[Objective] To analyze the infection status of hepatitis E virus (HEV) among blood donors in Zhengzhou, so as to provide data support for formulating local blood screening strategies. [Methods] Random samples from blood donors from January to December 2022 were tested for HEV RNA using PCR technology. Reactive samples were sequenced for gene analysis, and the donors were followed up. [Results] Among 21 311 samples, 3(0.14‰) were reactive for HEV RNA, all of whom were male. Genetic sequencing results revealed that one strong positive sample was genotype 4, while sequencing failed for the other two due to low viral load. A follow-up of 25 strong positive donors showed that ALT significantly increased on day 7 after donation, anti-HEV IgM and anti-HEV IgG turned positive. On day 21, ALT returned to normal, and on day 35, HEV RNA turned negative. Notably, anti-HEV IgM and anti-HEV IgG persisted until day 482. [Conclusion] There is HEV infection among blood donors in Zhengzhou, and it is necessary to expand the screening scope to comprehensively explore the prevalence and genotype distribution of HEV among blood donors.

【Objective】 To explore the factors affecting NAT reactive blood donors re-entry, so as to provide data support for formulation of scientific and reasonable strategy. 【Methods】 The basic data and laboratory test results of 174 NAT reactive returning blood donors from January 2019 to August 2021 were collected and statistically analyzed by logistic regression. 【Results】 Among 174 HBV DNA reactive blood donors applying for re-entry, 81 (46.6%) were eligible for re-entry. Blood donation type and deconstructed Ct value were independent influencing factors of blood donors’ re-entry (P<0.05). The Ct value of minipool and deconstruction test showed significant affection on the re-entry (P<0.05). Donors with minipool-Ct-value exceeding deconstructed-Ct-value had a low likelihood of success with re-entry(P>0.05). No significant difference was observed in Ct values of deconstruction test, first re-entry test and second re-entry test (P<0.05). 【Conclusion】 In view of the low re-entry rate of NAT reactive blood donors, it is necessary to establish a set of safety criteria to lessen workloads. Donors with exceeding minipool-Ct-values, repeat reactive by two NAT reagents, failure in the first re-entry test are suggested to be deferred permanently.

Objective: To investigate the mechanism of moxibustion in the treatment of diarrhea-predominant irritable bowel syndrome (IBS-D), by observing the effects of moxibustion at Tianshu (ST25) and Shangjuxu (ST37) on microRNA-133b (miRNA-133b), pituitary homeobox family factor 3 (Pitx3)/tyrosine hydroxylase (TH), and neurotransmitters in the brain tissue of IBS-D rats. Methods: Healthy Sprague-Dawley rats were randomly divided into a normal group, a model group, a moxibustion group, and a Western medicine group, with 12 rats in each group. Except for the normal group, the IBS-D rat model was established by mother-offspring separation and acetic acid enema combined with restraint stress stimulation in all the other groups. No intervention was performed in the normal and model groups. Mild moxibustion was applied to both Tianshu (ST25) and Shangjuxu (ST37) in the moxibustion group. Rifaximin was given by gavage in the Western medicine group. The physical status of rats in each group was observed at different periods. After the intervention, hematoxylin- eosin staining was performed to observe the histopathological morphology of rat colon; enzyme-linked immunosorbent assay was used to measure the levels of dopamine (DA), noradrenaline (NE), and 5-hydroxytryptamine (5-HT) in plasma, colon, and midbrain tissue of rats; the relative expression levels of miRNA-133b, Pitx3 mRNA, and TH mRNA in the midbrain tissue were measured by real-time fluorescence quantitative polymerase chain reaction, and the relative expression levels of Pitx3 and TH proteins in the midbrain tissue were measured by Western blotting and immunofluorescence. Results: The body weights of rats among groups and at different time points were statistically different (P<0.01). The body weight of the normal group was higher than that of the other groups over time (P<0.01). After modeling, the minimum volume threshold of abdominal withdrawal reflex (AWR) was significantly lower (P<0.01) and the loose stool rate was significantly higher (P<0.01) in the model, moxibustion, and Western medicine groups compared with the normal group; the miRNA-133b expression in the midbrain tissue was significantly lower (P<0.01), the expression levels of Pitx3 and TH in the midbrain tissue were significantly higher (P<0.01), and the levels of DA, NE, and 5-HT in plasma, colon and midbrain tissue were significantly higher (P<0.01). After the intervention, the minimum volume threshold of AWR was significantly higher (P<0.01), the loose stool rate was significantly lower (P<0.01), the miRNA-133b expression was significantly increased (P<0.01 or P<0.05) and the expression levels of Pitx3 and TH were significantly decreased (P<0.01) in the midbrain tissue, the levels of DA, NE, and 5-HT in plasma, colon, and midbrain tissue were significantly reduced (P<0.01) in the moxibustion and Western medicine groups compared with the model group; the levels of 5-HT in the colon and midbrain tissue of the moxibustion group were significantly lower than those in the Western medicine group (P<0.05), and there was no statistical difference compared with the remaining groups (P>0.05). Linear correlation analysis showed that miRNA-133b was negatively correlated with Pitx3 (r<0, P<0.01); Pitx3 with TH, TH with DA, and NE with 5-HT were positively correlated (r>0, P<0.01).Conclusion: Moxibustion at Tianshu (ST25) and Shangjuxu (ST37) improves diarrhea symptoms and visceral hypersensitivity in IBS-D rats. The mechanism may be related to up-regulating miRNA-133b, inhibiting Pitx3/TH, and reducing neurotransmitter expression levels in the midbrain tissue.

Objective To study the diagnostic value of endoscopic ultrasonography (EUS)for benign and malignant bile duct stricture.Methods Data of 51 patients who underwent EUS from January 2007 to March 2015 due to distal biliary stricture were retrospectively studied.And their diagnosis with EUS,IDUS,bile duct cytological brushing and final diagnosis were compared.Results Malignant bile duct stenosis were finally confirmed in 19 cases and benign stenosis were confirmed in 32 cases.The sensitivity (73.7％ VS 57.1％) and positive predictive value (73.7％ VS 57.1％) of EUS for the benign and malignant diagnosis of biliary tract stenosis were significantly higher than that of IDUS (P＜0.05),while their specificity(84.4％ VS 84.2％)and accuracy(80.4％ VS 76.9％)were similar.The sensitivity of EUS was significantly higher than that of bile duct cytological brushing (73.7％ VS 50.0％),while their specificity (84.4％ VS 100.0％)and accuracy(80.4％ VS 81.6％)were similar.EUS findings of hypoechoic mass features had higher diagnostic accuracy for detecting malignant distal bile duct stricture than irregular thickening of the lumen in the distal bile duct (100.0％ VS 64.3％,P＜0.05).Conclusion For patients with lesions of the distal bile duct that CT/MRI could not diagnose,EUS has an important value for the further diagnosis of benign and malignant bile duct stricture.

[ ABSTRACT] AIM:To study the effect of livin gene-modified bone marrow mesenchymal stem cells ( BM-MSCs) transplantation on the cardiac function following acute myocardial infarction in a rat model and the expression of livin , caspase-3, caspase-7 and caspase-9 in the livin gene-modified BM-MSCs.METHODS: The MSCs were obtained by the whole bone marrow culture method , and the apoptosis of the MSCs after infection with adenovirus vector carrying enhanced green fluorescent protein ( EGFP) gene and livin recombinant vector ( rAd-livin) were detected by flow cytometry .The ex-pression of livin, caspase-3, caspase-7 and caspase-9 was detected by Western blot .After permanent left anterior descend-ing artery occlusion , the rats were randomized to receive intramyocardial injection of DMEM without cells ( vehicle group ) , or containing MSCs ( MSCs group ) , MSCs ( EGFP ) ( rAd-control/MSCs group ) or MSCs ( livin ) ( rAd-livin/MSCs group).Left ventricular systolic pressure (LVSP), left ventricular end-diastolic pressure (LVEDP), the maximum in-creased rate of left ventricular pressure ( -dp/dtmax ) and the maximum decline rate of left ventricular pressure ( +dp/dtmax ) were recorded for evaluating the cardiac functions .RESULTS: The apoptosis of rAd-livin/MSCs was significantly decreased as compared with MSCs and rAd-control/MSCs (P<0.05).Meanwhile, the expression of caspase-3, caspase-7 and caspase-9 was significantly downregulated as compared with the other 2 groups ( P<0.05 ) .The cardiac function in rAd-livin/MSCs group was significantly improved as compared with DMEM group , and those in the other 2 groups got the similar results, but the function in rAd-livin/MSCs group was better improved .Meanwhile, the number of surviving cells in rAd-livin/MSCs group was significantly improved as compared with the other 2 groups .CONCLUSION:The apoptosis of MSCs is decreased after rAd-livin transfection, and the expression of caspase-3, caspase-7 and caspase-9 is also significant-ly downregulated while the expression of livin is significantly upregulated .Transplantation of livin-modified BM-MSCs by lentiviral vector results in better prognosis for treating myocardial infarction by enhancing cell survival .

Objective To evaluate the effectiveness and safety of double balloon enteroscopy( DBE) in retrieval of retained capsule and identify the factors associated with successful retrieval. Methods A total of 23 consecutive retention cases who received retrieval of retained capsules by DBE from January 2010 to December 2013 were reviewed. They were assigned to success group and failure group. The differences in insertion route, insertion depth, lesion location between the two groups were analyzed. Results Fifteen cases of all 23 retention cases were successfully retrieved and the success rate was 65?2%. There was no significant difference in the mean entrapped period of CE between the two groups [20?0(15?0,57?0)d VS 21?0(16?0,240?0) d,P=0?525]. DBE via oral route exhibited remarkable higher success rate than anal route [ 71?4%( 15/21) VS 0/5, P=0?007] . Compared with ileum, it was easier to take out CE located at jejunum( 8/8 VS 7/13, P=0?046 ) and the insertion depth was significantly less in the success group [(167?3±33?8)cm VS (258?3±23?9) cm, P=0?041]. Whether the capsule was in pelvic cavity shown by x?ray film before the surgery was irrelevant to the successful rate(9/14 VS 5/6,P=0?613) and insertion depth of the DBE on access to the capsule[(132?0±68?6) cm VS (200?0±40?3) cm, P=0?376],or to the actual location of the capsule. Conclusion Peroral DBE is an effective method for removal of retained CE and the success rate isn′t relevant to the entrapped period. Retained CE locates in ileum and jejunum is more difficult to be taken out than in duodenum.

Objective To evaluate the risk factors,treatment and follow-up of capsule retentions after capsule endoscopy examination.Methods A total of 1 100 capsule enteroscopic examinations,performed at our hospital from October 2006 to March 2013,were retrospectively studied.The positive findings of lesions, clinical indications of capsule endoscopy,treatment and follow-ups were recorded.Results The incidence of capsule retentions was 1.18%(n =13).The rates of capsule retentions in OGIB,suspected Crohn′s disease (CD),known CD,suspected tumors and chronic abdominal pain were 0.95%,4.0%,10.5%,7.1% and 0.3%,respectively.In 11 patients,the capsule was removed by means of double-balloon enteroscopy,the cap-sule was removed surgically in one patient,and spontaneous expulsion occurred in another patient after 1 year of treatment.Risk factors for capsule retention were known or suspected CD and suspected tumor(OR =11.44, P =0.02;OR =5.59,P =0.02),and suspected tumor was also a risk factor(OR =7.42,P =0.04).Conclu-sion Capsule endoscopy is a safe procedure with low risk of capsule retentions.Advantages and disadvantages of capsule endoscopy examinations should be considered carefully when high-risk patients are involved.

Background and purpose: Radiofrequency ablation (RFA) is one of the effective treatment methods for primary liver cancer and metastatic liver cancer. The purpose of this study was to investigate the risk factors of residual tumor after RFA for hepatic malignancies. Methods:A total number of 302 hepatic malignancies cases with 691 tumors after ultrasound-guided RFA from Jan. 2010 to Mar. 2013 were retrospectively analyzed. Single factor and multi-factor Logistic regression model were used to analyze the risk factors of residual tumor after RFA. Results:Complete ablation cases were 90.07%(272/302) for patients and 91.46%(632/691) for tumors, and the ablation residual rate was 8.54%. Ablation residual rates for tumor ≤3 cm, 3-5 cm and >5 cm in diameter were 6.30%, 9.57% and 28.57%, for tumor close to the intrahepatic vascular and gallbladder were 17.14%and 18.52%, for with and without combination with other local treatments were 7.02%and 13.41%, respectively. Multivariate analysis showed that tumor size>5 cm (P=0.044), proximity to large vessel (P=0.039) and without combination with other local treatments (P=0.001) were independent risk factors for ablation residual. Multivariate analysis showed that tumor near the intrahepatic vascular (P=0.014), single needle RFA (P=0.047) and without combination with other local treatments (P=0.023) were independent ablation residua risk factors for tumors between 3-5 cm in maximum diameter. Conclusion:Ultrasound-guided RFA can achieve satisfactory ablation effect. Tumor close to the intrahepatic vascular, tumor diameter>5 cm and without combination with other local treatment act as the independent risk factors for ablation residual. For tumors between 3-5 cm in diameter, in addition to close to intrahepatic blood vessels and without combination with other local treatment, single needle RFA is also another independent risk factor for ablation residual, and double-needle or multi-needle treatment can improve the ablation efifciency and reduce residual rate.

Objective The aim of this randomized,double-blind,placebo-controlled trial was to evaluate the efficacy of the Saccharomyces boulardii (S.boulardii) power in preventing antibiotic-associated diarrhea (AAD) in hospitalized children with pneumonia.Methods Two hundred and forty-five hospitalized children with pneumonia were randomly divided into two groups,group 1 treated with antibiotics and S.boulardii power (n =104),and group 2 with antibiotics and placebo,along with S.boulardii power and zinc when suffered from diarrhea (n =141).All children received montmorillonite powder and fluid replacement therapy for diarrhea.The stool frequency and consistency were observed.Diarrhea incidence,diarrhea and pneumonia duration of treatment,and therapeutic effect were recorded.Results AAD is more prevalent in group 2 than in group 1 (P ＜0.05).A 55.7％ relative risk reduction in AAD was seen in group 1 compared with group 2 (RR =0.443,95％CI 0.233 ～ 0.845,P =0.012).Patients with preventive treatment of S.boulardii power in broup 1 had lower AAD incidence compared with those in group 2 (P ＜ 0.05).Both the diarrhea and pneumonia duration of treatment in group 1 were shorter than that in group 2(P =0.001 for diarrhea duration,P =0.030 for pneumonia duration,respectively).No drug related adverse reactions were found during the observation period.Conclusion Preventive use of S.boulardii power may effectively reduce the risk of AAD,improve therapeutic effect,and shorten hospital stays for hospitalized children with pneumonia.

Objective To investigate the relationship between coagulation function and pediatric critical illness scores (PCIS) in children with severe pneumonia.Methods The PCIS were collected in 152 children with severe pneumonia (pneumonia group) admitted in our pediatric intensive care unit from Jan 2010 to Jul 2011,and 20 healthy children in the same period were selected as the healthy control group.The coagulation indicators of children in both groups were detected and the relationship between coagulation markers and severity of pneumonia was analyzed.Results There were significant differences in platelet count,fibrinogen,D-Dimer,soluble P-selectin between pneumonia group and healthy control goup [(185.74 ±116.26) × 109/L vs (287.10 ±90.01) × 109/L,(3.51 ±0.50) g/L vs (3.15 ±0.15) g/L,(1.39 ±2.18) μg/ml vs (0.36 ± 0.07) μ g/ml,(110.07 ± 83.47) ng/ml vs (33.74 ± 9.47) ng/ml,P ＜ 0.05].There were positive correlation between soluble P-selectin,D-Dimer and severity of disease and negative correlation between platelet count and severity of disease in children with severe pneumonia.Regression equation:y =1.154 +0.003 × soluble P-selectin + 0.089 × D-Dimer-0.001 × platelet count (P ＜ 0.05).As the children's critical condition getting worse,soluble P-selectin and D-Dimer levels increased (P ＜ 0.05).Hatelet count showed no significant difference between critical group and extremely critical group,which was significantly lower than that in non-critical group (P ＜ 0.05).Conclusion Soluble P-selectin,D-Dimer,and platelet count are associated with the severity of pneumonia.The children with severe pneumonia are easy to have coagulation disturbance.