The incidence rate of hepatocellular carcinoma (HCC) is increasing around the world and tends to decrease in East Asia and several regions in China;however, China still has higher incidence rate and mortality rate of HCC than most countries.Studies have shown that long-term antiviral therapy can inhibit HBV replication to a very low level or help patients with HCV infection achieve sustained virologic response, which can further reduce the incidence rate of virus-related HCC.New evidence suggests that compared with nucleos(t)ide analogues, PEG-IFNα has a better effect of secondary prevention.Studies also indicate that interferons play an important role in tertiary prevention of virus-related HCC.This article reviews the epidemiological studies on virus-related HCC in recent years and the role of antiviral therapy in second and tertiary prevention and points out that adequate and effective antiviral therapy is the basis for preventing the development and recurrence of HCC.

Objective To identify the predictive factors associated with hepatitis B surface antigen (HBsAg) loss in hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB) patients treated with pegylated interferon (PEG-IFNα-2a).Methods Seventy-two HBeAg positive CHB patients were treated with PEG-IFNa-2a 180 μg weekly for 48 weeks. The serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and hepatitis B virus (HBV) DNA,HBeAg, and HBsAg were quantitatively detected every 3 months. The relationship between HBV DNA, HBeAg, and HBsAg levels at baseline, week 12, 24 of treatment and HBsAg loss was analyzed.The data were statistically assessed by Fisher's exact test,and receiver operating characteristic (ROC) curve. ResultsTotally 65 patients accomplished the therapy, and 7 (10.8％)patients achieved HBsAg loss. HBsAg loss at week 48 of treatment was associated with HBeAg level at week 12 of treatment (Fisher's exact test, P= 0. 023), HBeAg level at week 24 (Fisher's exact test, P=0. 004), and lower HBsAg levels (＜250 IU/mL) at week 12 and 24 of treatment (Fisher's exact test,P=0. 001 and 0.002, respectively). HBsAg loss was associated with HBV DNA negative ( ＜ 1000 copy/mL) at week 12 of treatment (Fisher's exact test, P = 0. 039), while not associated with HBV DNA negative at week 24 of treatment (Fisher's exact test, P=0. 130). ROC curve analysis revealed that the AUC was 0. 8584(P=0. 0021) of HBsAg level at week 12, 0. 9606(P=0. 001) of HBsAg level at week 24, and 0. 8350(P=0. 040) of HBeAg level at week 24. ConclusionLevels of HBsAg and HBeAg at week 24 of treatment might serve as effective factors to predict HBsAg loss in patients received PEG-IFN monotherapy.

Objective To investigate risk factors for hepatic steatosis in patients with chronic hepatitis B (CHB). Methods One hundred and eighty patients with biopsy-proven chronic hepatitis B were included in the study. Those with liver steatosis (61 from 93 cases) and those without it (61 from 87 cases)were matched on gender and age ( ± 3 years). Results Body mass index (BM I) was significantly higher in case group (24 ±3) than that in controls (22 ±3) (P ＜0.01 ). No significant difference was found in fasting plasma glucose, total cholesterol, triglycerides, urine acid, alanine aminotransferase, glutamyl transpeptidase and hepatitis B virus ( HBV ) DNA between the cases and controls ( all P ＞ 0. 05 ).Conditional logistic regression analysis with proportional hazard regression model statement by SPSS software showed that BMI was the only independent correlate to liver steatosis in patient with CHB ( OR = 1. 488, P ＜0. 01 ). Conclusions Liver steatosis in patients with CHB associates with BMI of the hosts, but does not correlate to their HBV DNA level.

Objective To investigate the relationship between trace elements and rachitis in children.Methods Three hundred and twelve patients with rachitis and 297 healthy children were selected for this study.Blood zinc(Zn),iron(Fe),plasma copper(Cu),calcium(Ca),magnesium(Mg),lead(Pb) and cadmium(Cd) were assayed by atomic absorption spectrophotometer.Results The levels of Zn,Fe,Cu of rachitis in blood were significantly lower than those of healthy children,while the levels of Mg,Pb were higher.There were significant differences between 2 groups(P

OBJECTIVE:To evaluate the clinical efficacy of Shuanghuanglian injection in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD),and to observe its effects on the plasma levels of C-reactive protein (CRP),procalcitonin(PCT)and interleukin-6(IL-6). METHODS:A total of 100 AECOPD patients were randomly divided into observation group and control group,with 50 cases in each group. Control group received routine treatment,such as controlled oxygen therapy,intravenous dripping of moxifloxacin,bronchodilator for relieving asthma,mucolytic for eliminating phlegm,nu-tritional support. Observation group was additionally given Shuanghuanglian injection 1 ml/(kg·d)added into 5% Glucose injec-tion 250 ml intravenously,qd,on the basis of control group. Treatment course of 2 groups lasted for 10 d. Clinical efficacies of 2 groups were compared as well as the changes of serum levels of CRP,PCT and IL-6 before and after treatment and the occur-rence of ADR. RESULTS:After treatment,total effective rate of observation group was 96.0%,which was significantly higher than 82.0% of control group,with statistical significance(P<0.05). Before treatment,there was no statistical significance in se-rum levels of CRP,PCT and IL-6 between 2 groups (P>0.05). After treatment,serum levels of CRP,PCT and IL-6 were de-creased significantly in 2 groups,and those of observation group were significantly lower than those of control group,with statis-tical significance (P<0.05). There was no statistical significance in the incidence of ADR between 2 groups (P>0.05). CON-CLUSIONS:Shuanghuanglian injection can effectively improve serum inflammatory factors of AECOPD patients,and shows good clinical efficacy and safety.

Objective: To study the relationship between plasma NT-ProBNP level and the severity of coronary artery lesions including left anterior descending (LAD) involvement in acute ST-elevation myocardial infarction (STEMI) patients with normal left ventricular ejection fraction (LVEF) while without diastolic heart failure. Methods: A total of 280 qualiifed patients were collected, plasma NT-proBNP level was examined in all patients within 24-hour of admission. The patients were divided into 3 sets of groups. By Gensini score system: Gensini score<30 group, n=94, Gensini score (30-60) group,n=87 and Gensini score>60 group,n=99; by the number of coronary branch lesions: Single branch group,n=78, Double branch group,n=105 and Triple branch group,n=97; by LAD condition: Criminal LAD group,n=146 and Non-criminal LAD group,n=134. Relevant comparison was conducted in all patients. Results: Plasma NT-proBNP level in Gensini score>60 group was higher than the other 2 Gensini groups, it was higher in Gensini score (30-60) group than Gensini score<30 group; the more branches were involved, the higher NT-proBNP were found (1176.70±492.50) pg/ml vs (608.70±331.20) pg/ml vs (336.90±176.70) pg/ml; NT-proBNP was higher in Criminal LAD group than Non-criminal LAD group (1199.40±725.00) pg/ml vs (607.40±244.20) pg/ml, allP<0.05. Pearson correlation analysis showed that NT-proBNP was positively related to Gensini score (r=0.278,P<0.05). Conclusion: Plasma NT-proBNP level was positively related to severity of coronary lesions, it had certain predictivevalue for triple vessel disease and criminal LAD; routine NT-proBNP examination was helpful for risk stratiifcation and clinical treatment in acute STEMI patients.

BACKGROUND:Platelet rich plasma contains various growth factors, such as platelet-derived growth factor, metastatic growth factor, insulin-like growth factor, epidermal growth factor as wel as vascular endothelial growth factor. Therefore, it can directly or indirectly promote cel differentiation and proliferation in different stages of bone regeneration.
OBJECTIVE:To study the effects of coral bone with platelet rich plasma in the repair of mandibular defects.
METHODS: Totaly 24 New Zealand white rabbits were randomly divided into three groups (n=8 per group) including test group, control group and blank control group. Coral bone with autologous platelet rich plasma, coral bone or nothing was implanted, respectively, after establishing unilateral mandibular defect models. The defects were evaluated by imaging observation and bone his-tomorphometric analysis at 2, 4, 8, 12 weeks after surgery.
RESULTS AND CONCLUSION:At 12 weeks after surgery, by imaging observation, density of the defect increased in the blank control group, which was lower than that of the normal bone; the bone density in the test group was higher than that in the control group, both of which were similar with the normal bone. Besides, the materials were closely combined with the new tissues. By bone his-tomorphometric analysis, area of the new bone in the test group was significantly larger than that in the control and blank control group (P< 0.05). In conclusion, coral bone with platelet rich plasma has good biocompatibility and bone conductivity, which can induce bone regeneration to promote defect repair.

Objective To learn current status of health management provided by primary health professionals working in rural areas of Beijing.Methods Health professionals in township hospitals in Beijing were selected by multi-phase random sample method in 2012 and surveyed by a standardized questionnaire to gathering the data on various health management contents,including health checkup,chronic disease management et al,the action location,its collaborative persons and sectors.Statistics description and inference were conducted to describe and compare the distribution of health management implementation across rural areas by descriptive methods and test,respectively.Results Nearly 66.3％ (321/484) of subjects provided health check-up,and 19.1％ (92/481)involved in follow-up study of mental diseases.The main targets population of health management were chronic diseases and the elderly,with response rate of 44.7％ (214/479) and 38.0％ (182/479),respectively.Health check-up,health education and follow-up of chronic diseases were performed in 62.1％ (298/480),52.4％ (251/479) and 42.8％ (206/481) of the township health centers.About 66.1％ (292/442) township health centers had cooperation with general practitioners; however,cooperation with administrative personnels was only 10.6％ (47/443).More than 41.4％ (201/463) township health centers cooperated with community administrative sectors,and cooperation with the propaganda department was only 10.6％ (49/464).The statistical difference across regions shows in the following,including health management action (health checkup,chronic disease patients following-up,et al),the target population covered (youth,elder person,children,and chronic disease patients),health management location(health checkup,education and chronic disease patients following-up in township hospital and village clinic),cooperation with General Practitioner.Conclusions Our results suggest that the actual situation on health management service in Beijing rural areas and the standards of public health equalization of China are still disjoined,even difference exists across regions.In order to improve the health management service quality,we should strengthen the health management personnel training,increase the general practitioner in proportion,establish the performance evaluation mechanism,increase governmental finance to support those service.

Objective To investigate the awareness and trainning needs of health management knowledge in primary healthcare professionals in Beijing.Methods Six hundred primary healthcare staff from Daxing,Fangshan,Miyun,Pinggu and Huairou District of Beijing were selected in 2012 through muhiphase random sampling method and required to complete a standardized questionnaire.The survey included the average awareness rates of health management(tobacco,body weight and alcohol consumption control and daily physical exercises),the rates of application and conception awareness of risk assessment tools of chronic diseases,the awareness rates of normal levels of blood pressure and serum glucose as well as training needs.Differences in different regions were analyzed.Chi-square test was used for data analysis.Results The average awareness rates of tobacco,body weight and alcohol consumption control and daily physical exercises were 94.1％ (513/545),95.3％ (522/548),94.0％ (515/548) and 85.9％ (470/547),respectively.However,the rates of application and conception awareness of risk assessment tools of chronic diseases were only 55.1％ (295/535) and 59.8％ (329/550),respectively.Those who knew the normal levels of blood pressure and serum glucose accounted for 85.4％ (475/556) and 92.4％ (514/556),respectively; although only 23.6％ (131/556) and 21.2％ (118/556) were completely familiar with the major risks of these conditions.About 57.4％ (308/537) or 56.7％ (305/538) participants reported urgent needs for health education on diabetes and hypertension management.Conclusion The awareness of health management of primary healthcare professionals in rural areas of Beijing remains lower and may need to be raised by education or training.

Objective To investigate the relationship between levels of ceruloplasmin (CP) and inflammation grade,fibrosis stages in liver of patients with chronic hepatitis B (CHB),and to establish liver fibrosis non-invasive model and evaluate its diagnostic value for liver pathological stages.Methods Both liver biopsy samples and sera were collected from 148 consecutive CHB patients in Liver Center,First Affiliated Hospital,Fujian Medical University during January 2009 to June 2011.The relationships between CP and liver pathological stages were analyzed using Spearman rank correlation analysis.Receiver operator characteristic (ROC) curve was used to evaluate the diagnostic value of CP for liver pathological stages.The diagnostic values of relevant indicators were analyzed by Logistic regression.The liver pathology-predicting model was built and the diagnostic value of the model was analyzed by ROC curve.Results The mean values of CP in 148 CHB patients with liver inflammation grades of G1 to G4 were (212.5 ± 34.9),(205.5± 32.0),(201.4 ± 37.7) and (172.8 ± 20.4) mg/L,respectively,which were significantly different by ANOVA test (F=6.309,P＜0.01).Similarly,the mean values of CP in patients with liver fibrosis stages of S1 to S4 were (217.4±32.3),(206.0±37.7),(194.2±29.8) and (179.7±30.4) mg/L,respectively,which were significantly different by ANOVA test (F =8.608,P ＜ 0.01).Spearman rank correlation analysis showed that CP was negatively correlated with liver inflammation grades (r=-0.316,P＜0.01) and fibrosis stages (r=-0.404,P＜0.01).ROC curve analysis revealed that the area under the curves (AUC) were 0.71 (S≥2),0.70 (S≥3) and 0.72 (S=4).Multiple Logistic regression analysis showed that CP,α-fetoprotein,cholesterol,platelet and age were independent predictors for liver fibrosis.ROC curve analysis revealed that AUC were 0.84 in model-1 (S≥2),0.83 in model-2 (S≥3) and 0.87 in model-3 (S=4).The accuracy rates were 71.8％,80.3％ and 79.2％,respectively.Conclusions The CP levels are negatively correlated with inflammation grades and fibrosis stages in the liver of CHB patients.CP could be an important non-invasive indicator for liver fibrosis and the model including CP can be used to predict liver fibrosis in CHB.