Objective To investigate the efficacy of entecavir (ETV) sequential therapy in the treatment of hepatitis B e antigen(HBeAg) positive chronic hepatitis B(CHB) patients with suboptimal early response to Peginterferon-α(Peg-IFN-α).Methods The cases of HBeAg-positive CHB who were treated with Peg-IFN-α for 12 to 24 weeks and serum HBsAg ＞ 20 000 IU/mL were enrolled into observation group.Treatment naive HBeAg positive CHB with serum HBsAg ＞ 20 000IU/mL were enrolled into control group.Both two groups received ETV for 96 weeks.Hepatitis B virus (HBV) virological and serological data were collected every 12 weeks.Results At the end of 48-week and 96-week,the rates of HBeAg seroconversion in the observation group were 23.3％ (10/43),30.2％ (13/43),respectively,which in the control group were 23.1％ (12/52),28.8％ (15/52),respectively.The HBsAg decline at 24-week was observed in both two groups.Conclusion Sequential strategy for patients with suboptimal early response to IFN is preferable.

Objective To explore the 5,10-methylenetetrahydrofolate reductase (MTHFR) and 5-methyltetrahydro-folate-homocysteine methyltransferase reductase ( MTRR ) gene polymorphisms among the Han women in Zhangjiagang city .Methods A total of 4008 Han women were recruited .Their oral epithelial cells were collected to extract genome DNA in order to detect gene polymorphisms of MTHFR and MTRR using fluorescence quantitative PCR.Then the results were compared with those in other cities in China .Results The genotype frequencies of MTHFR C677T CC, CT and TT among Zhangjiagang women are 32.2%, 49.5%and 18.3%, respectively.The C allele frequency is 64.3%, T allele frequency is 35.7%.The genotype frequencies of MTHFR A1298 C AA, AC and CC are 68.7%,28.7% and 2.5%, respectively .The A allele frequency is 80.8%, C allele frequency is 19.2%.The genotype frequencies of MTRR A66 G AA, AG and GG are 54.4%, 38.5%and 7.1%, respectively . The A allele frequency is 76.3%, G allele frequency is 26.4%.Conclusions The MTHFR, MTRR polymorphism distribution of Han women in Zhangjiagang city is region specific.

Objective To examine cardiotoxicity of anthracyclines and trastuzumab in patients with breast cancer by two dimensional speckle tracking imaging. Methods Fifty-eight human epidermal growth factor receptors-2 (HER2) positive patients with breast cancer treated by anthracyclines and trastuzumab were monitored by echocardiography before treatment (Group A), after completion of anthracyclines (Group B), and at follow-up of 3 months (Group C) and 12months (Group D) after using trastuzumab. LVEDD, IVSTD, PWTD, LVEDV, LVESV were measured in the apical four- and two-chamber views. Left ventricular ejection fraction (LVEF) was measured using a modified Simpson's biplane method. Global longitudinal strain (GLS) and longitudinal strain rate (LSR) were calculated via Qlab8.0 analysis software off-line. Results LVEDDs in A-D groups were (47.95 ±4.12), (48.45 ±4.02), (48.91 ±3.83) and (49.98 ±3.72) mm, respectively, and LVEDVs were (108.70 ±21.26), (111.90 ±20.91), (113.50 ±20.25) and (119.20 ±20.02) ml, respectively. LVEDD, PWTD [(9.14 ±0.76) mm vs. (9.00 ±0.82)mm], LVEDV, LVESV [(54.60 ±14.58) ml vs. (50.97 ±14.35) ml] were increased in group B compared with those in A group (all P<0.05). LVEDD and LVEDV were increased in group C(P<0.05) compared with those in group B. CLVEDD, LVEDV, LVESV [(59.18±13.88) ml vs. (55.23± 13.81) ml] were increased in group D compared with group (P<0.05). Differences of LVEF between group C and group D were statistically significant[(59.48±2.62) % vs. (62.00±1.40) %, P<0.001]. Differences of GLS [(-21.16±2.33)%, (-19.76±1.98) %, (-19.22±1.89) % and (-18.74±1.79) %, respectively, P<0.001] and LSR [(-1.27±0.11), (-1.22±0.09), (-1.17±0.07) and (-1.14±0.06) /s, respectively, P<0.001] among four groups had all statistically significant. Conclusions Longitudinal left ventricle systolic function are impaired in patients with breast cancer treated by anthracyclines and trastuzumab. GLS and LSR of myocardium traced by two dimensional speckle tracking imaging would be useful for early evaluation of the severity.

Objective To observe the correlation between cardiac two-dimension global strain-speckle tracking imaging (2D-STI) and coronary artery disease index (CADi) scores in patients with acute myocardial infarction(AMI). Methods Eighty patients with AMI were chosen and given myocardial motion analysis using 2D-STI. The global longitudinal strain (GLS), global radial strain (GRS) and global circumferential strain (GCS) was calculated. All patients were given scoring according to CADi scores standard by coronary angiography. The correlations between 2D-STI indexes and CADi scores were analyzed. The area under curve(AUC) of the receiver operating characteristic curve (ROC) of critical coronary stenosis was calculated. Results GLS, GRS and GCS was all correlated to CADi scores (r=0.670, -0.621, 0.525, all P < 0.01). The sensitivity, specificity and AUC of GLS for critical coronary stenosis was 82.35%, 80.43% and 0.831. The sensitivity, specificity and AUC of GCS for critical coronary stenosis was 76.47%, 76.09% and 0.797. The sensitivity, specificity and AUC of GRS for critical coronary stenosis was 97.06%, 78.26% and 0.880. The AUC of GLS and GRS was larger than that of GCS, and the sensitivity, specificity for critical coronary stenosis was larger. Conclusions 2D-STI indexes have correlation with CADi scores. GLS and GRS has correlation with coronary artery stenosis.

Objective:To evaluate the left ventricular myocardial work parameters of the animal models with left bundle branch block (LBBB) and evaluate the effects of LBBB on left ventricular function and motion pattern by pressure-strain loops (PSL) of speckle tracking imaging (STI).Methods:In Twenty-four healthy male beagles, LBBB was induced by radio frequency ablation under anesthesia, and blood pressure was measured at the same time. Electrocardiograms and echocardiography images were acquired before (baseline), 30 minutes after (acute-LBBB) and 3 months after(chronic-LBBB) the creation of LBBB respectively. STI was applied to measure the left ventricular global longitudinal strain (GLS) and obtain the the PSL of each time point to evaluate the left ventricular global and segmental myocardial work parameters.Results:Compared to the baseline, the global work efficiencies(GWE) were obviously reduced ( P<0.05) and global wasted works(GWW) were significantly increased ( P<0.01) in the acute-LBBB and chronic-LBBB, significant differences were observed in GLS between acute-LBBB and baseline( P=0.04). In baseline, the work efficiency (WEsept) and the constructive work (CWsept) in the basal and middle segments of the septal wall were both obviously higher than the corresponding segments of left ventricular lateral wall( P<0.01), while the distribution of the wasted work(WWsept) was opposite( P<0.01). In acute-LBBB, the WEsept of all segments were significantly decreased ( P<0.05), the WWsept were obviously increased( P<0.05), the CWsept of basal segment was significantly reduced( P=0.01), while the wasted work in the basal segment of lateral wall(WWlat) was increased( P=0.04) compared with the baseline. Compared with the acute-LBBB, the WEsept of basal and middle segments were mildly recovery( P=0.03) in chronic-LBBB, but were still lower than the baseline ( P=0.001), the changes of the other myocardial work parameters of septal and lateral wall were similar to the acute-LBBB. Conclusions:Both acute-LBBB and chronic-LBBB can lead to the changes of left ventricular global and segmental myocardial work parameters. The myocardial work parameters of left ventricle can quantitatively analyze the changes of left ventricular function and motion pattern of the LBBB.

Aural vertigo frequently encountered in the otolaryngology department of traditional Chinese medicine （TCM） mainly involves peripheral vestibular diseases of Western medicine， such as Meniere's disease， benign paroxysmal positional vertigo， vestibular neuritis， and vestibular migraine， being a hot research topic in both TCM and Western medicine. Western medical therapies alone have unsatisfactory effects on recurrent aural vertigo， aural vertigo affecting the quality of life， aural vertigo not relieved after surgery， aural vertigo with complex causes， and children's aural vertigo. The literature records and clinical practice have proven that TCM demonstrates unique advantages in the treatment of aural vertigo. The China Association of Chinese medicine sponsored the "17th youth salon on the diseases responding specifically to TCM： Aural vertigo" and invited vertigo experts of TCM and Western medicine to discuss the difficulties and advantages of TCM diagnosis and treatment of aural vertigo. The experts deeply discussed the achievements and contributions of TCM and Western medicine in the diagnosis and treatment of aural vertigo， the control and mitigation of the symptoms， and the solutions to disease recurrence. The discussion clarified the positioning and advantages of TCM treatment and provided guidance for clinical and basic research on aural vertigo.