OBJECTIVE To investigate the correlations on hepatitis B virus(HBV)preS1-antigen(preS1-Ag)and HBV-DNA,HBV markers in patients with hepatitis B.METHODS The markers,preS1-Ag and HBV-DNA were determined by ELISA and PCR in 406 patients with hepatitis B and 80 healthy persons.RESULTS The positive rates of preS1-Ag in 160 patients with HBsAg(+)and HBeAg(+)were 84.4%.The positive rates of preS1-Ag in 246 patients with HBsAg(+)and HBeAg(-)were 42.3%;the difference between them was significant(?2=70.9,P

Objective To investigate the approaches and effect of Ilizarov external fixators combined with limited operation in treatment of posttraumatic clubfoot in children.Methods The study involved 40 cases (43 feet) of posttraumatic clubfoot treated with Ilizarov external fixators combined with limited operation including soft-tissue releases (26 cases,28 feet) or osteotomies (14 cases,15 feet)from January 2006 to June 2012.Scoring system of intemational clubfoot study group (ICFSG) including aspects of functional assessment (36 points),morphology (12 points) and radiological assessment (12points) were employed before and after surgery.Results All the cases were available to the follow-up of 0.5-6 years.ICFSG score was excellent in 28 feet,good in 10,fair in four and poor in one foot,with excellent-good rate of 88％.This suggested the good correction of posttraumatic clubfoot,satisfactory weight-bearing exercise and a low relapse rate.Conclusions Conservative open operation brings large trauma and poor results in treatment of posttraumatic clubfeet in children,while Ilizarov invasive distraction technique is probable to offset those weak points.Therefore,Ilizarov external fixators combined with limited operation is an effective treatment.

Objective To compare the treatment effect between Duply combined with Duckett and Koyanagi surgical methods in severe hypospadias.Methods Forty-two cases of severe hypospadias were divided into two groups according to the surgical method,23 cases was enrolled in Duply combined with Duckett group while 19 cases in Koyanagi group.The operation time,the incidence rate of urinary fistula,urethral stricture,urethral diverticulum and penis torsion were compared.Results The operation time between two groups had no significant difference (P ＞ 0.05).The incidence rate of urinary fistula,urethral stricture,urethral diverticulum and penis torsion between two groups had no significant difference (x2 =0.04,0.31,0.03,1.16,P ＞ 0.05).The total incidence rate of complications between Duply combined with Duckett group and Koyanagi group had significant difference [69.6％ (16/23) vs.6/19] (x2 =4.59,P ＜ 0.05).Conclusion Each of the two methods can be a choice in treatment of severe hypospadias.

Objective To explore the change of blood coagulation function and the clinical diagnosis and treatment for early deep venous thrombosis in patients with fracture after operation.Methods A total of 80 fracture patients were divided into control group and observation group,40 cases in each group.Blood coagulation indexes and platelet count before and 1,3,5 and 7 days after the operation were compared between two groups.Results The PT,TT,and APFT increased significantly at 1,3,5 and 7 days after surgery in all the patients (P ＜ 0.05).After operation,the PLT decreased significantly (P ＜ 0.05).After treatment,the indexes of blood coagulation function in the observation group significantly decreased (P ＜ 0.05).Conclusion After the operation,the patients with fracture had venous relaxation and high blood coagulation status caused by anesthesia and other reasons.

Objective To explore the change of blood coagulation function and the clinical diagnosis and treatment for early deep venous thrombosis in patients with fracture after operation.Methods A total of 80 fracture patients were divided into control group and observation group,40 cases in each group.Blood coagulation indexes and platelet count before and 1,3,5 and 7 days after the operation were compared between two groups.Results The PT,TT,and APFT increased significantly at 1,3,5 and 7 days after surgery in all the patients (P ＜ 0.05).After operation,the PLT decreased significantly (P ＜ 0.05).After treatment,the indexes of blood coagulation function in the observation group significantly decreased (P ＜ 0.05).Conclusion After the operation,the patients with fracture had venous relaxation and high blood coagulation status caused by anesthesia and other reasons.

Objective To investigate the histological changes of the right ventricular remodeling in Xinjiang Mar-mota baibacina which are adapted to high-altitude hypoxia .Methods Hematoxylin and eosin and Masson staining was used to examine the pathological changes and degree of fibrosis , and immunohistochemical technique was used to detect connexin 43 ( CX43) expression in the right ventricular myocardium .Results In the right ventricular myocardium , cardio-myocyte hypertrophy and increased amount of collagen fibers were observed .The right ventricular hypertrophy index and weight index of Marmota baibacina were significantly higher , and expression of CX43 was significantly reduced than that of normal rats ( P<0.05 for both ) .Conclusions High-altitude hypoxia induces right ventricular remodeling in Xinjiang Marmota baibacina.It can be used as an ideal animal model for studies on the mechanisms of hypoxia adaptation on high -altitude plateau .

Objective:To explore the effect of the problem-based learning method (PBL) combined with the case-based learning (CBL) in clinical practice teaching of orthopedic interns.Methods:Totally 60 interns of clinical medicine who studied from July 2018 to December 2019 were randomly divided into two groups: experimental group ( n=30) receiving PBL combined with CBL teaching and control group ( n=30) receiving traditional teaching. The theory examination and satisfaction survey were conducted to assess the effects two teaching methods, and t-test was performed for data analysis using SPSS 15.0. Results:No significant difference was found in the average score of examination ( P>0.05), but the examination group showed a higher average score in the clinical case analysis than the control group ( P<0.05). The satisfaction survey showed that the students in the experimental group were more satisfied with the improvement in learning interests, self-study ability, and cooperation ability. Conclusions:PBL combined with CBL teaching method achieves good teaching effect and it is worth being recommended in clinical teaching.

With the development of Internet technology and big data, artificial intelligence has been widely used in the field of clinical anesthesia. In the field of clinical teaching, artificial intelligence has also led to a series of innovations and changes in teaching model, contents, and evaluation. With reference to the current status of the application of artificial intelligence in the field of anesthesia, this article analyzes the possible impact of artificial intelligence on teaching model, teaching effect evaluation, teaching management, and ethical issues in clinical anesthesia teaching, so as to provide a theoretical basis for integrating artificial intelligence into clinical anesthesia teaching practice in the future.

Objective This study aimed to describe the sex disparities on cancer incidence and mortality in Jiashan population.Methods All data concerning incident and death cases of cancers were gathered from the database of Cancer Registry in Jiashan county.Data from the 2010 China census was used as the standard population.Sex-specific age-standardized incidence rates (ASIRs),mortality rates (ASMRs) per 100 000 persons for all cancers and types of each cancer were calculated for the years of 1990 to 1999,2000 to 2009,2010 to 2014,and 1990 to 2014.In addition,the corresponding male-to-female incidence rate ratios (IRRs) and mortality rate ratios (MRRs) were also calculated.Results The ASIR of all cancers was 226.13/105 for the whole period of 1990 to 2014,with 266.04/105 for males and 187.22/105 for females,respectivcly.The corresponding IRR was 1.42 (95％CI:1.39-1.46),with significant difference noticed in the incidence rates between males and females (P＜0.05).The ASMR of all cancers was 155.39/105,with 206.55/105 for males and 104.98/105 for females,respectively.The corresponding MRR was 1.97 (95％ CI:1.91-2.03),with significant difference between males and females (P＜0.05).Among all the cancer types,only gallbladder cancer and thyroid cancer showed female predominance in both incidence and mortality,with male predominance in all the remaining cancers.Conclusion Finding from our study suggested that a male predominance in both incidence and mortality for a majority of cancers in Jiashan population.

Objective To understand the situations of departments of intensive care units (ICUs) of different level hospitals in Guizhou Province, and to provide directions and evidences for improving quality control in critical care medicine.Methods A county-level hospital and a provincial-level hospital's comprehensive ICU in Guizhou Province were selected to record and analyze and compare the structural indicators, patient admission and transfer, disease distribution, ventilator associated pneumonia (VAP), intravascular catheter related blood stream infection (CRBSI) and catheter-associated urinary tract infection (CAUTI) of the two hospitals' comprehensive ICU in 2017.Results The ICU of the People's Hospital of Suiyang County (county hospital) was found in 2012, and the ICU of the Affiliated Hospital of Guizhou Medical University (provincial hospital) was found in 1994. Until 2017, there were 10 and 46 beds, 6 (all of them hold bachelor's degree) and 18 physicians (6 of them hold PhD, 5 of them hold master's degree, 7 of them hold bachelor's degree), 17 (4 of them hold bachelor's degree, 13 of them hold college degree or graduated from secondary school) and 69 nurses (2 of them hold master's degree, 53 of them hold bachelor's degree, 14 of them hold college degree or graduated from secondary school) in the two ICUs respectively, there were significant differences in the education background of the physicians and nurses between the two ICUs (bothP < 0.01). During 2017, 471 cases were admitted to the ICU of the county hospital while 1633 cases were admitted to the ICU of the provincial hospital. Compared with the ICU of the provincial hospital, the ratio of the patients with acute physiology and chronic health evaluationⅡ(APACHE Ⅱ) ≥ 15 at admission was lower (74.8％ vs. 85.1％,P < 0.01), the ratio of direct admission was higher (30.8％ vs. 17.4％,P < 0.01), the ratio of the patients admitted to the ICU more than once was lower (0.8％ vs. 5.0％,P < 0.01), the ratio of the patients whose the length of ICU stay less than 24 hours was higher (51.6％ vs. 13.7％,P < 0.01), the ratio of the patients whose the length of ICU stay more than 28 days was lower (1.1％ vs. 2.9％, P < 0.05), the ratio of the patients discharged against-advice (25.5％ vs. 20.5％,P < 0.05) was higher, the ratio of the patients transferred to other hospitals was higher (5.1％ vs. 0.3％,P < 0.05), and the ICU mortality was lower (4.0％ vs. 13.9％,P < 0.01) in the ICU of the county hospital. The top three kinds of diseases treated in the ICU of the county hospital were brain injury (27.4％), trauma (19.1％) and toxication (6.8％); while in the ICU of the provincial hospital were brain injury (18.6％), sepsis (16.2％) and severe acute pancreatitis (4.8％). In addition, the incidences of VAP, CRBSI and CAUTI in the ICU of the county hospital were 10.0/1000 ventilator days, 1.4/1000 catheter days, 0.5/1000 catheter days; while in the ICU of the provincial hospital were 5.8/1000 ventilator days, 2.0/1000 catheter days, 3.7/1000 catheter days, respectively.Conclusions There are short of physicians and nurses in the ICU of the provincial and county hospitals in Guizhou Province, and the educational level of the medical staff in the ICU of the county hospital is relatively low. Moreover, there were significant differences in the admissions and treatments and the outcomes of the critically ill patients between the two ICUs. The characteristics of the ICUs of county hospitals should be fully considered when the quality control of critical care medicine and continuing medical education are done.