Objective: To investigate the clinical effect of entecavir combined with pegylated interferons in the patients with hepatitis B.Methods: Totally 72 patients with hepatitis B were randomly divided into the experimental group and the control group with 36 ones in each.The patients in the experimental group were treated with entecavir combined with pegylated interferons, and those in the control group were treated with entecavir.The clinical indicators in the two groups were detected and compared after the 24-week, 48-week and 6-month treatment.The adverse drug reactions in the two groups were recorded and compared.Results: After the 24-week treatment, the differences in the clinical indicators between the groups were not statistically significant (P >0.05).After the 48-week and 6-month treatment, the clinical indicators in the experimental group were obviously higher than those in the control group, and the differences were statistically significant (P <0.05).The difference in the adverse drug reactions in the two groups was not statistically significant (P >0.05).Conclusion: Compared with entecavir, pegylated interferon combined with entecavir in the treatment of hepatitis B shows better clinical effect and security, which is more worthy of clinical promotion.

OBJECTIVE:To evaluate the pharmacoeconomics effectiveness of venlafaxine combined with quetiapine in the treatment of treatment-resistant depression.METHODS:74 patients with treatment-resistant depression were randomly divided into treatment group(n=38) and control group(n=36).Clinical efficacies of 2 groups were evaluated at baseline and the end of 12 weeks treatment using Hamilton Rating Scale for Depression(HAMD).The total cost of the two groups was calculated and cost-effectiveness analysis was carried out.RESULTS:The per capita cost of treatment group and control group were 1 688.69 and 1487.22 yuan.The HAMD reduction score of 2 groups were 14.5 and 10.2 and the C/E of 2 groups were 116.46 and 145.81,respectively.CONCLUSION:Venlafaxine combine with quetiapine is more economical and practical than venlafaxine alone in the treatment of treatment-resistant depression.

Objective To investigate the correlation between serum bone metabolism biomarkers and bone mineral density (BMD) in chronic kidney disease (CKD) patients with different stages. Methods Seventy-eight CKD patients were enrolled in this study and were assigned to different groups according to their ereatinine clearance (Cer). Patients with Cer ≥ 15 ml/min were divided into 4 groups based on clinical CKD 1-4 stage standard, and those with Ccr<15 ml/min were divided into two groups of hemodialysis (HD) and non-HD. Their levels of serum calcium, phosphorus, alkalinity phosphatase (ALP), urea, Ser, osteocalein (gla-protein, OC), calcitonin (CT), intact parathyroid hormone (iPTH), osteoprotegerin (OPG) and BMD were detected respectively. Results (1) The serum levels of OPG, iPTH and phosphorus increased significantly in stage 3, 4, 5, respectively (P<0.01), and serum OPG level was elevated to (5.1±1.34) ng/L after HD, which was significantly higher than (3.35±0.76) ng/L before HD (P<0.05). The levels of serum OC, CT, calcium, ALP were not significantly different among patients with different CKD stages, while the level of OC was elevated in HD patients (P<0.05). The femoral WARDS triangle BMD of CKD stage 4 patients decreased to 0.77±0.09, which was less than the value of CKD stage 1 patients (P<0.01), with litde influence from hemodialysis treatment. (2) The level of serum OPG was positively correlated with the levels of serum phosphorus, iPTH, OC (r = 0.51, 0.39, 0.36,all P<0.01), and it was negatively correlated with the level of Ccr (r =-0.70, P<0.01). The femoral WARDS triangle BMD was negatively correlated with the levels of iPTH, OC, phosphorus and OPG (r =-0.59,-0.51,-0.45,-0.48, all P<0.05). Conclusions Most of serum bone metabolism biomarkers change according to the declined level of Cer. Compared with serum phosphorus, the levels of iPTH, BGP and femoral WARDS triangle BMD, serum OPG may be early diagnosticmarkers of renal osteodystrophy in CKD patients.

Objective To observe the change of invasion and migration of the pancreatic carcinoma cell line SW1990 transfeeted with EEF1A2 gene.Methods Pancreatic carcinoma cell line SW1990 was transfected with EEF1A2 by recombinant adenovirus vector.The alteration of motility、invasion and adhesion property of SW1990 was evaluated by wound healing assay,transwell With or without Matrigel basement membrane and adhesion assay.Results Wound healing assay revealed that EEF1A2 enhanced cell motility and transwell assay with Matrigel indicated that the average numbers of transwell cells with EEFlA2 was increased from 23.25±5.23 to 65.42±8.24(P＜0.05).The adhesive rate was substantially increased in EEF1A2 transfected SW1990 cells compared with control cells.Conclusions EEF1A2 gene can promote the migration.invasion and adhesion ability of pancreatic cancer cell in vitro.It is indicated that EEF1A2 may involve in the development of human pancreatic cancer by influencing cell biological characteristics.

OBJECTIVE:To study the econamics effect of risperidone and quetiapine in treating of schizophrenia.METH ODS:64schizophrenia patients were randomly divided into risperidone group(34cases)and quetiapine group(30cases).The effects were evaluated based on the reduction of scores determined by brief psychiatric rating scale(BPRS);the adverse effects were evaluated by treatment emergent symptom scale(TESS).And then the cost-effectiveness analysis was carried through.RESULTS:The per capita costs for risperidone and quetiapine were3598.85yuan and3778.63yuan respectively;the re-duction of BPRS scores were(36.09?15.52)and(25.03?14.45)respectvely;the respective cost-effect ratio was99.72yuan and150.96yuan;the increment of the cost-effect ratio for the quetiapine group was-16.25compared with the risperidone group.CONCLUSION:Risperidone is more economical than quetiapine in the treatment of schizophrenia.

OBJECTIVE:To analyze the cost-effectiveness of3kinds of Chinese patent drugs in the treatment of insomnia outpatients.METHODS:78outpatients with insomnia were randomly divided into group A,group B and group C,and they were treated with shumian capsule,sweet dream capsule and compound semen ziziphi spinosae capsule,respectively,then,cost-effectiveness analysis was carried out with pharmacoeconomics.RESULTS:The per capita costs(C)for group A,B and C were288.20yuan,163.08yuan and139.22yuan respectively,the reduction in PSQI scores(E 1 )were5.15,8.88and11.84respectively,the effective rates(E 2 )were26%,46%,and64%respectively;The average cost-effect ratios C/E 1 were55.96,18.36,and11.76respectively;C/E 2 were11.08,3.55,and2.18respectively;The increment of the cost-effect ratios?C/?E 1 for group A and B were—22.27and—8.06respectively;?C/?E 2 were—3.92,—1.33respectively,as compared with group C.CONCLUSION:Compound semen ziziphi spinosae capsule is more economical in3drugs in treating insomnia outpatients.

Background Anaphylactic reactions during anesthesia and operation are common and life threatening.Follow-up investigation is necessary for avoiding potential re-exposure of the patients to the offending drugs.The purpose of this study was to assess cellular allergen stimulation test (CAST) as a diagnostic instrument in immunoglobulin E (IgE)-and non-lgE-mediated anaphylactic reactions.Methods This study included 25 patients who developed perioperative anaphylactic reactions and 10 subjects that tolerated anesthetics and other drugs during perioperative period from September 2009 to October 2013 in Peking Union Medical College Hospital.We performed skin tests and flow cytometric analysis of basophil activation-based CAST in all subjects.Results Of the 25 patients,17 had IgE-mediated anaphylactic reactions (causative agent identified by skin tests) and 8 had non-lgE-mediated anaphylactic reactions (negative skin tests).CAST showed a sensitivity of 42.9％,specificity of 90％,and negative predictive value of 80.6％ for neuromuscular blocking agents.Conclusions CAST may be useful for the diagnosis of anaphylactic reactions during perioperative period.Our findings call for further investigation to increase the sensitivity of the test.

Objective To summarize surgical experience of eight patients with pentalogy of Cantrell. Methods Six male and two female patients with pentalogy of Cantrell,aged from 4 months to 26 years old, average 7.35 years old, underwent surgical therapy for intracardiac anomalies and extracardiac anomalies from July 2007 to June 2009. Eight case with intracardiac anomalies include one case with only VSD, one case with only ASD, two cases with DORV, four cases with VSD and ASD or PTO. Experts majoring in cardiovascular surgery cooperated with doctors majoring in thoracic surgery and general surgery for satisfactory correction of intracardiac anomalies and extracardiac anomalies and repositioning heart to thoracic cavity. Results Ectopic heart of the first patient was simply repositioned into thoracic cavity following surgery of double outlet of right ventricle in another hospital two years before. Correction of introcardiac anomaly and reposition of ectopic heart finished at one time in 7 cases. Eight patients got full recovery except that residual shunt occurred in the second case which also got full recovery after transcatheter therapy. Ventricular diverticulum was removed in the fourth case because of difficult reposition of ectopic heart.With the help of general surgeon and thoracic surgeon, partial coronary ligament of liver and falciform ligament of liver in the left was cut in the first case and the left half lobe of liver was pushed downward. Bilateral pleural and marginal costal costochondral was cut and make thoracic wall upward so that ectopic heart can reset into thoracic cavity. And then, defect of diaphragm and abdominal wall were repaired with Proceed patch. In the other seven cases, bilateral pericardium and mediastinal pleura was cut and the 7th and 8th cartilage was transected and bilateral costal arch was closed so for complete thoracic angioplasty.Left ventricular dysfunction occurred in the fifth case with DORV and also got full recovery after symptomatic treatment. Full recovery was got in all cases after followingup from 1 to 23 months. No adverse complications occurred and every case live a wonderful life. Conclusion Pentalogy of Cantrell can be cured at one time by accurate correction of cardiac anomalies, cutting of bilateral pleural and marginal costal costochondral to make thoracic wall upward and enlarge thoracic space for repositinning of ectopic heart and using artificial patch to repair defect of diaphragm when necessary.

Objective To investigate the relationship between the incipient serum C-reactive protein (CRP) and clinicopathologic features in anti-neutrophil cytoplasmic antibody associated vasculitis (AAV).Methods Data of 138 consecutive AAV patients were collected.According to their serum CRP levels,patients were divided into group 1 with normal CRP,group 2 with slightly increased CRP and group 3 with severely increased CRP.Clinical features of AAV and histopathologic features of the kidney injury were compared among groups.Results CRP levels increased in 77.53％ AAV patients on admission.Patients in the group of severely increased CRP had the highest levels of BVAS,serum C3,serum ANCA titer,leukocyte counts and the lowest levels of hemoglobin and albumin among the 3 groups (all P ＜ 0.05).The mortality during the stage of therapy was highest in patients with severely increased CRP (P ＜ 0.05).The focal kidney damage was more obvious in patients with severely increased CRP.There was no significant difference in renal prognosis among patients with different CRP levels.Conclusion The levels of incipient serum C-reactive protein of AAV vary in different patients and are positively correlated with patients' inflammation status as well as the disease activity,but are not correlated with the severity of kidney injury.

The paper reports a rare case of alkaptonuria (AKU) with IgA nephropathy, and analyzes its clinical manifestations, imaging findings, pathological features, gene diagnosis and treatment process, so as to provide reference for the diagnosis and treatment of the disease. The clinical symptoms of the patient were mainly black urine, microscopic hematuria and proteinuria. Renal pathology showed mild mesangial hyperplasia IgA nephropathy, and renal tubular epithelial cytochrome deposition. Genetic analysis indicated that a pathogenic mutation was detected on the AKU-related homogentisate 1, 2-dioxygenase gene possibly associated with the phenotype of the patient. Genetic testing and renal pathology were effective methods to make a definite diagnosis for the case.