With the development of automated quantitative detection of serum hepatitis B surface antigen ( HBsAg) , HBsAg quantification is becoming increasingly important in management of chronic HBV infections.Studies have shown that HBsAg quantification together with HBV DNA load may be used to monitor the natural history of chronic HBV infection as well as to predict the clinical outcome of interferon treatment.However, there is no consensus on the clinical use of HBsAg quantification for evaluating patients′responses to nucleos( t) ide analogues therapy.This paper reviews the up-to-date clinical studies on the clinical significance of HBsAg quantification in management of chronic HBV infection.

Objective To evaluate the short-term therapeutic effect of entecavir in treatment of HBV-related liver failure.Methods Randomized controlled trails on treatment of HBV-related liver failure with entecavir were searched in Embase,PubMed,BIOSIS Previews,HMIC,CNKI,Wanfang data,cqvip and SinoMed from March 2005 to September 2012.Meta-analysis was performed by using RevMan 5.0 software.Fixed effects model or random effect model was used according to heterogeneity differences.To evaluate the effect of entecavir,risk ratio (RR) was applied to assess the improvement of mortality rate and HBV DNA negative conversion rate,and weighted men differences (WMD) was applied to assess the changes of alanine aminotransferase (ALT),total bilirubin (TBil),albumin (Alb) and plasma thromboplastin antecedent (PTA) levels.Funnel plots and fail-safe number were used for sensitivitypublication bias analysis.Results Totally 10 eligible literatures with 790 patients were included in this analysis.Compared with the controls,the mortality rate (RR =0.68,95％ CI =0.56 to 0.81,Z =4.21,P＜0.01),TBil (WMD=-133.97,95％CI=-185.15 to-82.78,Z=5.13,P＜0.01) and ALT (WMD =-99.81,95％ CI =-187.37 to-12.24,Z =2.23,P ＜ 0.01) levels were lower in entecavir group,while HBV DNA negative conversion rate (RR =5.21,95％ CI =3.66 to 7.42,Z =9.15,P ＜0.01),PTA(WMD=21.49,95％CI=19.32 to 23.67,Z=19.37,P＜0.01) and Alb (WMD=3.81,95％CI=1.24 to 6.37,Z=2.91,P＜0.01) were higher in the entecavir group.Conclusion Entecavir can significantly reduce mortality rate,ALT and TBil levels,improve PTA,Alb levels and increase HBV DNA negative conversion rate for patients with HBV-related liver failure.

Heart failure is a common critical disease in children.Systolic heart failure can be caused by common diseases in children such as congenital heart disease,fulminant myocarditis and arrhythmogenic cardiomyopathy.Positive inotropic drug is the most common medication for treating systolic heart failure in children.Common inotropic drug includes digitalis,β-receptor agonist,phosphodiesterase inhibitor and calcium sensitizers.This article reviewed the using and progress of positive inotopic drugs.

Objective To observe the clinical characteristics and improve the diagnosis and treatment of right coronary artery anomalies in children.Methods The clinical characteristics,laboratory examination,treatment and prognosis were retrospectively analyzed in children with right coronary artery anomalies (complex cardiac anomalies was excluded),who were admitted into Beijing Children's Hospital Affiliated to Capital Medical University from January 2009 to December 2014.Results A total of 8 medical records of children with right coronary artery anomalies,among whom 5 cases were male and 3 cases were female,with a mean age of (7.06 ± 1.37) years old.In these 8 patients,there were 5 patients with right coronary artery originating from left coronary sinus,1 patient with right coronary artery originating from left wall of aorta,1 patient with single left coronary artery type Lipton L Ⅱ,and 1 patient with right coronary artery absence.The main symptoms included chest distress,chest pain and palpitation in elder children,but in infants,the primary symptom was poor feeding.One case of these patients represented syncope.Electrocardiogram of these patients showed ST-T wave changes,sinoatrial block,and sinus arrest.Ultrasonic cardiogram failed to discover the coronary artery anomalies.Four cases showed enlarged left ventricular end-diastolic diameter,and 1 case showed slight decrease of left ventricular ejection function.All 8 patients were given myocardial tonic with limitation in doing exercise,and clinical follow-up studies were conducted for 6 months.Four patients with enlarged left ventricular were treated with Captopril,and 3 patients of them recovered after 3 to 6 months.Two patients with sinus node malfunction were treated with permanent pacemaker implantation in other hospitals.Conclusions Right coronary artery anomaly in children is rare.Patients with cardiac ischemia and sinus node malfunction should be aware of right coronary malformation.64-section multidetector computerized tomography angiography can diagnose right coronary artery anomalies.To patients with right coronary artery anomalies,vigorous exercises should be avoided to decrease adverse cardiac events.

Objective To describe the academic impact of publications from National Institute of Parasitic Diseases （NIPD），Chinese Center for Disease Control and Prevention，so as to give the quantity evidence for scientific research decision making. Methods The SCIE papers of NIPD published from 2011-2015 were searched and statistically analyzed. The number of published papers，citation frequencies，h⁃index，and funding resources were analyzed. The academic impact of the institute was assessed according to these data. Result A total of 361 papers were published by NIPD，and the quantity increased year by year. The majority type is original articles. The total citations were 1 641 times，the average citation per paper was 5.19 and h⁃index was 17. The majority of these papers were published in foreign professional periodicals，whose impact factors were between 1.194 and 6.751. The major resources of NIPD were from China，and NIPD also had good collaborations with institutions in US and Switzerland. In China and Asia，NIPD led the research in the field of parasitology and tropical medicine. Conclusion The quantity and quality of annual published papers of NIPD are on the rise. However，NIPD lagged behind the leading institutions in the world.

Histone acetyltransferases(HATs) faciliate histone acetylation and histone deacetylases(HDACs) serve to remove acetyl groups from histones.The activation and repression of gene expression can be regulated by the acetylation of histone or specific genes.It is certified that acetylation of related genes is down-regulated in diabetic retinopathy,retinal ischemia-reperfusion,degenerative retinopathy,infective retinopathy and retinal tumors,which results in cell apoptosis and retinal dysfunction.So the physiology and pathology of retina have a close relation.The effects of histone acetylation and deacetylases on retinal diseases are still studying because of the complexity and diversity of genetic modification io epigenetic inheritance.This article reviewed the classification of HATs and HDACs and their inhibitors,their effects and function,their relationship to retinopathy,and discuss the protection of their inhibitors to retina.

Chronic Disease ; Humans ; Rhinitis ; Sinusitis

Acromioclavicular Joint ; injuries ; surgery ; Endoscopy ; Humans ; Joint Dislocations ; surgery ; Ligaments ; surgery ; Reconstructive Surgical Procedures

AIM: To promote the clinical application of biology-psychology-social medical mode in national hospitals.METHODS: To analyze the clinical applicative characteristics of biopsychosocial medical mode to enhance to complete understanding of the scientific intension of modern medical mode by medical professionals, and thereby to improve the consciousness in the application of modern medical mode.RESULTS: Hospitals must establish the patient-centered medical service mode, which not only understand the generative process of the disease, but also pay attentions to the physiological changes of the patients, and pay more attentions to the life character and social environment of the patients as well to form patient-centered integrative diagnostic therapeutic system.CONCLUSION: Patient-centered medial service mode represents the scientific intension of biopsychosocial medical mode, which should be greatly developed to advance the transition of medical mode.Yuan Z. Clinical applicative charocteristics of biopsychosocial medical mode.

Enhanced recovery after surgery (ERAS) combines various techniques used in the care of patients undergoing elective surgery,with an aim to attenuate the surgical stress response and energy loss,improve the organ function,reduce postoperative complications and the time required for full recovery.ERAS was first applied in the colorectal surgery,and gradually expanded to other surgical areas.As for ERAS in the gastric surgery,the safety and efficacy have been proved preliminarily by evidence-based medicine.However,there is still controversy about the individual items of the ERAS programs due to limited studies.Recent publications of the 2014 consensus guidelines for enhanced recovery after gastrectomy Enhanced Recovery After Surgery (ERAS@) Society recommendations that was composed by the ERAS Society indicated the developing direction of ERAS,and also updated perioperative practice to each medical unit implementing ERAS.Meanwhile,general principles (guideline or consensus) and patients' conditions should be combined closely into clinical practice.Since gastric cancer surgery is complex and patients' conditions are various,further research may focus on individualized ERAS.In the further study,more high-quality randomized clinical trials with single-component administration in fast recovery settings need to reach more definite conclusions and recommendations.Furthermore,attentions should be paid to enhance patients' compliance with the ERAS items.