Cervical spine infection arising from chronic paronychia:A case report and review of literature

BACKGROUND Cervical spine pyogenic infection(CSPI)is a rare and challenging form of spinal infection that is typically caused by pyogenic bacteria and primarily affects the cervical vertebral bodies and surrounding tissues.Given its nonspecific symptoms,such as fever and neck pain,early diagnosis is crucial to prevent severe complications,including spinal cord injury.We report a previously unreported case of acute CSPI arising from chronic paronychia,exploring its diagnostic and therapeutic challenges through a review of the current literature.CASE SUMMARY The presented case involved a 15-year-old man with CSPI caused by Staphylococcus aureus,which led to complications including bacteremia and a paronychiaassociated abscess.Acute pyogenic infection was initially diagnosed by typical symptoms and blood culture.Fever improved after antibiotic treatment while developing progressive limbs dysfunction.Six days after admission,the patient underwent anterior cervical debridement+autogenous iliac bone graft fusion+plate internal fixation and received 12 weeks of antibiotic treatment after the operation.Re-examination 3 years postoperatively showed that the patient had stable cervical fixation,no significant neck pain or upper limb abnormalities,and normal urinary function.CONCLUSION Early imaging findings,laboratory markers,and timely antibiotic treatment are crucial for CSPI management,preventing complications and facilitating recovery.

采用恒界面池法研究双(2-乙基己基)磷酸酯(HDEHP)-乳酸复合体系萃取镧和铈动力学

研究在乳酸络合体系中HDEHP萃取镧和铈的动力学。通过恒界面池装置分别研究不同搅拌速度、比界面积、温度和溶液组分浓度对萃取速率的影响。当搅拌速度为130~180 r/min时,萃取反应速率以化学反应控制为主,并且随着比界面和温度的升高,萃取速率变快。萃取动力学研究表明,萃取反应符合准一级反应,传质过程发生在有机相与液相界面而不是在相体内。萃取反应吉布斯自由能ΔG<0,能够自发进行反应,表观活化能的计算表明HDEHP在萃取中更易与铈结合。

Prediction of risk factors for lymph node metastasis in early gastric cancer

AIM:To explore risk factors for lymph node metastases in early gastric cancer(EGC) and to confirm the appropriate range of lymph node dissection.METHODS:A total of 202 patients with EGC who underwent curative gastrectomy with lymphadenectomy in the Department of Surgery,Xinhua Hospital and Ruijin Hospital of Shanghai Jiaotong University Medical School between November 2003 and July 2009,were retrospectively reviewed.Both the surgical procedure and the extent of lymph node dissection were based on the recommendations of the Japanese gastric cancer treatment guidelines.The macroscopic type was classified as elevated(type Ⅰ or Ⅱa),flat(Ⅱb),or depressed(Ⅱc or Ⅲ).Histopathologically,papillary and tubular adenocarcinomas were grouped together as differentiated adenocarcinomas,and poorly differentiated and signet-ring cell adenocarcinomas were regarded as undifferentiated adenocarcinomas.Univariate and multivariate analyses of lymph node metastases and patient and tumor characteristics were undertaken.RESULTS:The lymph node metastases rate in patients with EGC was 14.4%.Among these,the rate for mucosal cancer was 5.4%,and 8.9% for submucosal cancer.Univariate analysis showed an obvious correlation between lymph node metastases and tumor location,depth of invasion,morphological classification and venous invasion(χ 2 = 122.901,P = 0.001;χ 2 = 7.14,P = 0.008;χ 2 = 79.523,P = 0.001;χ 2 = 8.687,P = 0.003,respectively).In patients with submucosal cancers,the lymph node metastases rate in patients with venous invasion(60%,3/5) was higher than in those without invasion(20%,15/75)(χ 2 = 4.301,P = 0.038).Multivariate logistic regression analysis revealed that the depth of invasion was the only independent risk factor for lymph node metastases in EGC [P = 0.018,Exp(B) = 2.744].Among the patients with lymph node metastases,29 cases(14.4%) were at N1,seven cases were at N2(3.5%),and two cases were at N3(1.0%).Univariate analysis of variance revealed a close relationship between the depth of invasion and lymph node metastases at pN 1(P = 0.008).CONCLUSION:The depth of invasion was the only independent risk factor for lymph node metastases.Risk factors for metastases should be considered when choosing surgery for EGC.

ERCP for patients who have undergone Billroth Ⅱ gastroenterostomy and Braun anastomosis

Endoscopic retrograde cholangiopancreatography (ERCP) is efficacious in patients who have undergone Billroth II gastroenterostomies, but the success rate decreases in patients who also have experienced Braun anastomoses. There are currently no reports describing the preferred enterography route for cannulation in these patients. We first review the patient&#x02019;s previous surgery records, which most often indicate that the efferent loop is at the greater curvature of the stomach. We recommend extending the duodenoscope along the greater curvature of the stomach and then advancing it through the &#x0201c;lower entrance&#x0201d; at the site of the gastrojejunal anastomosis, along the efferent loop, and through the &#x0201c;middle entrance&#x0201d; at the site of the Braun anastomosis to reach the papilla of Vater. Ten patients who had each undergone Billroth II gastroenterostomy and Braun anastomosis between January 2009 and December 2011 were included in our study. The overall success rate of enterography was 90% for the patients who had undergone Billroth II gastroenterostomy and Braun anastomosis, and the therapeutic success rate was 80%. We believe that this enterography route for ERCP is optimal for a patient who has had Billroth II gastroenterostomy and Braun anastomosis and helps to increase the success rate of the procedure.

Characteristics and Seasonal Variations of PM2.5, PM10, and TSP Aerosol in Beijing

Objective To investigate the seasonal characteristics and the sources of elements and ions with different sizes in the aerosols in Beijing. Methods Samples of particulate matters （PM2,5）, PM10, and total suspended particle （TSP） aerosols were collected simultaneously in Beijing from July 2001 to April 2003. The aerosol was chemically characterized by measuring 23 elements and 18 water-soluble ions by inductively coupled plasma-atomic emission spectroscopy （ICP-AES） and ion chromatography （IC）, respectively. Results The samples were divided into four categories： spring non-dust, spring dust, summer dust, and winter dust. TSP, PM10, and PM2.5 were most abundant in the spring dust, and the least in summer dust. The average mass ratios of PM〉10, PM2,5-10, and PM2.5 to TSP confirmed that in the spring dust both the large coarse （PM〉10） and fine particles （PM2.5） contributed significantly in summer PM2.5, PM2,5-10, and PM〉10 contributed similar fractions to TSP, and in winter much PM2.5. The seasonal variation characteristics of the elements and ions were used to divide them into four groups： crustal, pollutant, mixed, and secondary. The highest levels of crustal elements, such as AI, Fe, and Ca, were found in the dust season, the highest levels of pollutant elements and ions, such as As, F, and Cl^-, were observed in winter, and the highest levels of secondary ions （SO4^2-, NO3^-, and NH4^＋） were seen both in summer and in winter. The mixed group （Eu, Ni, and Cu） showed the characteristics of both crustal and pollutant elements. The mineral aerosol from outside Beijiug contributed more than that from the local part in all the reasons but summer, estimated using a newly developed element tracer technique.

Lymph node metastasis in gastric cardiac adenocarcinoma in male patients

AIM:To reveal the clinicopathological features and risk factors for lymph node metastases in gastric cardiac adenocarcinoma of male patients.METHODS:We retrospective reviewed a total of 146male and female patients with gastric cardiac adenocarcinoma who had undergone curative gastrectomy with lymphadenectomy in the Department of Surgery,Xin Hua Hospital and Rui Jin Hospital of Shanghai Jiaotong University Medical School between November2001 and May 2012.Both the surgical procedure and extent of lymph node dissection were based on the recommendations of Japanese gastric cancer treatment guidelines.Univariate and multivariate analyses of lymph node metastases and the clinicopathological features were undertaken.RESULTS:The rate of lymph node metastases in male patients with gastric cardiac adenocarcinoma was72.1%.Univariate analysis showed an obvious correlation between lymph node metastases and tumor size,gross appearance,differentiation,pathological tumor depth,and lymphatic invasion in male patients.Multivariate logistic regression analysis revealed that tumor differentiation and pathological tumor depth were the independent risk factors for lymph node metastases in male patients.There was an obvious relationship between lymph node metastases and tumor size,gross appearance,differentiation,pathological tumor depth,lymphatic invasion at pN1and pN2,and nerve invasion at pN3in male patients.There were no significant differences in clinicopathological features or lymph node metastases between female and male patients.CONCLUSION:Tumor differentiation and tumor depth were risk factors for lymph node metastases in male patients with gastric cardiac adenocarcinoma and should be considered when choosing surgery.

Retrieval-balloon-assisted enterography for ERCP after Billroth Ⅱ gastroenterostomy and Braun anastomosis

AIM: To describe an optimal route to the Braun anastomosis including the use of retrieval-balloon-assisted enterography.METHODS: Patients who received a Billroth Ⅱ gastroenterostomy(n = 109) and a Billroth Ⅱ gastroenterostomy with Braun anastomosis(n = 20) between January 2009 and May 2013 were analyzed in this study. Endoscopic ret-rograde cholangiopancreatography(ERCP) was performed under fluoroscopic control using a total length of 120 cm oblique-viewing duodenoscope with a 3.7-mm diameter working channel. For this procedure, we used a triplelumen retrieval balloon catheter in which a 0.035-inch guidewire could be inserted into the "open-channel" guidewire lumen while the balloon could be simultaneously injected and inflated through the other 2 lumens.RESULTS: For the patients with Billroth Ⅱ gastroenterostomy and Braun anastomosis, successful access to the papilla was gained in 17 patients(85%) and there was therapeutic success in 16 patients(80%). One patient had afferent loop perforation, but postoperative bleeding did not occur. For Billroth Ⅱ gastroenterostomy, there was failure in accessing the papilla in 15 patients(13.8%). ERCP was unsuccessful because of tumor infiltration(6 patients), a long afferent loop(9 patients), and cannulation failure(4 patients). The papilla was successfully accessed in 94 patients(86.2%), and there was therapeutic success in 90 patients(82.6%). Afferent loop perforation did not occur in any of these patients. One patient had hemorrhage 2 h after ERCP, which was successfully managed with conservative treatment.CONCLUSION: Retrieval-balloon-assisted enterography along an optimal route may improve the ERCP success rate after Billroth Ⅱ gastroenterostomy and Braun anastomosis.

Application of modified primary closure of the pelvic floor in laparoscopic extralevator abdominal perineal excision for low rectal cancer

AIM To introduce a novel,modified primary closure technique of laparoscopic extralevator abdominal perineal excision(LELAPE) for low rectal cancer.METHODS We retrospectively analyzed data from 76 patients with rectal cancer who underwent LELAPE from March 2013 to May 2016.Patients were classified into the modified primary closure group(32 patients) and the biological mesh closure group(44 patients).The total operating time,reconstruction time,postoperative stay duration,total cost,postoperative complications and tumor recur-rence were compared.RESULTS All surgery was successfully performed.The pelvic reconstruction time was 14.6 ± 3.7 min for the modified primary closure group,which was significantly longer than that of the biological mesh closure group(7.2 ± 1.9 min,P < 0.001).The total operating time was not different between the two groups(236 ± 20 min vs 248 ± 43 min,P = 0.143).The postoperative hospital stay duration was 8.1 ± 1.9 d,and the total cost was 9297 ± 1260 USD for the modified primary closure group.Notably,both of these categories were significantly lower in this group than those of the biological mesh closure group(P = 0.001 and P = 0.003,respectively).There were no differences observed between groups when comparing other perioperative data,long-term complications or oncological outcomes.CONCLUSION The modified primary closure method for reconstruction of the pelvic floor in LELAPE for low rectal cancer is technically feasible,safe and cost-effective.

Long-term outcomes after radical gastrectomy in gastric cancer patients with overt bleeding

AIM: To investigate the difference in long-term outcomes between gastric cancer patients with and without a primary symptom of overt bleeding(OB).METHODS: Consecutive patients between January 1, 2007 and March 1, 2012 were identified retrospectively by reviewing a gastric cancer database at Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine. A follow-up examination was performed on patients who underwent a radical gastrectomy. OB due to gastric cancer included hematemesis, melena or hematochezia, and gastric cancer was confirmed as the source of bleeding by endoscopy. Patients without OB were defined as cases with occult bleeding and those with other initial presentations, including epigastric pain, weakness, weight loss and obstruction. The 3-year overall survival(OS) rate, age, gender, AJCC T stage, AJCC N stage, overall AJCC stage, tumor size, histological type, macroscopic(Borrmann) type, lymphovascular invasion and R status were compared between patients with and without OB. Moreover, we carried out a subgroup analysis based on tumor location(upper, middle and lower).RESULTS: We identified 939 patients. Of these, 695(74.0%) were hospitalized for potential radical gastrectomy and another 244 received palliative resection, rerouting of the gastrointestinal tract, chemotherapy, radiotherapy or no treatment due to the presence of unresectable tumors. Notably, there was no significant difference in the percentage of OB patients between resectable cases and unresectable cases(20.3 % vs 22.1 %, P = 0.541). Fo l l o w- u p examination was performed on 653 patients(94%) who underwent radical gastrectomy. We found no significant difference in 3-year OS rate(68.2% vs 61.2%, P = 0.143) or clinicopathological characteristics(P > 0.05) between these patients with and without OB. Subgroup analysis based on tumor location showed that the 3-year OS rate of upper gastric cancer was significantly higher in patients with OB(84.6%) than in those without OB(48.1%, P < 0.01) and that AJCC stagesⅠ-Ⅱ(56.4% vs 35.1%, P = 0.017) and T1-T2 category tumors(30.8% vs 13%, P = 0.010) were more frequent in patients with OB than in those without OB. There was no significant difference in 3-year OS rate or clinicopathological characteristics between patients with and without OB(P > 0.05) for middle or lower gastric cancer.CONCLUSION: Upper gastric cancer patients with OB exhibited tumors at less advanced pathological stages and had a better prognosis than upper gastric cancer patients without OB.

Retrieval-balloon-assisted enterography in post-pancreaticoduodenectomy endoscopic retrograde cholangiopancreatography

This case reports an application of conventional duodenoscope in a post pancreaticoduodenectomy patient with the help of retrieval balloon assisted enterography.The 56-year-old woman had pancreaticoduodenectomy with Child reconstruction 9 mo ago because of pancreatic adenocarcinoma and now there are recurrent enlarged lymph nodes in the anastomotic stoma of hepaticojejunostomy.Considering the patient's late-stage cancer,a plastic stent was then successfully placed there to drainage.The main challenge in this case was the extremely long afferent loop and blind cannulation through the anastomotic stoma of hepaticojejunostomy.Retrieval balloon assisted enterography is very helpful for duodenoscope going through the reconstructed intestinal tract and for the cannulation.After two weeks,the patient remained free of painful symptoms and free of fever.Liver function improved well.Four months after the placement of stent,the patient died of cachexia without jaundice,fever and abdominal pain according to her daughter's statement.

Influencing factors,prediction and prevention of depression in college students:A literature review

The high prevalence of depression among college students has a strong negative impact on individual physical and mental health,academic development,and interpersonal communication.This paper reviewed the extant literature by identifying nonpathological factors related to college students'depression,investigating the methods of predicting depression,and exploring nonpharmaceutical interventions for college students'depression.The influencing factors of college students'depression mainly fell into four categories:biological factors,personality and psychological state,college experience,and lifestyle.The outbreak of coronavirus disease 2019 has exacerbated the severity of depression among college students worldwide and poses grave challenges to the prevention and treatment of depression,given that the coronavirus has spread quickly with high infection rates,and the pandemic has changed the daily routines of college life.To predict and measure mental health,more advanced methods,such as machine algorithms and artificial intelligence,have emerged in recent years apart from the traditional commonly used psychological scales.Regarding nonpharmaceutical prevention measures,both general measures and professional measures for the prevention and treatment of college students'depression were examined in this study.Students who experience depressive disorders need family support and personalized interventions at college,which should also be supplemented by professional interventions such as cognitive behavioral therapy and online therapy.Through this literature review,we insist that the technology of identification,prediction,and prevention of depression among college students based on big data platforms will be extensively used in the future.Higher education institutions should understand the potential risk factors related to college students'depression and make more accurate screening and prevention available with the help of advanced technologies.

Application of single balloon enteroscopy-assisted therapeutic endoscopic retrograde cholangiopancreatography in patients after bilioenteric Roux-en-Y anastomosis: Experience of multi-disciplinary collaboration

BACKGROUND Bilioenteric Roux-en-Y anastomosis is one of the most complicated approaches for reconstructing the gastrointestinal tract, and endoscopic retrograde cholangiopancreatography (ERCP) is technically challenging in patients after bilioenteric Roux-en-Y anastomosis. The optimal endoscopic strategies for such cases remain unknown. AIM To explore the feasibility and effectiveness of single balloon enteroscopy-assisted (SBE-assisted) therapeutic ERCP in patients after bilioenteric Roux-en-Y anastomosis based on multi-disciplinary collaboration between endoscopists and surgeons as well as report the experience from China. METHODS This is a single center retrospective study. All of the SBE-assisted therapeutic ERCP procedures were performed by the collaboration between endoscopists and surgeons. The operation time, success rate, and complication rate were calculated. RESULTS Forty-six patients received a total of 64 SBE-assisted therapeutic ERCP procedures, with successful scope intubation in 60 (93.8%) cases and successful diagnosis in 59 (92.2%). All successfully diagnosed cases received successful therapy. None of the cases had perforation or bleeding during or after operation, and no post-ERCP pancreatitis occurred. CONCLUSION Based on multi-disciplinary collaboration, SBE-assisted therapeutic ERCP in patients after bilioenteric Roux-en-Y anastomosis is relatively safe and effective and has a high success rate.

Affinity peptide developed by phage display selection for targeting gastric cancer

AIM:To develop an affinity peptide that binds to gastric cancer used for the detection of early gastric cancer.METHODS:A peptide screen was performed by biopanning the PhD-12 phage display library,clearing non-specific binders against tumor-adjacent normal appearing gastric mucosa and obtaining selective binding against freshly harvested gastric cancer tissues.Tumortargeted binding of selected peptides was confirmed by bound phage counts,enzyme-linked immunosorbent assay,competitive inhibition,fluorescence microscopy and semi-quantitative analysis on immunohistochemistry using different types of cancer tissues.RESULTS:Approximately 92.8% of the non-specific phage clones were subtracted from the original phage library after two rounds of biopanning against normal-appearing gastric mucosa.After the third round of positive screening,the peptide sequence AADNAKTKSFPV(AAD) appeared in 25%(12/48) of the analyzed phages.For the control peptide,these values were 6.8 ± 2.3,5.1 ± 1.7,3.5 ± 2.1,4.6 ± 1.9 and 1.1 ± 0.5,respectively.The values for AAD peptide were statistically signif icant(P < 0.01) for gastric cancer as compared with other histological classif ications and control peptide.CONCLUSION:A novel peptide is discovered to have a specific binding activity to gastric cancer,and can be used to distinguish neoplastic from normal gastric mucosa,demonstrating the potential for early cancer detection on endoscopy.

Comparison of ultrasound biomicroscopy and spectraldomain anterior segment optical coherence tomography in evaluation of anterior segment after laser peripheral iridotomy

AIM：To quantitatively assess narrow anterior chamber angle using spectral-domain anterior segment optical coherence tomography（SD-AS-OCT） and ultrasound biomicroscopy（UBM）,and to evaluate the correlations and consistency between SD-AS-OCT and UBM.· METHODS：Fifty-five eyes from 40 patients were examined.Patients were diagnosed with primary angleclosure glaucoma（PACG） remission（11 eyes from 8patients）,primary angle closure（PAC,20 eyes from 20patients） and PAC suspect（24 eyes from 12 patients）.Each eye was examined by SD-AS-OCT and UBM after laser peripheral iridotomy（LPI）.The measurements of SD-AS-OCT were angle open distance（AOD）,anterior chamber angle（ACA）,trabecular iris angle（TIA）,and trabecular iris space area（TISA）.UBM measurements were AOD and TIA.Correlations of AOD500 and TIA500 between UBM and AS-OCT were assessed.All parameters were analysed by SPSS 16.0 and MedCalc.· RESULTS：ACA,TIA and AOD measured by SD-ASOCT reached a maximum at the temporal quadrant and minimum at the nasal quadrant.Group parameters of AOD500 and AOD750 showed a linear positive correlation,and AOD750 had less variability.UBM outcomes of AOD500 and TIA500 were significantly smaller than those of SD-AS-OCT.The results of the two techniques were correlated at the superior,nasal and inferior quadrants.CONCLUSION：Both UBM and SD-AS-OCT are efficient tools for follow-up during the course of PACG.We recommended using parameters at 750 μm anterior to the sclera spur for the screening and follow-up of PACG and PAC.The two methods might be alternatives to each other.

Entering the duodenal diverticulum:A method for cannulation of the intradiverticular papilla

Successful cannulation of the common bile duct may be difficult in patients in whom the papilla is located entirely within a diverticulum.In this study,we report successful biliary cannulation in three patients following intubation of the distal tip of the duodenoscope into the duodenal diverticulum and locating the major papilla.No complications occurred during the operation or during the postoperative period.This method didn't need second incubation an endoscope and might lower the burden of patients.So this skill is useful to deal with the papilla hidden inside the large diverticulum because of its safety and convenience.

Thermoelastic stress analysis of multilayered films in a micro-thermoelectric cooling device

This paper presents an analytical solution for the thermoelastic stress in a typical in-plane＇s thin-film micro- thermoelectric cooling device under different operating con- ditions. The distributions of the permissible temperature fields in multilayered thin-films are analytically obtained, and the characteristics, including maximum temperature dif- ference and maximum refrigerating output of the thermo- electric device, are discussed for two operating conditions. Analytical expressions of the thermoelastic stresses in the layered thermoelectric thin-films induced by the tempera- ture difference are formulated based on the theory of mul- tilayer system. The results demonstrate that, the geometric dimension is a significant factor which remarkably affects the thermoelastic stresses. The stress distributions in layers of semiconductor thermoelements, insulating and support- ing membrane show distinctly different features. The present work may profitably guide the optimization design of high- efficiency micro-thermoelectric cooling devices.

Application of the interventional limb raising management strategy(ILRMS) at radial vascular access sites in coronary angiography and percutaneous coronary intervention:A randomized trial

Purpose:To compare the effectiveness of the interventional limb raising management strategy(ILRMS)to elastic bandage compression at radial vascular access sites following coronary angiographies(CAGs)and percutaneous coronary interventions(PCIs).Methods:Patients with ischemic coronary heart disease whose condition was stable over three months were enrolled in this clinical study(n=590;aged 25e80).All participants had just undergone CAG and PCI.Patients were randomized into either the ILRMS group(n=360)or standard post-intervention care with an elastic bandage(n=230).Overall comfort and wrist pain was assessed and the degree of index finger swelling and oxygen saturation was measured on the affected arm.All variables were measured prior to postintervention treatment and again at six hours after CAG and PCI.Results:We found that patients receiving ILRMS had significantly lower wrist pain scores and swelling around the index finger compared to the elastic bandage group(p<0.05).Oxygen saturation of the index finger was not statistically significant(p>0.05).We also found that 19.57%of the elastic bandage patients were comfortable,while ILRMS patients were significantly more comfortable(93.06%;p<0.05).Conclusions:We find that ILRMS alleviates swelling and pain of the wrist more effectively than current practices and improves the degree of overall comfort of patients who undergo CAG and PCI.

金属氧化物半导体气敏传感器的温度补偿技术（英文）

为了解决金属氧化物半导体气敏传感器易受外界环境温度影响而产生输出漂移的问题,提出了一种基于温度负反馈的补偿方法。通过构造适当的热敏电阻,设计了可调式开关稳压电路,为传感器提供加热电压,保证敏感材料较稳定的工作条件。通过TGS2610气敏传感器的对比实验,探测误差可由原来的-40%,+70%降低到±10。

Correlation of Primary Hepatocellular Carcinoma with HBV Genotypes, Subgenotypes and Gene Mutations in Gansu Province

Objective To investigate the occurrence of basal core promoter(BCP) and pre-C mutations in patients with hepatitis B virus(HBV) infection in Gansu Province, China, and to analyze the correlation of HBV mutation and HBV genotype with primary hepatocellular carcinoma(HCC). Methods PCR-RFLP was applied to detect HBV subgenotypes, and the presence of the pre-C and BCP mutations in 62 patients with HCC, 70 patients with hepatitis B induced liver cirrhosis(LC) and 90 patients with chronic hepatitis B(CHB). Results In HCC patients, genotype C was the major genotype(70.97%). The pre-C mutation was found in 59.68%, 31.43% and 16.67% patients with HCC, LC and CHB, respectively. The frequency of BCP mutations was significantly different between patients with HCC, LC and CHB(74.19%, 51.43% and 37.78%, respectively; χ2=30.727, 19.540, respectively, P < 0.01). Patients in HCC group had a higher incidence of pre-C as well as BCP mutations compared to the other groups. The prevalence of pre-C and BCP mutations was significantly higher in patients with genotype C1(44.32% and 69.32%, respectively) compared to patients with other subgenotypes(P < 0.05). Conclusions The incidence of pre-C and BCP mutations increases with disease progression. Pre-C and BCP mutations frequently occur in patients with genotype C1. HBV genotype C, pre-C mutations and BCP mutations are closely related to the occurrence of HCC.

电针改善糖尿病肾病模型小鼠肾微血管损伤

Objective:Renal microvascular injury,as the result of diabetic toxicity,plays a vital role in the pathogenesis of diabetic kidney disease(DKD)during diabetes progression.Here,we investigated whether electroacupuncture(EA)could ameliorate renal microvascular impairment to prevent DKD and its underlying mechanism.Methods:The male db/db mice with Leprdb mutation were used as the model of type 2 diabetes mellitusinduced DKD and treated with EA at"Zusanli(ST36)"and"Weiwanxiashu(EX-B3)"acupoints for 4 weeks.Age-matched wild-type mice were used as control group.Renal protection of EA was evaluated by mouse urine production,water consumption,renal index and tubules dilation.Two-photon microscope imaging was applied to visualize renal microvascular blood flow in vivo.Immunostaining and western blot analysis were used to detect the glomerular alternations and inflammatory signaling.Results:EA significantly attenuated renal dysfunction in db/db mice.The protective effect of EA on renal microvascular recovery was observed both in function and structure analysis.Firstly,EA restored the renal microvascular blood flow in db/db mice.Then,glomerular hypertrophy and glomerular barrier destruction were suppressed after EA,as respectively demonstrated by the reduction of glomerular dilation,Collagen IV and Claudin-1 deposits.In mechanism,EA suppressed the diabetes-induced inflammatory response in renal microvessels,presenting as the downregulation of inflammatory cytokines interleukin-1β(IL-1β)and tumor necrosis factor(TNF-α),intercellular cell adhesion molecule-1(ICAM-1)activation,and macrophage infiltration after EA treatment.Conclusion:These findings indicated the benefits of EA against renal microvascular impairment and DKD progression,which was associated with the action of anti-inflammation,and supported EA as a promising modality for DKDmanagement.