Objective To explore the reason of negative HBeAg result detected by ELISA in the specimen with both positive HBV DNA and positive PreS1 in order to provide objective analysis of HBV replication.Methods Senty-six sera with negative HBeAg,but positive PreS1 and HBVDNA were included in this study.(1) HBeAg was detected again by ELISA after the specimen was diluted at a ratio of 1:100.(2) HBeAg/IC was detected by solid ELISA using monoclonal antibody against HBeAg.(3) The gene mutation of Pre C region was detected by oligonucleotide hybridization.Results HBeAg was positive in 5 specimen which were detected in dilution of 1:100 and HBeAg/IC was detectable in 38 specimen.The gene mutation of Pre C region was found in 24 specimen.Conclusion Hook effect of post-zone,formation of HBeAg/IC and gene mutation of Pre C region were the main reasons of negative HBeAg result by ELISA in the specimen with positive HBV DNA.The specimen with positive HBV DNA and negative HBeAg were presented in the patients who were mostly infected by wild type of HBV.Formation of HBeAg/IC result in the undetectable HBeAg in serum by routine ELISA.

Objective To investigate the clinical features,etiology and related clinical factors in neonatal anemia.Methods Two hundreds and sixty four infants admitted to the Neonatal Intensive Care Unit between January 2009 to March 2012 were retrospectively analysed with different levels,different age,different gestational age.Results Among 264 patients,the occupancy of blood loss anemia was 54.5 ％.Mild and medium neonatal anemia were more than severe anemia (172 vs 92).Fetomaternal hemorrhage syndrome occurred commonly in severe anemia (16.3％,15/92).Early anemia was more than late anemia(182 vs 82).Hemorrhagic anemia in early anemia (64.3％,117/82)occurred mainly.Late anemia with infection mainly (67.1％,55/82).Fetomaternal hemorrhage syndrome were all early anemia and term to account for a higher proportion (94.4％,17/18);twin-to-twin transfusion syndrome occurred commonly among preterm term infants (96.7％,29/30).Conclusion Blood loss anemia was the main etiological factor resulting in neonatal anemia.The incidence of mild and medium neonatal anemia was quite high.Early anemia was more than late anemia.There might be some differences in the etiology between term and perterm infants.

Protein kinase B( Akt)is an intermediate signal molecule in PI3K-Akt-mTOR signaling pathway which plays an important role in development and incidence of colorectal cancer when activated by phosphorylation. As target of drugs,Akt has become a focus in the treatment of colorectal cancer. Clinical trials research proves that many kinds of Akt inhibitors have good antitumor activity. In recent years,the Akt inhibi-tors are more and more be taken seriously in colorectal cancer treatment.

This study is to investigate whether naked plasmid DNA can effectively transfect lung cancer related cells and express human kallistatin, an endogenous protein that inhibits angiogenesis and tumor growth, and to explore the biological activity of the low-level expressed kallistatin to lung cancer in vitro and in vivo. The plasmids were delivered with Lipofectamine 2000 to transfect various lung cancer related cells. Kal expression was determined by ELISA. The biological effects of Kal expression on proliferation, migration and apoptosis rate of the cells were examined. In subcutaneous NCI-H446 xenograft model, pKal was injected directly into tumors, the changes of CD34, Ki-67 and E-cadherin expression were detected with immunohistochemical assay, the tumor apoptosis was analyzed with TUNEL assay. Both the endothelial cell and lung cancer cells could express kallistatin after plasmid transfection. The proliferation and migration of human umbilical vein endothelial cells were inhibited, but the apoptosis rate was not affected. The proliferation rates of all the three tested lung cancer cells, such as NCI-H446, NCI-H460 and A549, were inhibited, and their apoptosis rates were enhanced, but different cells behaved differently. In subcutaneous NCI-H446 xenograft model, intratumor injection of pKal inhibited the growth of lung cancer by reducing angiogenesis and proliferation of tumor cells. In conclusion, this study demonstrated the efficacy of plasmid-mediated expression of kallistatin to lung cancer related cells, thus providing a basis for their clinical application in the treatment of lung cancer.

Recovery after surgery can be substantially facilitated by taking fast track surgery.Preoperative patient preparation is the beginning of the fast-track surgery,and it will influence the course of patient care after the operation.Preoperative patient preparation of the fast-track surgery was reviewed.

A model of traum a shook was established in rats by comminutedly fracturing of the right femur and bleeding of 15% of the body weight.In the 1st hour after injury,the content of malondialdehyde (MDA) of the heart and the lungs increased,the activity of sv.peroxide dismutase (SOD) in the lungs decreased,and the MDA content and SOD activity in hepatic mitochondria increased synchronously.In the 3rd hour after injury,the MDA content increased not only in the heart,the lungs and hepatic mitochondria but also in the liver and the kidneys,and the SOD activity increased in the heart,the kidneys and the intestinal tract but decreased in hepatic mitochondria.There were further marked elevation of MDA content and progressive inhibition on SOD activity in the 5 vital organs and hepatic mitochondria in the 5th hour after injury.When shock continued to progress,the plasma MDA content increased gradually,the SOD activity of the hemolytic blood decreased,and the activities of plasma acid phosphatase and ?-glucuronidase,the indicators of lysosome destruction,increased markedly.These findings suggest that the oxygen-derived free radicals are responsible for the damages to cells of the vital organs and subcellular organelles during traumatic shock.

Based on a study of the relationship between research hospitals and furthering of the healthcare reform,the authors hold that a key to the ongoing reform lies in building the hierarchical medical system,an objective in building and development of research hospitals as well.Furthering of the reform will highlight advantages of such hospitals,as they can play an important role in leading practice with theoretical innovation,translating frontier technology to clinical use,promoting the system to serve primary care,and upgrading quality effectiveness at general level.

Objective To find the course of theme evolution for study of medical protection against nerve agents.Meth-ods A method of information visualization based on co-cited analysis was used.The research domain of medical protection against nerve agents was mapped using software VOSviewer.Results There were five research clusters including clinical research, oxime reactivators, detoxification and detection,and bioscavengers.Conclusion Theme evolution is described and research trends are predicted.

OBJECTIVE:To observe the clinical efficacy and safety of saxagliptin combined with metformin in the treatment of type 2 diabetes. METHODS:A total of 95 patients with type 2 diabetes were randomly divided into observation group(47 cases) and control group(48 cases). All of the patients received Metformin hydrochloride sustained-release tablets 0.5 g for continuous 4 weeks,orally,3 times a day;based on the treatment,control group was continuously given Metformin hydrochloride sustained-re-lease tablets 0.5 g for continuous 24 weeks,orally,3 times a day;observation group was given Saxagliptin tablets 5 mg continu-ous 24 weeks based on the treatment of control group,orally,once a day;the treatment course was 28 weeks. The clinic data was observed,including clinical efficacy,FPG,2 h PG,bed time glucose,HbA1c,BMI before and after treatment,incidence of hypoglyce-mia,severe hypoglycemia and adverse reactions. RESULTS:The total effective rate in observation group was higher than control group,the incidence of hypoglycemia in observation group was lower than control group(P<0.05). After treatment,the glucose in-dexes in 2 groups was significantly lower than before,and FPG and HbA1c in observation group were lower than control group(P<0.05). There were no significant differences in the BMI before and after treatment,incidence of severe hypoglycemia and adverse reactions between 2 groups(P>0.05). CONCLUSIONS:Saxagliptin combined with metformin has better efficacy and safety than metformin alone in the treatment of type 2 diabetes,and can significantly reduce the incidence of hypoglycemia.

The first domestic patient who had received implantation of a stimulator of anterior root of sacral nerve was followed up for 42 months. The result showed that the patient regained control of micturition and absolute continence under electric stimulation. Life quality was improved apparently. No signs of sacral nerve root injury were found. In conclusion, stimulator of anterior root of sacralnerve (SARS) implantation is a safe and effective procedure and can be used in such patient for a long term. A test of the exterior parts of an indigenous stimulator shows that it is comparable to imported ones