Hepatitis B virus (HBV)-related liver failure is an end-stage liver disease with a high mortality.Biomarkers,which are of interest,are helpful for diagnosis and treatment of liver failure.The purpose of this review is to highlight the recent advances in this field.Although many new biomarkers can improve the prognostic efficacy,the dynamic biochemical function of liver and kidney as well as the function of coagulation are still the most practical and common indexes for the development and prognosis evaluation of liver failure.

Objective To explore the effects of interactive health education on the knowledge and behaviors of medicine use and the biochemistry indicators in hemodialysis patients. Methods Forty-eight eligible hemodialysis patients were intervened with interactive health education once every month. After three times'intervention, phosphorus, hemoglobin and hematocrit level were compared before and after the intervention. Results After the intervention, phosphorus, levels of hemoglobin and hematocrit were all significantly improved ( P<0 . 001 ) compared with that before the intervention . Conclusion The interactive health education can improve the knowledge and compliance behaviors in medicine use, serum phosphate and symptoms of anemia in hemodialysis patients.

Objective To observe the clinical efficacy and safety of immediate-effect moxibustion combined with massage for the treatment of knee stiffness after knee ligament reconstruction surgery.Methods A total of 138 patients after knee ligament reconstruction surgery were randomly divided into control group and observation group,69 cases in each group.The control group received joint rehabilitation therapy,which included TDP light radiation,joint exercise by continuous passive motion apparatus,contraction and relaxation of quadriceps femoris muscle and ankle pump.The treatment group was given immediate-effect moxibustion combined with massage based on the treatment for the control group.The treatment lasted from postoperative day 3 to 14.Before and after treatment,Lysholm knee joint scores,joint activity scores and activities of daily living(ADL) scores of the two groups were observed.Results After treatment,the Lysholm knee joint scores,joint activity scores and ADL scores of the two group were obviously increased (P ＜ 0.05 or P ＜ 0.01 compared with those before treatment),and the increase in the observation groups was superior to that in the control group,the differences of the alove indexes except for joint activity scores being statistically significant between the two groups (P ＜ 0.05 or P ＜ 0.01).Conclusion Immediate-effect moxibustion combined with massage is effective on preventing knee from postoperative ankylosis after knee ligament reconstruction surgery.

Objective To obtain two-dimensional gel electrophoresis maps of the renal tissue proteins of normal and chronic intermittent hypoxia(CIH) rats for identifying the diferentially expressed proteins in the CIH rats.MethodsCIH rat models were established, and the proteins in the renal tissue underwent two-dimensional gel electrophoresis with immobiline pH gradientisoeleclricfocusingasthefirstdimensionandverticalSDS-PAGEasthesecond dimension.Analysis of 2-DE maps was used to determine differential expression of proteins between the two groups by ImageMaster 2D Platinum 5.0, and four protein spots expressed differently were picked up for further identification by MALDI-TOF-MS.Results Matched and compared with those of control group, 112 protein spots were determined with differently expressive levels in CIH group.By MALDI-TOF-MS, three protein spots of them were identified as ATP synthase delta subunit of mitochondrial precursor, catechol O-methyltransferase, apurinic/apyrimidinic endonudease.Conclusions There is obvious difference in expressive proteomes in renal tissue between normal and chronic intermittent hypoxia rats.The functions of those identified proteins are involved in cellular energy metabolism, apoptosis, signal transduction, anti-cell injury and hormone metabolism,so that proteomics can serve as a new approach in the study of obstructive sleep apnea-hypopnea syndrome to discover new therapeutic targets.

Aim To obtain two-dimensional gel electrophoresis maps of the prefrontal cortex(PFC)proteins of normal and morphine-addicted rats for identifying the diferentially expressed proteins in the addicted rats.Methods Rat models of morphine addiction were established.The proteins in the PFC underwent two-dimensiona1 gel electrophoresis with immobiline pH gradient isoelectric focusing as the first and vertica1 SDS-PAGE as the second dimension.Analysis of 2-DE maps was used to determine differential expressions of proteins between the two groups by ImageMaster 2D Platinum v5.0,and four protein spots expressed differently were picked up for further identification by MALDI-TOF-MS.Results Matched and compared with those of control group,87 protein spots had been determined with differently expressive levels in morphine addiction group.By MALDI-TOF-MS,two protein spots of them had been identified as Snap25 Isoform ?-Snap 25 of Synaptosomal-associated protein 25 and Actb Actin,cytoplasmic 1.Conclusions There is obvious difference in expressive proteomes in PFC between normal and morphine-addicted rats. The functions of those identified proteins are involved in cell growth,apoptosis,differentiation,signal transduction,axon growth and cellular energy metabolism,so proteomics can serve as a new approach in the study of morphine dependence to discover new therapeutic targets.

The overuse of injection exists more than 20 years since economic reform in China. It is a persistent problem and seems becoming a new challenge in the new health reform period. This study was designed to assess the effect of national essential medicines policy (NEMP) on injection use at primary health facilities in China by investigating their prescription information. Questionnaires were designed and disseminated to collect empirical data on injection use at 120 primary health facilities in 6 provinces from January to September in 2010 and 2011. The injection use was measured as the indicator as the percentage of prescriptions with one or more injections. The results showed that the percentage of prescriptions with one or more injections was decreased from 38.91% to 36.82% (χ (2)=11.158, P=0.001) in the all survey areas during the NEMP reform. The difference in level of the injection use in 2011 was significant among the eastern, central and western regions (χ (2)=223.584, P=0.000); level of the injection use in western region was the lowest (27.73%), while that in the central region was the highest (43.10%). The level of the injection use in 2011 among different provinces was also of great difference (26.00%-58.25%, range: 32.25%). The level of the injection use in 2011 was still much higher than the standard suggested by WHO for developing countries (13.4%-24.1%). It was concluded that NEMP has improved injection use in China, but the injection abuse situation remains serious, indicating that one of the priorities to the next stage of NEMP is to promote the rational use of drugs, especially the injection use.

Objective To evaluate the cost-effectiveness of entecavir and lamivudine in treatment of early stage acute on chronic liver failure (ACLF),and analyze the predictive factors.Methods Forty nine patients with early ACLF were enrolled.Of which,28 patients were treated with entecavir,and 21 patients were treated with lamivudine.Mortality,length of hospital stay,cost,liver function,coagulation function,and model for end-stage liver disease (MELD) score were compared between two groups.Pharmacoeconomic evaluation was taken using cost-effectiveness analysis and cost minimization analysis.Results Mortality,length of hospital stay and cost had no significant difference between two groups.Ratio of costeffectiveness in lamivudine group was higher than that in entecavir group.Cox analysis showed that primary peritonitis and MELD score at the end of the second week were the main predictive factors.Conclusions Entecavir cannot improve the survival rate of early stage ACLF compared to lamivudine,but may provide economic benefit to patients with early stage ALCF.

Objective To evaluate the incremental value of 131I SPECT/CT over 131I whole body scan (WBS) in the patients with DTC.Methods A total of 97 patients with DTC (31 males,66 females,mean age:44.1 years,age range:17 to 74 years) were retrospectively reviewed.All subjects underwent 131I WBS and SPECT/CT after 131I treatment.The images were interpreted by 2 experienced nuclear medicine physicians.The final diagnosis was based on the pathologic findings and clinical follow-up.The diagnostic accuracies between 131I WBS and 131I SPECT/CT were compared using x2 test with SPSS 13.0.Results 131I WBS detected 175 lesions (128 neck and 47 distant lesions),while 131I SPECT/CT found 176 lesions (128 neck and 48 distant lesions).Out of the 176 lesions,78 were confirmed as benign and 95 as malignant,including 51 lesions in thyroid bed,67 cervical lymph nodes or local residual lesions,7 lesions related to local physiological uptake,30 distant metastases and 18 distant foci due to physiological uptake.The other 3 lesions were still in follow-up.The sensitivity and specificity of 131 I WBS was 73.7％ (70/95) and 78.2％ (61/78),respectively.The accuracy of 131I WBS (106/173,61.3％) was lower than that of 131I SPECT/CT (171/173,98.8％; x2=72.3,P＜0.05).131I SPECT/CT corrected the diagnosis of 131I WBS in 67 lesions,including 37 local lesions (37/128,28.9％) and 30 (30/48,62.5％) distant metastases.The sources of error for the 67 lesions were due to wrong location (n =27) or wrong characterization (n =40).Compared with 131I WBS,131I SPECT/CT changed the location in 27 lesions,clinical staging in 8 cases and therapeutic strategy in 14 cases.Conclusions 131 I SPECT/CT could improve the differentiation of malignant local lesions from residual thyroid,of distant metastatic lymph node,lung or bone lesions from physiological uptake.Such incremental values would be valuable to the management of DTC patients compared with WBS.

Objective To explore the ultrasonographic features of yolk sac tumors of ovary.Methods Totally 12 patients (13 lesions) of the yolk sac tumors of ovary confirmed by pathology were analyzed retrospectively.Two-dimensional ultra sonography,color Doppler and spectral Doppler features were observed and combined with clinical manifestations.Results Ultrasound showed 1 case with bilateral single lesion and 11 cases with unilateral single lesion,the median size of tumors was 11.82 cm × 11.19 cm.Thirteen lesions showed liquid-solid mixed echo,and the blood flows in solid region were ≥ grade Ⅱ according to Adlefs semi quantitative method,the resistance index of blood was 0.37 0.55;Six cases combined with abdominal cavity effusion.Pathology showed 2 cases combined with omentum or rectal pouch metastasis and 1 case was tubal,ovarian artery and vein invasion.Conclusion Ultrasound images in the yolk sac tumors of ovary have characteristics and diagnosis must closely combine with clinical manifestations,some cases still need to be confirmed by pathology and immunohistochemist r y.

Objective To investigate the characteristics of decision-making impairment in male patients with heroin dependence in methadone maintenance treatment(MMT). Methods A total of 45 male patients in MMT were compared with matched 32 health controls on the Iowa Gambling Task. Results Participants with anxiety or depression had to be excluded, MMT subjects were required to have negative urine toxicology screening tests.The MMT group selected more net disadvantageous cards (number of cards selected from the disadvantageous decks minus number of cards selected from advantageous decks) than health controls( (9.11 ± 19.60, -4.25 ±10.27 respectively), t=3. 884, P＜0.01). A 2(group) ×5(block) ANOVA (analysis of variance) on the cards of net disadvantageous from the gambling task revealed a significant main effect of group( F= 12.414, P＜0.01 ).The ANOVA also revealed a significant main effect of block( F=6.871, P＜0.01 ). The study indicated the totalnumber of net disadvantageous cards for MMT subjects was negative correlation to the age of initial drug use ( r=- 0. 320, P ＜ 0. 05 ). Meanwhile, methadone dose and the time of enrollment MMT did not reveal a significant main effect on decision-making biases. Conclusion The deficit of decision making for male heroin dependent patients might be attributed to the dysfunction of the ventromedial prefrontal cortex, and this effect does not resolve with abstinence, even very long term abstinence. Methadone may not get worse this impairment in male patients who have a history of heroin use during maintenance treatment intervention.