Objective To evaluate the effects of pegylated interferon plus ribavirin on naive and retreated chronic hepatitis C (CHC) patients.Methods A total of 67 CHC patients were divided into naive group (n =35) and retreat group (n =32) based on their treatment history.And their virological responses [rapid virological response (RVR),early virological response (EVR),virological response to etravirine (ETR) and sustained virological response (SVR)] and risk factors were analyzed.Results ①RVR and EVR of naive group were 60％ (n =21) and 77％ (n =27),respectively,and the retreat group were 28％ (n =9),53％ (n =17).The differences between the two groups were significant (both P ＜ 0.05).On the contrary,CHC patients in both groups might achieve similar ETR and SVR rates (P ＞ 0.05) ; ② The relapse rate in the retreat group was higher than that in the naive group (22％ vs.10％).But the differences had no statistical significance (P ＞ 0.05) ; ③ CHC patients in the retreat group could achieve similar responses,including RVR,EVR,ETR and SVR (P ＞ 0.05) whether treated previously with standard interferon or pegylated interferon; ④ According to muhivariable logistic regression analysis,the retreated genotype 1 CHC patients has a lower SVR rate compared with naive genotype non-1 counterparts (OR =0.29 and 0.26,all P ＜ 0.05).Conclusions CHC patients in the naive group could achieve higher virological responses and a lower relapse rate compared to those in the retreat group.The previous treatment regimeu has no significant effect on virological responses of CHC patients retreated with Peg-IFN plus ribavirin.Genotype 1 and retreatment are both risk factors of achieving SVR.

Objective To explore three under nasal endoscope surgery treatment the clinical curative effect of maxillary sinus cyst.Methods 95 cases of maxillary sinus cyst patients were chosen,the maxillary sinus were used respectively to open to expand,the nasal passages of maxillary sinus fenestration and maxillary sinus anterior wall fen-estration three types of surgical treatment,postoperative follow -up of 1 year,the clinical curative effect of three kinds of operation method were analyzed.Results The maxillary sinus mouth open expansion of 39 cases during operation,37 cases were cured,2 cases of recurrence;The nasal passages under the maxillary sinus fenestration 27 cases, 26 cases cured,1 case of recurrence;The maxillary sinus anterior wall fenestration 29 cases,29 cases healed;Three kinds of operation cure rate difference had no statistical significance(P >0.05).Conclusion The treatment of max-illary sinus cyst operation should be selected according to the location and size of cysts and whether the various associ-ated withnasal sinuses diseases and other factors determine the.Maxillary sinus cyst neararound the maxillary sinus, sinus cavity lateral wall or with sinus disease can use theostium of maxillary sinus extending open surgery path;near the sinus cavity innerwall and the bottom wall can use windowing of the inferior nasal meatus approach;near the front wall of sinus cavity and large cysts or recurrence can be choice ofmaxillary sinus by fenestration operation path;the purpose is to remove the cystoccurs completely,reduce tissue injury and complications.

Objective:To investigate the changes of Th cell differentiation in the VMC and interference effect of Qingxin capsule on them.Methods:BALB/c mouses with different courses of VMC were established, after treated with Qingxin capsule, the cardiac pathological changes were observed by light microscope and transmisson electron microscope,levels of IL-2,IL-4,IL-10 and IFN-? in blood serum were detected by ELISA.Results: Whatever in acute stage or recovery stage of VMC, the myocard pathological changes of mouses were lighter after treated with Qingxin capsule;moreover, levels of IFN-? and IL-2 in blood serum of mouses with VMC decreased significantly(P0.05).Conclusion:Qingxin capsule can restore the balance of Th1 and Th2 cells through inhibiting reaction of Th1 and enhancing reaction of Th2.

Tumor cells can metabolize glucose through glycolysis to intermediates for biomacromolecule synthesis by inhibiting the activity of the pyruvate dehydrogenase complex (PDC) in mitochondria. In this process, pyruvate dehydrogenase kinases (PDKs) play a key role. The inhibition of the activity of PDKs can effectively block this metabolic pathway, activate mitochondrial oxidative metabolism, and induce tumor cell apoptosis. PDK inhibitors have become a research hotspot in medicinal chemistry, and novel structures targeting classical binding sites have been synthesized. In this paper, recent research progress on PDK inhibitors is reviewed to provide information on these latest entities and to explore their clinical applicability.

OBJECTIVETo assess the clinical effectiveness of volar and radial column approach by plate fixation for the treat- ment of unstable fracture of distal radius.

METHODSAccording to Cochrane Systematic Review, Medline, Embase, Cochrane Li- brary, CNKI and CBM, randomised controlled trials (RCTs) of volar and radial column approach by plate fixation for the treat- ment of unstable fracture of distal radius were searched for from 1966 to 2014. Data analysis was performed with the Cochrane Collaboration's RevMan 5.0 software.

RESULTSTotally 391 patients of 6 RCTs and 2 retrospective cohort studys were included and divided into volar plate group (187 cases) and radial column plate group (204 cases). Meta-analysis result showed: compared with radial column plate group, volar plate group had significant difference in recovery of wrist function [SMD = 0.74, 95% CI (0.47, 1.01), P < 0.00001], Gartland-Werley scores [SMD = -1.39, 95% CI (-2.24, -0.53), P = 0.001], postoperative neural in- jury [OR = 3.67, 95% CI (1.37, 9.84), P = 0.01 1 and postoperative wrist pain [OR = 0.32, 95% CI (0.13, 0.74), P = 0.008]. But no significant difference was identified in DASH scores [SMD = -0.36, 95% CI (-0.97, 0.26), P = 0.25], radiographic result assess- ment [SMD = -0.18, 95% CI (-0.53, 0.16), P = 0.3], postoperative grip strength [SMD = 0.71, 95% CI (-0.12, 1.54),P = 0.09], postoperative tendinous damage [OR = 0.31, 95% CI (0.10, 0.98), P = 0.05] and carpal tunnel syndrome [OR = 0.96, 95% CI (0.63, 1.48), P = 0.87].

CONCLUSIONCompared with radial column plate internal fixation, volar approach plate fixation for treat- ment of distal radius intra-articular fracture has advantage of recovery of joint functionand. However, the volar approach plate fix- ation was associated with a higher risk of long-term complications than the radial column approach plate fixation.

Objective To investigate the value of human epididymis secretory protein 4 ( HE4 ) combined with CA125 assay in differential diagnosis of endometriosis cyst and ovarian malignant tumor.Methods The level of HE4 and CA125 were measured by enzyme-linked immunosorbent assay (ELISA) in the serum specimens of 46 cases in endometriosis cyst group,36 cases in malignant ovarian tumor group,60 cases in benign ovarian diseases and 50 women in healthy women group.Those results were shown with median level.The normal range were 0-150 pmol/L in HE4 and 0-35 kU/L,which either one was more than the threshold value defined as positive index.The sensitivity of assay was evaluated by receiver operating characteristic (ROC) curve,the relation and value of HE4 or CA125 alone and combination assay in diagnosis of endometriosis was analyzed by Mann-Whitney U test and correlation analysis.Results (1) HE4:the median levels of HE4 were 52.4,51.0,50.0 pmol/L in group of endometriosis,normal control and benign ovarian tumor,which didn't show statistical difference.However,HE4 was 507.5 pmol/L inovarian cancer group,which was significantly higher than those of 3 groups (P < 0.05 ).(2 ) CA125:there were significant different in median level of CA125 was observed as 743.0 kU/L in ovarian cancer,84.9 kU/L in endoemtriosis,15.4 kU/L in benign ovarian disease,and 11.5 kU/L in healthy women (P < 0.05).( 3 ) The single assay:when compared with that in endometriosis group,receiver operating characteristic area under the curve( ROC-AUC) were 0.933 in HE4 alone and 0.821 in CA125 alone assay in ovarian cancer group.The specificity was 95% and the sensitivity was 79.6% and 49.0%.(4) The combination assay:when compared with those in endometriosis group,the ROC-AUC was 0.936,the specificity was 95% and the sensitivity was 81.0% in ovarian cancer.Conclusions Measurement of HE4 could be used in differential diagnosis of endometriosis cyst.And the combination of HE4 and CA125 assay could discriminate ovarian endometriosis cysts from ovarian malignant tumors effectively.

Fifty-six patients diagnosed as early stage lung cancer by spiral CT scan,underwent CTguided percutaneous transthoracic biopsy with a successful rate of 100%.Forty nice cases were confirmed pathologically including adenocarcinoma in 30 cases,squamous carcinoma in 14,alveolar cell carcinoma in 2 and small cell lung cancer in 3.Three cases were diagnosed as chronic inflammatory lesion,2 cases as tuberculosis and the diagnosis was not confirmed in 2 cases.The results suggest that CT-guided percutaneous transthoracic biopsy is an effective diagnostic measure for patients with stage Ⅰ-Ⅱ lung cancer.

ObjectiveTo investigate the variations and distributions of the plasmid-mediated quinolone resistance genes in clinical isolates of Shigella and their resistance to antimicrobial agents. Methodsqnr, aac(6')-Ib-cr and qepA genes were identified by polymerase chain reaction (PCR) in 137 clinical isolates of Shigella.DNA sequencing of gene-positive strains were analyzed and the conjugation experiment was performed. The minimal inhibitory concentrations (MIC) of Shigella isolates, recipient strains and transconjugants were tested by agar dilution method for quinolones and other antimicrobial agents. The genotype of transconjugants were determined by PCR and sequencing. ResultsFour (2.9％) strains of the 137 Shigella isolates were qnr gene positive, including 3 qnrS2 positive and 1 qnrB4 positive (GenBank accession numbers of the complete sequence were JF261185 and HQ917003, respectively).Furthermore,five (3.6％) aac ( 6')-Ib-cr gene-positive strains (GenBank accession number JF261186 ) and one (0.7％) qepA gene-positive strain were identified in all isolates. The conjugation experiments were successfully carried out in six out of ten PCR-positive isolates. The MIC of transconjugants against quinolones and other antimicrobial agents increased differently compared to recipient strains. Conclusions The plasmid-mediated quinolone resistance genes are lowly prevalent in clinical isolates of Shigella. However, these resistance genes have the characteristic of horizontal transfer, which indicates that more attention should be paid to this phenomenon.

Objective To determine whether prenatal ultrasonography (US) score is more effective than renal pelvic anterior posterior diameter (PAPD) for the prognostic evaluation of fetal hydronephrosis.Methods Fetuses with hydronephrosis (PAPD≥ 10 mm) were examined by prenatal US in the third trimester.PAPD,renal parenchyma thickness (RPT) and pelvicaliceal morphology (PM) were measured and graded from 0 to 3 score on the basis of severity of hydronephrosis,then the total US score of each kidney was obtained.According to the follow-up results after birth,all the cases were divided into two groups:physiological and pathological hydronephrosis.Via Z test,paired comparison was made to analyze area under the curve (AUC) of US score and each of the other three factors.Results Confirmed by postnatal US and other clinical examinations,of 198 kidneys (158 cases ) with hydronephrosis,139 (70.20％ ) were physiological hydronephrosis and 59 (29.80％ ) were pathological hydronephrosis.AUC of PAPD,RPT,PM,US score was 0.897 (minimum),0.957,0.944 and 0.982 (maximum) respectively,and there was significant difference between AUC of US score and each of the other three ( P ＜0.05).US score was the best approach for differential diagnosis of fetal hydronephrosis.Conclusions Prenatal US score is more effective and accurate than the single factor (PAPD,RPT,PM) to differentiate fetal physiological and pathological hydronephrosis.It was a new quantitative method to evaluate the prognosis of fetal hydronephrosis,and should be disseminated and applied clinically.