OBJECTIVE:To observe the clinical efficacy of pegylated interferon α-2a(Peg-INFα-2a)combined with adefovir (ADV)in the treatment of HBeAg-positive chronic hepatitis B (CHB). METHODS:An open randomized controlled clinical trial was performed. According to random number table,70 patients with HBeAg-positive chronic hepatitis B were divided into observa-tion group and control group,with 35 cases in each group. Observation group received Peg-INF α-2a combined with ADV,and control group was treated with Peg-INF α-2a only. Therapeutic efficacy and safety evaluation were evaluated after 24 and 48 weeks of treatment. RESULTS:After 24 weeks of treatment,ALT normalization rate of observation group and control group were 51.43%and 25.71%,and HBV-DNA negative rate of 2 groups were 68.57% and 37.14% respectively,with statistical significance (P<0.05). There was no statistical significance between HBsAg negative rate and HBeAg negative rate (P>0.05). After 48 weeks of treatment,ALT normalization rate of observation group and control group were 77.14% and 54.29%,and HBeAg negative rate 54.29% and 31.43%,and HBV-DNA negative rate 82.86% and 42.86% respectively,with statistical significance(P<0.05).There was no statistical significance in HBsAg negative rate and ADR (P>0.05). CONCLUSIONS:Peg-INFα-2a combined with ADV have good clinical efficacy in the treatment of HBeAg-positive CHB,and it is better than Peg-INFα-2a monotherapy and has less ADR.

Objective:To investigate the effect of local application of bisphosphonates(BPs) and systemic estrogen replacement therapy on the osseointergration of hydroxyapatite-coated implant in ovariectomized rats.Methods:12 weeks after ovariectomiy,each of the 20 female rats accepted 2 hydroxyapatite-coated implant screws in proximal tibiae,with and without immobilized BPs respectively on 2 sides.Half of the animals received subcutaneous injections of 17β-estradiol(E).Thus,there were 4 groups:control,estrogen (E),BPs and E + BPs.Tibiae with the implant screws were examined by μ-CT and push-out test was performed 12 weeks after implantation.Results:The bone volume ratio around screws and the percentage osteointegration in E + BPs group increased by 2.3-fold and 1.9-fold,and the push-out force by 3.3-fold respectively,compared to untreated controls.In group E the fixation of screws was also increased but less than that in group E + BPs.Conclusion:Systemic estrogen replacement therapy and locally immobilized BPs have additive effects on osseointergration of hydroxyapatite-coated implant screws in ovariectomized rats.

Laparoscopic anatomical hepatectomy of segment 7 is recognized as one of the most difficult hepatectomies. Because of its location and anatomic characteristics, the resection of hepatic segment 7 has the difficulties of poor surgical view, instrumental accessibility, hepatic pedicle anatomy, confirmation of dividing line and secure hemostasis. When performing laparoscopic anatomical hepatectomy of segment 7, the authors routinely put patient at left semi-decubitus position, set all trocars at the right upper quadrant of the abdomen, and select proper approach for hepatic pedicle anatomy according to the results of individualized preoperative three-dimensional reconstruction. The authors use to transect the liver parenchyma at the plane between hepatic segment 6 and segment 7, with the direction perpendicular to the right hepatic vein, and then finish parenchymal dissection using right hepatic vein as the intrahepatic landmark. According to the authors experiences, choosing appropriate tactics can effectively reduce the difficulty of laparoscopic anatomical hepatectomy of segment 7, improve the safety and controllability of operation, and ensure the oncological radical effects.

Tumor microvessel including two modes,as one is classic vascular structures surrounded with vascular endothelial cells and the other is vasculogenic mimicry( VM) surrounded with cancer cells.Recent studies suggested that anti-angiogenic drugs can inhibit classic microvessel structure significantly, but can not inhibit VM formation and even promote VM formation further more.This is one of the reasons affecting its clinical effica-cy.However,basic research has shown that traditional chinese medicine,gene therapy and drugs which is targeting for VM formation have an unique advantage in anti-VM.In this review, we summarize the progress of cancer therapy on targeting vasculogenic mimicry,and provide a basic for the development of new drugs for cancer thera-py through targeting both angiogenesis and VM formation.

Depression is a serious mental disorder characterized by lasting anhedonia and anorexia .The pathophysiology of depression is complicated , which is related to many neuroendocrine disturbances .Increased levels of glucocorticoid hor-mones and hyperactivity of the hypothalamus pituitary adrenal ( HPA) axis are the most consistent and typical pathophysio-logical alternations in patients with major depression , which are possibly caused by altered functions of the receptor of glu-cocorticoid hormones , the glucocorticoid receptor ( GR) .Promoting the expression and function of GR and restoring the im-paired feedback inhibition of the HPA axis seem to be particularly important for the therapeutic efficacy of antidepressants . In this review, the role of GR in the development and resolution of depression is discussed .

Objective To explore the possible mechanism by which protein kinase C (PKC) involves in the neuronal apoptosis induced by cerebral ischemia/reperfusion Methods After the model of ischemia/reperfusion was established in male Wistar rats, PKC activity, FOS protein expression and neuronal apoptosis in their brains were observed The effect of PKC inhibitor, Dengzhanghua, on above indexes were studied at the same time Results Cerebral ischemia/reperfusion resulted in transloactional activation of PKC, accompanied with the increase of FOS expression and neuronal apoptosis Dengzhanghua prevented against the above changes Conclusion Activated PKC is involved in ischemia/reperfusion induced neuronal apoptosis by regulating FOS expression

[Objective]To explore a new type of internal fixation system for the fixation of femoral intertrochanteric fracture.[Method]According to femoral tuberosity anatomical shape,anatomical locked hook-plate internal fixation system(ALHP) was designed,its biomechanical properties was examined and ALHP was applied for the clinical treatment of intertrochanteric fracture of the aged patients.[Result]Twenty-seven cases of intertrochanteric fracture were fixed with ALHP and followed up from 1.5 to 2 years,with an average time was 1.8 years.According to Sanders functional sores:the good and excellent rate was 100%.[Conclusion]Anatomy type locked hook-plate internal fixation system possesses reasonable design and produces firm fixation for intertrochanteric fracture.It can offer the elderly patients early exercises and reduce the incidence of complication.

Objective To retrospectively analyze the clinical features,diagnostic experience and therapy of pulmonary embolism for reduction of misdiagnosis and missed diagnosis,and for improving the cure rate.Methods The data of clinical features,findings by auxiliary examination and therapeutic efficacy of 67 patients with pulmonary embolism admitted to the First Affiliated Hospital of General Hospital of PLA were summarized.The usual clinical manifestations were summarized based on the clinical symptoms of and the frequency of objective signs in the patients with the correct diagnosis.Auxiliary examinations included routine and sophisticated examinations such as CT pulmonary angiography(CTPA) and emission computed tomography(ECT),which were specially emphasized for summing up and optimizing the diagnosis.Comparisons were made of the therapeutic efficacy and complications between the treatment with thrombolysis combined with anticoagulation and simple anticoagulation.Results The primary clinical manifestations of the patients with pulmonary embolism included dyspnea,cough,chest pain,fever and hemoptysis,etc.Findings of D-Dimer assay might serve as a sensitive but not specific indicator in screening the suspected patients.For the sophisticated examinations,CTPA confirmed the diagnosis in 28 out of 31(90.32%) patients,and ECT confirmed the diagnosis in 39 out of 51(76.47%).All the patients who had undergone lung angiography received the final diagnosis,but the majority of them were reluctant to accept this examination because of potential risk of the technique.The total cure rate of thrombolysis combining anticoagulation was 90.62%(29/32),in which the administration of recombinant tissue-type plasminogen activator(rt-PA)-2h was most efficacious(with 100% of cure rate).Simple anticoagulation therapy gave a lower cure rate(68.57%,24/35) but a higher incidence of hemorrhagic complication(31.25%).After the administration of thrombolysis combined with anticoagulation therapy,both PaO2 and CTPA examinations showed significant changes for the better after the treatment compared with that before the treatment(P

Down-regulation of adult hippocampal neurogenesis has been regarded as one of the important biological and cellular basis of depression. Recent studies have shown that there is a close correlation between neurogenesis and angiogenesis. Several angiogenesis factors, especially vascular endothelial growth factor (VEGF), play a vital role on angiogenesis. They not only have the neurotrophic and neuroprotective effects, but also up-regulate hippocampal neurogenesis. Thus,VEGF may be involved in the occurrence and treatment of major depression. This article reviews current understanding of the relationship between adult brain angiogenesis and depression.

Rupture of anterior cruciate ligament (ACL) is a common sports injury.It will cause knee osteoarthritis because of joint instability and acceleration of degenerative changes after injury.Arthroscopic reconstruction with a tendon graft is a common procedure to achieve function recovery.A series of histological changes and structural modification happened between the tendon and bone tunnel after ACL reconstruction and complete tendon-bone healing was achieved finally.A number of factors affects the healing process which determined the long-term result of the treatment.Published literatures reported that about 11％-32％ patients underwent ACL reconstruction were not satisfied with the results and 10％ of them required reoperation.Studies on the tendon-bone healing have long been a research hotspot in sports medicine.Controversy still remains not only on the fundamental healing process but also on the stimulating factors despite of a large amount of researches on its physiological basis,influencing factors,et al.This article provides a review of the basis and influence factors of the healing process,and summarizes the methods to accelerate the process of tendon-bone healing.