Objective To observe the clinical effects of anti-hepatitis B virus with telbivudine combined with adefovir dipivoxil.Methods 82 cases of patients diagnosed with chronic hepatitis B from January 2014 to February 2016, were randomly divided into two groups, the control group were treated with adefovir ester treatment, the observation group were treated with telbivudine combined with adefovir dipivoxil treatment, patients were followed up and recorded Child-Pugh score, aspartate aminotransferase ALT, total bilirubin TBIL, aspartate aminotransferase AST, albumin ALB, HBV-DNA negative rate, HbeAg seroconversion rate case, the use of statistical methods for data analysis.Results After treatment, the observation group Child-Pugh score, ALT values were(4.01±0.79)points,(37.19±4.82)U/L, were better than the control group(5.46±1.16)points,(61.49±9.78)U/L, and the differences were statistically significant (P<0.05).Observation group after treatment TBIL, AST, ALB, respectively(34.91±5.49)μmol/L,(56.49±5.28)U/L,(45.51±4.24)g/L, were better than the control group(61.62±10.06)μmol/L,(78.64±8.16)U/L,(38.76±3.21)g/L, and the differences were statistically significant (P<0.05).The observation group after treatment for HBV-DNA negative rate and HbeAg seroconversion rate(82.93%, 58.54%)respectively were higher(58.54%, 29.27%), and the difference was significant (P<0.05).Conclusion Telbivudine combined with adefovir dipivoxil anti-HBV effect is good, better than medication alone is worthy of further research and application.

The training of residents constitutes the primary work of Graduate Medical Education.Reviewing the historical development of the training of residents,we find that it has experienced four stages and trended to establish the medical specialist training system.

The quality of doctoral degree conferring depends on the quality of doctoral dissertation.Based on the quality evaluation of doctoral dissertation in medical School of Shanghai Jiaotong University in 2005,the author points out the problems existing in doctoral dissertation nowadays and makes some explorations on how to improve the quality of doctoral degree conferring.

The article summarizes the questions of clinical teaching of advanced urologists,and find out some measures to improve the clinical teaching quality of advanced urologists.

Acupuncture Points ; Acupuncture, Ear ; Adult ; Aged ; Combined Modality Therapy ; Female ; Humans ; Laser Therapy ; Male ; Middle Aged ; Urination Disorders ; therapy

Objective To observe the clinical outcomes of modified posteromedial and posterolateral approaches for the treatment of posterior tibial plateau fractures.Methods Between January 2006 and October 2011,25 patients with posterior tibial plateau fracture were identified.They were 17 men and 8 women,aged from 22 to 76 years (average,46.4 years).According to the AO/OTA classification,there were 4 cases of type 41-B1,6 cases of type 41-B2 and 15 cases of type 41-B3.According to Luo's three-column classification,they were all posterior column fractures.Ten patients with posterolateral tibial plateau fracture were treated by the modified posterolateral approach and the other 15 patients with posteromedial tibial plateau fracture by the modified posteromedial approach.The posterior fractures were fixated with a buttress plate.The knee function was evaluated at the last follow-up by the The Hospital for Special Surgery (HSS) Score.Results All the 25 cases were followed up for a mean time of 13.2 months (from 10 to 24 months).By the radiological Rasmussen criteria for fracture reduction,the mean score immediately after surgery was 16.5 points (from 13 to 18 points),with 20 excellent cases,4 good cases and one fair case.All patients were pain-free with full range of motion.Radiologically,bone union was achieved in all cases after a mean time of 13.9 weeks (from 12 to 18 weeks).No surgery-related complications were found.The mean HSS score was 91 points(range,74 to 97 points) and the good to excellent rate was 100％ (17 excellent and 8 good cases) at the last follow-up.The average range of knee motion ranged from 0° to 125°.Conclusion In the treatment of posterior tibial plateau fractures,because the modified posteromedial and posterolateral approaches can result in excellent fracture reduction under direct visualization and allow for posterior buttress plating,soft tissues can be well preserved and good functional results can be expected.

Early diagnosis and timely treatment of hepatic steatosis is very important for controlling the development and improving the prog-nosis of disease.This paper introduces the controlled attenuation parameter (CAP),a novel non -invasive method to quantitatively assess hepatic steatosis.This paper briefly describes the advantages of CAP compared with other methods for detecting hepatic steatosis:CAP is simple,fast,repeatable,and generally accepted by patients.CAP is of great value for early detection of fatty liver.Moreover,this paper re-views the optimal cut -off values of CAP for detection of fatty liver in different studies.CAP can be used to dynamically monitor the progres-sion and regression of fatty liver as a guide to clinical treatment.

Infant functional constipation is one of the common clinical symptoms in infancy stage,so far we do not have a specific diagnostic criteria and treatment for infant functional constipation.In this paper,we reviewed the diagnostic methods,clinical evaluation,differential diagnosis,and treatment recommendations according to recent research results for infant functional constipation.

Hypospadias repair is highly challenging especially for those severe or cripple variants.Correction via single stage or staged repair is controvercial whereas the controversies are with different content with advancement of hypospadiology.Here the authors introduce the contemporary concepts of staged repair for hypospadias.

Objective To explore the relationship between epilepsy and stroke,the features of secondary epilepsy and its treatment. Methods 233 stroke patients were observed and the clinical data of 21 patients who had secondary epilepsy were analyzed. Results Secondary epilepsy after stroke was mainly seen in the cortical stoke patients, the incidence of epilepsy of the cortical stroke group was 16.7% , which was significantly higher than that of the gubcortical stroke patients(5.7% ) ,and there was significant difference between the two groups. The incidence of epilepsy of stroke with a lesion >4cm group was 17. 3% .which was significantly higher than that of stroke with a lesion <4cm group(5.4% ), there was also significant difference between the two groups. There was no significant difference between ischeraic stroke and hemorrhagic stroke(P>0.05). Conclusion The incidence of secondary epilepsy after stroke had no correlations with the stroke types,but was related to the area and the location of the stroke.