HBV/HCV dual infection is not uncommon, especially in highly endemic areas and among individuals at elevated risk of infection, because of the common transmission mode of hepatitis B virus (HBV) and hepatitis C virus (HCV) and may be underestimated due to the presence of occult HBV infection. HBV/HCV dual infection is associated with more rapid progression to advanced severe liver disease, severely increased fibrosis or cirrhosis, liver decompensation, and the development of hepatocellular carcinoma, thus requiring effective antiviral treatment. However, the intracellular interaction between HBV and HCV has not been fully elucidated at present. This paper summarizes the recent research on HBV/HCV dual infection and the current status of treatment and emphasizes the aspects that need further clarification in order to provide a basis for exploring treatment strategies for dual infection.

This paper summarises the nursing care in an ischemia-free liver transplantation combined with islet transplantation of a patient with hepatocellular cancer,hepatic cirrhosis and Type Ⅱ diabetes.The key measures of nursing care include postoperative observations and cares to prevent thrombosis and bleeding,monitoring the functions of transplanted liver and islet to avoid an immune rejection,and application of a scientific and effective nutritional management.After 17 days of treatment and nursing care,the patient was discharged.

This paper summarises the nursing care in an ischemia-free liver transplantation combined with islet transplantation of a patient with hepatocellular cancer,hepatic cirrhosis and Type Ⅱ diabetes.The key measures of nursing care include postoperative observations and cares to prevent thrombosis and bleeding,monitoring the functions of transplanted liver and islet to avoid an immune rejection,and application of a scientific and effective nutritional management.After 17 days of treatment and nursing care,the patient was discharged.

HBV/HCV dual infection is not uncommon, especially in highly endemic areas and among individuals at elevated risk of infection, because of the common transmission mode of hepatitis B virus (HBV) and hepatitis C virus (HCV) and may be underestimated due to the presence of occult HBV infection. HBV/HCV dual infection is associated with more rapid progression to advanced severe liver disease, severely increased fibrosis or cirrhosis, liver decompensation, and the development of hepatocellular carcinoma, thus requiring effective antiviral treatment. However, the intracellular interaction between HBV and HCV has not been fully elucidated at present. This paper summarizes the recent research on HBV/HCV dual infection and the current status of treatment and emphasizes the aspects that need further clarification in order to provide a basis for exploring treatment strategies for dual infection.

Objective : To compare the clinical characteristics of ordinary and severe coronavirus disease 2019 ( COVID-19 ) cases, so as to provide basis for the diagnosis, treatment and prognosis. Methods : We recruited 77 COVID-19 cases in Wenzhou Central Hospital from January 15 to February 29, 2020, collected their general information, clinical symptoms, laboratory test and CT scan results, and compared the clinical features of ordinary and severe cases. Results: There were 50 ordinary cases and 27 severe cases. The age, prevalence of hypertension and other baseline diseases of severe cases were higher than those of ordinary cases ( P<0.05 ) . The maximum body temperature during 1-3 days of hospitalization, proportion of body temperature rising, prevalence of cough, yellow phlegm, hemoptysis, chest tightness and shortness of breath of severe cases were higher than those of ordinary cases ( all P<0.05 ) . The proportion of pulmonary consolidation, glazing and patch shadow, the number of solid changes and the cumulative number of lesions of severe cases were higher than those of ordinary cases ( all P<0.05 ) . The values of LYM during 1-10 days of hospitalization, total T-lymphocyte percentage, CD4 count and percentage, CD8 count, Hb and oxygenation index of severe cases were lower than those of ordinary cases; while the values of LDH and NLR during 1-10 days of hospitalization, N8R, AST, ferritin, CRP during 1-7 days of hospitalization and D-dimer of severe cases were higher than those of ordinary cases ( all P<0.05 ). Conclusions Severe COVID-19 cases have older age, higher prevalence of baseline diseases, fever, shortness of breath symptoms, more lung consolidation and lesions, significantly decreased lymphocyte level ( especially CD4 ) , and increased LDH, NLR, ferritin and CRP.

Objective:To evaluate the imaging features of CT scan in patients with COVID-19.Methods:Clinical data of 56 patients with COVID-19 from January 17 to 19, 2020 admitted to Wenzhou Central Hospital and the Second Affiliated Hospital of Wenzhou Medical University were retrospectively reviewed. The clinical manifestations, lung imaging characteristics and treatment outcomes of patients with different severity were analyzed with SAS software.Results:Fever (92.8%, 52/56), dry cough (75.0%, 42/56) and asthenia (58.9%, 33/56) were the first symptoms in most of the patients; some patients also had shortness of breath (25.0%, 14/56) and pharyngeal pain (10.7%, 6/56). Chest high-resolution CT scan showed that in 42 moderate patients, ground glass-like high-density shadows in the lung were observed in 30 cases (71.4%) ; localized plaque consolidation shadows and bronchial inflation signs were observed in 10 cases (23.8%). In 12 severe patients, 11 had high-density patches involving multiple lung lobes (≥3). In 2 critically ill patients the patches and stripes involving the entire lung were observed; and cord-like high-density shadow, local consolidation and fibrosis were also shown.Conclusion:The multiple ground-glass changes outside the lungs are early imaging manifestations of COVID-19 patients. The increase in pulmonary lobe consolidation and fibrosis may indicate the disease progression, and the degree of lung consolidation and fibrosis is closely related to the disease severity.

Objective To summarize the perioperative nursing care of a patient with ischemia-free liver transplantation. Methods The nursing measures were developed according to the characteristics of the disease and the individual conditions of the patients: including preoperative psychological care;preoperative preparation; prevention of postoperative infection; meticulous observation of the patient′s conditions, transplanted liver function and postoperative complications; the early guidance of rehabilitation activity, nutritional support treatment and the care of water and electrolyte balance. Results The patient recovered well with careful nursing care and no nursing-related complications occurred, and he was discharged successfully on the 18th day after surgery. Conclusion According to the patient's condition and individual situation, the development of nursing measures can effectively prevent the potential infection, timely discover the changes of the patient′s condition, understand the recovery of the transplanted liver function and observe the related postoperative complications, and help to promote the early recovery of patients.

A 77-year-old female patient with type 2 diabetes mellitus mistakenly injected insulin aspart 16 U subcutaneously as glargine insulin before bedtime.One hour later,she developed slow response and paraphasia.Her urgent blood glucose level was 2.8 mmol/L.An Ⅳ injection of 50％ glucose injection 40 ml,mask oxygen absorption,and continuous ECG monitoring were given immediately.Thirty minutes later,her blood glucose level increased to 8.4 mmol/L.The adjusted hypoglycemic regimen was subcutaneous injection of 8,10,and 8 units of insulin aspart 15 minutes before 3 meals,respectively,and glargine insulin 18 U before bedtime.Six days later,her fasting and 2-hour postprandial blood glucose levels were 7.0-8.3 mmol/L and 9.1-10.2 mmol/L,respectively.

A 77-year-old female patient with type 2 diabetes mellitus mistakenly injected insulin aspart 16 U subcutaneously as glargine insulin before bedtime.One hour later,she developed slow response and paraphasia.Her urgent blood glucose level was 2.8 mmol/L.An Ⅳ injection of 50％ glucose injection 40 ml,mask oxygen absorption,and continuous ECG monitoring were given immediately.Thirty minutes later,her blood glucose level increased to 8.4 mmol/L.The adjusted hypoglycemic regimen was subcutaneous injection of 8,10,and 8 units of insulin aspart 15 minutes before 3 meals,respectively,and glargine insulin 18 U before bedtime.Six days later,her fasting and 2-hour postprandial blood glucose levels were 7.0-8.3 mmol/L and 9.1-10.2 mmol/L,respectively.

Objective To investigate the value of intravoxel incoherent motion MR imaging (IVIM-MRI)on monitoring impairment of renal function in hydronephrosis.Methods Left hydronephrosis model of Healthy New-Zealand rabbits made by ureteral incomplete obstruction were scanned by IVIM-MRI at 4, 8, 12, and 16 weeks.The change of IVIM-MRI quantitative parameters (ADC values, D values, D* values, and f values) in left hydronephrosis kidney were observed.The correlation between these parameters and glomerular filtration rate (GFR) were evaluated.Results ADC values, D values, D* values and f values at cortex and medulla in left hydronephrosis model of rabbits decreased gradually in the progression of renal damage after 4, 8, 12, and 16 weeks.For D value, f value and ADC values, there was statistical significant difference among the group of 12 weeks, the group of 16 weeks, the control group, and the group of 4 weeks;statistical significant difference was also observed between the group of 8 weeks and the group of 16 weeks by LSD contrast.ADC values, D values, D* values, and f values were positively correlated to GFR at 4, 8, 12, and 16 weeks for left hydronephrosis model of rabbits.Conclusion IVIM-MRI could monitor impairment of renal function in hydronephrosis dynamically.