Different subtypes of chronic hepatitis B virus(HBV)infection occurred clinically because of the status of virus’s interaction with immune system. In patients with immune tolerance,high level of HBV DNA was found,serum hepatitis B e antigen(HBeAg)was positive,and serum level of alanine aminotransferase(ALT)was normal with only mild or no inflammation in liver tissue. However,not all the patients with normal ALT were in immune tolerance status,the disease could progress insidiously and develop into liver cirrhosis. Whether these patients need anti-viral therapy has always been a hotspot of study. This article reviewed the correlation between immune status and HBV infection,the identification of patients with normal ALT but not in immune tolerance status,and the indication of anti-viral therapy for these patients.

Objective: To explore the compatibility and application methods of clinical formulas.Methods: In the guidance of monarch,minister,assistant and guide theory, the constructions of prescription were divided into principal agents and lesser agents;500 prescriptions were from 1000 set prescriptions and empirical formulas recorded in pharmacology of traditional Chinese medical formulae teaching material and well-chosen efficacy nostrum written by national lever famous veteran teran doctors of TCM.Then they were analyzed to study the constituting formats of(clinical) formulas and the derivation methods of set prescriptions in clinical application.Results: Through analysis,we found the constituting formats of formulas in terms of single taste single group having principal agents but lesser agents(12.3%),multitude groups having principal agents but lesser agents(13.7%),single taste or single group principal agents with one group lesser agents(14.4%),multitude groups principal agents with one group lesser agents(17.7%),single taste or single group principal agents with multitude groups lesser agents(18.3%) and multitude groups principal agents with multitude groups lesser agents(23.6%) et al.From the 500 randomly extracted prescriptions,among 68.4% prescriptions were present derivation relationship,that is,for adapting new pathogenesis conditions,through methods in terms of replacing principal agents(10.2%),mild recipe lowering to lesser agents(17.0%),two formulas to put together(14.3%),expanding principal agents(16.4%),changing lesser agents(18.7%),principal agents pero-replacing(10.2%) and others(13.2%),changed constituted relation of principal agents or lesser agents,so to generate several formulas possessing new effect characteristics.Conclusion: The(divide) of principal agents and lesser agents has a universal applicability in analyzing the constitutions of formulas;the clinical application and derivation methods of set prescriptions revealed by this method have guide effect to initial(experiencing) clinical worker.

It has been nearly 20 years from the discovery of hepatitis C virus (HCV)and clinical diagnosis of hepatitis C to antiviral therapy with interferon,and significant progress has been made.Substantial changes have taken place in both the concept and strategy for antiviral treatment of hepatitis C,with more and more direct-acting antiviral agents emerging in recent years;these changes are as follows:from the control of HCV to clinical cure,from a sustained virologic response (SVR)rate around 30%with conventional interferon therapy to an SVR rate of 70%-80% with standard therapy with pegylated interferon and ribavirin,and from evaluating the difficulty of treatment based on genotypes and viral load to determining the treatment strategy according to host IL28B genotypes and response patterns (rapid virologic re-sponse and complete early virologic response).The progress in antiviral therapy strategies for hepatitis C is systematically reviewed for re-understanding of refractory hepatitis C.

BACKGROUND:Clinical treatment of tibiofibular syndesmosis separation of unstable ankle fractures can be treated by surgical internal fixation method. The internal fixation process can choose different materials, in the past, most of the operations used metal pul ing nail, but there may be broken nails and other risks. OBJECTIVE:To explore the application effect of traditional metal pul ing nail and macromolecule absorbable screw fixation in tibiofibular syndesmosis separation of unstable ankle fracture. METHODS:The clinical data of 63 patients with tibiofibular syndesmosis separation of unstable ankle fractures who received surgical internal fixation treatment in Affiliated Hospital of Shaanxi University of Chinese Medicine from February 2013 to February 2014 were retrospectively analyzed. Patients were divided into metal pul ing nail group (n=32) and absorbable screw group (n=31) according to the use of different materials. The fracture end was reset by cutting from the outside of the lower section of the fibula. The steel plate was used for fixation. The traditional metal pul screws and macromolecule absorbable screw were used for fixation. During the 12 months of fol ow-up after internal fixation, the ankle function scores of two groups (Baird-Jackson), clinical effect and the incidence of adverse events were observed and compared. RESULTS AND CONCLUSION:The average ambulation time and hospital stay of patients after internal fixation in absorbable screw group were significantly less than those of metal pul ing nail group (P<0.05). The ankle joint function scores (Baird-Jackson) in these two groups were increased compared with those before surgery, but the difference was not significant (P>0.05). The excel ent and good rate of patients in absorbable screw group was significantly higher than that in the metal pul ing nail group (P<0.05). During 12 months of fol ow-up after internal fixation, one patient had screw breakage in metal pul ing nail group. There was no wound infection among patients in these two groups. These results confirm that the use of macromolecule absorbable screw fixation for the treatment of tibiofibular syndesmosis separation of unstable ankle fractures can obtain better application effect compared with the traditional metal pul ing nails.

Objective To compare the influence of early weight bearing exercise and plaster fixed method on postoperative function and fracture healing of unstable ankle fracture patients.Methods 50 cases of unstable ankle fracture patients who did surgical treatment in our hospital were selected as the research object,and were randomly divided into an observation group and a control group.The observation group was applied with early postoperative weight bearing exercise,while the control group patients was applied with postoperative plaster fix with 2 weeks.The postoperative function and fracture healing situation of both groups were compared.Results At postoperative 24 hours and 1 week,the perimeter difference of two groups were not statistically different (P＞0.05).At postoperative 6 weeks,the perimeter difference was (0.53 ±0.31) cm in the observation group and (1.25±0.47)cm in the control group,the comparative differences was statistical significance (t=6.39,P＜0.05).The total effective rate of alleviate swelling in the observation group at postoperative 6 weeks was 96.0％,which was higher than that of the control group (76.0％) with statistical difference (x2=4.15,P＜0.05).At postoperative 24 hours,postoperative 1 week and postoperative 6 weeks,the pain index comparison difference between the two groups was not statistically significant (P＞0.05).The Baird-Jackson score of the observation group at postoperative 3 months was not different with the control group with statistically significant (P＞0.05) ; At the postoperative 6 months,the Baird-Jackson score of the observation group was (95.21 ± 8.25),which was higher than that in the control group (82.52±6.96) with statistical difference (t=5.88,P＜0.05).Conclusion The early weight bearing exercise can promote haemal circumfluence,relieve swelling,and be helpful for function recovery and fracture healing of unstable ankle fracture patients.

280r/40min). So the PD model was regarded eligible. In the site of lesion in SN, the number and volume of dobaminergic neurons were decreased, and the tissue structure of SN became indistinct, the levels of dopamine (DA), dihydroxyphenylaceticacid (DOPAC), homovanillicacid (HVA) 5-hydroxytryptamine (5-HT) and 5-hydroxyindoleaceticacid (5-HIAA) were more conspicuously reduced than that in uninjured side. TH-immunoreactive cells of substantia nigra compact part were lessened obviously on injured side. The abnormal rotatory behavior of PD rats did not spontaneously disappear during 10 months of continuous observation. Conclusion The PD rat model, which is reproduced by injecting 6-OHDA to selectively destroy dopaminergic neurons in the substantia nigra of rat, is stable and reliable, and demonstrated similar primary pathological changes of PD.

Objective To explore the mechanism of therapeutic effect of Yichantang in the treatment of Parkinson′s disease (PD). Methods A rat model of PD was replicated. The experimental animals were divided into a normal control group,a normal saline control group and a Yichantang group. Changes in the rats' behavior pattern was obrerved. Using the technique of intracerebral dialysis,the content of catecholamine like substances in the nigral extracellular fluid(NECF)was measured by means of high performance liquid chromatography(HPLC). Changes in the affinity and quantity of M and DA receptors were determined too. Results Yichantang markedly improved the rats' rotation behavior,and enhanced the Bmax and KD of DA and M receptors in the brain tissues on the side of lesion. The levels of DOPAC,HVA,DA and 5-HT in the NECF of the side of lesion in the Yichantang group were significantly higher than that of the normal saline group ( P

Objective To analyze the clinical manifestation, diagnosis and treatment of acute mesenteric vascular obliteration (AMVO). Methods 112 cases of AMVO were analyzed, including 20 cases admitted to our hospital from 1992 to 2004 and 92 cases reported by other hospitals. Results Abdominal pain, abdominal distension, nausea and vomiting, decrease or disappearance of bowel sound, elevation of white blood cell count were more frequent manifestations.Cardiovascular disease, portal vein stasis or hypercoagulation state were common findings in patients' history. The average misdiagnosis rate of AMVO in these 112 patients was 61.5%, with a misdiagnosis rate of 45.0% in 20 cases of our hospital. The average mortality rate of all these patients was 41.9%, with a mortality rate of 30.0% for 20 cases of our hospital. Conclusion The early clinical manifestation of AMVO lacks specificity, the misdiagnosis ratio and mortality rate are very high. Angiography should be done early to confirm the diagnosis and improve the therapeutic effect in the patients suspicions of having this ailment.

Objective To explore the association between the daily intake of alcohol and blood pressure in Chinese.Methods With the baseline data of the Qingdao Port Health Study,all subjects aged 18 to 54 yrs including all in-service and retired employees in Qingdao port were selected and divided into seven groups according to their daily intake of alcohol: groups of 0,0～,5～,10～,20～,40～ and 60～g alcohol/d,also stratified by ages.The amount of alcohol intake was assessed by a questionnaire.The cross-sectional association between blood pressure and intakes of alcohol was analyzed with general linear model and Logistic regression.Results In the groups of 25～34,35～44,45～54 yrs old both before and after adjustment,systolic and diastolic blood pressure were linearly increased with the amount of alcohol intake from the 0 g/d group to 60～g/d group.In the group of 18～24 yrs old,there was no obvious relationship between BP and alcohol intake.Logistic regression model showed that odds ratios in the groups of 0～g/d,5～g/d,10～g/d,20～g/d,40～g/d and 60～g/d versus the abstainers was 1.05,1.14,1.08,1.24,1.30 and 2.02,respectively,and the prevalence of hypertension in the 20～g/d group was significantly higher than that in the 0 g/d group and groups of low or moderate alcohol intake.Conclusion An increasing and linear relationship between alcohol consumption and blood pressure was established,and alcohol intake ≥20 g /d is an independent risk factor for hypertension.

Mycotoxins,secondary metabolites produced by certain fungi,have become one of the most harmful factors that affect the clinical safety of medicinal herbs that probably can be contaminated by harmful toxins generated from fungi in the whole process from planting to clinical use. Therefore,more toxicological research of mycotoxins,a better knowledge of the pathogenesis and quick detection with sensitivity and accuracy will play an important role in targeted therapy of poisoning by mycotoxins and early warning . In this paper,the current status of mycotoxin contamination in medicinal herbs was ana?lyzed,and the progress of toxicological study on common contaminants was reviewed. In view of the high toxicity of toxins,the strategy of ″Prevention First″ is highly desirable. Hence,the development of rapid detection of typical mycotoxins was systematically discussed. The review was intended to provide ref?erence for ensuring clinical safe administration of medicinal herbs and for reducing the risk of mycotoxin poisoning.