Objective To explore the use of lamivudine alone induced the poor response,especially the related factors of the occurrence of YMDD.Methods Retrospective analysis of 160 cases of the poor answering cases after lamivudine treatment,the baseline parameter values,the time appearing to the poor answering and the HBVDNA load in treatment were analyzed,to study their relationship with poor response.Results The lamivudine prolonged,the poor response to the probability gradually increase.The mutation rate in the 12nd month was 19.67％ and in the 36th month was 49.18％ ( P ＜ 0.05 ).Response to the many reasons,the YMDD mutation is the more common one.The relationship among HBVDNA load,ALT level on baseline and the rate of poor response emergence,the YMDD mutation rate was clear.By comparison in groups,the difference was significant (P＜0.05).Conclusion The lower baselins of ALT level,the higher of HBVDNA load,the greater probability of the poor response and the YMDD mutation.

Objective In order to investigate and evaluate the heating-ventilating-air conditioning (HVAC) systems in the public areas and therefore provide the support for the hygiene management. Methods According to Hygiene Criterion of HVAC System, 10 HVAC systems in 10 star grade hotels in Nanchang were selected and PM10 and the total count of aerobic bacterial in the air condition systems, the collected dust weight and the total count of aerobic bacterial in the dust in the inner surface of ventilation vessels, the legionella bacteria in cooling tower water were determined. Results The HVAC systems in the 10 hotels, 90.1% for the PM10 and 73.3% for the total count of aerobic bacterial in the air condition systems, 8.9% for the collected dust weight and 86.7% for the total count of aerobic bacterial in the dust in the inner surface of ventilation vessels were over the standard limits, the legionella bacteria were detected in two of the investigated HVAC systems cooling tower water. Conclusion The hygienic problems are existed in the ventilated systems in the air conditioners in the pubic places.The health supervision and monitoring must go on enhancing.

Objective To know the relationship between air pollutants and daily hospital visits for respiratory diseases in Guangzhou. Methods The data of daily hospital visits for respiratory diseases in a hospital in Guangzhou during 2006 to 2008, along with the daily meteorological factors, air pollutants concentration (NO2, PM10,PM2.5 and SO2) were collected. The time series analysis auto-regression model was used, considering the potential confounding factors such as seasonal and meteorological factors. Results Daily hospital visits for respiratory diseases presented a significant week effect, the time of higher daily hospital visits for respiratory diseases was the same of higher concentration of pollutants. When SO2 and NO2 increased by 10 ?g/m3, the daily hospital visits increased by 3%(P

OBJECTIVE:To evaluate the long-term toxicity of Ginkgolide B injection on Beagle dogs,and to provide safety evidences for clinical experiment.METHODS: A total of 24 Beagle dogs were equally assigned to receive placebo(control group,n=6) or Ginkgolide B injection at high,medium,and low doses(80,20,and 5 mg?kg-1) by iv gtt for 6 consecutive days per week for up to 90 days.There were 6 Beagle dogs(male: female =1∶1) in each group.All the laboratory indicators were monitored and the recovery of the Beagle dogs was observed.RESULTS: During medication,vomiting was noted in one dog in high dose group,and the clotting time in high and medium dose groups was prolonged obviously.During the recovery stage,one dog in high dose group was strong positive in urinary protein test.No significant drug-associated toxic reactions were noted judging from Beagle dogs' body weight,appetite,temperature,ECG,hematology,blood biochemical analysis,ophthalmology test,marrow test,urine routine test,histopathologic examination etc.CONCLUSION: The non-toxic dose of Ginkgolide B injection for Beagle dogs was 20 mg?kg-1.

Objective To investigate the effect of Xingnaojing injection solution in treating severe burn patients with sepsis. Methods 41 cases of burn patients with sepsis were randomly divided into experimental group and control group. The experimental group were intravenously injected 40ml/day Xingnaojing injection solution for 7 days. The control group received routine therapy. Bacteria counts in burn wound, the survival rate of the patients and the positive rate of blood culture in the both groups were determined and compared. Results The experimental group had significantly lower bacteria counts in burn wound compared with the control group, and the negative blood culture rate and patient's survival rate in the experimental group were also obviously higher than those in the control group (P

Objective To study the influence of cholangiocarcinoma cells on endothelial cells in a co-culture system. Methods A co-culture system of eholangioeareinoma cell line QBC939> and endothelial cells was established in vitro (co-culture group). Endothelial cells were cultured individually during the same time (control group). The mixed supematant of cholangiecareinoma cells and endothelial cells was in the mixed group. Light microscopy and transmission electron micrescopy were used to observe the morphology of the endothelial cells. Changes in expression of ppI25FAK, MMP-2, MMP-9 and uPA of the endothelial cells were detected by mmunofluorescence, and the activities of MMP-2 and MMP-9 were detected by gelatin zymography. All the data were analyzed by paired t test. Results The intercellular space between endothelial cells in co-cuhure group was wider than in the control group. The expression of pp125FAK, MMP-2, MMP-9 and uPA was 394 ±51,455±82, 377±48,422±55 in control group, and was 1096±128,931±72,815±76,801±56 in the eo-euhure group. The difference between the 2 groups had statistical significance (t = 6.53,4.32, 3.61,3.45, P < 0. 05). The values of gray-scale scanning of MMP-2 and MMP-9 in the mixed group were 240.2±15.2 and 2.4±0.8, respectively. The values of gray-scale scanning of MMP-2 and MMP-9 in the co-culture group were significantly increased, they were 687.4 ± 43.6 and 150.9 ± 13.2, respectively (t = 4.89, 5.43, P < 0.05). Conclusions The intercellular space between endothelial ceils and the expression of the proteolytie enzymes are increased after co-culturing endothelial cells with eholangiocarcinoma cells. Proteolytie enzymes may be involved in the process of degradation of subendothelial matrix, and promotes the metastasis of cholangiocarcinoma.

Objective To evaluate contrast-enhanced ultrasound (CEUS) for the diagnosis and follow-up of hepatocellular carcinoma ( HCC) patients after percutaneous radiofrequence ablation ( RFA). Methods The data of 46 HCC cases were reviewed in our study. Results of contrast enhanced computed tomography (CT) , ultrasound contrast agent sonography and grey ultrasound were compared with each other pre- and after percutaneous radiofrequence ablation. Results Contrast agent ultrasound imaging had the same value with CT in preoperative diagnosis of HCC, with postive likelihood ratio of 1.26 and 1.31, respectively,sensitivity of 97% and 91% and specificity of 23% and 31% respectively. For grey ultrasound the positive likelihood ratio was 0.99, sensitivity and specificity was 76% and 23% respectively. The sensitivity and specificity of contrast-enhanced ultrasound after percutaneous radiofrequence ablation was 60% and 90% respectively, and the postive likelihood ratio and negative likelihood ratio was 6. 18 and 0. 44 respectively. The difference was significant while compared with CT (P = 0. 012). All cases were followed-up from 1 to 9 months, and all were alive with recurrence found by contrast-enhanced ultrasound in 3 cases. Conclusions Contrast agent ultrasound imaging is sensitive and effective in the diagnosis of HCC and follow-up after percutaneous radiofrequence ablation.

Objective To investigate of the accuracy and feasibility of independent check for intensity-modulated radiotherapy (IMRT).Methods Inputing the linear accelerator Varian 600C/D physical data to IMsure ( a independent checking software) and constructing a calculation model.Use of IMsure to calculate the point dose and fluence of 25 cases IMRT treatment plans which have been calculated by Eclipse treatment planning system (TPS),and do a actual measurement of these plans by Matrixx at the same time.IMsure,TPS calculation results and measurement results of Matrixx were compared.Results Select Matrixx's center probe as a reference point,to TPS calculated results as the standard,then the average difference of the IMsure calculation and Matrixx measurement were ( -0.13 + 1.24)％ (t =0.20,P =0.840 ) and ( - 0.18 ± 1.45 ) ％ ( t =0.86,P =0.400 ),respectively.Compared IMsure with 3 mm/3 ％and 2 mm/2％ standard respectively,the average γ rate of TPS were (98.7 ±2.8)％ and (94.9 ±7.2)％ ;compared matrixx measurement results,the average γ rate of TPS were ( 99.0 + 2.0 ) ％ and ( 93.2 ±6.9) ％.The results show that the difference of the point dose and the γ rate of dose distribution by Matrixx measurement and IMsure calculation was no statistically significant difference ( t =1.54,P =0.126 ).Conclusions Independent checking software can be used in the treatment planning system to acceptance and initial clinical tests.In routine,a independent checking software as IMsure may do a pre-verificaton of IMRT treatment plan,or even partially replace of the actual measurement if the adequate conventional quality assurance do well,thus reducing the daily measurements.

Objective To investigate the value of continuous occlusion of hepatic artery proper to intermittent Pringle maneuver in partial hepatectomy for ruptured hepatocellular carcinoma(HCC).Methods The clinical data of 36 patients(test group)who received partial hepatectomy for ruptured HCC by adding continuous occlusion of hepatic artery proper to intermittent Pringle maneuver at the Southwest Hospital were retrospectively analyzed.Thirty-six patients(control group)who received intermittent Pringle maneuver only were selected as the control.All data were analyzed using the chi-square test,Fisher exact probability and analysis of variance.Results The mean hepatic artery occlusion time of the test group was 58 minutes(range,36-98 minutes).The median blood loss of the test group was 400 ml,which was significantly less than 750 ml of the control group(F =16.47,P ＜ 0.05);78%(28/36)of patients in the test group did not receive blood transfusion,which was significantly more than 53%(19/36)of the control group(x2 =6.01,P ＜0.05).The levels of postoperative serumaspartate transaminase and total bilirubin of the 2 groups were peaked at postoperative day 2 and then decreased to the normal level 1 week later.There were no significant differences in the incidences and levels of complications between the 2 groups(x2 = 1.83,0.89,P ＞ 0.05).Conclusion The addition of continuous occlusion of hepatic artery proper to intermittent Pringle maneuver significantly reduces intraoperative blood loss and doesn't bring any adverse effects to hepatic function for partial hepatectomy in patients with ruptured HCC when compared with intermittent Pringle maneuver alone.

Objective In order to explore the ways of reflecting the dose distribution in the implementation of the of IMRT (intensity modulated radiation therapy),a 2D diode array (2D-DA) was used in verifying the composite dose distribution of IMRT plans in the way of multi-gantry-angle composite (MGAC).Methods IMRT quality assure (QA) plans of 27 patients,based on the 2D-DA and solid water phantom,were designed and verified in two ways of single-gantry-angle composite (SGAC) and MGAC verifications.The comparison and analyzation of the dose distributions of the TPS calculation and the measurement of the 2D-DA were done.Results (1) When the beam central axes were not superposed with the detectors'plane of the 2D-DA,the verification passrate of SGAC and MGAC planar dose distribution of 27 patients'IMRT plan were 94.56%±4.28% and 94.81%±3.80% (the criteria:rvalue,3 ram/3%),respectively.There was no statistical difference between the results of two sets (t =-0.213,P＞0.05).(2) When one of the beam central axes was superposed with the detectors'plane of the 2D-DA,the verification passrate of MGAC planar dose distribution were 79.72%±12.77%.Conclusions Using the 2D-DA with a proper phantom,there was no statistical difference in the SGAC and MGAC verifications of IMRT plans when the beam central axes were not superposed with the detectors'plane.However,the MGAC dose distribution can provide more about the clinical dosimetry,and the errors in the implementation of the of IMRT were easier located.