OBJECTIVE:To observe the short-term efficacy and ADR of tenofovir disoproxil fumarate(TDF)in the treatment of multi-drug resistant chronic hepatitis B(CHB). METHODS:32 patients with multi-drug resistant CHB were analyzed retrospec-tively,and HBV drug-resistant genes were detected before treatment;there were a number of points to resistance;they were gave TDF orally. The recovery rate of serum alanine aminotransferase(ALT),HBV-DNA conversion rate,lactic acid and renal function were observed before and after treatment. RESULTS:The recovery rate of ALT reached 100% at 3 months,and the conversion rate of HBV-DNA reached 96.88%. The lactic acid levels and renal dysfunction was not found during treatment. CONCLUSIONS:TDF take effect quickly on multi-drug resistant CHB,and no obvious ADR is found.

Objective To design technique of local flap transposition to refine the aesthetic appearance of reconstructed fingers by toes transfer.Methods Nine cases with 21 reconstructed finger were included,which involved 6 males and 3 females with an average age of 21.8 years(range,18-34years).A lingual contour flap with a lateral pedicle Was shifted from the inflated distal pulp to the narrow middle part of the"finger"to refine the aesthetic appearance.Overall results were evaluated in terms of the survival of the flap,the appearance improvement and the functional influence of the reconstructed finger.Results All of the flaps survived and healed perfectly.After a mean follow-up of 9.3 months(range,6-12months),the appearance of the reconstructed fingers were impmved apparently.There was little influence on the function of the finger.The results showed that all the patients gained more acceptable fingers.Conclusion From our experience,local flap transposition is a useful method for remolding of reconstructed fingers by toes transfer.

The cellulase production and extraction from Trichoderma Longibrachiatum ANU_3-958 were reported. The results indicated that maximum enzyme activity can be obtained when the fungus was grown on a solid medium for 144 hours, the proportion between the solid culture and the extracting agent was about 1:7(W/V) and extract was precipitated twice by adding solid (NH_4)_2SO_4. Cellulase powder obtained by freeze drying was analysed for its related enzyme activities. The highest CMC and FPA enzyme activity are about 2788.89IU/g enzyme powder and 79.44IU/g enzyme powder respectively. The yield for the solid culture is about 13.28% averagely.

A Neurospora sp was used to ferment organic waste materials such as sugarcane residue powder (bagasse), bran and cassava residue The feed complex enzymes including cellulase, saccharifying enzyme,neutral proteinase and other growth factors were produced The experimental results showed that suitable medium contained sugarcane residue powder 100 g ?bran 600 g, cassava residue 300 g, mixed nitrogen sucrose 20 g per kilogram solid materials and some content of phosphate, the water in medium was twice as weight as the solid materials;the suitable fermentation conditions were that the strain was cultured first for 2 days under 34℃ and then fermented for 2～3 days at 37℃, no light,keeping the watering medium and suppling enough oxygen during fermentation The cellulase (CMC+C1) was 1759mg/g/h, saccharifying enzyme to 3110 mg/g/h, neutral proteinase 297mg/g /h in ferment product On the other hand, light,enough air,lower temperature and less water content in medium were benefit to producing spores

Objective To study the periodontal status and risk factors for periodontitis in periodontitis patients at different ages in wuhan. Methods From January 2007 to March 2008, the cross-sectional survey on periodontal conditions of 493 physical examinees in Wuhan city was carried out with random cluster sampling method. 458 cases of them were in accordance with the inclusive criteria and were stratified into two groups: young and middle-aged adults (aged 30-59 years) and old adults (aged 60 years and over). A case-control study was carried out in the periodontitis cases group (n=280) and the control group (n=178). Database was created by SQSERVER2000 and SPSS11.0 was used for statistical analysis. The relationship of periodontitis with age, gender, nation, educational background, diabetes mellitus, smoking, drinking, mental pressure and oral hygiene habits were analyzed by univariate and multivariate logistic regression analysis. Results The prevalence of periodontitis was 61.1% (280/458). Univariate analysis revealed that age, educational background, diabetes mellitus, smoking and oral hygiene habits were related factors for periodontitis (OR:0.44, 2.27, 3.44, 1.75, 9.82, P<0.05 or P<0.01). Meanwhile, multivariate analysis showed that suffering from diabetes mellitu and low educational background were the independent risk factors for periodontitis (OR=2.66, 1.95, all P<0.05). After stratification by age, multivariate logistic regression analysis showed that there was no correlation between diabetes mellitus and periodontitis prevalence in young and middle-aged adults and diabetes mellitus was a risk factor for periodontitis in old adults(OR=6.91, 95%CI: 1.27～37.42). Conclusions There are many risk factors for periodontitis and diabetes plays a major role in the development of periodontitis in old adults.

By three-dimensional finite element analysis,the present research inquired about the stress on the surface of alveolar bone of mandibular incisor with different level of bone loss under different loadings. For the mandibular incisor without bone loss, the maximums of the von Mises stress under vertical and 15 degree oblique loading were 13.171 and 14.315 MPa respectively, both located in the apical region, and the lingual displacement of the tooth were 0.056 and 0.197mm respectively; under 30 degree oblique loading, the maximum of the von Mises stress was 15.262 MPa, located not only in the apical region but also on the crest, and the lingual displacement of the tooth was 0.324 mm. However, when vertical loading was applied on the mandibular incisor with half of the alveolar bone loss, the maximum of the stress increased significantly, located in the apical regions. And under oblique loadings, the value of the stress of this model increased dramatically,being three to five times over that of mandibular incisor without bone loss. Both of them concentrated on the crest. The scope of its distribution decreased from area to point. The significant lingual displacement happened, amounting to 2.850 mm. So when the loss of alveolar bone is not less than half,occlusal adjustment and splinting should be considered during the initial treatment of periodontal disease in order to avoid the significant change of the stress and alleviate the damage to the periodontal tissues.
Alveolar Bone Loss ; physiopathology ; Finite Element Analysis ; Humans ; Imaging, Three-Dimensional ; Incisor ; Mandible ; physiopathology ; Mandibular Diseases ; physiopathology ; Stress, Mechanical

Objective To observe the clinical efficacy of ebastine combined with Runzao Zhiyang capsules in the treatment of patients with chronic urticaria. Methods A total of 126 patients with chronic urticaria admitted to Department of Dermatology of Tianjin Third Central Hospital from January 2015 to May 2017 were enrolled and they were divided into two groups by the random number table method. The patients in control group (62 cases) were given oral ebastine administration 10 mg once per day, and those in observation group (64 cases) received oral administration of ebastine 10 mg once per day combined with Runzao Zhiyang capsule 2 g, 3 times per day, the therapeutic course being 4 weeks. The changes of clinical efficacy and the symptom scores, including urticaria activity score (UAS) and dermatolo-gical disease life quality index (DLQI) scores of the two groups were observed after treatment of 4 weeks;the incidence of adverse reactions and the recurrence situation after drug withdrawal for 4 weeks at follow-up were analyzed. Results Compared with the control group, the total effective rate of the observation group was significantly increased [92.2% (59/64) vs. 79.0% (49/62), P ＜ 0.05]. After treatment, the overall UAS score and DLQI score in two groups were both significantly decreased, the degree of decrease in observation group were more siginificant than those in control group [UAS: 1.26 (0.52 - 7.35) vs. 1.68 (0.75 - 8.65), DLQI: 0.56±0.52 vs. 1.57±0.96, P ＜ 0.01]. In addition, the total decrease degree of symptom score reducing index (SSRI) in the observation group was significantly greater than that in the control group [(76±21)% vs. (69±23)%, P ＜ 0.05], the incidence of adverse reactions [7.8% (5/64) vs. 12.8% (8/62)] and recurrence rate [8.3% (3/64) vs. 23.8% (5/62)] in the observation group were obviously lower than those in the control group (both P ＜ 0.05). Conclusion The efficacy of ebastine combined with Runzao Zhiyang capsule in the treatment of patients with chronic urticaria is prominent and superior to that of using ebastine alone, the combined method is capable of elevating the therapeutic effect obviously and has less adverse reactions.

Objective To analyze the clinical data of brucellosis,and to provide references for brucellosis therapy.Methods The patients definitely diagnosed brucellosis at the First Affiliated Hospital of Zhengzhou University from January 2013 to June 2016 were assessed,data of clinical features,laboratory examination,treatment and prognosis were analyzed.Results Of all 99 cases,the mean age was (46.7 ± 15.7) years old,83 cases had a history of closely contacted with sheep,2 cases with pig and 1 case with cattle.The occupational distribution of patients included 90 farmers,1 veterinarian,2 cooks,6 children and students.All patients had clinical manifestations such as fever,fatigue,and sweating.There were 18 patients with back and joint pain,13 cases had abnormal manifestation on magnetic resonance imaging (MRI).Blood culture was positive in 54 (71.05％,54/76) and serum test tube agglutination test was positive in 61 (98.39％,61/62).Eighty-one patients received doxycycline combined with rifampicin treatment,six months laters,all patients were cured.Conclusions Sheep are the main sources of infection for brucellosis.Fatigue,sweaty and fever are the most common symptoms,and osteoarticular is the most frequently involved.Serum agglutination test and blood culture are important tests for diagnosis of brucellosis.Doxycycline combined with rifampicin was the most common used antibiotics regimen.Early,combined,regular,full-course antibiotic treatment has a better prognosis.

ObjectiveTo investigate the inhibitory effect of fibroblast growth factor-21 (FGF-21) on the carcinogenesis of L02 cells induced by diethylnitrosamine (DEN).Methods L02 cells were cultured and treated with different concentrations of DEN (1,10,20,50,100,and 150 μmol/L).MTT assay was used to measure the influence of DEN on the viability of L02 cells,and an appropriate stimulation concentration of DEN (20 μmol/L) was selected for further study.The malondialdehyde (MDA) and superoxide dismutase (SOD) detection kits were used to measure the levels of MDA and SOD in L02 cells treated by DEN (20μmol/L) and normal L02 cells.Then L02 cells were divided into model control group (treated with 20μmol/L DEN and PBS),low-dose FGF-21 group (20 μmol/L DEN + 1 μmol/L FGF-21),and high-dose FGF-21 group (20 μmol/L DEN +2 μmol/L FGF-21).The levels of MDA and SOD were measured after 12 hours of cell culture.Real-time PCR and Western blot were used to measure the expression of βKlotho (KLB),and Western blot was used to measure the level of phosphorylated protein kinase B (p-AKT).The t-test was used for comparison of continuous data between two groups;an analysis of variance was used for comparison between multiple groups,and the least significant difference t-test was used for further comparison between two groups.Results There was a significant increase in the level of MDA and a significant reduction in the level of SOD after L02 cells were treated with DEN (t =9.336 and 16.281,P =0.011 and 0.004).Compared with the model control group,the low-and high-dose FGF-21 groups had a significant reduction in the level of MDA and a significant increase in the level of SOD (P ＜ 0.05),and compared with the low-dose FGF-21 group,the high-dose FGF-21 group had a significantly lower level of MDA and a significantly higher level of SOD (P =0.030 and 0.042),and there was a significant difference between two groups.The high-and low-dose FGF-21 groups had significantly higher mRNA expression of KLB than the model control group (P ＜ 0.001),and the high-dose FGF-21 group had significantly higher mRNA expression of KLB than the low-dose FGF-21 group (P ＜ 0.001),and there was a significant difference between two groups;the protein expression of KLB showed the same trend.The model control group had a significantly higher level of p-AKT than the other two groups (P ＜0.05),and the high-dose FGF-21 group had a significantly lower level of p-AKT than the low-dose FGF-21 group (P ＜ 0.05).Conclusion DEN can increase oxidative stress in L02 cells.By upregulating the expression of KLB,FGF-21 can reduce the level of p-AKT,inhibit oxidative stress in L02 cells induced by DEN,and thus inhibit the development of hepatocellular carcinoma.

OBJECTIVETo perform a retrospective cohort study in order to determine the differences in short-term curative effect of ribavirin in combination with interferon alfa (IFNa)-2a vs. pegylated (Peg)-IFNa-2a in patients with chronic hepatitis C (CHC).

METHODSOne-hundred-and-eighty-eight treatment of the CHC patients who were administered combination therapy of ribavirin with IFNa from 2010 to 2012. One-hundred-and-thirty-three of the patients received the therapy with IFNa-2a and the remaining 55 received Peg-IFNa-2a. Hepatitis C virus (HCV) load and levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured at treatment weeks 4, 12, 24, and 48. Adverse reactions were recorded. Differences between the groups were assessed by statistical analysis.

RESULTSThe patients in the Peg-IFNa-2a group and the IFNa-2a group showed no significant difference in sex distribution, age, smoking habits, or drinking habits at baseline (all P more than 0.05). Both antiviral therapies significantly reduced the HCV load and levels of ALT and AST (baseline levels vs. all treatment weeks examined, P less than 0.05); however, the reduction in the HCV load at week 4 was significantly more robust with the Peg-IFNa-2a therapy (2.96 ± 0.66) log10 IU/ ml vs. (3.47 ± 1.42)1og10 IU/ml; F =4.14, P=0.04). The Peg-IFNa-2a group also showed a significant higher rate of rapid virological response (RVR) than the IFNa-2a group (72.72% vs .57.14%; x²=4.37, P=0.04), but there were no statistically significant differences found between the two groups for early virological response rate (EVR), endpoint antiviral treatment virologic response rate (ETR), biochemical response rate, or rate of adverse reactions (all P more than 0.05).

CONCLUSIONRibavirin in combination with Peg-IFNa-2a produces a better RVR than in combination with IFNa-2a .Yet, the EVR, ETR, biochemical response rate, and rate of adverse reactions is similar for the two forms of IFNa-2a. Further studies are required to determine the potential superiority of Peg-IFNa-2a for a long-term curative effect.

Adolescent ; Adult ; Aged ; Antiviral Agents ; therapeutic use ; Child ; Child, Preschool ; Drug Therapy, Combination ; Female ; Hepatitis C, Chronic ; drug therapy ; Humans ; Infant ; Infant, Newborn ; Interferon-alpha ; therapeutic use ; Male ; Middle Aged ; Polyethylene Glycols ; therapeutic use ; Recombinant Proteins ; therapeutic use ; Retrospective Studies ; Ribavirin ; therapeutic use ; Treatment Outcome ; Young Adult