Objective To evaluate the efficacy and safety of entecavir(ETV)treatment on patients with chronic severe hepatitis B.Methods 82 native patients of chronic severe hepatitis B with positive HBV-DNA were divided into two groups,treatment group(37 cases) were prescribed with normal treatment plus ETV(0.5mg qd),while control group(45 cases) were treated with normal treatment alone.Symptoms,the levels of TB,ALT,PTA,HBV-DNA loads were determined before and at the end of the study.Results The effective rate of the treatment group(75.7%) were significant higher than that in the control group(53.4%)(P

ObjectiveTo analyze the relationship of depression after stroke with the location of lesion and the leve l of central nervous system (CNS) damage, and evaluate the treatment effect.Methods86 stroke patients were evaluated by Zung's self-rating depression scale (SDS). If SDS score ≥50 points, the patient was s elected as subjects for this study and treated with fluoxetine. The relationship of depression with the location of lesion and the level of CNS damage, and the treatment effect were analyzed.ResultsThere were 3 4 cases evaluated as depression (with 27 light depressive cases, 7 moderate depr essive and severe depressive cases). The symptom of depression has a positive co rrelation to the damage level (P<0.05). The depression inci dence of patients with acute sub-cortex stroke is higher than that of cerebral cortex and cerebellum stroke (P<0.01). Fluoxetine has a goo d effect on depression after stroke.Conclusions Th e symptom of depression after stroke has a positive correlation to the damage le vel. Fluoxetine has a good effect on depression after stroke.

Objective To analyze and consider the design for nursing English course through the investigation of demands for nursing English in 6 domestic high-end medical institutions.Methods Firstly,a face-to-face discussion was held with 10 experts in nursing management from above-mentioned institutions,field notes were made and themes were refined afterwards.Then,111 nurses were investigated in the 6 hospitals using purposive sampling method by filling questionnaire.Results In the teaching content,77 kinds of diseases were involved,including 27 most common ones; on the aspect of teaching methods and skills,90.1％ of the nurses recommended situational dialogue,72.1％ in favor of case teaching,92.8％ believed that nursing English course should cultivate students' communication skills; Its teaching emphasis in turn included vocabulary,communication capability,nursing knowledge (89.2％,88.3％,73.0％).Conclusions The objective of nursing English course should focus on cultivating nurse students' applied capability including listening,reading,speaking and written English.The textbook of nursing English should be written based on the characteristics of common diseases in the hospital stressing on nursing knowledge,vocabulary and communication skills.Teaching method of nursing English should consider the situational teaching model in hospital nursing English.

Objective To explore the factors affecting diagnosis accuracy on T stage of oral ultrasonic contrast agent examination on ulcerative gastric neoplasms.Methods Data from 82 patients were analyzed who were pathologically diagnosed as ulcerative gastric neoplasms ultrasounds data of oral ultrasonic contrast agent before surgery were compared to postoperative pathology,analysis had been done on influence of the lesion site,size of the T staging on ulcerative gastric neoplasms.Results The diagnosis accuracy rate of T stage on lesser curvature of stomach and gastric antrum were 91.3 ％ (21/23) and 85.7 ％ (24/28),compared with the pathological results were in good concordancy (Kappa =0.763,0.68,P ＜ 0.05).The accuracy rate of T stage on cardiac lesions was 68.0 ％ (17/25),compared with the pathological results consistency in general (Kappa =0.446,P ＜ 0.05).Further research on the effects of T stage accuracy would be necessary.The accuracy rate ofT staging on tumor size ≤ 5.0 cm group and ＞ 5.0 cm were 92.3 ％ (36/39) and 72.1％ (31/43),the difference was significant in two groups (x2 =5.591,P ＜ 0.05).Conclusion Oral ultrasonic contrast agent application is more accurate on lesser curvature of stomach,gastric antrum and lesions size ≤ 5.0 cm.

Objective To compare the value of intrarectal filling with water and filling in rubber sheath with water in endoluminal uhrasonography for preoperative staging of rectal tumors. Methods 215 cases of rectal tumors were divided into two groups. 120 cases using the method of filling in rubber sheath with water and 95 cases using intrarectal filling with water were diagnosed with uhrasonography. The results were compared with corresponding pathologic results for the judgment of their accuracy. Results The accuracy for the diagnosis of infiltration depth was 60.0 % in the first group and was 73.7 % in the second. The difference was statistically significant (P <0.05). The accuracy for diagnosis of metastases of perirectal lymph nodes was 82.5 % in the first group and was 80.0 % in the second. The difference has no statistical significance (P >0.50). Conclusion Intrarectai filling with water is better than filling in rubber sheath with water in the diagnosis of infiltration depth of rectal tumors, while there is no difference in the diagnosis of metastasis of perirectal lymph nodes.

Objective To evaluate the clinical value of color Doppler ultrasound-guided percutaneous transhepatic cholangiol drainage(PTCD) for treating obstructive jaundice. Methods 248 cases of PTCD were performed in 224 patients under the guidance of color Doppler ultrasound. 118 PTCD cases were carried out passing through the inferior segmental biliary duet of Left laterallobe (Left drainage mode). Right lobe drainage mode (right drainage mode)was conducted in 130 patients. Left plus right lobe drainage mode in 16 patients. Results The total success rate was 99.59 %(247/248), and the success rate of the firs time PTCD was 92.33 %(229/248). The success rate of left drainage mode was significantly higher than righl lobe drainage (96.61% vs 88.46 %, P ＜0.05). Conclusion The technique of color Doppler ultrasound-guided PTCD is an efficient method in obstructive jaundice therapy, with the advantages of safety, convenience, minimal invasion, and higher success rate.

Objective To investigate the sonographic diagnostic value of poorly differentiated thyroid carcinoma and anaplastic thyroid carcinoma. Methods Ultrasonography of 22 cases with differentiated thyroid carcinoma and anaplastic thyroid carcinoma were observed with color doppler sonography.The shape,size,echo,boundary,microcalcifieation foci and blood stream distribution were studied,and contrasted with pathological diagnosis after operation.Lymphnode in cervical part and sulcus esophagus were examined.The characters of thyropathy according to the above sonographie features were judged. Results 16uhrasonography or before operation and biopsy,in which 9 were left,7 were right.6 cases were in both leaves.Ultrasound showed that 2 cases were poody differentiated thyroid carcinoma, 1 case was parathyroid carcinoma. 1 case was Hashimoto's thyroditis, and remainders were thyroid carcinoma. Conclusion Ultrasonography could enhance the detection rates and diagnose accordance rates of poorly differentiated thyroid carcinoma and anaplastic thyroid carcinoma.

OBJECTIVE:To study the correlation of inorganic elements and active ingredients in Paris polyphylla. METH-ODS:HPLC was adopted for contents determination of polyphyllinⅠ,Ⅱ,Ⅵ and Ⅶ:the column was Phenomenex C18 with mo-bile phase of acetonitrile-water(gradient elution)at a flow rate of 1.0 ml/min,detection wavelength was 203 nm,and column tem-perature was 30 ℃. ICP-MS was adopted for contents determination of Na,Mg,K,Ca,Cr,Mn,Fe,Ni,Zn,Se,Sr,Mo,Pb, Cd,Hg,Cu and As:RF power was 1.55 kW,sampling depth was 10 mm,the plasma gas flow was 15.0 ml/min,carrier gas flow rate was 0.86 L/min,spray chamber temperature was 2 ℃,helium collision mode was He,gas flow was 4.5 ml/min,measurement points/peak was 6,sampling mode was hopping peak collection(repeated 3 times). And SPSS 21.0 software was adopted for step-wise regression analysis of correlation between the two above-mentioned. RESULTS:The linear range was 0.939-4.697 μg(r=0.999 8)for polyphyllinⅠ,1.124-5.620 μg(r=0.999 6)polyphyllinⅡ,0.784-3.918 μg for polyphyllin Ⅵ,0.976-4.880 μg for poly-phyllinⅦ.RSDs of precision,stability and reproducibility tests were lower than 2%,recoveries were 96.53%-100.71%(RSD=1.69%,n=6) for polyphyllinⅠ,98.19%-99.55%(RSD=0.58%,n=6) forⅡ,95.45%-100.83%(RSD=1.87%,n=6) for poly-phyllin Ⅵ,96.11%-102.01%(RSD=2.07%,n=6)for polyphyllin Ⅶ . The linear range was 0-195.984 3 mg/kg(r≥0.999 3),de-tection limit was no higher than 65.201 ng/kg. PolyphyllinⅠshowed positive correlation with Mg and negative correlation with Pb;polyphyllin Ⅱ showed positive correlation with Cu and negative correlation with As;polyphyllin Ⅵ showed positive correlation with Sr and Hg and negative correlation with Mn;polyphyllin Ⅶ showed positive correlation with Na and Ni and negative correla-tion with As;the total contents of the 4 polyphyllins showed positive correlation with Ni and Sr and negative correlation with Fe. CONCLUSIONS:The contents of inorganic elements and P. polyphylla have certain correlation with active ingredient.

Objective:To investigate Th17,Treg and related factors before and after myocardial infarction ,and explore the cor-relations among them.Methods:Extracted mononuclear cell in peripheral blood ,and used fluorescence-activated cell sorting analysis to detect the contect of Th17 and Treg.Enzyme-linked immunosorbent assay was used to detect cytokine production of IL-17 and TGF-β;real-time PCR was used to detect the contect of RORγT and Foxp3.Results: Compared with the control group , experimental group (both before and after thrombolysis) had increased expressions of Th17,IL-17 and RORγT(P<0.05);the expressions of Treg,TGF-βand Foxp3 had decreased(P<0.05).Compared with the group of before thrombolysis ,the group of after thrombolysis 7 d had decreased expressions of Th17,IL-17 and RORγT(P<0.05);increased expressions of Treg,TGF-βand Foxp3(P<0.05).Conclusion:Compared with the control group,patients with myocardial infarction have the high levels of Th 17 and the related factors,the decreased levels of Treg and the related factors.Thrombolytic therapy can decrease the levels of Th 17 and the related factors,and increase levels of Treg and the related factors.

In order to improve bilingual teaching in clinical epidemiology,a multidimensional teaching mode with flexible method was constructed.And it was proposed that based on the student-centered learning,the content of teaching should be adjusted,English should be used logically and clinical courses and practice should be closely connected.The new teaching method was proved successful.