Objective To evaluate the clinical efficacy and safety of bicyelol tablets in treatment of hepatitis B patients infected with YMDD mutation of HBV. Methods Sixty-eight chronic hepatitis patients infected with HBV YMDD mutants and 100 patients with non-mutants HBV were enrolled in the study. All patients received bicyclol tablets orally 150 mg/d, t. i. d, for 24 weeks. Clinical symptoms, signs and adverse effects were observed, and the blood routine, liver function tests, serum HBV markers and HBV DNA loads were examined at 12th and 24th week of the study, Results After treatment for 24 weeks, the normalization rates of ALT and AST in mutant group were 79.4% ( 54/68 ) and 70. 6% (48/68) ; 11 ( 16. 2% ) patients were markedly effective and 14 (20. 6% ) were effective. Clearance rates of HBeAg and HBV DNA were 27.9% ( 17/61 ) and 17.6% ( 12/68 ), while the seroconversion rate of HBeAg was 14. 7% (9/61). The differences of the above indexes were not statistically significant between mutant group and non-mutant group. Conclusion Bicyciol can both protect liver functions and inhibit virus replication in patients infected with HBV YMDD mutants.

OBJECTIVETo discuss the influence of setup errors on the accuracy of pelvic cancer in IGRT, analysis setup errors and determine the CTV-to-PTV margins.

METHODS60 pelvic cancer patients treated with Varian 23IX, all of them were performed by CBCT before and after-correction three times in the first week and after that once a week. Then, to measure the setup errors at X(left-right), Y(superior-inferior), Z(anterior-posterior) axis and E(coronal), F(sagittal), G(axial) rotation directions.

RESULTS530 scans obtained in all, the setup errors in X, Y, Z, E, F, G were (-0.52 ± 4.18) mm, (0.73 ± 4.86) mm, (-0.36 ± 3.62) mm, (0.14 ± 1.20)degrees, (0.13 ± 1.34)degrees, (0.21 ± 1.73)degrees respectively and were much lower after correction at X, Y, Z axis, besides, CTV-to-PTV margins decrease a lot.

CONCLUSIONThe accuracy of radiotherapy can be highly increased with the use of IGRT in pelvic cancer.

Objective To investigate the value of ISS in predicting mortality after multiple trauma.Methods A total of 550 patients with multiple trauma treated from March 2007 to May 2011 were divided into survivor group (n =473) and death group (n =77) according to the outcome.ISS and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ]) were used to predict patients' risk of death.Receiver operation characteristic curve (ROC) was developped to compare the area under the curve (AUC),optimal cut-off point,and prediction index for the two scoring systems.Results ISS and APACHE Ⅱ score were higher in death group than in survivor group (P ＜ 0.05).ISS showed the diagnostic cut-off point of ≥20,with a sensitivity of 76.7％,specificity of 83.7％,concordance rate of 82.7％,and AUC of 0.835.With regard to APACHE Ⅱ,the diagnostic cut-off point was ≥20,with a sensitivity of 80.5％,specificity of 89.2％,concordance rate of 88.0％,and AUC of 0.922.ISS and APACHE Ⅱ were equivalent in predicting mortality (P ＞ 0.05).Conclusion ISS presents a moderate value for predicting the mortality of multiple trauma patients and it is more rational to set ISS≥20 points as the criteria for severe multiple trauma.

Objective To study the utility and feasibility of CRAMS score to assess prognosis of patients with acute trauma.Methods A retrospective review of 1 802 patients with acute trauma was conducted to calculate CRAMS and ISS score.Receiver operation characteristic curve (ROC) was used to measure the prognostic role of CRAMS in comparison with ISS.Results Area under the curve (RUC) was 0.885 for CRAMS (95 ％ CI 0.870-0.900) and was 0.792 for ISS (95％ CI 0.773-0.811),with statistical difference of the two scoring systems (Z=4.280,P ＜0.01).To identify patients with potential critical illness,optimal cut-off point was≤7 for CRAMS and≥24 for ISS.CRAMS presented better sensitivity (x2 =16.910,P ＜ 0.01),but lower specificity (x2 =5.260,P ＜ 0.05) and accuracy (x2 =0.693,P ＞ 0.05) for predicting mortality when compared with ISS.Conclusions CRAMS is better than ISS in predicting prognosis for patients with acute trauma and exhibits a high discrimination.RAMS has advantages of simple operation,easy grasping and accurate and timely reflection of illness severity,which facilitates the early detection and treatment of critical illness in inhospital trauma patients.

Objective To evaluate the application value of prehospital index (PHI) in hospitalized patients with acute trauma.Methods A study was done in 1802 hospitalized patients with acute trauma by random sampling.PHI and injury severity score (ISS) were made respectively.Receiver operating characteristic curve (ROC curve) was used for detecting optimal cut-off point by taking the date of discharge as the endpoint and the outcome as observed indicator.In order to compare the predicting prognosis value of PHI in hospitalized patients with acute trauma,the corresponding predicting indicators were calculated and ISS was used for reference.Results The area under the ROC curve was 0.871 (95％ CI:0.855-0.886) by the score of PHI and 0.792 (95％ CI:0.773-0.811) by the score of ISS,and there was statistically difference between the two scoring systems (Z =2.674,P =0.007),and the optimal cut-off point was used for judging the potential for critically ill patients when PHI was ≥ 4,ISS ≥ 22.The sensitivity predictors of critically ill patients death of PHI was superior to ISS (x2 =6.975,P =0.008),the specificity and the accuracy of PHI and ISS showed no significant difference (P ＞ 0.05).Conclusions PHI has high potential for assessing patient condition and predicting the death of hospitalized patients with acute trauma,and it is equivalent to ISS in prediction value.The advantages of PHI are simple in operation,easy to learn,reflecting the condition timely and reliably,suitable for dynamic evaluation and comparison,which is suitable for critical patients with trauma of preliminary screening.

Objectives To explore the calcium signaling mechanism of STIM1 in breast cancer cells. Meth-ods After SiRNA interruption, Western blot and Transwell were used to measure protein expression of STIM1 and cell migration in MDA-MB-231 cells respectively. The relationship between STIM1 and SOCE calcium signaling were analysed by Laser confocal microscopy. Western blots were used to measure protein expression of FAK after si-lence STIM1. Results The numbers of cells without STIM1 were significantly lower than those cells with STIM1 by Transwell assay. STIM1 mediated SOCE in MDA-MB-231. Blocking SOCE might inhibite cells migration. Si-lence STIM1 did not affect the expression or activation of FAK in MDA-MB-231 cells. Conclusion STIM1 influ-ences cell migration through SOCE pathway in breast cancer cells, which is independent on the expression or activa-tion of FAK.

The deep analysis has been done on the cases of adverse events and common injury of cupping therapy encountered in recent years in terms of manipulation and patient's constitution. The adverse events of cupping therapy are commonly caused by improper manipulation of medical practitioners, ignoring contraindication and patient's constitution. Clinical practitioners should use cupping therapy cautiously, follow strictly the rules of standard manipulation and medical core system, pay attention to the contraindication and take strict precautions against the occurrence of adverse events.
Hospitals ; statistics & numerical data ; Humans ; Medicine, Chinese Traditional ; adverse effects ; instrumentation ; methods

Objective:To explore the safety and effect of intra-aortic balloon counterpulsation (IABP) combined non-invasive ventilator on recent curative effect in patients with acute myocardial infarction (AMI) complicated pump failure after emergency percutaneous coronary intervention (PCI) .Methods:A total of 105 patients ,who hospital-ized in our CCU because of AMI complicated pump failure from Jul 2012 to Jun 2014 ,were selected .They were di-vided into IABP group (n=68 ,received IABP and noninvasive ventilator based on routine treatment ) and routine treatment group (n=37 ,received routine treatment and noninvasive ventilator therapy ) ,and all patients received e-mergency coronary angiography ,PCI and medication etc .Changes of blood pressure ,heart rate ,urine volume , echocardiography and brain natriuretic peptide (BNP) level etc .,and incidence of complications and cardiac adverse events were observed and compared between two groups during hospitalization . Results:Compared with routine treatment group during hospitalization ,blood pressure significantly rose and heart rate gradually declined to stable ;there was significant rise in left ventricular ejection fraction [(35 ± 9)% vs .(37 ± 10)% ] ,and significant reductions in BNP level [ (467 ± 197) pmol/L vs .(236 ± 146) pmol/L] ,mortality rate (28.9% vs .19.1% ) and hospital stay [ (16.2 ± 4.1) d vs .(11.6 ± 3.4) d] in IABP group , P<0.05~ <0.01 .Conclusion:IABP combined noninvasive ventilator can effectively improve patient′s condition ,stabilize hemodynamic status , reduce in-hospital mortality rate and gain time for further therapy to improve prognosis in patients with AMI complicated pump failure .

Objective To evaluate the effect of dexmedetomidine on the expression of nerve growth factor (NGF) in isolated hippocampal neurons of fetal rats incubated with propofol.Methods Hippocampal neurons derived from the fetal rats of pregnant Sprague-Dawley rats at 5-13 days of gestation were primarily cultured for 7 days,and were inoculated in the culture plate at a density of 5×105 cells/ml.The neurons were randomly divided into 3 groups (n =15 each) using a random number table:control group (group C),propofol group (group P),and dexmedetomidine + propofol group (group DP).In group P,propofol with the final concentration of 100 μmol/L was added to the culture medium,and the cells were incubated for 3 h.In group DP,dexmedetomidine with the final concentration of 1 μmol/L was added to the culture medium,the cells were incubated for 30 min,and then propofol with the final concentration of 100 μmol/L was added to the culture medium,and the cells were incubated for 3 h.The viability of hippocampal neurons was assessed by CCK-8 assay.NGF mRNA expression was detected by real-time reverse transcriptase polymerase chain reaction.NGF protein expression was detected by Western blot.Results Compared with group C,the viability of hippocampal neurons was significantly decreased,and the expression of NGF protein and mRNA was down-regulated in group P (P＜0.05).Compared with group P,the viability of hippocampal neurons was significantly increased,and the expression of NGF protein and mRNA was up-regulated in group DP (P＜0.05).Conclusion Dexmedetomidine improve propofol-induced decrease in the viability of isolated hippocampal neurons of fetal rats through up-regulating the expression of NGF.

Objective To study the feasibility of modified early warning scores (MEWS) for assessing the severity and death prediction in the pre-hospital traumatic patients.MethodsData of the prehospital traumatic patients admitted between January 1,2010 and December 31,2010 were collected and assessed onsite by using MEWS.Numeration data was presented in percentage by using chi-square test,and measurement data was xepressed in mean with standard deviation,and P ＜ 0.05 was considered to be difference with statistical significance.Observation was lasted for 90 days after admission to get final results as observation object and ROC curve was drew and calculated the area under the curve for predicting severity and death of patients.The patients without vital signs and unsuccessful resuscitations were not included in this study.ResultsThere were 1475 (87.95％) cases/times with score of 0 -2,and 202 (12.05％)cases/times with score of 3 - 13.In the non-survival group,MEWS were higher than that in the survival group with statistic significance ( P ＜ 0.01 ).When the area under ROC was 0.94,the optimal cutoff point for potentially severe patients was MEWS≥3 for predicting the death of severe pre-hospital traumatic patients with sensitivity of 85.7％,specificity of 88.6％,accuracy of 88.6％ and Youden of 0.743,showing high significance of the application of MEWS to assessing severity of traumatic patients and death prediction.ConclusionsMEWS used to assess the pre-hospital traumatic patients and predict death with high validity and accurate quantification is a simple,practical and easily operable method with strong application significance.