Objective To compare the antiviral efficacy and economics between lamivudine and entecavir in patients with low preoperative HBV replication after liver transplantation. Methods Liver transplantation patients from 2006 July to 2013 July were selected for being studied prospectively. Statistically evaluated between entecavir and lamivudine efficacy by the analysis of postoperative follow-up of seroconversion and HBV reinfection. Results The cumulative overcast rate of entecavir group was 98.04% one month after transplatation. And 3 of 51 cases were reinfected with average turn time of 9.73 days. Meanwhile , the cumulative overcast rate of Lamivudine group was 100% and 3 of 26 cases were reinfected with average turn time of 5.11 days. There are no statistical differences between the two groups accumulation rate , reinfection rates , as well as cumulative infection rates. Conclusion In the cases of low hepatitis B virus replication before liver transplantation, Entecavir and Lamivudine have the similar effect of preventing HBV reinfection after operation. Compared with the cost of Entecavir group, Lamivudine is more economy.

This paper introduced the scheme,form and measures of implementing problem-based learning in the teaching practice of human central nervous system anatomy.This paper discussed on the depth and scope of the issue,how to mobilize the enthusiasm of the students in the process of discussion,how to be conscious of curriculum knowledge system and logic in the teaching process,how to make students expose to clinical at early stage,how to provide corresponding assessment methods and other aspects of the practice in an aim to help peers to improve the teaching practice.

The words and deeds of rehabilitation therapists are associated with the health and life of patients,the stability and harmony of the families.The language is the bridge of communication.Therapists should employ the speech correctly.More attention should be paid to artistic speech.The therapist could use the speech,which could promote patients.So that,patients can renew their work,and lofty morality could be showed.Meanwhile,therapists should use speech rationally and grasp the skills of speech to avoid the doctor-patient quarrel.

Objective To study the effect of laparoscopic cholecystectomy endoscopic sphincterotomy combined with Oddi lithotomy (EST) treatment of gallbladder stone on common bile duct stones. Methods A retrospective analysis between May 2003 and June 2009 ,the combined treatment of LC and EST in 78 patients with common bile duct stones was retrospectivelly analyzed. First, bile duct stones were removed by EST, then laparoscopic cholecystectomy was performed within 5 days. Results EST was performed successfully in 76 cases (97%), failure in 2 cases, 1 case abdominal choledochojejunostomy due to the end of bile duct stenosis; one cases of common bile duct stone diameter of 1.6 cm, firm, failure of mechanical lithotripsy received common bile duct ploration T-tube drainage 76 cases of laparoscopic operation is successful, without obvious bleeding, bile leakage and other severe complications. Conclusions The advantages of EST + LC for the gallbladder stones and common bile duct stones with less trauma, faster recovery, fewer complications, and no T-tube drainage, etc; this is a safe and effective treatment.

Objective: To determine the transdermal absorption of phloretin and ligustilide in Fufang phloretin cream.Methods: In vitro percutaneous absorption test using the Franz intelligent transdermal absorption apparatus was adopted, an HPLC method was used to determine the contents of phloretin and ligustilide in the accepting solution at different time points, and then the cumulative release amount and the total penetration amount were calculated to evaluate the percutaneous absorption behavior.Results: Phloretin and ligustilide showed a good linearity within the range of 0.044 2-4.42 μg·ml-1(r=0.999 9) and 0.048 7-4.87 μg·ml-1(r=0.999 9), respectively, the average recovery was 99.85% and 99.92%, and RSD was 0.67% and 0.66% (n=9), respectively.The in vitro permeation behavior of phloretin and ligustilide through the skin of rats fit Higuchi equations(r>0.9), suggesting a good linear correlation between the cumulatine penetration amount (Qn) and (time).Conclusion: Fufang phloretin cream has a good percutaneous permeation property in vitro.

Objective To study the sensitivity and specificity of the Chinese eating assessment tool (EAT-10) in screening acute stroke patients for oropharyngeal dysphagia (OD).Methods A total of 130 inpatients with acute stroke were screened using the Chinese EAT-10.On the same day they were also screened using the gold standard technique for diagnosing dysphasia-videofluoroscopy.A receiver operating characteristics (ROC) curve was developed to study EAT-10's sensitivity and specificity.A Youden index,positive predictive value (PPV),negative predictive value (NPV),and positive and negative likelihood ratios (LHR+ and LHR) were quantified.Results According to the ROC curve,a cut-off point of 1 (EAT-10 score≥ 1) gave the best sensitivity (77.9％),the highest NPV (73.2％),with 66.1％ specificity,71.6％ PPV,2.30 LHR+ and 0.33 LHR in screening for OD.The test-retest reliability was above 0.7.An investigator consistency reliability test showed good repeatability,and the consistency between each item and the mean total score was high.Conclusion The Chinese EAT-10 has good test-retest reliability and investigator consistency.The optimal cut-off point is 1,with good sensitivity and NPV at scores ≥ 1.The test can be recommended as a screening tool for OD in acute stroke patients.

Objective To explore the image quality and radiation dose for coronary angiography using DSCT (dual-source computed tomography) under lower tube voltage and lower contrast agent concentration ('double low').Methods A total of 160 patients with suspected coronary artery disease underwent dual-source CCTA.80 patients (BMI ＜ 25 kg/m2) were randomly assigned to group A (270 mg I/ml-80 kV) and B (350 mg I/ml-120 kV).The other 80 patients (25 ≤ BMI ＜30 kg/m2) were randomly assigned to group C (270 mg I/ml-100 kV) and D (350 mg I/ml-120 kV),sonogram affirmed iterative reconstruction technology and 270 mg I/ml contrast agent were applied to group A and C ; FBP technology and 350 mg I/ml contrast agent were applied to group B and D.Adaptive cardio-sequence prospective ECG-gated technology was applied in all patients,while the acquisition phase was 65％-75％ RR interval (when heart rate ＜ 75 beats / min) or 40％-50％ RR interval at when heart rate ≥ 75 beats/min.Volume CT dose index (CTDIvol),dose length product (DLP),effective dose (E),size specific dose estimates (SSDE),image noise,CT value,signal-to-noise ratio (SNR),and contrast-to-noise ratio(CNR) were all evaluated for each patient.Results There was not statistical difference in scan length among groups A and B,C and D.There was statistical difference in tube current between group A and B (t =8.932,P ＜0.05).There was not statistical difference in tube current between group C and D (tCD =-1.212,P ＞ 0.05).There was statistical difference in CTDIvol,DLP,E and SSDE between group A and B,C and D (tCTDIvol =-16.141,-11.440 ; tDLP =-17.454,-10.521 ; t =-17.444,-10.523 ;tSSDE =-13.032,-9.119,P ＜0.05).Compared to group B,the SSDE in group A decreased by 64.4％.Compared to group D,the SSDE in group C decreased by 39.3％.There was no statistical difference in image noise between group A and B,C and D (P ＞ 0.05).There was statistical difference in CT value,SNR and CNR between group A and B (t =0.436,4.623,3.272,P ＜ 0.05).There was no statistical difference in CT value and CNR between group C and D,while there was statistical difference in SNR between group C and D (t =2.981,P ＜0.05).There was no statistical difference in image quality scores between group A and B,C and D (P ＞ 0.05).Conclusion Compared with conventional DSCT coronary angiography,'double low' DSCT coronary scanning solution can significantly reduce the radiation dose and contrast agent,and could provide the effective coronary images which meet the clinical diagnostic needs.

Objective To observe the effect of low doses of ultrashortwave therapy (USW) on sciatic nerve injury and to deduce its possible mechanism.Methods Fifty-four Sprague-Dawley rats were randomly divided into a USW group,a control group and a normal group with 18 rats in each.Each group was then sub-divided into 1 week,2 week and 3 week subgroups with 6 rats in each.A model of peripheral nerve injury was established by forceps clipping of the sciatic nerve in the USW and control groups.The USW group was then treated with USW exposure.Rats from the appropriate subgroups were sacrificed after 1,2 and 3 weeks of treatment.Sciatic nerve samples were stained using hematoxylin-eosin and toluidin blue.Expression of basic fibroblast growth factor (bFGF) was detected by immunohistochemical methods.Results Degeneration of axons was observed in both the therapy and control groups after 1 week,and regeneration at the end of the 2nd and 3rd weeks.The number of axons with myelin sheaths was significantly higher in the therapy group than in the control group at the end of the 2nd and 3rd weeks.The expression of bFGF was significantly higher in the USW group compared with the control group at all observation time points.Conclusion USW can obviously accelerate the regeneration of the sciatic nerve,probably through increased expression of bFGF.

Objective To observe the effect of aerobic exercise of different intensities on type Ⅱ collagen,glycosaminoglycan (GAG) and chondrocyte apoptosis in rabbits modeling knee osteoarthritis (OA),so as to explore the preventive effect and its possible mechanism.Methods Twenty healthy New Zealand white rabbits were randomly divided into Groups A,B,C and D,each of 5.Group A was allowed free activity in a cage for 9 weeks.Group B was allowed free activity for 4 weeks,then an OA model was established using papain and confirmed via MRI 1 week later,Another 4 weeks of free activity were then allowed.Groups C and group D were given running training for 20 minutes a day at 0.5 km/h,3 times a week,and then 20 minutes a day at 1.5 km/h,5 days a week on a treadmill for 4 weeks.Nine weeks later,all 4 groups of rabbits were killed and the articular cartilage damage of each group was compared using Mankin scoring,and expression of type Ⅱ collagen,GAG content and chondrocyte apoptosis in the cartilage.Results After the intervention,the average Mankin score,expression of type Ⅱ collagen and GAG content of groups B,C and D were significantly lower than those of group A,and all of those values in group B were significantly lower than those of group D.After 9 weeks the chondrocyte apoptosis rate of group A was significantly lower than that of the other groups,and that of groups C and D was significantly lower than that of group B.Conclusion Aerobic exercise may prevent knee articular cartilage degeneration through inhibiting reduction in the amount of type Ⅱ collagen and GAG in the cartilage matrix.It may be related to decreasing the chondrocyte apoptosis.

Objective To observe the effects of pulsed electromagnetic fields (PEMFs) on histological changes and myogenic differentiation factor D (MyoD) expression in rats with acute skeletal muscle contusion ( ASMC), and to explore the effects of PEMF therapy on rats with ASMC in its very early stages. Methods Forty-two rats were randomly divided into three groups : a treatment group, a control group and a blank control group. ASMC models were established with all the animals in the treatment and control groups. PEMF treatment was admin-istered to the treatment group immediately after the establishment of the ASMC model. Seven rats in each group were sacrificed at the 12th and 18th h after the models were set up. Their triceps surae muscles were sampled and treated with haematoxylin-eosin staining for study using immunofluorescence techniques and a fluorescence microscope. Re-suits In the control group at the 12th h and 18th h, HE staining showed pale cytoplasm and polymorphism in the cell nuclei ; in the treatment group these effects were significantly lighter, but in both groups it was more serious than in the blank control group. In the treatment and control groups, the fluorescence intensity of MyoD at the 18th h was higher than at the 12th h, and at each time point in both groups it was higher than in the blank control group. At the 18th h, fluorescence in the treatment group was stronger than in the control group. Conclusion MyoD expression in rats with ASMC is upregulated by thel8th h after early PEMF treatment. This might be one of the mechanisms ac-celerating the regeneration of skeletal muscles after trauma.