AIM:Anti-hepatis B immunoglobulin in combination with lamivudine is efficient to prevent chronic hepatitis B virus (HBV) reinfection following liver transplantation. However, long-term usage of lamivudine can result in YMDD variation and lead to medicine resistance even HBV relapse. In this study, we investigated etiological factors and prevention and treatment protocol of HBV recurrence and YMDD variation after liver transplantation. METHODS:A computer-based online search of Pubmed database from January 2002 to January 2008 and Chinese Journal Full-text Database from January 2003 and December 2007 was undertaken to identify articles about HBV recurrence and YMDD variation after liver transplantation. The collected articles were firstly selected and the references of each article were looked up. Only articles that involved in HBV recurrence and YMDD variation after liver transplantation were included. The articles published in authoritative journals in recent 5 years were accepted in priority. Repetitive articles and Meta analysis were excluded. RESULTS:HBV recurrence after liver transplantation is associated with hepatitis B DNA loading dose, invasion of hepatitis B into non-liver tissues, immunosuppressive therapy and viral genovariation. The major prevention and treatment protocol of HBV reinfection after liver transplantation is the combination of anti-hepatis B immunoglobulin and lamivudine, which is economical and efficient. However, long-term administration of lamivudine induces YMDD variation in hepatitis B DNA polymerase, leading to drug resistance even HBV recurrence. Now adefovir dipivoxil is regarded as an effective remedy for YMDD variation. CONCLUSION:Virus variation and HBV recurrence can influence prognosis of HBV-related end-stage diseases after liver transplantation. Prevention and cure approaches are developing. It is important to find an economic, safe, convenient and effective therapeutic regimen. In addition, individualized treatment and the evaluation of risk and advantage should be emphasized.

Objective To compare the hemodynamic response to orotracheal intubation by Macintosh laryngoscopy (MAC) with Shikani optical stylet (SOS). Methods Forty neurosurgical patients, ASA physical status Ⅰ~Ⅲ, were prospectively randomized to MAC group (n = 20) and SOS group (n = 20) according to the method of orotracheal intubation. Heart rate (HR) and invasive systolic blood pressure (SBP) were recorded at pre- and post-intubation. Results The intubation time was significantly longer in SOS group than in MAC group [(22 ± 8) s vs. (17 ± 8) s, P < 0.05]. SBP in both groups decreased significantly after induction (P < 0.05) and increased greatly at 1 and 2 min post-intubation (P < 0.05), but did not differ at 3, 4 and 5 min. HR in both groups did not differ significantly between the SBP after induction. HR in both groups increased greatly at 1 and 2 min post-intubation (P < 0.05), but did not differ markedly at 3, 4 and 5 min after induction. There were no significant differences in the peak SBP and HR between the two groups. Conclusion MAC and SOS cause similar hemodynamic responses to orotracheal intubation.

Hepatic myelopathy is a rare disease with high mortality. There has been no report of an effective treatment to date. In order to evaluate the beneficial effect of orthotopic liver transplantation in patient with hepatic myelopathy. One patient, who was suffering from hepatie myelopathy complicating hepatic pathology, underwent liver transplantation in 2002 was studied. The muscle strength of the patient’s extremities was carefully assessed both pre-operatively and postoperatively. It was found that symptoms and signs of hepatic myelopathy were improved, especially the muscle strength recovered from 1-2 degree to 3-4 degree half a year after the operation. Therefore it is our belief that liver transplantation might be beneficial to patients who are suffering from hepatic myelopathy as a complication of the hepatic disease.

Objective To observe the therapeutic effects and side-effects of tacrolimus (FK506) in the recipients who had undergone liver transplantation, and summarize the clinical experience of its use. Method The clinical data of 36 recipients of allogeneic liver transplants followed by tacrolimus-based anticoagulant regimen were retrospectively analyzed. After liver transplantation, all the recipients received the triple-drug immunosuppressive protocol, including tacrolimus as the basic drug, mycophenolat-mofetil (MMF), and prednisone. Twenty-four of 36 cases received Zenapax as an antibody induction therapy. Results Acute rejection occurred in 3 of 36 cases. After the use of methylprednisolone and OKT3, acute rejection was reversed. The main side-effects of tacrolimus were nervous system disturbance(40.0%), hypertension(13.3%), hyperglycemia(26.7%), and liver dysfunction(6.7%). Conclusion Tacrolimus is a safe and potent immunosuppressive agent, which can decrease the incidence of rejection in liver transplant recipients. The dosage of tacrolimus should be adjusted according to trough level with in the therapeutic window. The timely and appropriate adjustment of the immunosuppressive strategy is essential for the recipient and graft survival. Meanwhile, it is emphasized that the regime should be individualized. [HS(1*2/3]

OBJECTIVE:To evaluate the efficacy and adverse effects of paroxetine alone or in combination with small dose of doxepin for somatization disorder.METHODS:280 patients with somatization disorder were randomly assigned to receive paroxetine alone or in combination with small dose of doxepin for 8 weeks.Clinical global impression scale(CGI)and symptom check list(SCL-90)were used to assess the efficacy,and treatment emergent symptom scale(TESS)was used to assess the adverse effects.RESULTS:After treatment for 8 weeks,CGI score showed the total effective rate was 87.5% in the patients treated with paroxetine alone versus 93.8% in those treated with paroxetine in combination with small dose of doxepin(P0.05).CONCLUSION:Paroxetine in combination with small dose doxepin showed better efficacy for somatization disorder yet without increasing adverse effects as compared with paroxetine alone.

Objective To analyze the characters about anticoagulation EDTA on the platelet aggregation ,and discuss the risk factors about EDTA‐PTCP by analyzing the biochemical parameters .Methods 30 700 EDTA‐K3 blood samples were collected from January 2014 to August 2015 .WBC was performed using Sysmex XN‐3000 and 27cases were identified of EDTA‐PTCP .The blood samples of 27 subjects were recollected and WBC was repeated using EDTA‐K3 and sodium citrate blood ,respectively .Manual platelet counting and smear microscope examination on periphery blood were also performed .Biochemical parameters of 27 subjects with EDTA‐PTCP were compared with 50 randomly selected non EDTA‐PTCP controls .Results Platelet counts in citrated blood were significantly higher than EDTA blood ,the difference was statistically significant(P< 0 .05) ,but similar to manual platelet counting(P>0 .05) .ALT ,Glu and TG in patients with EDTA‐PTCP were significantly higher than normal people ,but HDL was significantly lower than control group ,the difference was statistically significant(P<0 .05) .Conclusion EDTA‐dependent pseudo‐thrombocytopenia varies from people with different disease or using different medicine .It may be relative to hyperglycemia and hy‐perlipidemia .Another approach for rectifying ,changing anticoagulant or manual platelet counting is a better way lead to correctly di‐agnose when EDTA‐PTCP occurred .

Objective To establish the basis of molecular systematics of Angelica from different areas of Gansu province so as to offer molecular basis of identification Gansu-produced Angelica with geoherbalism. Methods The ITS gene of Angelica was obtained by PCR and sequenced to be analyzed by DNAStar software to calculate the genetic distance among different specimens. Results The ITS sequence of Angelica between Min County and Zhang County of Gansu Province shows trivial differences with the range of 0.000 0～0.008 3. All 5 Min County-produced Angelica specimens have same bases at 586 site with "C" and 589 site with "T" with Zhang County-produced Angelica DG9 specimen, whereas the 586 site and 589 site bases of the other 3 Zhang County-produced Angelica specimens are "T" and "G" respectively. Conclusion The ITS sequence characteristics can be recognized as effective molecular marker of Angelica, and both 586 site base and 589 site base of the ITS sequence of Angelica can be recognized as identification bases of Min County-produced Angelica.

Objective To study the effects of pulsed radiofrequency(PRF)and radiofrequency thermocoagulation(RFTC)in the treatment of idiopathic infraorbital neuralgia.Methods 16 patients suffering idiopathic infraorbital neuralgia were randomly divided into PRF(n=8)and RFTC(n=8).Numeral rating scale(NRS),pain relief(PR)and effective rate of treatment was performed before operation and at 1 hour、1 st day、7th day、15th day、1 st month、3rd month and 6th month after operation.Results The preoperative and postoperative impedance of thefirst,second and third operation in RFTC group were(490±86)Ω and(424±82)Ω,(492±90)Ω and(432±84)Ω,(481±98)Ω and(409±85)Ω respectively and the postoperative impedance was significantly decreased(P＜0.05).The preoperative NRS in group PRF and RFTC were 9(7～10)and 8.5(7～10)respectively and the postoperative NRS at all points in two groups were significantly decreased as compared with the preoperative NRS(P＜0.05).The PR at 7 and 15d in group PRF were 3(0～4)and that in group RFFC were 4(3～4)(P＜0.05).There were no significant differences in effective rate of treatment at each time between two groups(P＞0.05).Numbness appeared after operation in group PRF and disappeared in a week,however,that was persistent and all sense disappeared in group RFTC.Conclusion Curative effect of PRF for idiopathic infraorbital neuralgia is as well as RFTC and it is a kind of safe and effective technology that causes less side effects.

The patterns of efficient components recognition and quality control for Chinese materia medica (CMM) have been the difficult and hot topics for CMM modernization.To get a radical and significant breakthrough in the investigation on the efficient component recognition and quality control standard for CMM,a tentative idea about efficient component recognition and quality control pattern for CMM based on constituent knock-out/knock-in is initially proposed in this article on the foundation of retrospective and prospective analyses.And its main aim is to provide some creative and practical ideas and methods to recognize the key efficient components of CMM precisely and quickly,and to meet with the requirements that the quality control standards for CMM will be effectiveness-related,quantitative and accurate,controllable and assessable.

Objective To survey the value of risperidone in the treatment of depression without psychotic symptoms. Methods 205 depressive patients were randomly divided into 3 groups: risperidone group, fluoxetine group and combined group (risperidone+fluoxetine). They were assessed with Hamilton Depression Scale (HAMD), Treatment Emergent Symptom Scale (TESS) before treatment and in 2nd week, 4th week, 6th week and 8th week after treatment. Results The reduction rate of HAMD of combined group was the best among three groups(P<0.05), and that of fluoxetine group was better than that of risperidone(P<0.01). The significant difference in reduction rate of HAMD between combined group and other two groups was observed since 2nd week after treatment(P<0.05). No difference in scores of TESS has been observed in any time among three groups. Conclusion Risperidone can improve the efficacy of fluoxetine on depression without psychotic symptoms without increasing side effects, but itself is less effective than fluoxetine.