Nucleoside and nucleotide analogs (NAs) have been successfully used for treatment of chronic hepatitis B. Hepatitis B virus (HBV) replication is now recognized as the key driver of liver injury and disease progression, so the primary aim of treatment for chronic HBV infection is to maximize sustained suppression of HBV replication to undetectable levels. The long-term treatment has also been shown to achieve substantial histological improvement and regression of liver fibrosis or cirrhosis, and reduction of hepatocellular carcinoma. This paper has reviewed the necessity, clinical benefits, and the management of long-term treatment for chronic hepatitis B.
Antiviral Agents ; Carcinoma, Hepatocellular ; Hepatitis B virus ; Hepatitis B, Chronic ; Humans ; Liver Cirrhosis ; Nucleosides ; Virus Replication

Objective:To presents a new way of constructing post crowns for the anterior maxillary teeth which had the subginginval crown fracture more than 3 mm.To discusse the difficulties in the restoration of the subgingival residual roots and residual crowns of anterior maxillary teeth,and to explore the principles of the new restoration by the casting post-core and the porcelain fused mental crowns with wings. Methods: 23 patients(26 teeth) which had crown fracture more than 3 mm under the gingival were enrolled in this study.After those residual roots and crowns were endodontically treated following the conventional root canal therapy,the casting post-core and the porcelain fused mental crowns with wings were applied to reconstructing those missing crowns. Results: After 3 months to 5 years clinic observation,restored crowns were still stable with good retention and fracture resistance. Conclusion: Those residual roots and crowns can be preserved by this innovative way and can also acquire satisfactory effects in esthetics and functions.

Objective To estabolish a scientific, objective, comprehensive and quantitative combined with qualitative evaluation indicator system for research input-output effeciency, which is applied especially for grade 3 and firt-class hospital in Xinjiang Uygur aotunomous region.Methods We analyzed the research input-output effeciency of one hospital.We performed three time questionaires to 25 experts who come from different fields, by using Delphi method and analytic hierarchy process.Based on screening estimation of experts, we determined the indicators, the weight and the standards of each indicator, the logic consistency of the above were tested, and the model of input-output ratio was set up.Results The response rate of three-time quesitonaires was above 85％.Authority coefficient of estimation indicators from experts was above 0.7.The kandall coefficient of concordace was between 0.179 and 0.442, P＜0.01.We estabolished evaluation indicator system for research input-output effeciency composed of 5 grade Ⅰ indicators, 12 grade Ⅱ indicators and 28 grade Ⅲ indicators.Conclusions This study result is reliable, the index system conform to the industry standard and regional characteristics.In order to improve the hospital performance level, increaseing investment in scientific research should be needed.Combined with scientific research input-output, the management should take measures to optimize the allocation of resources, broaden the way of project application fighting for money, pay attention to personnel training amd form a scientific research team.

Objective To investigate the distribution of acquired resistance-related genes and markers of mobile genetic elements, and their relationships in multidrug-resistant Escherichia coli. Methods From October 2008 to March 2009, 28 strains of multidrug-resistant Escherichia coli isolated from urine were collected from the Ningbo First Hospital. Then, 47 kinds of acquired resistance genes to beta-lactams, aminoglycosides, quinolones, 2 kinds of acquired drug efflux gene and 13 kinds of genetic markers of mobile genetic elements: conjugal plasmids, transposons, insertion sequences, and integrons were analyzed by PCR. The index cluster analysis was used to investigate their relationships. Results In 28 strains of Escherichia coli, 7 kinds of acquired beta-lactam-resistance genes, 8 kinds of acquired aminoglycosideresistance genes, 1 kind of acquired drug efflux gene, 2 kinds of genetic markers of conjugal plasmids, 3 kinds of genetic markers of transposon and insertion sequences, 1 kind of genetic marker of integron were detected; but other 46 kinds of genes were not detected. Two clusters, A and B, were divided by index cluster analysis depending on positive genes. Conclusions In this group of Escherichia coli, acquired resistance related genes may be associated with resistant phenotypes of antimicrobial agents. Horizontal transfer of mobile genetic elements may bring rapid spread of resistance of bacterial pathogens, not only among the same kind of pathogens, but also among the different kinds. In addition, index cluster analysis suggests that correlation might exist between acquired resistance-related genes and mobile genetic elements.

Objective:To evaluate the efficacy of occlusal rehabilitation in old patients with decreased vertical dimensions caused by serious attrition.Methods:Sixty-five patients with decreased vertical dimension caused by serious attrition were divided into 3 groups according to the defect of dentition and/or TMD.Group A included 42 patients with serious attrition and defection of dentition.Group B had 15 patients with heavy tooth wear,defection of dentition and TMD.Group C included 8 patients with serious attrition and functional TMD.All patients were conducted occlusal rehabilitation at increased vertical dimensions in normal intercuspital position(ICP) by removable denture with occlusal pad and removable occlusal splints.The time of follow-up visit of these patients ranged from 1.5 months to 9 years. Results:The masticatory efficacy of the patients was obviously improved,and all the symptoms of TMD were relieved.Furthermore,the symptoms of TMD were not observed after the treatment in patients without TMD.Conclusion:The results achieved by removable occlusal rehabilitation to aged people with serious attrition and decreased vertical dimension are satisfactory,and suggest that the occlusal rehabilitation is necessary for them.Furthermore,the removable occlusal rehabilitation can be acted as a reference and transition to permanent fixed occlusal rehabilitation.

Abstract: To report on two patients with Coronavirus Disease 2019 (COVID-19) combined with diffuse connective tissue disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection followed for nearly 3 years, in order to understand the long-term effects on the patients' immune system. Both patients were male, aged 81-82 years, and were hospitalized with fever on January 29, 2020 and February 10, 2020, respectively. Both were diagnosed with COVID-19 after positive SARS-CoV-2 polymerase chain reaction (PCR) tests. After receiving anti-infection treatment, cough suppressants, ex‐pectorants, and symptomatic supportive treatment, their body temperature returned to normal and two consecutive PCR tests were negative for SARS-CoV-2, and they were discharged from hospital. However, due to recurring fevers and varying degrees of rheumatic disease-related symptoms, both patients were readmitted to the hospital, indicating the presence of positive auto‐ antibodies and organ involvement. One patient recovered from COVID-19 with recurrent fever, joint pain, muscle aches and subcutaneous nodules, and was subsequently diagnosed with undifferentiated connective tissue disease. The other patient developed recurrent fever, mouth ulcers and rash after recovery from COVID-19 and was subsequently diagnosed with anti neutro phil cytoplasm antibody (ANCA)-associated vasculitis (AAV). The patient was treated with glucocorticoids and immunosuppres sive drugs and the symptoms resolved rapidly and subsequent laboratory and imaging examinations showed stable condition. However, due to self-termination of medication, their symptoms quickly relapsed, and further treatment with glucocorticoids and immunosuppressive agents resulted in sustained stability of their condition. The erythrocyte sedimentation rate and hyper‐sensitive C-reactive protein remained within normal limits, and lung CT scans showed stable lesions with partial absorption.SARS-CoV-2 infection may have long-term effects on patients' immune systems, leading to abnormal immune responses and diffuse connective tissue disease. This suggests that regular follow-up observation of immune system-related diseases may be necessary for elderly patients with COVID-19.

BACKGROUND:The majority of published article on cardiopulmonary resuscitation (CPR) used healthy animals. In fact, patients commonly have severe heart diseases before CPR, leading to ventricular fibrillation. OBJECTIVE: To investigate outcome of myocardial function and cardiopulmonary resuscitation in myocardial infarction rats treated with bone marrow mesenchymal stem cells (MSCs) transplantation.DESIGN, TIME AND SETTING: A randomized, controlled animal experiment was performed at the University of Southern California and Second Hospital of Sun Yat-sen University from April to August 2007.MATERIALS: A total of 18 adult male SD rats were randomly divided into model control and cell transplantation groups with 9 animals in each group. In addition, 1 SD rat aged 1 month was used to prepare bone marrow MSCs.METHODS: Myocardial ischemia was induced by ligation of the left anterior descending artery (LAD). Animals respectively received 5×106 MSCs (0.1 mL) marked with PKH26 in phosphate buffer solution (PBS) or PBS alone 4 weeks after LAD ligation. Ventricular fibrillation and CPR were performed 4 weeks after MSCs or PBS injection.MAIN OUTCOME MEASURES: Heart function was evaluated by ultrasound cardiography 2, 4 weeks after transplantation; hemodynamics was measured before and 4 hours following CPR. Myocardial tissues were harvested 72 hours after CPR for pathological exanimation.RESULTS: Compared with model control group, ejection fraction of transplantation group was significantly increased 2 and 4 weeks after transplantation (P<0.01), and cardiac index, dp/dt40, and -dp/dt were significantly improved before and within 4 hours after CPR (P<0.01, P<0.05). Moreover, the rats survived longer in transplantation group (72 hours) after CPR compared with control group (P<0.05). Pathological section results showed a large number of PKH26-1abeled MSCs in the rnyocardium.CONCLUSION: Myocardial function, hemodynamics and survival time after CPR were significantly improved in animals treated with MSCs transplantation.

Guidelines as Topic ; Hepatitis B, Chronic ; drug therapy ; prevention & control ; Humans

OBJECTIVE:To observe the efficacy and safety of moxifloxacin combined with Jiehe pill in the treatment of muilt drug-resistant tuberculosis(MDR-TB). METHODS:116 patients with MDR-TB were randomly divided into control group and ob-servation group. Control group was given Moxifloxacin hyohochloride tablet 0.4 g once a day,observation group was additionally given Jiehe pill 9 g,twice a day,and 2 groups were given rifapentine,albendazole isoniazid,amikacin,pasiniazide,pyrazin-amide,p-amino salicylic acid and other conventional treatment. The treatment course for both groups was 18 months. The clinical efficacy,and T cell subsets (CD3+,CD4+,CD4+/CD8+),interferon(INF)γ,interleukin(IL)4 levels before and after 6,12 and 18 months,and incidence of adverse reactions in 2 groups were recorded. RESULTS:The total effective rate in observation group was significantly higher than control group,the difference was statistically significant(P<0.05). After treatment,CD3+,CD4+,CD4/CD8 and INF-γ level in 2 groups were significantly higher than before and gradually increased by time,and observation group was high-er than control group;IL-4 level was significantly lower than before and graually decreased by time,and observation group was lower than control group,the differences were statistically significant(P<0.05). There was no significant difference in the inci-dence of adverse reactions(P>0.05). CONCLUSIONS:Based on the coventional treatment,moxifloxacin combined with Jiehe pill has better efficacy than moxifloxacin in the treatment of MDR-TB,with similar safety.

Objective To investigate changes in plasma levels of D-dimer in patients with prostate hyperplasia(BPH)complicat-ed with acute urinary retention(AUR),and to explore its clinical significance.Methods 102 cases of patients with prostate hyper-plasia complicated with acute urinary retention,treated in this hospital from July 2013 to December 2014,were selected and divided into the simple BPH group(56 cases)and BPH complicated with AUR(BPH+AUR)group.The plasma levels of D-dimer of these patients were detected and comparatively analysed.Results Compared with the simple BPH group,the plasma levels of D-dimer of patients in the BPH+AUR group was increased,had statistically significant difference.(P <0.01).Conclusion The plasma levels of D-dimer in patients with BPH complicated with AUR increase significantly,which indicates that patients are with secondary in-creased fibrinolytic activity.Measures should be taken to relieve urinary retention as soon as possible,so as to protect the vascular endothelial function of patients and reduce the incidence of complications.