Objective To establish a method for efficient,accurate genotyping and nucleoside drug-resistant mutation analysis for hepatitis B virus ( HBV ).Methods The 48 HBV serum samples were collected from the Third People's Hospital of Taiyuan from July to August 2011,and HBV DNA were extracted using the commercial kit.The HBV whole genome and P gene were amplified and sequenced.Each HBV sample was genotyped by both constructing phylogenetic trees and genotyping software analysis.The results from two strategies were compared for every sample.Results A total of 48 HBV full genome sequences were identified into 12 B and 36 C genotype's by both constructing phylogenetic trees and genotyping software analysis,which was exactly the same as the analysis using P gene fragment sequencing.Seven forms of nucleoside drug-resistant mutation were found in the P gene for all the samples,with the ratio of 27.1％ ( 13/48 ),in which all the mutation forms were associated with lamivudine or adefovir,and no other nucleotide drugs-related resistance mutations existed.In addition,there were 11 B and 35 C genotype and 2 B/C hybrid type with the analysis using Real-time PCR genotyping for the 48 samples.Conclusion P gene sequencing can be used as a new clinical method for efficient,accurate HBV genotyping and resistant mutation analysis,which provides guidance for hepatitis B treatment.

Objective To explore the clinical value of transvaginal three-dimensional color Doppler ultrasound in assessing effects of Chinese herbal drugs on improving endometrial receptivity in patients with thin endometrium.Methods A total of 76 cases of patients diagnosed with thin endometrium in Jiangbei District Hospital of Traditional Chinese Medicine from June 2015 to October 2016 were selected and treated with Chinese herbal prescription for three months.The endometrial thickness,endometrial volume and blood flow indexes before and after treatment were measured by using transvaginal three-dimensional color Doppler ultrasound.Results After 3 months treatment,the endometrial thickness and endometrial volume were increased,and the pulse index (PI) and resistance index (RI) of endometrial blood flow were decreased,compared with those before treatment,there were statistically significant differences(P＜0.05).The results of three-dimensional color Doppler ultrasound indicates that after 3 months treatment the vascularization index (VI),flow index (FI) and vascularization flow index (VFI) were significantly higher than those before treatment,there were statistically significant differences (P＜0.05).Conclusion The Chinese herbal prescription could increase the thickness and volume of endometrium,augment blood supply,and improve endometrial receptivity significantly.Transvaginal color three-dimensional Doppler ultrasound is a convenient and objective method for evaluating clinical efficacy of Chinese herbal prescription in patients with thin endometrium,which has high practical value.

Objective: To investigate the self-care activities and their influencing factors among young and middle-aged patients with type 2 diabetes mellitus ( T2DM ), so as to provide the basis for the care management of T2DM. Methods: T2DM patients at ages of 18 to 59 years that were admitted to Department of Endocrinology, Hangzhou First People's Hospital Affiliated to Medical School of Zhejiang University were selected using the convenient sampling method from January to August 2021, and the demographic data were collected using questionnaires, including gender, age and educational levels. The self-care level was measured using the Summary of Diabetes Self-Care Activities ( SDSCA ) was used to assess self-management behaviors, and the social support level was evaluated using the Social Support Rating Scale ( SSRS ), while the coping modes were assessed using the Medical Coping Modes Questionnaire ( MCMQ ). Factors affecting the self-care activities were identified among young and middle-aged patients with T2DM using multivariable linear regression analysis. Results: The 342 respondents included 185 men ( 54.07% ) and 157 women (45.93% ), and had a mean age of ( 43.76±3.82 ) years. The total score of self-care activities was ( 94.22±18.74 ), and the overall scoring rate was 72.48%, including 63 cases with high scores ( 18.42% ), 208 cases with moderate scores ( 60.82% ) and 71 cases with low scores ( 20.76% ). Multivariable linear regression analysis identified gender ( women, β'=0.213 ), educational level ( high school/technical secondary school, β'=0.187; diploma and above, β'=0.411 ), household monthly income per capita (5 000 Yuan and higher, β'=0.390), course of disease ( >5 years, β'=0.340 ), history of receiving health education targeting diabetes ( β'=0.411 ), coping mode ( avoidance, β'=0.195; confronce, β'=0.367 ) and social support level ( general, β'=0.206; high, β'=0.383 ) as factors affecting self-care activities among young and middle-aged patients with T2DM. Conclusions The overall self-care activities at a moderate level among young and middle-aged patients with T2DM, which are associated with gender, educational level, economic income, course of disease, health education targeting diabetes, coping mode and social support level.

Objective To study the imaging characteristics of vesical leukoplakia under the cys-toscope imaging system. Methods The characteristics of vesical leukoplakia were observed under the cystoscope imaging system in 556 cases. After anti-infection treatment to these patients, the chan-ges of the characteristic under the cystoseope imaging system were re-observed and compared before and after treatment. SPSS 11.0 software package x2 teat for statistical analysis was used. Results Under the cystoscope imaging system, there were four different imaging manifestations in the 556 pa-tients. These were, from mild to severe, congestive type in 42 cases, spots type in 56 cases, thin macular type in 399 cases and thick macular type in 59 cases. One type could transform to another af-ter anti-infection treatment. When reexamination by the cystoscope, 131 cases got improved, 304 cases had no changes and 121 cases were aggravated. Statistical analysis showed the transformation among the 4 types had significant difference (x2 = 130.92, v=6, P<0.001). From congestive type to spots type, thin macular type and thick macular type, after anti-infection treatment, the ratio of improved cases decreased gradually, however the ratio of aggravated cases and cases without changes increased gradually. Conclusion Vesical leukoplakia could be classified into 4 types initially: congestive type,spots type, thin macular type, thick macular type. The different clinical treatments should be provid-ed.

Objective:To determine the seroprevalence of celiac disease in susceptible population, and to analyze the relationship between demographic characteristics, dietary habits, lifestyle and serological positivity so as to provide guidance for the prevention and treatment of celiac disease in Southern China.Methods:A total of 1 273 individuals who participated in Guangdong Province Health Screening Program in 2015, were selected as serologically positive subjects of celiac disease, including people with irritable bowel syndrome, colitis, diarrhea, anemia, low BMI, short stature, type 1 diabetes mellitus (T1DM), rheumatoid arthritis (RA), ankylosing spondylitis, psoriasis and bristol grade=6 or 7. All subjects were tested for serum IgA anti-tissue transglutaminase antibodies (TTGA), IgA antibodies against deamidated gliadin peptides(DGPA) and IgG against deamidated gliadin peptides (DGPG). Dietary habits, lifestyle and demographic characteristics were compared in subgroups.Results:The seroprevalence of celiac disease in susceptible population was 0.94% (95% CI 0.54%-1.64%) including 0.08% (1/1 273) for TTGA, 0.47% (6/1 273) for DGPA, and 0.39% (5/1 273) for DGPG. The seropositive rate was 3.6% (1/28) in patients with psoriasis, 2.1% (2/95) in the low BMI group, 1.9% (1/53) in T1DM group, 1.8% (3/169) in diarrhea group and 1.1% (5/463) in RA group. No significant difference was found in age, gender, high carbohydrate diet or lifestyle between the negative and the positive subjects. Conclusions:In Southern China, the seropositive rate of celiac disease is 0.94% in susceptible population, which prompts an urgent need of serological screening for early diagnosis.

Objective:To understand the molecular transmission characteristics of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome(AIDS) patients in the mountainous area of southwest Zhejiang Province(Lishui city).Methods:A total of 147 blood samples were collected from newly-diagnosed HIV-1 infected who received no antiviral therapy, and pol gene was amplified, followed by sequencing. MEGA6.0 software was used to construct phylogenetic tree and determine gene subtypes. HIVDB online was used to analyze drug resistance mutation, then the pairwise genetic distance(GD) was calculated and the opitimal threshold of GD was selected, finally the molecular transmission network was constructed by Cytoscape3.7.0 software. Chi-square or Fisher′s exact probability method was used for statistical analysis. Results:A total of 134 sequences were obtained successfully, and nine subtypes were detected. The dominant subtypes were CRF08_BC (34.33%, 46/134), CRF01_AE (29.85%, 40/134) and CRF07_BC (23.88%, 32/134). It also found that age, registered residence, education level and transmission route had significant differences in distribution of subtypes ( P<0.05). Nineteen drug resistance individuals were found, and the total drug resistance rate was 14.18% (19/134). The HIV-1 molecular transmission network was plotted based on 1.2% GD threshold. A total of 15 transmission clusters (cluster size ranging from 2 to 29) were found. The network access rate was 49.25% (66/134), mainly including male (75.76%, 50/66), heterosexual (81.82%, 54/66) and patientsrinfected with CRF08_ BC (50.00%, 33/66). A transmission cluster including two cases of female sex workers and seven cases of drug resistance was identified, in which the average age of the patients was 57.21 years old and the average degree value was 22.7, and the cases were mainly infected through heterosexual contact (96.55%, 28/29). The highest homology of the sequences in the cluster was in Yunnan. Conclusions:The HIV-1 subtypes were diverse in the mountainous area of southwest Zhejiang Province(Lishui city). Drug resistant transmission had reached a moderate epidemic level. There were molecular transmission clusters with the aggregation characteristics of elderly clients in specific regions. It was urgent to formulate and implement precise intervention strategies to curb the spread of HIV.