After the origin, definition and functions of core journal were described, scientifically understanding their value and accurately defining their functions were proposed.The current evaluation of military sciences core journals was analyzed with measures put forward for perfecting their evaluation systems.

Objective To investigate the blood glucose control level,the characteristics of complications and treatment programme in senile patients with type 2 diabetes.Methods From Aug 2010 to Jul 2011,gender,age,height,weight,disease course and underlying disease were recorded in 119 patients with type 2 diabetes aged 80 years and over.The levels of glycosylated hemoglobin (HbA1c),fasting C-peptide (FC-P) and 2 hours postprandial C-peptide (2h C-P),urinary albumin excretion rate (UAER) were tested.Ultrasonic Doppler examination of lower-limb arteries as well as non-mydriatic colour eye-ground photography were also examined,peripheral nerve lesions were evaluatcd according to the criteria of diabetic neuropathy system (DNS).The patients were divided into two groups:HbA1c＜7.0％ group (65 cases) and HbA1c ≥ 7.0 ％ group(54 cases).Results The disease course[(12.1±8.5)years vs.(16.6±7.5)yeas,t=3.01,P=0.003],UAER[(20.2±11.9)μg/min vs.(47.0±21.4)μg/min,t=2.48,P=0.015] and incidence of diabetic nephropathy [23.1％(15/65)vs.50.0％(27/54),x2=9.36,P=0.002] were all less in HbA1c＜7.0％ group than in HbA1c ≥ 7.0％ group,while the levels of FC-P and 2hC P were higher in HbA1c＜7.0％than in HbA1c ≥ 7.0％ group[(2.1±1.2)μg/L vs.(1.5±1.0)μg/L,t=1.87,P=0.042; (6.5± 3.3)μg/L vs.(4.3 ± 2.9) μg /L,t =2.10,P =0.037].The proportion of patients who took oral hypoglycemic agents was increased while those who received insulin therapy decreased in HbA1c＜7.0％ group (all P=0.000).The α-glucosidase inhibitors were the most commonly used in each group,followed by metformin and insulin secretagogue,and the thiazolidinediones were rarely used,while there was no significant difference in the proportion of medicine between the groups.The overall incidence of symptomatic hypoglycemia was 23.5％(28/119).It was higher in HbA1c ≥ 7％ group than in HbA1c＜7.0％ group[33.3％(18/54)vs.15.4％(10/65),x2 =5.20,P=0.022].However,71.4％(5/7)of the patients with hypoglycemic coma came from HbA1c＜7.0％ group.Conclusions There are obvious individual differences in blood glucose control and complications among senile type 2 diabetes patients,thus the characteristics of the elderly should be considered in the choice of drugs while hypoglycemic events should be paid more attention.

Objective To compare the model for end-stage liver disease (MELD) and PT in survival prediction of hepatitis B patients with acute-on-chronic liver failure. Methods One hundred and thirty-nine hepatitis B patients with acute-on-chronic liver failure were divided into survival and death group, and evaluated by MELD and FT. The area under ROC curve was used to compare the MELD and PT. The mortality was observed within 3 months. Results The MELD score and PT of survival group was 25.09 ± 3.92 and (26.46 ± 6.46) seconds respectively, and those for the death group were 36.25 ± 6.42 and (40.78 ± 10.80) seconds. The differences were of statistical significance ( P < 0.01 ). MELD score showed significant correlations with PT(r =0.824, P <0.01). The area under ROC curve was 0.936 (95% CI 0.895 ± 0.977 ) on MELD score and 0. 890 (95 % CI 0.839 ± 0.941 ) on PT, and there was no significant difference between them. Conclusions Both MELD score and PT can accurately predict the short-term prognosis of hepatitis B patients with acute-on-chronic liver failure. The validity of prognosis by MELD is similar to PT. The mortality increases with the MELD score and PT increasing.

Objective:To study the HBV infection in peripheral blood mononuclear cells in mediating the role of mother -to-child transmission of hepatitis B virus.Methods: The peripheral blood mononuclear cells ( PBMCs ) in maternal and cord blood mononuclear cells ( CBMCs ) in newborns were conventionally isolated by Ficoll-Hypaque medium.The loads of HBV-DNA in peripheral blood of maternal and cord blood of newborns were both detected by PCR .Results:The clinical data showed that the positive detection rates of HBV-DNA in serum and PBMCs of pregnant women with HBeAg (+) were 100.00%( 25/25 ) and 72.00%( 18/25),and the positive detection rates of HBV-DNA in the neonatal umbilical cord blood serum and CBMCs were 60.00%(15/25) and 44.00%(11/25),respectively.There were significantly difference between HBeAg (+) and HBeAg(-) in the pregnant women (P<0.05 ).The positive detection rates of HBV-DNA in neonatal umbilical cord blood serum and CBMCs were higher in the group with high HBV loads (more than 106copies/ml) in PBMCs than those of low HBV loading group (102-103copies/ml).The significantly difference was explored between the two groups.Conclusion: Mononuclear cells can not only be infected by HBV , but also play a critical role in the intrauterine vertical transmission of HBV via the pathway transmitted from PBMCs in pregnant women to CBMCs in newborns.

Objective To investigate the causes of biliary tract complications after liver transplantation, and to put forward effective measures of prevention, diagnosis and treatment. Methods The literatures of recent years were reviewed and summarized. Results The causes of biliary tract complications after liver transplantation are very complex, and there are no standard preventive measures. Treatment differs according to causes. Conclusion One of the most important causes leading to biliary complications is preservative and ischemic injury. Poorly operative techniques and blood supply to biliary tract are also disastrous. Improving T tube placement can reduce the incidence of biliary complications related with T tube. To prevent biliary complications, it is crucial to completely wash the biliary tract, avoid damaging the blood supply to donor biliary tract and manage perfect biliary mucosa-to-mucosa anastomosis without tension. T tube cholangiography combined with noninvasive MRCP enables accurate depiction of the biliary tree and diagnosis of biliary complications. Doppler ultrosonography should be routinely applied postoperatively. Timely application of interventional radiological technique is a valuable nonoperative procedure for treatment of biliary complications. Meanwhile, biliary sludge or cholestasis and mixed infections of biliary tract should be handled actively and properly.

The effects of polysaccharidical peptides (PSP) on the functions of tumour infiltrating lymphocytes (TILs) in vitro was explored. The results showed that PSP, at the concentration of 37-1200?g/ml, promoted the proliferation of TILs in dose-related manner. Combination of PSP with interleukin-2 (IL-2) enhanced the cytotoxicity of TILs and reduced the dose of IL-2 used for activating TILs. The results suggested that PSP could augment the proliferation and cytotoxicity of TILs in vitro.

LDM, a product of the combination of contemporary information network technology and the traditional medical mode, is a rapidly developing new undertaking of recent years. The transformation of the medical mode in the establishment of LDM has brought about a series of problems, including quality control of LDM, delegation of responsibility in LDM, standardization and unification of LDM, and psychological problems of patients under the mode of LDM. These problems present issues of new conternplation and exploration for hospital managers.

OBJECTIVE: To evaluate the utilization and its trend of narcotic analgetics in this hospital.METHODS: The use of narcotic analgetics during the period 2005-2007 in our hospital was analyzed retrospectively.RESULTS: The consumption quantity of narcotic analgetics in our hospital increased year-on-year,much as in the consumption of morphine preparations,with oral morphine preparations dominating the 3 first places over the 3 years,however,the increase of pethidine was slowed down in consumption quantity.CONCLUSION: The use of narcotic analgetics in our hospital is rational on the whole,but measures should be taken to tighten the control on the use of narcotic analgetics.

LDM, a product of the combination of contemporary information network technology and the tradi tional medical mode, is a rapidly developing new undertaking of recent years. The transformation of the medical mode in the establishment of LDM has brought about a series of problerms, including quality control of LDM, delegation of responsibility in IDM, standardization and unification of LDM, and psychological problems of patients under the mode of LDM. These problems present issues of new contemplation and exploration for hospital managers.

Objective To investigate the effect of seasonal variation of blood pressure (BP) on the incidence of cardiovascular and cerebrovascular events in the elderly aged 80 years and over.Methods The 67 patients (aged 80-86 years) with essential hypertension were enrolled, the BP were measured at home, in consulting room, and by 24-h ambulatory BP monitor in every season for 2 years. The incidences of cardiovascular and cerebrovascular events were recorded in the meantime.Results Both systolic BP (SBP) and diastolic BP (DBP) were lower in summer than in any other season (P＜0. 01 ). SBP was higher in winter than in any other season. (P＜0.01), DBP was higher in winter than in summer(P＜0. 01). There were no significant differences in SBP and DBP between spring and autumn. The incidence of cardiovascular and cerebrovascular events were higher in winter and summer than in spring and autumn (P＜0.05). The season (OR= 1. 525, P=0. 001), BMI (OR =1.145, P=0.018) and heart function (OR= 2. 037, P=0.01) were related to the incidence of cardiovascular events. And the season (OR = 1. 604, P= 0. 001 ), history of cerebrovascular disease (OR= 1. 598, P=0. 034), office-measured SBP (OR=0.960, P=0.013) and ambulatory DBP (OR =0. 936, P = 0. 008) were related to the incidence of cerebrovascular events.Conclusions The blood pressure measured by three methods in the elderly aged 80 and over shows that both SBP and DBP are at the lowest in summer; SBP is at the highest in winter, DBP is higher in winter than in summer. There are no significant differences in BP between spring and autumn. The incidences of cardiovascular and cerebrovascular events are significantly higher in winter and summer than in spring and autumn.