ObjectiveTo investigate the role of serum HBV RNA in assessing antiviral therapy for patients with chronic hepatitis B， as well as its potential as a biomarker in clinical therapy， and to provide a scientific basis for the clinical treatment of chronic hepatitis B. MethodsA total of 134 patients who were diagnosed with chronic HBV infection in The Second Affiliated Hospital of Kunming Medical University from April 2023 to May 2024 were enrolled as subjects， and related examinations were performed， including HBV DNA， serum HBV RNA， liver function， HBsAg， anti-HBs， HBeAg， anti-HBe， anti-HBc， and transient elastography of the liver. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups， and the Kruskal-Wallis H test was used for comparison between multiple groups； the chi-square test or the continuity-adjusted chi-square test was used for comparison of categorical data between two groups. Pearson correlation analysis or Spearman correlation analysis was performed. ResultsThe 134 patients with chronic HBV infection were divided into HBeAg-positive group with 45 patients and HBeAg-negative group with 89 patients， and there were significant differences between the two groups in age， the positive rate and quantitative value of HBV DNA， the positive rate and quantitative value of serum HBV RNA， HBsAg， anti-HBe， and ALT （all P<0.05）. In the cohort study of the HBeAg negative group， there were significant differences in the levels of HBV DNA， HBsAg， and GGT between the serum HBV RNA-negative group with 14 patients and the serum HBV RNA-positive group with 75 patients （all P<0.05）. There were 28 patients in the HBeAg-positive group and 62 in the HBeAg-positive group who used antiviral drugs for ≥1 month， and the 28 HBeAg-positive patients had an HBV RNA positive rate of 100%， while for the 62 HBeAg-negative patients， there were significant differences in the positive rate and level of serum HBV RNA between the patients with different durations of medication （both P<0.05）. Among the 89 HBeAg-negative patients， there were 62 treatment-experienced patients and 27 treatment-naïve patients， and there was a significant difference between the two groups in HBV RNA level ［2.07 （1.52 — 2.82） log₁₀ copies/mL vs 2.69 （1.80 — 3.55） log₁₀ copies/mL， Z=2.034， P=0.042］. For HBeAg-negative patients， serum HBV RNA was positively correlated with HBV DNA and HBsAg （both P<0.05）， and for HBeAg-positive patients， serum HBV RNA was significantly positively correlated with HBV DNA， HBsAg， and HBeAg （all P<0.05）. ConclusionAntiviral therapy can reduce viral load， and for HBeAg-negative patients with high-sensitivity HBV DNA below the lower limit of detection， serum HBV RNA can fill the “gap” in the detection of viral replication.

Objective:To discuss the diagnosis and treatment process of the patients with parasitic leiomyoma(PM)of the abdominal wall complicated with disseminated peritoneal leiomyomatosis(DPL)after laparoscopic myomectomy,and to improve the clinical understanding and management of this condition.Methods:The clinical data of one patient with PM of the abdominal wall complicated with DPL after laparoscopic myomectomy were collected.The causes,clinical features,diagnosis,differential diagnosis and treatment process were analyzed,and the relevant literatures were reviewed.Results:The patient,a 49-year-old woman,was admitted due to a self-discovered abdominal mass lasting for one year.The physical examination results showed a palpable mass,approximately 6 cm×4 cm,in the lower left abdominal wall with poor mobility,with clear borders,and without tenderness.Another palpable mass,approximately 7 cm×5 cm,was found in the lower right abdomen with fair mobility,with clear borders,and without tenderness.The gynecological ultrasonography results showed a hypoechoic area of approximately 6.6 cm × 2.7 cm in the subcutaneous tissue below the left umbilicus and another hypoechoic area of approximately 7.6 cm×3.3 cm in the abdominal cavity below the umbilicus.The superficial ultrasonography of the local area showed a hypoechoic area of approximately 5.79 cm× 2.55 cm×4.74 cm within the left lower abdominal rectus muscle,with smooth edges,located 1.97 cm from the skin at its shallowest point and 4.73 cm at its deepest point,without penetration of the rectus sheath but adjacent to the peritoneum.The patient was diagnosed as uterine leiomyoma,abdominal mass,and post-myomectomy status.The elective surgeries for uterine leiomyoma enucleation,abdominal wall leiomyoma excision,and peritoneal leiomyoma excision were performed under combined intravenous-inhalation anesthesia.The operation procedure was successful,and the patient recovered well and was discharged smoothly.Conclusion:PM and DPL lack typical clinical features and require imaging examinations for diagnosis.Surgical exploration is the main treatment modality,and while PM and DPL are generally benign,there is a potential for malignant transformation,and the patients need further postoperative follow-up.

Objective:To summarize the best evidence of intracranial hypertension nursing for adult patients with severe brain injury, and to provide reference for clinical nursing practice.Methods:According to the evidence-based methodology, a systematic search of Chinese and English literature on intracranial hypertension nursing of adult patients with severe brain injury was conducted in domestic and foreign databases such as CNKI, Wanfang, PubMed, Cochrane Library and Cinahl Plus and so on, as well as related guide websites and professional association websites from the establishment of database to August 2022. Two researchers independently evaluated literature quality and screened evidence, and then the project team summarized and concluded the evidence.Results:A total of 6 009 articles were obtained through preliminary search, and 33 articles were included after screening, including 13 guidelines, 1 systematic review, 17 expert consensus, 1 evidence summary, and 1 meta-analysis. In total, 33 pieces of best evidence were obtained from 8 dimensions, including intracranial pressure related threshold, assessment and monitoring, respiratory care, circulation care, analgesic and sedative care, temperature care, nutrition care and cerebrospinal fluid care.Conclusions:This study summarizes the evidence-based basis of intracranial hypertension nursing in adult patients with severe brain injury, which provides a basis for the standardized construction of clinical nursing strategies and empirical research.

Objective:To observe the efficacy of drug combined with red-blue light irradiation, chemical peeling by glycolic acid and intense pulsed light (IPL) in the treatment of moderate acne vulgaris.Methods:A total of 187 patients with moderate acne vulgaris were divided into five groups. There were 59 males and 128 females, aged from 16 to 29 years (21.79±2.52). In group A, patients were treated with oral medicines; the patients were treated with oral medicines combined with red-blue light irradiation, chemical peeling by glycolic acid and IPL respectively in group B, group C and group D. In group E, patients were treated with oral medicines combined with chemical peeling by glycolic acid and IPL. The number of different types of skin lesions (comedoes, papules, pustules) were compared between before and after treatment in five groups. The clinical effect of five treatment groups was evaluated by comparing regression rates of different types of skin lesions and total skin lesions and treatment efficiency.Results:All the patients with moderate acne vulgaris were brought into this study. The regression rates of comedoes, papules and total skin lesions were (86.37±9.64)%, (94.25±9.79)% and (88.80±9.40)% respectively in group E, and significantly higher than that of other four groups ( P<0.05). The treatment efficiency of group E also were significantly higher than that of other four groups ( P<0.05). Then, the regression rates of comedoes (70.91±18.52) in group C was significantly higher than that of group A and group B ( P<0.05). The regression rates of papules (91.42±13.86) in group D was significantly higher than that of group A and group B ( P<0.05). Conclusions:Oral medicines combined with chemical peeling by glycolic acid and IPL has obvious clinical efficacy in treatment of patients with moderate acne vulgaris. Oral medicines combined with chemical peeling by glycolic acid can obviously improve comedoes, and oral medicines combined with IPL can obviously improve papules.

Objective T o detect the genotype of A B O blood group by SN aPshot technology. Methods D N A w ere extracted from the peripheral blood sam ples w ith know n blood groups (obtained by serology) of 107 unrelated individuals in Y unnan. Six SN P loci of the 261th, 297th, 681th, 703th, 802th, and 803th nucleotide positions w ere detected by SN aPshot M ultiplex kit, and relevant genetics param eters w ere cal-culated. Results In 107 blood sam ples, the allele frequencies of types A , B , O A, and O G w ere 0.3551, 0.1682, 0.2300 and 0.2476, respectively, w hile that of types A G and cis A B w ere not detected. T he geno-typing results of A B O blood group w ere consistent w ith that of serologic testing. Conclusion SN aPshot technology can be adapted for genotyping of A B O blood group.

Objective:To investigate the clinical characteristics of idiopathic hypereosinophilic syndrome (IHES) with gastrointestinal manifestations,and to improve the level of diagnosis and treatment of IHES. Methods:The clinical materials, process of diagnosis and treatment and prognosis of 9 patients diagnosed as IHES with gastrointestinal manifestations were retrospectively analyzed. Results:The average age of 9 patients was (22.66± 12.86)years old,and the ratio of male and female was about 1.25∶ 1. The main clinical manifestations included abdominal pain,diarrhea and abdominal distension.The eosinophil percentages in peripheral blood and bone marrow of the patients were (42.66 ± 19.88 )% and (39.33 + 15.99 )%, respectively.The ascites exudate cytology examination showed eosinophil infiltrated.The results of gastroscope or colonoscope showed mucosal hyperemia and edema,scattered bleeding spots, and dark red granular hyperplasia; the colon was affected frecuently.The histological biopsy confirmed that the mucosal was infiltrated by eosinophils.The abdominal CT of 6 patients showed that the walls of stomach or bowel were thickened.The abdominal symptoms disappeared,and the ascites was absorpted in 9 patients after the treatment of glucocorticoid.After 2 years of follow up,2 patients had relapse, others had no recurrence.Conclusion:Performing the routine diagnosis and treatment of gastrointestinal diseases, the clinicians should consider the possibility of IHES in order to avoid the misdiagnosis and delayed treatment. When IHES is diagnosed,steroid treatment should be performed in preference.