Objective To study the distribution of drug resistance mutations and genotypes in the patients with chronic hepatitis B(CHB)in Taicang area.Methods 350 cases of CHB were selected and detect the drug resistance mutations and genotypes before using nucleoside(acid)anti-viral drugs.The correlation between the drug resistance mutations with genotypes in CHB patients was analyzed.Results Among 350 cases of CHB,the distribution of genotypes was genotype B in 172 cases,accounting for 49.14%, genotype C in 164 cases,accounting for 46.85%,genotype D in 9 cases,accounting for 2.57%,mixed genotype of B and C in 5 ca-ses,accounting for 1.42%,no other genotypes were found.In this study,the drug resistance mutations were detected in 58 cases,in-cluding 22 cases of genotype B,35 cases of genotype C and 1 case of genotype D,no drug resistance mutations were found in mixed genotype B and C.The drug resistance mutations sites:lamivudine resistance-associated mutations in 36 cases(10.28%),and adefo-vir resistance-associated mutations in 16 cases(4.57%)and entecavir associated resistance mutations in 6 cases(1.71%).Conclusion The genotype of CHB patients in Taicang area was dominated by genotype B and C,which accounting for more than 90% and the proportion of these two kinds of genotype is similar.The proportion of drug resistance mutation occurrence in the patients with gen-otype C is higher than that with genotype B.The lamivudine resistance-associated mutation has the highest proportion of drug re-sistance occurrence.It is suggested that the CHB patients with undefined medication history and recurrence treatment should be per-formed the drug resistance detection for selecting the targeted therapeutic schemes before accepting nucleoside(acid)drug therapy.

[Objective]To investigated the clinical result of transpedicle fixation combined with injectable calcium sulfate vertebroplasty in patients with thoracolumbar fractures.[Method]From April 2005 to June 2007,43 patients with thoracolumbar fractures were treated with vertebroplasty reinforced by calcium sulfate injection and short-segment pedicle screw fixation.The symptom improvement was observed.Plain X-rays were taken at pre-operation and post-operation and final follow-up to determine the improvement of the injured vertebral height and Cobb′s angle.[Result]All the patients underwent surgery uneventfully.Thirty-eight patients were followed up for an average of 22 months.After operation Frankel Grading System improved to Grade E.The loss rates of anterior,mid and posterior height were 51.4%,41.5%,3.5% before operation but 11.7%,14.3%,1.7% after operation.The Cobb′s angles were improved from 16.3?preoperatively to 0.8?postoperatively.The loss rates of vertebral height between pre-operation and post-operation were significantly different(P0.05).There was no breakage of pedicle screw or loosening of instrument.Pain score by visual analog scale(VAS) reduced from 8.5 to 1.0.[Conclusion]The surgery of transpedicle fixation combined with injectable calcium sulfate vertebroplasty is a mini-invasive and effective method for the treatment of patients with thoracolumbar fracture.It can achieve and maintain kyphosis correction,decrease the instrument failure rate,and provide better postoperative outcomes.

Objective To understand and analyse the epidemic status of human intestinal nematode infection in Jiangsu Province, so as to provide basis for making control measures. Methods The typical thirty-nine spots in thirteen counties among the sampling spots of National Investigation on Distribution of Human Parasites in 1990 were selected and investigated according to the Methods of National Investigation Scheme on Human Principal Parasites in 2004. Results The total prevalence was 3.88%, which decreased by 46.92% compared with the investigation in 2002 (7.31%). The infection rates of hookworm, Ascaris and Trichuris were 1.14%, 1.06% and 1.73%, respectively, and the proportion of light infection was 91.75%. The rate of multiple infections was 9.40%. The proportion of hookworm infection was 78.06% in Southern Jiangsu and the proportion of Ascaris or Trichuris was 89.03% in Northern Jiangsu. The infection rate of Enterobius was 3.72% among children aged less than 12 years. Conclusions The prevalence of intestinal nematodes has decreased to lower level in Jiangsu Province. The difference of prevalence in different regions has a relationship with the disease control and social-economic, culture and health levels. The principal control work should be still put in the northern part of Jiangsu Province. The preschool children and the middle and old age peasants are high-risk population. The different control measures should be taken in accordance with the situation of different regions in the future.

Identifying the similarity and differences of malpractice,medical negligence and medical error has realistic meaning to deal with medical disputes efficiently.They are all subjective negligence and belong to the category of medical behavior.This paper mainly discussed the criteria and civil liability of their differences.

Objective To investigate the predictive value of combined analysis on single nucleotide polymorphisms (SNPs) of X-ray cross-complementing1 ( XRCC1 ) gene 194 and 399 codon,xeroderma pigmentosum group D (XPD) gene 312 codon and glutathione S-transferase P1 (GSTP1) gene 105 codon in platinum based chemotherapy.Methods Direct sequencing was performed to detect XRCC1,XPD and GSTP1 genotypes in peripheral blood from 50 cancer patients receiving platinum-based chemotherapy.Genetic polymorphisms of these genes related to sensitivity of platinum were reviewed.Results Favorable genotypes were Arg/Trp and Trp/Trp in XRCC1 194 codon,Arg/Arg in XRCC1 399 codon,Asn/Asn in XPD 312 codon and Val/Val in GSTP1 105 codon.The response rate to chemotherapy was 57.1％,75.0％,60.9％,85.7％ and 87.5％,respectively.The response rate for patients possessing ≥2 favorable genotypes and those possessing 1 or 0 favorable genotype was 78.9％,36.4％ and 0,respectively.Patients possessing ≥2 favorable genotypes demonstrated higher sensitivity to platinum based chemotherapy,compared with those possessing 1 or 0 favorable genotype ( x2 =25.79,P ＜ 0.01 ).Conclusions Combination analysis of genomic polymorphisms of XRCC1,XPD and GSTP1 may be useful in predicting sensitivity of platinum based chemotherapy.

Objective To investigate the quality of life(QOL) and symptoms of community patients with advanced cancer,and analyze their correlation.Methods 94 advanced cancer patients in 3 communities of Yangpu district in Shanghai were surveyed by self-designed questionnaire,FACT-G and MDASI.The correlation between QOL and symptoms was analyzed.Results QOL of advanced cancer patients was poor,and the main influencing factors were gender,age,stage of cancer,KPS score,marital statusand economic burden.There was significant negative correlation between symptoms and QOL.Fatigue,amnesia,uneasy sleep,insensible feeling,distress and dry mouth were the symptoms patients suffered mostly.Conclusions For patients with advanced cancer,evaluation of the influencing factors of QOL and better control of symptoms could improve their QOL.

Objective To develop an ideal substitution material for bladder defect ,which can reduce serious complications of urinary intestinal diversion ,we establish experimental rabbit model of reconstruction the new bladder by ileal seromuscular with transplantation of autologous peritoneum .This animal research provides the basical ground for the experimental model and further clinical application of replacement bladder .Methods Randomly ,seven experimental female rabbits were chosen ,and their body weight was 4 .0-5 .0 kg .By intravenous anesthesia ,the bladder substitute operation was carried out (to transplant the peritoneum to an ileum segment which mucosa had been removed .These flaps were used to mend and reconstruct the bladder by composite cys‐toplasty) .Animals were euthanized at 4 ,8 weeks for routine pathology and immunohistochemistry .Results Seven rabbits under‐went reconstruction ,but three were lost to complications .The length of ileum was 4 .0 cm ,and the area of substitute peritoneum was 4 .0 cm × 2 .5 cm .Voiding behaviour was normal ,and urine was clear in the remainder .At autopsy ,reconstructed bladders were healthy .Pathological examination showed that the technique was successful in creating seromuscular segments with no epithelial remnants .When applied surgically ,the seromuscular flaps with peritoneum survived at 4 weeks and the peritoneum was substituted by transitional epithelium at 8 weeks .Conclusion In this experimental rabbit model ,reconstruction bladder by autologous peritone‐um and seromuscular segment is an ideal approach for which can prevent regrowth by ileal epithelial cells and overcome the compli‐cations of conventional enterocystoplasty .Voiding behaviour is normal in the remainder .This animal study provides the basical ground for the large experimental model and further clinical application of the new enterocysplasty .

Objective To investigate and analyze the changes of Ascaris lumbricoides infection in rural residents of Jiangsu Province during 13 years and its influencing factors in order to provide the basis of making practical policies for ascariasis control in future. Methods The data were analyzed about the rates of Ascaris infection and mass chemotherapy, per capita income, and the rates of the use of running water and hygienic toilets in the southern part, the middle part and the northern part of Jiangsu Province from 1990 to 2002, and the main influencing factors for Ascaris infection were explored. Results The prevalence rate of Ascaris infection decreased continuously during 13 years, from 39.51% to 2.14%, and the decrease rate was 94.58%. In 2002, the infection rate was the lowest, only 0.41%, decreased by 98.92% in the middle part of Jiangsu Province, and the infection rate was the highest, 5.09%, decreased by 89.97% in the northern part of Jiangsu Province. The accumulated rates of mass chemotherapy were 159.00% in middle part of Jiangsu Province,103.00% in the southern part of Jiangsu Province and 105.00% in the northern part of Jiangsu Prvince.The per capita income, the use of running water and hygienic latrines increased gradually from the northern part to the southern part and there were significant differences in the 3 survey regions. Conclusion The Ascaris infection rate is influenced by mass chemotherapy, economics and health conditions in rural residents, especially the mass chemotherapy.

Objective To discuss the present situation and existing problems of the funded projects, especially in the gap between western region and eastern central region by analyzing the funding situation of the projects funded by the National Natural Science Foundation of China (NSFC) and the completed projects in the TCM field from 1989 to 2015. Methods The website was searched thoroughly, and data of Division Ⅹ of Health Science Department of National Natural Science Foundation of China from 1989 to 2015 (ie TCM, Chinese materia medica and integrated traditional Chinese and Western medicine) funded by the National Science Foundation for Young Scientists in China were obtained, and the projects of the National Science Foundation for Young Scientists funded by Division Ⅹ of Health Science Department of National Natural Science Foundation of China from 1989 to 2015 were included, and incomplete or inavailable items were eliminated. Relevant information according to the extracted forms was extracted. The situation of different regions and the situations of the projects have been concluded and the titles of different titles have been analyzed. Results By 2015, the number of funded projects and the amount of financing in the TCM field were increasing year by year. In the western regions, the number of funded projects and the amount of financing accounted for only 11.29% of the total number and 11.28% of the total financing. Compared with the less supporting western regions, much more were mainly in eastern and central regions. The number of SCI papers published and single cited times of the finished projects were 988 and 20.85. Compared with the developed areas in eastern and central regions, there was no statistical significance in the average number of SCI papers (P=0.493), average SCI papers cited article number (P=0.449), SCI papers in average cited frequency (P=0.589), the average CSCD papers number (P=0.579), average CSCD papers cited article number (P=0.883) and average single CSCD papers cited frequency (P=0.753) in western regions (P>0.05). Conclusion Under the stable supports of the Young Scientists Fund, scientific researches in the TCM field have achieved remarkable achievements. In addition, the ability of scientific research and innovation of the young scientific workers have been improved. The funded projects in western regions are far less than those in eastern and central regions, with great differences. However, there is no statistical significance in the research results of the items in western regions and eastern and central regions.

Objective To evaluate the clinical value of bedside index for severity in acute pancreatitis (BISAP) and APACHEⅡ score in predicting the severity and organ failure of acute pancreatitis (AP).Methods One hundred eighty-five patients of AP admitted to Department of Gastroenterology of First affiliated Hospital of Soochow University from January 2012 to December 2014 were studied retrospectively.According to BISAP score, patients who were ≥3 points were considered as high risk group, while ＜3 points were considered as low risk group.According to APACHEⅡ score, patients who were ≥ 8 points were considered as high risk group, while ＜ 8 points were considered as low risk group.According to the criteria of Pancreatic Diseases Group of Chinese Society of Gastroenterology of Chinese Medical Association, the patients were diagnosed as mild acute pancreatitis (MAP), moderately severe acute pancreatitis (MSAP), and severe acute pancreatitis (SAP).The BISAP, APACHEⅡ scores were calculated and compared between MAP group and MSAP + SAP group, respectively.The incidence of MSAP + SAP between high risk group and low risk group was also compared.The area of ROC curve (AUC) was used to evaluate the ability of BISAP and APACHEⅡ scoring system for predicting the severity of AP and the multiple organ dysfunction syndromes (MODS).Results Among 185 patients, MAP was identified in 101 patients, MSAP in 76 patients and SAP in 8 patients.Twenty-five MSAP patients developed organ dysfunction, and all the 8 SAP patients developed organ dysfunction.The BISAP scores of MSAP + SAP group and MAP group were (1.43 ± 0.89), (0.38 ± 0.61),andAPACHⅡ scores were (2.45± 1.36), (0.87± 0.62), the scores of MSAP+ SAP group were significantly higher than those in MAP group (P ＜0.01).In the 137 patients of low risk BISAP group, there were 47 MSAP + SAP patients (34.3％), while in the 48 patients of high risk BISAP group, there were 37 MSAP + SAP patients (77.0％);in the 153 patients of low risk APACHEⅡ group, there were 56 MSAP + SAP patients (36.6％), while in the 32 patients of high risk APACHEⅡ group, there were 28 MSAP + SAP patients (87.5％);the incidence of MSAP + SAP patients was significantly higher in high risk group than that in low risk group (P＜0.01).The AUC of BISAP, APACHEⅡ for MSAP+ MAP was 0.804 (95％ CI 0.738 ～ 0.870), 0.794 (95％ CI 0.725 ～ 0.863), and the AUC for organ dysfunction was 0.758 (95％ CI 0.686 ～0.830), 0.781 (95％ CI 0.710 ～0.852) , and the difference between BISAP and APACHE Ⅱ was not statistically significant (P ＞ 0.05).Conclusions The BISAP has the prediction ability for AP severity and prognosis similar to APACHEⅡ , and it consists of only 5 parameters and can be completed in the first 24 h of admission, therefore it is worth of clinical application.