Objective To investigate the clinical outcomes of patients with chronic hepatitis B and its influencing factors,and provide reference for the prognosis of patients with hepatitis B.Methods 102 patients with chronic hepatitis B from January 2009 to June 2014 were selected and divided into the case group of 32 patients and the control group of 70 patients according to whether to occur with cirrhosis or liver cancer.The two groups of patients were analyzed and compared for general information,HBV DNA,serum ALT and other indicators.Results The cumulative cases of negative HBsAg,chronical hepatitis B,liver cirrhosis and liver cancer were 5,65 and 32,respectively.Univariate Logistic regression analysis showed that the differences between the two groups in age,sex,drinking history,HBV DNA levels and serum ALT levels were statistically significant (all P ＜ 0.05).Whether to cirrhosis or liver cancer was the dependent variable,the statistically significant single factors between the two groups were the independent variable,multivariate Logistic regression analysis showed that older age,male sex,alcohol abuse,high level of HBV DNA and high level of serum ALT were the risk factors of leading to cirrhosis,liver cancer for the patients with chronic hepatitis B (OR values were 9.94,14.36,8.25,13.01,120.32,respectively).Conclusions The older age,male,alcohol history,high level of HBV DNA and high level of serum ALT are higher risk factors for patients with chronic hepatitis B to development of cirrhosis and liver cancer.Patients with risk factors should be gave systematic interventions to reduce progression to cirrhosis,liver cancer and improve the quality of life.

Objective To study the extraction process of Jiejiu Gankang granules by orthogonal test.Methods With the ethanol extraction rates of the medical materials like ginseng,radix salviae miltiorrhizae,the water extraction rates of the medical materials like hawthorn,and Tanshinone ⅡA as the parameters,the extract conditions of Jiejiu Gankang granules was optimized by orthogonal design.Results The optimal preparation process was as follows:the mixture of medical materials like ginseng and Schisandra chinensis was refluxed twice with total 10 times of 70% alcohol,2.0 hours for each time,and then the mixture of medical materials like hawthorn extracted twice with total 10 times of boiling water,2.0 hours for each time.Conclusion The optimal preparation process is reasonable and with high extraction rate of active components.

Objective To analyze the clinical factors for pathologic complete response ( pCR) after preoperative neoadjuvant chemoradiotherapy ( neo?CRT) for locally advanced rectal cancer. Methods From 2005 to 2012, 297 patients with locally advanced rectal cancer and complete clinical data were enrolled as subjects. Those patients were diagnosed with biopsy and treated with neo?CRT ( radiotherapy by 3?dimonsional conformal radiotherapy or volumetric?modulated arc therapy) followed by radical surgery. The logistic regression model was used for the multivariate analyses of the correlation of pCR with age, gender, distance between tumor and the anal verge, serum level of carcinoembryonic antigen ( CEA ) before treatment, hemoglobin level before treatment, cT staging, and cN staging. Results In all patients, 78 ( 26?7%) patients had pCR after treatment. The numbers of patients with pCR were 42( 34?4%) in patients with stage T1?T3 disease and 37(21?1%) in patients with stage T4 disease. In the patients with serum CEA levels no higher than 5?33 ng/ml, 55(36?4%) had pCR after treatment, while in the patients with serum CEA levels higher than 5?33 ng/ml, only 24( 16?4%) had pCR. The univariate analysis revealed that age, gender, distance between tumor and the anal verge, anemia before treatment, or cN staging were not related to pCR. The multivariate analysis showed that stage cT1?T3 and a serum CEA level no higher than 5?33 ng/ml before treatment were influencing factors for pCR after neo?CRT for locally advanced rectal cancer ( P=0?031,P=0?000) . Conclusions The clinical staging and the serum CEA level before treatment are influencing factors for pCR after neo?CRT for locally advanced rectal cancer. The serum CEA level before treatment can be considered as a predictor of pCR after neo?CRT for locally advanced rectal cancer.

OBJECTIVE: To investigate the classification and incidence of acid-base disturbance (ABD) in the patients with post-traumatic multiple organ dysfunction syndrome (MODS). METHODS: A total of 119 patients with MODS were examined with arterial blood gas analysis and serum electrolytes detection for 675 times in this study. RESULTS: Different types of ABD existed in 647 times out of 675 times (95.9%) of blood-gas analyses. There were 270 times (41.7%) of simple ABD, 271 times (41.9%) of double ABD and 106 times (16.4%) of triple ABD. Among which, 404 times (62.4%) were in respiratory alkalosis (RAL), 332 times (51.3%) in metabolic acidosis (MA), 227 times (35.1%) in metabolic alkalosis (MAL) and 167 times (25.8%) in respiratory acidosis (RA). In this study, 79 cases (66.4%) out of 119 cases with MODS died from these kinds of ABD. CONCLUSIONS: It suggests that in the early stage of MODS, RAL with or without hypoxemia may exist, and later on, MA or even triple ABD may occur. In order to detect and correct the primary disorders as early as possible, it is important to keep the balance of hydrolyte. The treatment of primary diseases is also important. Disorders of acid-base balance were corrected according to pH standard values, anion gap (AG) and the potential [HCO(3)(-)] were also calculated simultaneously. When pH was more than 7.50 or lower than 7.20, it is necessary to give drugs of acidity or alkalinity to the patients with ABD to maintain pH value within a normal range.

Basal cell carcinoma has a low mortality rate, but its multiple occurrence, recurrence and metastasis have caused problems for patients and clinical work. In recent years, with the in-depth study of the tumor microenvironment in basal cell carcinoma, previous understanding and treatment concepts for basal cell carcinoma have been changed. This article focuses on the role of tumor microenvironment in the occurrence and development of basal cell carcinoma, and reviews the treatment method based on this.

Basal cell carcinoma has a low mortality rate, but its multiple occurrence, recurrence and metastasis have caused problems for patients and clinical work. In recent years, with the in-depth study of the tumor microenvironment in basal cell carcinoma, previous understanding and treatment concepts for basal cell carcinoma have been changed. This article focuses on the role of tumor microenvironment in the occurrence and development of basal cell carcinoma, and reviews the treatment method based on this.

BackgroundThe incidence of delirium in critically ill psychiatric patients is high， and there are many factors affecting delirium occurrence. At present， epidemiological studies on delirium among critically ill patients in psychiatric hospitals are limited. ObjectiveTo explore the risk factors for delirium in critically ill patients in a psychiatric hospital， so as to guide the clinical management of delirium in psychiatric hospitals. MethodsThis retrospective study included 427 critically ill patients who were admitted to Shenzhen Kangning Hospital from January 1， 2019 to May 31， 2021. The delirium situation， gender， age， pre-admission course of illness （duration from the onset of acute mental state changes to in-patient registration at a psychiatric hospital）， history of mental illness， history of cognitive dysfunction， history of using psychoactive substances， history of using sedative and hypnotic drugs， number of combined chronic diseases， number of combined drugs and type of disease were examined as potential risk factors for delirium. Single Logistic regression was used to analyze the potential risk factors for delirium， and the potential risk factors were incorporated into the multi-factor Logistic regression analysis model so as to gradually screen out the risk factors for delirium in critically ill psychiatric patients. ResultsDelirium was present in 33.49% （143/427） of critically ill patients. Multi-factor Logistic regression analysis demonstrated that the presence of delirium was associated with mental and behavioral disorders caused by psychoactive substances （OR=8.949， P<0.01）， absent history of mental illness （OR=4.202， P<0.01）， number of combined chronic diseases （OR=1.249， P<0.01）， age （OR=1.031， P<0.01） and pre-admission course of illness （OR=0.942， P<0.01） . ConclusionDelirium was present in nearly 1/3 critically ill patients in the psychiatric hospital. The risk factors for delirium included short course of illness before admission， age， more combined chronic diseases， absent history of mental illness， mental and behavioral disorders caused by psychoactive substances. ［Funded by Shenzhen Fund for Guangdong Provincial High-level Clinical Key Specialties （number， SZGSP013）］