Objective To optimize the treatment of chronic hepatitis C recurrence.Methods During May 2008 to May 2012, 50 patients with chronic recurrent hepatitis C were chosen in the infectious department of our hospital.They were divided into two groups with 25 cases in each group.Group A was treated by standard extended treatment scheme,while Group B was treated by standard large dose scheme.The effect was estimated by the observation of sustained virologic response in the two groups (sus-tained virologic response,SVR).Results 32% SVR rate was found in group A and 23% SVR rate was found in Group B.38% re-currence rate appeared in group A after six months and 43% recurrence rate occurred in group B,there were significant difference between two groups(P <0.05).Conclusion The standard extended treatment schemes of pegylated interferon and ribavirin is su-perior to group B in SVR rate.

Objective To evaluate the apphcation of wireless mobile infusion system in the outpatients and emergency patients.Methods A total of 566 outpatients and emergency patients with infusion were divided into the observation group and the control group according to the order of infusion.The observation group with 297 cases was used wireless mobile infusion system,and the control group with 269 cases was used traditional infusion method.The reception time,infusion waiting time and satisfaction for nurses' job of patients between two groups were compared.The satisfaction for job of nurses among different work models were compared,too.Results The reception time,infusion waiting time of patients in the observation group were less than those in the control group:(2.07±0.26) min vs.(3.17±0.26) min,(9.89±0.31) min vs.(13.49± 0.21) min,and there were significant differences,P＜0.01.The satisfaction for nurses' job of patients in the observation group were better than those in the control group,x2=8.921,7.064,5.251,and there were significant differencs,P＜0.05.The satisfaction for job of nurses in the observation group was better than that in the control group,and there was significant difference,P＜0.05.Conclusion Wireless mobile infusion system can improve work efficiency,guarantee the safety of infusion,improve patients and nurses' satisfaction.

Objective To select microRNAs (miRNA) associated with human cutaneous malignant melanoma (MM). Methods Total RNA was extracted from 6 tissue samples of MM and 9 human control samples of pigmented nevi, and small RNAs of less than 200 bp were enriched, miRNA microarray was used to select differentially expressed miRNAs between tissue samples of MM and pigmented nevi from 468 candi-dates. The expression of differentially expressed miRNAs was confirmed by fluorescence based real-time quan-titative PCR (qPCR) in all of these samples. Those miRNAs that were identified as differentially expressed with both miRNA microarray and qPCR were considered as significant miRNAs. Results Between the tissue samples of MM and pigmented nevi, 12.18% to 86.33% of miRNAs differentially expressed by more than 2 folds, 1.28% to 19.02% by more than 5 folds, and 0.43% to 5.34% by more than 10 folds. The expression of miRNA-21 was obviously up-regulated, while that of miRNA-320 and miRNA-494 was down-regulated in the MM samples. Conclusion There is an increase in the expression of homo sapiens miRNA-21 but a decrease in that of miRNA-320 and miRNA-494 in MM tissues.

OBJECTIVETo investigate the effect of photodynamic therapy combined with compound betamethasone in the treatment of hypertrophic scar.

METHODS37 cases of keloid were divided into two groups, 19 cases in the treatment group, 18 cases in the control group. The patients in treatment group were treated with photodynamic therapy combined with compound betamethasone injection therapy. The patients in the control group were treated by compound betamethasone injection. The effect and recurrence rate were compared before and after treatment.

RESULTSThe effective rate was 89.5% in the treatment group, 55. 6% in the control group, showing significant difference between the two groups (P = 0.029) The relapse rate in treatment group was significantly lower than that in the control group (P = 0.047) CONCLUSIONS: Photodynamic therapy combined with compound betamethasone has good effect and safety for the treatment of hypertrophic scar. The combined treatment can reduce the treatment period and side effects

Betamethasone ; therapeutic use ; Case-Control Studies ; Cicatrix, Hypertrophic ; drug therapy ; Combined Modality Therapy ; methods ; Glucocorticoids ; therapeutic use ; Humans ; Photochemotherapy ; methods ; Recurrence

Objective To investigate the effect of postconditioning with propofol and ischemia on the hepatic ischemia-reperfusion (I/R) injury in rats. Methods Thirty male SD rats weighing 200-250 g were randomly divided into 5 groups of 6 animals each: group I sham operation (group S); groupⅡ I/R; group Ⅲ ischemic postconditioning (group IPC); group Ⅳ propofol postconditioning (group PPC) and group V IPC + PPC. In group Ⅱ-Ⅳ the hepatic arteries and veins of middle and left lobes were occluded for 1 h followed by 4 h reperfusion. Ischemia of the liver was confirmed by the color of the liver turning from red to gray. In group Ⅲ and Ⅴ the livers were subjected to six episodes of 10 s ischemia at 10 s intervals at the end of 1 h ischemia before 4 h reperfusion. In group Ⅳ and V 0.5 % propofol 10 mg/kg was given iv at the end of ischemia followed by propofol infusion at 40 mg·g~(-1) ·h~(-1). Blood samples were taken at the end of 4 h reperfusion for determination of serum ALT activity. Mean-while liver specimens were taken for electron microscopic examination and determination of MDA content and SOD activity. Results I/R significantly increased serum ALT activity and MDA content in the liver and decreased liver SOD activity in group Ⅱ . The I/R-induced changes were significantly attenuated by propofol and/or ischemic postconditioning in group Ⅲ ,Ⅱ and Ⅴ . I/R significantly increased Bel-2 and Bax protein expression in the liver cells. Propofol and/or ischemic postconditioning increased Bel-2 protein expression further but decreased Bax protein expression in group Ⅲ , Ⅳ and Ⅴ as compared with group Ⅱ (group I/R).Electron microscopic examination showed that the pathologic changes induced by I/R were less severe in group Ⅲ, Ⅳ and Ⅴ than in group I/R. Conclusion Postconditioning with propofol and ischemia can reduce the hepatic I/R injury and the mechanism may be related to inhibition of lipid peroxidation and apoptosis, but the efficacy is the same as that of propofol postconditioning alone.

Purpose To evaluate short term visual acuity effects of a single photodynamic therapy(PDT) treatment with Visudyne (CIBA Vision Corp, Duluth, Ga) for choroidal neovascularization (CNV) in age related macular degeneration (AMD). Methods Definitely diagnostic AMD patients with classic CNV were treated with PDT (5 cases, 7 eyes). The data of visual acuity testing, ophthalmic examination, color photographs, optic coherence tomography, fluorescein angiograms and indocyanine green angiogram before photodynamic therapy and 1 week ,1 month after it were used to evaluate the effects of a single treatment of PDT with Visudyne. Results The visual acuity of all the treated eyes at the follow up examination at 1 month after PDT were not reduced. Distinct reduction of fluorescein leakage from CNV was noted in all patients by 1 week after PDT. Fluorescein leakage from a portion of the CNV reappeared by 1 month after treatment in 2 eyes. Conclusion PDT with Visudyne achieved short term cessation of fluorescein leakage from CNV without loss of vision or growth of classic CNV in some patients with AMD.

Objective To summarize the clinical results and safety of photodynamic therapy (PDT) through 4 years after single and multi-treatments of patients with subfoveal choroidal neovascularization (CNV) caused by age-related macular degeneration (AMD). Methods Clinical data of 73 AMD cases (95 eyes) diagnosed through fluorescein angiography (FFA), indocyanine green angiography (ICGA) and optic coherence tomography (OCT), treated with PDT were reviewed and analyzed in this hospital from June 2000 to June 2004. The changes of best corrected visual acuity (BCVA), fundus pictures, FFA, ICGA and OCT were compared before and after PDT. Follow-up time varied from 3 months to 4 years (mean, 2 years). Results The mean age of 73 patients was 67.8 years old. The BCVA was from (CF/10 cm) to 1.0. At the final follow up, the BCVA was improved (increase≥2 lines) in 39 eyes (41.1%), stabilized (?1 line) in 51 eyes (53.7%) and decreased 2 lines in 5 eyes (5.3%). Fundus hemorrhage and exudation reduced after PDT. FFA and ICGA showed CNV complete closure in 58 eyes (61.05%), partial closure in 6 eyes (6.32%), CNV incomplete closure in 22 eyes (23.16%) and recurrence in 9 eyes (9.47%). After once PDT of 12 eyes with early-stage AMD, the BCVA improved (from 0.6 to 1.5), CNV completely closed, and the OCT showed disappearance of macular edema and neursensory retinal detachment. No CNV recurred in our four years follow-up observation and the BCVA of the patients remained stable. The mean number of PDT treatment was 1.8 per eye in 95 cases. No serious local or systemic complications were encountered. Conclusions Single or multiple sessions of PDT can acheive long-term safety and efficacy. For early-stage AMD patients with minimally classic CNV, PDT can completely make CNV closed and reduce the risk of visual loss.

BACKGROUND:Percutaneous transforaminal endoscopic discectomy combined with radiofrequency annuloplasty is a minimaly invasive therapy for chronic discogenic low back pain, especialy suitable for lumbar disc herniation. OBJECTIVE:To evaluate the safety and short-term efficacy of percutaneous transforaminal endoscopic discectomy combined with radiofrequency annuloplasty for treatment of lumbar disc herniation. METHODS:Thirty-two patients with lumbar disc herniation were subjected to percutaneous transforaminal endoscopic discectomy combined with radiofrequency annuloplasty. Visual analogue scale and modified Macnab criteria were used to evaluate the relief of low back pain, and the Oswestry Disability Index was used for daily life evaluation of patients. Al the patients were folowed for 1-6 months, with an average of 3.5 months. RESULTS AND CONCLUSION:The operation was successfuly completed in al patients, and no complications such as damage to nerve and vascular systems occurred. Low back pain and living ability of the patients were improved obviously. Visual analog scale score and the Oswestry Disability Index were improved significantly after operation (P < 0.01); according to Macnnab's criteria, the results showed that at 1 week after the operation, the effective rate reached 94%; at 3 months after the operation, the effective rate was up to 97%. These findings indicate that percutaneous transforaminal endoscopic discectomy combined with radiofrequency annuloplasty in the treatment of lumbar disc herniation is confirmed in the short-term efficacy, and characterized as fewer complications and stable functional recovery.

Objective To investigate the status of vitamin(Vit)B12 deficiency in elderly inpatients in department of neurology.Methods 827 patients admitted to the department of neurology of Shanghai Punan hospital from March 2007 to July 2008,aged 60 and older,with no severe hepatosis and renal disfunction,and without using VitB12 preparation for 3 months,were included in the study.The levels of serum VitB12,folate,homocysteine(Hcy) were tested to screened patients with VitB12 deficiency.The results of symptoms,positive signs of neurological system and the laboratory examination were analysed and compared between patients with or without VitB12 deficiency.Results There were 827 patients,with the mean age of(77.1?7.5)years old,fulfilled the enrolling criteria.VitB12 deficiency was found in 163 patients(19.7%).The prevalence was higher in female(21.9%)than male(17.4%),which had a tendency of increased with age.In the patients with VitB12 deficiency,the rate of complicating gastrointestinal diseases was higher.Compared with patients with normal serum VitB12 level,there were more cases suffered from unstable gait(27.0%),hypopallesthesia(34.4%),and more cases combined with some chronic diseases such as cerebral infarction(62.6%),hypertension(68.7%),coronary heart disease(39.9%).77% cases had neuroelectricphysiological abnormalities,but only 9.82% cases had megaloblastic anemia.Conclusions VitB12 deficiency is common in elderly inpatients in neurology department,whose clinical manifestations are various and atypical,and the neurological symptoms are more common than megaloblastic anemia.

Objective To study the application of doses of remifentail intravenous anesthesia in vocal nodule extirpation.Methods Sixty ASAⅠ～Ⅱpatients with vocal nodule were selected and randomly divided into three groups. Group F were given anesthetic induction with fentanil and maintenance with isoflurane; Group L were given anesthetic induction and maintenance with remifentail at the dose of 0.5?g/(kg?min); Group H were given anesthetic induction and maintenance with remifentail at the dose of 1?g/(kg?min).The anesthetic induction time,blood flow dynamics during maintenance phase,recovery time and quality were recorded. Results (1)Anesthesia produce less circulatory fluctuation in group H than in group F and L.(2) Group L and H were faster than group F on recovery profile including the time of response to verbal commands,autonomous breathing,tracheal extubation and discharging from operating room. The OAA/S score was higher in group L and H than in group F 5 min after intubation. There were no significant differences between group L and H. Conclusions Remifentanil intravenous anesthesia can achieve better recovery profile from anesthesia than fentanyl in vocal nodule extirpation. 1?g/(kg?min) remifentanil can inhibit the stress responses to tracheal intubation and laryngoscope inserted effectively with a stable circulatory function.