ObjectiveTo investigate the clinical efficacy of 96-week entecavir (ETV) treatment for HBeAg-negative chronic hepatitis B patients with compensated cirrhosis, as well as its effect on patients with different HBV DNA loads. MethodsA total of 118 chronic hepatitis B patients with compensated cirrhosis who visited Xiangyang Hospital of Traditional Chinese Medicine from January 2009 to June 2013 were enrolled and all had Child-Pugh class A cirrhosis. According to HBV DNA load, these patients were divided into high-load group (group A, HBV DNA≥105 copies/ml) and low-load group (group B, HBV DNA＜105 copies/ml). All the patients were treated with ETV 0.5 mg/d for 96 weeks. Child-Pugh score was used to evaluate liver function before and after treatment, and the changes in alanine aminotransferase (ALT), albumin (Alb), and total bilirubin (TBil) after treatment were observed. Hyaluronic acid (HA), α2-macroglobulin, and liver stiffness measurement (LSM) were used to evaluate liver fibrosis. The t-test was used for comparison between groups, and a repeated-measures analysis of variance was used for comparison within one group and between groups at different time points. Chisquare test was applied for comparison of categorical data between the two groups. ResultsThe two groups showed significant reductions in ALT, Alb, and TBil at weeks 12 and 24 of treatment (all P＜0.05), and the ALT normalization rate and HBV DNA clearance rate at weeks 24 and 48 of treatment showed significantly differences between the two groups (χ2=9241，6428，11134，5139，all P＜0.05). Both groups showed significant reductions in HA, α2-macroglobulin, and LSM after treatment (t=2648，1921，4018，3166，2136，3461，all P＜0.05). The incidence rates of complications such as variceal bleeding, ascites, and hepatocellular carcinoma showed no significant differences between the two groups (all P＞0.05). ConclusionIn HBeAg-negative chronic hepatitis B patients with compensated cirrhosis, ETV can significantly improve liver function, slow down the process of liver fibrosis and cirrhosis, and effectively reduce long-term complications.

OBJECTIVE To analyze the profile of the pathogens and their drug resistance isolated from children with lower respiratory tract infection in Wenzhou area from Jan 2004 to Dec 2006.METHODS Lower respiratory tract secretions were obtained from children with lower respiratory tract infection for bacterial culture.The K-B method was applied for the antibiotic susceptibility test.RESULTS Total 1605 strains were isolated.The isolating rates of Gram-positive cocci,Gram-negative bacilli and fungi were 24.9%,61.2% and 14.0%,respectively.60.5%,and 54.6% of the isolates of Escherichia coli and Klebsiella pneumoniae produced extended-spectrum beta-lactamases(ESBLs).The rate of Penicillin-resistant Streptococcus pnenmoniae(PRSPN)was 30.6%.20.5% isolates of Staphylococcus aureus were MRSA.All isolates of Enterobacteriaceae and Gram-positive cocci were susceptible to imipenem and vancomycin in vitro.CONCLUSIONS Gram-negative bacilli are still the primary pathogens resulting in lower respiratory tract infection in children.Fungi and muti-drug-resistant bacteria are on the rise trend.

BACKGROUND: Learning and memory is a very complex biological phenomenon. Although quite a few researches on the substances participate in learning and memory and the brain areas related with learning and memory,its mechanism is still not completely clarified.OBJECTIVE:ro study the difference of antioxidase activity at different brain area in rats with different ability of learning and memory to reveal the relationship between the ability of learning and memory and the activity of antioxidase in specific brain area.DESIGN: A randomized controlled trial based on the experimental animals.SETTING: Department of Biochemistry in Jining Medical College.MATERIALS: The study was conducted in the Laboratory of Biochemistry of Jining Medical College and Suzbeu Medical College between March 2001 and January 2004. Forty 15-month old male Wistar rats with a body mass between 580 g and 650 g were selected.INTERVENTIONS: The detection of learning memory ability was carried out in MG-2 trisection radiation maze. Correction response was that the rats escaped to safe area after electric shock. Standard of master was that the rats had 9 out of 10 times continuously of correction. Observatory indicators included times of response required reaching the standard and the correct response rate. Good learning. ability meant 40 or less than 40 times of responses to reach standard; otherwise, poor learning ability was considered. Detection was repeated after 24 hours to observe the memory. Good memory meant 3 times continuously of correct response; otherwise, poor memory was considered. Rats with good learning ability and memory were included into group 1 (n= 10) and the rats with poor learning ability and memory were included into group 2( n = 12). The rest rats were washed out.MAIN OUTCOME MEASURES: Activities of superoxide dismutase (SOD), catalase(CAT) and glutathione-peroxidase(GSH-Px) of five brain areas including cerebral cortex, cerebella, striatum, hippocampus and hypothalamus in rats of two groups.RESULTS: To compare the rats with poor learning and memory ability with rats with good learning and memory ability: SOD activity in cortex, hippocampus and striatum significantly reduced ( t = 3.82, 4. 50, 6. 76, P ＜0.01); CAT activity in cortex, hippocampus, striatum and hypothalamus significantly reduced(t =4.75, 7.06, 10. 88, 17.28, P＜0.001); and GSH-Px activity was similar in each brain area without statistical significance.CONCLUSION: Hippocampus, cortex, striatum and hypothalamus all might participate in learning memory process, and the activities of antioxidases in these areas are closely related with learning memory.

Objective To investigate the proper dose of propofol injected intraperitoneally ( i.p.) in neonatal rats and to study the regional distribution of propofol at different doses in the neonatal brain.Methods Part I:Sixty postnatal 7-day-old rats were randomly divided into 5 groups, which received different doses of propofol injected i.p.The behavior, anesthetic intervals and arterial blood gas were recorded.Part II: Twenty neonatal rats were randomly divided into 2 groups:anesthesia group ( group A) and sedation group ( group S) , and were injected propofol i.p.at the proper dose ac-cording to the results of Part I.Rats were decapitated when they reached the ideal anesthesia depth.The regional concen-tration of propofol in different regions of the brain was examined by high performance liquid chromatography.Results 25 mg/kg propofol i.p.was the sedate dose for neonatal rats, while 75 mg/kg i.p.was the anesthetic dose.In the group S, the concentration of propofol in the thalamus was significantly higher than in other regions (P<0.05), while in the group A, the concentrations of propofol in the frontal and parietal cortex were obviously lower, and the concentrations of propofol in the hippocampus and cingulate gyrus were obviously higher than that in other regions (P<0.05).Conclusions Propo-fol is a suitable anesthetic for neonatal rats and its distribution in the brain is quite different when given at different doses.

Objective To discuss and analyze the clinical relationships between the gene polymorphism of vitamin D receptor and adiponectin with the susceptibility of non-alcohol fatty liver disease(NAFLD).Methods One hundred and two cases of NAFLD were selected as the observation group,and other 100 healthy volunteers were selected as the control group.The gene polymorphism of vitamin D receptor and adiponectin in the two groups was detected,then the genotype distribution and allele frequencies of vitamin D receptor and adiponectin were compared between the two groups,then their relationship with the susceptibility of NAFLD was analyzed.Results The genotype distribution situation of vitamin D receptor BsmI site,adiponectin 45 and 276 sites had statistically significant difference between the observation group and control group(P＜0.05).The B allele frequency of BsmI site of vitamin D receptor in the observation group was far lower than that in the control group,and the allele frequencies of 45-T and 276-G of vitamin D receptor in the former were far higher than those in the latter,and the differences between the two groups were statistically significant(P＜0.05).The multivariate unconditional Logistic regression analysis showed that vitamin D receptor:bb genotype,adiponectin 45 locus:TT genotype and ALT,TG,complicating hypertension history and HOMA-IR all were the independent risk factors in NAFLD patients.Conclusion The genotype distribution of different sites of vitamin D receptor and adiponectin has obvious abnormality in the patients with NAFLD,and both are closely related with the NAFLD susceptibility.

The most reliable and convenient measurement method of tibial posterior slope(TPS) and its biomechanical relationship with posterior cruciate ligament (PCL) are still controversial. For X-ray measurement, it is recommended to use full-length lateral X-ray of the lower extremity in quatrous section, which has advantage of highly repeatable and common in the daily diagnosis and treatment process, but it is only applicable to patients with tibial rotation within 15°. When the rotation exceeds 30°, it is difficult to identify the inner contour of platform and is no applicable. If it is only used for daily diagnosis and treatment evaluation, when tibial rotation angle is less than 15°, lateral knee X-ray also has a certain reference significance, but the accuracy could not meet requirements of higher clinical research. For CT measurement method, it could correct tibial rotation, but using the fitting point to measure tibial posterior slope on three-dimensional CT reconstruction is only applicable to knee joint without degeneration, more osteophyte affects the way of using fitting point to determine the plane of tibia with real tibia platform conformity degree, have some limitations. For measurement of MRI, it could not only correct tibial rotation, but also minimize the effect of osteophytes by using tibial anatomical axis as the reference axis, which is a good measurement method. For the biomechanical relationship between tibial posterior slope and tibial posterior slope, increased tibial posterior slope indirectly alleviates tension of PCL through tibial anterior displacement or directly reduces load on posterior cruciate ligament in tibial osteotomies, suggesting a protective mechanism for tibial posterior slope;in total knee arthroplasty with cruciate ligament preserved, the size of tibial posterior slope will affect roll back mechanism of femur. When affected knee with PCL injury, it should be avoid to release then aggravate injury, and the stress could be alleviated by increasing tibial posterior slope appropriately. There has been no unified conclusion on the range of tibial posterior slope that is most beneficial to PCL. The natural tibial posterior slope is between 7 ° and 10°, which is considered to be the most beneficial to protection of PCL, but further studies are needed according to the differences in patients' bone status, surgical methods and so on.
Arthroplasty, Replacement, Knee/methods* ; Femur/surgery* ; Humans ; Knee Joint/surgery* ; Osteophyte/surgery* ; Posterior Cruciate Ligament/surgery* ; Tibia/surgery*

Aim To investigate the pharmacokinetic characteristics of silibinin in Chinese healthy volunteers.Methods Nine Chinese male healthy volunteers were divided into receiving orally a single dose of silibinin capsule corresponded 70,140 and 280 mg of silibinin,respectively,in Latin square design study.After administration of silibinin capsule,the plasma concentrations were determined by HPLC with UV detection.The pharmacokinetic parameters were analyzed by Topfit 2.0 program.Results The linearity of this method was found to be from 3.125 to 10 000 μg·L~(-1) with a lower limit of quantitation(LLOQ) of 3.125 μg·L~(-1) for silibinin.The pharmacokinetic parameters were calculated as the follows:at the three different dosages(70,140 and 280 mg),T_(1/2) was 2.44,2.38 and 2.47 h;C_(max) was 1135.6,2841.1 and 3946.9 μg·L~(-1);T_(max) was 1.35,1.26 and 1.39 h;AUC_(0-11 h) was 1287.2,3337.8 and 5398.5 μg·h·L~(-1);AUC_(0-∞)was 1300.7,3377.1 and 5453.9 μg·h·L~(-1);CL/F was 1062.1,824.7 and 943.2 ml·min~(-1);And V_d was 219.9,167.1 and 212.0 L,respectively.Conclusions The developed method is shown to be sensitive,accurate and simple,and can satisfy the requirement of pharmacokinetic study of silibinin in human.The C_(max),AUC_(0-11 h) and AUC_(0-∞) of silibinin in Chinese healthy volunteers(in ranges of 40～120 mg)are fitted with non-linear kinetic model,while there are no significant differences in T_(1/2) at the three different dosages.

A 48-year-old man presented with a 4-day history of fever and 10-year history of papulovesicles on the face, neck, trunk and limbs which had been aggravated 10 days prior to the presentation.Skin biopsy showed a dermal infiltration of numerous small- to medium-sized atypical lymphocytes, which was mainly located around blood vessels or appendages, with the involvement of subcutaneous fat tissue and destruction of blood vessels. The infiltrating atypical cells stained positive for CD45RO, CD8, CD56, T-cell intracellular antigen-1, granzyme B, Epstein-Barr virus-encoded small nuclear RNAs (EBER), but negative for CD20, CD79a, CD3, CD4 or CD30. Cytoplasmic CD3ε was also observed in these cells. Laboratory examinations on admission revealed a progressive decrease in peripheral erythrocytes, white cells and platelets, persistent increase in serum aminotransferase and bilirubin, and decline in serum fibrinogen and hypertriglyceridemia. The B-mode ultrasound of the abdomen showed hepatosplenomegaly. Based on the above findings,the diagnosis was made as extranodal nasal type NK/T-cell lymphoma of skin complicated by hemophagocytic syndrome.

Objective To evaluate the role of miR-143, miR-145 in the development of gastric gastrointestinal stromal tumor. Methods The expression levels of miR-143 and miR-145 in 21 cases of gastric gastrointestinal stromal tumor and the matched non-tumor adjacent tissue specimens were examined by stem-loop real-time RT-PCR, and its correlation with clinicopathologic features of gastric gastrointestinal stromal tumor were analyzed. Results Expression level of miR-145 were significantly higher in tumor than adjacent normal tissues (P＜0.01 ) and that with mitotic count ≥ 5/50HPF cases was significantly lower than that with mitotic count ＜5/50HPF cases (P=0.02). miR-145 expression in huge tumor (＞10 cm)was significantly lower than that in the large tumor (5～10 cm) and small tumor (2～5 cm) (P=0.048).By Fletcher risk stratification system, miR-145 expression in high-risk cases was significantly lower than that in the intermediate-risk and low-risk cases (P=0.048). While the expression of miR-145 in low-risk group was significantly different compared to that in intermediate-risk group and high-risk group (P=0.01).There was no difference between the expressions of miR-143 in tumor and that in normal tissue(P=0.06).Conclusion In gastric gastrointestinal stromal tumor, MiR-145 expression is significantly higher in tumor than adjacent normal tissues. miR-145 is closely associated with tumor size. mitotic counts and Fletcher risk stratification system.

A 38-year-old woman presented with a 20-year history of yellow papules and band-like atrophy on the right neck. The lesions developed slowly and were asymptomatic. There was no history of long-term sun exposure or family history of similar diseases. Skin examination revealed multiple irregularly sized yellow papules and plaques on the right anterior neck following cleavage lines, multiple pin cap-sized perifollicular papules on the posterior right neck. Well-defined band-like atrophic patches with fine wrinkling were observed in the whole right neck, giving an aged appearance. The skin of the left neck was nearly normal. Pathological examination of biopsy specimens from the yellow papules showed a normal epidermis, scant lymphohistiocytic and melanophage infiltrates around the vessels in the superficial dermis without solar degradation. The collagen bundles in the mid dermis were slightly thickened and arranged tightly in parallel to the skin surface with the absence of inflammatory infiltrate. Verhoeff-van Giesen's staining confirmed a nearly complete absence of elastic fibers in the mid dermis as well as obvious swelling and breakage of resident scant elastic fibers. Von Kossa's staining was negative. Based on the above findings, the diagnosis was made as unilateral mid-dermal elastolysis.