Objective To understand the hepatitis B virus(HBV)genotyping and pre-existing antiviral resistance mutation in the patients with clinical chronic HBV infection in Shenzhen area.Methods Serum samples in 244 cases of chronic HBV infection were detected for HBV genotyping and pre-existing antiviral resistance mutation by using PCR combined with reverse dot hybridization. Results In 244 cases of chronic HBV infection,3 kinds of genotype were found,including 143 cases(58.6%)of genotype B,100 ca-ses(41%)of genotype C and 1 case(0.4%)of genotype D;38 cases(15.57%)of pre-existing antiviral resistance mutation were de-tected out.The total detection rate of pre-existing antiviral resistance mutation was 15.57%,in which 22 cases(9.01%)were related with lamivudine resistance and 16 cases(6.56%)were related with adefovir dipivoxil resistance.Conclusion The genotype B and C are the main genotypes in Shenzhen area,and the incidence rate of pre-existing antiviral resistance mutation in the patients with chronic HBV infection is relatively high.The detection of genotyping and pre-existing antiviral resistance mutation of HBV has the important significance to predict the disease progression and guide the individulized treatment.

Objective To investigate the effects of whole grain-bean mixed staple food on intestinal microecology,anthropometric,and metabolic parameters of obese people.Methods Totally 87 obese people were divided with random number table into whole grain-bean mixed staple food group (test group) and refined grains staple food group (control group).Body weight (BW),body mass index (BMI),waist circumference (WC),hip circumference (HC),waist/hip ratio (WHR),fasting plasma glucose (FPG),triglyceride (TG),total cholesterol (TC),high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C),and colony count of intestinal flora (bacillus bifidus,lactobacillus,clostridium perfringens,enterobacteria,enterococcus,bacteroides) were measured at baseline and 3 months after intervention.Results Ten people were excluded from this research,6 in the test group and 4 in the control group.Mter 3 months of dietary intervention,BW,BMI,WC,HC,and WHR were significantly lower in the test group than in the control group [(69.45 ± 7.07) kgvs.(72.42 ±5.79) kg,P=0.000; (26.08 ±1.48) kg/m2 vs.(27.27 ±0.81) kg/m2,P=0.000; (82.48±9.30) cm vs.(86.96±4.93) cm,P =0.000; (90.08 ±6.57) cm vs.(92.42 ±6.67) cm,P =0.000; 0.92 ±0.11vs.0.95 ±0.10,P =0.003].The levels of FPG,TC,and LDL-C in the test group were significantly lower than those in the control group [(4.92 ± 0.75) mmoL/L vs.(5.41 ± 1.21) mmoL/L,P=0.037; (3.85±1.13) mmoL/L vs.(4.38 ±1.26) mmoL/L,P=0.046; (3.55 ±1.04) mmoL/L vs.(4.16 ± 1.40) rnmoL/L,P =0.033] ; the level of HDL-C in the test group was significantly higher than that in the control group [(1.13 ± 0.37) mmoL/L vs.(0.92 ± 0.26) mmoL/L,P =0.004].The colony counts of intestinal bacillus bifidus,lactobacillus,and bacteroides in the test group were significantly higher than in the control group [(7.94 ± 0.58) lg CFU/g vs.(6.95 ± 0.38) lg CFU/g,P =0.000 ; (7.67 ± 0.46) lg CFU/g vs.(6.96 ± 0.57) lg CFU/g,P =0.000 ; (5.53 ± 0.44) lg CFU/g vs.(4.80 ±0.23) lg CFU/g,P =0.000],while the colony count of clostridium perfringens was significantly lower than in the control group [(4.40 ± 0.49) lg CFU/g vs.(5.11 ± 0.63) lg CFU/g,P =0.000].Conclusions In obese people,whole grain-bean mixed staple food can improve anthropometric parameters,some lipid metabolic parameters,and intestinal flora.The underlying mechanism may involve promoting the survival and proliferation of probiotics,thereby improving glucose and lipid metabolism.

Objective To explore the pathogenesis mechanism of hyperoxic lung injury and the effective means for its clinical treatment,the difference of the gene expressions between lung tissues of hyperoxic lung injury and normal lung was compared.Methods The differentially expressed genes between lung tissues of hyperoxic lung injury and normal lung were obtained from PubMed.The dysregulated genes in lung tissues of hyperoxic lung injury were analyzed by a series of bioinformatics methods,including pathways,gene ontology and functional annotation clustering analysis.Results 467 lines of differentially expressed genes were found and genes more than 2-fold regulated were 189.We sought the mapping of genes in the KEGG databases through functional annotation tools,and we discovered there were 5 lines of pathways with difference having outstangding statistical significance through metabolic pathways enrichment degree analysis.It reflected the pathways were closely related to hyperoxic lung injury (the 2-fold upregulated genes were 14,the 2-fold down-regulated genes were 6).GO analysis revealed that these genes were involved in hematopietic cell lineage,axon guidance,adherens junction,T cell receptor signaling pathway and focal adhesion.Conclusions Therefore,it is believed that the above-mentioned 20 lines of gnes are the major ones for the hyperoxic lung injury and the research on them will provide effective means for revealing the molecular mechanism of hyperoxic lung injury and identifying the targeted therapy.

The evaluation of undergraduate course teaching by the Ministry of Education is a challenge to all our teachers,but it is also a chance for us to improve the teaching quality of infectious disease class.In this article we summarized the experience of the infectious disease education reform of many years,and discussed the approach and means of improving the teaching quality of infectious disease class.

Objective To compare the scores of amplitude-integrated electroencephalogram (aEEG) tracings between preterm infants who were smaller for gestational age (SGA) and those who were appropriate for gestation (AGA).Methods A total of 139 preterm infants were collected in the Neonatal Intensive Care Unit of the Affiliated Hospital of Guangdong Medical College during the period of Mar.2013 to Feb.2014.One hundred and fourteen patients met the inclusion criteria with gestational ages from 32 to 36 weeks at birth,including 54 SGA infants and 60 AGA infants.The aEEG recordings were obtained within 72 h after birth by using the NicoletOne monitor.Duration of each recording was at least 3 h.Five aspects of each tracing,such as continuity (Co),sleep-wake cycling (Cy),amplitude of the lower border (LB),bandwidth (B) and total maturation scores,were evaluated and compared between 2 groups by applying a aEEG scoring system.Results 1.As SGA infants,scores for Co,Cy,LB,B as well as total maturation scores were progressively increased with gestational age advancing(all P ＜ 0.05).As AGA infants,scores for Cy,B and total maturation scores progressively increased with advancing gestational age (all P ＜ 0.05),but there were no statistical differences between each gestational ages in Co,LB scores (all P ＞ 0.05).2.Linear regression analysis of SGA infants' gestational age to Co,Cy,LB,B and total maturation scores showed positively correlation,and the correlation coefficients were 0.438,0.597,0.385,0.606 and 0.608,respectively (all P ＜ 0.05).As AGA infants,a positive correlation between gestational age and Cy,B as well as total maturation scores were observed,and the correlation coefficients were 0.528,0.615 and 0.635,respectively (all P ＜ 0.05).3.At the same gestational age,both the B scores and total maturation scores in SGA group were lower than those in AGA group.Conclusions SGA and AGA,Co,Cy and total maturation scores can be used to evaluate the maturation of cerebral function.At the same gestational age,the scores of B and total maturation scores are lower in the SGA,and this might be associated with their delayed neuromotor development.

OBJECTIVE: To study the diagnosis and treatment of parotid Lymphoepithelioma-like carcinoma (LELC), and improve the rate of the diagnosis and treatment. METHOD: Eighteen cases with parotid LELC confirmed pathologically were collected in our department, and the clinical presentation, diagnosis, treatment and prognosis were retrospectively summarized and analyzed from 1982 to 2002. RESULT: All of these LELC patients were found in unilateral side. All cases received Epstein-Barr virus serological test except 2 cases because of refusing, and the testing result displayed: EBV-VCA-IGA positive rate in 93% (15/16); EBV-EA-IGA in 75% (12/ 16); EBV-DNA enzyme in 63% (10/16). Of 16 cases with facial nerve reserved, parotid superficial lobectomy were undertaken in 6 cases, resecting a majority of parotid in 5 cases, whole lobectomy in 5 cases. Facial never resection and whole lobectomy in 2 cases due to facial nerve trunk involved. Functional neck lymph dissection in superior and middle part was undertaken in 14 cases and radical neck lymph dissection in 4 cases, total neck lymph node metastasis rate was 67% (12/18). All of patients received radiotherapy to 50-70 Gy. The follow up were over 1 year, and local recurrence occurred in 2-4 years after operation for 4 cases and had to undergo reoperation. The 1, 3, 5 years survival rates of the 18 cases were 94% (17/18), 72% (13/18) and 50% (9/18), respectively. The chief Causes of death were distant metastasis and local recurrence. CONCLUSION There maybe be close relationship between occurrence of LELC and Epstein-Barr virus infection. Its histopathologic feature is similar to undifferentiated nasopharyngeal carcinoma and nasopharynx biopsy must be demanded before confirming diagnosis for eliminating metastasis focus. The neck lymph node metastasis rate of LELC is high and local invasion is strong. It is important to undergo enlarged local resection, neck lymph dissection and postoperative radiotherapy.
Adolescent ; Adult ; Aged ; Antigens, Viral ; analysis ; Carcinoma ; diagnosis ; surgery ; virology ; Female ; Herpesvirus 4, Human ; pathogenicity ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neck Dissection ; Parotid Neoplasms ; diagnosis ; surgery ; virology ; Prognosis ; Retrospective Studies ; Young Adult

Medical insurance services provided by medical institutions are managed by medical insurance agencies via agreements, one of the most popular means of management. Hence the safe use of medical insurance funds depends on the correct performance of medical insurance service agreements. To improve the standardization and accuracy of medical insurance agreement management behavior, and protect the interests of medical institutions and the insured at large, the authors demonstrated the feasibility and necessity of public interest litigation in medical insurance agreement management from both theoretical and practical perspectives. They also proposed to promote the effective resolution of medical insurance disputes by expanding clues sources, strictly the initiating thresholds, and maintaining the modesty of public interest litigation.

OBJECTIVE: To investigate the effects of radioactive ray on transmission capability of nose mucociliary. METHOD: Forty-six patients with NPC were selected and saccharin clearance time (SCT) for 7 phases were detected in both pre- and post-radiotherapy respectively. RESULT: Among 46 patients with NPC, the shortest SCT was 247 seconds and the longest 601 seconds in pre-radiotherapy phases; from 4th week of introradiotherapy to 18 months of postradiotherapy, the longest SCT was in 12 months after radiotherapy, which was 903 seconds. There were no significant differences in SCT before radiotherapy and 18 months after radiotherapy. There were significant differences in SCT of preradiotherapy and introdiotherapy, post radiotherapy, after radiotherapy 3 months, 6 months, 12 months after radiotherapy. CONCLUSION Radiotherapy is the important factors in influencing transmission capability of nose cavity and sinus mucociliary and hints that gender and nasal cavity side don't affect SCT. Detection of SCT in different stages of NPC patients can be helpful to protect nasal mucous membrane effectively, and to reduce incidence rate of RNS.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Mucociliary Clearance ; radiation effects ; Nasal Mucosa ; physiopathology ; Nasopharyngeal Neoplasms ; physiopathology ; radiotherapy ; Saccharin ; metabolism ; Young Adult

Objective To explore the application of Monte Carlo simulation in optimizing and adjusting the reimbursement scheme with regard to the New Rural Cooperative Medical System (NCMS)to scientific steering practice. Optimization of the reimbursement scheme in rural areas of China was also studied. Methods A multi-stage sampling household survey was conducted in Sihui county,with 4 433 rural residents from 1 179 households from 13 towns in Guangdong province surveyed by self-designed questionnaire. Probit Regression Model was applied in fitting data and then estimating the own-price elasticity and cross elasticity of healthcare demand for both outpatients and inpatients. Monte Carlo simulation model was constructed to estimate the reimbursement effects of various alternative reimbursement schemes,by replicated simulation for one thousand times and each sampling on five hundred households. In this way,optimization of the implemented reimbursement scheme in Sihui county was conducted. Results Own-priced elasticity of demands for outpatient visit,inpatient visit in the township hospital center,secondary hospital and tertiary hospital were-0.174,-0.264,-0.675 and -0.429,respectively. Outpatient demand was affected by the per-visit price of township hospital center and secondary hospital. The cross-priced elasticity of demands for outpatient visit appeared to be 0.125 and 0.150. The reimbursement effects of Scheme B7 showed that the efficiency of NCMS fund was 17.85%,the reimbursement ratio for healthcare was 25.63%,and the decreased percentages of poverty caused by illness was 18.25%,more than 9.37%, from the implemented scheme A. So the implemented scheme was in need for optimization. Conclusion Monte Carlo simulation technique was applicable to simulate the effects of the optimized alternative reimbursement scheme of NCMS and it provided a new idea and method to optimize and adjust the reimbursement scheme.

Objective To evaluate the clinical efficacy of antibiotic -impregnated shunt catheters in hydrocephalus shunt. Methods A retrospective analysis of clinical data from patients with hydrocephalus shunt surgery in our hospital during the period from May 2011 to August 2016. Based on the types of catheters, patients were divided into common conduit (not AISCs group) and antibiotics infiltrating pipe groups (AISCs group). All patients were followed up for 6 months after shunt surgery. The diversion and infection was recorded. Results The data of 193 patients with hydrocephalus shunt were analyzed, including 124 cases of non-AISCs group and 69 cases of AISCs group. Compared with non-AISCs group,the incidence of postoperative infection of AISCs was significantly decreased(P<0.05). There was no significant difference in the incidence of shunt and reoperation between the two groups (P>0.05). In addition, there was no significant difference in the rupture, displacement and exposure of the two groups (P>0.05).Conclusion ASICs can effectively reduce the incidence of hydrocephalus shunt infection.