Hepatitis A is one of the global public health problems,and China has high prevalence. In order to decrease the incidence of hepatitis A,China has integrated Hepatitis A vaccine into Expanded Program on Immunization (EPI) in 2007. The paper will provide some ideas on the immunogenicity and impact factors of the different types of hepatitis A vaccines that are used in China.

Orthodox Manual of External Diseases is a book giving an exhaustive description on various kinds of external and surgical disease,written by CHEN Shi-gong(1617),the author pay more attention to concept of wholism and syndrome differentiation.He provided the original view on the treatment of disease that combine internal with external therapy,needle with herbs.① All the external symptoms originates from internal causes and all diseases arisen from pathogenetic fire.Carbuncle definitely caused by visceral disorders,addiction to greasy diet,overstrain and exhaustion of sexual activities.② Based on occurrence and development of surgical disease,currency of ebb and flow between pathogenic factors and health qi,he provided three therapeutic methods for surgical disease including resolving,expelling from within,and reinforcing.③ He created and improved some surgical operation and provide the new therapeutic way that expelling the pathogenic factor by opening and drainage.④ He also believed that invigorating and regulating spleen and stomach,harmonizing qi and blood should be put in the first place when treating disease.

The pancreatic polypeptide (PP) cells of rat pancreatic islets were demonstrated by immunocytochemical method. The distribution and morphology of PP cells were investigated in order to observe their changes during postnatal development. At the lst day and 7th day of rat after birth, the PP cells of islets were different from that in adult, the processes of PP cells were not evident, and the immunoreactivity was weaker. In addition, the PP cells were also presented in the duodenum epithtlium. After 18th day, the distribution and morphology of the PP cells did not show obvious difference from that in adult. The percentage of PP cells of islets was less in lst day, and approximated to adult level in 18th day, and over adult level in 28 th day. The above changes of percentage of the PP cells showed mainly in islets in the head of pancreas. The changes of volume density and numerical density per area corresponded with the changes of percentage of the PP cells. Immunoelectron microscopic study showed that the secretory granules (SGs) and gold la belled particles on the SGs of the PP cells in 7th day were less than that in 28th day and adult. Based upon the morphology of the SGs, the PP cells can be classified into two types. The type Ⅰ cells contained SGs with medium electron density or empty-like cores, and larger SGs were more. The type Ⅱ cells contained SGs with lower electron density cores, and small SGs were more. The gold labelled particles in SGs in the type Ⅰ were more than that in the type Ⅱ. The results suggest that the PP cells of rat islets continue to change after birth.

Objective To explore the construction and application effects of extended care form for children with epilepsy based on Omaha System.Methods Based on Omaha System,the form was established by referring medical records,literature review and three rounds of focus group discussion.From February to June,2016,48 children with epilepsy were selected as the observation group and received routine care as well as management using the form based on Omaha System;from August to December,2015,48 children with epilepsy were selected as the control group and received routine care and follow-up.The effects of intervention and scores of Family Management Measure were compared between two groups.Results Nursing issues in all domains for the observation group 3 months after intervention were lower than those during hospitalization except financial situation (P＜0.05);there was statistically significant difference in scores of knowledge-behavior-status of main nursing issues before and after intervention except cognition and mental health items (P＜0.05).Duration of hospitalization,expenditure,readmission rate,EEG results and scores of FAMM in the observation group were better than those in the control group (P＜0.05).Conclusion The construction and application of the form based on Omaha System can provide references for longterm management for children.

Objective To discuss the efficacy and security of entecavir and interferon sequential combination therapy on chronic hepatitis B.Methods 108 patients with chronic hepatitis B were randomly divided into the sequential combination therapy group,the entecavir group and the interferon group.Each group had 36 cases.The efficacy and security of different therapy were observed.Results The HBV DNA negative rate of the sequential combination therapy group was 77.78％,and the ALT normalization rate was 91.67％,which were both higher than those of the entecavir group and the interferon group(x2 =14.40,22.12,20.07,18.47,all P ＜ 0.05).The total effective rate of the sequential combination therapy group was 91.67％,which was obviously higher than that of entecavir group and the interferon group(x2 =12.09,6.82,all P ＜ 0.05).The entecavir and interferon sequential combination therapy had a good security.Conclusion Entecavir combined with interferon sequential therapy in the treatment of chronic hepatitis B had a significant clinical efficacy and deserved promotion.

Objective:To investigate dermoscopic features of molluscum contagiosum.Methods:A total of 82 outpatients with molluscum contagiosum were collected from Dalian Dermatosis Hospital between August 2019 and January 2020, and the dermoscopic features of 227 skin lesions were analyzed retrospectively.Results:Of the 227 skin lesions, hilar depression and orifices were observed in 120 (52.86%) by naked eyes and 198 (87.22%) by dermoscopy, and blood vessels were observed in 20 (8.81%) by naked eyes and 214 (94.27%) by dermoscopy. Different vascular patterns were identified by dermoscopy, including crown-shaped vessels (132 lesions, 58.15%) , punctate vessels (34 lesions, 15.00%) , and a mixed pattern (48 lesions, 21.15%) . The proportion of punctate vessels was significantly higher in lesions with inflammation or exfoliation (86.00%) than in those without (22.03%, χ2=81.685, P < 0.001) , and significantly higher in lesions with eczematous changes (50.00%) than in those without (33.85%, χ2=17.784, P < 0.001) . The most frequently observed structures were round, white-yellow, amorphous structures (40.53%) , followed by four-leaf clover-like pattern (33.48%) , polylobular pattern (20.26%) and nonspecific pattern (5.73%) . Conclusion:Orifices, vascular structures and white-yellow amorphous structures can be observed in molluscum contagiosum by dermoscopy, and the most common vascular pattern is the crown-shaped vessel.

In non-dialytic composite treatment of chronic renal failure, wheat (or corn) starch should be used for low protein (20-40 g/day) diet in substituting grains, to increase high biological value protein intake (about 50-70% of total protein intake). This principle has been used in 30 Patients (33 times) for 1-2 monthes. Daily total calorie intake should be maintained within 2000-3000 kcal. According to the status of the patient, EAA-TR2 (13.8 g/day I.V.) and other supporting measurements may be used for most patients. In all the patients, except six (2 cases useless, observation of 4 cases discontinued), uremic manifestations were ameliorated, nutritional status was improved and azotemia markedly alleviated, life span may be prolonged. According to nitrogen balance studied, in 6 cases it is indicated that nitrogen balance can be maintained if protein intake is not less than 0.5 g/kg/day (with sufficient calorie intake) for chronic renal failure patients (Cr clearance 5-10 ml/min).

Combined pulsed-field gradient, shaped pulses, and product operator calculations (algorithm), two-dimensional 1 H-31 P hetero-nuclear multiple quantum coherence ( HMQC) pulse sequence was established with the aid of C language. The result showed that coherent transfer path selection could be achieved by adjusting the ratio of two gradient strength ( g1 , g2 ) . The best ratio of g1 and g2 was -5:4 . The HMQC method based on the above sequence can be used for identifying the alkyl groups coupling with phosphorous nucleus. For the different alkyl groups, the sensitivity of this method decreased in the order methyl>isopropyl>ethyl>propyl. The limit of detection was about 10 mg/L. This method can be directly used for the screening and identification of phosphorus chemical warfare agents and related compounds.

Objective To explore the relative factors on delayed encephalopathy after acute carbon monoxide poisoning(DEACMP)and the signifiance of P 300 for judging the severity and prognosis of DEACMP.Methods Thirteen aspects such as contact time with carbon monoxide (CO)?coma time et al were analysed between 44 patients with DEACMP (DEACMP group)and 42 patients with acute CO poisoning but without DEACMP (ACMP group). P 300 s were studied in the patients with P 300 as compared with the patients had just caught acute CO poisoning (DEACMP group).and 44 normal controls (NC group).Results There was extremely significant difference in contact time with CO,coma lasting time,treatment time with hyperbaric oxygen,age,complication ( P

Objective To evaluate the efficacy of retroperitoneoscopic radical nephrectomy.Methods From October 2001 to September 2006,a total of 108 patients underwent retroperitoneoscopic radical nephrectomy in our department.The tumors sized 1.0-8.0 cm in diameter with a mean of(4.3?2.9)cm.Before the operation,42 patients were in stage T1N0M0,54 in stage T2M0N0,and 12 in stage T3aN0M0.Results The operation time was 35-180 min with a mean of(63.5?30.3)min,and the blood loss was 20-1500 ml [mean,(75?23)ml].Totally 3 patients were converted to open surgery.The intra-and postoperative complications included hemorrhage caused by the injury of the inferior vena cava or renal artery(4 cases),wound infection(3 cases),and hypercapnia(8 cases).The patients were followed up for 6-36 months(over 12 months in 61 cases),during which 2 patients died of pulmonary metastasis one year after the surgery,1 patent died of liver metastasis 7 months after postoperation,the other 105 patients survived without tumor.The 1-year survival rate was 98.4%(60/61);and 3-year survival rate was 85.7%(18/21).Conclusions Retroperitoneoscopic radical nephrectomy is mini-invasive and effective for renal carcinoma.The patients recover quickly after the surgery.The procedure is worth being wildly used.