Drug-resistance mutation is inevitable during long-term monotherapy with nucleus(t)ide analogues in hepatitis B patients.Early detection the drug-resistance mutations could contribute to adjusting the therapeutic regimen,reducing resistance rate,improving therapeutic efficacy and performing individual treatment.

Despite decades of the prevention and control.China is still one of the countries with high prevalence of hepatitis B virus (HBV).It is imperative for us to innovate.Lab diagnostic platforms for drug-resistant mutation and HBV genotyping to enhance the management level in patients with CHB.Specifically,the following three strategies should be included:firstly,choose an appropriate platform for drug-resistant mutation detection according to the actual situation in laboratory.Secondly,establish a practical and simple genotyping platform for real-time monitoring of HBV genotypes.Thirdly,combined with clinical,explore the correlation among genotypic resistance,phenotypic resistance and clinical resistance when different medications are adopted,confirm the percentage or threshold of resistant strains causing clinical resistance,and ascertain the influence of HBV genome polymorphism (genotype) on clinical prognosis.These strategies above mentioned will lay a foundation for CHB personalized treatment and prognosis.

AVNRT, (3)There was no evidence of new arrhythmia occurring for the late electrophysiologic sequelae of RFCA lesions. Conclusion The technique of RFCA is safe, it causes significant minor myocardial injury and takes 3 months to develop from initially resembling coagulation necrosis to fibrosis. There is no evidence of new arrhythmia occurring for late electrophysiologic sequelae of RFC lesions.

Objective:To establish the high performance liquid chromatography (HPLC) combined with switching wavelength method to determinate chlorogenic acid, ferulic acid, Calycosin-7-glucoside in Shenqi-Yiqi oral liquid. Methods:The Shenqi-Yiqi oral liquid was separated on an Agilent HC-C18 column by gradient elution using acetonitrile (A) - 0.1% phosphate (B) as the mobile phase. The flow rate was 1.0 ml/min. The detection wavelengths were 260 nm (chlorogenic acid and Calycosin-7-glucoside), 316 nm (ferulic acid) by wavelength conversion method. Results:The linear ranges of chlorogenic acid, ferulic acid, Calycosin-7-glucoside were 70.40-704.00 μg ( r=0.999 8), 1.36-13.60 μg ( r=0.999 8), 1.28-12.80 μg ( r=0.999 7), the average recovery rate were 99.44% ( RSD=2.54%), 101.06% ( RSD=1.57%), and 98.00% ( RSD=2.09%). Conclusion:This method is convient, rapid and accurate for determinating chlorogenic acid, ferulic acid and Calycosin-7-glucoside in Shenqi-Yiqi oral liquid.

Objective To evaluate the safety and efficacy of mesohepatectomy for large and centrally located hepatocellular carcinoma.Methods A retrospective study was carried out on 136 pa tients who underwent mesohepatectomy for large and centrally located hepatocellular carcinoma at Xiangya Hospital,Central South University,from 2001 to 2007.Intraoperative/post operative data and long-term survivals were analyzed.Results Vascular occlusion time,operative time,intraoperative blood loss,intraoperative blood transfusion and hospital stay were (13.3 ± 9.1) min,(173.1 ±41.1)min,(548.7±320.5)ml,(511.4±231.7)ml and (18.6±8.8)d,respectively.Four patients developed major complications.There was no in-hospital death.The 1-,3-,and 5-year overall survival rates and disease-free survival rates were 71％,46％,29％ and 65％,40％,24％,respectively.Conclusions Mesohepatectomy for large and centrally located hepatocellular carcinoma preserved the maximum amount of functional liver parenchyma.It is safe and reliable and may be used as the treatment of choice.

Objective To discuss the clinic and imaging features of solitary enchondroma.Methods Radiography,CT and MRI were performed in 11 cases of solitary enchondroma confirmed by pathology.The imaging findings were retrospectively analysed.Results The tumors in 11 cases localized in metacarpal bone in 3, in bones of fingers in 4, in shaft of humerus in one,in metaphysis of femur in 2 and in metaphysis of tibia in one.Plain radiography showed typical radiographic features including a well defined central lucency in the diaphysis of the metacarpal bones and bones of fingers with calcifications inside the lesions and lobulated contour,the cortex was thinned and cortical expansion also might occur.The lesions appeared as soft tissue density with stippling calcification on CT,low signal intensity on T1WI and mixed mainly high signal intensity on T2WI.A low signal zone around the lesion could be seen on T2WI in one case.Conclusion The qualitative and differential diagnosis of solitary enchondroma can be made mostly by imaging examination.

OBJECTIVE:To study the characteristics and preventive measures of the ADRs associated with astragalus in?jection.METHODS:ADRs to astragalus injection in41cases,reported in domestic medical journals from1988～2003,were col?lected and analysed.RESULTS:The ADRs to astragalus injection were independent of patient's sex and age.ADRs occured du_ ring intravenous drop in32cases(78.05%)mostly within30min after injection,and24cases(41.46%)had ADRs at a second time or repeated injection.The clinical manifestations of ADRs were varying,of which the allergic reaction was the commonest one including anaphylactic shock.CONCLUSION:Clinical physicians and pharmacists should pay attention to the ADRs of as?tragalus injection and rationally use the preparation.

BACKGROUND: Severe acute respiratory syndrome (SARS) is caused by a genetically novel coronavirus that is caused by acute infectious disease. It is not yet clear for the immunology function of SARS patients in their convalescent stage.OBJECTIVE: To study the effects on T lymphocyte, and the titer profiling of 24 T cell receptor (TCR) V β subfamilies expressions in SARS convalescent patients.DESIGN: A self-control observation.SETTING: Central Laboratory, Guangdong Provincial Hospital of Traditional Chinese Medicine.PARTICIPANTS: Seventy-six cured SARS patients who received treatment in the Second Hospital Affiliated to Guangzhou University of Traditional Chinese Medicine between January and April 2003. All the patients corresponded to "clinical diagnostic criteria of atypical pneumonia", " diagnostic criteria of severe atypical pneumonia and discharge criteria" and "clinical diagnostic criteria and discharge criteria of severe acute respiratory syndrome". The involved patients, 30 male and 46 female, averaged (32±11 (years old. Another 10 subjects who simultaneously received health examination in the same hospital, 5 male and 5 female, aged (32±7(years, were involved in the study. Informed consents of detected items were obtained from all the subjects.METHODS：①Detecting the expression of 24 T cell receptor(TCR)V β subfamilies in SARS convalescent patients：Peripheral blood(2 mL) was collected from the healthy convalescent subjects,and EDTA-K2 was used as anticoagulant．In the flow cytometry delection tubes．10 μL various fluorescein-labeled mAb，such as anti-CD3,anti-CD4，anti-CD8,anti-CD25，anti-CD28，anti-HLA-DR，anti-CD3mAb conjugated with PC5，TCR Vβ1(PE+FITC)．Vβ2(PE+FITC)。Vβ3 (FITC)，Vβ4(PE+FITC)，Vβ5．1(PE+FITC),Vβ5．2(PE),Vβ5．3(PE)，Vβ7．1(PE+FITC)，Vβ7．2(FITC),Vβ8(FITC),Vβ9 (PE)，Vβ11(PE)，Vβ12(FITC)，Vβ13．1(PE),Vβ13．2(PE),Vβ13．6(PE+FITC)，Vβ14(FITC),Vβ16(FITC),Vβ17 (PE+FITC)，Vβ18(PE)，Vβ20(FITC)，Vβ21．3(FITC),Vβ22(PE+FITC)and Vβ23(PE)，was added in special flow tubes,and then 50 μL whole blood was added．The mixed solution was incubated away from light for 15 minutes．After erythrocytolysin being added，mixed solution was washed．Finally．cell deposit was dissolved in 300 μl phosphate buffer solution (PBS)．Coulter ESP flow cytometer was used for detection．For the analysis of TCR expression,an electronic gate was set on these cells and at least 5000 events per sample were collected．Three-color cytofluodmetric analysis was performed using a Coulter ESP flow cytometer．②Detecting the T cell subset,activated T and B cells,and the percentage of Ts and Tc cells：5000 cells were collected and used to calculate the expression of T cells (CD3,CD4 and CD8),the activated T and B cells(CD3+／CD25+,CD3+/HLA-DR+ and CD3-／HLA-DR+),as well as the percentage of Ts and Tc cells by Coulter ESP flow cytometer and its software．MAIN OUTCOME MEASURES：①The change of T cell subset(CD3，CD4，and CD8)from SARS convalescent patients．②The change of activated T and B cells(CD3+／CD25+，CD3+／HLA-DR+ and CD3-／HLA-DR+)．③The percentage of Ts and Tc cells(CD8+／CD28+，CD8+/CD28-)in convalescent patients．④Analysis of the 24 TCR V β subfamilies from SARS patients in convalescence．RESULTS：All data were explored to analyze the expression profiling of 24 TCR Vβ subfamilies,the data from 74 SARSpatients and 10 healthy controls were explored to other result analysis．①The detecting results of T celI subset：The percentage of CD4+T cell mean value was lower than the reference value[(33．33±6．64)％ vs．(43±9)％，P＜0．01]．The percentage of CD8+T cell mean value was higher than the refefence value[(34．07±6．40)％ vs．(30±9)％,P＜0．01]．② The expression of activated T and B cells：Percentage of HLA-DR+ T and B cell was Increased while the percentage of CD25+ T-cell was decreased compared with reference values．In 53 out of 74 patients,the percentage of CD25+ T cells was lower than the reference value,and 64 patients had a lower percentage in CD3+/CD25+ T cells．The percentages of CD3+/HLA-DR+ and CD3-／HLA-DR+ cells were higher than the normal reference value．T cells expressing higher CD3+／HLA-DR+ were found in 36 patients，and T cells expressing higher CD3-/HLA-DR+ were found in 30 patients．③The ratios of Ts and Tc cells：The percentage of Ts cells which expressed CD8+／CD28- was increased compared with reference value [(28．75±7．31)％ vs．(15．99±5．1)％，P＜0．01],while the percentage of Tc cells which expressed CD8+／CD28+ was decreased [(5．99±3．60)％ vs．(13．2±4．1)％，P＜0．01]．Thirty-nine patients were found to possess the lower Tc cells and forty-eight patients were found to possess the higher Ts cells．The ratios of both CD4+ and CD8+ T cells were in the normal reference value．④24 TCR Vβ subfamilies expressions in T cells：It was noteworthy that Vβ14 had a highest percentage in all 24 Subfamilies,and followed by Vβ 5．3,and Vβ 23 in the convalescent patients．The percentage of Vβ 14 was the highest in the normal controls,which was consistent with the results of SARS patients．But the other subfamilies expression patterns were different．There were significant differences between Vβ1,Vβ5．2,Vβ5．3,Vβ7．2，Vβ9，Vβ11,Vβ13．1,Vv13．2，Vβ17,Vβ18，Vβ22 and Vβ23．In the convalescent period，each TCR Vβ expression of SARS patients was higher than that of controls(P＜0．05-0．01)．CONCLUSION:In SARS convalescent patients,the increased CD8+CD28- T cell may elevate CD8+ T cell number;Meanwhile.the reduced CD3+ and CD4+ T cell number may be corresponding to the increased Ts cell number．For some inhibiting factor secreted by Ts cell was also increased．The usage pattern of 24 TCR Vβ subfamilies in SARS patients is different from that of control group．The increase of percentage of CD3+／HLA-DR+ and CD3-／HLA-DR+ T cell may be related to the late response of activated T and B cells.

Objective To evaluate the value of pre-operative 99Tcm-MIBI SPECT/CT in patients with HPT by comparing with planar 99Tcm-MIBI and ultrasound imaging. Methods A total of 57 patients (9 males, 48 females; average age: (52.9±15.5) years) were enrolled into this retrospective study. They all underwent 99Tcm-MIBI planar scintigraphy, 99Tcm-MIBI SPECT/CT and ultrasound during March to October in 2016. All patients received parathyroidectomy and the surgical pathology was considered as the gold standard. The diagnostic efficiencies were compared using χ2 test. Results A total of 86 HPT lesions were confirmed, including 47 lesions in 46 PHPT patients and 39 lesions in 11 SHPT patients. The sensitivities of SPECT/CT, planar, ultrasound and combined imaging (planar plus ultrasound) were 87.21%(75/86), 69.77%(60/86), 65.12%(56/86) and 84.88%(73/86), respectively. The overall sensitivity of SPECT/CT was significantly higher than that of individual planar imaging and that of ultrasound (χ2 values: 4.691 and 7.818, both P<0.05), but similar to that of the combined imaging (χ2=0.044, P>0.05). No significant difference was observed among the specificities of all these modalities (χ2=2.219, P>0.05). For PHPT lesions, the sensitivities of SPECT/CT, planar imaging, combined imaging and ultrasound were 9574%(45/47), 93.62%(44/47), 97.87%(46/47) and 76.60%(36/47), respectively. No statistically significant difference was found in the sensitivity of the former 3 modalities (χ2=1.044, P>0.05), but the sensitivity of ultrasound was the lowest(χ2=16.223, P<0.05). For SHPT, the sensitivities of the corresponding 4 modalities were 76.92%(30/39), 41.03%(16/39), 51.28%(20/39) and 69.23%(27/39), respectively. SPECT/CT was significantly superior to planar imaging and ultrasound(χ2 values: 10.386 and 5.571, both P<0.05), but comparable to the combined imaging(χ2=0.586, P>0.05). Only SPECT/CT could accurately localize 5 ectopic HPT lesions. Conclusion Compared to planar imaging and ultrasound, SPECT/CT has higher sensitivity for SHPT patients, and could provide precise localization for ectopic lesions, thus facilitating patient planning for minimally invasive surgery.

Objective Describes the use of homemade simple bedside bracket of children supracondylar fracture closed reduction and percutaneous pin fixed surgical methods and clinical effects.Methods 16 cases of children supracondylar fractures Gartland type Ⅱ cases,15 cases Gartland type Ⅲ,13 males and 3 females,with an average age of 6 years old,all patients used our hospital homemade simple bedside shelf assisted closed reduction,percutaneous pin fixation,and fixed with plaster immobilization.Results 16 patients were followed-up,in addition to the two cases of pin tract infection,fracture all were healed smoothly.Without iatrogenic nerve injury and internal fixation loosening,and also no volkmann contracture,and myositis ossificans etc complications.The average fracture healing time for three weeks,no bone delayed union or nonunion occurred.According to Flynn clinical function evaluation,there were excellent in 7 cases,good in 9 cases.Conclusion Useing homemade simple bedside shelf to children supracondylar fractures closed reduction and percutaneous Kirschner wire fixed can ensure the efficacy,and also simplify the surgical procedure,reduce radiation intake,which is the worthy of clinical practice.