Objective To investigate the efficacy of interferon alpha (IFNα) plus adefovir dipivoxil (ADV) and tebivudine (LdT) monotherapy for patients with HBeAg positive chronic hepatitis B (CHB) who have poor response to IFNα treatment.Methods A total of 86 HBeAg positive CHB patients admitted to the Sixth People' s Hospital of Shaoxing during February 2010 and April 2013 were enrolled in the study.All the patients received IFNα monotherapy for 24 weeks and had poor responses.The patients were voluntarily divided into three groups:IFNα monotherapy group (n =21),IFNα plus ADV group (n =30) and LdT monotherapy group (n =35).Chi-square test was used to compare ALT normalization rates,rate of HBV DNA load ＜ 500 copies/mL,HBeAg seroconversion and HBsAg seroconversion rates among three groups.Results After 48 weeks of treatment,the ALT normalization rate in IFNα monotherapy group was 52.6％ (10/19),which was lower than those in IFNα plus ADV group (86.7％,26/30) and LdT monotherapy group (84.8％,28/33) (x2 =6.913 and 6.361,P ＜ 0.05).The rate of HBV DNA load ＜500 copies/mL in IFNα monotherapy group was 26.3％ (5/19),which was lower than those in IFNα plus ADV group (60.0％,18/30) and LdT monotherapy group (54.5％,18/33) (x2 =11.33 and 3.895,P ＜0.05).No HBeAg negative conversion or seroconversion was observed in IFNα monotherapy group,but it was observed in 6 (20.0％,6/30) patients in IFNαt plus ADV group and 7 (21.2％,7/33) patients in LdT monotherapy group (x2 =4.330 and 4.657,P ＜ 0.05).No HBsAg seroconversion was observed in three groups.There were no statistical significant differences in ALT normalization rates,rate of HBV DNA load ＜ 500 copies/mL,HBeAg seroconversion and HBsAg seroconversion rates between IFNαt plus ADV group and LdT monotherapy (x2 =0.042,0019 and 0.064,P ＞ 0.05).Conclusion For patients with HBeAg positive CHB who had poor response to IFNα treatment,IFNα plus ADV therapy and LdT monotherapy have the same efficacy in improvement of both liver function and virological response.

Objective To investigate the impact and clinical significance of helicobacter pylori (Hp) elimination on ghrelin. Methods Forty patients with chronic superficial gastritis (CSG), 42 patients with chronic atrophic gastritis (CAG), 41 patients with peptic ulcer (PU) and 17 patients with gastric adenocarcinoma (CA) were included in this study. All of pa-tients in four groups were Hp-positive. Forty patients with Hp-negative were used as control. The Hp elimination were only performed in CAG,CSG and PU groups. The serum ghrelin and pepsinogen (PG) levels before and after Hp elimination were detected with ELISA assay in CSG, CAG and PU groups. The correlation between PG and glrelin was also detected. The ex-pression of ghrelin in gastric mucosa was detected by RT-PCR. Results Comparing with control group (30.41 ± 8.97), the ghrelin level was increased in PU group (35.42±9.87), but which were decreased in CAG group (18.59±8.19) and CA group (18.33±6.88). There was no significant difference in ghrelin level between CSG group (26.08±9.14) and control group. After Hp elimination, the serum and gastric mucosa ghrelin levels were significantly increased in CSG group (P＜0.01), but both serum and gastric mucosa ghrelin levels were significantly decreased in PU group (P＜0.01). And no significant difference in the level of ghrelin after Hp elimination in CAG group (P>0.05). A positive correlation was found between serum PGⅠ/PGⅡand serum ghrelin level in CSG, CAG and CA groups (r=0.668,P＜0.01). Conclusion Hp elimination has an impact on ghrelin level in patients with upper gastrointestinal diseases. The changes of ghrelin level related to PGⅠ/PGⅡ. Ghrelin can be used as one of the indexes of diagnostic and prognostic evaluation in Hp related upper gastrointestinal diseases.

Objective; To evaluate the influence of electrolyte's concentration at micro-arc oxide treatment on the bonding strength of titanium to porcelain. Methods; CP titanium specimens with size of 25 mm ×3 mm ×0. 5 mm were treated with micro-arc oxidation (MAO) in Na_2SiO_3 solution of three different concentrations. After ultra-low-fusing porcelain was applied, a three-point-flexure-test was used to evaluate the bonding strength of titanium to porcelain. The surface of the specimens was observed by SEM and EDS, as well as the interface between titanium and porcelain. Results; The bonding strength values between titanium treated with MAO and porcelain was significantly higher then the control groups, Croup 20 g/L has the highest bonding strength values. SEM/EDS suggested that a porous thin layer of oxide which contains Si element is created by MAO, and higher concentration of Na_2SiO_3 leads to more Si element in oxide. Conclusion; MAO treating can improve the bonding strength between titanium and ceramic. Electrolyte's concentration has an effect on the bond strength between titanium and porcelain.

Guided by the antioxidant activity, the EtOAc-soluble and n-butanol-soluble fractions of the 50% methanol extract of Lonicera japonica leaves were isolated and purified by various chromatorgraphic methods, and the structures were identified by spectral analysis and comparison to the data reported in literature. As a result, nine compounds were obtained and identified as 5-O-caffeoylquinicacid (1), chlorogenicacid (2), 4-O-caffeoylquinicacid (3), luteolin-7-O-[α-L-arabinopyranosyl-(1 --> 6)] -β-D-glucopyranoside (4), luteoloside (5), 3,4-di-O-caffeoylquinic acid (6), 3,5-di-O-caffeoylquinic acid (7), 4, 5-di-O-caffeoylquinic acid (8) and luteolin (9). The antioxidant activity of the nine compounds were determined by using DPPH free radical scavenging method, and ascorbic acid was used as a positive control. Their antioxidant activities from high to low were 5 > 9 > 2 > 8 > 7 > 6 > 1 > 3 > 4. Among them, luteoloside (5) had the strongest antioxidant activity with an IC50 of 0.018 18 g x L(-1), and luteolin (IC50 0.023 6 g x L(-1)) and chlorogenicacid (IC50 0.035 17 g x L(-1)) ranks No. 2 and 3. Furthermore, the antioxidant activity of luteoloside and luteolin were stronger than that of ascorbic acid (IC50 0.027 54 g x L(-1)). These results gave a basis for the further study and utilization of L. japonica leaves.
Antioxidants ; chemistry ; isolation & purification ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Lonicera ; chemistry ; Mass Spectrometry ; Molecular Structure ; Plant Leaves ; chemistry

This paper reports 17 cases of hypomagnesemic convulsiens of the newhorn that were admitted from Se-Ptember 1981 to January 1983. Only 2 patients were breast-fed.Symptoms and signs of hypomagnesemia are indistinguishable from these of hypocalcemia unless the serum magne-sium is determ ined. Serum magnes iumlevels had been determined in 50 normal children. The average value-2 standard deviation=2.17-2?0.34=1.49mEq/L.We defined hypomagnesemia as the serum magnesium lcvels below 1.48mEg/L. The serum magnesium levels of 17 patients varied from 0.65 to 1.46m Eq/L. Of 10 cases serum calcium le-vel6mg/dl.2.5%MgSO_4 was given intraveno-usly by continuous infusion in a dose of 2-4ml/kg every 12 hours. After the convulsions had been controlled a dose of 25% MgSO_4 was given intramuscul-arly in a dose of 0.4ml/kg twice daily Convulsions usually ceased after 1--4doses of MgSO_4, but the serum magne-sium levels did not rise to normal le-vels until 2-6 days. The convulsions could not be controlled by repeated ad-ministrations of calcium gluconate in 5 patients who had both hypomagnes-emja and hypocalcemia. Only after theadministiation of MgSO_4 did the serum calicum levels rise to the normal level and the convulsions cease.Electrocardjograms recorded in 7 patients all were abnormal but 1 case,so we should pay attention to the inf-luence of magnesium upon the heart.

Objective The vertical mammaplasty improves the breast morphology,and reduces the operative scar.However,the nipple-and-areola complex (NAC) has the risk of necrosis on those severe patients.In this report,we performed the vertical incision scar reduction mammaplasty based on Würinger's horizontal septum to reduce the NAC necrosis possibility.Methods Typical Lejour mosque-dome design was performed.The inferior part of glandular tissue and skin were excised.The NAC was elevated to normal position with medial-superior pedicle based on the horizontal septum.The breast morphology was modified with lateral and medial glandular pillar suturing using nonabsorbent thread.For reducing the vertical scar,the lower breast flap was thinned to induce the skin contraction.Results 27 patients with breast hypertrophy were operated from May 2009 to October 2012.1 patient had unilateral breast reduction,and 6 patients with 8 breasts had partial wound dehiscence.They were treated conservatively with topical dressings.No complete NAC necrosis occurred.Conclusions The vertical reduction mammaplasty based on Würinger's horizontal septum is a safe and effective approach,and the NAC necrosis possibility is reduced with this procedure.

Objective To investigate the serum cystatin C (CysC) level and explore its relationship with cytokines and atherosclerosis (AS) in maintenance hemodialysis (MHD) patients.Methods A total of 110 stable MHD patients undergoing hemodialysis for at least six months and 60 healthy control people were enrolled in the study.Serum levels of CysC and high-sensitivity Creactive protein (hsCRP) were measured by immunoturbidimetry.The serum levels of total homocysteine (tHcy),IL-1β,IL-6 and TNF-α were determined by ELISA.Prevalence of atherosclerosis was detected by carotid ultrasonography.The relationship of CysC level and cardiac geometry incidence in MHD patients was analyzed by Logistic regression model.Results The serum CysC level was significantly higher in MHD patients as compared with healthy controls [(6.19±0.95) mg/L vs (0.76±0.21) mg/L,P＜0.01],and the serum levels of hsCRP,tHcy,IL-1β,IL-6,TNF-α were significantly higher in MHD patients than those in healthy control group (P＜0.05 or P＜0.01).The serum CysC level was higher in MHD patients with carotid artery atherosclerosis compared to patients without carotid artery atherosclerosis (P＜0.05).CysC was positively correlated with hsCRP,tHcy,IL-1β,IL-6,TNF-α respectively (P＜0.05 or P＜O.01),and was positively correlated with carotid intimal medial thickness (IMT) and AS.Besides,a negative correlation was found between the serum CysC level and the serum albumin level (P＜0.05),while CysC was positively correlated with dialysis duration,systolic pressure and iPTH (P ＜0.05).Conclusion Serum CysC level is significantly higher in MHD patients and is correlated with hsCRP,tHcy,IL-1β,IL-6,TNF-α as well as carotid artery atherosclerosis,which indicates that CysC is an independent risk factor of AS in MHD patients.

Objective To verify the best treatment strategy in reducing prostate specific antigen (PSA) progression and death rate in patients with locally advanced prostate cancer by a meta-analysis. Methods The literature search strategy was followed according to the Collaborative Review Group search strategy. Published data of randomized clinical trials comparing radical prostatectomy (RP) plus adjuvant therapy to either RP alone or other treatment were analyzed. Both fixed effect model and randomized effect model were applied and odds ratio (OR) with its 95% confidence interval (95% CI) was also used as the effect size 'estimate. Results Eight clinical trials were chosen with total in-volved cases of 3826. There were 5 trials compared post radical prostatectomy plus adjuvant hormonal therapy with radical prostatectomy alone. PSA progression was used as the indicator of progression and the combined OR was 0.86 (95%CI 0.48-1.56). There were 3 trails compared the combination of radical prostateetomy with hormonal therapy and radical prostatectomy alone. Disease specific death rate was used as the evaluating criteria and the OR was 0.72(95%CI,0.51-1.02). Conclusion RP plus adjuvant hormonal therapy can reduce PSA progression of patients with locally advanced pros-tate cancer, but it has no significant effect on disease specific death rate.

Objective To investigate the effects of trimetazidine on the oxidative stress in maintenance he-modialysis (MHD) patients. Methods Eighty-six MHD patients and 30 healthy volunteers were recruited in the study. The activity of glutathione peroxidase (GSHPx) was measured by colorimetry and superoxide dismutase (SOD) in serum was measured by hydroxylamine method. The levels of serum malondialdehyde (MDA) were meas-ured by thiobarbituric acid reaction. Serum advanced oxidation protein products (AOPP) levels were measured by enzyme-linked immunosorbent assay (ELISA). All MHD patients were randomly divided into two groups, treatment group (n = 46) and control group (n = 40), who had undergone hemodialysis for at least three months before the study and were in a stable clinic status without signs of infection or disease activity. In the treatment group,20 mg of trimetazidine was taken orally three times each day for twenty-four weeks, when the parameters for oxidative stress were studied. The levels of GSHPx. SOD, MDA and AOPP in serum were measured before and after the treat-ment. Results At the initiation of the investigation, the serum levels of GSHPx [(584.37±215.70) μmol/L, (580.87±309.12) μmol/L vs (769.06±302.46) μmol/L] and SOD [(347.87±82.09) kU/L, (348.16±75.33) kU/L vs (428.34±15.23)kU/L] in the M HD patients were significantly lower than those in the normal eontrol group (P < 0.01), whereas the content of MDA [(4.94±1.32) nmol/L, (4.97±1.61) nmol/L vs (3.56±0.46)nmol/L] and AOPP [(120.95±59.24) μg/L,(121.76±69.12) μg/L vs (47.69±20.15) μg/L] in MHD patients was higher than those in the control group( P < 0.05 and P <0.01, respectively). After treatment for twelve weeks, the scores of GSHPx and SOD were significantly increased in the treatment group compared to that before treatment (P <0.01). However, the contents of the MDA and AOPP decreased. There were significant differences in the levels of GSHPx, SOD,MDA and AOPP between the two groups of MHD patients after the treatment with trim-etazidine. Conclusions Trimetazidine in maintenance hemodialysis patients appears to be associated with an im-provement of oxidative stress.

Objective To investigate cardiac reserve function and pregnant results of preeclampsia.Methods Pregnant women chosen by randomized table and hospitalized in the department of obstetrics of the first affiliated hospital of Chongqing MedicaI University were involved in this study from January to December,2008.Sixty-nine cases of normal pregnant women were divided into 3 groups:normal group 1(20cases),normal group 2(26 cases)and normal group 3(23 cases).The normal group number 1 to number 3 were paired to gestational hypertension(20 cases),mild preeclampsia(26 cases)and severe preeclampsia (23 cases),respectively.The digital technique of heart sound signal processing WaS used to measure cardiac reserve function parameters including the heart rate(HR),the ratio of the amplitude of the first heart sound to the second heart sound(S1/S2)and the ratio of diastolic to systolic duration(D/S)of pregnant women.The pregnant results were also recorded.Results (1)The ratio of S1/S2 in the group of severe preeclampsia 4.5±3.2 was significantly bigher than the group of gestational hypertension 2.2±1.1 and normal group 32.2±1.1(P＜0.01).The ratio of D/S of the group of severe preeclampsia 1.1±0.3 Was significantly lower than the group of gestational hypertension 1.4±0.3 and normal group 31.4±0.2(P＜0.01).(2)All cases of the normal group number 1 to number 3 and the group of gestational hypertension were found the ratio of D/S≥1.00,whereas 1 case(1/26,4%)of the group of mild preeclampsia and 4 cases(4/23.17%)of the group of severe preeclampsia were found the ratio of D/S＜1.00.(3)The two cases of the pregnant wornen(including one woman died of cardiac arrest)with S1/S2＞5.00 and D/S＜1.00,who were in the group of severe preeclampsia,were sent to Intensive Care Unit after delivery.There were 4 cases(4/26,15%)and 6 cages(6/23,26%)of 1 minute Apgar score less than 7,7 cases(7/26,27%)and 6 cases(6/23,26%)sent to neonatal Intensive Care Unit,2 cases(2/26,8%)and 4 cases(4/23,17%)of neonatal death in the group of mild preeclampsia and in the group of severe preeclampsia,respectively.All newborns in the normal group number 1 to number 3 and the group of gestational hypertension were normal.Conclusions The cardiac reserve function of a pregnant woman with preeelampsia is decreased with the severity of preeclampsia and the parturient and neonatal results get worse.The distal technique of heart sound signal processing is a safe,harmless,simple and effective tool to measure cardiac reserve funotion of preeclampsia,and is worthy of widely used clinically.