Objective To investigate the clinical and pathological features of patients co-infected with hepatitis B virus(HBV)and hepatitis C virus(HCV)and to study the underlying interaction between HBV and HCV in these patients.Methods The liver biopsy and sera samples of 226 patients with chronic hepatitis were collected.Real-time fluorescent quantitative polymerase chain reaction were used tO measure HBV DNA and HCV RNA,respectively.Enzyme-linked immunosorbent assay (ELISA)was utilized to detect HBV serological marker and anti-HCV antibody.Liver biopsy examination was performed through needle aspiration.HBsAg and HBcAg in liver tissue were detected by immunohistochemistry,while HBV DNA and HCV RNA were detected by in situ hybridization.Results Sixty two point five percent patients co-infected with HBV and HCV suffered from severe hepatitis,while the rates of those infected with HBV or HCV alone were 27.1%and 30.6%,respectively(X2=14.70,P＜0.01).The serum alanine aminotransferase,aspartate aminotransferase, total bilirubin.direct bilirubin and albumin levels of patients infected with HBV alone were higher than those of patients co-infected with HBV and HCV or those infected with HCV alone,which showed statistically significant difference(X2=8.52.P＜0.05).The HBsAg titers in serum samples and in liver tissue samples were inconsistent in both co-infected patients and HCV mono infected patients (X2=15.60,P＜0.01).The HBV DNA positive rate of co-infected patients was 12.5%,which was lower than that of patients infected with HBV alone(87.7%,X2=17.66,P＜0.01).Meanwhile,the HCV RNA positive rate of patients co-infected with HBV and HCV was 75.0%,which was lower than that of patients infected with HCV alone(80.6%).However,the difference was not statistically significant(P＞0.05).Conclusion Co-infection with HBV and HCV may induce severer liver injury than HBV infection or HCV infection alone.

Objective:To study the clinical features and prognostic factors of brain injury after radiothera-py for nasopharyngeal carcinoma(NPC).Methods:From January 1998 to June 2006,49 NPC patients with Dost-radiation brain injury in our hospital were analyzed retrospectively.Results:The incidence of post-radia-tion brain injury after single-pass radiotherapy and re-course radiotherapy was 2.31%and 9.64%.respectively ,(P＜0.05).The median latency period was 50.5 months for single-pass radiotherapy and 25.5 months for re-course radiotherapy.Fourty-nine patients suffered from radiation injury in the brain.The lesions were locat-ed in the temporal lobe in 37 patients(75.5%),in the pens in 9 patients(18.4%)and in mixed position in 3 pa-tients(6.1%).The symptoms and signs of the patients could be alleviated by therapy, but the quality of life was not improved.Conclusion:Radiation brain injury in NPC patients after radiotherapy is related to field de-sign.The incidence of radiation brain injury in the temporal lobe is the highest.Compared with single-pass ra-diotherapy, re-course radiotherapy leads to higher incidence of brain injury and shorter latency period.

Objective To evaluate the measurement accuracy of serum gamma-glutamyltransferase (GGT) assays manufactured in China. Methods The International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) reference method for GGT was set up and, after verification, was used to evaluate the performance of routine assay systems made in China. The evaluation was performed twice before and after a calibration by a common serum calibrator. Results For the reference measurement, the within run and total CVs were all less than 1%. The biases with the target values of IFCC External Quality Assessment Scheme for Reference Laboratories (RELA) were all within the limit of equivalence. Before a calibration with a common calibrator, the largest biases of results of GGT of the routine tasting systems compared with reference method at three medical decide levels were -47.53%, -34.11% and -30.07% respectively, and the averaged biases were 14.53% ,12.88% and 12.48%. After calibrating by fresh serum calibrator,the largest biases were reduced to - 17.63%, -5.88% and -4.08% ,the averaged biases were reduced to 7.50%, 2.70% and 1.87%. Conclusion The performance of GGT measurements can be effectively improved by using a common fresh serum calibrator that has a value assigned with the reference method.

OBJECTIVETo summarize and critically assess the effificacy of Eastern and Western manipulative therapies for the treatment of neck pain in adults.

METHODSA search of PubMed/MEDLINE, the Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, EMBASE, etc. from their inception date to January 2014 with Chinese, Japanese, and Korean databases. Two reviewers independently selected randomized controlled trials (RCTs) with negative control or blank control, extracted data and assessed methodological quality. Meta-analysis and levels of evidence were performed by Revman5.1 and Grades of Recommendations Assessment, Development and Evaluation (GRADE) approach.

RESULTSNineteen clinical trials with adequate randomization were included in this review, 11 of them had a low risk of bias. The primary outcome for short-term pain had no significant differences, however, the secondary outcome, only the Numerical Pain Rating Scale (NPRS) score of intermediate-term [n=916, pooled mean differences (MD) =-0.29, P=0.02], the Neck Disability Index (NDI) score of short-term (n=1,145, pooled MD=-2.10, P<0.01), and intermediate-term (n=987, pooled MD=-1.45, P=0.01) were signifificantly reduced with moderate quality evidence. However, it supported the minimally clinically important difference (MCID) of the Visual Analogue Scale and NPRS pain score to be 13 mm, while NDI was 3.5 points. The meta-analysis only suggested a trend in favor of manipulative therapy rather than clinical signifificance.

CONCLUSIONSThe results do not support the existing evidences for the clinical value of Eastern or Western manipulative therapy for neck pain of short-term follow-up according to MCIDs. The limitations of our review related to blinding, allocation concealment and small sample size.

OBJECTIVETo evaluate the effect of individualized scalp acupuncture base on location of brain function for motor dysfunction in stroke patients.

METHODSA total of 180 patients were randomly assigned into an individualized scalp acupuncture (ISA) group, a conventional scalp acupuncture (CSA) group and a rehabilitation group, 60 cases in each one. In the ISA group, we stimulated Sishencong (EX-HN 1), motor area and balance area, matched with pre-motor area for higher muscle tension, application area and's three-needle for involuntary motion, application area for poor motor coordination, forehead five-needle for cognitive disorder, sensory area for sensory disturbance. In the CSA group, the affected Dingnieqianxiexian (MS 6), Dingniehouxiexian (MS 7) and Zhenxiapangxian (MS 14) were selected. Rehabilitation was used during needle retained in the two groups. Simple rehabilitation was used in the rehabilitation group. All the treatment was given from Monday to Friday for 4 weeks, once a day for 20 times. Eight-week follow-up was applied. The Fugl-Meyer assessment (FMA) for motor function, modified Barthel Index (MBI) were used to evaluate clinical effect.

RESULTSAfter treatment and at follow-up, FMA and MBI scores increased compared with those before treatment in the three groups（all<0.01）, with significant differences among the three groups (all<0.000 1) and better results in the ISA group compared with those in the other two groups (<0.05,<0.01) at the two time points. The FMA and MBI scores in the CSA group were higher than those in the rehabilitation group after treatment and at follow-up (all<0.05).

CONCLUSIONThe individualized scalp acupuncture can improve motor dysfunction and self-care ability of daily life for stroke patients.

OBJECTIVETo probe into eliminating action of mild moxibustion combined with cupping therapy on athletic fatigue.

METHODSObserve changes of serum creatine kinase activity in gym-athletes with once great intensity training or periodic great intensity training, and the interfering effect of mild moxibustion combined with cupping therapy.

RESULTSThe mild moxibustion combined with cupping therapy has a significant promoting action on recovery of the increased serum creatine kinase activity induced by once great intensity training or periodic great intensity training in gym-athletes.

CONCLUSIONThe method has a better action of eliminating athletic fatigue.

Acupuncture Points ; Adolescent ; Child ; Creatine Kinase ; blood ; Female ; Gymnastics ; Humans ; Male ; Medicine, Chinese Traditional ; Moxibustion

BACKGROUNDPatients on hemodialysis have a high-mortality risk. This study analyzed factors associated with death in patients on maintenance hemodialysis (MHD). While some studies used baseline data of MHD patients, this study used the most recent data obtained from patients just prior to either a primary endpoint or the end of the study period to find the characteristics of patients preceding death.

METHODSParticipants were selected from 16 blood purification centers in China from January 2012 to December 2014. Patients' data were collected retrospectively. Based on survival status, the participants were divided into two groups: survival group and the death group. Logistic regression analysis was performed to determine factors associated with all-cause mortality.

RESULTSIn total, 4104 patients (57.58% male, median age 59 years) were included. Compared with the survival group, the death group had more men and more patients with diabetic nephropathy (DN) and hypertensive nephropathy. The patients preceding death also had lower levels of diastolic blood pressure, hemoglobin, serum albumin, serum calcium, serum phosphate, Kt/V, and higher age. Multivariate analysis revealed that male sex (odd ratio [OR]: 1.437, 95% confidence interval [CI]: 1.094-1.886), age (OR: 1.046, 95% CI: 1.036-1.057), and presence of DN (OR: 1.837, 95% CI: 1.322-2.552) were the risk factors associated with mortality. High serum calcium (OR: 0.585, 95% CI: 0.346-0.989), hemoglobin (OR: 0.974, 95% CI: 0.967-0.981), albumin (OR: 0.939, 95% CI: 0.915-0.963) levels, and dialysis with noncuffed catheter (OR: 0.165, 95% CI: 0.070-0.386) were protective factors based on a multivariate analysis.

CONCLUSIONSHemodialysis patients preceding death had lower hemoglobin, albumin, and serum calcium levels. Multivariate analysis showed that male sex, age, DN, low hemoglobin, low albumin, and low serum calcium were associated with death in hemodialysis patients.

Adult ; Aged ; China ; Female ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Renal Dialysis ; adverse effects ; mortality ; Retrospective Studies ; Risk Factors