After the origin, definition and functions of core journal were described, scientifically understanding their value and accurately defining their functions were proposed.The current evaluation of military sciences core journals was analyzed with measures put forward for perfecting their evaluation systems.

Objective To compare the model for end-stage liver disease (MELD) and PT in survival prediction of hepatitis B patients with acute-on-chronic liver failure. Methods One hundred and thirty-nine hepatitis B patients with acute-on-chronic liver failure were divided into survival and death group, and evaluated by MELD and FT. The area under ROC curve was used to compare the MELD and PT. The mortality was observed within 3 months. Results The MELD score and PT of survival group was 25.09 ± 3.92 and (26.46 ± 6.46) seconds respectively, and those for the death group were 36.25 ± 6.42 and (40.78 ± 10.80) seconds. The differences were of statistical significance ( P < 0.01 ). MELD score showed significant correlations with PT(r =0.824, P <0.01). The area under ROC curve was 0.936 (95% CI 0.895 ± 0.977 ) on MELD score and 0. 890 (95 % CI 0.839 ± 0.941 ) on PT, and there was no significant difference between them. Conclusions Both MELD score and PT can accurately predict the short-term prognosis of hepatitis B patients with acute-on-chronic liver failure. The validity of prognosis by MELD is similar to PT. The mortality increases with the MELD score and PT increasing.

Objective To investigate the blood glucose control level,the characteristics of complications and treatment programme in senile patients with type 2 diabetes.Methods From Aug 2010 to Jul 2011,gender,age,height,weight,disease course and underlying disease were recorded in 119 patients with type 2 diabetes aged 80 years and over.The levels of glycosylated hemoglobin (HbA1c),fasting C-peptide (FC-P) and 2 hours postprandial C-peptide (2h C-P),urinary albumin excretion rate (UAER) were tested.Ultrasonic Doppler examination of lower-limb arteries as well as non-mydriatic colour eye-ground photography were also examined,peripheral nerve lesions were evaluatcd according to the criteria of diabetic neuropathy system (DNS).The patients were divided into two groups:HbA1c＜7.0％ group (65 cases) and HbA1c ≥ 7.0 ％ group(54 cases).Results The disease course[(12.1±8.5)years vs.(16.6±7.5)yeas,t=3.01,P=0.003],UAER[(20.2±11.9)μg/min vs.(47.0±21.4)μg/min,t=2.48,P=0.015] and incidence of diabetic nephropathy [23.1％(15/65)vs.50.0％(27/54),x2=9.36,P=0.002] were all less in HbA1c＜7.0％ group than in HbA1c ≥ 7.0％ group,while the levels of FC-P and 2hC P were higher in HbA1c＜7.0％than in HbA1c ≥ 7.0％ group[(2.1±1.2)μg/L vs.(1.5±1.0)μg/L,t=1.87,P=0.042; (6.5± 3.3)μg/L vs.(4.3 ± 2.9) μg /L,t =2.10,P =0.037].The proportion of patients who took oral hypoglycemic agents was increased while those who received insulin therapy decreased in HbA1c＜7.0％ group (all P=0.000).The α-glucosidase inhibitors were the most commonly used in each group,followed by metformin and insulin secretagogue,and the thiazolidinediones were rarely used,while there was no significant difference in the proportion of medicine between the groups.The overall incidence of symptomatic hypoglycemia was 23.5％(28/119).It was higher in HbA1c ≥ 7％ group than in HbA1c＜7.0％ group[33.3％(18/54)vs.15.4％(10/65),x2 =5.20,P=0.022].However,71.4％(5/7)of the patients with hypoglycemic coma came from HbA1c＜7.0％ group.Conclusions There are obvious individual differences in blood glucose control and complications among senile type 2 diabetes patients,thus the characteristics of the elderly should be considered in the choice of drugs while hypoglycemic events should be paid more attention.

Objective To investigate the causes of biliary tract complications after liver transplantation, and to put forward effective measures of prevention, diagnosis and treatment. Methods The literatures of recent years were reviewed and summarized. Results The causes of biliary tract complications after liver transplantation are very complex, and there are no standard preventive measures. Treatment differs according to causes. Conclusion One of the most important causes leading to biliary complications is preservative and ischemic injury. Poorly operative techniques and blood supply to biliary tract are also disastrous. Improving T tube placement can reduce the incidence of biliary complications related with T tube. To prevent biliary complications, it is crucial to completely wash the biliary tract, avoid damaging the blood supply to donor biliary tract and manage perfect biliary mucosa-to-mucosa anastomosis without tension. T tube cholangiography combined with noninvasive MRCP enables accurate depiction of the biliary tree and diagnosis of biliary complications. Doppler ultrosonography should be routinely applied postoperatively. Timely application of interventional radiological technique is a valuable nonoperative procedure for treatment of biliary complications. Meanwhile, biliary sludge or cholestasis and mixed infections of biliary tract should be handled actively and properly.

With the improvement of cataract operation, the cataract surgery has become increasingly perfect. The cataract patients show greater expectation for the result of cataract operation. As a result, refractive cataract surgery has become the main trend. Detailed investigations of corneal diseases, lens density, corneal topography, preferable intraocular lens ( IOL ) choice, and IOL power calculation can help us get a better knowledge of preoperative conditions on patients, which can be conducted with pentacam. So we can have a better forecast of post - operative outcome and improve the quality of vision for cataract patients after surgery.

Objective To investigate the clinical efficacy of gemcitabine and cisplatin chemotherapy combined with CT guided microwave ablation used in treatment of advanced squamous cell lung cancer. Methods 76 patients with lung squamous carcinoma in our hospital from April 2013 to July 2015 were selected,and randomly divided into treatment group and control group,38 cases in each groups. The control group were treated with gemcitabine and cisplatin chemotherapy. The patients in the treatment group in the control group based on the combined CT guided ablation under microwave, after the end of treatment to evaluate the efficacy of the two groups of patients, observe two groups of patients with adverse reactions, and were followed up for 1-2 years. Results The total effective rate of treatment group was significantly higher than the control group (P<0.05); pneumothorax treatment group after microwave ablation in patients with 2 cases, 3 cases of hemoptysis, 2 cases of fever, recovered after symptomatic treatment. The adverse reactions of the two groups due to chemotherapy caused by comparison of the rate of no significant difference; the treatment group of patients with PFS was significantly longer than the control group, the 1 year survival rate and 2 year survival rate was significantly higher than the control group(P<0.05). Conclusion Gemcitabine combined with cisplatin chemotherapy regimen combined with CT guided microwave ablation is effective in the treatment of advanced squamous cell lung cancer, and is worthy of clinical promotion.

Objective To evaluate the risk factors of gallstone occurrence after gastrectomy for gastric cancer.Methods Relevant documents published from 1990 to 2014 were retrieved through Pubmed,Cochrane Library,Embase,Web of Science CNKI,Wan Fang and VIP databases search.The Meta-analysis was applied with RevMan 5.3 software for Odds ratio and 95％ CI.Results 24 studies were selected for this Meta-analysis which included 3 randomized controlled trials,13 cohort studies and 8 case-controlled studies.These 24 studies included patient number which ranged from 32 to 893.The pooled OR (95％ CI) and P values of OR (95 ％ CI) for physiologic digestive tract reconstruction were 0.53 (0.44 ～ 0.65,P ＜ 0.05) ;amount of resection of stomach,1.98 (1.29 ～ 3.04,P ＜ 0.05) ; lymphadenectomy,0.38 (0.21 ～ 0.72,P ＜ 0.05) ; vagotomy,0.24 (0.13 ～ 0.45,P ＜ 0.05) ; and pylorus preservation,0.70 (0.48 ～ 1.02,P ＞ 0.05).Conclusions Physiologic digestive tract reconstruction and vagus nerve preservation reduced occurrence of gallstones after gastrectomy.On the other hand,total gastrectomy and extensive lymph node dissection increased the occurrence.There was no significant difference in the occurrence of gallstones whether there was pylorus preservation or not.

Objective To explore the effect of oleanic acid on key enzyme activity in insulin-resistant HepG2 cells. Methods The HepG2 cells were divided into normal control,model control,metformin,and oleanic acid groups.Glycogen content in insulin-resistant HepG2 cell model were detected by hepatic glycogen test kit upon treatment with oleanic acid.Activities of glucokinase ( GK) ,phosphoenolpyruvate carboxylase kinase (PEPCK),and glucose-6-phosphatase (G-6-Pase) were assayed by the glucose 6-phosphate dehydrogenase coupling colorimetric, lactate dehydrogenase coupling colorimetric and ammonium molybdate constant phosphorus methods. Results The oleanic acid enhanced glucose consumption,lowered the activity of G-6-Pase and PEPCK by 54.8% and 18.8%,respectively,and increased the activity of GK and glycogen content in also insulin-resistant HepG2 cells by 100.6% and 98.6%,respectively. Conclusion Aqueous extracts of shirako play a role in lowering PEPCK and G-6-Pase activities and inhibiting glucogenesis, resulting in the reduction of endogenous glucose in the cell. In addition,it can augment the activity of GK,accelerate the process of glucolysis,increase the glycogen content,and alleviate insulin resistance of HepG2.

Objective:To study the HBV infection in peripheral blood mononuclear cells in mediating the role of mother -to-child transmission of hepatitis B virus.Methods: The peripheral blood mononuclear cells ( PBMCs ) in maternal and cord blood mononuclear cells ( CBMCs ) in newborns were conventionally isolated by Ficoll-Hypaque medium.The loads of HBV-DNA in peripheral blood of maternal and cord blood of newborns were both detected by PCR .Results:The clinical data showed that the positive detection rates of HBV-DNA in serum and PBMCs of pregnant women with HBeAg (+) were 100.00%( 25/25 ) and 72.00%( 18/25),and the positive detection rates of HBV-DNA in the neonatal umbilical cord blood serum and CBMCs were 60.00%(15/25) and 44.00%(11/25),respectively.There were significantly difference between HBeAg (+) and HBeAg(-) in the pregnant women (P<0.05 ).The positive detection rates of HBV-DNA in neonatal umbilical cord blood serum and CBMCs were higher in the group with high HBV loads (more than 106copies/ml) in PBMCs than those of low HBV loading group (102-103copies/ml).The significantly difference was explored between the two groups.Conclusion: Mononuclear cells can not only be infected by HBV , but also play a critical role in the intrauterine vertical transmission of HBV via the pathway transmitted from PBMCs in pregnant women to CBMCs in newborns.

POEMS syndrome is a rare clonal plasma cell disease characterized by polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes. Significant advances have been made in the diagnosis and treatment of POEMS syndrome over the last decade. In this study, we reviewed the diagnostic criteria and characteristic features of POEMS syndrome. We also focused on the role of the characteristic features of POEMS syndrome in early diagnosis. Autologous peripheral blood stem cell transplantation has become the first-line treatment for younger patients with normal organ function because it has resulted in a high response rate and durable remission. Melphalan and dexamethasone is an effective and well-tolerated treatment for older patients and those with organ dysfunction. Patients with poor performance status or renal function can benefit from novel agents that can also improve transplantation eligibility.