before loosening the tourniquet, the joint cavity group were perfused with 1 g of tranexamic acid before closing the incision, and the control group were given the same amount of normal saline. The drainage tube was temporarily clamped for 4 hours in the three groups. Data were recorded and compared among the groups, including the surgical limb side, tourniquet use time, hemoglobin (Hb), D-dimer level, drainage, total blood loss, number of allogeneic blood transfusions, postoperative complications, and presence or absence of deep vein thrombosis (DVT) of the lower extremities at 72 hours after discharge.
Results:
There was no significant difference in baseline data between the three groups (