Adult ; Aged ; Aged, 80 and over ; Drugs, Chinese Herbal ; therapeutic use ; Esophageal Neoplasms ; radiotherapy ; Female ; Humans ; Lung Neoplasms ; radiotherapy ; Male ; Middle Aged ; Phytotherapy ; Radiation Pneumonitis ; drug therapy

Alveolar Epithelial Cells ; pathology ; Diagnosis, Differential ; Humans ; Hyperplasia ; diagnostic imaging ; etiology ; metabolism ; pathology ; Lung Diseases ; diagnostic imaging ; etiology ; metabolism ; pathology ; Mucin-1 ; metabolism ; Nuclear Proteins ; metabolism ; Radiography ; Thyroid Nuclear Factor 1 ; Transcription Factors ; metabolism ; Tuberous Sclerosis ; complications ; diagnostic imaging ; metabolism ; pathology

It is reported that type Ⅲ interferon (IFN-λ) has an anti-tumor effect on melanoma,hepatocellular carcinoma,esophageal carcinoma and fibrosarcoma in recent years.IFN-λ could not only inhibit melanoma metastasis,but also induce cell apoptosis;its constitutively expression could activate natural killer cells,affecting hepatocellular carcinoma growth;IFN-λ could induce cells of G1 phase in esophageal carcinoma directly to stagnation or apoptosis;IFN-λ could cause native and adaptive immune response to suppress fibrosarcoma growth.Research on the anti-tumor mechanisms of IFN-λ will provide new ideas for clinical tumor therapy.

Objective To determine the incidence and risk factors of iatrogenic retinal breaks in eyes undergoing pars plana vit- rectomy for idiopathic macular pucker.Design Retrospective case series.Participant 88 consecutive vitrectomies performed on eyes with idiopathic macular pucker.Method Consecutive vitrectomies performed on eyes with idiopathic macular pucker at Beijing Tongren Eye Center between 2002 and 2006 were retrospectively reviewed.Cases with iatrogenic retinal breaks were recorded and analyzed. Main Outcome Measure Number and location of retinal breaks,and anatomic outcome after surgical managements.Result A total of 88 consecutive vitrectomies were included in the study.Of the 88 eyes,8 eyes had 14 iatrogenic retinal breaks detected,with an aver- age incidence of 9.1%.Peripheral retinal breaks(8.0%)were more common than posterior retinal breaks(1.1%).All peripheral retinal breaks occurred around the selerotomy sites(100%)and the quadrant of predominant hand was involved most commonly(62%).Most of the breaks(88%)were detected during the surgery.All eyes with iatrogenic retinal breaks obtained anatomic retinal reattachment (100%).Conclusion Despite improvements in instrumentation and surgical techniques,iatrogenic retinal break continues to be an im- portant complication of pars plana vitrectomy in eyes with idiopathic macular pucker.This complication tends to occur more commonly at peripheral retina and is mainly selerotomy-related.

BACKGROUND: Open reduction and internal fixation is commonest surgical method for calcaneal fractures, but its postoperative complications are troublesome. Thereafter, choosing an appropriate treatment scheme is of great significance for reducing postoperative complications and promoting patients' functional recovery. OBJECTIVE: To compare the curative efficacy of the modified minimally invasive internal fixation with cannulated screws through tarsal sinus and traditional extended lateral "L-shape" incision with plate fixation for calcaneal fractures. METHODS: Sixty-eight cases of unilateral calcaneal fractures (Sanders II and III) were selected, followed by treated with modified minimally invasive internal fixation with cannulated screws through tarsal sinus (modified group, n=33) or traditional extended lateral "L-shape" incision with plate fixation (traditional group, n=35). The operation time, blood loss, and Visual Analogue Scale scores were compared between two groups; the preoperarive and postoperative American Orthopedic Foot and Ankle Society scores, Bohler angle, and Gissane angle as well as postoperative complications were detected and compared between both groups. Besides, the postoperative pain, range of motion, and ankle stability were evaluated. RESULTS AND CONCLUSION: (1) The American Orthopedic Foot and Ankle Society scores at 6 months postoperatively in both two groups were significantly higher than those at baseline, and the scores in the modified group were significantly higher than those in the traditional group (P < 0.05). (2) The Bohler angle, Gissane angle, and calcaneal width in the modified group were significantly improved compared with the traditional group at 1 week, 6 and 12 months postoperatively (P < 0.05). (3) Compared with the traditional group, the operation time, blood loss, and Visual Analogue Scale scores in the modified group were significantly improved (P < 0.05). (4) The incidence of complications in the modified group was significantly lower than that in the traditional group (P < 0.05). (5) These results manifest that compared with the traditional extended lateral "L-shape" incision with plate fixation for calcaneal fractures, the modified minimally invasive internal fixation with cannulated screws through tarsal sinus can significantly alleviate pain, and improve the range of motion and stability of the ankle joint.

BACKGROUNDSeveral studies have shown that coronary stenting reduces the frequency of clinical and angiographic restenosis in patients with mild to moderate renal insufficiency. However, less is known about the long-term benefits of stent use in this population. This study was aimed to determine the impact of coronary stenting on extended (5 years) long-term outcomes of patients with chronic renal insufficiency.

METHODSThe study included 602 consecutive patients who underwent successful percutaneous coronary intervention with stenting. Renal insufficiency was defined as an estimated glomerular filtration rate < 60 ml x min(-1) x 1.73 m(-2). The major adverse cardiac events were compared for patients with (n = 160) and without (n = 442) renal insufficiency.

RESULTSAfter the third year of follow-up, nonfatal myocardial infarction and revascularization rates were significantly increased in patients with renal insufficiency compared with those without renal dysfunction (16.9% vs 7.7%, P = 0.001; 29.4% vs 15.8%, P < 0.001). In patients who had recurrent cardiovascular events, a significantly higher rate of de novo stenosis revascularization was found in patients with renal insufficiency than without renal insufficiency (57.7% vs 22.7%, P < 0.001), while there was no significant difference in target lesion revascularization between the groups (51.9% vs 43.6%, P = 0.323). Multivariate analysis demonstrated an independent impact of the presence of renal insufficiency on the major adverse cardiac events (hazard ratio: 1.488, 95% confidence interval: 1.051 - 2.106, P = 0.025) and de novo stenosis (hazard ratio: 5.505, 95% confidence interval: 2.151 - 14.090, P < 0.001).

CONCLUSIONSThe late major adverse cardiac events, after successful coronary stenting, is increased in patients with an estimated glomerular filtration rate < 60 ml x min(-1) x 1.73 m(-2). This might be associated with increased risk of de novo stenosis in this population.

Angioplasty, Balloon, Coronary ; adverse effects ; Coronary Angiography ; Coronary Restenosis ; pathology ; therapy ; Female ; Glomerular Filtration Rate ; Humans ; Male ; Middle Aged ; Renal Insufficiency ; pathology ; therapy ; Stents

BACKGROUNDTelbivudine, one of the five nucleos(t)ide antiviral drugs, was reported to be superior to lamivudine in a better biochemical, virological, and histological response for treatment-naive patients in the GLOBE trial. The aim of this study was to determine the antiviral potency, viral resistance, and the signifcance of early response for long-term telbivudine treatment.

METHODSWe recruited 161 patients of chronic hepatitis B (CHB) on telbivudine between January 2009 and September 2011 in Macau, China. The serum hepatitis B virus DNA levels, hepatitis B e antigen (HBeAg) seroconversion, alanine aminotransferase (ALT) normalization, and viral resistance were analyzed.

RESULTSThe median age and follow-up duration were 48 years and 16.9 months. All patients were followed up for at least 6 months, while data were collected for 132, 120, 95, and 53 patients at 12, 24, 48, and 96 weeks respectively. The cumulative HBeAg seroconversion rate was 20.8% and only three patients (1.9%) presented with telbivudine low level resistance. The ALT normalization rates were 76.9% at 48 weeks and 77.6% at 96 weeks. Undetectable HBV DNA was achieved by 1.8%, 31.6%, 60%, and 74.1% in HBeAg positive patients and 29.3%, 60.3%, 84%, and 84.6% in HBeAg negative patients at each time point. Week 12 HBV DNA level < 1000 copies/ml (< 200 IU/ml) was a better predictor of viral suppression at 2-year follow-up (P = 0.001, OR = 27.00) than undetectable HBV DNA level at week 24 (P = 0.120, OR = 4.81).

CONCLUSIONSTwo-year telbivudine treatment yielded high rates of viral suppression and ALT normalization. Serum HBV DNA level at week 12 is a superior predictor for long-term viral suppression.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Alanine Transaminase ; blood ; Antiviral Agents ; therapeutic use ; DNA, Viral ; blood ; Drug Resistance, Viral ; Female ; Hepatitis B, Chronic ; drug therapy ; virology ; Humans ; Male ; Middle Aged ; Thymidine ; analogs & derivatives ; therapeutic use ; Time Factors

Aluminum ; adverse effects ; Female ; Granuloma ; etiology ; therapy ; Humans ; Lung Diseases ; etiology ; therapy ; Middle Aged ; Occupational Diseases ; etiology ; therapy ; Sarcoidosis ; etiology ; therapy

Cysts ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Tomography, X-Ray Computed ; Tuberculosis, Pulmonary ; diagnostic imaging ; pathology

Objective To understand the association of human leukocyte antigen (HLA)-DRB polymorphism and patients diagnosed as hemorrhagic fever with renal syndrome (HFRS). Methods HLA-DR allele polymorphism was detected by PCR-sequence specific primers (PCR-SSP). Hantavirus (HV) typed as Hantaan virus (HTNV) and Seoul virus (SEOV) in patients were detected by RT-heminested PCR. Results The gene frequency of DRB1*0401-0411, *1001 and *1101-1105 in HFRS case group were 3.1%, 2.2% and 15.7% respectively. Compared with control group, it was significant higher in HFRS case group (RR=13.87, 9.72 and 2.00 respectively with Chi-square value as 10.006,6.324 and 6.472 respectively, P<0.05). When compared with HFRS case group, the gene frequency of DRB1*1501-1502, DRB4 and DRB5 in control group were 11.0%, 19.0% and 16.9% respectively, markedly lower than in patients (RR=0.45, 0.58 and 0.23 respectively. Chi-square values were 6.138, 4.583 and 21.076 respectively, P<0.05). There was no significant difference in other HLA-DR gene frequencies. Mixed infection was found in Hubei, with HTNV slightly more than SEOV. Distinct hantaviruses could coexist in either different or the same geographic or ecological zores in Hubei province. Patients with HLA-DRB1*1101-1105 alleles were 81.8%(27/33) infected by HTNV and only 18.2% infected by SEOV, which had significant difference (P<0.05). Conclusion DRB1*0401-0411,*1001 and *1101-1105 were possibly associated with increased susceptibility to HV infection. On the other hand there was an inverse correlation among HFRS, DRB1*1501-1502, DRB4 and DRB5.