Objective To investigate clinical efficacy of adefovir dipivoxil (ADV) combined with interferon α-2b in treatment of chronic hepatitis B.Methods During Jan 2008 to Dec 2014,ninety patients with chronic hepatitis B were divided into adefovir dipivoxil group (33 cases),interferon group (28 cases),and adefovir dipivoxil combined with interferon α-2b group (29 cases).Alanine aminotransferase (ALT) normalization rate,negative rate of HBV-DNA,and HBeAg/anti-HBe seroconversion rates were evaluated among three groups.Results After 48 weeks of treatment,HBeAg negative rate,HBV-DNA negative rate,and ALT normalization rate of combination group were significantly higher than that of interferons αt-2b group and adefovir dipivoxil group (P ＜ 0.05).Conclusions Adefovir dipivoxil combined with interferon α-2b treatment can inhibit the hepatitis B virus,increase the negative rate of HBV-DNA and HBeAg,and reduce liver cell damage.

Objective To investigate the effect of acupuncture at Huatuo jiaji points plus virtual balancing game on balance function in stroke patients.Methods Fifty patients with poststroke balance dysfunction were randomly allocated: 25 cases to the treatment group and 25 cases to the control groups. The treatment group received acupuncture at Huatuo jiaji points plus virtual balancing game-based rehabilitation training and the control group, virtual balancing game-based rehabilitation training alone. The Berg Balance Scale (BBS) score, the Timed Up and Go Test (TUGT) score, the COP offset distance indices (EO2, EC2, EOTS and EO1) and the modified Barthel Index (MBI) score were recorded in the two groups before and after treatment.Results There were statistically significant pre-/post-treatment differences in the BBS score, the TUGT score, the COP offset distance indices and the MBI score in the two groups of patients (P<0.05). There were statistically significant post-treatment differences in the BBS score, the TUGT score, the COP offset distance indices and the MBI score between the treatment and control groups (P<0.05).Conclusion Acupuncture at Huatuo jiaji points plus virtual balancing game is an effective way to treat poststroke balance dysfunction.

Objective To analyze factors influencing β-blocker response rates of patients with portal hypertension and to explore the effect of nursing interference for increasing response rates with goal-directed nursing model. Methods 83 cases of portal hypertension were enrolled.Questionnaire about medical visiting behaviors and medication compliance were compared and analyzed after routine medication for 3 months.Bivariate and multivariate regression analysis were performed and related factors were used to establish a goal-directed nursing model for nursing interference guidance.52 non-response patients were randomly divided into the study group(27 cases)and the control group(25 cases).In the study group,compensation system and supportive-education according to Orem model were given,while the control group was given routine nursirng.Response rates and related factors were compared after 3 months of nursing intervention. Results Awareness of self-care responsibility,knowledge about the medication target,risk of sudden drug withdrawal,related medical knowledge,ability for pulse rate measurement and dose adjustment according to pulse rate changes were related to the response rates.Multivariate regression analysis showed that awareness of self-care responsibility,sudden drug withdrawal,utilization of social support and regular return visit were the independent factors.In the study group,ability for pulse rate measurement and dose adjustment acconding to pulse rate changes improved,phenomenon of sudden drug withdrawal declined and response rate increased,comparing with the control grpup. Conclusins For patients fail to respond to β-blockers,compliance behavior and medication compliance should be analyzed,and much attention should be paid to the education of the related medical knowledge,risk of sudden drug withdrawal and drag using targets.Goal-directed medel could be a guidance for nursing intervention to increase the response rates.

Thirty four patients with decompensated cirrhosis received umbilical blood stem cell transplantation via hepatic artery from December 2008 to August 2009. The symptoms and biochemical testing results were observed before and after stem cell transplantation. One month after the transplantation,appetite was improved in 32 patients ( 94% ), physical capacity improved in 29 patients ( 85% ) and the abdominal distention relieved in 28 patients (82%). Abdominal B-ultrasonography showed that ascites decreased in 15 cases(60% ), and disappeared in 9 cases(36% ). Six month later the mean serum albumin levels were increased from ( 30. 9 ± 0. 6) g/L to ( 35.5 ± 2. 5 ) g/L( P ＞ 0. 05 );alanine aminotransferase levels decreased from (57 ±7) U/L to (46 ± 10) U/L(P ＞0. 05);total bilirubin decreased from (47 ±5 )μmol/L to (25 ±4) μmol/L(P =0. 017);prothrombin time decreased from ( 17.9 ±0. 7) s to ( 16. 4 ±1.3) s (P ＞ 0. 05 ). Hemophagocytic syndrome developed in one case but no severe adverse reactions occurred. The results indicate that umbilical blood stem cell transplantation may improve liver function in various degrees with safety for patients with liver cirrhosis.

Objective: To investigate the associations between early life exposure to particulate matter with an aerodynamic diameter less than 2.5 μm (PM 2.5 ) and the risk of autism spectrum disorder (ASD) among school aged children. Methods: A total of 165 children with ASD and 165 age and gender matched typical development (TD) children were recruited. Children s basic information were obtained via questionnaires, and the severity of ASD symptoms was assessed with Social Responsiveness Scale (SRS). Early life PM 2.5 exposure (preconception, entire pregnancy, and the first two years after birth) were extracted from the Tracking Air Pollution in China (TAP) datasets. Conditional Logistic regression and generalized linear model were used to evaluate the associations of early life exposure to PM 2.5 with the risk and the ASD severity symptoms, respectively. Results: The PM 2.5 exposure of ASD group during preconception[(55.08±9.34)μg/m 3], entire pregnancy[(50.44±8.71)μg/m 3], the first year after birth [(45.04± 8.25 )μg/m 3] and the second year after birth [(40.19±7.12)μg/m 3] were significant higher than those in TD children [(47.66± 7.63 , 44.19±7.16, 38.95±6.07, 35.76±5.65)μg/m 3]( t =7.94, 7.13, 7.70, 6.32, P <0.05). After adjusting for potential confounding, each increase of 1 μg/m 3 in PM 2.5 was associated with higher risk of ASD during preconception ( OR=1.21, 95%CI =1.13-1.29), entire pregnancy( OR=1.18, 95%CI =1.11-1.26), the first year after birth ( OR=1.30, 95%CI =1.18-1.43) and the second year after birth ( OR=1.29, 95%CI =1.17-1.42). No similar results were observed regarding the analyses of SRS total and sub scale scores( P >0.05). Conclusion Early life exposure to PM 2.5 is relate to the risk of ASD, these findings indicated that more attention should be paid to ambient PM pollution in the early life prevention and control of ASD.

Objective To evaluate the role of α7 nicotinic acetylcholine receptor (α7nAChR) in postoperative cognitive dysfunction in aged rats with tibial fracture. Methods One hundred and fifty clean-grade healthy male Sprague-Dawley rats, aged 18-22 months, weighing 440-580 g, were divided into 5 groups ( n=30 each ) using a random number table method: control group ( group C ) , sham operation group ( group S) , tibial fracture group ( group T) , normal saline group ( group N) and α7nAChR agonist PUN282987 group (group P). Group C received no treatment. Ten percent chloral hydrate 0. 4 ml/100 g was injected intraperitoneally in group S. Group T underwent tibial fracture. PUN2829872. 4 mg/kg was in-traperitoneally injected at 5 min before tibial fracture in group P . The equal volume of normal saline was giv-en at 5 min before tibial fracture in group N. Morris water maze test was performed at day 7 after surgery. At days 1, 3 and 7 after surgery, the pathological changes of the hippocampal CA3 region were observed by haematoxylin and eosin staining, and the expression of α7nAChR, choline acetyltransferase ( ChAT ) , tumor necrosis factor-α( TNF-α) and interleukin-1β( IL-1β) in the hippocampal CA3 region was measured by Western blot. Results Compared with group C, the postoperative escape latency and swimming dis-tance were significantly prolonged, and the expression of α7nAChR, ChAT, TNF-α and IL-1β was up-regulated at each time point after operation in T, N and P groups ( P＜0. 05) , and no significant change was found in the parameters mentioned above in group S ( P＞0. 05) . Compared with group T, the postoper-ative escape latency and swimming distance were significantly shortened, and the expression of α7nAChR and ChAT was up-regulated and the expression of TNF-α and IL-1β was down-regulated at each time point after operation in group P ( P＜0. 05) , no significant change was found in the parameters mentioned above in group N ( P＞0. 05) , and the pathological changes of the hippocampal CA3 region were significantly at-tenuated in group P. Conclusion α7nAChR antagonism is involved in the development of postoperative cognitive dysfunction in aged rats with tibial fracture.

Based on LCD Module and Visual C++ development environment, this paper proposes a new method which can quickly develop the human-machine interface .We define a LCD module programming interface by designing Serial Communication Class(SCS). On this basis,we achieve the transplantation on an Embedded ARM Platform to fulfil the requirements of Medical Diagnostic Instruments (MDI). Experimental results show that this method has advantages of short development cycle and high level transplantation which has broad application prospects in the field of Medical Diagnosis Instrument.
Diagnosis, Computer-Assisted ; instrumentation ; Equipment Design ; Liquid Crystals ; Robotics ; instrumentation ; methods ; Software ; User-Computer Interface

Objective:To investigate the correlation between serum uric acid level and heart rate variability (HRV) in patients with acute ischemic stroke.Methods:Patients with acute ischemic stroke admitted to the Department of Neurology, the First Affiliated Hospital of Nanjing Medical University from July 2017 to July 2019 were enrolled retrospectively. They were divided into 4 groups (Q1, Q2, Q3, and Q4) according to the sex-specific serum uric acid quartiles. The demographic data, baseline clinical data, laboratory indicators and HRV recorded by 24-h dynamic electrocardiogram in each group were compared. The independent correlation between HRV time domain parameters RR (normal-to-normal, NN) interval standard deviation (standard deviation of the NN intervals, SDNN), RR interval mean standard deviation (standard deviation of the average NN intervals, SDANN) and serum uric acid level was analyzed through multiple linear regression model.Results:A total of 141 patients were enrolled in the study, including 100 males (70.92%), aged 61.55±12.92 years. The median baseline National Institutes of Health Stroke Scale (NIHSS) score was 2 (interquartile range: 1-4), and the serum uric acid level was 302.87±73.48 μmol/L. There were significant differences in the NIHSS score ( P<0.034), the proportion of patients with hypertension ( P=0.015), the estimated glomerular filtration rate ( P<0.001), and the HRV time domain parameters (all P<0.001) between each quartile group. The proportion of patients with low HRV (SDNN <100 ms) in the lowest serum uric acid level quartile group was significantly higher than that in other quartile groups ( P<0.05). Multiple linear regression analysis showed that serum uric acid levels were significantly and positively correlated with SDNN (standardized β=0.321, P<0.001) and SDANN (standardized β=0.266, P=0.001). Conclusions:The low level of serum uric acid in patients with acute ischemic stroke indicates that HRV is low, which may suggest that the mechanism of oxidative stress is involved in the decrease of HRV in patients with acute ischemic stroke.

Objective:To investigate the neutrophil to lymphocyte ratio (NLR) and clinical manifestations, imaging manifestations and plasma D-dimer in cerebral venous sinus thrombosis (CVST) patients with headache as the first symptom.Methods:CVST inpatients with headache as the first symptom admitted to the First Affiliated Hospital of Nanjing Medical University from January 2012 to December 2019 were enrolled retrospectively as case group. In the same period, patients with similar headache symptoms and healthy subjects were included consecutively as control group. The differences of demographic data, biochemical indexes, blood routine indexes and plasma D-dimer were compared among the three groups. Multivariate logistic regression analysis was used to identify the independent correlation between NLR and plasma D-dimer and CVST with headache as the first symptom. According to the median NLR, patients with CVST were divided into low NLR group and high NLR group, and the differences in clinical manifestations, imaging manifestations and plasma D-dimer were compared between the two groups. Multiple linear regression analysis was used to determine the independent correlation between the reciprocal of NLR and plasma D-dimer and clinical features. Results:A total of 51 CVST inpatients with headache as the first symptom, 54 headache controls and 53 healthy controls were included in the study. There were significant differences in triglyceride ( P=0.002), fasting blood glucose ( P=0.044), serum albumin ( P=0.013), uric acid ( P=0.010), plasma D-dimer ( P<0.001), proportion of D-dimer negative patients ( P<0.001), mean corpuscular volume ( P=0.015), white blood cell count ( P<0.001), neutrophil count ( P<0.001), lymphocyte count ( P=0.005), monocyte count ( P=0.004), mean platelet volume ( P=0.010), platelet distribution width ( P=0.029), NLR ( P<0.001) and lymphocyte to monocyte ratio ( P<0.001) among the three groups. Post-hoc analysis showed that plasma D-dimer and NLR in the case group were significantly higher than those in the two control groups (all P<0.001). Multivariate logistic regression analysis with the headache control group and the healthy control group as references showed that NLR and plasma D-dimer were significantly and independently correlated with CVST with headache as the first symptom (all P<0.05). According to the median NLR (4.817 6), the case group was divided into low NLR group and high NLR group. The comparison showed that the onset time ( P=0.041), the proportion of patients with headache as the only symptom ( P=0.016) and the proportion of plasma D-dimer negative patients ( P=0.002) in the low NLR group were significantly higher than those of the high NLR group, and the proportion of patients with headache complicated with disturbance of consciousness ( P=0.032), plasma D-dimer ( P<0.001) and fasting blood glucose ( P<0.001) were significantly lower than those in the high NLR group. With the reciprocal of NLR as the dependent variable, multiple linear regression analysis showed that the reciprocal of NLR was independently negatively correlated with plasma D-dimer ( R=-0.521, P<0.001), and independently positively correlated with headache as the only symptom ( R=0.280, P=0.049). Conclusions:NLR was significantly increased in CVST patients with headache as the first symptom. It might help early diagnosis and clinical feature prediction of CVST patients.

Objective:To evaluate the relationship between the tea drinking habit and postoperative delirium (POD) in elderly patients.Methods:Two hundred and ninety-two patients, aged 65-85 yr, weighing 50-80 kg, of American Society of Anesthesiologists physical status Ⅰ-Ⅲ, undergoing elective knee/hip arthroplasty under spinal-epidural anesthesia in our hospital, were enrolled in this study.The patient′s cognitive function was assessed using Mini-Mental State Examination at 1 day before operation.Peripheral venous blood samples were collected before anesthesia, and the concentrations of caffeine and tea polyphenols in plasma were measured by enzyme-linked immunosorbent assay.In the anesthesia recovery room after operation and at 1, 3 and 7 days after operation (or before discharge), neuropsychological tests were performed, and the Delirium Rating Scale was used to recognize POD developed.The patients were divided into POD group (P group) and non-POD group (NP group) according to whether POD occurred after operation.Logistic regression analysis was used to analyze the variables of which P values were less than 0.05. Results:There was no significant difference in age, American Society of Anesthesiologists physical status, concentrations of caffeine and tea polyphenols in plasma between P group and NP group ( P<0.05). The results of logistic regression analysis showed that age was an independent risk factor for POD, and concentrations of caffeine and tea polyphenols in plasma and tea drinking habits were protective factors for reducing the occurrence of POD in elderly patients. Conclusion:Tea drinking habit is a protective factor for reducing the occurrence of POD in elderly patients.