Chronic hepatitis B(CHB)is one of the most commom cause of liver fibrosis. Accurate assessment of liver fibrosis is essential for the strategy of treatment and judgement of prognosis . Liver biopsy is the gold standard for staging fibrosis,but it is invasive with high cost,low reproducibility and poor acceptance by patients. Therefore,it is urgent to explore a noninvasive modality for the assessment of liver fibrosis. Recent evidence highlights that elastographic techniques, biochemical markers and the diagnostic model consisted of several serum markers have the potential for the diagnosis of liver fibrosis. This article reviewed the progress in noninvasive assessment of liver fibrosis in patients with CHB.

0.05).Conclusion Acupuncture has an effect on I/O curve amplitude of EPSP and PS,and on LTP induction of PS of dentate gyrus(DG) in rats after cerebral ischemia.However,the difference of effect of acupuncture at different doses on LTP induction is insignificant.

Objective To analyse effect of different doses of parecoxib on perioperative cellular factors and the maintenance dose of propofol in patients with laparoscopic cervical cancer surgery.Methods Collected 60 patients who were diagnosed with cervical cancer in our hospital from June 2014 to June 2015.All patients underwent laparoscopic surgery,according to the injection of parecoxib different amount before induction of anesthesia divided into control group,low dose group and high dose group,20 cases in each group,respectively before anesthesia, postoperative, postoperative 12 h and postoperative 24 h, of all patients with serum IL-6, IL-12 and TNF-a level,intraoperative propofol maintenance dose,and postoperative analgesia were detected.ResuIts The levels of serum IL-6 and TNF-αin three groups showed that:high dose group low dose group>control group (P<0.05).The maintenance dose of propofol in the three groups showed that:high dose group

Objective To investigate the expression and the clinical significance of Lewis y antigen and Mucin 1 (MUC1),as well as to evaluate the correlation between them in epithelial ovarian tumor.Methods The expression of Lewis y antigen and MUC1 in 60 cases of epithelial ovarian malignant tumors,30 cases of borderline ovarian tumors,30 cases of benign ovarian tumors and 20 cases of normal ovarian tissues were detected by immunohistochemical staining.The relationship between Lewis y antigen and MUC1,and their relationship with biology characteristic of ovarian carcinoma were analyzed.An immunofluorescence double labeling methods was performed to detect the correlation between Lewis y antigen and MUC1.Results In malignant epithelial ovarian tumors,the positive rates of Lewis y antigen was 88.33％,which was significantly higher than the positive rates in borderline(60.00％,x2 =9.6405,P ＜0.01) and benign ovarian tumors(33.33％,x2 =28.8095,P ＜0.01) and normal ovarian samples (0,x2 =52.3457,P ＜ 0.01).The positive rates of Lewis y antigen had nothing to do with the clinical pathological parameters of ovarian tumor,but the expression intensity of Lewis yantigen was increased with the development of the malignant degree(P ＜ 0.05).The positive rates of MUC1 in malignant epithelial ovarian tumors was also significantly higher than that in borderline,benign ovarian tumors and normal ovarian samples (86.67％ vs 53.33％,30.00％,25.00％,x2 =12.0321,29.4064,27.8464 ; P ＜0.01).And the expression intensity of MUC1 also increased with the development of clinical stage(P ＜0.01),but had nothing to do with the lymph node metastasis and histological grade(P ＞ 0.05).In ovarian cancer,both Lewis y antigen and MUC1 were highly expressed,and their expression levels were positively correlated (r =0.707,P ＜0.01),and Lewis y antigen colocalized with MUC1.Conclusion Both Lewis y antigen and MUC1 are associated with the occurrence and development of ovarian cancer.Lewis y antigen and MUC1 might be a sigh of biological behavior in ovarian cancers,and this study provides theoretical evidence of ovarian cancer biological treatment.

Objective The purpose of this research is to calculate the prevalence of thyroid dysfunction during pregnancy and to discuss the relationship between gestational thyroid diseases and pregnancy outcomes.Methods There were 3 745 pregnant women who took antenatal care at Sun Yat-sen Memorial Hospital,Sun Yat-sen University were chosen as the research objects during March 2012 to February 2014.All of them were given close monitoring and tracking till the termination of pregnancy.These subjects took thyroid function testing (TT4,FT4,TSH,thyroid peroxidase antibody),if the result was abnormal,they were followed up periodically.Results The prevalence of overt hyperthyroidism is 1.90％,1.20％ for subclinical hyperthyroidism,1.17％ for hypothyroidism,6.78％ for subclinical hypothyroidism,and 3.82％ for isolated hypothyroxinemia.Compared with normal thyroid function group,the morbidity of placental abruption increased in overt hyperthyroidism group (5.8％ vs 1.0％,P＜ 0.01) ; the incidence of gestational diabetes mellitus was increased in subclinical hyperthyroidism group (37.5 ％ vs 16.6％,P＜0.01) ; and the morbidity of preterm birth increased in subclinical hypothyroidism group (14.3％ vs 7.7％,P =0.002).Conclusion Gestational thyroid diseases may increase the incidence of adverse pregnancy outcomes ; such as placental abruption,gestational diabetes mellitus,and premature birth.

Objective To analyze the effect of clopidogrel combined with low molecular weight heparin on the treatment of middle-aged and elderly patients with acute coronary syndrome.Methods Totally 94 patients with acute coronary syndrome were selected and randomly divided into control group and observation group,47 cases in each group.The patients in the control group were given clopidogrel,while patients in the observation group were given clopidogrel combined with low molecular weight heparin sodium.The clinical efficacy,platelet aggregation rate,drug safety and cardiac function improvement were observed and compared between the two groups before and after treatment.Results The total effective rate in the observation group was 93.62％,which was significantly higher than 78.72％ in the control group (P ＜ 0.05).Mter the treatment for 1 and 2 weeks,the platelet aggregation rate in the observation group was significantly lower than that in the control group (P ＜ 0.05).After the treatment,LVEDD and LVESD levels in both groups were significantly lower than those before treatment,LEVF level was significantly higher than that before treatment,LVEDD and LVESD levels in the observation group were significantly lower than those in the control group,and LEVF level was significantly higher than the control group (P ＜ 0.05).There was no significant differences between the two groups in the incidence rates of bleeding,gastrointestinal reactions,headache and rash (P ＞ 0.05).Conclusion Clopidogrel combined with low molecular weight heparin is effective in the treatment of middle-aged and elderly patients with acute coronary syndrome,which can effectively reduce the platelet aggregation rate,enhance cardiac function and exercise tolerance,reduce the risk of sudden death and improve prognosis.

Objective To analyze the effect of clopidogrel combined with low molecular weight heparin on the treatment of middle-aged and elderly patients with acute coronary syndrome.Methods Totally 94 patients with acute coronary syndrome were selected and randomly divided into control group and observation group,47 cases in each group.The patients in the control group were given clopidogrel,while patients in the observation group were given clopidogrel combined with low molecular weight heparin sodium.The clinical efficacy,platelet aggregation rate,drug safety and cardiac function improvement were observed and compared between the two groups before and after treatment.Results The total effective rate in the observation group was 93.62％,which was significantly higher than 78.72％ in the control group (P ＜ 0.05).Mter the treatment for 1 and 2 weeks,the platelet aggregation rate in the observation group was significantly lower than that in the control group (P ＜ 0.05).After the treatment,LVEDD and LVESD levels in both groups were significantly lower than those before treatment,LEVF level was significantly higher than that before treatment,LVEDD and LVESD levels in the observation group were significantly lower than those in the control group,and LEVF level was significantly higher than the control group (P ＜ 0.05).There was no significant differences between the two groups in the incidence rates of bleeding,gastrointestinal reactions,headache and rash (P ＞ 0.05).Conclusion Clopidogrel combined with low molecular weight heparin is effective in the treatment of middle-aged and elderly patients with acute coronary syndrome,which can effectively reduce the platelet aggregation rate,enhance cardiac function and exercise tolerance,reduce the risk of sudden death and improve prognosis.

Objective:To analyze the characteristics of clinical manifestation, auxiliary examination and gene mutation of 3-hydroxy-isobutyryl-coenzyme A hydrolase (HIBCH) deficiency to better understand this disease.Methods:The clinical manifestations and genetic results of a patient with HIBCH deficiency were analyzed. The clinical features and genetic characteristics of HIBCH deficiency were summarized based on the literature review.Results:The proband, female, one year and four months old, was admitted to Children′s Hospital Affiliated to Zhengzhou University for “vomiting and diarrhea for 15 days, dyspnea and intermittent convulsions for 13 days after digestive tract infection”. The intelligence was normal, however, the motor development was slightly delayed before onset. Physical examination showed light coma, poor response and insensitivity to light. She also had shortness of breath, weak positive three concave signs and coarse breath sound in both lungs with sputum purrs. In addition, the muscle tension of extremities was increased. Bilateral Brudzinski′s sign, Babinski′s sign and Kernig′s sign were negative. Serum hydroxybutyryl carnitine (C4OH) was increased. Cranial magnetic resonance imaging (MRI) showed atrophy in bilateral cerebral hemispheres and abnormal symmetry signals in bilateral globus pallidus and cerebral peduncle. Novel compound heterozygous variants of HIBCH, c.489T>A (p. C163*) and c.740A>G (p. Y247C), were found in the patient, which respectively inherited from her healthy parents. Her symptoms were relieved after“cocktail”therapy and symptomatic treatment. Literature related to HIBCH deficiency published all around the world was reviewed. As a result, 17 articles, including 24 cases, had been reported. The majority of patients presented with poor feeding, dystonia and progressive motor developmental delay in early infancy. Cranial MRI showed lesions in bilateral basal ganglia. Serum C4OH concentration was elevated. And compound heterozygous or homozygous variants of HIBCH gene were found in patients with HIBCH deficiency.Conclusions:The detection of serum amino acids and acylcarnitine profiles on HIBCH deficiency was relatively specific and it was helpful to make a clear diagnosis by combining with cranial MRI and genetic tests. In this study, a case of HIBCH deficiency was confirmed, which expanded the mutation spectrum of HIBCH gene. Meanwhile, summarizing the clinical and genetic characteristics of cases reported improved understanding of HIBCH deficiency.

BACKGROUND: The study was conducted to investigate the current status of the occupational health and safety management system (OHSMS) in the construction industry and the effect of OHSMS on accident rates. Differences of awareness levels on safety issues among site general managers and occupational health and safety (OHS) managers are identified through surveys. METHODS: The accident rates for the OHSMS-certified construction companies from 2006 to 2011, when the construction OHSMS became widely available, were analyzed to understand the effect of OHSMS on the work-related injury rates in the construction industry. The Korea Occupational Safety and Health Agency 18001 is the certification to these companies performing OHSMS in South Korea. The questionnaire was created to analyze the differences of OHSMS awareness between site general managers and OHS managers of construction companies. RESULTS: The implementation of OHSMS among the top 100 construction companies in South Korea shows that the accident rate decreased by 67% and the fatal accident rate decreased by 10.3% during the period from 2006 to 2011. The survey in this study shows different OHSMS awareness levels between site general managers and OHS managers. The differences were motivation for developing OHSMS, external support needed for implementing OHSMS, problems and effectiveness of implementing OHSMS. CONCLUSION: Both work-related accident and fatal accident rates were found to be significantly reduced by implementing OHSMS in this study. The differences of OHSMS awareness between site general managers and OHS managers were identified through a survey. The effect of these differences on safety and other benefits warrants further research with proper data collection.
Certification ; Construction Industry* ; Data Collection ; Korea ; Motivation ; Occupational Health* ; Surveys and Questionnaires ; Republic of Korea ; Safety Management*

Objective To study the Chlamydia trachomatis(CT)and Ureaplasma urealyticum (UU)infection in Guangzhou area, and analyze the consistency of simultaneous amplification and testing (SAT)and conventional methods(CT was detected by latex immunochromatography, UU was detected by liquid culture method).Methods A total of 12 120 samples of urogenital secretions or urine samples were collected from Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University from January 2015 to December 2016.CT-RNA and UU-RNA were detected by the SAT technique, a part of samples were tested by conventional methods at the same time.The positive rates of CT and UU by SAT and the conventional methods between different gender and age groups were analyzed by χ2test, the consistencies between different detection methods were analyzed by Kappa test.Results The positive rate of CT was 4.05%(356/8 781), UU 33.69%(1 125/3 339)in Guangzhou from 2015 to 2016.The positive rate of UU was significantly higher than that of CT(χ2=1 981,P<0.01).Of 145 specimens for CT test,the coincidence rate between SAT and latex immunochromatographic method was 96.55%(140/145), which showed good consistency(Kappa=0.65).Of 186 specimens for UU test,the coincidence rate of the results between the SAT method and liquid culture was 92.47%(172/186),which showed strong consistency(Kappa=0.81). Conclusions The positive rate of UU was significantly higher than that of CT in Guangzhou.The SAT method and conventional methods to detect CT and UU show high consistency, which can provide the evidence for clinical diagnosis of CT and UU infection.