中国北方汉族人群白细胞抗原DRB1及DQA1区基因多态性与乙型肝炎病毒感染结局的关系

目的探讨中国北方汉族人群白细胞抗原(HLA)DRB1及DQA1区等位基因多态性与乙型肝炎病毒(HBV)感染不同结局的关系,分析基因—环境交互在慢性乙肝发生中的作用。方法采用病例—对照研究(慢性乙肝患者207人,HBV携带者212人,自限性HBV感染者148人)方法,比较3组人群检测的HLA等位基因频率并应用交互相乘模型分析基因—环境交互作用。结果慢性乙肝组HLA-DQA1*0301等位基因频率(14·81%)显著低于HBV携带组(25·24%)和自限性HBV感染组(25·00%)(Pc=0·002;Pc=0·007);自限性HBV感染组HLA-DQA1*0102等位基因频率(8·78%)显著高于HBV携带组(1·89%)和慢性乙肝组(2·18%)(Pc=0·000;Pc=0·000);自限性HBV感染组HLA-DQA1*0302等位基因频率(4·05%)显著低于慢性乙肝组(11·41%)(Pc=0·005)。经多元logistic回归分析调整年龄、性别、吸烟和饮酒的混杂效应后,HLA-DQA1*0302仍是发展为慢性乙肝的危险因素(OR=3·913,P=0·0006),HLA-DQA1*0102和HLA-DQA1*0301是HBV感染后的保护因素(OR=0·200,P=0·0004;OR=0·258,P=0·0000)。饮酒与HLA-DQA1*0102[交互指数(Ⅱ)=1·49]、HLA-DQA1*0302(Ⅱ=12·12)在慢性乙肝的发生中可能存在正交互作用,与DQA1*0301存在负交互作用(Ⅱ=0·78)。结论携带HLA-DQA1*0302等位基因者感染HBV后可能增加慢性乙肝发生的风险,而携带HLA-DQA1*0301和HLA-DQA1*0102者可能降低慢性乙肝发生的风险;基因—环境交互作用可能影响HBV感染的结局。

Synaptic remodeling in mouse motor cortex after spinal cord injury

Spinal cord injury dramatically blocks information exchange between the central nervous system and the peripheral nervous system.The resulting fate of synapses in the motor cortex has not been well studied.To explore synaptic reorganization in the motor cortex after spinal cord injury,we established mouse models of T12 spinal cord hemi-section and then monitored the postsynaptic dendritic spines and presynaptic axonal boutons of pyramidal neurons in the hindlimb area of the motor cortex in vivo.Our results showed that spinal cord hemisection led to the remodeling of dendritic spines bilaterally in the motor cortex and the main remodeling regions changed over time.It made previously stable spines unstable and eliminated spines more unlikely to be re-emerged.There was a significant increase in new spines in the contralateral motor cortex.However,the low survival rate of the new spines demonstrated that new spines were still fragile.Observation of presynaptic axonal boutons found no significant change.These results suggest the existence of synapse remodeling in motor cortex after spinal cord hemi-section and that spinal cord hemi-section affected postsynaptic dendritic spines rather than presynaptic axonal boutons.This study was approved by the Ethics Committee of Chinese PLA General Hospital,China(approval No.201504168S)on April 16,2015.

A brief review on anterior urethral strictures

The treatment of urethral strictures remains a challenging field in urology even though there are a variety of procedures to treat it at present,as no one approach is superior over another.This paper reviewed the surgical options for the management of different sites and types of anterior urethral stricture,providing a brief discussion of the controversies regarding this issue and suggesting possible future advancements.Among the existing procedures,simple dilation and direct vision internal urethrotomy are more commonly used for short urethral strictures(<1 cm,soft and no previous intervention).Currently,urethroplasty using buccal mucosa or penile skin is the most widely adopted clinical techniques and have proved successful.Nonetheless,complications such as donor site morbidity remain problem.Tissue engineering techniques are considered as a promising solution for urethral reconstruction,but require further investigation,as does stem cell therapy.

Effects of Dahuang( Rhubarb) Retention Enema on Leukocyte Interleukin-6,High Sentive C Reactive Protein and Endotoxin in Patients with Acute Pancreatitis

[Objectives] To observe the clinical effect of Dahuang( Rhubarb) retention enema on patients with severe acute pancreatitis and its influences on leukocyte interleukin 6( IL-6),high sentive C reactive protein( hs-CRP) and endotoxin. [Methods]86 cases of acute pancreatitis were randomly divided into the control group( 43 cases) and the treatment group( 43 cases). The control group was given saline enema and routine treatment of western medicine,while the treatment group was treated with Dahuang( Rhubarb) decoction retention enema and routine treatment,2 times/d. After 7 days of treatment,two groups of clinical curative effects were compared. And changes of IL-6,hs-CRP,endotoxin and amylase levels before and after treatment in two groups were compared. [Results] Abdominal pain,abdominal distension,exhaust defecation,bowel sounds in treatment group patients were obviously improved. After treatment,the decline levels of serum IL-6,hsCRP,endotoxin and amylase in the treatment group were significantly better than those in the control group. [Conclusions] Dahuang( Rhubarb) retention enema can significantly improve the clinical curative effect of severe acute pancreatitis,and its mechanism may be related to the inhibition of inflammatory reaction.

Deep learning model improves radiologists'performance in detection and classification of breast lesions

Objective:Computer-aided diagnosis using deep learning algorithms has been initially applied in the field of mammography,but there is no large-scale clinical application.Methods:This study proposed to develop and verify an artificial intelligence model based on mammography.Firstly,mammograms retrospectively collected from six centers were randomized to a training dataset and a validation dataset for establishing the model.Secondly,the model was tested by comparing 12 radiologists’performance with and without it.Finally,prospectively enrolled women with mammograms from six centers were diagnosed by radiologists with the model.The detection and diagnostic capabilities were evaluated using the freeresponse receiver operating characteristic(FROC)curve and ROC curve.Results:The sensitivity of model for detecting lesions after matching was 0.908 for false positive rate of 0.25 in unilateral images.The area under ROC curve(AUC)to distinguish the benign lesions from malignant lesions was0.855[95%confidence interval(95%CI):0.830,0.880].The performance of 12 radiologists with the model was higher than that of radiologists alone(AUC:0.852 vs.0.805,P=0.005).The mean reading time of with the model was shorter than that of reading alone(80.18 s vs.62.28 s,P=0.032).In prospective application,the sensitivity of detection reached 0.887 at false positive rate of 0.25;the AUC of radiologists with the model was 0.983(95%CI:0.978,0.988),with sensitivity,specificity,positive predictive value(PPV),and negative predictive value(NPV)of94.36%,98.07%,87.76%,and 99.09%,respectively.Conclusions:The artificial intelligence model exhibits high accuracy for detecting and diagnosing breast lesions,improves diagnostic accuracy and saves time.

Effect of Bifidobacterium triple live bacteria on inflammatory factors, oxidative stress and T lymphocyte subsets in patients with ulcerative colitis

Objective: To explore the effect of Bifidobacterium triple live bacteria on inflammatory factors, oxidative stress and T lymphocyte subsets in patients with ulcerative colitis (UC). Method: A total of 90 patients with UC treated in our hospital were selected and randomly divided into the observation group and the control group each with 45 cases. The control group was given Mesalazin Enteric-coated Tablets 1 g/times, 4 times/d, continuous treatment for 1 months:when the clinical symptoms were stable, switched to 500 mg/times, 3 times/d, continuous treatment for 3 months. The observation group on the basis of conventional treatment to give Bifidobacterium triple live bacteria scattered adjuvant therapy (Bifico capsule), 0.84 g/time, 2 times/d, continuous treatment for 3 months. In the two groups, the levels of inflammatory factors (IL-6, IL-10, CRP, TNF-α), oxidative stress markers (MDA, SOD) and T lymphocyte subsets (CD3+, CD4+, CD8+, CD4+/CD8+) were compared pre and post treatment. Results: The levels of IL-6, CRP, MDA, TNF-α, CD8+ in both two groups were significantly decreased compared with treatment before;the levels of IL-10, SOD, CD3+, CD4+ and CD4+/CD8+were significantly increased compared with treatment before. After treatment, the levels of serum IL-6, CRP, TNF-α, MDA and CD8+ in observation group with the data (72.17±15.18) pg/mL, (21.52±10.21) mg/mL, (15.98±4.12) pg/mL respectively were decreased more significantly than those data in control group which were (86.55±17.26) pg/mL, (43.02±12.27) mg/L, (22.35±3.67) pg/mL, MDA level (5.89±0.56) nmol/mL in observation group was decreased more significantly than the level in the control group (6.75±0.68) nmol/mL;CD8+level (17.24±3.06)% in observation group was decreased more significantly than the level (19.01±2.62)% in the control group. After treatment, IL-10 level (70.21±6.03) pg/mL in observation group was increased more significantly than the level in the control group (56.48+ 8.67) pg/mL;SOD level (1.84±0.06) U/mL in observation group was increased more significantly than the level in the control group (1.32±0.05) U/mL;the levels of CD3+, CD4+, CD4+/CD8+ in the observation group (57.84±6.07)%;(36.78±4.32)%;(1.92±0.29) were increased more significantly than the level in the control group (54.93±6.87)%;(35.42±5.27)%;(1.89±0.12). Conclusion: Bifidobacterium triple live bacteria scattered adjuvant treatment of ulcerative colitis helps regulate oxidative stress and inflammatory cytokines inhibiting inflammatory reaction and improving enhance function, and can effectively improve the clinical symptoms of patients with UC.

Effects of Dengzhan Shengmai Capsule combined with antiplatelet drug and statin therapy on platelet function, inflammatory response and lipid metabolism in patients with unstable angina pectoris

Objective: To study the effects of Dengzhan Shengmai Capsule combined with antiplatelet drug and statin therapy on platelet function, inflammatory response and lipid metabolism in patients with unstable angina pectoris. Methods: A total of 96 patients who were diagnosed with unstable angina pectoris for the first time in Beijing Shunyi District Hospital of Traditional Chinese Medicine between February 2015 and January 2018 were chosen and randomly divided into two groups, the observation group received Dengzhan Shengmai Capsule combined with antiplatelet drug and statin therapy, and the control group only accepted antiplatelet drug and statin therapy. Platelet function parameters, inflammatory response parameters and lipid metabolism parameters were determined before treatment and after 2 months of treatment. Results: Compared with those of same group before treatment, PAF, P-selectin, PDGF, E-selectin, Gal-3, TNF-α, IFN-γ, LDL-C, PCSK9, Chemerin and Visfatin contents in serum as well as C3aR and C5aR contents in peripheral blood platelets of both groups of patients were decreasing whereas sFGL2, TGF-β1, APN and Vaspin contents in serum were increasing after treatment, and PAF, P-selectin, PDGF, E-selectin, Gal-3, TNF-α, IFN-γ, LDL-C, PCSK9, Chemerin and Visfatin contents in serum as well as C3aR and C5aR contents in peripheral blood platelets of observation group after treatment were lower than those of control group whereas sFGL2, TGF-β1, APN and Vaspin contents in serum were higher than those of control group. Conclusion: Dengzhan Shengmai Capsule combined with antiplatelet drug and statin therapy for unstable angina pectoris can more effectively inhibit the platelet aggregation and improve the inflammatory response and lipid metabolism.

Effects of complex salvia miltiorrhiza on blood coagulation, inflammation, oxidative stress and endothelial index in patients with acute pancreatitis

Objective: To investigate the effects of complex salvia miltiorrhiza on blood coagulation, inflammation, oxidative stress and endothelial index in patients with acute pancreatitis. Methods: A total of 122 patients with acute pancreatitis admitted to digestive system department in our hospital from April 2016 to November 2017 were randomly divided into control group (n=61) and observation group (n=61), the control group was treated with ulinastatin and the observation group was treated with complex salvia miltiorrhiza injection on the basis of the control group. The levels of coagulation, inflammation, oxidative stress and endothelial markers were compared between the two groups. Results: After treatment, the levels of APTT and PT in the two groups were significantly higher than those before treatment, while the levels of DD were significantly lower than those before treatment, and the levels of APTT and PT [(38.19±7.05) s,(17.60±3.68) s] in the observation group were significantly higher than those in the control group, while the levels of DD [(0.51±0.10) mg/L] in the observation group were significantly lower than those in the control group;the levels of CRP, PCT and TNF-α in the two groups were significantly lower than those before treatment, and the levels of CRP, PCT and TNF-α [(29.10±4.76) mg/L, (0.59±0.17) μg/L, (57.28±10.61) ng/L] in the observation group were significantly lower than those in the control group;the levels of SOD in the two groups were significantly higher than those before treatment, but MDA was significantly lower than that before treatment, and the level of SOD [(179.10±4.76) U/mL] in the observation group was significantly higher than that in the control group after treatment, while the level of MDA [(1.97±0.55) mmol/mL] in the observation group was significantly lower than that in the control group after treatment;the levels of NO in the two groups were significantly higher than those before treatment, while the levels of ET and vWF were significantly lower than those before treatment, and the levels of NO [(10.56±1.17) U/mL] in the observation group were significantly higher than those in the control group after treatment, while the levels of ET and vWF [(105.83±5.20) pg/mL, (102.47±16.91)%] in the observation group were significantly lower than those in the control group after treatment. Conclusions:Complex salvia miltiorrhiza injection can improve the blood coagulation function, alleviate inflammation, enhance antioxidant function and vascular endothelial function in patients with acute pancreatitis, which has clinical value of promotion.

Effects of low molecular heparin combined with ursodeoxycholic acid on liver function, immunologic function and pregnancy outcome in patients with intrahepatic cholestasis of pregnancy

Objective: To investigate the effects of low molecular heparin (LMWH) combined with ursodeoxycholic acid (UDCA) on liver function, immunologic function and pregnancy outcome in patients with intrahepatic cholestasis of pregnancy (ICP). Methods: A total of 110 patients with ICP were randomly divided into the observation group (n=55) and the control group (n=55). Patients in the control group received conventional therapy, while patients in the observation group were treated with LMWH hypodermic injection and UDCA orally on the basis of the treatment plan of the control group. Before and after treatment, the levels of serum total bile acid (TBA), glutamic-pyruvic transaminase (ALT), glutamic-oxalacetic transaminase (AST), total bilirubin (TBIL), direct bilirubin (DBIL), alkaline phosphatase (ALP) and immunoglobulin (IgG, IgA, IgM) between the two groups were compared. The changes of T lymphocyte subsets of peripheral blood in the two groups were analyzed, and the pregnancy outcomes of the two groups were observed. Results: After treatment, the serum levels of TBA, ALT, AST, TBIL, DBIL and ALP in the two groups were significantly lower than those before treatment, and the change of each index in the observation group was more obvious than that in the control group. The serum levels of IgG, IgA and IgM in the observation group after treatment were significantly higher than those before treatment and those in the control group after treatment. However, the percentage of CD4+T cells and the ratio of CD4+/CD8+ in the observation group after treatment were significantly lower than those before treatment and those in the control group after treatment. Conclusions: LMWH combined with UDCA could effectively reduce serum bile acid level, improve liver function and regulate immune balance in patients with ICP, and improve outcomes of maternal and fetal.

Characterization of patients and its relationship with medical complaints

Background Patient characteristics may be an internal factor influencing patient complaints, but in China patient characterization is restricted to patient satisfaction surveys, and few studies have considered the relationship between patient characteristics and patient complaints. The aim of this research was to determine the reasons for complaints. Methods In this study, we analyzed the characteristics of hospitalized patients and explored their relationship with medical complaints. Results The significant factors were age （P=0.045）, hospital cost （P=0.003）, household nature （P 〈0,001）, and education （P 〈0.001）. The complaint rate decreased when the patients＇ age increased （regression coefficient, -0.606; OR, 0.545, and 95%C/, 0.301-0.987）. The complaint rate increased with an increase in hospital cost （regression coefficient, 0.818; OR, 2.266; and 95%C/, 1.320-3.889）. Patients from non-agricultural households had a higher complaint rate （regression coefficient, 1.051; OR, 2.861; and 95%C/, 1.611-5.082）. Patients with higher education levels had lower complaint rates （regression coefficient, -0.944; OR, 0.389; and 95%C/, 0.234-0.647）. Conclusion The survey confirms that older patients and patients with higher education levels had lower complaint rates, while non-agricultural population and patients with higher hospital expenses had higher complaint rates.