Objective:To evaluate the clinical efficacy and the mid- and long-term follow-up outcomes of transanal anaplasty for treating rectovestibular fistula.Methods:The clinical data of 68 female infants diagnosed with rectovestibular fistula undergoing transanal anoplasty at the Department of Pediatric Surgery, the First Affiliated Hospital of Zhengzhou University from Oct 2014 to Dec 2023 was collected. Postoperative complications, perineal and anal appearances, and defecation function of postoperative children aged 3 years or older were recorded.Results:After surgery 68 children followed-up for 6 months of recent with short-term complications in 6 cases, including 3 cases of incision infection, 2 cases of rectal mucosal prolapse, and 1 case of anal stenosis. Rintala score was (18.65±1.99). Twenty-five children underwent anorectal manometry, no significant differences were observed in the maximal systolic pressure of the anal canal( t=-0.596, P=0.563) and the maximum systolic time( t=-0.183, P=0.854). The resting pressure( t=-3.050, P=0.005), functional length( t=2.696, P=0.012), and positive rate of rectal anal inhibitory reflex( χ2=6.382, P=0.012) of the anal canal were significantly lower than those of the normal group( P<0.05). Conclusions:Transanal anaplasty for the treatment of rectovestibular fistula in girls has a low incidence of complications. It results in a normal perineal body appearance, good anal bowel control, and high quality of life.

Objective:To evaluate the clinical efficacy and the mid- and long-term follow-up outcomes of transanal anaplasty for treating rectovestibular fistula.Methods:The clinical data of 68 female infants diagnosed with rectovestibular fistula undergoing transanal anoplasty at the Department of Pediatric Surgery, the First Affiliated Hospital of Zhengzhou University from Oct 2014 to Dec 2023 was collected. Postoperative complications, perineal and anal appearances, and defecation function of postoperative children aged 3 years or older were recorded.Results:After surgery 68 children followed-up for 6 months of recent with short-term complications in 6 cases, including 3 cases of incision infection, 2 cases of rectal mucosal prolapse, and 1 case of anal stenosis. Rintala score was (18.65±1.99). Twenty-five children underwent anorectal manometry, no significant differences were observed in the maximal systolic pressure of the anal canal( t=-0.596, P=0.563) and the maximum systolic time( t=-0.183, P=0.854). The resting pressure( t=-3.050, P=0.005), functional length( t=2.696, P=0.012), and positive rate of rectal anal inhibitory reflex( χ2=6.382, P=0.012) of the anal canal were significantly lower than those of the normal group( P<0.05). Conclusions:Transanal anaplasty for the treatment of rectovestibular fistula in girls has a low incidence of complications. It results in a normal perineal body appearance, good anal bowel control, and high quality of life.

Objective:To explore the risk factors for recurrence of intussusception in children after successful ultrasound-guided saline enema reduction.Methods:The clinical and follow up data of 355 hospitalized children with intussusception at the First Affiliated Hospital of Zhengzhou University from Feb 2018 to Feb 2023 were reviewed.Patients were divided into two groups by recurrence develped and the differences were compared, Data with significant differences were incorporated into multi-factor logistic analysis.Results:The overall recurrence rate was 15.8% (56/355). By univariate variable analysis model, there were statistically significant differences between the two groups in age, previous intussusception history, vomiting, maximum diameter of concentric circles shown by ultrasound, and concurrent bowel organic diseases (lead points) (all P<0.05). In multivariate Logistic regression model, age, previous intussusception history, maximum diameter of concentric circles, and lead points were independent risk factors for recurrent intussusception after saline enema.The optimal cut-off values for age and maximum diameter of concentric circles were 2 years and 33.5 mm, respectively, according to ROC curve analysis. Conclusion:Age older than 2 years, previous intussusception history, maximum diameter of concentric circles longer than 33.5 mm, and lead points are independent risk factors for recurrence after saline enema.

Objective: To study the functional effects of killer cell lectin-like receptor subfamily G member 1 (KLRG1) expression on natural killer cells (NK cell) in chronic hepatitis B virus infection (HBV). Methods: Peripheral blood mononuclear cells (PBMC) were extracted from 120 patients with chronic hepatitis B virus infection and 19 healthy persons. The frequency of NK cells and KLRG1+ NK cells in peripheral blood was detected by flow cytometry. Interferon-γ levels secreted by NK cells were detected in peripheral blood. Statistical analysis of experimental data was performed using GraphPad Prism 6.03 software. Results: The frequency of NK cells in HBV-infected group (16.92% ± 7.9%) was not significantly different from that in healthy controls (10.57% ± 6.5%). The frequency of KLRG1+NK cells in HBV-infected group was significantly higher (49.43% ± 21.2%) than that to healthy control group (31.60% ± 17.9%), (t = 7.347 6, P < 0.001). IFN-γ secretion of KLRG1 + NK cells in HBV-infected patients (2.59% ± 1.0%) were significantly lower than healthy controls (5.96% ± 2.4%), (P = 0.009). Conclusion HBV infection can increase the expression of KLRG1 in NK cells and further reduce the secretion of IFN-γ in NK cells, which may be an important cause for chronic HBV infection.

Objective: Hepatitis B surface antigen (HBsAg) loss is seldom achieved with nucleos(t)ide analog (NA) therapy in chronic hepatitis B patients but may be enhanced by switching to finite pegylated-interferon (Peg-IFN) alfa-2a. We assessed HBsAg loss with 48- and 96-week Peg-IFN alfa-2a in chronic hepatitis B patients with partial response to a previous NA. Methods: Hepatitis B e antigen (HBeAg)-positive patients who achieved HBeAg loss and hepatitis B virus DNA < 200 IU/mL with previous adefovir, lamivudine or entecavir treatment were randomized 1:1 to receive Peg-IFN alfa-2a for 48 (n = 153) or 96 weeks (n = 150). The primary endpoint of this study was HBsAg loss at end of treatment. The ClinicalTrials.gov identifier is NCT01464281. Results: At the end of 48 and 96 weeks' treatment, 14.4% (22/153) and 20.7% (31/150) of patients, respectively, who switched from NA to Peg-IFN alfa-2a cleared HBsAg. Rates were similar irrespective of prior NA or baseline HBeAg seroconversion. Among those who cleared HBsAg by the end of 48 and 96 weeks' treatment, 77.8% (14/18) and 71.4% (20/28), respectively, sustained HBsAg loss for a further 48 weeks. Baseline HBsAg < 1 500 IU/mL and week 24 HBsAg < 200 IU/mL were associated with the highest rates of HBsAg loss at the end of both 48- and 96-week treatment (51.4% and 58.7%, respectively). Importantly, extending treatment from 48 to 96 weeks enabled 48.3% (14/29) more patients to achieve HBsAg loss. Conclusion Patients on long-term NA who are unlikely to meet therapeutic goals can achieve high rates of HBsAg loss by switching to Peg-IFN alfa-2a. HBsAg loss rates may be improved for some patients by extending treatment from 48 to 96 weeks, although the differences in our study cohort were not statistically significant. Baseline and on-treatment HBsAg may predict HBsAg loss with Peg-IFN alfa-2a.

Objective: To dynamically analyze the discipline status, influence factors and key issues of Chinese Journal of Hepatology from 2010 to 2016 and explore the development rules of citation indexes. Methods: We collected information published by the China Institute of Scientific and Technological Information [China Science and Technology Journal Citation Report (Core Edition)] and Wanfang Database Periodicals statistical analysis platform from 2010 to 2016. A bibliometric analyses on article volume, citation frequency, citation rate, h-index, ratio of fund-aided papers, periodical influence, key number published period, number of relevant articles, and so on were analyzed for annual’s impact factor. Results: According to the data released by the China Institute of Science and Technology Information, from 2010 to 2011, the impact factor of Chinese Journal of Hepatology was at leading level in the field of internal medicine and ranked sixth in the Journal of Internal Medicine. From 2012 to 2016, the overall comprehensive assessment score and citation frequency score of Chinese Journal of Hepatology were ranked first in the Journal of Gastroenterology. Core impact factors kept the discipline ahead. Indexes such as immediacy index, h- index, cited half-life and all other indicators were increased. Citation rate was >90% and cited issue number had greatly increased. Conclusion Chinese Journal of Hepatology has a leading position in the Journal of Gastroenterology and credited by inland readers and authors of digestive and infectious fields. It has played a positive role in promoting the development of the discipline.

Objective To explore the cost-effectiveness and clinical effect of three platinum based chemotherapy regiments for advanced non small cell lung cancer (NSCLC).Methods 100 patients who were diagnosed as NSCLC,were randomly divided into four groups.The group Ⅰ received NP which was given NVB and DDP.The group Ⅱreceived GP which was given GEM and DDP.The group Ⅲ received TP which was given taxotere and DDP.The clinical effect,adverse reaction and cost effectiveness of the three groups were assessed.Results The clinical effective rates of the three groups were 31.43%,36.36%,37.50% from Ⅰ to Ⅲ group.The adverse events of the group Ⅰ and group Ⅱ were more than those of the group Ⅲ.In the adverse effects of treatment,the major cytotoxicity was digestive reaction and leukopenia in the two groups,but they were tolerable.The ratios of cost effectiveness in the four groups were 550.22yuan,556.48yuan,583.23yuan from Ⅰ to Ⅲ group.Conclusion The NP group is the best one in total cost.

OBJECTIVETo investigate the relationship between hepatitis B virus (HBV) infection and risk of pancreatic cancer.

METHODSVarious English and Chinese language literature databases, including PubMed, Web of Knowledge, Embase, Cochrane Library and the Chinese National Knowledge Infrastructure, were searched for case-control studies comparing rates of HBV infection and pancreatic cancer. The RevMan meta analysis software, version 5.0, was used to perform the meta-analysis of the 6 included studies.

RESULTSCompared with the control group, the pancreatic cancer group had a significantly higher rate of positivity for hepatitis B surface antigen (HBsAg) (8.87% vs.5.86%, odds ratio (OR) =1.24, 95% confidence interval (CI):1.06 to 1.47, P =0.009) and a lower rate of patients never exposed to HBV (defined as HBsAg(-)/hepatitis B core antibody (anti-HBc)(-) (69.4% vs.77.1%, OR =0.68, 95% CI:0.51 to 0.92, P =0.01). There was no significant difference between the two groups in the rate of hepatitis B e antigen positivity (P =0.55).

CONCLUSIONHBV-infected patients with HBsAg(+) status are at greater risk of developing pancreatic cancer; however, since most of the research studies evaluated were conducted in Asians, the generalizability of this conclusion is unknown.

Hepatitis B ; epidemiology ; Hepatitis B Surface Antigens ; blood ; Hepatitis B virus ; Humans ; Pancreatic Neoplasms ; epidemiology ; virology ; Risk Factors

Medical ethics is correlated with further development of affiliated teaching hospital.Our hospital took ‘ Bethune spirit’ and philosophy of forgiveness and kindheartedness as guidance and became the first batch of Bethune spirit model hospital of Chongqing.Teaching quality was improved by providing lectures about ‘ Bethune spirit’ for medical students and equally emphasizing medical knowledge and medical ethics education.Anti-corruption and academy governing movements with the subject of ‘ Bethune spirit’ were carried out to repel academic misdeed,with the result that clinical,teaching and scientific works were promoted and advanced.