Objective To investigate the distribution of five indicators of hepatitis B(HBV-M)and its relationship with liver function parameters and HBV-DNA load in patients with chronic HBV infection in different stages.Methods The serum samples were collected from 456 patients infected with HBV.The HBV-M,liver functional parameters and HBV-DNA level were quantita-tively detected.According to the stages of disease,the patients were divided into 3 groups including chronic hepatitis B group(inclu-ding mild subgroup,moderate subgroup and severe subgroup),liver cirrhosis group(including compensatory subgroup,decompen-sated subgroup)and hepatocellular carcinoma goup.Results The ratio of HBsAg,HBeAg,HBcAb positive pattern(135 pattern) and HBsAg,HBeAb,HBcAb positive pattern(145 pattern)in the three groups were statistically different(P <0.05).In each chron-ic hepatitis B subgroup,both ALT and AST levels of 135 pattern were significantly higher than the other two patterns(P <0.05). In each liver cirrhosis subgroup and hepatocellular carcinoma group,there were statistically significant differences in ALB and TBIL levels between the three patterns(P <0.05 ).In each group,the HBV-DNA level of 135 positive pattern were significantly higher than the other two patterns(P <0.05).Conclusion With the advancement of chronic hepatitis B,there is a downtrend in the ratio of 135 pattern and increasing trend in the ratio of 145 pattern.If the stage of hepatitis B is discriminated,ALT,AST,ALB TBIL and HBV-DNA level were closely related to HBV-M pattern.

Objective To develop a reliable scale for evaluating medication compliance among patients with chronic diseases in China.Methods An initial item pool was generated by literature review,based on the definition of compliance generally accepted in China.The items were then subjected to item selections by using item answer distribution and other four methods,which resulted in a primary scale with 16 items.The reliability and validity of this scale was examined.Results Common factors extracted by factor analysis were well explained,there being a close correspondence between the scale construction and the theoretical construction. Convergent validity with the patients' self-ratings on medication compliance ranged from 0.55 to 0.59,and the correlation coefficient with the score of Morisky questionnaire was 0.58.The Cronbach ?,0 and ? coefficients were 0.717,0.751,0.893 respectively,and test-retest reliability was 0.95.Conclusion The newly developed scale appears reliable and may be a useful tool for measuring drug compliance among patients with chronic diseases,but there are still areas where further improvements may be needed.

Objective To investigate the value of laparoscopy in comprehensive early ovarian cancer staging by comparing the feasibility and safety of laparoscopy and laparotomy in surgical staging of early-stage epithelial ovarian cancer (EOC). Methods A total of 102 patients with EOC who underwent comprehensive laparoscopic (LPS group, n=71) or laparotomic (LPT group, n=31) staging at Southwest Hospital from November 2007 to November 2014 were retrospectively analyzed. The perioperative parameters, postoperative complication rate and the long-term curative effect were compared between the two groups. Results (1)LPS group had less intra-operative blood loss [(288±239) vs (631±463) ml], lower rate of blood transfusion(14%vs 58%), larger number of pelvic dissected lymph nodes (18.1±5.6 vs 15.5± 4.6), lower vasual analogue scalescore(VAS) pain score (2.1 ± 1.6 vs 3.0 ± 1.1), shorter gastrointestinal recovery time [(2.6 ± 0.8) vs (3.5 ± 0.9) days] and shorter hospital stay [(9.9 ± 2.9) vs (11.3 ± 5.0) days] when compared with LPT group (all P<0.01). No significant difference were found in operation time, number of para-aortic lymph nodes, rate of postoperative upstaging and adjuvant chemotherapy between the two groups (all P>0.05). (2) No significant difference was found in postoperative rate of complications [11%(8/71) vs 19%(6/31),χ2=1.192, P=0.275]. (3) No significant difference was found in recurrence rate [17%(11/66) vs 14%(4/29), χ2=0.125, P=0.724] and 5-year overall survival (86.7% vs 86.8%, P=0.874). Conclusion Compared with LPT group, there are no significance differences in recurrence rate and mortality between two groups, laparoscopic staging, which could be recommended as a choice of surgical treatment of early ovarian cancer, shows more favorable operative outcomes including minimally invasive, less intra-operative blood loss, less postoperative pain and quicker recovery.

Objective To investigate characteristics of anti-Müllerian hormone (AMH) secretion and mechanism of aberrant folliculogenesis by the ratio of luteinizing hormone (LH)/follicle-stimulating hormone(FSH) in polycystic ovarian syndrome (PCOS) patients. Methods Base on the ratio of LH/FSH,total 95 patients with PCOS were divided into two groups,including 49 cases in higher ratio group (LH/FSH≥2) and 46 cases in normal ratio group (LH/FSH < 2) matched with 62 infertile cases with tubal factor and regular menstruation as control group. Body mass index (BMI) were calculated in all objectives. The serum AMH were detected by enzyme linked immunosorbent assay(ELISA). Ovarian sexual hormones,fasting blood glucose, insulin and lipid were measured by chemiluminescence method. The correlation between AMH and metabolic index was analyzed by multilinear regression. Results (1) AMH: the serum level of AMH were (7.2±4. 3) μg/L in higher LH/FSH group, (5. 2±3. 8) μg/L in normal LH/FSH group and (3.7 ±2. 2) μg/L in control group, which all reached significant difference among those 3 groups(P < 0. 01). (2) The correlation between AMH and biological metabolic index: estradiol (E2) was negatively correlated with serum level of AMH in higher LH/FSH ratio group (r = -0. 318). The serum level of AMH were positively correlated with BMI, fasting glucose, homeostasis model assessment insulin resistance index (HOMA-IR) in normal LH/FSH ratio group (r = 0. 493,0. 362,0.303). After controlling affect factors, serum levels of AMH were positively correlated with LH/FSH in higher LH/FSH ratio group (r = 0. 301), but negatively correlated with E2 (r = -0. 429). However, in normal LH/FSH group, serum level of AMH was only positively correlated with BMI (r = 0. 428). Conclusion The PCOS patients with higher LH/FSH ratio are primarily caused by hypothalamic-pituitary dysfunction, while the PCOS patients with normal LH/FSH ratio are mainly caused by metabolic disorders.

Objective To investigate surgical technique and clinical efficacy of Sky bone ex- pander kyphoplasty in the treatment of osteoporotic vertebral body compression fractures.Methods Eighteen cases with osteoporotic vertebral body compression fractures were treated with Sky bone expander kyphoplasty from August 2004 to November 2005.Under the local anesthesia,3.5-5ml of bone cements were injected into each pathologic vertebral body through unipedicle approach after reduction procedure was done with Sky bone expander.Results The postoperative follow-up ranged from 3 to 11 months, with an average of 4.5 months.Back pain was effectively relieved after the operation in all cases.No complications occurred.Conclusion The Sky bone expander kyphoplasty has the advantages of safe- ty,easy operation,minimal invasion,effective restoration of the vertebral body height and fast relief of pain.

Patient-reported outcomes (PROs) provide clinical researchers with a good means to assess patient-based outcomes. Yet there are still some problems to pay attention to while using PROs as an effectiveness assessment index, including the selection of an appropriate scale of PRO, quality control in PRO data collection, and the interpretations and application ranges of the PRO results.
Outcome Assessment (Health Care) ; methods ; Patient Satisfaction ; Psychometrics ; Quality Control

BACKGROUND:Skeletal muscle satelite cels are muscle-derived stem cels with proliferation and differentiation potential distributing between the muscle cel membrane and the base film. Studies have shown that skeletal muscle satelite cels are of efficacy and safety, but the survival rate of the transplanted stem cels is very low, which greatly limits the application of skeletal muscle satelite cels. OBJECTIVE: To observe the effects of Fasudil on apoptosis of skeletal muscle satelite cels induced by H2O2. METHODS: Skeletal muscle satelite cels cultured in vitro were randomly divided into three groups including H2O2group, H2O2+Fasudil group (Fasudil group) and control group. Apoptosis rates were observed by flow cytometry. The concentrations of interleukin-4 and tumor necrosis factor-a in each group were detected by ELISA. Western blot was employed to measure the protein level of Bax in each group. RESULTS AND CONCLUSION: Compared with the H2O2group, a significant decrease was found in the apoptosis rate of cels, protein level of Bax, and concentrations of interleukin-4 and tumor necrosis factor-a in the Fasudil group (alP < 0.05). These findings indicate that Fasudil can play anti-apoptosis protection by inhibiting Rho-kinase signaling pathway, which may be related to the reduced expression of Bax.

Objective To investigate the application effect of nasojejunal feeding tube nutrition in patients with severe traumatic brain injury. Methods The clinical data of 54 patients with severe traumatic brain injury admitted to the Department of Surgical Critical Care Medicine,the Third Affiliated Hospital,Sun Yatsen University between June 2012 and December 2014 were analyzed retrospectively. They were divided into either a nasojejunal feeding tube nutrition support group (nasojejunal group,n = 26)or an asogastric feeding tube nutrition support group (asogastric group,n = 28)according to the different ways of enteral nutrition. All patients began to receive nasal feeding whole protein preparations (enteral nutritional emulsion,TPF-D)from the second day after admission to intensive care unit (ICU). The time to reach the enteral nutrition support target,the time of parenteral nutritional support,nutritional index (albumin and hemoglobin),the time admission to ICU,and the incidences of infection and gastrointestinal complications in both groups were observed. Results (1)According to the body weight to calculate calorie demand, the nasojejunal group reaching the time of enteral nutrition support target was faster than that of the asogastric group (3. 0 ± 0. 8 d vs. 7. 7 ± 2. 5 d). There was significant difference between the 2 groups (P < 0. 01). The time of the combined parenteral nutrition support in the nasojejunal group was reduced significantly compared with the asogastric group (2. 0 ±0. 8 d vs. 6. 7 ±2. 5 d). There was significant difference between the 2 groups (P <0. 01). (2)At day 30after treatment,the levels of total serum protein and hemoglobin in the nasojejunal group were higher than those of the asogastric group (64 ± 6 g/ L vs. 61 ± 6 g/ L and 120 ± 17 g/ L vs. 106 ± 16 g/ L,respectively. There were significant differences (P < 0. 05). (3)The mean length of stay in the ICU was obviously shorter in nasojejunal group compared with the asogastric group (11 ± 5 d vs. 14 ± 6 d). There was significant difference between the 2 groups (P < 0. 05). (4)There were no significant differences in complications of the patients,such as the incidences of pulmonary infection,hyperglycemia,and diarrhea between the 2 groups (P > 0. 05). Conclusion Nasojejunal feeding tube nutrition support may be faster to achieve the target of enteral nutrition supports and shorten the time in ICU.

Based on the capacitance coupling principle, we studied a capacitive way of non-contact electrocardiogram (EGG) monitoring, making it possible to obtain ECG on the condition that a patient is habilimented. Conductive fabric with a good electrical conductivity was used as electrodes. The electrodes fixed on a bed sheet is presented in this paper. A capacitance comes into being as long as the body gets close to the surface of electrode, sandwiching the cotton cushion, which acts as dielectric. The surface potential generated by heart is coupled to electrodes through the capacitance. After being processed, the signal is suitable for monitoring. The test results show that 93.5% of R wave could be detected for 9 volunteers and ECG with good signal quality could be acquired for 2 burnt patients. Non-contact ECG is harmless to skin, and it has advantages for those patients to whom stickup electrodes are not suitable. On the other hand, it is convenient to use and good for permanent monitoring.
Electric Conductivity ; Electrocardiography ; instrumentation ; Electrodes ; Humans

Clinical trials are often designed as either pragmatic or explanatory. The pragmatic clinical trials are generally used for measuring the effectiveness of a treatment in common clinical practice, while the explanatory trial for measuring the efficacy of a treatment under ideal conditions. Since the methods concerning pragmatic clinical trials are less introduced in China, its archetypal features, advantages and limitations were introduced in this paper. And a current study of pragmatic clinical trials on using acpuncture for treatment of low back pain carried out in German was taken as an example to illustrate the practical methods concretely. The key steps of the design were presented in detail, and reasonable suggestions about the problems often encountered in the trial, as well as how to balance the internal and external validity, outcome measurement, etc., were offered.
Clinical Trials as Topic ; methods ; standards ; Data Interpretation, Statistical ; Decision Making, Organizational ; Humans