OBJECTIVE To investigate the distribution of familial hepatitis B virus (HBV) genotypes and analyze the relationship between genotypes and clinical outcome. METHODS A total of 136 cases of familial hepatitis B were involved in this study,including 25 cases of asymptomatiec HBV carriers (ASC),85 cases of chronic hepatits B (CHB),24 cases of liver cirrhosis (LC) and 4 cases of hepatocellular carcinoma (HCC). Nested polymerase chain reaction-restriction fragment length polymorphism (ntPCR-RFLP)was used to identify the genotypes of HBV. RESULTS There were 124 cases with hepatitis genotype C,7 cases with genotypes B+C mixed,3 cases with genotype B and 2 cases that did not conformed to be any of genotypes from A to H. Genotype C in the HCC was predominant genotype (100%),next in the LC(96%),CHB (95.3%) and ASC(66.7%).Compared with genotype C,genotypes B and B+C only existed in ASC and CHB,the proportion was 9.5% vs 23.8% and 1.2% vs 2.3%,respectively. There were no other HBV genotypes from A to H seen in familial hepatitis B in Shanxi province. CONCLUSIONS HBV genotype C is the major one in familial hepatitis B in Shanxi. There are a few genotypes B and B+C existed. Genotype C induces a relatively bad prognosis.

Objective To investigate the clinical characteristics and therapeutic plan of Miller Fisher syn-drome( MFS) complicated with Guillain-Barrésyndrome( GBS) .Methods The clinical data of one patient of MFS complicated with GBS was reviewed retrospectively,and analysis combined with literature review was given.Results The patient had infectious history before the onset of MFS and GBS.Clinical manifestations included MFS triad,bulbar paralysis,bilateral facial paralysis,protein-cell dissociation of cerebrospinal fluid and neurogenic damages in electro-myography.Plasm exchange and adrenocortical hormones treatment were effective.Conclusion MFS complicated with GBS is an independent disease which is different from MFS or GBS.It has its distinct clinical features which should apply appropriate treatment.

Objective]To explore the clinical value of the theories in the seven papers of Yunqi.[Method] Analysing the usage of the correlation theories of Yunqi in Cases of Well-known Physicians and its sequel, consulting the commentaries and application of many well-known physicians, this paper summarizes some theories which are applicable to clinic.[Result]In the seven papers of Yunqi, the theory of avoidance of harm by restraining excess and the theory about the inconformity of pulse and disease can exclude false symptoms and infer real pathogenesis.19 questions about pathogenesis can be a reference of clinical diagnosis.The theory of South-North can be used to exclude the impact of climate on the pulse and assist diagnosis. Rationally using the theory of Suiyun contributes to infer etiology and establish therapy.[Conclusion]Cases of Well-known Physicians and its sequel reflect the application and exertion of the theories of Yunqi by ancient physicians. They help to understand the theoretical system and instruct clinical application. In addition to the theory of Suiyun, the seven papers of Yunqi also include a lot of theories which are applicable to clinic.

Objective　To investigate clinical features of neonatal ventilator associated pneumonia.Methods　Retrospective analysis of clinical features was performed in twenty-two newborns with ventilator associated pneumonia.Results　Ventilator associated pneumonia were found in 22 ou t of 36 neonates with mechanical ventilation.Conclusion　The incidence of VAP is significantly increased if the time of mechanical ventilation in longer than 96 hours.

Objective To investigate the effects of ketamine on anoxia-reoxygenation(A/R)induced glutamate release from cerebral cortex neurons.Methods Primary cultured neurons obtained from cerebral cortex of fetal Wistar rats(16-18 d)were randomly divided into 3 groups:Ⅰcontrol group;ⅡA/R group andⅢketamine pretreatment+I/R group.The control group was not subjected to A/R while A/R group was exposed to anoxic air(95% N_2+5% CO_2)for 5 h followed by 24 h reoxygenation.In groupⅢdifferent doses of ketamine were added to the culture media before anoxia and the final ketamine concentrations were 1,20 and 100?mol?L~(-1) respectively.The extracellular glutamate concentration was detected at the end of 24 h reoxygenation.Results The extracellular glutamate concentration was significantly higher after 24 h reoxygenation in A/R group than in control group.Ketamine 20 and 100?mol?L~(-1) significantly inhibited glutamate release from the neurons induced by A/R in a dose-dependent manner.Conclusion Ketamine can inhibit glutamate release from neurons induced by A/R in a dose-dependent manner.

Objective To investigate the possible association between vascular endothelial growth factor (VEGF), endostatin (ES) and type 2 diabetic nephropathy. Methods The level of serum VEGF and ES were measured by ELISA in eighty type 2 diabetic patients including thirty subjects without diabetic nephropathy , twenty with microalbuminuria and thirty with macroalbuminuria, and the correlation was analyzed. Results The level of serum VEGF and ES in patients with macroalbuminuria were both significantly higher than that of patients with and without microalbuminuria (P < 0.05). The level of serum VEGF and ES in patients with microalbuminuria were significantly higher than that of patients without diabetic nephropathy (P<0.05). Both VEGF and ES level were positively correlated with the level of microalbuminuria (mAlb) (r=0.226, P<0.01; r=0.491, P<0.01), and negatively correlated with the level of estimated glomerular filtration rate (eGFR) (r=-0.237, P<0.05;r=-0.620, P<0.01). There was a significantly positive correlation between VEGF and ES in patients with microalbuminuria and macroalbuminuria (r1=0.633, P1<0.01; r2=0.532, P2<0.05). However, there was no correlation between VEGF and ES in patients without diabetic nephropathy (r3=0.175, P3>0.05). Conclusion The levels of VEGF and ES in type 2 diabetic nephropathy had varying degree of increasing in different diabetic nephropathy stage , and closely related to mAlb and eGFR. Disequilibrium of VEGF and ES may speed up the progression of diabetic nephropathy.

Objective To explore the comprehensive approach of rhinoplasty using autologous costal cartilage and e-PTFE,and to observe the outcome and possible complications.Methods A 3-4 cm long costal cartilage was taken out mostly from the 6th or 7th rib and then divided into several parts and shapes.Structural reconstruction of the nasal tip was then done with these costal cartilage parts.Radix augmentation was conducted with e-PTFE.Results From Jan.2013 to Sept.2014,48 patients were treated with this method,all females,aged 22-35 years.36 of them had received rhinoplasty before,12 of them received none.Satisfying aesthetic contouring of the nasal tip and dorsum had been achieved in 45 patients.Deviation of the collumella and nostril asymmetry were found in 3 patients.Among all patients,no such complications as pneumothorax,hemothorax,infection,or hemotoma were observed.The scar on the donor site was not obvious.Conclusions Costal cartilage is sufficient,supportive and easily shapable,when applied to the structural reconstruction of the nasal tip,which can meet the demands of patients who prefer more outstanding and delicate nasal tip contouring.

Objective To investigate the spiral CT features of gastric carcinoma in the invasion and metastasis and its correlation with the expression of phosphatase and tensin horology deleted on chormosome ten(PTEN)and basic fibroblast grouth factor(bFGF).Methods Spiral CT plain scan and triphasic enhanced scans were performed in 83 patients.The postoperative specimens were embedded with paraffin to obtain 5?m thickness tissues and stained with HE and immunohistochemistry.Spiral CT findings were compared with the expression of phosphatase and tensin horology deleted on chormosome ten(PTEN)and basic fibroblast growth factor(bFGF).Results(1)The accuracy of spiral CT in T and N staging of gastric carcinoma was 94.0%(78/83)and 89.2%(74/83),respectively.(2)The expression of PTEN was 47.0%(39/83)in gastric carcinoma.The expression of PTEN in T_(3.4)(40.8%,29/71)and N_(1+2) (38.3%,23/60)gastric carcinoma was significantly lower than that of T_2(10/12)and N_0(16/23)gastric carcinoma,respectively(X~2=7.439,P=0.006;X~2=6.511,P=0.011).(3)The expression of bFGF was 63.9%(53/83)in gastric carcinoma.The expression of bFGF in T(3.4)(70.4%,50/71)and N_(1+2) (71.7%,43/60)gastric carcinoma was significantly higher than that of T_2(3/12)and N_0(10/23)gastric carcinoma,respectively(X~2=7.314,P=0.007;X~2=5.724,P=0.017).(4)Both PTEN-positive expression and bFGF-positive expression were detected in 16 specimens.The expression of PTEN(41.0%, 16/39)was negatively correlated with that of bFGF(30.2%,16/53)(r=-0.447,P=0.000). Conclusion Spiral CT triphasic enhanced scans combined with biologic characteristics can improve diagnostic accuracy of gastric carcinoma in the invasion,metastasis and prognosis.

Objective Tostudyrecentclinicalefficacyandadversereactionsofpemetrexedincombi-nationwithcisplatininthetreatmentofadvancedbreastcancer.Methods Usingenvelopesandrandomlythe patients were dividing into treatment group and control group.The treatment group with 1 8 cases of advanced breast cancer were treated with pemetrexed and cisplatin while in the control group ,23 cases advanced breast cancer patients were treated with gemcitabine and cisplatin with 21 days as a cycle.The efficacy and adverse re-actions were determined according to the WHO on Response Evaluation Criteria in Solid Tumors therapy and chemotherapytoxicityevaluationcriteria.Results Tumorcontrolrateinthetreatmentgroupwas83.3%(1 5/1 8),while in the control group was 78.3%(1 8/23 ),and the difference was not statistically significant (χ2 =0.000 94,P>0.05);while the adverse reactions differenced between the treatment group and the con-trol group were statistically significant(bone marrow suppression χ2 =9.23;fatigue χ2 =4.96;nausea and vomi-tingχ2=4.98;diarrheaχ2=4.45;skinrashχ2=5.03,P<0.05).Conclusion Pemetrexedcombinedwith cisplatin in patients with advanced breast cancer has a good effect,and the adverse reaction is low.

Adult ; Embolism, Amniotic Fluid ; etiology ; therapy ; Female ; Humans ; Pregnancy