Nosocomial infections or healthcare associated infections occur in patients under medical care.These infections occur worldwide both in developed and developing countries.Nosocomial infections accounts for 7% in devel...Nosocomial infections or healthcare associated infections occur in patients under medical care.These infections occur worldwide both in developed and developing countries.Nosocomial infections accounts for 7% in developed and 10% in developing countries.As these infections occur during hospital stay,they cause prolonged stay,disability,and economic burden.Frequently prevalent infections include central line-associated bloodstream infections,catheter-associated urinary tract infections,surgical site infections and ventilator-associated pneumonia.Nosocomial pathogens include bacteria,viruses and fungal parasites.According to WHO estimates,approximately 15% of all hospitalized patients suffer from these infections.During hospitalization,patient is exposed to pathogens through different sources environment,healthcare staff,and other infected patients.Transmission of these infections should be restricted for prevention.Hospital waste serves as potential source of pathogens and about 20%–25% of hospital waste is termed as hazardous.Nosocomial infections can be controlled by practicing infection control programs,keep check on antimicrobial use and its resistance,adopting antibiotic control policy.Efficient surveillance system can play its part at national and international level.Efforts are required by all stakeholders to prevent and control nosocomial infections.展开更多
Beta-adrenergic receptor antagonists(β-blockers) have been well established for use in portal hypertension for more than three decades. Different Non-selective β-blockers like propranolol, nadolol, timolol, atenolol...Beta-adrenergic receptor antagonists(β-blockers) have been well established for use in portal hypertension for more than three decades. Different Non-selective β-blockers like propranolol, nadolol, timolol, atenolol, metoprolol and carvedilol have been in clinical practice in patients with cirrhosis. Carvedilol has proven 2-4 times more potent than propranolol as a beta-receptor blocker in trials conducted testing its efficacy for heart failure. Whether the same effect extends to its potency in the reduction of portal venous pressures is a topic of on-going debate. The aim of this review is to compare the hemodynamic and clinical effects of carvedilol with propranolol, and attempt assess whether carvedilol can be used instead of propranolol in patients with cirrhosis. Carvedilol is a promising agent among the beta blockers of recent time that has shown significant effects in portal hypertension hemodynamics. It has also demonstrated an effective profile in its clinical application specifically for the prevention of variceal bleeding. Carvedilol has more potent desired physiological effects when compared to Propranolol. However, it is uncertain at the present juncture whether the improvement in hemodynamics also translates into a decreased rate of disease progression and complications when compared to propranolol. Currently Carvedilol shows promise as a therapy for portal hypertension but more clinical trials need to be carried out before we can consider it as a superior option and a replacement for propranolol.展开更多
The Laojiezi alkaline volcanic rocks, which are located in the intraplate region of the Yangtze craton, coincide with the formation of the Jinshajiang-Ailaoshan-Red River alkaline rock belt. Although this belt has bee...The Laojiezi alkaline volcanic rocks, which are located in the intraplate region of the Yangtze craton, coincide with the formation of the Jinshajiang-Ailaoshan-Red River alkaline rock belt. Although this belt has been widely studied by geologists because of its porphyry-related Pb-Ag-Au polymetallic deposit and geotectonic location, the material sources of this belt are still debate. Whole-rock analyses show that these rocks have high total alkali contents(3.73–11.08 wt%), and their aluminum saturation index(ASI) values widely vary from 0.82 to 3.07, which comprise a metaluminous-peraluminous magma series. These rocks are characterized by high K(K2 O/Na2 O>1) and low Ti and Mg contents; enrichment in large-ion lithophile elements, such as Rb, Ba, K and light rare earth elements; and depletion in high field strength elements, such as Ta, Nb, P, and Ti. These rocks exhibit moderate Eu(Eu/Eu*=0.86–1.04) and Ce(Ce/Ce*=0.63–0.96) anomalies. Their(87 Sr/86 Sr)i, εNd(t), zircon εHf(t) and δ18 O values range from 0.70839 to 0.71013, from-10.16 to-12.45, from-19.6 to-5.8, and from 5.69‰ to 8.54‰, respectively, and their Nd and Hf two-stage model ages(TDM2) are 1.67–1.86 Ga and 1.27–2.02 Ga, respectively. These data reflect the primary partial melting of Paleoproterozoic to Mesoproterozoic lower crust with minor residual continental lithospheric mantle and supracrustal metasediments. The lithosphere was likely thickened along the southeastern margin of the Tibetan Plateau following the Indian-Asian continentcontinent collision(65–41 Ma). During the post-collision phase(36–16 Ma), the transition from a compressional to extensional setting triggered the convective removal of the over-thickened CLM beneath the Yangtze craton, which led to the upwelling of asthenospheric materials. This process created alkali-rich and high-K magma through the partial melting of the thickened lower crust. Magma that carried Cu-Au-Pb-Ag minerals was emplaced by strike-slip motion along the E-to W-or ENE-to WSWtrending tecto展开更多
To assess the genetic diversity between randomly and selectively bred populations,we sequenced 438 bp of the mitochondrial DNA control region from 102 pigs.These samples represented four native pig breeds,one nucleus ...To assess the genetic diversity between randomly and selectively bred populations,we sequenced 438 bp of the mitochondrial DNA control region from 102 pigs.These samples represented four native pig breeds,one nucleus and one conservation herd from Yunnan,China.Twenty haplotypes with sixteen polymorphic sites were identified.The number of haplotypes in the nucleus herd of Saba pig and the conservation herd of Banna miniature pig were restricted to three and one,respectively,while the randomly bred pig populations exhibited over six haplotypes.Notably,haplotype diversity in randomly bred populations was significantly greater than the selectively bred populations（h=0.732 vs.0.425 and 0,exact test,P≤0.0036）.These findings demonstrate that selective breeding generated low genetic diversity compared to randomly bred pig breeds.A timely intervention and well programmed breeding approach would stop further genetic diversity reduction in the nucleus and conservation herds of native pig breeds.Otherwise,selective breeding would dramatically reduce genetic diversity in only several years,indicating that sharp contradictions exist between breeding,conservation and genetic diversity.Genetic relationships are discussed based on net genetic distances among pig populations.展开更多
AIM: To systematically analyze the randomized trials comparing the oncological and clinical effectiveness of laparoscopic total mesorectal excision(LTME) vs open total mesorectal excision(OTME) in the management of re...AIM: To systematically analyze the randomized trials comparing the oncological and clinical effectiveness of laparoscopic total mesorectal excision(LTME) vs open total mesorectal excision(OTME) in the management of rectal cancer.METHODS: Published randomized, controlled trials comparing the oncological and clinical effectiveness of LTME vs OTME in the management of rectal cancer were retrieved from the standard electronic medical databases. The data of included randomized, controlled trials was extracted and then analyzed according to the principles of meta-analysis using RevMan? statistical software. The combined outcome of the binary variables was expressed as odds ratio(OR) and the combined outcome of the continuous variables waspresented in the form of standardized mean difference(SMD). RESULTS: Data from eleven randomized, controlled trials on 2143 patients were retrieved from the electronic databases. There was a trend towards the higher risk of surgical site infection(OR = 0.66; 95%CI: 0.44-1.00; z = 1.94; P < 0.05), higher risk of incomplete total mesorectal resection(OR = 0.62; 95%CI: 0.43-0.91; z = 2.49; P < 0.01) and prolonged length of hospital stay(SMD,-1.59; 95%CI:-0.86--0.25; z = 4.22; P < 0.00001) following OTME. However, the oncological outcomes like number of harvested lymph nodes, tumour recurrence and risk of positive resection margins were statistically similar in both groups. In addition, the clinical outcomes such as operative complications, anastomotic leak and all-cause mortality were comparable between both approaches of mesorectal excision.CONCLUSION: LTME appears to have clinically and oncologically measurable advantages over OTME in patients with primary rectal cancer in both short term and long term follow ups.展开更多
Experimental and analytical investigation is conducted to explore the effects of stitching on plain （without hole） and open-hole compressive and tensile strength of uniweave T300/QY9512 laminates under different env...Experimental and analytical investigation is conducted to explore the effects of stitching on plain （without hole） and open-hole compressive and tensile strength of uniweave T300/QY9512 laminates under different environmental conditions （20 ℃/dry and wet, 150 ℃/dry and wet）. Strength performance of stitched composite laminates is also studied using finite element analysis （FEA） model and compared with the experimental results to validate the model. It is found that under similar environmental conditions, the open-hole compressive strength of stitched laminate is decreased and open-hole tensile strength increased as compared to the unstitched laminates. Predicted tensile and compressive strengths are found to be in a good agreement with the test results and the relative error in all cases is less than 15%.展开更多
Traumatic brain injury (TBI), an unmet need: TBI is an alteration in brain function caused by an external force with evidence of brain pathology. It could be from a bump, blow, blast or jolt to the head including pene...Traumatic brain injury (TBI), an unmet need: TBI is an alteration in brain function caused by an external force with evidence of brain pathology. It could be from a bump, blow, blast or jolt to the head including penetrating the cranium. TBI is a public health concern worldwide due to its economic impact. Most TBIs are survivable, do not need hospitalization but may influence productivity. A smaller percentage of TBI due to falls or penetrating TBI (PTBI) needs hospitalization and accounts for largest fraction of TBI care costs.展开更多
BACKGROUND: Timely identifi cation of high blood lactate levels in septic patients may allow faster detection of those patients requiring immediate resuscitation. Point-of-care(POC) testing is being increasingly utili...BACKGROUND: Timely identifi cation of high blood lactate levels in septic patients may allow faster detection of those patients requiring immediate resuscitation. Point-of-care(POC) testing is being increasingly utilized in the emergency department(ED). We examined the accuracy and timesaving effect of a handheld POC lactate device for the measurement of fingertip and whole blood lactate as compared with reference laboratory blood testing in septic ED patients.METHODS: A convenience sample of adult ED patients receiving serum lactate testing were enrolled prospectively in the ED of a multidisciplinary tertiary care hospital serving the population of one of the major cities of Pakistan. Participants underwent fi ngertip POC lactate measurement with a portable device and simultaneous whole blood sampling for analysis by both the POC lactate device and standard laboratory method. Lactate measurements were compared by intraclass correlation(ICC) and Bland and Altman plots.RESULTS: Forty-three septic patients were included in the study. The fingertip POC & whole blood POC lactate measurements each correlated tightly with the reference method(ICC=0.93 & ICC=0.92, respectively). Similarly at 6 hours, the fingertip POC & whole blood POC lactate measurements demonstrated satisfactory correlation with the reference method(ICC=0.95 & ICC=0.97, respectively).CONCLUSION: Fingertip POC lactate measurement is an accurate method to determine lactate levels in septic ED patients.KEY WORDS: Sepsis; Point of care; Lactate; Emergency department;展开更多
Background:Maternal mortality is a prevalent issue in healthcare provision worldwide.It is particularly common in developing and underdeveloped countries,where maternal deaths during childbirth or pregnancy occur freq...Background:Maternal mortality is a prevalent issue in healthcare provision worldwide.It is particularly common in developing and underdeveloped countries,where maternal deaths during childbirth or pregnancy occur frequently.Various internal and external factors contribute to the high maternal mortality rate in specific regions.One model,known as the three delays model approach,examines three distinct causes that contribute to this problem.The first delay is the lack of awareness in seeking timely healthcare,the second delay involves obstacles in reaching healthcare facilities on time,and the third delay relates to poor or inadequate healthcare provision in tertiary care facilities.These delays are responsible for the elevated maternal mortality rates,with the prevalence of each delay varying across regions.Objective:The objective of this literature review is to examine and critically evaluate existing literature on perceptions and investigations regarding maternal mortality in Southeast Asia,Europe and Africa,utilizing the three delays model approach as a categorization framework.Method:This literature review followed BEME guide No.3.A total of 18 articles were included in the sample after conducting a thorough search of various databases and search engines.A Prisma flowchart was created,and the articles were critically appraised.Results:A total of 18 articles focusing on different regions were analyzed.The findings revealed that in countries of Southeast Asia,the primary cause of maternal mortality is the first delay,which refers to the lack of awareness in seeking medical care.On the other hand,in Africa and other European countries,the second and third delays are more prominently associated with maternal mortality.Conclusion:Inadequate care is one of the major causes of maternal mortality in majority of regions acrossthe globe.Multiple factors can hinder access to appropriate healthcare.The three delays model plays a significant role in the higher maternal mortality rate.By raising awareness among women and th展开更多
Background:The monkey pox virus is caused by monkey pox(MPX),which is similar to both smallpox and cowpox.Near tropical rain forests,it usually occurs in isolated communities in Central and West Africa.The monkey pox ...Background:The monkey pox virus is caused by monkey pox(MPX),which is similar to both smallpox and cowpox.Near tropical rain forests,it usually occurs in isolated communities in Central and West Africa.The monkey pox virus,a member of the family Poxviridae and belongs to the genus Orthopoxvirus.Close contact with infected animals,sick people,or contaminated inanimate things can cause the virus to spread to humans.The illness typically takes 7 to 14 days to incubate and is characterized by fever,headache,lethargy,myalgia,generalized body pains,lymph node swelling,and skin lesions.Given the variety of illnesses that can result in skin rashes,it could be challenging to differentiate monkey pox solely based on clinical presentation,particularly for patients with an uncommon look.Objective:The main objective of the study is to evaluate public perceptions regarding the emerging human monkey pox disease and vaccination.Methods:The study was conducted using a cross-sectional study design.The sample size was 472 participants;however,10 questionnaires were excluded because of invalid data.The 462 questionnaires were included by expert validation from the general public of Rawalpindi and Islamabad,Pakistan.The data were analyzed using Chi-squared tests.Results:This questionnaire-based cross-sectional study was conducted from 15 Sep to 15 Oct 2022.The participants’perceptions,knowledge,and attitudes were collected via a 24-item-based questionnaire survey.The survey was based on 462 participants,196(42.4%)were females,and 266(57.6%)were males.The results reveal that out of 462 participants,clinical symptoms of monkey pox disease 82.7%(382),complications of monkey pox disease 81.2%(375),lymphadenopathy(swollen lymph nodes)is one clinical feature that could be used to differentiate between monkey pox and smallpox 81.2%(375)and monkey pox is common in Western and Central Africa 24.2%(112).Furthermore,the majority of participants(P≤0.05)agreed that health officials should start a vaccination campaign to combat monkey pox.Rega展开更多
When better fuel-air mixing in the combustion chamber or a reduction in base drag are required in vehicles,rockets,and aeroplanes,the base pressure control is activated.Controlling the base pressure and drag is necess...When better fuel-air mixing in the combustion chamber or a reduction in base drag are required in vehicles,rockets,and aeroplanes,the base pressure control is activated.Controlling the base pressure and drag is necessary in both scenarios.In this work,semi-circular ribs with varying diameters(2,4,and 6 mm)positioned at six distinct positions(0.5D,1D,1.5D,2D,3D,and 4D)inside a square duct with a side of 15 mm are proposed as an efficient way to apply the passive control technique.In-depth research is done on optimising rib size for various rib sites.According to this study,the base pressure rises as rib height increases.Furthermore,the optimal location for the semi-circular ribs with a diameter of 2 mm is at 0.5D.The 1D location appears to be optimal for the 4 mm size as well.For the 6 mm size,however,the 4D position fills this function.展开更多
Rheumatoid Arthritis(RA)is an autoimmune disorder that hinders the normal functioning of bones and joints and reduces the quality of human life.Every year,millions of people are diagnosed with RA worldwide,particularl...Rheumatoid Arthritis(RA)is an autoimmune disorder that hinders the normal functioning of bones and joints and reduces the quality of human life.Every year,millions of people are diagnosed with RA worldwide,particularly among elderly individuals and women.Therefore,there is a global need to develop new biomaterials,medicines and therapeutic methods for treating RA.This will improve the Healthcare Access and Quality Index and also relieve administrative and financial burdens on healthcare service providers at a global scale.Hydrogels are soft and cross-linked polymeric materials that can store a chunk of fluids,drugs and biomolecules for hydration and therapeutic applications.Hydrogels are biocompatible and exhibit excellent mechanical properties,such as providing elastic cushions to articulating joints by mimicking the natural synovial fluid.Hence,hydrogels create a natural biological environment within the synovial cavity to reduce autoimmune reactions and friction.Hydrogels also lubricate the articulating joint surfaces to prevent degradation of synovial surfaces of bones and cartilage,thus exhibiting high potential for treating RA.This work reviews the progress in injectable and implantable hydrogels,synthesis methods,types of drugs,advantages and challenges.Additionally,it discusses the role of hydrogels in targeted drug delivery,mechanistic behaviour and tribological performance for RA treatment.展开更多
Thiswork investigates an oblique stagnation point flowof hybrid nanofluid over a rigid surface with power lawfluidas lubricated layers. Copper (Cu) and Silver (Ag) solid particles are used as hybrid particles acting i...Thiswork investigates an oblique stagnation point flowof hybrid nanofluid over a rigid surface with power lawfluidas lubricated layers. Copper (Cu) and Silver (Ag) solid particles are used as hybrid particles acting in water H2O asa base fluid. The mathematical formulation of flow configuration is presented in terms of differential systemthat isnonlinear in nature. The thermal aspects of the flow field are also investigated by assuming the surface is a heatedsurface with a constant temperature T. Numerical solutions to the governing mathematical model are calculatedby the RK45 algorithm. The results based on the numerical solution against various flow and thermal controllingparameters are presented in terms of line graphs. The specific results depict that the heat flux increases over thelubricated-indexed parameter.展开更多
This study deals with base pressure management in a duct for various values of the Mach number(M),namely,Mach number corresponding to sonic and four supersonic conditions.In addition to the Mach number,the nozzle pres...This study deals with base pressure management in a duct for various values of the Mach number(M),namely,Mach number corresponding to sonic and four supersonic conditions.In addition to the Mach number,the nozzle pressure ratio(NPR),the area ratio,the rib dimension,and the duct length are influential parameters.The following specific values are examined at M=1,1.36,1.64,and 2,and NPRs between 1.5 and 10.The base pressure is determined by positioning ribs of varying heights at predetermined intervals throughout the length of the square duct.When the level of expansion is varied,it is seen that the base pressure initially drops for overexpanded flows and increases for under-expanded flows.When ribs are present,the flow field in the duct and pressure inside the duct fluctuate as the base pressure rises.Under-expanded flows can achieve a base pressure value that is suitably high without experiencing excessive changes in the duct flow in terms of static pressure if a rib height around 10%of the duct height close to the nozzle exit is considered.Rectangular rib passive control does not negatively affect the duct’s flow field.展开更多
Rice ARGONAUTE2(OsAGO2)is a core component of the rice RNA-induced silencing complex(RISC),which is repressed by Magnaporthe oryzae(M.oryzae)infection.Whether and how OsAGO2-mediated gene silencing plays a role in ric...Rice ARGONAUTE2(OsAGO2)is a core component of the rice RNA-induced silencing complex(RISC),which is repressed by Magnaporthe oryzae(M.oryzae)infection.Whether and how OsAGO2-mediated gene silencing plays a role in rice blast resistance and which sRNAs participate in this process are unknown.Our results indicate that OsAGO2 is a key immune player that manipulates rice defense responses against blast disease.OsAGO2 associates with the 24-nt miR1875 and binds to the promoter region of HEXOKINASE1(OsHXK1),which causes DNA methylation and leads to gene silencing.Our multiple genetic evidence showed that,without M.oryzae infection,OsAGO2/miR1875 RISC promoted OsHXK1 promoter DNA methylation and OsHXK1 silencing;after M.oryzae infection,the reduced OsAGO2/miR1875 led to a relatively activated OsHXK1 expression.OsHXK1 acts as a positive regulator of blast disease resistance that OsHXK1-OE rice exhibited enhanced resistance,whereas Cas9-Oshxk1 rice showed reduced resistance against M.oryzae infection.OsHXK1 may function through its sugar sensor activity as glucose induced defense-related gene expression and reactive oxygen species(ROS)accumulation in Nipponbare and OsHXK1-OE but not in Cas9-Oshxk1 rice.OsAGO2 itself is delicately regulated by OsPRMT5,which senses M.oryzae infection and attenuates OsAGO2-mediated gene silencing through OsAGO2 arginine methylation.Our study reveals an OsPRMT5-OsAGO2/miR1875-OsHXK1 regulatory module that fine tunes the rice defense response to blast disease.展开更多
BACKGROUND: The objective of this article is to review the literature and discuss the various tools used in hepatobiliary surgery for the measurement of health related quality of life (HR-QOL) and highlight various ou...BACKGROUND: The objective of this article is to review the literature and discuss the various tools used in hepatobiliary surgery for the measurement of health related quality of life (HR-QOL) and highlight various outcome variables that affect the HR-QOL among patients with common hepatobiliary disorders. DATA SOURCES: We reviewed HR-QOL articles published in the last 20 years on different hepatobiliary curative or palliative procedures in all languages. RESULTS: HR-QOL is a questionnaire tool which is utilized to assess the changes in the health status of patients after a hepatobiliary intervention. These surveys are of increasingly importance, as health care providers are challenged to justify treatment approaches and rationale for any surgical intervention. These HR-QOL tools are very helpful for the evaluation of subjective outcome of common hepatobiliary procedures like gastrointestinal quality of life index (GIQLI) for cholecystectomy, functional assessment in cancer therapy (FACT) for liver resection, short form 36 (SF-36) for liver transplantation, and quality of life questionnaire for patients with pancreatic cancer (QLQ-PAN). CONCLUSIONS: Use of validated and reliable health instruments in hepatobiliary surgery is directed at measuring the impact in a reproducible and valid fashion. Curative or palliative procedures should be offered to the patients of hepatobiliary disorders after the assessment by HR-QOL tools. Because the impairments of function that may occur after different operations vary considerably, an operation-specific assessment of HR-QOL for each type of surgical procedure is becoming an essential principle to follow in a successful healthcare system.展开更多
.Organ-on-Chip(OoC)has emerged as a revolutionary approach to emulate human organ function-ality in vitro,offering unparalleled insights into physiological processes and disease modeling.The integration of artificial i....Organ-on-Chip(OoC)has emerged as a revolutionary approach to emulate human organ function-ality in vitro,offering unparalleled insights into physiological processes and disease modeling.The integration of artificial intelligence(AI)with OoC platforms presents a transformative synergy,combining the precision of microscale organ replication with the analytical prowess of intelligent algorithms,is emerging as a transforma-tive force in harnessing the full potential of OoC.This perspective investigates the multifaceted implications of integrating AI with OoC,examining its impact on biomedical research,acknowledging the synergistic po-tential that arises from combining the precision of microscale organ replication with the analytical capabilities of intelligent algorithms,and fostering a future where the intricate workings of the technology and biology.展开更多
Context:Bioinspired Artificial Intelligence(Bio-AI)has emerged as a transformative tool in biomedical research,addressing challenges in cell labeling essential for understanding cellular behavior and interactions.Trad...Context:Bioinspired Artificial Intelligence(Bio-AI)has emerged as a transformative tool in biomedical research,addressing challenges in cell labeling essential for understanding cellular behavior and interactions.Traditional cell labeling methods often struggle with accuracy,scalability,and adaptability in complex datasets.Objective:This paper theoretically explores the integration of Bio-AI models into cell labeling process.It aims to assess how these models C encompassing neural networks,swarm intelligence,evolutionary algorithms,and self-organizing maps C can enhance cell identification and classification.Method:The paper examines various Bio-AI models that mimic biological processes such as neural functioning,swarm behavior,and evolutionary dynamics.It also evaluates the application of multimodal AI systems that combine imaging data with molecular and genetic information.In addition,the potential of dynamic cell labeling,inspired by neural plasticity,is discussed.Result:The integration of Bio-AI models has demonstrated significant improvements in accuracy,adaptability,and scalability for cell labeling.Automated labeling systems minimize human error and enhance reproducibility.Recent advancements in multimodal AI systems have shown promise in combining imaging with genetic and molecular data,providing more comprehensive insights into cellular behavior.Dynamic labeling models inspired by neural plasticity offer enhanced tracking of cellular transitions over time.Conclusion:Bio-AI holds transformative potential in biomedical research via enabling real-time,dynamic labeling,essential for tracking cellular changes over time in processes like cancer progression,stem cell differentiation,and immune response.The continued evolution of these AI-driven approaches is expected to accelerate breakthroughs in understanding diseases,tissue engineering,and regenerative medicine.展开更多
BACKGROUND:Bangladesh is a densely populated country where about 10 million people are chronically infected with hepatitis B virus(HBV).The aim of the present study was to evaluate the biochemical,virological and hist...BACKGROUND:Bangladesh is a densely populated country where about 10 million people are chronically infected with hepatitis B virus(HBV).The aim of the present study was to evaluate the biochemical,virological and histological characteristics of HBeAg-negative chronic hepatitis B(CHB). METHODS:Patients were included in this study if they were chronically infected with HBV with detectable DNA.The patients who were co-infected with human immunodeficiency virus,hepatitis delta virus or hepatitis C virus,and previously subjected to antiviral treatment,and those with hepatocellular carcinoma were excluded.The study was conducted during the period of January 2001 to December 2007.During this period 2617 patients with CHB were studied.HBeAg-positive cases were included to compare the characteristics.Among them,237 cases underwent liver biopsy. RESULTS:2296 patients(87.7%)were male,with a mean age of 28.9±13.7 years.2375 patients(90.8%)had CHB,and 242(9.2%)were cirrhotic.HBV DNA levels were 7.6±1.5 copies/ml,ALT was 111.3±212.5 U/L,and AST was 91.5± 148.9 U/L.The number of HBeAg-negative CHB cases was 1039(39.7%).HBeAg-negative patients with a lower DNA load were older,and they had more fibrotic changes in the liver than HBeAg-positive patients.The two groups did not differ in necroinflammatory activity,but the former had lower ALT and AST values.Cirrhosis was more common in e-antigen-negative patients.CONCLUSIONS:e-antigen-negative CHB patients are older and have more hepatic fibrosis patients than HBeAg-positive patients,although they have similar necroinflammatory activity.展开更多
文摘Nosocomial infections or healthcare associated infections occur in patients under medical care.These infections occur worldwide both in developed and developing countries.Nosocomial infections accounts for 7% in developed and 10% in developing countries.As these infections occur during hospital stay,they cause prolonged stay,disability,and economic burden.Frequently prevalent infections include central line-associated bloodstream infections,catheter-associated urinary tract infections,surgical site infections and ventilator-associated pneumonia.Nosocomial pathogens include bacteria,viruses and fungal parasites.According to WHO estimates,approximately 15% of all hospitalized patients suffer from these infections.During hospitalization,patient is exposed to pathogens through different sources environment,healthcare staff,and other infected patients.Transmission of these infections should be restricted for prevention.Hospital waste serves as potential source of pathogens and about 20%–25% of hospital waste is termed as hazardous.Nosocomial infections can be controlled by practicing infection control programs,keep check on antimicrobial use and its resistance,adopting antibiotic control policy.Efficient surveillance system can play its part at national and international level.Efforts are required by all stakeholders to prevent and control nosocomial infections.
文摘Beta-adrenergic receptor antagonists(β-blockers) have been well established for use in portal hypertension for more than three decades. Different Non-selective β-blockers like propranolol, nadolol, timolol, atenolol, metoprolol and carvedilol have been in clinical practice in patients with cirrhosis. Carvedilol has proven 2-4 times more potent than propranolol as a beta-receptor blocker in trials conducted testing its efficacy for heart failure. Whether the same effect extends to its potency in the reduction of portal venous pressures is a topic of on-going debate. The aim of this review is to compare the hemodynamic and clinical effects of carvedilol with propranolol, and attempt assess whether carvedilol can be used instead of propranolol in patients with cirrhosis. Carvedilol is a promising agent among the beta blockers of recent time that has shown significant effects in portal hypertension hemodynamics. It has also demonstrated an effective profile in its clinical application specifically for the prevention of variceal bleeding. Carvedilol has more potent desired physiological effects when compared to Propranolol. However, it is uncertain at the present juncture whether the improvement in hemodynamics also translates into a decreased rate of disease progression and complications when compared to propranolol. Currently Carvedilol shows promise as a therapy for portal hypertension but more clinical trials need to be carried out before we can consider it as a superior option and a replacement for propranolol.
基金funded by the Open Foundation of the Beijing SHRIMP Center (DDC15-016)the Applied Basic Research Program Youth Project of Yunnan Province (2016DF031)the National Basic Research Program of China (2015CB452605)
文摘The Laojiezi alkaline volcanic rocks, which are located in the intraplate region of the Yangtze craton, coincide with the formation of the Jinshajiang-Ailaoshan-Red River alkaline rock belt. Although this belt has been widely studied by geologists because of its porphyry-related Pb-Ag-Au polymetallic deposit and geotectonic location, the material sources of this belt are still debate. Whole-rock analyses show that these rocks have high total alkali contents(3.73–11.08 wt%), and their aluminum saturation index(ASI) values widely vary from 0.82 to 3.07, which comprise a metaluminous-peraluminous magma series. These rocks are characterized by high K(K2 O/Na2 O>1) and low Ti and Mg contents; enrichment in large-ion lithophile elements, such as Rb, Ba, K and light rare earth elements; and depletion in high field strength elements, such as Ta, Nb, P, and Ti. These rocks exhibit moderate Eu(Eu/Eu*=0.86–1.04) and Ce(Ce/Ce*=0.63–0.96) anomalies. Their(87 Sr/86 Sr)i, εNd(t), zircon εHf(t) and δ18 O values range from 0.70839 to 0.71013, from-10.16 to-12.45, from-19.6 to-5.8, and from 5.69‰ to 8.54‰, respectively, and their Nd and Hf two-stage model ages(TDM2) are 1.67–1.86 Ga and 1.27–2.02 Ga, respectively. These data reflect the primary partial melting of Paleoproterozoic to Mesoproterozoic lower crust with minor residual continental lithospheric mantle and supracrustal metasediments. The lithosphere was likely thickened along the southeastern margin of the Tibetan Plateau following the Indian-Asian continentcontinent collision(65–41 Ma). During the post-collision phase(36–16 Ma), the transition from a compressional to extensional setting triggered the convective removal of the over-thickened CLM beneath the Yangtze craton, which led to the upwelling of asthenospheric materials. This process created alkali-rich and high-K magma through the partial melting of the thickened lower crust. Magma that carried Cu-Au-Pb-Ag minerals was emplaced by strike-slip motion along the E-to W-or ENE-to WSWtrending tecto
基金supported by research grants of the National Basic Research Program of China (2007CB815700 2006CB102100)Bureau of Science and Technology of Yunnan Province, and Natural Science Foundation of China (30621092)
文摘To assess the genetic diversity between randomly and selectively bred populations,we sequenced 438 bp of the mitochondrial DNA control region from 102 pigs.These samples represented four native pig breeds,one nucleus and one conservation herd from Yunnan,China.Twenty haplotypes with sixteen polymorphic sites were identified.The number of haplotypes in the nucleus herd of Saba pig and the conservation herd of Banna miniature pig were restricted to three and one,respectively,while the randomly bred pig populations exhibited over six haplotypes.Notably,haplotype diversity in randomly bred populations was significantly greater than the selectively bred populations（h=0.732 vs.0.425 and 0,exact test,P≤0.0036）.These findings demonstrate that selective breeding generated low genetic diversity compared to randomly bred pig breeds.A timely intervention and well programmed breeding approach would stop further genetic diversity reduction in the nucleus and conservation herds of native pig breeds.Otherwise,selective breeding would dramatically reduce genetic diversity in only several years,indicating that sharp contradictions exist between breeding,conservation and genetic diversity.Genetic relationships are discussed based on net genetic distances among pig populations.
文摘AIM: To systematically analyze the randomized trials comparing the oncological and clinical effectiveness of laparoscopic total mesorectal excision(LTME) vs open total mesorectal excision(OTME) in the management of rectal cancer.METHODS: Published randomized, controlled trials comparing the oncological and clinical effectiveness of LTME vs OTME in the management of rectal cancer were retrieved from the standard electronic medical databases. The data of included randomized, controlled trials was extracted and then analyzed according to the principles of meta-analysis using RevMan? statistical software. The combined outcome of the binary variables was expressed as odds ratio(OR) and the combined outcome of the continuous variables waspresented in the form of standardized mean difference(SMD). RESULTS: Data from eleven randomized, controlled trials on 2143 patients were retrieved from the electronic databases. There was a trend towards the higher risk of surgical site infection(OR = 0.66; 95%CI: 0.44-1.00; z = 1.94; P < 0.05), higher risk of incomplete total mesorectal resection(OR = 0.62; 95%CI: 0.43-0.91; z = 2.49; P < 0.01) and prolonged length of hospital stay(SMD,-1.59; 95%CI:-0.86--0.25; z = 4.22; P < 0.00001) following OTME. However, the oncological outcomes like number of harvested lymph nodes, tumour recurrence and risk of positive resection margins were statistically similar in both groups. In addition, the clinical outcomes such as operative complications, anastomotic leak and all-cause mortality were comparable between both approaches of mesorectal excision.CONCLUSION: LTME appears to have clinically and oncologically measurable advantages over OTME in patients with primary rectal cancer in both short term and long term follow ups.
基金National Natural Science Foundation of China(10672009)Basic Science Foundation of Aviation(05B51044)"FanZhou" Youth Scientific Funds(20060501)
文摘Experimental and analytical investigation is conducted to explore the effects of stitching on plain （without hole） and open-hole compressive and tensile strength of uniweave T300/QY9512 laminates under different environmental conditions （20 ℃/dry and wet, 150 ℃/dry and wet）. Strength performance of stitched composite laminates is also studied using finite element analysis （FEA） model and compared with the experimental results to validate the model. It is found that under similar environmental conditions, the open-hole compressive strength of stitched laminate is decreased and open-hole tensile strength increased as compared to the unstitched laminates. Predicted tensile and compressive strengths are found to be in a good agreement with the test results and the relative error in all cases is less than 15%.
文摘Traumatic brain injury (TBI), an unmet need: TBI is an alteration in brain function caused by an external force with evidence of brain pathology. It could be from a bump, blow, blast or jolt to the head including penetrating the cranium. TBI is a public health concern worldwide due to its economic impact. Most TBIs are survivable, do not need hospitalization but may influence productivity. A smaller percentage of TBI due to falls or penetrating TBI (PTBI) needs hospitalization and accounts for largest fraction of TBI care costs.
文摘BACKGROUND: Timely identifi cation of high blood lactate levels in septic patients may allow faster detection of those patients requiring immediate resuscitation. Point-of-care(POC) testing is being increasingly utilized in the emergency department(ED). We examined the accuracy and timesaving effect of a handheld POC lactate device for the measurement of fingertip and whole blood lactate as compared with reference laboratory blood testing in septic ED patients.METHODS: A convenience sample of adult ED patients receiving serum lactate testing were enrolled prospectively in the ED of a multidisciplinary tertiary care hospital serving the population of one of the major cities of Pakistan. Participants underwent fi ngertip POC lactate measurement with a portable device and simultaneous whole blood sampling for analysis by both the POC lactate device and standard laboratory method. Lactate measurements were compared by intraclass correlation(ICC) and Bland and Altman plots.RESULTS: Forty-three septic patients were included in the study. The fingertip POC & whole blood POC lactate measurements each correlated tightly with the reference method(ICC=0.93 & ICC=0.92, respectively). Similarly at 6 hours, the fingertip POC & whole blood POC lactate measurements demonstrated satisfactory correlation with the reference method(ICC=0.95 & ICC=0.97, respectively).CONCLUSION: Fingertip POC lactate measurement is an accurate method to determine lactate levels in septic ED patients.KEY WORDS: Sepsis; Point of care; Lactate; Emergency department;
文摘Background:Maternal mortality is a prevalent issue in healthcare provision worldwide.It is particularly common in developing and underdeveloped countries,where maternal deaths during childbirth or pregnancy occur frequently.Various internal and external factors contribute to the high maternal mortality rate in specific regions.One model,known as the three delays model approach,examines three distinct causes that contribute to this problem.The first delay is the lack of awareness in seeking timely healthcare,the second delay involves obstacles in reaching healthcare facilities on time,and the third delay relates to poor or inadequate healthcare provision in tertiary care facilities.These delays are responsible for the elevated maternal mortality rates,with the prevalence of each delay varying across regions.Objective:The objective of this literature review is to examine and critically evaluate existing literature on perceptions and investigations regarding maternal mortality in Southeast Asia,Europe and Africa,utilizing the three delays model approach as a categorization framework.Method:This literature review followed BEME guide No.3.A total of 18 articles were included in the sample after conducting a thorough search of various databases and search engines.A Prisma flowchart was created,and the articles were critically appraised.Results:A total of 18 articles focusing on different regions were analyzed.The findings revealed that in countries of Southeast Asia,the primary cause of maternal mortality is the first delay,which refers to the lack of awareness in seeking medical care.On the other hand,in Africa and other European countries,the second and third delays are more prominently associated with maternal mortality.Conclusion:Inadequate care is one of the major causes of maternal mortality in majority of regions acrossthe globe.Multiple factors can hinder access to appropriate healthcare.The three delays model plays a significant role in the higher maternal mortality rate.By raising awareness among women and th
文摘Background:The monkey pox virus is caused by monkey pox(MPX),which is similar to both smallpox and cowpox.Near tropical rain forests,it usually occurs in isolated communities in Central and West Africa.The monkey pox virus,a member of the family Poxviridae and belongs to the genus Orthopoxvirus.Close contact with infected animals,sick people,or contaminated inanimate things can cause the virus to spread to humans.The illness typically takes 7 to 14 days to incubate and is characterized by fever,headache,lethargy,myalgia,generalized body pains,lymph node swelling,and skin lesions.Given the variety of illnesses that can result in skin rashes,it could be challenging to differentiate monkey pox solely based on clinical presentation,particularly for patients with an uncommon look.Objective:The main objective of the study is to evaluate public perceptions regarding the emerging human monkey pox disease and vaccination.Methods:The study was conducted using a cross-sectional study design.The sample size was 472 participants;however,10 questionnaires were excluded because of invalid data.The 462 questionnaires were included by expert validation from the general public of Rawalpindi and Islamabad,Pakistan.The data were analyzed using Chi-squared tests.Results:This questionnaire-based cross-sectional study was conducted from 15 Sep to 15 Oct 2022.The participants’perceptions,knowledge,and attitudes were collected via a 24-item-based questionnaire survey.The survey was based on 462 participants,196(42.4%)were females,and 266(57.6%)were males.The results reveal that out of 462 participants,clinical symptoms of monkey pox disease 82.7%(382),complications of monkey pox disease 81.2%(375),lymphadenopathy(swollen lymph nodes)is one clinical feature that could be used to differentiate between monkey pox and smallpox 81.2%(375)and monkey pox is common in Western and Central Africa 24.2%(112).Furthermore,the majority of participants(P≤0.05)agreed that health officials should start a vaccination campaign to combat monkey pox.Rega
基金supported by the Structures and Materials(S&M)Research Lab of Prince Sultan Universitysupport of Prince Sultan University in paying the article processing charges(APC)for this publication.
文摘When better fuel-air mixing in the combustion chamber or a reduction in base drag are required in vehicles,rockets,and aeroplanes,the base pressure control is activated.Controlling the base pressure and drag is necessary in both scenarios.In this work,semi-circular ribs with varying diameters(2,4,and 6 mm)positioned at six distinct positions(0.5D,1D,1.5D,2D,3D,and 4D)inside a square duct with a side of 15 mm are proposed as an efficient way to apply the passive control technique.In-depth research is done on optimising rib size for various rib sites.According to this study,the base pressure rises as rib height increases.Furthermore,the optimal location for the semi-circular ribs with a diameter of 2 mm is at 0.5D.The 1D location appears to be optimal for the 4 mm size as well.For the 6 mm size,however,the 4D position fills this function.
基金supported by grant#SZ-SZSTI2010 by the Shenzhen Science and Technology Innovation Committee(SZSTI),Guang Dong Basic and Applied Basic Research Foundation(2022B1515130010)Hong Kong Research Grant Council(RGC)funding projects(GRF#16308818,GRF#16309920,and GRF#16309421)Hong Kong Innovation and Technology Commission(HKITC)funding project(MHP/003/19).
文摘Rheumatoid Arthritis(RA)is an autoimmune disorder that hinders the normal functioning of bones and joints and reduces the quality of human life.Every year,millions of people are diagnosed with RA worldwide,particularly among elderly individuals and women.Therefore,there is a global need to develop new biomaterials,medicines and therapeutic methods for treating RA.This will improve the Healthcare Access and Quality Index and also relieve administrative and financial burdens on healthcare service providers at a global scale.Hydrogels are soft and cross-linked polymeric materials that can store a chunk of fluids,drugs and biomolecules for hydration and therapeutic applications.Hydrogels are biocompatible and exhibit excellent mechanical properties,such as providing elastic cushions to articulating joints by mimicking the natural synovial fluid.Hence,hydrogels create a natural biological environment within the synovial cavity to reduce autoimmune reactions and friction.Hydrogels also lubricate the articulating joint surfaces to prevent degradation of synovial surfaces of bones and cartilage,thus exhibiting high potential for treating RA.This work reviews the progress in injectable and implantable hydrogels,synthesis methods,types of drugs,advantages and challenges.Additionally,it discusses the role of hydrogels in targeted drug delivery,mechanistic behaviour and tribological performance for RA treatment.
文摘Thiswork investigates an oblique stagnation point flowof hybrid nanofluid over a rigid surface with power lawfluidas lubricated layers. Copper (Cu) and Silver (Ag) solid particles are used as hybrid particles acting in water H2O asa base fluid. The mathematical formulation of flow configuration is presented in terms of differential systemthat isnonlinear in nature. The thermal aspects of the flow field are also investigated by assuming the surface is a heatedsurface with a constant temperature T. Numerical solutions to the governing mathematical model are calculatedby the RK45 algorithm. The results based on the numerical solution against various flow and thermal controllingparameters are presented in terms of line graphs. The specific results depict that the heat flux increases over thelubricated-indexed parameter.
文摘This study deals with base pressure management in a duct for various values of the Mach number(M),namely,Mach number corresponding to sonic and four supersonic conditions.In addition to the Mach number,the nozzle pressure ratio(NPR),the area ratio,the rib dimension,and the duct length are influential parameters.The following specific values are examined at M=1,1.36,1.64,and 2,and NPRs between 1.5 and 10.The base pressure is determined by positioning ribs of varying heights at predetermined intervals throughout the length of the square duct.When the level of expansion is varied,it is seen that the base pressure initially drops for overexpanded flows and increases for under-expanded flows.When ribs are present,the flow field in the duct and pressure inside the duct fluctuate as the base pressure rises.Under-expanded flows can achieve a base pressure value that is suitably high without experiencing excessive changes in the duct flow in terms of static pressure if a rib height around 10%of the duct height close to the nozzle exit is considered.Rectangular rib passive control does not negatively affect the duct’s flow field.
基金supported by the Natural Science Foundation of China(31872040)a Jiangsu Agricultural Science and Technology Innovation Fund(CX(21)3090)to HZ+2 种基金Shandong Province Natural Science Foundation of China(ZR2019PC049)Science and Technology Program of Zaozhuang(2020NS13)National College Students Innovation and Entrepreneurship Training Program(202110904107)to PN。
文摘Rice ARGONAUTE2(OsAGO2)is a core component of the rice RNA-induced silencing complex(RISC),which is repressed by Magnaporthe oryzae(M.oryzae)infection.Whether and how OsAGO2-mediated gene silencing plays a role in rice blast resistance and which sRNAs participate in this process are unknown.Our results indicate that OsAGO2 is a key immune player that manipulates rice defense responses against blast disease.OsAGO2 associates with the 24-nt miR1875 and binds to the promoter region of HEXOKINASE1(OsHXK1),which causes DNA methylation and leads to gene silencing.Our multiple genetic evidence showed that,without M.oryzae infection,OsAGO2/miR1875 RISC promoted OsHXK1 promoter DNA methylation and OsHXK1 silencing;after M.oryzae infection,the reduced OsAGO2/miR1875 led to a relatively activated OsHXK1 expression.OsHXK1 acts as a positive regulator of blast disease resistance that OsHXK1-OE rice exhibited enhanced resistance,whereas Cas9-Oshxk1 rice showed reduced resistance against M.oryzae infection.OsHXK1 may function through its sugar sensor activity as glucose induced defense-related gene expression and reactive oxygen species(ROS)accumulation in Nipponbare and OsHXK1-OE but not in Cas9-Oshxk1 rice.OsAGO2 itself is delicately regulated by OsPRMT5,which senses M.oryzae infection and attenuates OsAGO2-mediated gene silencing through OsAGO2 arginine methylation.Our study reveals an OsPRMT5-OsAGO2/miR1875-OsHXK1 regulatory module that fine tunes the rice defense response to blast disease.
文摘BACKGROUND: The objective of this article is to review the literature and discuss the various tools used in hepatobiliary surgery for the measurement of health related quality of life (HR-QOL) and highlight various outcome variables that affect the HR-QOL among patients with common hepatobiliary disorders. DATA SOURCES: We reviewed HR-QOL articles published in the last 20 years on different hepatobiliary curative or palliative procedures in all languages. RESULTS: HR-QOL is a questionnaire tool which is utilized to assess the changes in the health status of patients after a hepatobiliary intervention. These surveys are of increasingly importance, as health care providers are challenged to justify treatment approaches and rationale for any surgical intervention. These HR-QOL tools are very helpful for the evaluation of subjective outcome of common hepatobiliary procedures like gastrointestinal quality of life index (GIQLI) for cholecystectomy, functional assessment in cancer therapy (FACT) for liver resection, short form 36 (SF-36) for liver transplantation, and quality of life questionnaire for patients with pancreatic cancer (QLQ-PAN). CONCLUSIONS: Use of validated and reliable health instruments in hepatobiliary surgery is directed at measuring the impact in a reproducible and valid fashion. Curative or palliative procedures should be offered to the patients of hepatobiliary disorders after the assessment by HR-QOL tools. Because the impairments of function that may occur after different operations vary considerably, an operation-specific assessment of HR-QOL for each type of surgical procedure is becoming an essential principle to follow in a successful healthcare system.
文摘.Organ-on-Chip(OoC)has emerged as a revolutionary approach to emulate human organ function-ality in vitro,offering unparalleled insights into physiological processes and disease modeling.The integration of artificial intelligence(AI)with OoC platforms presents a transformative synergy,combining the precision of microscale organ replication with the analytical prowess of intelligent algorithms,is emerging as a transforma-tive force in harnessing the full potential of OoC.This perspective investigates the multifaceted implications of integrating AI with OoC,examining its impact on biomedical research,acknowledging the synergistic po-tential that arises from combining the precision of microscale organ replication with the analytical capabilities of intelligent algorithms,and fostering a future where the intricate workings of the technology and biology.
文摘Context:Bioinspired Artificial Intelligence(Bio-AI)has emerged as a transformative tool in biomedical research,addressing challenges in cell labeling essential for understanding cellular behavior and interactions.Traditional cell labeling methods often struggle with accuracy,scalability,and adaptability in complex datasets.Objective:This paper theoretically explores the integration of Bio-AI models into cell labeling process.It aims to assess how these models C encompassing neural networks,swarm intelligence,evolutionary algorithms,and self-organizing maps C can enhance cell identification and classification.Method:The paper examines various Bio-AI models that mimic biological processes such as neural functioning,swarm behavior,and evolutionary dynamics.It also evaluates the application of multimodal AI systems that combine imaging data with molecular and genetic information.In addition,the potential of dynamic cell labeling,inspired by neural plasticity,is discussed.Result:The integration of Bio-AI models has demonstrated significant improvements in accuracy,adaptability,and scalability for cell labeling.Automated labeling systems minimize human error and enhance reproducibility.Recent advancements in multimodal AI systems have shown promise in combining imaging with genetic and molecular data,providing more comprehensive insights into cellular behavior.Dynamic labeling models inspired by neural plasticity offer enhanced tracking of cellular transitions over time.Conclusion:Bio-AI holds transformative potential in biomedical research via enabling real-time,dynamic labeling,essential for tracking cellular changes over time in processes like cancer progression,stem cell differentiation,and immune response.The continued evolution of these AI-driven approaches is expected to accelerate breakthroughs in understanding diseases,tissue engineering,and regenerative medicine.
文摘BACKGROUND:Bangladesh is a densely populated country where about 10 million people are chronically infected with hepatitis B virus(HBV).The aim of the present study was to evaluate the biochemical,virological and histological characteristics of HBeAg-negative chronic hepatitis B(CHB). METHODS:Patients were included in this study if they were chronically infected with HBV with detectable DNA.The patients who were co-infected with human immunodeficiency virus,hepatitis delta virus or hepatitis C virus,and previously subjected to antiviral treatment,and those with hepatocellular carcinoma were excluded.The study was conducted during the period of January 2001 to December 2007.During this period 2617 patients with CHB were studied.HBeAg-positive cases were included to compare the characteristics.Among them,237 cases underwent liver biopsy. RESULTS:2296 patients(87.7%)were male,with a mean age of 28.9±13.7 years.2375 patients(90.8%)had CHB,and 242(9.2%)were cirrhotic.HBV DNA levels were 7.6±1.5 copies/ml,ALT was 111.3±212.5 U/L,and AST was 91.5± 148.9 U/L.The number of HBeAg-negative CHB cases was 1039(39.7%).HBeAg-negative patients with a lower DNA load were older,and they had more fibrotic changes in the liver than HBeAg-positive patients.The two groups did not differ in necroinflammatory activity,but the former had lower ALT and AST values.Cirrhosis was more common in e-antigen-negative patients.CONCLUSIONS:e-antigen-negative CHB patients are older and have more hepatic fibrosis patients than HBeAg-positive patients,although they have similar necroinflammatory activity.
