Objective To investigate the prognosis of patients with hepatitis B virus(HBV)-related intrahepatic cholangiocarcinoma(ICC)whose HBV DNA was negative before surgical.Methods A retrospective analysis was conducted on the clinical data of 97 ICC patients who underwent surgery resection at the Fifth Medical Center of Chinese PLA General Hospital between October 2010 and January 2017.All patients were divided into HBV-related ICC(HBV-ICC)group(n=62)and non-HBV-related ICC(Con-ICC)group(n=35).HBV-ICC group included 34 patients with HBV core antigen positive(HBcAb+)and HBV surface antigen positive(HBsAg+),and 28 patients with HBcAb positive and HBsAg negative.Kaplan-Meier analysis was used to plot survival curves and compare the overall survival(OS)and postoperative recurrence-free survival(RFS)among patients in Con-ICC,ICC patients with HBsAg+/HBcAb+,and ICC patients with HBsAg-/HBcAb+.Univariate and multivariate Cox proportional hazard models were used to analyze independent influencing factor for OS,RFS and early postoperative recurrence among gender,age,pathogenic factor,liver cirrhosis,Child-Pugh grade,carbohydrate antigen 19-9(CA199),alpha-fetoprotein(AFP),glutamine transferase(GGT),alkaline phosphatase(ALP),total bilirubin(TBil),direct bilirubin(DBil),American Joint Committee on Cancer(AJCC)stage,tumor size,tumor number,tumor differentiation,microvascular invasion,lymph node metastasis,hepatectomy procedure,cholecystectomy,and follow-up treatment.Results Of the 97 patients,the median age was 56 years,and 79(81.4%)of them were male.The median follow-up time was 92.2 months.Eighty-eight(90.7%)patients presented with tumor recurrence and 73(75.3%)died.In multivariate analyses,HBV-ICC and CA199>37 kU/L were independent predictors of OS(HR=0.45,95%CI 0.26-0.77,P=0.003;HR=2.10,95%CI 1.24-3.57,P=0.006),RFS(HR=0.43,95%CI 0.27-0.68,P<0.001;HR=1.78,95%CI 1.12-2.81,P=0.014),and postoperative early recurrence(HR=0.42,95%CI 0.26-0.70,P=0.001;HR=2.02,95%CI 1.20-3.39,P=0.008).AJCC stage Ⅲ was an independent risk factor for postoperative RFS(HR=1.81,95%CI 1.04-3.14,P=0.037).Multiple tumor lesions was an independent risk factor for postoperative RFS and early recurrence(HR=1.73,95%CI 1.07-2.77,P=0.024;HR=1.90,95%CI 1.12-3.24,P=0.017).There was no statistically significant difference in OS,RFS,and early recurrence between HBV-ICC patients with HBsAg-/HBcAb+and Con-ICC patients(P<0.05),whereas HBsAg+/HBcAb+was a significant factor affecting postoperative OS(HR=0.32,95%CI 0.16-0.62,P=0.001),RFS(HR=0.32,95%CI 0.18-0.55,P<0.001),and early recurrence(HR=0.29,95%CI 0.15-0.54,P<0.001)in ICC patients.Conclusions The prognosis of HBV-ICC patients with preoperative HBV-DNA-is better than that of Con-ICC patients.The prognosis of HBV-ICC patients with HBcAb+/HBsAg-is worse than that of HBV-ICC patients with HBcAb+/HBsAg+,but similar to Con-ICC patients.Therefore,the postoperative stratified management of HBV-ICC patients should be emphasized.

To analyze the efficacy and safety of Shensong Yangxin Capsules in treatment of bradycardia combined with premature beat. Databases, such as CNKI, VIP, WanFang, SinoMed, PubMed, Cochrane Library, ClinicalTrials were retrieved by computers for relevant randomized controlled trials of Shensong Yangxin Capsules in treatment of bradycardia combined with premature beat. Two researchers independently screened out the literatures, extracted data according to the inclusion criteria, and applied the Risk of Bias assessment tool in assessing the methodological quality. The Cochrane systematic evaluation software RevMan 5.3 was used for data analysis. Totally 9 randomized controlled trials including 706 subjects were included. The intervention measure was the single administration with Shensong Yangxin Capsules, and the control measure was the blank control. The results showed that Shensong Yangxin Capsules had an obvious effect on average heart rate(MD=6.59, 95%CI[3.87, 9.31], I~2=90%), premature beat efficacy(RR=1.72, 95%CI[1.53, 1.93], I~2=0%), heart rate efficacy(RR=1.74, 95%CI[1.40, 2.17], I~2=47%), and objective efficacy(RR=1.50, 95%CI[1.31, 1.70], I~2=31%). Eight studies reported safety events, with no significant adverse reaction. In conclusion, the single administration with Shensong Yangxin Capsules may have a certain effect in improving heart rate, controlling premature beats and alleviating clinical symptoms in patients with bradycardia combined with premature beat, with no obvious adverse reaction. Shensong Yangxin Capsules can be used in clinic. This potential conclusion needs to be confirmed in future trials using rigorous methodology.
Bradycardia/drug therapy* ; Capsules ; Cardiac Complexes, Premature/drug therapy* ; Drugs, Chinese Herbal/therapeutic use* ; Humans ; Randomized Controlled Trials as Topic

OBJECTIVE: To discuss the clinical effects of clomiphene citrate combined with low molecular weight heparin calcium in the treatment of patients with polycystic ovarian syndrome(PCOS)infertility. METHODS: A total of 105 patients with PCOS infertility who were admitted to the Outpatient Department of Women and Children's Hospital of Qingdao University from September 2016 to April 2018 were taken as research subjects.They were randomly divided into observation group(57 cases)and control group(48 cases).The control group received clomiphene citrate for ovulation treatment,the observation group was given clomiphene citrate combined with low molecular weight heparin calcium for ovulation treatment,and the endometrial receptivity changes,pregnancy rate and the incidence of adverse reactions of patients were compared between the two groups.RESULTS: In the observation group,the endometrial thickness,blood flow index(FI),endometrial spiral arterial blood flow resistance index(RI)and pulsatility index(PI)decreased,and the pregnancy rate was better than that in the control group;the difference was statistically significan(t P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).CONCLUSION: Clomiphene citrate combined with low molecular weight heparin calcium in the treatment of polycystic ovary syndrome infertility can improve the treatment efficiency,and is safe and reliable.It is worthy of clinical promotion.

Objective:To clone cellulose synthase-like(Csl)gene from ethnic medicinal plant Ampelopsis megalophylla,and analyze its sequence by bioinformatics. Method:Specific primers were designed for AmCsl gene sequences obtained from A. megalophylla transcriptome sequencing data. The full-length cDNA of AmCsl gene was amplified by PCR using cDNA of young leaves as template,and TA clone and sequencing was performed. The sequence was analyzed by bioinformatics. Result:The full length cDNA was 1 438 bp,containing a 561 bp open reading frame(ORF),and encoding 186 amino acids,the molecular formula of protein was C₁₀₁₁H₁₅₄₇N₂₃₃O₂₅₇S₁₀,the theoretical relative molecular weight was 22.40 kDa,the theory isoelectric point(PI)was 7.59,and the aliphatic index(AI)was 116.88.There was a transmembrane region and no signal peptide,which may be located in the endoplasmic reticulum,the average hydrophobic coefficient was 0.670,and the instability index was 42.56.It belonged to a hydrophobic unstable protein. The conserved domain contained a cellulose synthase,and the secondary structure mainly was dominated by α-helix. Amino acid sequence alignment and phylogenetic tree analysis showed that AmCsl had a high homology with Vitis vinifera. Conclusion:The full length of AmCsl gene was obtained for preliminary bioinformatics analysis,which laid a necessary foundation for further study on the accumulation of polysaccharides and the regulation of biosynthesis.

Objective To study the optimal waist circumference (WC) cut-off values for identifying metabolic risk factors in middle-aged and elderly subjects in Shandong Province of China.
Methods A total of 2 873 men and 5 559 women were included in this cross-sectional study. Metabolic syndrome (MetS) was diagnosed according to the definition of Chinese Diabetes Society in 2004. The relation between WC and MetS was analyzed by multivariate logistic regression analysis. The optimal WC cut-off values were identified using the area under the ROC curve and the different diagnostic criteria for central obesity were compared.
Results The WC was the risk factor for MetS independent of BMI, blood glucose, blood lipid, and blood pressure. The optimal WC cut-off value was 83.8 cm and 91.1 cm for identifying MetS in women and men, respectively. Compared with 80 cm and 85 cm for women and men, 85 cm and 90 cm had a higher Youden index for identifying all metabolic risk factors and MetS in women and men.
Conclusion The appropriate WC cut-off value is 85 cm and 90 cm for identifying central obesity and MetS in women and men in Shandong Province of China.

OBJECTIVETo investigate the association between birth defects and dietary nutrient intake in a high risk area of China.

METHODSA dietary survey was performed and serum folic acid was measured in women whose pregnancy was affected by neural tube defects (NTDs) or unaffected by any birth defects (BDs) in Zhongyang and Jiaokou Counties in Shanxi Province of China.

RESULTSThe local average consumption of foods including dark green vegetables, fruits, fat and meat, and nutrient intake (e.g., energy, protein, retinol, riboflavin, vitamin E, and selenium) were lower than the national average level. In women of childbearing age, these regions, the intake of nutrients was much lower than the recommended nutrient intake (9%-77%). The case-control dietary nutrition study of women whose pregnancy was affected by BDs (including NTDs and congenital heart defects) demonstrated that, in early pregnancy, adequate nutrition (i.e., eating meat, fresh vegetables, fruit more than once a week) was a protective factor, while eating germinated potatoes was a risk factor. The geometrical mean (p5-p95) of serum folic acid in women with NTD birth defects was 9.6 nmol/L (3.6, 23.03), which was significantly lower than that in normal women (14.03 nmol/L).

CONCLUSIONWomen of childbearing age in the two counties of Shanxi Province, China, have a marked insufficient intake of some nutrients, especially folic acid, zinc, vitamins A and B12. This nutrient deficiency may be an important risk factor for the high prevalence of birth defects in these regions. Therefore, adequate dietary nutrition in early pregnancy can prevent BDs.

Adolescent ; Adult ; Aged ; Case-Control Studies ; China ; epidemiology ; Female ; Folic Acid ; blood ; Humans ; Incidence ; Middle Aged ; Neural Tube Defects ; epidemiology ; Nutritional Status ; Surveys and Questionnaires

OBJECTIVETo construct a gene knock-out mutant of response regulator named RevS in Streptococcus suis serotype 2 virulent strain 05ZYH33, and to investigate the effects of its deletion on the biological characters of this pathogen and the pathogenesis to mice and piglets.

METHODSRecombinant gene knock-out vector consisting of Spc(r) cassette was constructed and flanking was constructed consisting of Spc(r) cassette with flanking homology regions to the RevS genes while the isogenic RevS-deficient mutant was screened by allelic replacement. The effects of RevS deletion on the basic biological characters of 05ZYH33 including growth stability, colonial morphology, haemolysis, Gram staining, growth curve and protein expression were examined in vitro. The mice and piglets were infected with 10(8) CFU wild virulent and mutant isolates.

RESULTSPCR analysis confirmed that the coding genes of RevS were replaced completely by Spc(r) cassette and the basic biological characters of 05ZYH33 did not undergo any apparent change. Balb/c mice infection assay indicated that RevS play a role in the pathogenesis of Streptococcus suis infections, while no remarkable difference was observed in the piglets' pathogenesis infection rates between mutant isolates deltaA05ZYH33 and wild-type isolates 05ZYH33.

CONCLUSIONThe mutant of Streptococcus suis 05ZYH33 response regulator was successfully constructed, while the mutation did not obviously affect the bacterial biological characters, while the knock-out mutant of RevS was shown to be attenuated in pathogenesis to mice and piglets.

Animals ; Bacterial Proteins ; genetics ; Gene Knockout Techniques ; methods ; Mice ; Mice, Inbred BALB C ; Models, Genetic ; Polymerase Chain Reaction ; Streptococcal Infections ; microbiology ; Streptococcus suis ; genetics ; pathogenicity

OBJECTIVETo explore the serological infection rate of hepatitis B virus (HBV) in general population aged over one year old in Beijing and to provide information for control and prevention of the disease.

METHODSA multistage randomized cluster sampling was carried out in general population of Beijing, aged over one year old. Every study subject's hepatitis B immunization history and main risk factors were investigated through questionnaire. Venous blood samples were collected and then tested for five hepatitis B serological antigens and antibodies by means of Abbott Microparticle Enzyme Immunoassy method.

RESULTSThe prevalence rates of HBsAg, anti-HBs, anti-HBc and total HBV infection rate were 3.49% (95% CI:2.99-3.99), 37.79% (95% CI: 36.46-39.12), 35.04% (95% CI: 33.72-36.35) and 35.09% (33.78-36.40) respectively. The age standardized rates were 3.02% ,42.47% ,26.86% and 26.90% respectively.

CONCLUSIONAchievement in hepatitis B control and prevention was made in Beijing since the prevalence rate of hepatitis B surface antigen had been below 1% for children aged less than 5 years old. As for the general population, the prevalence rate of hepatitis B surface antigen had reduced to

Adolescent ; Adult ; Age Distribution ; Child ; Child, Preschool ; China ; epidemiology ; Hepatitis B ; blood ; epidemiology ; immunology ; prevention & control ; Hepatitis B Antibodies ; immunology ; Hepatitis B Surface Antigens ; immunology ; Hepatitis B Vaccines ; therapeutic use ; Humans ; Infant ; Middle Aged ; Young Adult

OBJECTIVETo investigate the experience on diagnosis and treatment of multiple adrenal aldosterone-producing adenomas (APA).

METHODSEighteen cases of multiple adrenal APA were analyzed retrospectively, which were admitted from October 1992 to April 2006.

RESULTSAdrenalectomy was performed for 4 cases of unilateral synchronous multiple APA, which were discovered with three adenomas by 3D-CT; bilateral tumor resection was performed for 6 cases of bilateral synchronous multiple APA. There were 8 cases of bilateral metachronous multiple APA, including 2 cases of ipsilateral recurrent adrenal APA after adrenal tumor removal, which underwent tumor resection. Another 6 cases were contralateral APA following adrenalectomy due to adrenal APA, and underwent tumor resection. After operation, the adrenal function seemed to be normal, and no recurrence had been found on follow-up.

CONCLUSIONSUnilateral multiple synchronous APA require adrenalectomy. Tumor resection should be performed for bilateral or asynchronous APA, and it is very important to preserve healthy adrenal tissue as much as possible. 3D-CT has much value on diagnosis of small APA, unilateral multiple synchronous APA and ipsilateral recurrent adrenal APA.

Adenoma ; complications ; diagnosis ; surgery ; Adrenal Gland Neoplasms ; complications ; diagnosis ; surgery ; Adrenalectomy ; Adult ; Aldosterone ; blood ; Female ; Follow-Up Studies ; Humans ; Hyperaldosteronism ; blood ; etiology ; Male ; Middle Aged ; Retrospective Studies ; Tomography, X-Ray Computed

OBJECTIVETo provide basis for environmental factors of genuine crude Chinese angelica.

METHODOn-the-spot investigation and indoor chemical analysis were made to study the physicochemical properties of cultivated soil of Chinese angelica.

RESULT AND CONCLUSIONThe physical properties and the organic matte and mineral nutrition of cultivated soil of Chinese angelica are best in Min County, Gansu Province. The ecological environment is the leading factor in forming genuine crude Chinese angelica.

Angelica sinensis ; growth & development ; Ecology ; Phosphorus ; analysis ; Potassium ; analysis ; Quality Control ; Soil ; analysis ; Zinc ; analysis