Objective To explore the use of lamivudine alone induced the poor response,especially the related factors of the occurrence of YMDD.Methods Retrospective analysis of 160 cases of the poor answering cases after lamivudine treatment,the baseline parameter values,the time appearing to the poor answering and the HBVDNA load in treatment were analyzed,to study their relationship with poor response.Results The lamivudine prolonged,the poor response to the probability gradually increase.The mutation rate in the 12nd month was 19.67％ and in the 36th month was 49.18％ ( P ＜ 0.05 ).Response to the many reasons,the YMDD mutation is the more common one.The relationship among HBVDNA load,ALT level on baseline and the rate of poor response emergence,the YMDD mutation rate was clear.By comparison in groups,the difference was significant (P＜0.05).Conclusion The lower baselins of ALT level,the higher of HBVDNA load,the greater probability of the poor response and the YMDD mutation.

【Objective】In order to establish the foundation for transgenic mouse model,the human thalassemic gene(β654) was cloned and sequenced.【Methods】The human β654 gene was amplified by PCR,and cloned into the plasmid BGT51 in which the human β gene was cut out aforehand.The recombinant plasmid was certified by enzyme-digestion,reverse dot hybridization and sequencing.【Results】A recombinant plasmid was obtained,which contained the human β654 gene in the correct recombinant direction.Sequencing showed that the cloned insert was correct.【Conclusions】The recombinant plasmid constructed is useful for establishing a transgenic mouse.

ObjectiveTo discuss the causes and the managem ent of hemorrhagic c omplications after sterotactic surgery for Parkinson's disease (PD).Me thodsA total of 350 PD patients unresponsive to drug therapy from April 1999 to Decemb er 2001 underwent sterotactic surgery. Intracranial hemorrhage occurred in 6 cas es, consisting of 3 cases of lesion hemorrhage and 3 cases of puncture path hemo rrhage.ResultsOf the 6 cases, 4 were treated by surgical ope rations, with re covery of consciousness but hemiplegia left, and 2 were treated conservatively w ithout dysfunction left. No fatal cases were seen in the study.Conclus ionsHe morrhagic complications are often in association with repeated puncture, excessi ve heat, operative skills, patient's general condition and so on. Accurate targe t location by MRI combined with microelectrode guidance, reduce of microelectrod e recording times, lowering of the lesion temperature, and sufficient perioperat ive care contribute to the prevention of intracranial hemorrhagic complications.

ObjectiveTo study the clinical effects of X-kn ife in the treatment of intracranial meningiomas.MethodsA retrospective analysis of 52 cases of intracranial meningioma treated by X-knife was made. The peripheral dose was (10 ～20) Gy, with a mean of 13 Gy. Follow-up checkups consisted of clinical examina tions and contrast-enhanced CT scans.ResultsAfter the treatm ent, unilateral m ild hemiplegia occurred in 1 case (1 9%) and local epileptic attack occurred in 2 cases (3 8%). Imaging findings revealed asymptomatic transient peritumoral ed e ma in 12 cases (23 1%). Follow-up imaging lasting (3～92) months (mean, 23 mont hs ) in 40 cases (76 9%) found regression of tumor in 18 cases (45 0%) and unchan ge d tumor size in 22 cases (55 0%).ConclusionsX-knife is an e ffective and safe procedure for meningiomas.

ObjectiveTo evaluate the efficacy of the dual channel deep brain s timulation (DBS) for Parkinson's disease (PD). MethodsThirte en patients with PD presenting bilateral symptoms underwent dual channel DBS of bilateral subthal amic nucleus. The targets were identified by a combination of MRI scanning and m icroelectrode recording. Unified Parkinson's Disease Rating Scale (UPDRS) scores were evaluated postoperatively.ResultsAll the 13 patients w ere followed for 3 months～3 years, with a mean of 6 3 months. When the pulse generator was tur ned on, UPDRS motor scores showed 62 3% symptomatic improvement (75 5% improve me nt in those responsive to dopaminergic therapy) during the “off” status and 24 2% during the “on” status. No complications occurred.Conclusions DBS of bilateral subthalamic nucleus may significantly improve the motor functions in PD patients.

ObjectiveTo evaluate the clinical effects of microelectrode guided stereotactic pallidotomy and/or thalamotomy and deep brain stimulation (DBS) in the management of Parkinson's disease.MethodsA total of 510 patients with P arkinson's disease underwent stereotactic operations and 30 patients underwent D BS from April 1999 to March 2003. The 510 cases consisted of 385 cases of poster oventral pallidotomy (PVP), 91 cases of ventral intermedius (Vim) thalamotomy, 1 2 cases of PVP together with Vim thalamotomy on the same side, 8 cases of PVP on both sides at the same time, 10 cases of PVP on both sides at different times, and 4 cases of PVP on one side while Vim thalamotomy on the other at different t imes. Of the 30 cases of DBS (unilateral, 18 cases; bilateral, 12 cases), target s were located in subthalamic nucleus(STN) in 29 cases and ventralis intermedius nucl eus in 1 case.ResultsUnified Parkinson's disease rating scal e (UPDRS) scores were recorded postoperatively. Of the 510 cases, during the “off” and “on” stat es, symptoms improved by 47 3% and 38 7%, respectively. “On-off” phenomena a nd m otor symptoms disappeared. Follow-up information with a mean of 11 6 months in 2 20 cases revealed excellent outcomes in 130 cases (59 1%), improved in 75 (34 1%), a nd no change in 15 (6 8%). Of the 30 cases of DBS, during the “off” and “on ” state s, symptoms improved by 45 2% and 25 7%, respectively. All the 30 patients wer e followed for a mean of 10.3 months. No parameter adjustment was needed after 1 p ostoperative month in 18 cases, while the adjustment after operation was require d in the remaining 12 cases.ConclusionsPallidotomy is much m ore effective th an thalamotoy in Parkinson's patients with tremor. DBS can effectively control t he patient's motor symptoms.

Objective To evaluate the matching degree of donor's and receptor's tissue typing and analyze the relationship between the degree and the early survival of cardiac transplantation with donor's and receptor's tissue typing of 9 cases of cardiac transplantation. Methods In accordance with the international standard, donor's and receptor's blood type, HLA antibody, lymphocytotoxicity and panel reactive antibody were determined in 9 cases of cardiac transplantation, and the donor's and receptor's matching degree evaluated by methods of amino acid triplets and cross-reactive group. Results Of 9 cases, 6 survived while 3 died. Of the 3 dead cases, 2 came respectively from the two best comprehensively evaluated matching cases and two worst, and postoperative biopsy showed that there was no rejection in either survival cases or the dead cases. Conclusion With the effective immunosuppressant, the HLA typing doesn't affect the early survival.

Objective To investigate the effects of the expressions of thymidine kinase 1 (TK1) and Ki67 alone or their combination on the recurrence and metastasis of breast cancer.Methods Sixty-five samples were selected from the Second Affiliated Hospital of Guangzhou Medical University from March 2005 to June 2007,which were resected by surgical operation and confirmed as breast carcinoma by pathology.They were individed into two groups including 37 cases with recurrence or metastasis in 5 years (group A),28 cases without recurrence or metastasis in 5 years (group B).The expressions of TK1 and Ki67 in the two groups were detected by immunohistochemical staining assay.Then,Kaplan-Meier assay was used to describe survival curve.Results The positive expression rate of TK1 in group A was 91.8％,which was dramatically higher than that in group B 67.8％ (x2 =6.116,P =0.013).The positive expression rates of Ki67 in group A and B were 78.4％ and 42.9％ (x2 =8.635,P =0.003).The positive expression rates of TK1 combined with Ki67 in group A and B were 67.6％ and 39.3％ (x2 =5.159,P =0.023).Moreover,disease free survival of patients with positive expression of TK1 combined with Ki67 decreased significantly,compared with patients with positive expression of TK1 or Ki67 alone (x2 =6.137,P =0.046).Conclusion Positive expression of TK1 combined with Ki67 is the high risk factor of the reccurence or metastasis of breast carcinoma,and indicates poorer prognosis compared with positive expression alone.

Objective To investigate the effect of high frequency stimulation of bilateral nucleus accumbens on relapse behaviors in morphine-dependent rats.Methods Twenty adult SD rats were employed in the experiment.Through stereotactic operation,outer electrode cannula was implanted into rats' bilateral nucleus accumbens.After 5 days of rest,the morphine-dependent rat model with conditioned place preference (CCP) was established through intraperitoneal morphine injection (10 mg/kg).After acquisition of CPP,normal saline was replaced with morphine for CPP extinction training.CPP test was used to exam the effect of extinction.The rats,after being randomly divided into experimental group (morphine+DBS) and control group (morphine+sham DBS),were electrically stimulated using modified DBS circuits.Rats in the experimental group were given high frequency electrical stimulation while the control group was sham stimulation.After consecutive stimulation for 7 days,rats in the two groups were given small dose of morphine (3 mg/kg)to trigger relapse.Results (1) The CPP score increased after the establishment of rat models compared with pre-establishment of the rat models((616.2±74.7) s vs (353.9±84.3) s,P＜0.01).(2) The CPP score after extinction training decreased compared with pre-conditioned CPP score ((456.4± 148.8) s vs (353.9±84.3) s),P=0.0847) and had no statistical difference compared with post-conditioned CPP score ((456.4±148.8) s vs (616.2± 74.7) s,P=0.0219).(3) When the relapse was induced by small doses of morphine within 24h after the last stimulation,the CPP score of the experimental group decreased compared with the CPP score of control group ((330.1 ±212.6) s vs (684.2±230.2)s,P=0.0029),and the relapse was restrained.Conclusion High frequency DBS of bilateral nucleus accumbens can attenuate relapse behavior in rats

Objective To study the value of two-dimensional Echocardiography(2DE)and doppler tissue synchronization imaging (TSI) during early diagnosis of close myocardial contusion.Methods 9 small Guizhou-Panama pigs were used.The close myocardial contusion animal model was successfully established by using the serf made small impactor.Echocardiography wag applied before and after injury for 0.5,2,4,8 and 12h respectively,these data were analyzed together with the TYC pathological results.Results After the strike for 0.5h,the location and area of the damage call be directly and rapidly shown by 2DE and TSI,which showed that after myocardial contusion (MC),main damaged areas are anterior and lateral myocardial walls.After myocardial contusion MC,three echocardiography techniques were used to observe the scale of the abnormal segment,the movement of the myocardial wall,Time tO Peak of Systolic Velocity and wall motion segmental inter(WMSI),Time to Peak of Systolic Velocity index(TPI),which all were increased than that pre-injury.Conclusion 2DE and TSI can be used for accurately early diagnosis of the location of myocardial contusion.TSI is more specific for the diagnosis of myocardial contusion.