Objective To review pharmacological mechanism, pharmacokinetics, clinical research progress and prospects of pradefovir, a liver targeted medicine for hepatitis B.Methods The studies of pradefovir were summarized by searching literature databases of Web of Science,Elsevier ScienceDirect,Springer Link,Wiley Online Library, Pubmed, CNKI, Wanfang and VIP datebase.Results Pradefovir is a prodrug that targets to the liver, which absorbs rapidly by oral administration.Pradefovir could be quickly converted to adefovir with hepatic drug metabolizing enzyme CYP3A4. Compared with adefovir dipivoxil, it has shown smaller nephrotoxicity and larger liver targeting.Conclusion Pradefovir has shown favorable safety and effectiveness in the clinical study and has no durg resistance to be found.The approval Ⅲ clinical trial has been acquired of pradefovir in USA and has enteredⅠ clinical trial currently in our country, which has good prospects for clinical application in future.

Objective: To measure serum testosterone level, plasma levels of interleukin-18 (IL-18) and IL-10 and explore their correlation in patients with different types of coronary heart disease (CHD), and their possible role in occurrence and development of CHD. Methods: A total of 96 male CHD patients were divided into acute myocardial infarction (AMI) group (n=35), unstable angina pectoris (UAP) group (n=32) and stable angina pectoris (SAP) group (n=29). Another 30 patients who were excluded for CHD by coronary angiography were enrolled as non CHD control group. Enzyme linked immunosorbent assay (ELISA) was used to measure serum testosterone level and plasma levels of IL-18 and IL-10 in all groups. Results: Compared with non CHD control group, there were significant decreases in serum testosterone level [(13.46±1.99) mmol/L vs. (6.89±1.35) mmol/L vs. (5.02±1.87) mmol/L, t=1.917～2.365, P<0.05 both] in UAP group and AMI group, and that of AMI group was significantly lower than that of UAP group, t=1.034, P<0.05; there were significant increases in IL-18 levels [(146.72±79.36) pg/ml vs. (209.32±80.49) pg/ml vs. (316.78±75.63) pg/ml vs. (457.78±83.21) pg/ml, t=2.016～3.167,P<0.05 all] in SAP group, UAP group and AMI group, and those of UAP group and AMI group were significantly higher than that of SAP group, t=2.173, 2.596, P<0.05; there were significant increases in IL-10 levels [(48.46±18.27) pg/ml vs. (116.45±42.76) pg/ml vs. (85.64±27.33) pg/ml vs. (70.26±18.55) pg/ml, t=2.997～2.018, P<0.05 all] in SAP group, UAP group and AMI group, and those of AMI group and UAP group were significantly lower than that of SAP group (t=2.034, 2.291, P<0.05 both). Pearson linear regression analysis indicated that serum testosterone level was negatively correlated with levels of IL-10 (r=-0.678, P<0.01) and IL-18 (r=-0.579, P<0.01) in CHD group. Conclusion: There are significant changes in serum testosterone level and plasma IL-18, IL-10 levels, and testosterone level is significantly negatively related with IL-18, IL-10 levels, and they can be regard as new indexes assessing coronary atherosclerotic lesion.

Objective To retrospectively assess the diagnostic value of nuchal translucency (NT) thickness and facial profile ultrasonic markers [including frontomaxillary facial (FMF) angle,and the ratio of prenasal thickness to nasal bone length (PT/NBL)] for trisomy 21 syndrome in first-trimester fetuses.Methods Ultrasonograhic images of 35 fetuses with trisomy 21 syndrome and 70 gestational age matched normal fetuses were analyzed in first-trimester.NT,FMF angle and the PT/NBL ratio were measured retrospectively in stored images from digital database between January 2012 and December 2015.The diagnostic value of NT,FMF angle and PT/NBL ratio were compared with different combinations.Results (1) The mean NT was significantly higher in the trisomy 21 group than that in controls (t =7.401,P =0.00).The NT above 2.5mm was observed in 20 trisomy 21 fetuses (57.1％) and in 3 normal fetuses (4.3％).(2) The mean FMF angle was significantly higher in the trisomy 21 group than that in controls (t =-5.283,P =0.00).The FMF angle above the 95th percentile (93.6°) was observed in 13 trisomy 21 fetuses (37.1％) and in 1 normal fetus (1.4％).(3) The mean PT/NBL ratio was significantly higher in the trisomy 21 group than that in controls (t =-7.826,P =0.00).The PT/NBL ratio above the 95th percentile (0.93) was observed in 19 trisomy 21 fetuses (54.3％) and in 4 normal fetuses (5.7％).(4) The sensitivity and Youden index for trisomy 21 increased gradually,which were 57.1 ％ and 0.528 by using NT,and 74.3％ and 0.686 by using NT and FMF angle,and 91.4％ and 0.828 by using NT,FMF angle and PT/NBL ratio.There were significant differences in the detection rates of trisomy 21 among the three strategies,while the diagnostic specificity of the three strategies were more than 90％.Conclusions The three parameters are significantly increased in trisomy 21 fetus in first-trimester.First,increased NT was most commonly detected,followed by increased PT/NBL ratio,and increased FMF angle again.Detection rates for trisomy 21 fetuses in first-trimester by ultrasound screening can be significantly improved if combination of all three parameters rather than just one parameter are performed.

Objective To compare high-frequency ultrasonography and MRI in diagnosis of medial patellofemoral ligament (MPFL) injury after acute lateral traumatic patellar dislocation(LTPD).Methods According to surgical data of 35 patients with acute LTPD,the incidence and sites of MPFL injury were analyzed.Further,based on high frequency ultrasonography and MRI data,the sensitivity,specificity and accuracy of high-frequency ultrasonography and MRI in different MPFL injuries were analyzed and compared.Results Among 35 patients,there were 21 cases with complete MPFL tear and 14 cases with partial MPFL tear.Tear of MPFL at the femoral attachment in 19 cases,at the patellar attachment in 15 cases,and at the mid-substance in 1 case.The sensitivity,specificity,accuracy of high-frequency ultrasonography diagnosis were 78.6％,95.2％,88.6％ respectively on partial MPFL tear and 95.2％,78.6 ％,88.6 ％ respectively on complete MPFL tear.The sensitivity,specificity,accuracy of MRI diagnosis were 85.7％,90.5％,88.6％ respectively on partial MPFL tear and 90.5％,85.7％,88.6％ respectively on complete MPFL tear.There were no significant difference between high-frequency ultrasonography and MRI in diagnosis of partial and complete MPFL injury (x2 =0.243,0.267; P =0.622,0.599).Conclusions MPFL formoral attachment is most vulnerable to damage,followed by patellar attachment.High-frequency ultrasonography,as well as MRI,can be used clearly to diagnose MPFL injury and accurately classify the damage,and it is also an easy,reliable,rapid method,which can be applied routinely to diagnose MPFL injury after actue LTPD.

Objective To evaluate the clinical features of in-stent restenosis after drug eluting stent (DES) implantation and investigate the relationship between different patterns of DES restenostic lesions and long-term prognosis.Methods All scoronary heart disease patients who underwent repeated pereutaneous coronary intervention (PCI) for DES in-stent restenosis from September 2006 to December 2009 were enrolled.All patients were divided into focal group and non-focal group according to the pattern of restenosis.All patients were prospectively followed up for major adverse cardiovascular event (MACE) including death,repeat PCI and myocardial infarction.Results Totally 88 patients (40 with focal restenosis,48 with non-focal restenosis) were enrolled.There were no significant differences between two groups in age,gender,risk factors,clinical presentation and medical therapy (P ＞ 0.05).Compared with that in focal group,the patients in non-focal group had a higher portion of in-segment restenosis [58.3％ (28/48) vs.12.5％(5/40),P＜ 0.01],higher stenosis rate [(78.1 ± 10.0)％ vs.(70.0 ± 9.7)％,P ＜ 0.01],more need for another DES[81.2％(39/48) vs.17.5％(7/40),P＜ 0.01],and longer stent implanted [(25.0 ± 7.0) mm vs.(17.4 ±3.4) mm,P ＜0.01].After following up for (2.2 ± 1.0) years,there were no significant differences between two groups in MACE and each component (P ＞ 0.05),however,compared with that in focal group,there was a trend of increase in MACE in non-focal group[22.9％(11/48) vs.10.0％(4/40),P=0.092].Conclusion It suggests that patients with non-focal restenosis have a more severe lesion angiographically,which usually results in another DES implanted,and has a worse long-term prognosis.

Objective To investigate the effect of tail-suspension,noise stress and combination of them on immune function in rats.Methods The rats were divided into four different groups,A: control;B: noise stress(2 h);C: tail-suspension(30?,21 d);D: tail-suspension added noise stress.The body weight,thymus weight and spleen weight,circulating leukocytes and its distribution,T lymphocyte subpopulations(with flow cytometry) and NO level in serum(with Griess method) of rats were determined after exposed to 21 d tail-suspension,2 h noise stress and combination of them.Results Compared with group A,the body weight were significantly decreased(P

Objective To evaluate the safety and efficacy of drug-coated balloon in small branch ostial lesions of coronary arteries (Medina type 0,0,1 lesion).Methods A total of 48 patients were enrolled in the study and they were randomly divided into the Drug-Coated Balloon (DCB) angioplasty group (22 cases) and the Cutting Balloon (CB) angioplasty group (26 cases).They underwent percutaneous coronary intervention (PCI) with either DCB or with CB in small branch ostial lesions of coronary arteries respectively,The immediate outcomes and long-term efficacy were investigated.Results There were no statistical differences between the two groups in baseline clinical date before PCI.There were no coronary perforation,pericardial tamponade,acute thrombotic events in the two groups.There was no significant difference in minimal lumen diameter (MLD) immediately after PCI between the two groups.During followup angiography,the MLD in the DCB group was significantly larger than in the CB group [(1.8 ± 0.2) mm vs.(1.5 ± 0.3) mm,P =0.006].There were no death,nonfatal myocardial infarction or revascularization recorded in the groups during 6 months of follow-up.Conclusion The immediate outcomes between DCB and CB were similar in small branch ostial lesions for coronary arteries angioplasty.The long-term efficacy of DCB angioplasty is better than CB angioplasty.

Purpose To assess the clinical and pathological features of small gastrointestinal stromal tumours (sGIST).Methods To reevaluated the clinical,histological and immunohistochemical parameters of 21 sGISTs.The standard immunohistochemical panel antibodies were studied on the tumor sections.All data were compared with clinical sGIST.Results There were a total of 7 females and 14 males of sGISTs.The median age was 63 years old.The tumors were predominantly located in the stomach showing a spindle cell morphology and the tumor sizes ranged from 0.5 cm to 1.5 cm.9 sGISTs combined with malignant tumors,which were gastric cancer have been incidentally detected during surgery.As the lesions were small in size,with infrequent bleeding,necrosis,mucosal invasion,ulceration and less mitotic index,sGISTs reoccurred less compared with clinical sGIST.p53,Ki-67 labeling index and microvascular density (MVD) in sGIST were significantly lower than clinical sGIST (P ＜ 0.05).Conclusion sGIST may occure with digestive tract cancer synchronously.p53,Ki-67 labeling index and MVD were lower than clinical GIST,which means better prognosis.

Objective:To determine the inhibitory effect of Rupixiao ( RPX) granule on mammary gland hyperplasia ( HMG) in rabbits and explore the possible mechanism to provide reference for clinical medication. Methods:Rabbit model of mammary hyperpla-sia was established by estradiol benzoate and progesterone. Xiaoyao pills and tamoxifen were used as the positive control, and the RPX granule group was respectively at low, medium and high dose (0. 525,1. 05,2. 1 g·kg-1). Each group was with intragastric adminis-tration for 30 days. The levels of E2 , PROG, FSH, LH and PRL in serum and the expression of VEGF in the homogenate tissue were determined by an Elisa method. The breast tissue of rabbits in each group was withdrawn to observe the structure changes after Hema-toxylin-eosin staining ( HE) . Results:Ovarian preservation-benzoic acid, estradiol combined with progesterone could be used to estab-lish mammary gland hyperplasia in rabbits. RPX granule could significantly decrease the serum levels of E2 and PRL (P<0. 01)and increase that of PROG (P<0. 01 or P<0. 001). The results of pathological section showed that the breast structure in RPX granule high dose group could be restored to the level of the blank control group, which showed its therapeutic effect on HMG was better than that of tamoxifen and Xiaoyao pills. The expression of VEGF in each treatment group significantly decreased compared with that in the model group by the Elisa reagent (P<0. 001). Conclusion:RPX granule has good efficacy in HMG rabbits. The inhibitory effects of RPX granule on HMG in rabbits maybe related to the inhibition of VEGF in rabbit breast tissues, and the inhibition of RPX granule was similar to that of tamoxifen and Xiaoyao pills.

Objective To compare the safety and efficacy of direct and remedial rotational atherectomy in the treatment of heavily calcified coronary artery lesions.Methods We retrospectively reviewed 58 patients admitted in the Shanghai Chest Hospital and Liaocheng People Hospital from May 2012 to July 2015 who had received stent implantation and rotational atherectomy.The 58 patients were divided into two groups which were the direct atherectomy group (n =27) and the remedial atherectomy group (n =31).General clinical date,lesion and procedural characteristics,intraoperative complications,in-hospital and follow-up MACCE were compared between the two groups.Results There were no differences between the two groups in general clinical date intraoperative complications,amount of contrast agent used,proceduraltime,rates of in-hospital and follow-up MACCE.Nevertheless,compared with the direct artherectomy group,the remedial group had more number of balloon dilations during procedure [3 (1,5) vs.2 (1,2),P ＜ 0.001] and higher peak cardiac troponin levels [1.1 (0.3,3.0) μg/L vs.0.5 (0.1,2.3) μg/L,P =0.032].Conclusions Remedial rotational atherectomy with drug-eluting stent had the same safety and efficacy as direct atheretomy with drug-eluting stent in treating patients with heavily calcified coronary lesions.It is reasonable and safe to transform routine PCI to remedial rotational atherectomy when the 2.0 mm semi compliant balloon or/and 2.5 mm non-compliant balloon cannot pass through or dilate the lesions.