OBJECTIVE:To observe the clinical efficacy and safety of recombinant human interferon α2b (rhIFN α2b) combined with bozhi glycopeptides or thymopentin in the treatment of chronic hepatitis B (CHB).METHODS:Ninety HBeAg-positive CHB patients were selected from our hospital during Jan.2014-Jan.2015 and then randomly divided into group A,B,C,with 30 cases in each group.Group A was given rhINF α2b for injection (Pseudomonas) 5 million IU subcutaneously,qod;group B was additionally given Bozhi glycopeptides injection 4 mL added into 5％ Glucose injection 250 mL,ivgtt,qd,on the basis of group A;group C was additionally given Thymopentin for injection 2 mg added into 5％ Glucose injection 250 mL,ivgtt,qd,on the basis of group A.Three groups were treated for 24 weeks.The rate of ALT recovering to normal,negative rate of HBeAg,transformation rate of HBeAg/anti-HBeAg serum,negative rate of HBV-DNA and the decrease of HBsAg and HBV-DNA were compared among 2 groups after 4,8,12,24 weeks of treatment.The occurrence of ADR was recorded.RESULTS:After 4,8,12 weeks of treatment,there was no statistical significance in the rate of ALT recovering to normal,negative rate of HBeAg,transformation rate of HBeAg and the decrease of HBsAg among 3 groups (P＞0.05).After 4 weeks,negative rate of HBV-DNA in group B,C were significantly higher than group A;the decrease of HBV-DNA in group C were more significant than group A and B,with statistical significance (P＜0.05).After 8,12 weeks of treatment,the negative rate of HBV-DNA and the decrease of HBV-DNA in group B,C were significantly higher than group A,with statistical significance (P＜0.05);but there was no statistical signifi cance between group B and C (P＞0.05).After 24 weeks of treatment,there was no statistical significance in the rate of ALT recovering to normal,transformation rate of HBeAg,the decrease of HBsAg and negative rate of HBsAg among 3 groups (P＞0.05).The negative rate of HBsAg,negative rate of HBV-DNA and the decrease of HBV-DNA in group B,C were significantly higher than group A,with statistical significance (P＜0.05);there was no statistical significance between group B and C (P＞0.05).There was no statistical significance in the incidence of ADR among 3 groups(P＞0.05).CONCLUSIONS:rhIFN α2bcombined with bozhi glycopeptides or thymopentin shows good inhibitory effect on CHB,therapeutic efficacies of them are similar in the rate of ALT recovering to normal,but transformation rate of HBeAg,the decrease of HBsAg and negative rate of HBeAg.

BACKGROUND:Internal fixation has been shown to decrease intertrochanteric fracture complications in the clinic and to improve quality of life of patients. The major method widely used in the clinic is the fixation of proximal femoral nail and dynamic hip screw. ＜br> OBJECTIVE:To observe the clinical effects of proximal femoral nail and dynamic hip screw in treatment of intertrochanteric fracture in the elderly. ＜br> METHODS:A total of 60 patients with intertrochanteric fracture were randomly divided into proximal femoral nail and dynamic hip screw groups (n=30), and they respectively received proximal femoral nail and dynamic hip screw fixation. ＜br> RESULTS AND CONCLUSION:Compared with the dynamic hip screw group, operative time, blood loss, the incidence of complications one year after repair, fracture healing time and complications were lower in the proximal femoral nail group (P＜0.05). After repair, the excellent and good rate of Harris hip scores was higher (P＜0.05). No significant difference was detected in healing time of wound between the two groups (P>0.05). Results verified that compared with the dynamic hip screw fixation, the clinical effects of proximal femoral nail fixation were better, more safe and reliable in the treatment of intertrochanteric fracture in the elderly.

Objective: To investigate the efficacy of oral, external and oral plus external application of recipes for promoting granulation on chronic skin ulcers in rats. Methods: Sixty SD male rats were randomly divided into normal group, untreated group, oral group, external group and combined group (n=12). Chronic skin ulcer was induced by hydrocortisone injection and back skin incision. After oral administration of Fuzheng Huyu Recipe or (and) external application of Baiyu ointment, the compound traditional Chinese medicines for wound healing, healing time and healing rate of the ulcers were observed. Results: The healing rate was lower and the healing time was longer in the untreated group than in the normal group (P<0.01). The healing rates of the oral group and the combined group were higher than those of the untreated group at all observation points (P<0.05), and the healing rate of the external group was higher on the 3rd and 14th day after model establishment (P<0.05). On the 7th and 10th day after model establishment, the healing rates of the oral group and the combined group were higher than those of the external group (P<0.05), and the healing time of the combined group was shorter than that of the oral group and external group (P<0.05). Conclusion: Both orally and externally administered wound healing recipes can promote the restoration of chronic refractory ulcers; the effect of combined administration is superior to single administration. Oral, external and combined application can all improve the wound healing in inflammatory phase. Oral and combined application can obviously improve the wound healing in granulation phase and epithelial phase.

Objective To summarize the experience for diagnosis and treatment of parathyroid carcinoma(PTC).Methods The clinical data of 6 patients with PTC were retrospectively analyzed.Results Five patients complained of primary hyperparathyroidism,3 patients had manifestations of palpable neck mass,4 patients were admitted for hypercalcemia with calcium level of(3.62?0.56)mmol/L,and in 4 patients the parathyroid hormone(PTH) level was higher than two fold of the normal upper limit.Frozen section histopathology established diagnosis in 3 patients,routine histopathology combined with immunohistochemistry established the diagnosis in 2 patients,and routine histopathology combined with immunohistochemistry and clinical data established the diagnosis in 1 patient.Parathyroidectomy and ipsilateral subtotal thyroidectomy was performed in 5 patients,who were followed up for 1-5 years,recurrence in 1 patient 3 years after operation;tumor resection alone was performed in 1 patient with parathyroid cancer complicated with multiple bone metastasis,and the patient died of MOF 16 days postoperation.Conclusions The diagnosis of PTC is difficult before operation.Routine blood examinations,blood PTH,99mTc-MIBI scintigraphy,ultrasonography,CT,observation of specimen,and frozen section histopathology during operation are helpful to diagnosis.The surgical procedure of choice is parathyroidectomy and ipsilateral subtotal thyroidectomy.

Objective To investigate rare etiological causes of giant gastric ulcers. Methods A retrospective investigation was made on 4986 endoscopically proved giant gastric ulcer in our hospital, from January 1976 to December 2000. The morphological features under endoscopy, pathology, diagnosis, treatment and prognosis were analyzed in 59 giant gastric ulcers with special causes. Results Thirty two cases of gastric eosinophilic granuloma,8 gastric carcinoid tumor,8 gastric schistosomiasis, 5 gastric Crohn's disease,4 gastric lymphoma and 2 gastric Behcet's disease were identified. Ten gastric eosinophilic granuloma,3 gastric carcinoid tumor,3 gastric schistosomiasis, 5 gastric Crohn's disease,3 gastric lymphoma , 1 gastric Behcet's disease were misdiagnosed at initial endoscopy.Conclusions Rare etiological causes of giant gastric ulcers could be divided into 3 categories: non-epithelium gastric tumor, gastric granulomatous disease and gastric vascular disease. Careful observation ulcer endoscopy, history inquiry, physical examination, comprehensive analysis and laboratory examination may provide useful information for the diagnosis. Biopsy may be falsely negative in some cases.

AIM:Todiscusstherelationshipbetweensmallubiquitin-relatedmodifier4(SUMO4)expression and papillary thyroid carcinoma (PTC).METHODS:The mRNA and protein levels of SUMO4 in PTC and normal thyroid tissues were determined by the methods of real-time PCR, Western blot and immunohistochemistry .The relationship be-tween SUMO4 expression and clinicopathologic parameters in PTC was evaluated .RESULTS:The results showed that both the mRNA and protein levels of SUMO 4 expression in PTC were obviously higher than those in normal thyroid tissues ( P<0.01).CONCLUSION:The high level of SUMO4 expression in PTC suggests that SUMO4 plays an important role in PTC development and it is probably a molecular mechanism of PTC .

Objective To establish a quality standard for Biqing Suppository. Methods Rhizoma Dioscoreae Septemlobae, Rhizoma Acori Tatarinowii, Radix Et Rhizoma Salviae Miltiorrhizae and Cortex Phellodendri Chinensis were qualitatively identified by TLC method. The content of berberine hydrochloride in Biqing Suppository was determined by HPLC method. The chromatographic column was Waters C18 (250 mm×4.6 mm, 5 μm);the mobile phase was acetonitrile∶water (0.2%phosphoric acid-0.02%three triethylamine)=25∶75;the flow rate was 1 mL/min;the detection wavelength was 265 nm. Results The spots of qualitative identification method were clear without interference. Berberine hydrochloride had good linear relationship in the range of 0.235-9.40 μg;the regression equation was Y=40 033 998.176 3X-85 021.2, r=0.999 7;the average recovery rate was 99.16%, RSD=3.45%. Conclusion The method is simple, flexible and reproducible, which can be used as the quality control standard for Biqing Suppository.

OBJECTIVE:To introduce the application of control chart in quality trend analysis and abnormal location manage-ment of pharmaceutical production,thus encourage pharmaceutical manufacturing enterprises to more frequently use control chart as a statistical analysis tool in quality control process. METHODS:Taking a pharmaceutical manufacturing enterprise as examples,the way for selection of different kinds of control charts in different conditions(such as stability study,product quality review)was il-lustrated. Based on the given data of quality characteristic analysis and stability study of a certain product in this company,analysis process was demonstrated using control chart. RESULTS & CONCLUSIONS:When the sample capacity for analysis is not less than 25,meeting the minimum requirement for steady state estimation,Hugh Hart control chart (conventional control chart)alone can accurately locate the abnormal data;while under the adverse circumstance of small sample capacity,the modified control chart (such as the regression control chart)is still able to equally reflect the overall trend and out of trend(OOT)ones. As a statistical analysis tool,control chart introduced into quality management activities is an effective technic way for control.

Pancreatic adenocarcinoma is a highly lethal disease with a high morbidity and dismal prognosis.A multidisciplinary consultation based on evidence-based medicine has become the main modality for treatment of pancreatic adenocarcinoma.National Comprehensive Cancer Network (NCCN) clinical practice guidelines in oncology has been widely recognized and implemented.Recently,the guidelines (version 1.2017) in oncology have been published by NCCN.This article will summarize and interpret the updates of the new version of the NCCN guideline for pancreatic adenocarcinoma.

BACKGROUND:Abnormal stress is an important factor causing intervertebral disc degeneration. To establish an ideal in vivoanimal model of intervertebral disc degeneration is of great significance for in-depth study on the related pathogenesis. OBJECTIVE:To develop anin vivo rabbit intervertebral disc model and to investigate the relationship between continuous tensile load and intervertebral disc degeneration. METHODS:Twenty-five New Zealand white rabbits aged 6 months old were randomly divided into three groups: blank control (n=5), sham (n=10) and experimental (n=10) groups. The blank control group received no intervention, and the L4/5 segments were removed at the 1st day. The intervertebral disc assistor was used to fix the L4 and L5 vertebral bodies in the experimental and sham groups, the L4/5 segments in the experimental group were loaded 1 MPa axial tensile force, and the L4/5 segments in both two groups were then removed at 14 and 28 days. The changes of L4/5 intervetebral space height and surrounding bone substance were observed by X-ray examination, the morphological changes of the intervertebral disc were observed by hematoxylin-eosin staining, the cell survival was detected by nitro blue tetrazolium staining and mRNA expression levels of aggrecan, collagen type Ⅱ and SOX9 in the intervertebral disc tissues were assessed by RT-PCR at each time point. RESULTS AND CONCLUSION:The radiological manifestations, histological changes, cell survival and mRNA expression levels of aggrecan, collagen type Ⅱ and Sox9 showed no significant difference between the blank control and sham groups. Comparied with the blank control group, in the experimental group, the L4/5 intervertebral space was narrowed with time, the articular surface was coarse, and the upper and lower corpus vertebrae edge appeared to have lip-shaped hyperplasia; the intervertebral disc cells distributed irregularly; the nucleus pulposus was in dehydration and deflation, annulus fibrosus arranged irregularly, and the vacuoles in notochord cells tended to disappear; the expression levels of aggrecan, collagen type Ⅱ and SOX9 were markedly downregulated. These findings suggest that the in vivo rabbit model of intervertebral disc is successfully established, in which continuous mechanical tensile load is further proved to directly cause intervertebral disc degeneration.