Objective To evaluate the efficacy of entecavir in lamivudine-refractory patients with chronic hepatitis B.Methods Literature from Medline,Embase and CBM between January 2001 to December 2008 were reviewed.Acccording to the including and excwding criteria,four randomized controlled trials (RCT) were enrolled.The results of the trials were reviewed and analysed in software Revman 4.2.Results Patients in the entecavir group enjoyed significantly higher negative conversion ratios of HBV-DNA and ALT,and positive seroconversion of HBeAg:RR were 13.90(95% CI 6.39～30.24,P＜0.00001),2.49(95% CI 1.40～4.45,P=0.002),and 3.53 (95% CI 2.85～4.38,P＜0.000 01) respectively.There was a trend for the improvement of negative conversion ratio of HBeAg (RR=2.27,95% CI 1.00～5.15,P=0.05),but the incidence of side-effects of the drugs has no difference (RR=1.05,95% CI 0.97～1.14,P=0.21).Conclusions Compared with lamivudine or placebo,entecavir can significantly decrease HBV-DNA,improve liver function and positive seroconversion ratio of HBeAg without raising the incidence of drug side-effects.

Objective To investigate the feasibility and superiority of local anaesthesia video-assisted thoracoscopic surgery (LA-VATS) in diagnosis and treatment of open thoracic trauma (OTT).Methods Seventy-eight patients with OTT emergently admitted from February 2007 and June 2012 were randomized into LA-VATS group (n =37) and conventional treatment group (n =41) by the toss of a coin.In the LA-VATS group,further treatment was determined following LA-VATS.Volume of chest tube drainage,duration of chest tube placement,average length of hospital stay,and postoperative complications were measured and compared between groups.Results In the LA-VATS group,23 patients completed LA-VATS and 14 were transferred for simple VATS-assisted mini-thoracotomy under general anesthesia.In the conventional treatment group,24 cases completed debridement and chest drainage and 17 cases were transferred for thoracotomy under general anesthesia.Volume of chest tube drainage [(195.0 ± 150.8) ml/d∶ (480.0 ±212.3)ml/d] (t =-2.675,P ＜0.05),duration of chest tube placement [(2.6 ± 1.4) d∶ (3.8 ± 1.9) d] (t =-2.318,P ＜ 0.05),average length of hospital stay [(6.4 ±2.3) d ∶ (10.9 ± 3.3) d] (t =-2.471,P ＜ 0.05),and incidence rate of postoperative complications (10.8％ ∶22.0％) (x2 =4.132,P ＜0.05) were all significantly different between LA-VATS and conventional treatment groups.Conclusion LA-VATS is safe and feasible for diagnostic exploration and simple treatment of OTT.

The goal of this work was to explore the prospect of standardized application of an in-vitro bioactivity assay for recombinant human follicle-stimulating hormone based on a reporter gene. The relative accuracy, intermediate precision, linearity and applicable range of the method were validated according to the General Rules of Chinese Pharmacopoeia 2020 edition Volume IV (9401). Three laboratories used this method to determine the in-vitro biological activities of six batches of drug product and three batches of drug substance manufactured by two different companies. The consistency of the potency determined by three laboratories, the intra-laboratory precision and inter-laboratory precision were analyzed. The method was optimized during the collaborative validation. The results of method validation meet the requirements of the General Rules of Chinese Pharmacopoeia 2020 edition Volume IV (9401). Aiming to resolve the problems found in the collaborative validation, the medium for cell seeding, the pre-diluted buffer solution of standard and sample, and the means of removing and discarding supernatant after stimulation were optimized. After optimization, there was no significant difference in the bioactivity among the different laboratories (P > 0.05), indicating statistical equivalency. Intra-laboratory and inter-laboratory precision were good and the geometric coefficient of variation (GCV%) were both less than 15%. In conclusion, the reporter gene assay has good intra-laboratory repeatability and inter-laboratory reproducibility and is suitable for analyzing recombinant human follicle-stimulating hormone drug product and drug substance by different manufacturers. It is expected to be used as a standardized method for the determination of the in-vitro bioactivity of such products.

Objective To introduce and evaluate a new surgical technique about concealed penis.Methods The incision was chosen on the outer lamina of the bilateral sides of penis.The excision of fibrous cord of penis dartos and suprapubic fat pad and skin fixation on the penis root were done to the patients.For the severe patients,the superficial layer of the suspensory ligament of penis must be excised.Thirty-nine cases were treated with this new technique,22 cases with Devine technique,and 23 cases with modified Shiraki technique and clinical comparative research was carried out.Results Penis of 39 cases were found 2 to 3 centimeters pro-pubic projection.Within 3 to 36 months of follow-up,no obvious reduction of penis was found and the erection function was normal.By new evaluat standard of surgical efficacy,the clinical efficacy of new technique,Devine′s and modified Shiraki′s technique were 92.31%(36/39 cases),77.27%(17/22 cases) and 78.26%(18/23 cases),respectively and the efficacy rate in new technigue was significcmthy higher than that of Devines and modified Shirak′s groups(Pa

Aim The effects of midazolam on the whole-cell sodium currents in rat sympathetic neurons were studied to explore the mechanisms where by midazolam mediates hypotension. Methods Whole-cell patch-clamp recordings were performed on enzymatically isolated rat superior cervical sympathetic neurons. Results Midazolam dose-dependently blocked the whole-cell sodium currents evoked by a voltage step to 0 mV from a holding potential of -80 mV with a mean drug concentration required to produce 50% current inhibition (IC50) values of 18.35 ?mol?L-1; Clinically relevant concentration of midazolam(0.3 ?mol?L-1) reduced sodium peak currents by 19.98%(P

Objective:To explore the expression of TNF a and IL-10 in different layers of laryngeal tissues after laryngeal transplantation and its relationship with acute rejection.Methods:Laryngeal heterotopic transplantation was performed in Wistar and SD rats(Wistar→SD rats).The SD rats were divided into 4 groups:GroupⅠ:Sham control(receive no transplantation): GroupⅡ(receive transplantation,without cyelosporine A treatment);GroupⅢ(receive transplantation.with 5 mg?kg~(-1)?d cyelosporine A treatment):and GroupⅣ(receive transplantation.with 10 mg?kg~(-1)?d~(-1)cyelosporine A treatment).The transplanted larynx was harvested on 3,7 and 11 days after transplantation for pathological examination.The expression of TNF-?and IL-10 in different layers of grafts was detected immunohistochemically.Results:Pathological observation showed mild,moderate and severe acute rejection in GroupⅡandⅢon 3.7 and 11 days after transplantation,respectively:there was no obvious rejection in GroupⅣ.Immunohistochemical staining showed expression of TNF-?and IL-10 in GroupⅡ.Ⅲ.andⅣ,not in GroupⅠ.The ratios of the positive areas of TNF-?and IL-10 in the mucosal and submucosal layers were significantly higher than those in the muscle and cartilage layers of laryngeal tissues(P

OBJECTIVETo observe the effects of Dachengqi Decoction (大承气汤, DCQD) on morphological changes in the network of enteric nerve-interstitial cells of Cajal (ICCs)-smooth muscle cells (SMC) of enteric deep muscular plexuses (DMP) in the rats with multiple organ dysfunction syndrome (MODS).

METHODSOne hundred Wistar rats of both sexes weighing 200 to 250 g were randomly divided into the control group, MODS group, and DCQD group. The morphologic changes of enteric nerve-ICC-SMC network in the DMP of intestine was observed using c-Kit and vesicular acetylcholine transporter/neuronal nitric oxide synthase immunohistochemical double-staining with whole-mount preparation technique, confocal laser scanning microscopy, and electron microscopy.

RESULTSCompared with the control group, the distribution and densities of cholinergic/nitrergic nerves and ICC in the DMP (ICC-DMP) of intestine in the MODS group were significantly decreased (P<0.01), and the network of cholinergic nerve-ICC-SMC was disrupted; and the ultrastructural features of ICC-DMP, enteric nerve, and SMC were severely damaged. After treatment with DCQD, the damage in the network of enteric nerve-ICC-SMC was significantly recovered. Compared with the MODS group, the distribution and densities of cholinergic/nitrergic nerves and ICC-DMP in the DCQD group were significantly increased (P<0.01); and the ultrastructural features of ICC-DMP, enteric nerve, smooth muscle cells were significantly recovered.

CONCLUSIONSDCQD can improve the gastrointestinal motility in MODS. The mechanism may be related to the effect of repairing the damages in the network of enteric nerve-ICC-SMC.

Animals ; Interstitial Cells of Cajal ; cytology ; Intestines ; innervation ; Microscopy, Confocal ; Multiple Organ Failure ; physiopathology ; Plant Extracts ; therapeutic use ; Rats

OBJECTIVETo investigate the indications and effects of different levels of perforator-based sural neurofasciocutaneous flaps in repairing lower limb defects.

METHODSFrom 2004 to 2012,13 cases of soft tissue defects of lower extremity were successfully reconstructed using different levels of perforator-based sural neurofasciocutaneous flaps, included 8 males and 5 females with an average age of 38.6 years old ranging from 15 to 76 years old. Perforator-based sural neurofasciocutaneous flaps located at 4 to 7 cm above the tip of the lateral malleolus were used to resurface ankle and foot defects in 8 cases, perforator-based sural neurofasciocutaneous flaps located on 9 to 11 cm above the tip of the lateral malleolus were used to resurface lower third leg defects in 3 cases, as well as perforator-based sural neurofasciocutaneous flaps located on 2 cm above the tip of the lateral malleolus were used to repair heel defects in 2 cases. The area of the transferred flaps ranged from 4.5 cm x 2.5 cm to 16 cm x 10 cm. The donor sites were covered with skin grafts.

RESULTSAll the flaps survived uneventfully with primary healing. Eight patients were follow-up for 1 to 12 months with an average of 6 months. The color, luster and texture of flap were good, thickness of flaps was fair. No empyrosis and ulcer occurred. The contour and function were satisfied with both the donor and recipient site.

CONCLUSIONSatisfactory functional results can be achieved by using different segment of perforator-based sural neurofasciocutaneous flaps for repairing lower extremity defects.

Adolescent ; Adult ; Aged ; Female ; Humans ; Lower Extremity ; injuries ; surgery ; Male ; Middle Aged ; Perforator Flap ; Reconstructive Surgical Procedures ; methods ; Soft Tissue Injuries ; surgery ; Young Adult

OBJECTIVETo study the effect of levobupivacaine and bupivacaine on the contractility of isolated uterine muscle strips from pregnant and non-pregnant female rats.

METHODSFull-thick myometrial strips were prepared from 18- to 21-day pregnant (n=8) and non-pregnant rats (n=7). After contractions became regular, strips were exposed to cumulative concentrations of the two drugs from 10(-8) to 10(-4) mol/L, amplitude and frequency of the uterine contraction was recorded.

RESULTSTwo local anesthetics caused a concentration dependent inhibition on contractility of myometrial strips from pregnant and non-pregnant rats. In the myometrium from non-pregnant rats, -logIC(50) of levobupivacaine and bupivacaine were 4.85 and 4.25 respectively. In the myometrium from pregnant rats, similar concentrations of levobupivacaine and bupivacaine were observed, -logIC(50) were 2.7 and 2.9 respectively. Levobupivacaine produced an increase in amplitude of contractions, while bupivacaine showed an increased trend in frequency.

CONCLUSIONThese results demonstrate that levobupivacaine and bupivacaine may inhibit myometrium contractility. The inhibitory effect of levobupivacaine or bupivacaine is not enhanced by gestation in rat. Levobupivacaine may have more positive influence than bupivacaine in pregnant myometrium.

Anesthetics, Local ; pharmacology ; Animals ; Bupivacaine ; analogs & derivatives ; blood ; pharmacology ; Dose-Response Relationship, Drug ; Female ; In Vitro Techniques ; Pregnancy ; Rats ; Rats, Sprague-Dawley ; Uterine Contraction ; drug effects

OBJECTIVE The present study was aimed to investigate the role of Wnt/β-catenin sig-naling in spinal VGLUT2 regulation and neuropathic pain. METHODS To elucidate the association be-tween VGLUT2 and neuropathic pain,we determined the expression and distribution characteristics of VGLUT2 in mice subjected to spared nerve injury(SNI),and then observed the effects of two VGLUT2 targeting shRNAs on mechanical allodynia and glutamate release.The effects of Wnt/β-catenin signal-ing on VGLUT2 expression and pain behavior were investigated by using Wnt agonist,Wnt1,and Wnt/β-catenin pathway inhibitor XAV939 in SNI mice.RESULTS SNI surgery induced significant up-regula-tion of VGLUT2 on postoperative days 7,14,and 21.Double immunofluorescence labeling of VGLUT2 with NeuN,MAP2,Iba-1,or GFAP showed that VGLUT2 was mainly expressed in neurons in the dor-sal horn of the spinal cord after SNI(NeuN,MAP2).Intrathecal administration of VGLUT2 shRNAs be-fore or after SNI surgery significantly decreased mechanical allodynia and glutamate release. Mean-while,Wnt1/β-catenin signaling increased significantly after SNI surgery.Over-expression of β-catenin in PC12 cells increased VGLUT2 protein level,intrathecal administration of Wnt agonist or Wnt1 signifi-cantly increased VGLUT2 protein expression in spinal cord, while Wnt/β-catenin pathway inhibitor XAV939 decreased VGLUT2 expression in PC12 cells and spinal cord.Additionally,intrathecal admin-istration of XAV939 7 days after SNI significantly attenuated mechanical allodynia in mice, which was in accordance with down-regulation of VGLUT2 protein levels.VGLUT2 shRNAs significantly attenuat-ed Wnt agonist or Wnt1 induced mechanical allodynia. CONCLUSION Wnt1/β-catenin signaling path-way up-regu-lates the spinal VGLUT2 expression,and this regulation is involved in neuropathic pain behavior.