Despite decades of the prevention and control.China is still one of the countries with high prevalence of hepatitis B virus (HBV).It is imperative for us to innovate.Lab diagnostic platforms for drug-resistant mutation and HBV genotyping to enhance the management level in patients with CHB.Specifically,the following three strategies should be included:firstly,choose an appropriate platform for drug-resistant mutation detection according to the actual situation in laboratory.Secondly,establish a practical and simple genotyping platform for real-time monitoring of HBV genotypes.Thirdly,combined with clinical,explore the correlation among genotypic resistance,phenotypic resistance and clinical resistance when different medications are adopted,confirm the percentage or threshold of resistant strains causing clinical resistance,and ascertain the influence of HBV genome polymorphism (genotype) on clinical prognosis.These strategies above mentioned will lay a foundation for CHB personalized treatment and prognosis.

Objective To investigate the effect of hyperbaric oxygen therapy on awareness,sports,activities of daily living in the rehabilitation of patients with early traumatic brain injury,and to observe the curative effect. Methods 80 patients with severe traumatic brain injury whose disease course within 1 months were randomly divided into observation group and control group,40 cases in each group.The control group received conventional drug therapy in neurosurgery and rehabilitation training.The observation group received hyperbaric oxygen therapy on the basis of the control group.Before treatment and one month after treatment,consciousness (GCS score),motor function (FMA score),activities of daily living (MBI score),and the clinical efficacy were compared between two groups.Results The scores of FMA,MBI and GCS in the control group were (7.81 ±2.27),(26.05 ±22.58),(15.25 ±12.14), which in the observation group were (7.78 ±2.32),(27.01 ±23.60),(14.37 ±12.54),and the differences were not significant (P >0.05).After 1 month of treatment,the scores of the control group were (9.44 ±2.76),(43.10 ± 31.54),(42.75 ±16.58),which of the observation group were (10.67 ±2.48),(56.98 ±29.68),(52.76 ± 17.23).The scores in the two groups were improved,the observation group increased more and the clinical efficacy was more obvious,there were significant differences between the two groups (P =0.039,0.046,0.009).Conclusion Hyperbaric oxygen plays an active role in early rehabilitation of patients with traumatic brain injury,it can improve consciousness,motor function and activities of daily living,and can improve the prognosis.

Objective To investigate the clinical value of NT‐proBNP and cTnI detection in the diagnosis and treatment of con‐gestiveheartfailure.Methods 198patientswithcardiovascularwereastheresearchobjects,95caseswithHFwereasHFgroup, 103 caseswithout HF were as control group ,compared left ventricular ejection fraction (LVEF) and serum NT‐proBNP ,cTnI levels of patients ,and compared LVEF ,serum NT‐proBNP ,cTnI levels of patients with different cardiac functions ,analysed the correla‐tion between serum NT‐proBNP ,cTnI levels and LVEF in patients with HF ,and analysed the diagnosic value of NT‐proBNP ,cTnI combined detection and single detection on HF .Results LVEF and serum NT‐proBNP ,cTnI levels of the HF group were higher than those of the control group(P<0 .05) ,LVEF of the HFgroup decreased significantly when cardiac function classification in‐creased ,serum NT‐proBNP ,cTnI levels increased significantly ,there were statistically significant differences in the indices between the three groups(P<0 .05) ,serum NT‐proBNP ,cTnI was inversely related to the level of LVEF (r= -0 .536 ,-0 .328 ,P<0 .05);proBNP ,the specificity ,positive predictive value and accuracy in the diagnosis of HF byproBNP 、cTnI combined detection improved obviously than the single detection ,compared with cTnI the specificity ,accuracy rate ,there was difference significant(χ2 =4 .595 , 21 .648 ,P=0 .032 ,0 .000) .Conclusion It has important clinical value Serum NT‐proBNP ,cTnI levels detection for the diagnosis and judgment of HF .

Objective To standardize the operation processes of neonatal instrument,ensure the standards effectiveness and safety of equipment use.Methods A retrospective study had been taken on after the developments and implementations of all neonatal instruments standard operation procedure (SOP).The equipment maintenance data were collected and analyzed one year before and after the implementation of SOP.Results After the effective implementation of the SOP,the incidence of instrument repair due to misoperation,improper maintenance reduad by 59％(19/32),9/14,4/7,the instrument management efficiency was enhanced,and the safety of nurses and patients was guaranteed,and the patients satisfaction was improved,and also the quality of care was enhanced.Conclusions SOP procedure plays a very important role in improving neonatal care management and overall efficiency.It makes a continuous improvement of nursing care which is worth widely being implemented.

Corticotropin-releasing hormone(CRH) is the key regulator during stress reaction which integrates endocrine,autonomic,immune and behavioral responses to stressors.Receptors mediating the action of CRH have been identified as CRH-R1,CRH-R2 and CRH-R3.In the process of stress reaction,CRH mainly interacts with CRH-R1 and CRH-R2,producing multiple physiological and pathological effects.In recent years,by employing transgenic animals,selective CRH-receptor antagonists and special CRH-receptor agonists,the effect of CRH receptors on stress reaction and its mechainisms have been deeply realized.

OBJECTIVETo discuss the effect of surgical staging and using craft bone with vancomycin for the treatment of calcaneal fractures.

METHODSFrom January 2006 to December 2012,13 patients with open calcaneal fractures were treated including 9 males and 4 females with an average of 35.2 years old ranging from 23 to 66. All cases were emergency cases. According to Sanders classification of calcaneal fractures, 2 cases were type II, 7 cases were type III, 4 cases were type IV. According to Gustilo-Anderson soft tissue injury classification, 8 cases were type II, 2 cases were type III A, 2 cases were type III B, 1 case were type III C. Firstly a thorough debridement or VSD procedures were applied,secondly calcaneal fracture were treated with open reduction, plate fixation and bone graft complex with antibiotics. Based on clinical examination, radiographic evaluation, and American Foot and Ankle Surgery Society (AOFAS), ankle function were evaluated after operation.

RESULTSOpen wounds were headed after dressing and repairing,, lateral calcaneal wound were healed during the first period. All patients were followed up for 6 to 36 months (means 14.5 months). Fracture healing time was 14 to 20 weeks (means 16.2 weeks). Last follow-up AOFAS ankle-hindfoot score was (80.0 +/- 7.4) ranging from 55 to 95.

CONCLUSIONFor patients with open fractures, through reasonable clinical evaluation, staging operation, using bone graft with antibiotics can reduce the incidence of postoperative wound infection and promote fracture healing.

Adult ; Aged ; Anti-Bacterial Agents ; administration & dosage ; Bone Transplantation ; methods ; Calcaneus ; injuries ; surgery ; Female ; Fracture Fixation, Internal ; Fracture Healing ; Fractures, Open ; surgery ; Humans ; Male ; Middle Aged

Objective To stduy the expression of PTEN ,P27 and BAG-1 in endometrial carcinoma ,and to analysis the clinical significance .Methods The expression of PTEN ,P27 and BAG-1 in 102 cases of endometrial carcinoma ,90 cases of endometrial hy-perplasia and 44 cases of normal endometrium tissue were detected by immunohistochemistry .Results PTEN and P27 in endome-trial carcinoma and hyperplasia tissue showed lower expression ,BAG-1 showed high expression in them .The expression of PTEN and BAG-1 were well correlated to histology degree and muscular infiltration .BAG-1 expression also had a well correlated to clinical stage .In this study ,we had not find a correlated between the expression of P27 and clinical and pathology characteristic of patien . PTEN expression had a Pearson relevance to P27 or BAG-1 expression ,but there was no correlation between P27 and BAG-1 .Con-clusion PTEN and P27 in endometrial carcinoma and hyperplasia tissue showed lower expression ,BAG-1 showed high expression in them .PTEN ,P27 and BAG-1 might play a role in the development of endometrial cancer .

Purpose To investigate estrogen receptor ( ER ) , progesterone receptor ( PR ) expression in PTEN-deficient endometrial carcinoma and to analysis the relationship of PTEN, ER and PR protein expression with histological grade, pathological staging and muscle invasive. Methods Immunohistochemistry EnVision was used to detect the expression of PTEN, ER and PR protein in 100 ca-ses of endometrial carcinoma. Results The rate of PTEN-deficient endometrial carcinoma was 52. 0% (52/100). The expression rate of ER, PR protein on PTEN-deficient endometrial carcinoma was 15. 4% (8/52), 19. 2% (10/52), respectively. And the expression rate of ER, PR protein on PTEN over-expression endometrial carcinoma was 72. 7% (8/11), 63. 6% (7/11), respectively. The rate of PTEN, ER and PR expression types shown PTEN-ER-PR- was 42. 0% (42/100), which was higher than other types (P <0. 05). Different PTEN, ER and PR expression types were well correlated with histological grade and pathological staging (P<0. 05), but not with muscle invasive. Conclusion Combined detection of PTEN, ER and PR may have an important reference value for prog-nosis and treatment of endometrial carcinoma.

The fast development of the molecular biology and the further research on the nucleic acid set a solid foundation for the development of genosensor.Genosensor is the result of combining molecular biology with microelectronics,electrochemistry,optics and etc,which will build a bridge between the life science and the information science and become one of the most important technologies for DNA information analysis and detection.The working principle,classification of genosenor and the recent research on its application in the detection of functional genes of environmental microorganisms are discussed according to the latest literature.And it is pointed out that the application in the determination of microorganism functional genes in compost is an important development orientation of genosensor.

Objective To investigate the clinical value and prenatal diagnosis feasibility of fetal aberrant right subclavian artery(ARSA) with fetal echocardiography.Methods The data of 39 fetuses with ARSA were retrospectively reviewed.The prenatal and postnatal medical records,including the presence of fetal abnormalities,cardiac defect,karyotype and the outcomes of each pregnancy were collected.Results The echocardiographic feature of ARSA was that an ARSA arises as a fourth branch of the arch,from the descending aorta behind the trachea,crosses the thorax between the trachea and the spine,to reach the right arm.The overall incidence of ARSA was 2.3 ％ (39/17 280),23 cases (59.0 ％) as an isolated malformation,16 cases (41.0％) combined with cardiac defect and extracardiac abnormalities,9 cases (23.1％) with chromosomal abnormalities.23 cases underwent termination of pregnancy,2 cases died in uterus and 14 cases were born live.Isolated ARSA group had lower incidence of chromosomal abnormalities (8.7％ vs 43.8 ％,P ＜ 0.05) and higher fetal survival rate (56.5％ vs 6.2％,P ＜0.05) than the combined detects group.Conclusions The fetus with ARSA complicated with aneuploid karyotype,cardiac defects and extracardiac anomalies are at hight risk of poor prognosis.