OBJECTIVE:To observe the effect of compound glycyrrhizin on patients with chronic type B hepatitis.METH_ ODS:126patients with chronic type B hepatitis were randomly divided into two groups:the control group was administered with common therapy like reducing jaundice and protecting liver;the trial group was administered with compound glycyrrhizin plus the therapy of the control group.Time of therapy for both groups was8wk.RESULTS:The total effective rates for the tri_ al group and the control group were93.6%and33.3%,respectively,and significant differences were noted between groups(P

Objective To investigate the pathogenesis of diagnosis and treatment for delayed gastric emptying(DGE) after pancreaticoduodenectomy(PD).Methods The clinical data of 226 patients admitted between 1983 and 2001 undergoing PD were retrospectively analysed.Results In 226 PD cases DGE was observed in 62 patients(27.4%). Patients with DGE had longer duration of nasogastric tube drainage(21 days vs. 5.6 days).All patients were treated by non-operative methods. The average recovery time was 21 days.Conclusions It is emphasized that DGE has been associated with several factors, including preoperative status of diabetes, bowel obstruction, and jaundice,and postoperative pancreatic fistula, intra-abdominal abscess. Octreotide administration had no relation with the occurrence of DGE.

ObjectiveTo evaluate the potential prognostic factors, and to better define appropriate treatment strategies for patients with phyllodes tumor of the breast. MethodsFourteen patients treated primarily for phyllodes tumor of the breast were reviewed retrospectively.Results The median age was 35 years. According to the histologic criteria of WHO, there were 5 benign cases(36%), 5 borderline cases(36%), and 4 malignant cases(29%). Seven patients underwent local excision, 4 cases did simple mastectomy, and 3 cases did modified radical mastectomy. Follow-up was obtained for 11 cases, with an average of 19 months. One patient died from metastasis 2 years after a modified radical mastectomy. Three patients treated by local excision presented local recurrence.Conclusion The outcome of phyllodes tumor appears to be determined by the biology of the tumor rather than by treatment modality. A wide local excision, with an adequate margin of normal breast tissue is the preferred initial therapy for phyllodes tumor of the breast.

Objective To explore the clinical characteristics,pathology,prognosis and proper treatment of tubular carcinoma of the breast. Methods The clinical data of 11 patients with tubular carcinoma of the breast treated in Peking Union Medical College Hospital were retrospectively analyzed.Results The incidence of tubular carcinoma of the breast account for 0.4% of the total breast cancer cases.Eight out of 11 cases had palpable painless lumps in the breast.Six cases received modified radical mastectomy,among which one patient received modified radical mastectomy of both sides.Four patients underwent breast conservation therapy.Sentinel lymph nodes biopsy was conducted in 2 patients.By immunohistochemistry ER was positive in 6 cases,PR was positive in 7 cases,2 cases were axiilary lymph node positive.Three patients received chemotherapy.Two patients received endocrine therapy(tamoxifen or aromatase inhibitor).Other patients received combined therapy including radiation,endocrine therapy and chemotherapy.All the patients have been followed up from 1 month to 7 years and within the period there is no recurrence,metastasis and death. Conclusion Tubulax carcinoma of the breast is a kind of low malignant tumor.Proper surgery and adjuvant therapy is important to improve survival and the quality of life.

Objective To observe the effects of cyclovirobuxinum D(Cvb-D)on the myocardium cell apoptosis of myocardial ischemia rats.Methods The rats were given Cvb-D 0.55,1.1 and 2.2 mg/kg orally per day for 21 days respectively.The myocardial ischemia model was induced by isoprenaline intraperitoneal injection.Myocardium tissue was observed under light microscope and end labelling TUNEL method was used to determine the cell apoptosis.Then the average percentage of apoptosis cell was figured out to evaluate the effect of Cyb-D.Results Cvb-D obviously lightened isoprenaline-induced myocardial pathological changes such as turbulence of myocardial fiber,plasmolysis of necrotic cell,inflammatory cell infiltration of necrotic interstitial region.Cvb-D remarkably inhibited myocardium cell apoptosis of myocardial ischemia rats caused by isoprenaline.Conclusion Cvb-D has the action of ameliorating myocardium cell apoptosis caused by myocardial ischemia.

Objective To assess the value of combined detection of enterovirus nucleic acid and antibody in early etiological diagnosis for hand-foot-and-mouth disease ( HFMD).Methods A case-control study was conducted.A total of 1 066 cases of children clinically diagnosed with HFMD from Hangzhou Children′s Hospital were involved into the research group from January to June 2014, consisting of 401 common cases and 665 severe cases; Throat swabs and serum samples from these children underwent combined detection for EV71/CA16/EV of enterovirus nucleic acid by fluorescence quantitative RT-PCR and for EV71/CA16-IgM by ELISA.All data were analyzed with SPSS 16.0.Results The total positive rate of enterovirus nucleic acid EV71/CA16/EV by fluorescence quantitative RT-PCR in the 1 066 cases of children clinically diagnosed with HFMD was 75.52%( 805/1 066 ) ( 95%CI: 72.80%-78.05%).But the total positive rate of combined detection was 91.46%( 975/1 066 ) ( 95%CI:89%.58-93.04%).The total positive rate of combined detection is higher than that of RT-PCR test(χ2 =98.338,P=0.000).The positive rate of EV71 type of combined detection was 64.63%(689/1 066)(95%CI:61.67%-67.49%),which is 15.38%higher than that of RT-PCR test 49.25%(525/1 066)(95%CI:46.21%-52.29%)(χ2 =51.453, P=0.000).In 665 severe cases of HFMD, the total positive rate of combined detection was 96.69%(643/665)(95%CI:94.95%-97.87%), which is higher than that of RT-PCR test 79.25%(527/665)(95%CI:75.92%-82.22%)(χ2 =95.607, P =0.000).In the severe cases, the positive rate of EV71 type of combined detection was 87.52%( 582/665 ) ( 95%CI:84.71%-89.89%) , which is 18.95% higher than that of RT-PCR test 68.57%(456/665) (95%CI:64.87%-72.06%) (χ2 =69.665, P=0.000).In the fatal cases, the positive rate of EV71 type of combined detection was 95.92%(94/98) (95%CI:89.28%-98.68%).Conclusions The combined detection of enterovirus nucleic acid and specific IgM antibody can significantly increase the positive rate of HFMD, especially for severe cases.The combine detection increases both the total positive rate and EV71 positive rate.Thus it has a high potential for becoming a new guidelines for laboratory diagnosis of HFMD.

Objective To examine the therapeutic effect of Kummerowia striata (KS) on IgA nephropathy (IgAN) rats.Methods Sixty SD rats were equally randomized into 6 groups after adaptive feeding for 3 days:blank control group,model control group,tripterygium glycosides (TG) group (in the dose of 0.0165 g/kg),and high-,middle-and low-dose KS groups (in the dose of 16.0,8.0,4.0 g/kg respectively).IgAN rat model was established with bovine serum albumin (BSA),lipopolysaccharide (LPS) and carbon tetrachloride.After modeling,rats except those in blank control group received gastric gavage of corresponding drugs for 10 continuous weeks.Levels of 24-hour proteinuria and hematuria in each group were measured,serum levels of total protein (TP),serum albumin (ALB),aspartate aminotransferase (AST),and alanine aminotransferase (ALT) were tested.The pathological changes of renal tissue were observed under light microscope by HE staining.Results Water decoction of KS could significantly decrease the proteinuria and hematuria levels,and reduce renal pathological changes of IgAN model rats.However,water decoction had no effect on indicators of liver function such as TP,ALB,AST,and ALT in IgAN rats.Conclusion KS has certain therapeutic effect on IgAN model rats.

Objective To establish a rapid and high sensitive assay of real-time fluorescence loop-mediated isothermal amplification assay for clinical detection of HIV-1 DNA.Methods Four loop primers were constructed for loop-mediated isothermal amplification ( LAMP) assay based on six conserved regions selected from HIV gene sequence .SYBR Green Ⅰdye was added into the established LAMP assay and its specificity and sensitivity were evaluated .Results The real-time fluorescence LAMP assay for the detection of HIV-1 DNA was successfully established .It was used for the detection of HIV-1 DNA among 200 patients with HIV infection, of which 195 cases were positive.Moreover, 50 healthy subjects were found HIV-1 DNA negative tested by the real-time fluorescence LAMP assay .Quantitative testing for HIV-1 DNA showed that the lowest and the highest detectable amount were 51 copies/ml and 8.21×106 copies/ml respectively, and the average amount was 5.78×105 copies/ml.HIV viral loads ranging from 1×105 to 10×105 were detected in 162 of 200 patients (83.08%).The ten times dilution method showed that the lowest detection limit of the assay was 50 copies/ml.The crossover experiment indicated that the specificity of the assay was 100%as none of HBV-DNA, HSV-DNA and HCV-RNA was determined by the assay .Conclusion The present study shows that 97.5%of the patients with HIV infection are confirmed HIV-1 DNA positive by the real-time fluorescence LAMP assay , suggesting that the real-time fluorescence LAMP assay is a rapid and sensi-tive assay with high specificity and could be applied for clinical detection of HIV-1 DNA.

Breast cancer is the leading cause of malignancy-related mortality in women worldwide. The more accurate prediction of lymph node metastasis and evaluation of personalized prognosis of breast cancer patients could provide evidence and reference for individualized comprehensive treatment and clinical decision-making. Nomogram is statistical calculation model developed to generate individualized prediction of a certain clinical event through the factors associated with it. Currently breast cancer related nomogram models is most commonly used in the prediction of non-sentinel lymph node status in patients with sentinel lymph node-positive breast cancer, sentinel lymph node metastasis in clinical node-negative breast cancer and prognosis evaluation of breast cancer. This article reviewed the recent advances in breast cancer related nomograms according to the above mentioned three aspects, and evaluated respectively the predictive factors, accuracy, characteristics and clinical application potential.

Objective To investigate cerebrospinal fluid characteristics and clinical features in children with severe hand,foot and mouth disease (HFMD) induced by enterovirus 71 (EV71) infection.Methods A total of 114 children with severe HFMD,in whom EV71 was detected by reverse transcription polymerase chain reaction (RT-PCR),were admitted in Hangzhou Children's Hospital during May and August 2013.Seventy-eight children with severe HFMD induced by other enteroviruses admitted at the same period served as controls.The results of cerebrospinal fluids (CSF) routine examination and biochemical tests,and the clinical symptoms were compared between two groups.Differences in enumeration data were compared with x2 test,and measurement data were compared with Mann-Whitney U test.Results The incidences of vomiting and limb shaking in EV71 infection group were 35.1％ and 50.9％,which were higher than those in control group (x2 =7.864 and 19.682,P ＜ 0.05).The incidence of limb shaking in children with nucleated cells count ≥ 100 × 106/L in EV71 group was higher than that with nucleated cells count ＜ 100 × 106/L (72.3％ vs.35.8％,x2 =14.740,P =0.000).The nucleated cells count,protein quantity and their positive rates in EVT1 infected group were higher than those in control group (Z =-9.458 and-6.591,P=0.000; x2=105.421 and 10.932,P =0.000 and 0.001).Conclusion The symptoms of nervous system damage and abnormal CSF examination were more serious in HFMD induced by EV71 infection,and in EV71 infected patients the incidence of limb shaking is correlated with nucleated cell count in CSF.