Objective It is purposed to evaluate clinical efficacy of adefovir dipivoxil combined with anti-tuberculosis (TB) drugs in treatment for chronic hepatitis B (HB) complicated with pulmonary TB. Methods Ninety-four eases of pulmonary TB complicated with chronic HB receiving anti-TB drug treatment at Liaocheng Hospital for Infectious Disease during September 2006 to September 2008 were divided into treatment and control groups matched on their pulmonary TB lesion, damage in liver function and HB virus (HBV) DNA load. Forty-seven cases in the treatment group were administered with anti-TB drugs, i.e., isoniazid (INH) 0. 3 g daily, rifapentine (RFT) 0.45 g twice a week, pyrazinamide (PZA) 1.5 g daily, streptomycin (SM) 0. 75 g daily or ethambutol (EMB) 0. 75 g daily, and regular liver-protection drags, as well as oral adefovir dipivoxil 10 mg daily for eight months, and another 47 cases in the control group were administered with the same anti-TB drugs and regular liver-protection drugs as the treatment group. Two to eight weeks after treatment, clinical symptoms, liver function, HBV DNA load, negative conversion of acid-fast staining bacteria in sputum smear, and absorption of pulmonary TB lesion were evaluated for all the patients in both groups. Data were analyzed with U-test and χ2-test, respectively. Results After treatment, damage in liver function worsened in three cases (6.4%), as compared to that in 47.3 percent of the control group (P<0.05). Clinical symptoms, including tiredness, loss of appetite, abdominal distension, uncomfortable in upper abdomen, and so on, appeared in three cases of the treatment group (6.4%) during anti-TB treatment, as compared to those in 18 cases of the control group (47.3%) (P<0.05). HBV DNA conversed to negative (less than 1.0×103 lg copies/ml) in 24 cases of the treatment group (51.1%), HBV load went down to 1.0×103-1.0×104 lg copies/ml in 23 cases (48. 9%), sputum smear bacteria conversed to negative in 41 cases (87. 2%) and pulmonary lesion absorbed in 45 cases (95.7%), all with statistically significance as compared to those in the control group (47. 3% , 0. 0% , 2. 6% , 39. 5% and 50. 0% , respectively, P <0. 05). Renal function was all in normal in both groups and no patient with drug resistant variant HBV was found during and after treatment, and no obviously adverse reaction was found in patients with adefovir dipivoxil. Conclusion Adefovir dipivoxil has a good safety and can reduce laver damage in anfi-TB drug treatment for patients of chronic hepatitis B complicated with pulmonary TB.

The methyl group plays an important role in the rational drug design. Introducing methyl into small molecules has become an important strategy of lead compound optimization. The application of methyl in drug design is reviewed in this paper. Methyl can modulate the physicochemical, pharmacodynamic, and pharmacokinetic properties by ortho effect, inductive effect, and conformational effect. It also improves the metabolic stability as a soft metabolic point. In addition, introducing methyl into drug molecules can also be applied as a strategy in new uses of old drugs and generate me-too drugs.

Objective To observe the adverse reaction of dexmedetomidine(Dex)combined with dezocine in gynecological laparoscopic surgery after general anesthesia.Methods 120 cases of gynecologic laparoscopic surgery,ASA Ⅰ-Ⅱ,according to random number table method were divided into three groups,40 cases in each group.A group was intravenously injected Dex 1μg/kg 10min before induction,intravenously injected dezocine 5mg+ ondansetron 4mg 30min before the end of the operation.B group was intravenously injected dezocine 5mg+ ondansetron 4mg 30min before the end of surgery.C group was intravenously injected saline 1mL+ ondansetron 4mg.Before induction(T0),5min before extubation(T1),extubation(T2),10min after extubation(T3),the MAP,HR,SpO2 of three groups were recorded.The postoperative recovery time,degree of agitation,extubation and Ramsay sedation score,VRS analgesia 24h score,postoperative adverse reaction were compared among three groups.Results There was no difference in the recovery time among the three groups(t=0.94,0.97,1.02,all P>0.05).Compared with T0,the MAP of the three groups at the time of T2 increased,but the MAP of B group and C group was significantly higher(t=4.65,5.201,all P<0.01),HR was significantly higher(t=2.382,2.915,all P<0.05).Compared with A group and B group,the agitation rate of C group was higher(u=5.54,3.47,all P<0.01).The ramsay sedation score of 1 in A group was lower than C group,the VRS score of painless rate in A,B group was higher than that of C group(all P<0.05).Postoperative 24h,there were 19,23,24 cases of the three groups with nausea and vomiting,and the incidence rates were 47.5%,57.5%,60%,respectively,the differences were not statistically significant among the three groups(all P>0.05).Conclusion General anesthesia in gynecological laparoscopic surgery using Dex combined with dezocine can make patients more stable circulation,improve patients'' recovery quatity,it is a safe and effective method for prevention of adverse reaction after general anesthesia.

Objective To investigate the epidemiologic factors associated with the age of natural menopause and menopausal symptoms in a large population at age of 40 to 65 years in Jiangsu Province.Methods From May 2010 to Oct.2011,a total of 20 275 women (40 to 65 years) attending health examination in Jiangsu Province were enrolled in this cross-sectional study.A structured questionnaire was used to collect data of demographics,menopausal status,chronic diseases,reproductive history.Also the menopausal symptoms were evaluated by Kupperman menopause index (KMI).Cox proportional hazards regression model and Logistic regression were performed to identify risk factors for earlier age of natural menopause and menopausal symptoms,respectively.Results The overall median age at natural menopause in Jiangsu women was 50 years.Lower educational level,poor economic status,lower body mass index (BMI),age at menarche less than 14 years,nulliparity and smoking were associated with earlier onset of natural menopause (P ＜ 0.05).The most frequently symptoms in perimenopausal women were fatigue (46.84％,1880/4014),insomnia (44.67％,1793/4014) and muscle/joint pain (43.80％,1758/ 4014),while sexual problems (57.06％,3463/6070),muscle/joint pain (53.30％,3235/6070) and insomnia (51.03％,3097/6070) were predominant symptoms in postmenopausal women.After adjusting for confounding factors,it was revealed that women with poor educational background,low income,divorce,higher BMI,higher parity,and smoking presented positive correlation with menopausal symptoms (P ＜ 0.05).Conclusions The study suggested that an estimate of median age at natural menopause were 50 years in Jiangsu women.The main factors contributing to earlier onset of menopause and menopausal symptoms were lower educational level,poor economic status,and smoking.Moreover,there were different menopausal symptoms between perimenopausal and postmenopausal women,which provided the important insights for physicians to prevent and treat menopause symptoms in their clinical practice.

ObjectiveTo study change of aminoacid content in the brain of newborn rabbits with bilirubin encephalopathy. MethodsNewborn rabbits (3-5 days after birth) with bilirubin encephalopathy were induced by administration intra peritoneally with bilirubin (200mg/kg). Aminoacid content in brain were analysed by Hitachi 835 50 type aminoacid analysis instrument.ResultsThe content of glutamate and aspartate in brain tissue with bilirubin encephopathy decrease; GABA, alanine, tyrosine, valine and pheny lalanine increase. ConclusionsThe change of content of neurotransmitters in brain indicates that excitotoxicity of EAAs may contribute to the bilirubin encephalopathy. The increase of non neurotransmitters level proves that bilirubin may inhibit the biologic composition of protein in brain.

ObjectiveTo measure cortical areas involved ankle dorsiflexion and planter flexion.MethodsSix-health subjects performed ankle dorsiflexion and planter flexion. While, functional MRI at 1.5 T was made.ResultsWhen ankle dorsiflexion, the excited cortical areas included bilateral primary motor cortex (MⅠ) and primary somatosensory cortex (SⅠ), but area on contralateral side bigger than that on ipsilateral side, as well as chief visual cortexes and vermis of cerebellum. Inhibited areas included area 19, area 20 and area 39. When ankle planter flexion, the excited areas included contralateral secondary motor area (MⅡ) and striate body, ipsilateral supplementary motor area (SMA) and limbic system. Inhibited areas included bilateral upper middle precentral gyrus and postcentral gyrus, superior parietal lobule, inferior parietal lobule and prefrontal cortex.ConclusionThere is a great difference in the brain function images respectively in ankle dorsiflexion and planter flexion.

Objective To observe the effects of hyperbaric oxygen (HBO) on the functional with hemiplegic patients of traumatic brain injury(TBI).Methods 186 TBI cases were allocated to the HBO group (94 cases) and control group (92 cases). The control group was subjected to rehabilitation treatment, while the HBO group received HBO in addition to the rehabilitation treatment.Results Fugl-Meyer Assessment (FMA) and Modified Barthel Index (MBI) scores in both groups were significantly increased after treatment(P<0.05). FMA and MBI scores in the HBO group were significantly better than those in the control group(P<0.05).Conclusion HBO is effective to improve the motor function and activities of daily living with hemiplegic patients of traumatic brain injury and can improve the curative effects.

Objective To compare the expression of serum miR-100 in patients with esophageal cancer and healthy person ,and explore the value of miR-100 in diagnosis for esophageal cancer .Methods Real-time fluorescent quantitative polymerase chain reac-tion was used to detecting miR-100 in 40 esophageal cancer patients(study group) and 50 healthy person(control group) .Results The expression of miR-100 in the study group and control group were 6 .399 ± 3 .541 ,2 .625 ± 1 .515 respective ,the expression in the study group was significant higher than that of the control group(t= 9 .07 ,P< 0 .05) .The under area of receiver operating char-acteristic curve of miR-100 in diagnosis for esophageal cancer was 0 .832(95% confidence interval was 0 .731 - 0 .934) ,when the Cut off value was 5 .285 ,the sensitivity and specificity of miR-100 in diagnosis for esophageal cancer were 65% and 95% . Conclusion Serum miR-100 in esophageal cancer patients is higher than that in healthy person ,which might be a new molecular markers in diagnosis for esophageal caner .

Objective To explore the effect of theta-burst stimulation (TBS) of the motor cortex on the suprahyoid muscles and the mechanism through which the bilateral motor cortex regulates the suprahyoid muscles.Methods Continuous TBS (cTBS) was applied to the left motor cortex followed by intermittent TBS (iTBS) applied to the right motor cortex of 24 healthy subjects.The motor-evoked potentials (MEPs) of the suprahyoid muscles on both sides were recorded before the stimulation and after 15 and 30 minutes.The MEP amplitudes of the left and right suprahyoid muscles were analyzed using repeated measures analysis of variance.Results Before stimulation, the average MEP amplitudes of the left and right suprahyoid muscles were (375.29 ± 176.09) μV and (368.17 ± 149.02) μV respectively, significantly lower than the values after the stimulation.Conclusion iTBS can distinctly enhance the excitability of the right motor cortex controlling the suprahyoid muscles and reverse the inhibition caused by cTBS applied to the left motor cortex.Clarifying the effect of TBS on the excitability of the bilateral motor cortex is important for the rehabilitation of dysphagic stroke survivors.

Objective To explore the association of genetic polymorphism of fucosyltransferase (FUT) 2 and FUT3 and expression of Lewis antigen with ulcerative colitis (UC) in Chinese Zhejiang Han population.Methods We genotyped FUT2 (rs281377, rs1047781 and rs601338) and FUT3 (rs28362459, rs3745635 and rs3894326) in 485 UC patients and 580 healthy controls using SNaPshot. By immunohistochemistry method, we also evaluated expression of Lewis a and b antigens in the sigmoid colon of 10 UC patients and 10 patients with benign colonic polyps.Results The frequencies of mutant allele (A) and genotype (GA+AA) in FUT3 rs3745635 were higher in UC patients than in controls (P=0.016, 95%CI 1.339-1.699;P=0.038, 95%CI 1.330-1.742, respectively). Stratified analyses revealed that the frequencies of mutant allele (G) and genotype (TG+GG) of FUT3 rs28362459 were significantly lower in patients with extensive colitis than in those with distal colitis (P=0.001, 95%CI 0.567-0.786;P<0.001, 95%CI 0.503-0.742, respectively). Similar conclusions were drawn for the mutant allele (A) and genotype (GA+AA) of FUT3 rs3745635 in patients with extensive colitis compared to those with distal colitis (P=0.011, 95%CI 0.621-0.900;P=0.006, 95%CI 0.553-0.845, respectively). Although expression of Lewis b antigen in the sigmoid colon did not differ between UC patients and controls, Lewis a antigen expression was higher in the crypt epithelium of both inflammatory and non-inflammatory sigmoid colon of UC patients than in controls (P=0.028).Conclusion Polymorphisms of FUT3 and expression level of Lewis a antigen might be associated with UC.