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

With the availality of new nucleotides (acid) analogues,the experience of anti-virus treatment has been continuously enriched.However,the problem of drug resistance becomes increasingly significant and the concern of individualized strategies,duration and endpoints of therapy as well as drug-resistance prevention for nucleoside (acid) analogues treatment has become a hot issue.Thus,the European Association for the Study of the Liver updated their guideline on diagnosis and treatment of chronic hepatitis B based on the principles of evidence-based medicine,so as to make it more flexible and practical.We briefly review and compare the updated content of this new guideline,and make analysis combined with the clinical practice,so as to promote the standardization of diagnosis and treatment of chronic hepatitis B.

Objective: To investigate the prevalence of nutritional risk,malnutrition and application of nutritional support in department of digestive trad in our hospital in Ningbo.Methods: The information of 205 patients were collected in our hospital.Nutrition status was assessed according to Nutrition Risk Screening(NRS) published by ESPEN in 2002.Results: A total of 205 patients were enrolled,and 189 patients(92.2%)underwent NRS 2002.Prevalence of malnutrition was 20.0% and nutritional risk was 32.7%.Totally 18 patients(8.8%) receiving nutritional support had a NRS2002≥3.The PN∶EN ratio was 2.6 ∶1. Conclusion: A large proportion of inpatients were at nutritional risk or malnutrition in our hospital.The application of PN and EN is inappropriate in inpatients.Evidence-based guidelines are required to improve this situation.

Colorectal cancer is one of the most commonly seen malignant tumors,and the metastatic colorectal cancer is of poor prognosis. The median overall survival for chemotherapy is only 1-1. 5 years. Recently,molecular targeted therapy targeting at vascular endothelial growth factor and epidermal growth factor receptor was used widely for metastatic colorectal cancer and becoming a hot spot of related researches. This article focused on the strategy and hypothesis of molecular targeted therapy for treatment of metastatic colorectal cancer.

The application of the Six Sigma working methods is introduced in the use and maintenance of monitor.By using Six Sigma working methods,the needs of clients are researched,and improved method are put forward.A solution to lower the failure rate of monitor is suggested,and the various causes are analyzed.By the comparison between the fore-and-aft situations,desired effect is obtained with improved work efficiency and better economic and social benefits.

Purpose To investigate the chest CT features of lung injury caused by oral paraquat,and deepen the understanding of paraquat poisoning.Materials and Methods The chest CT features of 74 patients with lung injury caused by oral paraquat were analyzed retrospectively and comparatively.74 patients were divided into 3 groups according to toxic dose:28 cases in the low dose group (paraquat dose less than 10 ml),34 cases in the medium dose group (paraquat dose among 11 to 50 ml),and 12 cases in the large dose group (paraquat dose more than 50 ml).74 patients were also divided into 3 groups according to course of disease:The course of disease among 1 to 7 days were in the early period,8 to 14 days in the medium period,and 14 days later in the later period.The image features were summarized by comparing the chest CT features,with toxic dose,course of disease,and the scope of lung injury.Results Poisoned patient's chest CT features,related with toxic dose (P＜0.05),appeared from increased bronchovascular shadows,ground glass opacity,to effusion and consolidation,and to pulmonary fibrosis along with time.The effusion and consolidation majorly located in the lateral lungs,which showed a characteristic disease extent.Conclusion The chest CT features of lung injury,caused by oral paraquat,have a certain characteristic.It relates to toxic dose and course of disease,which has a certain guiding significance to clinical diagnosis and treatment.

Objective To explore the influencing factors of hypotension in hemodialysis patients with end stage of diabetic nephropathy.Methods 106 patients of advanced diabetic nephropathy who received maintenance hemodialysis were selected in the present study.According to the patients'condition needs, chose different dialysis modes,dialyzers, dialysis blood flow and ultrafiltration rate, compared the frequency of occurrence of hypotension during treatment.Results By multivariate regression analysis,gender,dialysis mode,dialysis and blood flow had no correlation with hypotension during dialysis.The age, hemoglobin, serum albumin, cardiac function and individual ultrafiltration rate were correlated with the incidence of hypotension in patients with diabetic nephropathy.Individual-ized ultrafiltration rate was less than or equal to 10 mL · kg-1 · min-1 and individual ultrafiltration rate was up to 10 mL· kg-1 · min-1 ,the incidence rates of hypotension were 18.9% and 25.9%,the difference was statistically significant (χ2 =7.102,P<0.05).Conclusion Diabetic nephropathy patients during dialysis,ultrafiltration rate control individuals can effectively reduce the frequency of occurrence of hypotension during dialysis, hemodialysis patients may improve tolerability.

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.

Objective To explore different pathogenesis of chronic hepatitis B(CHB)and asymptomatic H BV carriers(ASCs)by identifying differentially expressed genes.Methods Subtracted library was constructed by suppression subtraetive hybridization(SSH),and α-defensin was identified by dot blot hybridization.Peripheral blood was collected from 46 CHB patients and 11 ASCs.and the expressions of α-defensin mRNA in peripheral blood mononuclear cell and protein in plasma were determined by the real time RT-PCR and enzyme-linked immunosorbent assay(ELISA).Results Real time RT-PCR showed that the expression of α-defensin mRNA in blood samples of CHB was 1.4-fold higher than that of ASCs.As shown by ELISA,the plasma level of α-defensin in CHB was higher than that of ASCs [(216.40±81.25)μg/L vs.(156.00±57.26)μg/L,t=2.23,P<0.05].Conclusion α-defensin may involve in the pathogenesis of CHB,for it iS over-expressed in CHB patients.

The proteome is the entire complement of proteins expressed by a genome, cell, tissue or organism,which are all types of proteins expressed by one cell in the specific physiological or pathological states. The study of proteomics not only can help us to understand the general rules of activity of proteins,but also illuminate the pathologic mechanisms of numerous diseases. By proteomic analysis of normal individual and pathological individuals, we can find some disease-specific protein molecules, which not only can be a new target for drug design, but also can be a molecular markers of some diseases especially tumors.