Objective　To evaluate the intelligence level and different subscales in TS patients. Methods　64 patients with TS and 60 normal children were evaluated with C-WISC. Results　The intelligence quotient of most TS patients fluctuated between normal and borderline range, all subscales except Vocabulary and knowledge, PIQ, VIQ and FIQ were significantly lower in TS patients than in controls (P＜0.05), the balance between PIQ and VIQ was poor in TS patients. Conclusion　The intelligent quotient of TS patients was lower than that of normal children, TS patients had more imbalance in intelligence development.

0.05). Genotype B+C(2.93?0.74 and 2.95?0.71) was associated with higher grade of necroinflammation and stage of fibrosis than genotype B(1.76?1.18 and 1.76?1.15 ) and C (1.93?1.32 and 1.84?1.29) HBV. Conclusions[KG1]genotype C or B+C HBV are associated with more severe liver damage in patients. Stratification for HBV genotypes should be considered in the antiviral treatment of chronic hepatitis B.

0bjective To analyze the factors related tO the changes of liver pathology in hepatitis B e antigen (HBeAg) negative chronic hepatitis B (CHB) patients.Methods Two hundred and eighty-eight HBeAg negative CHB patients were enrolled.Bivariate Pearson correlation was employed to analyze the correlation of different age,gender,alanine aminotransferase (ALT) level,the immunohistochemistry results of hepatitis B surface antigen (HBsAg) and hepatitis B core antigen (HBcAg) in liver tissue with hepatitis B virus (HBV) DNA level,changes of liver pathology.Results The inflammation grades and fibrosis stages of livertissuesinmale were 1.72±1.23 and 1.71±1.24,respectively;1.25±1.39 and 1.21±1.40 in female,respectively,which were significantly different (t=2.398,t-2.551;both P40 years old were all significantly higher than those<40 years old(t一2.060,t一2.536,t=2.808;all P<0.05).In patients with normal ALT levels,75 cases (52.03%) showed HBV DNA level≤1×103 copy/mL,56(38.89%) showed≥G2 of liver tissues; the ALT level and inflammation grade of liver tissues was significantly correlated(r:O.244,P-O.004).In patients with elevated ALT 1evels,42 cases (31.57%) showed HBV DNA level≤1×10s copy/mL,89 (66.92%) showed≥G2 of liver tissues; the ALT level and inflammation grade of liver tissues was not significantly correlated (r=0.007,P=0.939) .The inflammation/fibrosis of liver tissues,HBV DNA levels in patients with both HBsAg and HBcAg positive in liver tissues were significantly higher than those in other patients (P

Psychiatric professional talents is specially needed in China.Our university was ratified by ministry of education of people's republic of China in 2011 to cultivate professional master degree postgraduates majoring in mental health and psychiatry.According to the social needs and requirements of ministry of education,we carried out comprehensive reform and exploration in cultivation direction and objective,time management and course offering,cultivating model,examination and evaluation system.Cultivation direction included clinical psychiatry,forensic psychiatry,community psychiatry,behavioral medicine and clinical psychology,which were closely related with social needs.The objective was to cultivate high-grade psychiatric special talents with higher political diathesis,competent clinical skills,certain teaching and research abilities and grasping one foreign language.The total time for cultivating clinical skills should no less than two years and a half.Course offering included degree course and non - degree course,clinical skills,academic activities,teaching practice,medical record arrangement or case analysis essay writing.We developed the cultivating model combining ‘ medicine,study and research' and developed multilevel and comprehensive examination and evaluation system.

To construct the talent cultivating model of psychiatric major suited to our county's actual situation.Jining medical university has conducted explorations and practices persistently in aspects of cultivating objective,enrollment model,course system,teaching quality monitoring system and inspirational education through more than twenty years maneuver.Jining medical university has initially grasped the basic rules of cultivating talents of psychiatric major and has constructed talent cultivating model of psychiatric majors suited to our country's actual situation.

Objective To study effects of low molecular weight heparin on liver fibrosis and the serum levels of TGF-?_1 in patients with chronic hepatitis B virus.Methods 45 patients with chronic hepatitis B virus were randomized into control group(the routine strategy)and trial group(the routine strategy + low molecular weight heparin).The period of treatment is 3 weeks.Serum hepatic fibrosis indices before and after heparin treatment were examined by RIA,the levels of serum TGF-?_1 before and after heparin treatment were examined by ELISA.Results Hepatic functions became significantly better in trial groups,serum PⅢP and type IV collage levels and the levels of serum TGF-?_1 in trial group decreased significantly after treatment.Conclusions The mechanism of anti-fibrosis action of LMWH may inhibited production of TGF-?_1 in patients with HBV.

Objective A study on the loci variation characteristics of polymerase on area RT and it's clinical significance while a failure using Adefovir monotherapy antiviral treatment,by analyzing the HBV polymerase reverse transcription (RT) gene sequence of the serum from the chronic hepatitis B patients.Method By using retrospective analysis on the loci variation characteristics,clinical significance of polymerase on area RT and follow-up data from the 44 patients identified genetic mutations through the gene sequence of the HBV polymerase area RT,who had a virus re-activation after getting ADV mono therapy antiviral treatment.Result The 44 patients with Adefovir mono therapy,who had the mutation in area RT with the shortest treatment time eight months,up to five years,an average of(32.2 ± 6.7) months.The level fluctuations of the virus is between 103 copies/ml-108 copies/ml.After virological breakthrough,in these 44 cases,11 as A181T (25.0％),8 as A181V (18.2％),10 as 181T/N236T(22.7％),6 as A181V/N236T (13.6％),9 as N236T(20.4％); 40 cases (90.9％) appeared a biochemistry breakthrough,alanine aminotransferase index fluctuation during 37 IU/L-946 IU/L; Remedial treatment using combination lamivudine 23 cases,6 patients with jointing entecavir,than,1 case for jointing telbivudine,change single drug lamivudine in 4 cases,10 cases of single drug entecavir.Prognosis of severe disease (3 cases),and through the remedial treatment,42 cases was recovered.Conclusion ① RT area A181T (A181T/ N236T) variation accounted about a half of total(47.7％),after the drug resistance of the adefovir,2 years of follow-up,the incidence of liver cancer shows a higher trend than patients without A181T.②Conditions allowed,strong inhibitory effect medicines during tinitial therapy should be preferred,to low the incidence of drug-resistant HBV drug,avoid adverse events.

OBJECTIVETo study the clinical significance of hepatitis B surface antigen (HBsAg) levels and HBsAg/hepatitis B virus (HBV) DNA ratio in relation to liver inflammation in HBeAg-positive chronic hepatitis B (CHB).

METHODSOne hundred and fifty-three Chinese patients with chronic HBV infection with HBeAg-positive status were enrolled in the study.Quantitative measurements were made for HBsAg levels by immunoassay (Architect HBsAg QT by Abbott Diagnostic) and HBV DNA by real-time fluorescence quantitative PCR.Levels of liver function markers were measured by standard methods.Liver biopsy specimens were obtained from all patients and used to score the histology (liver inflammation) activity index (HAI) and grade (G) the extent of necroinflammation.Statistical correlation analysis was performed to determine the association of HBsAg titre or HBsAg/HBV DNA ratio with the various parameters of liver injury.

RESULTSHBsAg titre and HBsAg/HBV DNA ratio were significantly correlated (r =0.578, P less than 0.0001).A significant positive correlation (r =0.642, P less than 0.0001) was found between HBsAg titre and HBV DNA load, and a significant negative correlation was found between the HAI and HBsAg (r =-0.389, P less than 0.0001) and HBsAg/HBV DNA ratio (r =-0.307, P=0.000l).A significant positive correlation was found between alanine aminotransferase (ALT) level and the HAI (r =0.480, P less than 0.0001).Patients with G less than 2 necroinflammation had significantly higher HBsAg titre and HBsAg/HBV DNA ratio than patients with G more than or equal to 2 necroinflammation (both P less than 0.01) but similar levels ofHBV DNA.Generation of a receiver operating characteristic curve using G more than or equal to 2 as the positive index provided the following area under the curve (AUC) values:HBsAg titre, 0.700; HBsAg/HBV DNA ratio, 0.672; ALT level, 0.713.When the random chance AUC was 0.5, all levels of AUC were statistically significant (Pless than 0.001).HBsAg titre (sensitivity =76.92%) was more sensitive than ALT level (sensitivity =76.92%), and HBsAg/HBV DNA ratio (specificity =81.33%) was more specific than ALT level (specificity =81.33%).Youden's index for comprehensive evaluation using ALT was higher than those for HBsAg titre or HBsAg/HBV DNA ratio.When HBsAg and ALT were considered in parallel, the sensitivity increased to 94.08% and specificity rose to 85.60%.

CONCLUSIONHBsAg titre, HBsAg/HBV DNA ratio and ALT levels can be used as the index for judging the degree of liver inflammation in HBeAg-positive CHB patients.Higher sensitivity and specificity are attained when HBsAg and ALT are used in series or parallel.

Alanine Transaminase ; Area Under Curve ; Biomarkers ; DNA, Viral ; Hepatitis B e Antigens ; Hepatitis B virus ; Hepatitis B, Chronic ; Humans ; Inflammation ; ROC Curve ; Real-Time Polymerase Chain Reaction ; Serologic Tests

Immune checkpoint inhibitor (ICI) has been emerged as a major breakthrough in tumor immunotherapy, but its unique mechanism of action has also led to a number of immune-related adverse events (irAE). Type 1 diabetes mellitus (T1DM) is one of the rarest irAEs. This paper reports a case of advanced malignant liver tumor-induced T1DM who received second-line anti-PD-1 therapy and showed initial symptoms of hyperosmolar coma and hyperglycemia. In addition, the relevant literature at home and abroad was collected and reviewed, and the clinical characteristics of T1DM induced by anti-PD-1 therapy were summarized with a view to achieve early detection, diagnosis and treatment.

Objective To evulate the effection of HBV on controlled attenuation parameters(CAP)measurement of fatty liver using FibroScan(R).Methods Patients with only non alcohol fatty liverdisease (NAFLD),only chronic hepatitis B(CHB)and CHB combining with NAFLD (CHB + NAFLD) were complete the CAP measurement with FibroScan-502.Results 579 patients with CHB,624 patients with NAFLD and 124 patients with CHB + NAFLD were recruited.CAP values of CHB was 218.90 ±56.40 dB/m,significantly lower than that of NAFLD (290.85 ± 61.46 dB/m,P =0.00) and that of CHB + NAFLD (284.93 ±64.70 dB/m,P =0.00).It is no difference between CAP values of CHB + NAFLD and NAFLD (P =0.55).It is no difference between CAP values of high load of HBVDNA group and the low,high load of HBsAg group and the low,and HBeAg positive group and the negative (P =0.73,0.93,0.55).Conclusion HBV infection does not effect on CAP values of FibroScan(R).