Objective To explore the curative effects of Lamivudine combined with IFNα-1b in treatment of chronic hepatitis B. Methods 120 patients with chronic hepatitis B were divided into 3 groups. Patients in group A were treated with IFNα-2b 3 times a week for 26 weeks. Patients in group B were treated with Lamivudine one time a day for 52 weeks. Patients in group C were treated with IFNα-1b and Lamivudine symphysially. The serum indexes were observed and the clinical effects were evaluated. Results The ALT and AST levels in 3 groups were all decreased significantly(P ＜0. 01) after treatment. However,the ALT and AST in group C was lower than that of the other 2 groups(P ＜0. 05). Also there was a statistical difference(P ＜0. 05) between the effective rate of the group C and that of other 2 groups. Conclusion Treating chronic hepatitis B with Lamivudine and IFNα-1b federatively was more effective than using a single medicine.

Objective Through To analyzing analyze the pathogen distribution and resistance analysis of elderly patients with pulmonary infection,in order to provide basis for clinical rational administration.Methods The clinical data of 285 elderly patients diagnosed as pulmonary infection were selected,and their sputum specimens cultivation were collected for statistical analysis,and the pathogenic bacteria distribution and drug resistance were analyzed.Results 292 strains of pathogenic bacteria were detected from 285 patients,of which 204 strains of gramnegative bacteria,accounting for 69.8％,mainly including pseudomonas aeruginosa,acinetobacter baumannii and klebsiella pneumoniae,while 84 strains of gram-positive bacteria,accounting for 28.8％,mainly including staphylococcus aureus and 4 strains of fungus,accounting for 1.4％.Different pathogens showed different degrees of antimicrobial resistance:pseudomonas aeruginosa,acinetobacter baumannii,klebsiella pneumoniae and e.coli had highly sensitivity for imipenem and meropenem,which were secondly sensitive to amikacin and highly resistant to ampicillin;Staphylococcus aureus and epidermis staphylococcus were all sensitive to linezolid and vancomycin,which were highly resistant to benzyl penicillin.Conclusion Gram-negative bacilli is the main bacteria for patients with pulmonary infection,which has higher antimicrobial drug resistant rate,and antimicrobial agents should be rationally used according to drug susceptibility results.

Objective To investigate the efficacy of entecavir after partial embolization in patients with hepatitis B cirrhosis complicated with hypersplenism.Methods From February 2016 to October 2016,the clinical data of 92 patients with hepatitis B cirrhosis and hypersplenism in the First People 's Hospital of Taizhou were retrospectively analyzed.Among them,46 cases were treated with lamivudine antiviral therapy after partial embolization as the control group.46 cases were treated with entecavir tablets after partial embolization as the observation group.After 36 weeks of contact therapy,liver fibrosis was compared between the two groups:procollagen Ⅲ (PC-Ⅲ),serum hyaluronic acid (HA),collagen Ⅳ (Ⅳ-C).The liver function of the two groups were compared:total bilirubin (TBil),alanine transaminase (ALT),albumin (ALB),aspartate aminotransferase (AST).The the control of hepatitis B virus were compared between the two groups:HBeAg/anti-HBe negative,negative HBV DNA.Results Liver fibrosis:the levels of PC-Ⅲ,HA and Ⅳ-C in the observation group were (93.6 ± 31.3) U/L,(83.2 ± 25.4) U/L and (85.5 ± 25.4) μ mol/L,respectively,which were significantly lower than those in the control group [(148.6 ± 24.4) U/L,(152.2 ± 34.5) U/L and (146.1 ± 36.6) μmol/L],the differences were statistically significant (t =3.457,3.848,4.065,all P ＜ 0.05).Liver function:the levels of TBil,AST and ALT in the observation group were (21.4 ± 5.4) μmol/L,(60.1 ± 20.6) U/L,(52.4 ± 15.4) U/L,respectively,which were significantly lower than those in the control group [(51.1 ± 6.7) μmol/L、(116.4 ± 25.5) U/L、(110.9 ± 20.5) U/L],the differences were statistically significant(t =4.106,3.763,2.945,all P ＜ 0.05).The ALB in the observation group was significandy higher than that in the control group [(31.2 ± 1.5) g/L vs.(35.9 ± 2.8) g/L,t =2.966,P ＜0.05].Hepatitis B virus control:the observation group and control group had 13 cases and 2 cases in HBeAg/antiHBe negative,respectively,the difference was statistically significant (x2 =5.035,P ＜ 0.05);the observation group and control group were 15 cases,2 cases in HBV DNA negative,respectively,the difference was statistically significant (x2 =5.364,P ＜ 0.05).Conclusion The treatment of entecavir by partial embolization of patients with hepatitis B cirrhosis complicated with hypersplenism can well control the liver function and hepatitis B virus replication and reverse the control of liver fibrosis.Antiviral therapy after embolization has an important role.

OBJECTIVETo assess the associations of death receptor DR4 and DR5 gene polymorphisms with Crohn's disease (CD).

METHODSA total of 295 CD patients and 490 healthy controls were recruited. Three single nucleotide polymorphisms (SNPs) of the DR4 (rs13278062, rs20575) and DR5 (rs1047266) genes were determined with a SNaPshot method. Unconditional logistic regression analysis was carried out for determining the allelic and genotypic differences of the three SNPs between CD patients and the controls, as well as the influence of the DR4 and DR5 gene polymorphisms on the clinical features of CD patients. Linkage disequilibrium and haplotype analysis were calculated by haplotype 4.2 and R language software. A gene-gene interaction model was established to analyze whether the three SNPs can exert a synergistic effect on the susceptibility to CD.

RESULTSThe mutant allele (T) and genotype (GT+TT) of DR4 (rs13278062) were increased among CD patients compared to the controls (37.12% vs. 32.04%, P = 0.040, 95%CI: 1.010-1.550; 62.71% vs. 54.90%, P = 0.032, 95%CI: 1.028-1.855, respectively). However, the allelic and genotypic frequencies of DR4 (rs20575) and DR5 (rs1047266) did not differ between the two groups (all P > 0.05). Based on the Montreal Classification Standards, the CD patients were stratified by locations and behaviors of the disease. After multiple comparison correction (P < 0.0125), compared to ileocolonic CD patients respectively, the mutant allele (T) and genotype (GT+TT) of the rs13278062 polymorphism were significantly increased in colonic CD patients (41.04% vs. 25.64%, P = 0.002, 95%CI: 0.315-0.778; 66.04% vs. 41.03%, P = 0.001, 95%CI: 0.196-0.655, respectively) and terminal ileum CD patients (41.44% vs. 25.64%, P = 0.002, 95%CI: 0.311-0.762; 74.77% vs. 41.03%, P < 0.001, 95%CI: 0.126-0.437, respectively). In comparison to penetrating CD patients, the mutant allele (T) and genotype (GT+TT) of DR4 (rs13278062) were significantly decreased in stricturing CD patients (32.29% vs. 48.91%, P = 0.007, 95%CI: 0.300-0.828; 57.29% vs. 86.96%, P = 0.001, 95%CI: 0.078-0.520, respectively). A similar conclusion was drawn for the mutant genotype (GT+TT) of DR4 (rs13278062) in non-stricturing, non-penetrating CD patients (58.82% vs. 86.96%, P = 0.001, 95%CI: 0.086-0.536). Haplotype analysis indicated that the CT haplotype formed by rs20575 and rs13278062 was increased in CD patients compared to the controls (37.1% vs. 31.8%, P = 0.029, OR=1.279, 95%CI: 1.022-1.600). The outcome of a gene-gene interaction model indicated that the mutant genotype (GT+TT) of DR4 (rs13278062) and mutant genotype (CT+TT) of DR5 (rs1047266) may play a negatively synergistic role in CD patients (B = - 0.483, OR = 0.617, P = 0.030).

CONCLUSIONThe rs13278062 polymorphism of the DR4 gene not only can confer an increased risk for CD, but may also influence the location of the lesions and the disease behaviors. The CT haplotype formed by rs20575 and rs13278062 may be an independent risk factor for CD. Furthermore, the mutant genotype (GT+TT) of DR4 (rs13278062) and mutant genotype (CT+TT) of DR5 (rs1047266) may exert a negative synergistic effect on CD.

Adult ; Crohn Disease ; genetics ; Epistasis, Genetic ; Female ; Genetic Predisposition to Disease ; Genotype ; Haplotypes ; Humans ; Male ; Middle Aged ; Polymorphism, Single Nucleotide ; Receptors, TNF-Related Apoptosis-Inducing Ligand ; genetics