Nucleos(t)ide analogues (NAs) have been widely used in clinical practice as first-line antiviral drugs.In recent years, many clinical studies have found that some patients cannot reach a satisfactory therapeutic outcome.This article introduces the antiviral indications and follow-up of chronic hepatitis B and summarizes the influence of baseline characteristics, HBV genotype, HBV mutation and drug resistance, patients'' medication compliance, presence or absence of other diseases or viral infection, and serum vitamin D level on the antiviral effect of NAs.It is pointed out that appropriate timing for antiviral therapy, patient education before treatment, regular follow-up during treatment, and timely identification of comorbidities and drug resistance help to improve the antiviral effect of NAs and delay the progression of liver diseases.

Objective To evaluate efficacy and safety of porcine small intestine submucosa (SIS) for the repair of severe vaginal relaxation (stage Ⅳ) in women.Methods Biological repair meshes were fixed in 18 patients with stage Ⅵ vaginal relaxation,among which anterior walls were fixed in 12 cases,posterior walls in 5 cases,and both walls in 1 patient.Patients with POP underwent vaginal vault suspension first,then patient with SUI underwent transvaginal urinary incontinence surgery.Extravesicle fascia was transversely folded and sutured with 2-0 Mousse.The pelvic arch ligament together with vesicle fascia,SIS mesh and vaginal submucosa were sutured 3 stitches per side with 1-0 Mousse.Scar tissue at posterior vaginal wall was rhombically excised followed by transverse folding constriction of the rectovaginal fascia with 2-0 Mousse.A 1-0 Mousse was then used for colpoperineoplasty by suturing ruptured superficial anal sphincter,superficial transverse perineal muscle,and bulbocavernosus muscle.Patients were followed at 2,6,and 12 months post-operatively.Unsuccessful outcome was defined as diameter of outer 1/3 of vagina greater than 3.5 cm,or vagina prolapsed beyond hymen.Results The median follow-up was 13 months.Pelvic Organ Prolapse/Urinary Incontinence/Sexual Function Short Form Questionnaire (PISQ-12) was obtained in 13 patients and the score increased was noted (P＜0.01).Pelvic floor distress inventory-short form for scoring the quality of life (PFIQ) was collected from 18 patients and the score decreased was noted (P＜0.01).Pelvic floor impact questionnaire (PFIQ-7) was gathered in 18 patients and the score decreased was noted (P＜ 0.01).One unsuccessful case with stage Ⅱ anterior vaginal wall prolapse who underwent posterior vaginal wall fixed with patch ended with a diameter of outer 1/3 of vagina greater than 4.0 cm post-operation.Severe complications like infection,rosion,rejection or SUI were not noticed in any case.Conclusions The anatomical repair of pelvic floor is the most effective modality for vaginal rejuvenation.Adjunct SIS can enhance vaginal elasticity,reduce scar formation and recurrence,particularly.

Objective To discuss the relationship between bone mineral salt metabolism index change and bone density in different stage of chronic kidney disease (CKD).Methods Three hundred and forty-five non-dialysis patients with CKD were enrolled in this study.According to the serum creatinine (SCr),glomerular filtration rate (GFR),they were divided into stage 1-5.CKD 1 had 75 cases,CKD 2 had 65 cases,CKD 3 had 65 cases,CKD 4 had 65 casès,CKD 5 had 75 cases.The level of blood calcium (Ca),phosphorus (P) and SCr were detected by ion selective electrode method.The level of urea nitrogen (BUN) was detected by picric acid method.The level of intact parathyroid hormone (iPTH) and 1,25 (OH)2VitD3 were detected by chemiluminescence.Results With the decline of renal function,the level of iPTH and blood P increased gradually,especially in stage CKD 4 and CKD 5,and compared with stage CKD 1,there were significantly differences [(289.6578 + 187.7945),(482.0667 + 232.2065) μ g/L vs.(77.8431 + 52.9760) μ g/L and (1.6938 + 0.1960),(2.6034 ± 0.5986) mmol/L vs.(1.3833 ± 0.4068) mmol/L,P ＜ 0.05].The level of blood Ca and 1,25 (OH)2VitD3 decreased gradually,especially in stage CKD 4 and CKD 5,and compared with stage CKD 1,there were significantly differences [(1.9185 +0.4633),(1.8293 ± 0.3075) mmol/L vs.(2.0893 + 0.2245) mmoi/L and (10.0892 + 0.2638),(7.6058 +0.4356) ng/L vs.(18.0036 + 0.3218) ng/L,P ＜ 0.05].With the decline of renal function,the proportion of osteoporosis also gradually increased,especially in stage CKDS,and compared with stage CKD 1 and CKD 2,there was significantly difference [60.00％ (45/75) vs.20.00％ (15/75),23.08％ (15/65),P ＜ 0.05].Conclusion With the decline of renal function,the level of blood P and iPTH increase,and blood Ca,1,25(OH)2VitD3,bone density decrease,especially in stage CKD 4 and CKD 5 patients.

Objective To study the expressions of mucin (MUC) 1 and 2 in extramammary Paget's disease(EMPD) lesions. Methods Tissue specimens were obtained from the lesions of 19 patients with EMPD and normal skin of 19 human controls during cosmetic surgery. Streptavidin-perosidase (SP) technique was used to detect the expressions of MUC1 and MUC2 in these specimens. Results As haematoxylin-eosin (HE) staining showed, 3 cases were accompanied by poorly differentiated adenocarcinoma, 6 were invasive Paget's disease and 10 were intraepithelial EMPD. MUC1 was expressed in 2 cases accompanied by poorly differentiated adenocarcinoma, and in all the cases of invasive and intraepithelial EMPD; MUC2 was observed in all the cases of adenocarcinoma-complicated EMPD and invasive EMPD, but only in 2 of 10 cases of intraepithelial EMPD.Neither MUC1 nor MUC2 was observed in normal control specimens. A significant increase was observed in the expression of MUC1 in lesions of intraepithelial EMPD compared with invasive EMPD and adenocarcinoma-complicated EMPD (both P ＜ 0.05), and in the expression of MUC2 in lesions of invasive EMPD and adenocarcinoma-complicated EMPD compared with intraepithelial EMPD (both P ＜ 0.05). The expression of MUC1 was uncorrelated to that of MUC2 (r= -0.5, P＞ 0.05). Conclusions MUC1 is generally expressed in the lesions of EMPD, while MUC2 is expressed in those of adenocarcinoma-complicated EMPD and invasive EMPD.

Objective To study the expression and significance of antiapoptosis facter-clusterin in prostate neoplasm. Methods Reverse transcriptive polymerase chain reaction(RT PCR) was used to examine the expression level of clusterin in prostate cancer tissues(3 cases),prostate cancer cell line PC3M and normal prostate tissues(3 cases). Results Compared with the internal marker gene ? actin , the expression level of clusterin in prostate cancer is much higher than that of normal prostate. Conclusions The high expression level of clusterin in prostate cancer indicates that clusterin may play an important role in the biological characteristics of prostate cancer through the antiapoptosis pathway.

Objective To study the application of ESWL for ureteral stones in acute colic and with impairment of renal function. Methods From Mar.1987 to Sep.2000,emergent ESWL was performed for 168 cases of ureteral stone in acute colic and with impaired renal function on IVU (nonvisualization on IVU). Results All the patients got well after ESWL.104 patients less than 60 with a history of renal colic within 1 month have been followed up for 1 year.The renal function has reco vered and the urinary tract became visualized on IVU. Conclusions Ureteral stone may induce acute injury to the kidney but the harm is temporary and reversible when the ureteral stone is cured by ESWL on time.

Objective To present our attempt on investigate the effect of MMC on a human bladder cancer cell line, EJ cells. Methods EJ cells were maintained under tissue culture conditions in the presence of Mitomycin C (MMC), which had a potent cytotoxic effect on these cells. The apoptosis and necrosis of EJ cells were assessed and by using flow cytometry (FCM) ,TUNEL technology and eosin exclusion assay . Results Apoptosis of bladder cancer cell line EJ could be observed within the 24 h after the use of MMC in different doses.The apoptosis peak appeared in the 24th hour and a dose dependment effect could be observed. Conclusions MMC could inhibit the growth of bladder cancer cell via inducing apoptosis and necrosis of the cells.This might enclose the therapeutic mechanism of MMC on bladder cancer.

Objective To study whether tissue injury could be increased by double shock wave while it improves the efficiency of lithotripsy. Methods A series of experiment study on the tissue injury in vivo pigs with double and single shock wave as well as electromagnetic shock wave has been carried out. Results Under the conditions of 8 kV and 1 000 times concussion, the trauma range of kidney is 18 mm?15 mm?3 mm with single shock wave,and 14 mm?11 mm?2 mm with double shock wave,the trauma range of ureter is 42 mm with single shock wave and 30 mm with double shock wave.Under the same energy and concussion,the injury focus induced by double shock wave is small than that induced by single shock wave.Microstructure pathology shows that the characteristics of focus on renal artery,vein,glumeruli,renal tubules and ureter are similar. Conclusions Compared with the focus induced by single or by electromagnetic shock wave,the focus on the tissue of kidney and ureter induced by the double shock wave is smaller.

Objective To study the expression of dihydrodiol dehydrogenase (DD) in prostate cancer and its significance. Methods With reference to expression of ?-actin gene,the expression level of a human dihydrodiol dehydrogenase isoform (DD2) mRNA was examined in prostate cancer tissues (11 cases) and normal prostate tissues (10 cases) by reverse transcriptive-polymerase chain reaction(RT-PCR). Quantitative determination of relevant band densities was performed using densitometry-scanning techniques. Results Strong expression of DD2 mRNA was detected in prostate cancer tissures with absorbance in the range of 0.550 to 1.018 (median,0.726),and low expression of DD2 mRNA in normal prostate tissues with absorbance in the range of 0.248 to 0.420 (median,0.333). The difference of the expression of DD2 mRNA between cancer and normal prostate was significant ( P

Objective To investigate the effect of clusterin on the cytobiological features of bladder cancer EJ cells. Methods EJ cells were transfected using lipofectine-induced antisense oligonucleotide of clusterin,and their expression was blocked.The biological behaviors of EJ cells,such as proliferation,apoptosis and necrosis,were observed. Results Compared with the sense group which were transfected by sense oligonucleotide of clusterin,the antisense group which were transfected by antisense oligonucleotide of clusterin exprerienced increase in apoptosis of EJ cells,reaching the peak on day 5 with apoptosis rate of 80%.The difference between the 2 groups was statistically significant ( P