Burns ; complications ; metabolism ; Endotoxemia ; etiology ; metabolism ; Humans ; Multiple Organ Failure ; etiology ; metabolism ; Myocytes, Cardiac ; metabolism

Objective To evaluate the efficacy of pegylated interferon α-2a and entecavir (ETV) combination therapy for patients with HBeAg positive chronic hepatitis B (CHB).Methods Fifty eight HBeAg positive CHB patients were assigned to two groups:29 patients received ETV 0.5 mg daily for 72 weeks (ETV group) and 29 patients received ETV and pegylated interferon α-2a 180 μg weekly for 48 weeks followed by ETV alone for 24 weeks (combination group).Serum samples were collected from all patients every 12 weeks for assessment of biochemical,virological and serological responses to treatment.Results Fifty four patients completed the 72-week study,including 28 in ETV group and 26 in combination group.There were no significant differences in week 24,week 48 and week 72 of ALT normalization [72％ (21/29)vs.93％ (27/29),x2 =2.104;90％ (26/29) vs.97％ (28/29),x2 =0.269;90％ (26/29) vs.97％ (28/29),x2 =0.269],HBV DNA undetectable rate [31％ (8/26) vs.46％ (13/28),x2 =1.391;62％ (16/26) vs.57％ (16/28),x2 =0.108;77％ (20/26) vs.75％ (21/28),x2 =0.027],HBeAg loss rate[12％(3/26) vs.25％ (7/28),x2 =0.850;31％ (8/26) vs.32％ (9/28),x2 =0.012;46％ (12/26) vs.36％(10/28),x2 =0.609] and HBsAg levels (log10 IU/ml) (3.63 ± 0.45 vs.3.36 ± 1.18,t =-1.066;3.45 ±0.43 vs.3.23 ± 1.15,t =-0.915;3.36 ± 0.58 vs.2.88 ± 1.28,t =-1.762) between two regimens (all P ＞ 0.05).Among 58 patients,15 were HBeAg and anti-HBe double-positive (26％)and 43 were HBeAg mono-positive patients.The baseline HBV DNA level [(5.07 ± 1.50) vs.(6.40 ± 1.47) log10 IU/ml,t =2.858,P ＜ 0.05] and HBeAg titer [14 (4-45) vs.732 (296-1 012) S/CO,Z =-5.031,P =0.05] in double-positive patients were lower than those in mono-positive patients.The HBV DNA undetectable rate of double-positive patients was significantly higher than that of mono-positive patients in 24 weeks [10/15 vs.26％ (10/39),x2 =7.819,P ＜0.05] and 72 weeks [15/15 vs.69％ (27/39),x2 =4.287,P =0.05].The HBeAg loss rate of double-positive patients was higher than that of mono-positive patients in 12 weeks [6/15 vs.10％ (4/39),x2 =4.533,P =0.05] and 48 weeks [9/15 vs.26％ (10/39),x2 =5.608,P =0.018].This tendency was more significant in the combination therapy group,but the difference was not statistically significant.(5/6 vs.4/9,P =0.065).Conclusions Compared with Entecavir monotherapy,entecavir combined with interferon may not improve the therapeutic effect in HBeAg positive chronic hepatitis B patients.However,the therapeutic response of HBeAg/anti-HBe double-positive patients may better than that of HBeAg mono-positive patients.

Functioning gonadotroph adenomas (FGA) are pituitary tumors secreting biologically active gonadotropins.Because of its low incidence,it can be diagnosed only in evident clinical manifestations,and clinicians are often not able to make right diagnosis.The published literature includes only small case series or individual case reports.In this review,we will focus on the main presenting manifestations,the reported management options,and the long-term outcome of the FGA.

0.05).It was revealed that all the patients followed up 3 to 6 months after treatment were free from complaints of the involved teeth,with nomal food intake and mastication.No abnormal adjacent tissues of dental roots were detected by imaging examination.Conclusion For the vital teeth,the similar clinical effect may be obtained by one-visit RCT and multi-visit RCT.

28 kg/m2) and 30 normal subjects (BMI

ObjectiveTo explore the effect of various forms of psychological intervention on psychological stress,mental state and treatment process of out- patients. Methods 198 outpatients from February 2010 to July 2011 were randomly divided into the observation group and the control group with 99 cases in each group.The control group received conventional treatment and care.The observation group was given multiple forms of psychological intervention on the basis of conventional treatment and care.Both groups were taken with Zung Anxiety Rating Scale (SAS)and the Hamilton Anxiety Scale(HAMA)to measure the psychological stress and the degree of anxiety before and after treatment.The total efficiencies of various disorders for the two groups before and after the diagnosis and treatment were compared. ResultsThere were no significant differences in SAS score and HAMA scores before psychological intervention.After the intervention,the SAS score and HAMA score in the control group were significantly higher than the observation group.The total effective rate after a course of treatment in the observation group was 90.6％.The total efficiency in the control group was 78.8％,which was significantly lower than that of the observation group. ConclusionsThe multiple forms of psychological intervention can reduce the mental stress,ease the patients' emotional state and improve the patients' therapy effect at the same period for out-patients.

Objective To investigate the effect of miR-21 on the secretion of IFN-γ and IL-17 from peripheral blood mononuclear cells (PBMC) in type 1 diabetic patients (T1D). Methods The expression levels of miR-21 in PBMC from 60 T1D patients and controls by quantitative real-time quantitative polymerase chain reaction (qRT-PCR) were detected and the secretions of IFN-γ and IL-17 from T1D PBMC after transfection with miR-21 were detected by enzyme linked immunosorbent assay. Results The expression of miR-21 in PBMC from T1D patients was significantly lower than the control (P<0.01). The levels of IFN-γand IL-17 from T1D PBMC after transfection with miR-21 were remarkably downregulated compared to the control (P < 0.05 or P < 0.01). Conclusion Compared with that at the healthy control group, the expression of miR-21 in PBMC from T1D patients is decreased. MiR-21 could suppress the secretions of IFN-γand IL-17 from PBMC in T1D patients.

Objective To evaluate the rate and types of human papillomavirus (HPV) in vulvar intraepithelial neoplasia (VIN).Methods We detected HPV DNA in 67 lesion tissues collected from 40 VIN patients with PCR based reverse line blot hybridization and DNA sequencing. The PCR using GP5/GP6 primers in HPV L1 region resulted in a 150-bp fragment. When the PCR did not amplify the target DNA,another PCR using SPF1/SPF2 primers was performed to amplify the 65-bp fragment.Results HPV DNA amplified with primers GP5/GP6 was positive in 52.2% (35/67) of the lesions. Of the 32 negative lesions,26 (81.2%) were positive for HPV DNA amplified with SPF1/SPF2 primers. The total positive rate was 91.0% (61/67). Ninety percent of the HPV belonged to high risk types. Sequencing data showed that the genotypes of 31 mono-infection lesions were the same as those of the reverse line blot results,yet the sequences in 4 multi-infection samples could not be determined. Of the 26 SPF PCR products,24 could be sequenced. 80.6% (25/31) patients with multiple lesions displayed the same genotype,suggesting HPV in the different lesions from the same patient was monoclonal.Conclusion The high risk type of HPV is associated with vulvar intraepithelial neoplasia and may play an important role in the development of invasive vulvar carcinoma.

To make biomedical engineer comprehend deeply the cleaning and disinfection method of hemodialysis equipment,this paper discusses two factors determining cleaning and disinfection method,analyzes the impurities infecting dialysis' quality and treatment effect in hemodialysis system,and systematically introduces the daily cleaning and disinfection of hemodialysis equipment as well as its notice by citing Gambro AK95 series hemodialysis equipment.

Based on the principle of evidence-based medicine, the efficacy and safety of consciousness-restoring and orifice-opening (CROO) acupuncture manipulation in treating stroke are systematically assessed. All reports of clinical trials of CROO acupuncture manipulation in treating stroke were collected and random-effect model of Meta-analysis was performed by using the statistical software of Review Manager (RevMan4.1). Sensitivity and heterogeneity were analyzed and tested; funnel-plot analysis was used to identify the publication bias. Comprehensive efficacy (Odds Ratio, OR) of CROO acupuncture manipulation in treating stroke was: OR of cure and markedly effective rate between groups being 3.65 and 95% confidence interval (CI) in the range of 1.70～7.83, OR for decreasing long-term death rate being 0.21 and 95% CI in the range of 0.08～0.52. Stratified analysis showed that OR of stroke sequela was 4.01 and OR of cerebral vascular infarction was 4.45. Adverse drug reaction was not found in all of the reports. Funnel-plot analysis showed the possible existence of publication bias. [ Conclusion]CROO acupuncture manipulation has certain effect in treating stroke, especially in treating acute stage of cerebral vascular infarction, and could reduce long-term death rate of stroke. Heterogeneity may result from the difference of trial designs and inclusive criteria. Funnel-plot analysis shows the possible existence of publication bias. This conclusion is rather limited and will get more evidence if multi-center, double-blinded, randomized and controlled trials could be carried out.