This paper summarized the effects of the treatment of chronic hepatitis B (CHB) by lamivudine combined with traditional Chinese medicine or western medicine in the past few years. Combined treatment of lamivudine and the other medicine had higher efficiency than lamvudine alone in the treatment of CHB. The Combined treatment should be a tendency of the treatment for chronic hepatitis B. The focal point is that the traditional Chinese recipe produces a multitarget effect in the treatment of CHB. The combined treatment of lamivudine and traditional Chinese recipe can reduce the treatment course and the recurrence rate. Combined treatment of traditional Chinese medicine and western medicine has notable superiority and broad developing prospect in the treatment of CHB.

It is necessary for the improvement of the medical education and medical system to reform the model of clinical teaching.This article analyzes some problems of today's clinical teaching and clarifies specific demands and aims of teaching,learning and managing in the process of clinical teaching.In order to improve the quality of clinical teaching,the author puts forward some conceives about constructing the "three-in-one" system including teaching,learning and managing in clinical education.

Objective To investigate the expression of inducible nitric oxide synthase (iNOS) in human gastric carcinoma and its relationship with angiogenesis, lymph nodes metastasi s and clinical staging of gastric carcinoma. Methods The expression of iNOS in 50 patients with gastric carcinoma was studied with im munohistochemical method. Microvessel density (MVD) of human gastric carcinoma was also determined with anti-CD34 as the labelled vascular endothelial cells. Results The rate of expression of iNOS in 50 cases of gastric carcinoma was 70.0% , and MVD averaged 22.0?9.8, higher than those in the tissues around cancer (16 .2%,6.1?3.4) and normal gastric tissues (15.0%,5.5?2.6; P

Methods:188 students majorting in clinical medicine were randomly divided into two groups:the experimental group with evidence based medicine(EBM)teaching method and the control group with traditional teaching method.Results:The experimental group was better than the control group in results of theory examination and skill test,writing medical record,analyzing condition of patients and the level of student's satisfaction.Conclusions:EBM thinking training is practicable in clinical teaching.

Excessive gestational weight gain has already become a global clinical and public health problem that seriously affects maternal health. Excessive gestational weight gain not only increases the cesarean section rate and induces adverse pregnant outcomes, but also affects offspring development and health. This article reviews the effects of excessive weight gain during pregnancy on offspring health and its underlying mechanisms. Excessive gestational weight gain may increase the risk of obesity, cardiovascular diseases, infectious diseases of the respiratory tract, diabetes, polycystic ovary syndrome, mental or psychological illness among offspring, and the pathophysiological mechanisms include inflammatory response, intestinal flora dysbiosis and epigenetics theory. However, further studies are required to validate these hypotheses and to evaluate the effect of excessive weight gain at different gestational stages on offspring health, so as to provide insights into reasonable management of weight gain during pregnancy and improvements of offspring health.

Objective To evaluate the feasibility in early diagnosis, predicting therapeutic effect, recurrence monitoring by examining promoter hypermethylation for cancer-associated genes E-cadherin in cancer tissue and peripheral blood of breast cancer patients. Methods The tumor tissue, paracancer- tissue and the paired plasma were examined for aberrant methylation of E-cadherin gene by methylation-specific PCR in 42 cases of breast cancer and 10 cases of breast benign diseases. Results The incidence of promoter hypermethylation of E-cadherin in tumor tissues was 52.4% and the paired plasma were 33.3%. E-cadherin hypermethylation in plasma samples and tumor samples significantly correlated with each other ( P

Objective To investigate the protection effects of recombinant human tumor necrosis factor-α receptor Ⅱ :IgG Fc fusion protein for injection (rhTNFR:Fc) on rats with collagen-induced arthritis (CIA) and analyze osteopontin (OPN) changes following therapy in order to understand its primary mechanism of action. Methods CIA was induced by bovine Ⅱ collagen (B Ⅱ C) injection. Rats were treated with rhTNFR:Fc from the 13th day after the first injection of B Ⅱ C till the 36th day. The anterior-posterior diameters of ankle joints and weight were measured weekly. The pathological score was evaluated by HE staining and toluidine blue staining. The blood plasma TNF-α and OPN levels were measured by ELISA and the histology expression was evaluated by immuno-histochemistry. Comparisons between groups were performed with one-way ANOVA. Results Quantitative analysis showed pathological score in the model group and treatment group was significantly reduced in joint pathology (8.2±1.0 vs 4.8±1.4, P<0.05). The mean plasma levels of TNF-α and OPN values were (713±146) pg/ml, (4.3±0.6) ng/ml respectively in the model group,but those of the treatment group were (68±20) pg/ml, (4.2±0.6) ng/ml. Serum TNF-α values were significantly different (P<0.05) between the two groups, while no significant difference was found in the value of plasma OPN (P=0.688) between the two groups. rhTNFR:Fc could reduce the cells OPN expression in the interface layer of the synovium and cartilage (P<0.05). Conclusion Pathology scores and ELISA results haveshown that rhTNFR:Fc has good therapeutic efficacy. It can significantly reduce the bone and cartilage damage of CIA mouse model, and can significantly reduce the expression of OPN in the sliding joints, thereby delay disease progression. However, it can not reduce the expression of OPN in the peripheral blood plasma.OPN may be involved in bone destruction and resorption rather than in inflammatory process.

OBJECTIVE To study the relativity among PreS1-Antigen,HBV markers and HBV-DNA. METHODS The HBV markers,PreS1-antigen and HBV-DNA were determined by ELISA and PCR in 102 patients with chronic hepatitis B and 73 healthy persons. RESULTS Among 102 patients with chronic hepatitis B,the concordance rate of PreS1-antigen and HBeAg with HBV-DNA was 70.6% and 75.5%.The sensitivity of PreS1 was better than HBeAg but the specificity was contrary.It represented some patients with HBeAg(-) still had viral replication.On the increase in the level of HBV-DNA,the positive rates of PreS1-antigen and HBV markers increased. CONCLUSIONS The detection of PreS1-antigen can well reflect the HBV replication.The synchronous dynamic detection of PreS1-Antigen,HBV markers and HBV-DNA has its important clinical meaning.

Objective To analyze the plasma amino acid levels and evaluate the free amino acids value of normal healthy volun-teers in plasma by establishing physiological fluid method.Methods ①Establishment of methodology:including repeatabili-ty of blood sample,recovery rate,linearity,and stability;②The free amino acid values in plasma in 40 normal healthy volun-teers were analyzed.Results With the standard solution of different concentrations (2,4 and 8 nmol)analyzed and linear re-gression of amino acid calculated,found that R2 of all the amino acids were within the range from 1 to 0.9 9 9.The repeatabili-ty with in batch and between batches of different amino acid in blood samples were respectively 0.30~2.90 (rsd)and 0.40~5.16(rsd);recovery rates were 93.1%~107.4%.Then evaluated the normal values of plasma amino acid in 40 healthy volunteers (male vs female:1 vs 1 ),and compared the results with that measured by other instruments.Conclusion With lithium citrate buffer system to analyze the free amino acid in blood samples,it displayed good reproducibility,recovery rate, linearity and stability.Comparison of different instruments measuring the free amino acids in plasma of normal healthy vol-unteers showed good agreement,confirming that the method of physiological fluid analysis is reliable.