Objective To evaluate the efficacy of telbivudine in HBeAg-positive chronic hepatitis B (CHB) patients by comparing the efficacy of initial telbivudine therapy in treatment-naive patients with sequential telbivudine therapy in patients with poor response to adefovir.Methods A total of 90 HBeAg-positive CHB patients were assigned to receive sequential telbivudine therapy following poor response to adefovir dipivoxil (n=45),or initial telbivudine therapy in antiviral treatment-naive patients (n=45).All patients were treated with telbivudine 600 mg daily for 104 weeks.The efficacy was evaluated in terms of liver function tests,serum HBV markers,HBV DNA and antiviral drug resistance.Results Telbivudine showed good overall efficacy after treatment for 104 weeks in terms of alanine aminotransferase normalization rate (91.1％),HBV DNA negative conversion rate (80.0％),HBeAg loss rate (57.8％),and HBeAg/HBeAb seroconversion rate (30.0％).The HBV DNA negative conversion rate in initial treatment group was significantly higher than that in sequential treatment group (P＜0.05).However,among the patients with early response,the efficacy did not show significant difference between groups (P＞0.05).The patients with early response showed significantly better efficacy than those without early response,in terms of higher HBV DNA negative conversion rate,higher HBeAg loss rate and HBeAg/ HBeAb seroconversion rate (P＜0.000 1 or P＜0.05),but lower virological breakthrough rate (P＜0.05).Conclusions Telbivudine has shown reliable efficacy in CHB patients.Initial telbivudine therapy is better than sequential therapy in CHB patients with poor response to adefovir.However,for patients with early response to telbivudine,no statistical difference is found between initial and sequential therapy in long-term treatment efficacy (104 weeks).The patients receiving sequential telbivudine therapy should be monitored closely for early antiviral response to optimize treatment.

Objective To observe the change of serum TG in elderly diabetic patients after fatty meal.Methods The diabetic patients and non-diabetic patients of fasting normotriglyceridemia ate the fatty test meal after having been fasting for 12h.Serum lipid were measured at 0,2,4 and 6h after the meal.Results The serum TG level increased in the two groups after the meal,the diabetic patients had a higher TG-AUC than the non-diabetic patients (P

Paroxysmal nocturnal haemoglobinuria ( PNH) is a clonal hematopoietic stem cell disease characterized by intravascular hemolytic anemia , pancytopenia and thrombosis .Although PNH is an non-malignant disease , its complications have very negative impacts on patient's quality of life .The most common serious complication is thrombosis formation .

[Objective] To investigate the causes,indications,operative methods and clinical results of lumbar reoperation.[Methods]Twenty-eight failure lumbar procedure cases were received reoperation from May 2003 to May 2005.There were 16 males and 12 females.These cases were from 31 to 70 years old(mean 47).It took a mean 1 year and 8 month(from 1 month to 8 year)from last operation to this registry.The causes of reoperation included rehemiated disc nucleus pulpous,degeneration of adjacent segment and instability and insufficiency of canal decompression.Some cases of discogenic back pain were operated by mistaken procedure.Some cases involved severe complications including infection in disc space or vertebral itself,pedicle screws misposition,aneurysm formation and CSF leakage.The operative methods included rediscectomy,lumbar canal decompression,and lumbar reconstruction by implant and fusion.[Results]The operative time and blood lose were from 50 to 350 minutes(mean 213)and from 100 to 3 000 ml(mean 760 ml)respectively.One patient died because of severe abdominal cavity infection.The other cases were recovered and clinical complaint became less.The VAS and Oswestry Disability Index decreased from(7.9?1.6)and(52.4?7.2)to(2.8?1.0)and(8.3?3.6)respectively(the decrease rate:64.3% and 66.5%)after 24 to 48 months follow-up(mean 32.8 months).[Conclusion]The causes of failure lumbar procedure must be analyzed as soon as possible.The risks and benefits of reoperation must be balanced although it may make patients get more chance to recovery.It is very difficult for these procedures and the risks are also high.The dura sac rupture is the most common complication.It is the most important to deal with the adhesion and bleeding control in canal.The use of the magnification and lighting equipment can reduce the complications.

Bronchi ; Child, Preschool ; Foreign Bodies ; complications ; Humans ; Male ; Pneumopericardium ; etiology ; Spinal Diseases ; etiology

SARS coronavims is an emerging virus. A lot of animals could be infected by SARS-CoV and Himalayan palm civets, as one of important hosts, is an ideal animal model. Viral genetic factors have been implicated in the emergence of SARS-CoV, with the suggestion that this virus is a recombinant between mammalian and avian coronaviruses. However, the recombination is unlikely to explain the appearance of SARS in humans.

Objective To study the effect of three kinds of disinfection liquid,namely chlorine dioxide,silver ion and BIOCIDE,on sterilization of Legionella pneumophila.Methods The suspended quantified disinfection test was conducted by using 7 type of Legionella p neumophila,0.5 ml of bacterial suspension and 4.5 ml disinfection liquid were mixed for certain period, the normal saline was used as the control.1.0 ml of the above liquid or its dilution was incubated with BCYE for 72 h in CO_2 and 35 ℃,the colony count and sterilization rate were calculated.Results The sterilization rate of chlorine dioxide was 6.04%,7.87% and 18.18% at the sterilization time of 0.5,1 and 2.5 h respectively.The sterilization rate of silver ion was 52.61%,99.46% and 99.80% at the time of 0.5,1,1.5 and 2.0 h respectively.As for BIOCIDE,the sterilization rate was 25.28%,93.62%,96.60% and 99.81% at the time of 0.5,1,1.5 and 2 h respectively.Conclusion Compared with chlorine dioxide,silver ion and biological disinfectant has a better sterilization effect on Legionella pneumophila.

Objective To investigate the effect of hydrogen sulfide (H2S) on brain injury and inflammatory response after cerebral ischemia/reperfusion in rats.Methods Forty-eight malc SD rats were randomly divided into four groups:sham operation group,ischemia/reperfusion (I/R) group,H2S-30 ppm group,and H2S-60 ppm group (n=12 in each group;1 ppm=1 mg/L).The middle cerebral artery occlusion method was used to induce a model of focal cerebral ischemia for 2 h and reperfusion for 24 h.After reperfusion for 24 h,the tape remove experiment was used to perform the nerve function evaluation.2,3,5-triphenyl-tetrazolium chloride staining method was used to measure the percentage of cerebral infarction volume.Enzyme-linked immunosorbent assay was used to measure the levels of interleukin (IL)-1 β and IL-6.Western blotting was used to detect the expression levels of inducible nitric oxide synthase (iNOS) and intercellular cell adhesion molecule-1 (ICAM-1),as well as the transposition activation of nuclear factor-κB (NF-κB).Results Inhalation of H2S could shorten the time required to remove the tape in a dose-dependent manner compared with the I/R group (I/R group vs.H2S 30 ppm group and H2S 60 ppm group:180 s vs.130 [113-157]s vs.110 [87-138] s;P＜ 0.05),reduced the cerebral infarct volume (48.8％ ± 9.1％ vs.23.3 ％ ± 5.1％ vs.17.3 ％ ± 3.5 ％;P ＜ 0.05),downregulated the expression levels of IL-1β (39.53± 6.02 pg/mg protein vs.30.17± 3.46 pg/mg protein vs.22.69± 6.09 pg/mg protein;P ＜0.05) and IL-6 (54.65 ± 10.68 pg/mg protein vs.37.89 ±4.54 pg/mg protein vs.27.00 ±3.08 pg/mg protein;P ＜ 0.05) in ischemic brain tissue,significantly decreased NF-κB nucleus/ cytoplasm ratio (4.40 ± 1.05 vs.3.07 ± 0.82 vs.2.30 ± 0.60;P ＜ 0.05),inhibited expressions of iNOS (4.22 ±0.67 vs.3.14 ±0.90 vs.2.08 ±0.35;P ＜0.05),and ICAM-1 (5.45 ± 1.08 vs.3.45 ±0.67 vs.2.21 ±0.39;P ＜0.05).Conclusions Inhalation of exogenous H2S can reduce cerebral infarct volume after cerebral ischemia/reperfusion in a dose-dependent manner and improve neurological function.Its mechanism may be associated with the inhibition of NF-κB activation,down-regulation of its downstream iNOS and ICAM-1 expression levels,and decrease of IL-1β and IL-6 levels.

Objective To provide an optimal working process for crossmatching by full-automatic blood typing instrument.Methods Two workflows were applied to crossmatch test by full-automatic blood typing instrument.One was diluting red blood cells of donor samples to concentrate of 1%,the other was detecting directly the donor′s packed red blood cells.Compared consistency and processing time of the two different workflows.Results Cross match results of two workflows were consistent well(U=0,P>0.05).The average processing times before testing and undergoing testing were not significantly different(t=0.692,t=0.562,P>0.05),whereas the average processing times after testing and throughout testing were significantly different(t=146.485,t=67.053,P<0.05).Conclusion The workflow of diluting donor′s sample before testing saved processing time and better suits hospital having a large quantity of specimens.

BACKGROUND: Compression occurs in several horizontal spinal cords of patients with multilevel cervical spondylotic myelopathy (CSM), especially compression is attacked on both ends of spinal cord. Therefore, there are so many choices of approach and way for operation. However, which approach and way have good effects and few complications is still controversial up to now.OBJECTIVE: To observe the therapeutic effect of anterior multilevel decompression and internal fixation on multilevel CSM and compare with posterior mono-open-door vertebral canal expanding laminoplasty.DESIGN: Contrast analysis.SETTING: Department of Orthopaedics, Xiangya Hospital of South China University; Department of Orthopaedics, People's Hospital of Liuzhou.PARTICIPANTS: A total of 68 patients with multilevel CSM were selected from the Department of Orthopaedics, Xiangya Hospital of South China University from January 2000 to June 2005. All patients were divided into anterior approach surgery group (n =33) and posterior approach surgery group (n =35). Baseline data between the two groups were comparable.METHODS:①Anterior approach surgery group: All 33 patients received bone-transplanting and internal fixation through cervical spine. Among them, auto-iliac bone-graft was transplanted into 17 cases, Cage auto-bone graft combining with allogenic bone was transplanted into 11 cases, and titan-net and auto-bone combining with allogenic bone was transplanted into 5 cases. In addition, long segments were dealt with internal fixation of anterior cervical spine locking plate (CSLP). Among them, 12 cases used Orion plate, 13 cased used Zephir palte, and 8 cases used Codman plate. ②Posterior approach surgery group: Fifteen patients received total laminectomy for decompression and other twenty patients received mono-open-door vertebral canal expanding laminoplasty. After laminoplasty, all patients received negative pressure and neck support fixation for three months.MAIN OUTCOME MEASURES: ①Scores were measured based on JOA evaluating system before and after laminoplasty to calculate recovery rate. The scores of JOA ranged from 0 to 17. The higher the scores were, the milder the spinal cord damage was. ② Magnetic resonance image (MRI) was used to measure and calculate the sagittal diameter of dural sac.RESULTS: A total of 68 patients were involved in the final analysis. ①Mean operative time and bleeding volume were respectively shorter and less in the posterior approach surgery group than those in the anterior approach surgery group (P＜0.05). ②Recovery rates were higher in the anterior approach surgery group than those in the posterior approach surgery group [(58.28±7.16)%, (42.71±5.85)%; (45.64±6.56)%, (37.65±5.75)%; P＜0.05].③Follow up lasted for more than 6 months. Fusion rate in the anterior approach surgery group was 100%, and mean fusion time was 4.6 months. Mobilization and breakage of plate and screw were not observed during the laminectomy.CONCLUSION: The posterior approach surgery is simple and spends a short-term duration, but the effect of posterior approach surgery is inferior to anterior approach decompression.