Background::The study aimed to describe the aortic valve morphology in Chinese patients underwent transcatheter aortic valve replacement (TAVR) for symptomatic severe aortic stenosis (AS), and the impact of sizing strategies and related procedural outcomes.Methods::Patients with severe AS who underwent TAVR were consecutively enrolled from 2012 to 2019. The anatomy and morphology of the aortic root were assessed. "Downsize" strategy was preformed when patients had complex morphology. The clinical outcomes of patients who performed downsize strategy were compared with those received annular sizing strategy. The primary outcome was device success rate, and secondary outcomes included Valve Academic Research Consortium-3 clinical outcomes variables based on 1-year follow-up.Results::A total of 293 patients were enrolled. Among them, 95 patients (32.4%) had bicuspid aortic valve. The calcium volume (Hounsfield Unit-850) of aortic root was 449.90 (243.15-782.15) mm 3. Calcium is distributed mostly on the leaflet level. Downsize strategy was performed in 204 patients (69.6%). Compared with the patients who performed annular sizing strategy, those received downsize strategy achieved a similar device success rate (82.0% [73] vs. 83.3% [170], P= 0.79). Aortic valve gradients (downsize strategy group vs. annular sizing group, 11.28 mmHg vs. 11.88 mmHg, P = 0.64) and percentages of patients with moderate or severe paravalvular regurgitation 2.0% (4/204) vs. 4.5% (4/89), P = 0.21) were similar in the two groups at 30 days after TAVR. These echocardiographic results were sustainable for one year. Conclusions::Chinese TAVR patients have more prevalent bicuspid morphology and large calcium volume of aortic root. Calcium is distributed mostly on the leaflet level. Compare with annular sizing strategy, downsize strategy provided a non-inferior device success rate and transcatheter heart valve hemodynamic performance in self-expanding TAVR procedure.

Objective To explore the value of RT-PCRin diagnosis of patients with HIV-negative hypoimmunity and pneumocystis pneumonia (PCP).Methods Totally 71 phlegm samples of pulmonary infection patients with suspected PCP and HIV-negative hypoimmunity were selected.ITS-nested PCRand ITS-real-time fluorescence quantitative PCRwere used to detect pneumocystis jiroveci in samples.Results Among the 71 patients,18 cases were diagnosed as PCP.There were 25 cases with positive results by n-PCR,but the false-positive rate was 36.00%,and sensitivity,specificity and positive predictive values of n-PCRwere 88.89%,83.01% and 64.00%,respectively.If the threshold was 103 copies/mL,the specificity and positive predictive value of RT-PCRwere significantly higheRthan n-PCR.In patients with PCP,the the gene load of pneumocystis by RT-PCRwas significantly higheRthan non-PCP patients.Conclusion In patients with HIV-negative hypoimmunity,RT-PCRis more accurate and rapid than nested PCRin the diagnosis of PCP,and it can distinguish the infection and colonization of pneumocystis.

Objective To explore the value of RT-PCRin diagnosis of patients with HIV-negative hypoimmunity and pneumocystis pneumonia (PCP).Methods Totally 71 phlegm samples of pulmonary infection patients with suspected PCP and HIV-negative hypoimmunity were selected.ITS-nested PCRand ITS-real-time fluorescence quantitative PCRwere used to detect pneumocystis jiroveci in samples.Results Among the 71 patients,18 cases were diagnosed as PCP.There were 25 cases with positive results by n-PCR,but the false-positive rate was 36.00%,and sensitivity,specificity and positive predictive values of n-PCRwere 88.89%,83.01% and 64.00%,respectively.If the threshold was 103 copies/mL,the specificity and positive predictive value of RT-PCRwere significantly higheRthan n-PCR.In patients with PCP,the the gene load of pneumocystis by RT-PCRwas significantly higheRthan non-PCP patients.Conclusion In patients with HIV-negative hypoimmunity,RT-PCRis more accurate and rapid than nested PCRin the diagnosis of PCP,and it can distinguish the infection and colonization of pneumocystis.

Objective To investigate the association between the single nucleotide polymorphisms (SNPs) IL-18-137G/C (rs187238) and IL-18-607A/C (rs1946518) in interleukin-18 (IL-18) gene and hepatocellular carcinoma (HCC) caused by the hepatitis B virus (HBV).Methods The subjects were divided into HBV-related HCC group (109 patients),chronic HBV infection group (113 patients),and healthy control group (127 patients).The polymerase chain reaction-ligase detection reaction (PCR-LDR) was used to determine the alleles and genotypes of the two SNPs IL-18-137G/C and IL-18-607A/C.The t-test and chi-square test were used for baseline data.The chi-square test was used to investigate the differences in genotype and allele frequencies across the three groups.Non-conditional logistic regression analysis was used to compare the odds ratios (ORs) and 95％ confidence intervals (CIs) for different genotypes/alleles in predicting the risk ofHBV-related HCC.Results The HBV-related HCC group showed significantly higher AA genotype and A allele frequencies of the SNP IL-18-607A/C than the healthy control group (AA genotype frequency:29.4％ vs 18.1％,x2 =4.152,P ＜ 0.05;A allele frequency:54.6％ vs 44.1％,5.169,P ＜ 0.05),which were positively correlated with the risk of HBV-related HCC (AA genotype frequency:OR =1.879,95％ CI:1.020-3.464;A allele frequency:OR =1.524,95％ CI:1.059-2.193).The chronic HBV infection group had a significantly higher A allele frequency of the SNP IL-18-607A/C than the healthy control group (54.0％ vs 44.1％,x2 =4.680,P ＜ 0.05),which was positively correlated with the risk of chronic HBV infection (OR =1.487,95％ CI:1.037-2.132).The genotype and allele frequencies of the SNP IL-18-607A/C showed no significant differences between the HBV-related HCC group and the chronic HBV infection group (P ＞ 0.05).The genotype and allele frequencies of the SNP IL-18-137G/C showed no significant differences between any two groups of the three groups (P ＞ 0.05).Conclusion The AA genotype and A allele frequencies of the SNP IL-18-607A/C are positively correlated with the morbidity of HBV-related HCC,and the A allele frequency of the SNP IL-18-607A/C is positively correlated with the morbidity of chronic HBV infection.

Chronic hepatitis B virus (HBV) carriers are facing the risk of progression to liver fibrosis,liver cirrhosis,and hepatocellular carcinoma.However,due to low risk,slow disease progression,and unsatisfactory short-term effect of antiviral treatment,controversy still exists over whether such patients should be given antiviral treatment.This article reviews the research advances in the necessity and feasibility of antiviral therapy for chronic hepatitis B virus carriers,so as to provide a reference for clinical practice.

OBJECTIVETo evaluate the short-term effect and safety of entecavir for the treatment of chronic hepatitis B (CHB) virus carriers.

METHODSNinety-three cases of CHB virus infection (hepatitis B surface antigen (HBsAg)-positive, hepatitis B e antigen (HBeAg)-positive, hepatitis B core antibody (HBcAb)-positive, HBV DNA≥1x10(5) copies/mL) were divided into two groups: CHB virus carrier (47 cases) and CHB (46 cases). All of the 93 cases were given 0.5 mg entecavir orally once a day for 48 weeks. Virology, serology and biochemistry tests were perrmed at treatment weeks 0, 4, 12, 24 and 48. Side effects of entecavir and the incidence of liver cirrhosis and hepatocellular carcinoma were recorded.

RESULTSThe CHB virus carrier and CHB group had complete virological response rates of 14.9% and 17.4% at week 4, 51.1% and 63.0% at week 12, 76.6% and 89.1% at week 24, and 97.9% and 100% at week 48, respectively; there was no significant difference between the two groups (P>0.05). The CHB virus carrier and CHB group had partial virological response rates of 42.6% and 47.8% at week 4, 57.44% and 65.2% at week 12, 85.0% and 89.1% at week 24, and 100% and 100% at week 48, respectively; there was no significant difference between the two groups (P>0.05). No cases in either group experienced virologic breakthrough during the treatment course. The CHB virus carrier and CHB group had serological response (HBeAg-negative) rates of 0 and 4.3% at week 4, 2.1% and 8.7% at week 12, 4.3% and 13.0% at week 24, and 8.5% and 21.7% at week 48, respectively; there was no significant difference between the two groups (P>0.05). The CHB virus carrier and CHB group had HBeAg seroconversion rates of 0 and 0 at week 4, 0 and 4.4% at week 12, 2.1% and 10.9% at week 24, and 6.4% and 17.4% at week 48, respectively; there was no significant difference between the two groups (P>0.05). No case in either group showed HBsAg-negativity and seroconversion during the treatment course. The CHB group had a biochemical response (alanine aminotransferase normalization) rate of 26.1% at week 4, 65.2% at week 12, 91.3% at week 24, and 97.8% at week 48.No case in either group showed biochemical breakthrough during the treatment course. There were no cases of liver cirrhosis or hepatocellular carcinoma in either group. There were no side effects of the entecavir treatment experienced in either group.

CONCLUSIONAntiviral therapy with entecavir is effective, safe and well tolerated in CHB virus carriers.

Alanine Transaminase ; Antiviral Agents ; Carcinoma, Hepatocellular ; Guanine ; analogs & derivatives ; Hepatitis B e Antigens ; Hepatitis B virus ; Hepatitis B, Chronic ; Humans ; Liver Neoplasms

Objective To investigate the diagnostic value of the T-SPOT.TB test for diagnosing tuberculous meningitis(TBM) by meta-analysis.Methods A systematic retrieval from the databases of PubMed,EMBASE,etc.was performed.The literature on the T-SPOT.TB test for diagnosing TBM was collected.Two reviewers independently screened the literature,extracted the data and judged the quality.The meta analysis was conducted by the Meta-Disc 1.4 software.Results 8 articles were included,involving 425 patients including 232 cases of TBM.In the peripheral blood group,the combined sensitivity was 80%(95%CI:0.74-0.85),the combined specificity was 74%(95%CI:0.67-0.80),the area under the curve(AUC)of summary receiver operating characteristic (SROC)was 0.858 7;the diagnostic odds ratio(DOR)was 15.50.In the CSF group,the combined sensitivity was 76%(95%CI:0.70-0.82),the combined specificity was 83%(95%CI:0.77-0.88),AUC was 0.892 7;DOR was 22.62.Conclusion Adopting the T-SPOT.TB test conduces to increase the diagnostic rate of TBM.The diagnostic accuracy of the T-SPOT.TB test for CSF may be higher than that for peripheral blood.

Objective:To evaluate the clinical efficacy and safety of gatifloxacin in the treatment of mild and moderate bacterial infections of respiratory tract,urinary tract,genital tract,skin and soft tissues.Methods:115 patients in study group were treated with gatifloxacin 200mg taken orally q12h,and 108 patients in control group were treated with ciprofloxacin 250mg taken orally q8h for 7days to 14 days.Results:The total cure rates of study group and control group were 90.4% and 77.8%( P 0.05),respectively.The bacterial eradication rates of the two groups were 97.1% and 89.2%( P 0.05),respectively.Conclusion:Gatifloxacin is a highly effective and well tolerated antibacterial agent for treatment of acute bacterial infections of respiratory tract,urinary tract,genital tract,skin and soft tissues.

OBJECTIVEBy studying the possibility of obtaining expression of human hepatitis B virus (HBV) genes and production in normal liver cells from heterologous species like normal primary duck hepatocytes (PDH), to investigate the species-specificity of HBV infection and replication.

METHODSTwo days after transfecting the complete HBV genome into PDH by electroporation (transfected group), HBsAg and HBeAg in the supernatants and lysates of PDH were measured by the IMX system. Meanwhile, replication of HBV in PDH was analyzed by Southern blotting and dot blotting procedures. PDH was electroporated as control.

RESULTSHBsAg in the lysate of transfected group was 9.10 (P/N values, positive?2.1), HBeAg was 1.0 (negative?2.1), both were negative in the supernatants of transfected group. dot blotting revealed that transfected group was strongly positive, whereas the control group was negative. Southern blot analysis of intracellular total DNA indicated that there were relaxed circular (RC), covalently closed circular (CCC) and single-stranded (SS) HBV DNA replicative intermediates in the transfected group, and there was no integrated HBV DNA in the cellular genome. Control groups were negative.

CONCLUSIONSReplication of HBV can occur in hepatocytes from nonmammalian species, which strongly supports the idea that replication of HBV has no critical species-specificity, and yet it depends on the endoenvironment of hepatocyte.

Animals ; Cells, Cultured ; DNA Replication ; physiology ; DNA, Viral ; biosynthesis ; Disease Models, Animal ; Ducks ; Electroporation ; Hepatitis B Surface Antigens ; analysis ; Hepatitis B e Antigens ; analysis ; Hepatitis B virus ; genetics ; physiology ; Hepatocytes ; metabolism ; virology ; Humans ; Species Specificity ; Transfection ; Virus Replication

Hepatitis B ; virology ; Hepatitis B virus ; physiology ; Humans ; Virus Replication