Objective To investigate current status and influencing factors of patient delay in patients with advanced hepatocellular carcinoma and provide a theoretical evidence for the early diagnosis of HCC. Methods All patients with a primary diagnosis of advanced HCC admitted at Department of Hepatobiliary Medicine I, Eastern Hepatobiliary Surgery Hospital of the Second Military Medical University from January 2015 to October 2015 were investigated prospectively. The current status of patient delay was assessed by medical records and influencing factors of patient delay were analyzed by the self-designed questionnaires. Results Rate of patient delay in the patients with advanced HCC was 27.7%(53/191). The univariate analysis demonstrated that significant influencing factors for patient delay included age, education levels, economic status, place of residence, medical insurance, knowledge about follow-up examination for chronic viral hepatitis. The rate of patient delay was high in these patients with older age, lower income, less education, place of residence (countryside or small towns), new rural insurance, lack of the knowledge about follow-up examination for chronic viral hepatitis. Multivariate analysis showed that age and lack of the knowledge about follow-up examination for chronic viral hepatitis were significantly independent predictors for patient delay. Their OR (odd ratio) and 95%CI (confidence interval) were 2.770 and 1.424-5.388, 7.867 and 1.669-37.092, respectively. According to place of residence, the univariate analysis demonstrated that significant influencing factors for patient delay included marital status, age, economic status, and knowledge about follow-up examination for chronic viral hepatitis in the countryside or small towns. Multivariate analysis also further showed that age and lack of the knowledge about follow-up examination for chronic viral hepatitis were significantly independent predictors for patient delay. Their OR and 95% CI were 3.812 and 1.550-9.373, 15.400 and 1.793-132.245, respectively. Patient delay of HCC patients in county seat and city was not significantly associated with all of above mentioned influencing factors. Conclusions Patient delay of the patients with advanced HCC in countryside or small towns was comparatively common. To early find high risk factors of HCC, government should be intensified screening to chronic hepatitis B, hepatitis C in the middle and elderly population. To reduce the rate of patient delay in advanced HCC and improve results of treatment for advanced HCC, health care workers should popularize medicine-associated knowledge, especially about chronic hepatitis and its complications.

Objective To observe the effects of blocking renin-angiotensin system with losartan or perindopril on renal angiotensinⅡand its type 1 receptor （AT1R） expression in STZ-induced （diabetic） rats. Methods Male SD rats were randomly divided into 2 groups: normal control group （NC） and （diabetic） group. Diabetes was induced by STZ （65 mg/kg） abdominal injection. Four weeks later, diabetic rats were further divided into 4 groups: diabetic rats treated with losartan (DL, 20 mg·kg-1·d-1),diabetic rats treated with perindopril (DP,2 mg·kg-1·d-1) and diabetic untreated control group（DC）. Radioimmunoassay was used to measure plasma and renal angiotensin （Ⅱ.）Expression of AT1R was detected by RT-PCR in each group before and after 12 week′s treatment. Results At the 4th week, renal AT1R expression decreased. At the 16th week, plasma angiotensinⅡ,renal angiotensinⅡand AT1R mRNA in diabetic untreated group were significantly higher than those in normal rats. （Renal） angiotensinⅡand AT1R in losartan or perindopril-treatmented group were significantly lower than those in DC group. Conclusion Intrarenal RAS is abnormal in STZ-induced diabetic rats. Renoprotective effects of losartan and perindopril may partly induced by inhibiting renal angiotensinⅡ and AT1R （expression.）

Objective To study the renal protective effect of perindopril in diabetic rats. Methods The following groups of rats were studied: normal control rats ,diabetic control rats and diabetic rats treated with perindopril (2mg?kg -1 ?d -1 ) . After 4 weeks or 12 weeks treatment , alterations of renal ultrastructure were observed in each group, Urinary albumin excretion was observed every 4 weeks.Results Urinary albumin excretion of diabetic rats treated with perindopril were significantly lower than that of diabetic untreated group(P

Objective　To observe the effect of losartan on urinary albumin excretion in streptozotocin diabetic rats.Methods　The following groups of rats were studied:normal control rats(NC),diabetic control rats (DC),diabetic rats treated with losartan 〔20mg/(kg*d)〕(DL) and diabetic rats treated with perindopril （2mg/(kg*d)〕(DP).Urinary albumin was observed at the 4th、8th、12th and 16th week.Results　Urinary albumin excretion of diabetic rats treated with losartan or perindopril were significantly lower than that of diabetic untreated group (P＜0.01).The effect was not different between losartan treated and perindopril treated rats.Conclusion　The results suggested that losartan can reduce urinary albumin excretion in diabetic rats.

To investigate the DNA typing of Trichophyton mentagrophytes,and to find the relation- ship of DNA type with morphology,teleomorph type,the geographic origin and the sites of infection. DNA extraction was carried out by using benzyl chloride and random amplification of polymorphic DNA (RAPD)assay was employed for DNA typing of 42 strains of T.mentagrophytes isolated from clinical specimens and some other dermatophytes,also 8 preserved strains of Arthroderma.Results:(1)Forty two isolates of T.mentagrophytes can be classified into 3 main types,and the intratype polymorphism has been revealed with some primers.(2)There is no simple relationship between DNA type and mor- phology,but the DNA types are closely related to the geographic origin,and the isolates from different sites of infection have their own genotype characteristics.(3)DNA patterns of Arthroderma benhamiae and A.vanbreuseghemii are distinctly different,while 42 clinical isolates of T.rnentagrophytes share sim- ilar pattern with A.vanbreuseghemii.The clinical isolates of T.mentagrophytes can be divided into 3 types by RAPD,and its DNA type has certain relationship with morphology,teleomorph type,the geo- graphic origin and ttie sites of infection.RAPD provides an useful tool for the pathogenic diagnosis and epidemiology study to investigate the source of infection,and geographic distribution of strains.

BACKGROUND:Someone regards that treatments such as root canal therapy and post-core restoration can increase the fracture probability of teeth. Can fiber reinforced composite post enhance the fracture resistance of the severe wedge-shaped defected premolar? Three-dimensional finite element can simplify complex dental systems into a model analyzed by computer, and conduct biomechanical research through the model analysis. OBJECTIVE:To analyze the stress distribution of sever wedge-shaped defected first premolar which restored by fiber reinforced composite post and composite resin. METHODS:We established the three-dimensional finite element models of severe wedge-shaped defected maxil ary first premolar before and after restoration with fiber reinforced composite post and composite resin. The maximum bite force was designed to 267 N that was applied at 45° angle. Then, we analyzed the distribution of maximum principal stress in finite element models. RESULTS AND CONCLUSION:The maximum principal stress was concentrated in the tip of defected region. After restoration, the distribution of maximum principal stress was similar to that of the normal premolar, and the tensile stress was distributed uniformly in the upper-central part of buccal root. It may be beneficial for improving fracture resistance ability of severe wedge-shaped-defect premolar by restoration with fiber reinforced composite post and composite resin.

ObjectiveTo explore relationships among attention deficits, balance control and falls for stroke at chronic stage.Methods40 subjects were recruited. Fall histories were collected by Questionnaire. The Cancellation Test was used to measure sustained attention. The Berg Balance Scale (BBS) was used to measure the balance ability.Results14 subjects fell among 40 subjects, with fall rate 35%. Sustained attention scores were found to correlate with measures of balance (r=0.550, P<0.01) and with the number of fall(r=-0.458, P<0.01). Balance scores were found to correlate with the number of fall(r=-0.500, P<0.01). Scores for attention and balance for fallers were found to be significantly different from the scores of non-fallers(P=0.006, P=0.004 respectively).ConclusionHigh rate of fall can be found in stroke at chronic stage with a significant relationship among attention deficit, balance control and fall.

Objective To investigate the status of the cognition ,attitude and behavior related to hepatitis B among the college students in the business school ,and to provide the reference for making a reasonable and effective measures of prevention and health education .Methods A self‐designed questionnaire was used to surveyed 548 college students .Results The total awareness rate a‐bout the core information of hepatitis B prevention and treatment among the students was 81 .81% ,and rate of awareness of each hepatitis B question was between 54 .56% and 95 .44% .The total awareness rate of girls(82 .45% )was higher than boys(80 .69% ) (χ2 =5 .536 ,P=0 .019) .The total awareness rate of students in grade 3 and 4 (83 .13% )was higher than that of students in grade 1(79 .44% )(χ2 =17 .247 ,P=0 .000) .78 .83% student treated hepatitis B patients with the right mental attitude and students ac‐quired knowledge mainly from TV‐broadcast(75 .55% ) .Conclusion The college should strengthen health education on hepatitis B to improve students′awareness of hepatitis B ,eliminate hepatitis B discrimination and to improve the students′consciousness of prevention and treatment .

Objective We aimed to investigate the role of McMaster model of family therapy in improving family function of patients with advanced hepatocellular carcinoma (HCC).Methods Patients who had advanced HCC and received transarterial embolization (TAE) or transarterial chemoembolization (TACE) from Department of Hepatobiliary Ⅰ,Eastern Hepatobiliary Surgery Hospital between October 1,2012 and June 25,2013 were randomly divided into two groups:the experimental group (51 patients) and the control group (49 patients).The control group received routine family support education.The experimental group not only executed routine family support education,but also was given McMaster model of family therapy according to evaluation results of family assessment device (FAD) on the second and third day of hospitalization.The status of family function of all patients were assessed by FAD on the fnrst day of hospitalization and fourth week after therapy.We compared the status of family function between the two groups.Results In age,gender,educational level,place of residence,occupation,family economic status,medical payment,liver or kidney function,HBV infection,cirrhosis and tumor burden,no statistical differences were found between the experimental group and the control group patients before TAE or TACE.Two groups were dysfunction in communication,roles,affective responsiveness,affective involvement,behavior control,and general function in addition to problem solving before TAE or TACE.No statistical differences were found between two groups.After the therapy,compared with the control group,those patients in the experimental group had a lower level scoring in communication,roles,affective responsiveness,affective involvement,behavior control,and general function in addition to problem solving on the fourth week after the therapy,t value was-2.544,-3.767,-3.904,-2.848,-4.950 and-4.953,the difference had statistical significance.Conclusions McMaster model of family therapy may help to improve family function of patients with advanced HCC.

Objective To investigate the efficacy and safety of isosorbide mononitrate sustained release tables plus vinorelbine and cisplatin in patients with previously untreated advanced non-small-cell lung cancer (NSCLC).Methods One hundred and ten patients with stage ⅢB-Ⅳ NSCLC were randomly assigned to group A (57 cases) and group B (53 cases) by random mumber table.Patients in group A were treated with vinorelbine 25 mg/m2 on the first and eighth day and cisplatin 25 mg/m2 on day 2-4,with transdermally applied isosorbide mononitrate sustained release tables (40 mg,daily for 8 days),and patients in group B were treated with vinorelbine and cisplatin.Response to treatment was assessed by RECIST1.1 and adverse effect was assessed by NCI-CTC(3.0).Results The response rate in group A (58.2％,32/55 patients) was significandy higher than that for patients in group B (30.8％,16/52 patients; x2 =8.120,P =0.004).Median TTP and median OS in group A were longer than those in group B (8.2 vs 5.8 months,x2 =10.684,P =0.001 ; 11.6 vs 9.0 months,x2 =11.231,P =0.001).While,patients with squamous carcinoma showed better response to chemotherapy (RR =2.438,95％ CI:1.136-5.231,P =0.022).Adverse effect difference was not significant between group A and group B,except headache.The rate of grade 1 to 2 headache in group A (34.5％ ; 19 of 55 patients) was significantly higher than that in group B (3.8％ ; 2 of 52 patients; P ＜0.001).Conclusion Use of isosorbide mononitrate sustained release tables combined with vinorelbine and cisplatin may improve overall response,TTP and OS in patients with advanced stage NSCLC.