Objective To investigatethe changes of serum IL-12 level and Th balance of chronic hepatitis B (CHB) patients in the course of lamivudine therapy and the related significance. Methods According to the differ ent responses to lamivudine therapy, patients were divided into three groups: group I ( n = 10), HBeAg positive CHB and complete response group; group Ⅱ (n = 10), HBeAg positive CHB and non-complete response group;group Ⅲ ( n = 5), HBeAg negative CHB group. Sera were collected from patients with chronic hepatitis B before and after lamivudine therapy and healthy blood donors. Then serum IL-12, IFN?, and IL-4 levels were measured by ELISA method. The ratio of IFN?/IL-4 was selected as the marker of Th balance after comparison with that of the normal control. Results Before therapy, serum IL-12 level in chronic hepatitis B patients was lower than that of the healthy blood donors, and Th balance tendency was to Th2 direction. After lamivudine therapy, serum IL-12 level was increased. The highest point of IL-12 was observed in complete response group at the third month after therapy.The tendency of Th balance was to Th 1 direction in complete response group and to Th 2 direction in non-complete response group and HBeAg negative group. Conclusion After lamivudine therapy, the immunity response to HBV of chronic hepatitis B patients can be recovered. The response degree to therapy is associated with the level of serum IL-l2 and Th balance recovery level after lamivudine therapy. Serum IL-12 level may be an appropriable marker to predict the effect of lamivudine therapy in earlier period of the whole course. The recovery of Th balance is the assurance of complete response.

Objective To investigate the safety and short-term effect of anatomical hepatectomy for the treatment of hepatolithiasis with the caudate lobe as the sole remnant liver.Methods The clinical data of 1 patient with hepatolithiasis combined with liver atrophy-hypertrophy syndrome who was admitted to the Hunan Provincial People's Hospital in April 2014 were retrospectively analyzed.The stones were located in the left and right liver, the involved liver became fibroatrophy, and the hepatic caudate lobe not containing stones became hypertrophy.The body surface area of the patient was 1.65 m2 , standard total liver volume was 1 167.63 mL.According to the result of CT, expected residual liver volume after hepatectomy was 706.12 mL, and the ratio of residual liver volume over the standard total liver was 60.47％.The radio of residual liver volume over the body mass index was 1.21％.The patient received the second exploration of common bile ducts, hepatectomy with the caudate lobe as the sole remnant liver and T tube drainage.The follow-up including recurrence of calculus was performed by outpatient examination and telephone interview up to April 2015.Results The patient underwent caudate lobe as the sole remnant liver following anatomical hepatectomy successfully without blood transfusion.The operation time and volume of intraoperative blood loss were 380 minutes and 350 mL.The peritoneal drainage tube was removed at postoperative day 2 and the patient was discharged at postoperative day 8 with a good recovery of liver function.The postoperative pathological examination showed that there were focal biliary epithelial papillary hyperplasia combined with light-medium atypical hyperplasia and no canceration.The T tube cholangiography two month later showed that there were unobstructed lower bile duct and no residual intra-and extra-hepatic stones.The liver function was normal.Then T tube was removed and patient resumed normal life.During the 1-year follow-up, no chills and fever, jaundice and abdominal pain occurred, no calculus was detected by B-ultrasonography, and computed tomography reexamination showed that remnant liver volume was increased and no intra-and extra-hepatic bile duct stones were detected.Conclusion Anatomical hepatectomy for the treatment of hepatolithiasis with the caudate lobe as the sole remnant liver is safe and feasible, with a good curative effect.

Purpose/Significance To understand the fragmented reading behavior of the core user group of hospital libraries,and to propose countermeasures to improve the reading service.Method/Process The fragmented reading behavior data of 3 user groups(doc-tors,nurses,and medical technicians)in Children's Hospital of Soochow University are collected through the questionnaire method,and the characteristics of fragmented reading behavior of each group of users are analyzed.Result/Conclusion Fragmented reading has be-come an important informal learning approach for core users of hospital libraries.Users with different positions,titles and educational backgrounds have different fragmented reading behaviors.Hospital libraries can improve the level of fragmented reading service by provi-ding diversified reading services,promoting the learning type fragmented reading platforms,integrating collection resources and optimizing the overall spatial layout.

Objective:To investigate the efficacy of personalized family doctor contract services on risk factors of atherosclerotic cardiovascular disease (ASCVD) in high-risk population.Methods:Ten matched-community health centers of Shenzhen Luohu district were divided into intervention group and control group by cluster randomiztion. Subjects with high risks of ASCVD were screened out as intervention group from contracted residents who visited these centers and had complete data of the China-PAR model from August 2018 to April 2019. The control group received conventional general family doctor contract services. The individualized management were given to the intervention group after fully understanding patients′ ideas, concerns, and expectations (ICE). After 2-year intervention, score changes of ASCVD risk factors within and between groups were compared.Results:A total of 571 patients were enrolled, including 288 in the intervention group and 283 in the control group. After 2 years of intervention, 7 and 18 were lost to follow-up in two groups, respectively. Finally, 281 in the intervention group and 265 in the control group were included in the study. At baseline, there was no significant difference in ASCVD scores between the intervention group and the control group [(13.33±3.54) vs. (13.09±3.54) points; t=0.84, P=0.403], and the scores in both groups decreased significantly after the intervention [(10.89±4.01), (11.62±4.11) points], while the intervention group decreased more significantly (both P<0.05). Among the risk factors at baseline, HDL-C and diastolic blood pressure in the intervention group were lower than those in the control group, and there were no significant differences in other factors between the two groups. After the intervention, the levels of total cholesterol, systolic blood pressure and diastolic blood pressure in the two groups decreased significantly, and the number of people taking antihypertensive drugs increased significantly ( P<0.001 and P<0.05); HDL-C decreased in the control group ( P=0.023). After the intervention, compared to control group the intervention group had a higher proportion of patients taking antihypertensive drugs, with lower systolic and diastolic blood pressure ( P<0.05). After the intervention, the increase rate of HDL-C in the intervention group was more than that in the control group, and the decrease rate was less than that in the control group (χ 2=6.65, P=0.036). Conclusion:Family doctor contract services can reduce the risk factors of ASCVD, and personalized family doctor contract services can further improve the effects in the prevention and control of ASCVD. However, the effects might be insignificant and inconsistent for the ASCVD risk factors with deeper management requirements or no specific management measures, which highlights the complexity and diversity of ASCVD prevention and control, calling for multi-level and multi-faceted thinking and exploration.

Objective To explore the effect of head and face manipulation combined with five elements music therapy on the vertigo patients with insomnia in order to improve their sleep quality .Methods Sixty-eight vertigo patients with insomnia were chosen and divided into the control group ( n=33) and the intervention group ( n=35) .The control group received the oral estazolam , and the intervention group received the head and face manipulation combined with five elements music therapy .The curative effect and sleep quality were compared between two groups .Results The total effective rate was 94.29%in the intervention group , and was 75.75%in the control group, and the difference was statistically significant (U=3.88, P<0.01).Conclusions The head and face manipulation combined with five elements music therapy can significantly improve sleep quality of the vertigo patients with insomnia , and increase the clinical effect and life quality of patients .

A Survey on the current general practice residency training was carried out in January 2018 among 1 114 general practitioners (GPs) who attended the standardized residency training program during 2014-2017. Basic information was obtained from the management department, other information was obtained from questionnaire. Total 1089 valid questionnaires were received with a retrieval rate of 97.8%. The survey showed that the ratios of male trainees, trainees aged 20-30 years and with bachelor degree were increasing during 2014-2017. The participants were more satisfied with the teaching quality in general hospital bases than that in community practice bases. Participants suggested to improve teaching quality, add teaching contents of humanity courses and TCM knowledge. Only14.4%(157/1 089) participants choose GPs as their career because liked this specialty. And 77.7%(846/1 089) GPs understood the main work of GP. There were 81.4%(887/1 089) participants wanted to work in; 77.7%(846/1 089) participants thought that the prospect of general practice would be excellent or good. Increasing income, professional promotion and a sense of social recognition were their wishes. Standardized residency training is crucial for general practitioners to upgrade their quality and competence, to improve training quality and to develop incentive policies are necessary.

In left heart disease, pulmonary artery pressure would increase due to the elevated left atrial pressure. This type of pulmonary hypertension (PH) is belonged to type Ⅱ as a passive PH (pPH) in its classification. The essential cause of pPH is excessive blood volume. Recently, we have identified another type of pPH, which is induced by vasopressors. Vasopressor-induced pPH shares similar pathophysiological manifestations with left heart disease-induced pPH. pPH would, therefore, be aggressive if vasopressors were applied in patients with left heart disease, which may be common after cardiac surgery, because heart undergoing surgical trauma may require support of vasopressors. Unfortunately, pPH after cardiac surgery is often ignored because of the difficulty in diagnosis. To improve the understanding of pPH and its effect on outcomes, here we highlight the mechanisms of interaction between vasopressor-induced and left heart failure-induced pPH, and provide insights into its therapeutic options.

Objective    To investigate the protective effect and mechanism of curcumin on lipopolysaccharide (LPS)-induced acute lung injury. Methods    Totally 24 SD rats were randomly divided into a control group, a LPS group and a LPS+curcumin group (n=8 in each group). The degree of lung injury (oxygen partial pressure, wet/dry ratio, pathological scores) and inflammatory levels [tumor necrosis factor (TNF)-α, interleukin (IL)-6, monocyte chemotactic protein (MCP)-1, Toll-like receptor 4 (TLR4), mobility group box 1 protein (HMGB1) expression] of the lung were detected in different groups. Results    Oxygen partial pressure was significantly lower in the LPS group than that in the control group (P<0.05), while wet/dry ratio, pathological scores and expression levels of TNF-α, IL-6, MCP-1, TLR4 and HMGB1 were significantly higher in the LPS group than those in the control group (P<0.05). Compared with the LPS group, curcumin significantly reduced wet/dry ratio, pathological scores and expression levels of TNF-α, IL-6, MCP-1, TLR4 and HMGB1 in the LPS+curcumin group (P<0.05), while it significantly improved oxygen partial pressure (P<0.05). Conclusion    Curcumin might protect LPS-induced acute lung injury through inhibition of TLR4-HMGB1-inflammation pathway.