Objective To investigate the efficacy and safety of adefovir dipivoxil(ADV)for chronic hepatitis B(CHB)patients with lamivudine(LMD)resistance.MethodsA total of 247 LMDresistant CHB patients were included in this multi-center,randomized(1:1),double-blinded and LMDcontrolled clinical trial.All subjects were swithed to open-labelled ADV treatment after 12-week doubleblinded stage.Serum HBV DNA and ALT levels were monitored and safety assessments were conducted at 12th and 48th week during the treatment.Results At 12th week.mean reduction of ALT in trial group was 35.9 U/L,and the reduction of HBV DNA was 3.01 log10 copies/mL.The reductions of HBV DNA in 61.8%(76/123)subjects were more than 2 log10 copies/mL.While in the control group,ALT raised 2.8 U/L in average,and the reduction of HBV DNA was 0.78 log10 copies/mL.The reductions of HBV DNA in 17.7%(22/124)subjects were more than 2 log10 copies/mL.At 48th week,mean reduction of ALT in trial group was 59.7 U/L,and the reduction of HBV DNA was 4.70 log10 copies/mL.The reductions of HBV DNA in 87.0%(107/123)subjects were more than 2 log10 copies/mL.While in the control group,mean reduclion of ALT was 56.6 U/L,and the reduction of HBV DNA was 4.43 log10 eopies/mL.The reductions of HBV DNA in 85.5%(106/124)subjects were more than 2 log10 copies/mL.No severe adverse effect related to the investigational product was observed in both groups.Conclusion ADV is safe and effective in the treatment of LMD-resistant CHB patients with virological and biochemical improvements.

Objective　To study the role of the structural gene variation of hepatitis C virus(HCV) in the chronicity of HCV infection. Methods　Serum samples from four HCV infection acquired during six-month follow up and four patients with chronic hepatitis C type were obtained. A 1-kb fragment containing the 3' half of core ，completed E1 and 5' half of E2/NS1 was amplified by nested reverse transcription polymerase chain reaction (RT-PCR). For each，30 cloned cDNAs were examined by a method that combined heteroduplex analysis (HAD) and a single-stranded conformational polymorphisim (SSCP)assay to optimize selection of clones with unique gel shift patterns (clonotypes )as a measure of the quasispecies complexity. Results　There was obvious difference between the SSCP bands of cloned cDNAs representing core-E1 and E2 region，but more distinct difference between heteroduplex and the homoduplex of clones spanning E2 region which accurately reflected the degree of heterogeneity. Quasispecies complexity was higher in those with persistent viremia than those with acute viremia. Conclusion　HCV persistence is associated with complex quasispecies in viral structural region.

Objective To realize the fundamental conditions and variation trends of disease spectrum of Meizhou and its surrounding areas in order to investigate the focuses of diseases monitor and control .Methods Sta-tistic analysis was done on diseases of hospital in 2013 with Pareto Diagram .Results About twelve kinds of disea-ses, including circulatory diseases , tumor, digestive diseases , respiratory diseases and urinary diseases , accounted for the total number of 89.2%.Conclusion Characteristics of diseases spectrum in hospitals were analyzed , for which we can attach importance to disease prevention , optimize medical resource allocation , enhance key specialty construction and improve the level of diagnosis and treatment .

Effects of different edible oils on lipid and lipld peroxidation and their correlation were studied in rats. The results showed: 1.The tea-seed oil and soybean oil exhibited a good potency of reducing serum TC and TG comparing with lard did. 2. The plasma LCAT activity in the lard feeding group (57.07 nmol/ml.h) was lower than that of groups consuming four different vegetable oils which produced similar LCAT activities (80.26-94.03 nmol/ml-h). 3. Lard increased liver lipid and promoted TG sediment in aorta, but lowered brain lipid level. 4. Of lipid peroxidation in serum, liver, heart and kidney, the rats fed lard exhibited a highest level, and tea-seed oil fed group was lower relatively soybean oil promoted tissue lipid peroxidation while rape-seed oil and Salad oil suppressed it. 5. After experiment, the SOD activity of erythrocyte increased in rats fed oils riched in monounsaturated fatty acid, and decreased in rats fed soybean oil and lard. 6. The results of linear correlation and regression analysis showed that there was a significant positive relationship between lipid peroxidation and lipid TC, TG) in serum and liver (P

Large artery intracranial occlusive disease is a important and common vascular lesion type.It is closcly associated with the onset and recurrence of ischemic stroke; however,at present there are many inadequacies in the study of its etiology and treatment.This article mainly reviews the understanding process of the large artery intracranial occlusive disease,present research results and problems need to be solved.

Objective To investigate the expression level of serum Golgi protein-73 (GP73) in patients with primary hepatocellular carcinoma (HCC), or accompanied with Budd-Chiari syndrome (BCS), and to discuss its clinical value in making early diagnosis. Methods The peripheral serum samples were collected in 490 individuals, including patients with HCC (n = 65), cholangiocarcinoma (CC, n = 35), Budd-Chiari syndrome accompanied with HCC (n = 40), type B virus hepatitis (n = 60), cirrhosis after B hepatitis (n = 60), Budd-Chiari syndrome complicated by cirrhosis (n = 60), other malignant lesions (n =50), benign hepatic lesions (n = 60) and healthy volunteers (n = 60). The expression levels of serum GP73 and AFP were determined by using Elisa and electrochemiluminescence methods separately. Results The expression level of serum GP73 in the patients with HCC , CC or BCS plus HCC were significantly higher than that in the other individuals (P < 0.05). The area under the receiver operating characteristic curve (ROC), the sensitivity, the specificity and the diagnostic accuracy of GP73 and AFP for HCC were 0.868, 90.8%, 75.5%, 77.6% and 0.739, 60%, 83.2%, 80.2% respectively. The cut-off values of GP73 and AFP were 43.40 ng/ml and 20ng/ml respectively. The area under ROC and the sensitivity of GP73 for the diagnosis of HCC were strikingly higher than those of AFP (P < 0.05), while no significant differences in the specificity and diagnostic accuracy existed between GP73 and AFP (P > 0.05). The area under ROC, sensitivity, specificity and the accuracy of GP73 for the diagnosis of CC were 0.774 , 88.6%, 72.7% and 73.9%respectively, and the optimal cut-off value was 45.40 ng/ml. Conclusion In diagnosing HCC, the expression level of serum GP73 is superior to AFP. It is hopeful that serum GP73 may be proved to be an early serum tumor marker for HCC.

Objective To discuss the newrborn ARDS first time blood gas analysis characteristic.and the clinical significance. Methods Application blood gas analysis and PaO2/PAO2,QS/QT,PaO2/FiO2,A-ac-DO2,RI and so on many indexes of blood gas analysis,to 2001～2005 year period were hospitalized in my courtyard NICU makes clear diagnoses the ARDS parallel breath machine treatment 20 examples trouble carries on monitors. Results First time when blood gas analysis 60% trouble prompt low oxygen blood sickness (PaO2＜50 mm Hg).Parameter the and so on RI,QS/QT,A-acDO2,PaCO2/FiCO2,PaCO2/PaO2 values separately were:3.32±4.18,10±9.85,149.06±159.54,94.96±50.47,0.12±0.05. 72 hours ventilation after the breath machine. Conclusion Carries on the clinical appraisal using these targets to ARDS, to early strives for the breath machine treatment,the judgement condition and estimates pre-after has the vital significance.

Recent studies have demonstrated that hyperhomocysteinemia is an independent risk factor for stroke,which may cause vascular endothelial injury by multiple mechanisms,destroy blood coagulation and fibrinolytic systems,and influence on lipid metabolism.Methylenetetra hydrofolate reductase(MTHFR)is a key enzyme of homocysteine metabolic pathway in the human body.If it is insufficient or its activity decreases,it will directly result in the accumula tion of homocysteine in the human body,and callse hyperhomocysteinemia.Although a number of studies have found that MTHFR gene mutation is the main cause of MTHFR insufficient and its activity decrease,the correlation between MTHFR gene mutation and ischemic cerebral vascular disease is quite controversial now.This article reviews the relationship between MTHFR gene polymorphisms and ischemic stroke.

The effects of advanced glycation end-products (AGEs) on number and activity of vascular endothelial cells (VEC) from hone marrow stem cells (BMSC) of mice were investigated. 100 μ/ml AGEs markedly inhibited differentiation of BMSC into VEC with decreased vascular endothelial growth factor receptor-2 positive cells, hut 20 μg/ml AGEs had no effect.

Objective Study the effect of NMDA receptor antagonist GAPA on the [Ca 2+ ]i of the bilirubin precipitated brain tissue. Methods 10 ug/g of GAPA was administrated peritoneally to Gunn rat with bilirubin induced encephalopathy, brain tissue suspensions was prepared, Fura 2/AM was loaded. the neural cytosolic Ca 2+ was measured by flurescence imaging analysis. Results The concentration of neural cytosolic Ca 2+ in bilirubin precipitated brain tissue was significantly more than that in the control group; NMDA receptor antagonist GAPA could significantly decrease the cytosolic Ca 2+ overload. Conclusion Cytosolic Ca 2+ overload was found in the bilirubin precipitated brain tissue. NMDA receptor antagonist GAPA could prevent the cytosolic Ca 2+ overload in bilirubin induced brain tissue.