Objective To evaluate the efficacy of entecavir treatment up to 96 weeks for patients with chronic hepatitis B (CHB).Methods The study recruited 62 CHB patients who were admitted to or hospitalized at the Taixing People′s Hospital from July 201 1 to July 2014. The patients were treated with entecavir (0.5 mg/d)for 96 weeks of antiviral therapy.All the patients were divided into HBeAg-positive (n=43)and HBeAg-negative groups (n=19).The HBV DNA load was higher than 106 copies/ml in 38 patients and lower than 106 cop-ies/ml in 24 patients.The efficacy of entecavir in the two groups was compared at 24,48,and 96 weeks of treatment.Between-group com-parison of categorical data was performed byχ2 test.Results At 24,48,and 96 weeks of treatment,the HBeAg-positive group had a sig-nificantly lower HBV DNA clearance rate than the HBeAg -negative group (34.88% vs 78.95%,P=0.003;65.12% vs 89.47%, P=0.047;74.42% vs 100%,P=0.038);there was no significant difference in alanine aminotransferase (ALT)normalization rate be-tween the two groups (P=0.102,0.779,and 0.638).Patients with a HBV DNA load of >106 copies/ml had a significantly lower HBV DNA clearance rate than those with a HBV DNA load of <106 copies/ml at 24,48,and 96 weeks of treatment (34.21% vs 70.83%, P=0.005;57.89% vs 95.83%,P=0.001;76.32%vs 95.83%,P=0.002);there was no significant difference in ALT normalization rate between the two groups (P=0.940,0.150,and 0.280).Conclusion Entecavir has a high antiviral activity in the treatment of CHB, which can suppress HBV replication and concurrently improve liver function.

ObjectiveTo explore the effect of Curcumin on TGF-β1 and HGF in pulmonary fibrosis and the effect of different concentrations of Curcumin on the expression of HGF and TGF-β1 in pulmonary fibrosis.Methods90 health male SD rats were randomly divided into six groups as follows:the control group ( group A),model group ( group B),prednisolone-treated group ( group C),and groups of low ( D group),middle( group E) and high( group F) dose curcumin (50,100,and 200 mg/kg,respectively).Animal model of pulmonary fibrosis was produced in SD rats by the endotracheal bleomycin,samples were obtained on days 7,14,and 28.The expression of HGF and TGF-β1 were measured by RT-PCR and Westem blot.ResultsThe light density values (0.693 ±0.028) and gray value (0.96 ±0.10)of TGF-β1 on day 28 of group A was the lowest,while the light density values ( 1.586 ±0.020) and gray value ( 1.77 ±0.15 ) of group B was the highest,the light density values (0.881 ± 0.032) and gray value ( 1.19 ±+ 0.12 )of group F was lower than group B.But the light density value and gray value of HGF showed reverse,the light density values and gray value of HGF on day 28 of group F was the highest,there was no statistical difference between group B and group D ( P ＞ 0.05).ConclusionsThe protective effect of Cucumin against pulmonary fibrosis may be through stimulating the activity of HGF and inhibiting the activity of TGFβ1 in a dose-dependent manner.

Objective To investigate whether p53 expression is involved in human telomerase reverse trans-criptase (hTERT) regulation. Methods HepG2 cells and pPUR/U6/hTERT HepG2 cells were treated with the p53 antisense oligonucleotide respectively and p53 expression plasmid were introduced to HepG2 cells. The decreased or increased p53 level and the hTERT expression levels were analyzed by Western blotting. Results Down-regulation of p53 expression had no obvious effect on hTERT expression, but over-expression of p53 could significantly repress hTERT level. Conclusion p53 interacts with hTERT and inhibits hTERT expression in HepG2 cells.

Microteachingisthescientifictrainingsystemtoimprovetheteachingskills.Therea-sonable application of microteaching in training of the clinic teaching may effectively boost their clinic teaching techniques and dramatically promote the overall construction of medical college teachers.

Extremely severe pancytopenia induced by low dosage of azathioprine in systemic lupus erythematosus patients is rare. A 40-year-old Chinese female was diagnosed with systemic lupus erythematosus. She suffered worse erythema, oral ulceration, raised erythrocyte sedimentation rate and high anti-dsDNA in August 2013. Then she was initiated on oral azathioprine 50mg/d and extremely severe pancytopenia was seen in September 2013. She was recovered by a series of treatments. Regular monitoring of blood counts is highly recommended to reduce the possible serious myelosuppression induced by azathioprine.

Antigens, Nuclear ; metabolism ; Cordotomy ; methods ; Diagnosis, Differential ; Ependymoma ; metabolism ; pathology ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Nerve Tissue Proteins ; metabolism ; Neurocytoma ; metabolism ; pathology ; surgery ; Oligodendroglioma ; S100 Proteins ; metabolism ; Spinal Cord Neoplasms ; metabolism ; pathology ; surgery ; Synaptophysin ; metabolism

Objective The article was to analyze the features of gene mutation and clinical phenotype in Alport syndrome. Methods Next-generation sequencing was applied to capture the exons of COL4A3, COL4A4, COL4A5 genes in 30 cases of children with suspected or confirmed diagnosis of Alport syndrome and Sanger method was used to identify gene mutations of related family mem-bers.Provean database was applied in protein function prediction.We collected and analyzed clinical data of AS patients on the basis of gene mutation. Results All 30 children were diagnosed with AS by gene sequencing, among whom 4 boys were autosomal reces-sive inheritance, 16 boys and 10 girls were X-linked Alport syndrome.Next-generation sequencing detected 35 different gene mutations of COL4A3, COL4A4, COL4A5, including 19 missense mutations, 2 synonymous mutations, 4 splice-site mutations, 3 truncating mu-tations, 2 insertion mutations, 4 deletion mutations and 1 compound mutations.It was observed by Sanger sequencing that 20 mutations were inherited from the mother, 8 from the father, homozygous mutation in 1 propositus from the parents respectively, 8 novel mutations and 1 with unidentified source.All the 30 children had an onset of hematuria or proteinuria, 17 cases had a positive family history, 1 case had hearing loss, and no pathogenesis or renal insufficiency was found in the children.Renal biopsy was performed on 23 children, 13 minimal change disease ( MCD) and 10 mesangial proliferative glo-merulonephritis ( MsPNG) by light microscope.Extensive lamination and split of glomerular basement membrane dense layers were found in 9 children by electron microscope. Conclusion XLAS ac-counts for most AS patients and missense mutation is the main type in pathogenic mutations.Altogether, 31 mutations without disease notification were found.Most of children showed MCD in renal biopsy, with atypical electron microscope manifestations and rare extra renal manifestations.

Objective To observe the effectiveness and safety of basal insulin plus oral antidiabetic drugs (OADs) in treating the patients with type 2 diabetic mellitus (T2DM ) ,who were poor blood sugar control by premixed insulin with or without OADs . Methods 32 cases of T2DM and poor blood sugar control by premixed insulin combinated with or without OADs stopped the premixed insulin therapy and changed to insulin glargine plus OADs for 16 weeks .Glycosylated haemoglobin (HbA1c) ,fasting blood glucose(FBG) ,postprandial blood glucose(PBG) ,body mass index (BMI) and mean daily insulin dose were compared among patients .And the episodes of hypoglycemia events were recorded .Results After 16‐week treatment ,HbA1c ,FBG ,PBG and BMI were all significantly decreased comapared with before treatment (P<0 .01) .The mean insulin glargine daily dose was significantly decreased compared with the premixed insulin dose at admission .2 cases (6% )appeared twice hypoglycemia episodes during the treatment period ,all were general hypoglycemia .Conclusion Basal insulin once daily can effectively improve the sugar metabolism in T2DM patients failed by premixed insulin with or without OADs ,moreover the body mass is not increased .

Thirty assistant general practitioners (GPs) of Jiading District Shanghai were trained for clinical skills and communication skills by using standardized patients (SP) in outpatient department from January to April 2014.The scores of clinical skills and communication skills were evaluated and compared before and two months after training.The results showed that the score of clinical skills [(72 ± 5) vs (56 ± 7), t=7.871, P＜0.05] and communication skills [(71 ±4) vs (45 ±5), t =9.573, P＜0.05] were significantly improved after training.After training, the scores of medical history taking [(36 ±5) vs (28 ± 6), t =4.352], clinical thinking [(17 ± 2) vs (14 ± 3), t =3.974], health education [(3 ± 1) vs (2 ± 1), t =3.090] and medical record v,riting [(13 ± 1) vs (8 ±2), t =5.317] were significantly higher than those before training (all P ＜ 0.05).But there was no difference in reception time management [(4 ± 0) vs (4 ± 0), t =1.025] before and after training (P ＞ 0.05).After training, the scores and the proportions of the trainees qualified for building physician-patient relationship [(20 ± 3) vs (15 ± 4), t =4.056],collecting information and providing feedback [(22 ±4) vs (13 ±3), t =4.682], understanding complaints from patients' perspective [(5 ± 2) vs (3 ± 2), t =3.107], sharing information and obtaining informed consent [(19 ± 4) vs (11 ± 5), t =4.322] and closing consultation [(6 ± 2) vs (3 ± 1), t =2.987] were higher than before training (all P ＜ 0.05).The results indicate that training by using SP can effectively improve the clinical skills and communication skills of assistant GPs.