ObjectiveTo investigate the role of serum HBV RNA in assessing antiviral therapy for patients with chronic hepatitis B， as well as its potential as a biomarker in clinical therapy， and to provide a scientific basis for the clinical treatment of chronic hepatitis B. MethodsA total of 134 patients who were diagnosed with chronic HBV infection in The Second Affiliated Hospital of Kunming Medical University from April 2023 to May 2024 were enrolled as subjects， and related examinations were performed， including HBV DNA， serum HBV RNA， liver function， HBsAg， anti-HBs， HBeAg， anti-HBe， anti-HBc， and transient elastography of the liver. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups， and the Kruskal-Wallis H test was used for comparison between multiple groups； the chi-square test or the continuity-adjusted chi-square test was used for comparison of categorical data between two groups. Pearson correlation analysis or Spearman correlation analysis was performed. ResultsThe 134 patients with chronic HBV infection were divided into HBeAg-positive group with 45 patients and HBeAg-negative group with 89 patients， and there were significant differences between the two groups in age， the positive rate and quantitative value of HBV DNA， the positive rate and quantitative value of serum HBV RNA， HBsAg， anti-HBe， and ALT （all P<0.05）. In the cohort study of the HBeAg negative group， there were significant differences in the levels of HBV DNA， HBsAg， and GGT between the serum HBV RNA-negative group with 14 patients and the serum HBV RNA-positive group with 75 patients （all P<0.05）. There were 28 patients in the HBeAg-positive group and 62 in the HBeAg-positive group who used antiviral drugs for ≥1 month， and the 28 HBeAg-positive patients had an HBV RNA positive rate of 100%， while for the 62 HBeAg-negative patients， there were significant differences in the positive rate and level of serum HBV RNA between the patients with different durations of medication （both P<0.05）. Among the 89 HBeAg-negative patients， there were 62 treatment-experienced patients and 27 treatment-naïve patients， and there was a significant difference between the two groups in HBV RNA level ［2.07 （1.52 — 2.82） log₁₀ copies/mL vs 2.69 （1.80 — 3.55） log₁₀ copies/mL， Z=2.034， P=0.042］. For HBeAg-negative patients， serum HBV RNA was positively correlated with HBV DNA and HBsAg （both P<0.05）， and for HBeAg-positive patients， serum HBV RNA was significantly positively correlated with HBV DNA， HBsAg， and HBeAg （all P<0.05）. ConclusionAntiviral therapy can reduce viral load， and for HBeAg-negative patients with high-sensitivity HBV DNA below the lower limit of detection， serum HBV RNA can fill the “gap” in the detection of viral replication.

Objective To investigate the effects of mobile APP combined with WeChat group on the self-efficacy, self-management and medical adherence of the elderly patients with chronic obstructive pulmonary disease (COPD). Methods A total of 96 cases of elderly patients with COPD, who had been treated in Harrison International Peace Hospital of Hengshui in Hebei Province and finished 1 year follow-up from January 2013 to May 2016, were selected as the research objects by convenience sampling method, and divided into observation group and control group by random number table method, with 48 cases in each. The patients of the control group were given regular telephone follow-up as continuous nursing measures, while the patients of the observation group were given continuous nursing by mobile APP "317 nurse" combined with WeChat group. After 1 year follow-up, COPD severity distribution, the score of modified Medical Research Council (mMRC) scale, patients' self-efficacy and self-management and medication adherence were compared between the two groups. Results After the 1 year follow-up, the difference of the COPD severity distribution between the two groups was statistically significant (P< 0.05), but there was no significant difference in the score of mMRC scale between the two groups (P> 0.05). The score of each dimension in the self-management scale and the self-efficacy scale of the observation group was significantly higher than that of the control group (P< 0.05). Additionally, the medication compliance score of observation group was significantly higher than that of the control group (P<0.05). Conclusions It can effectively enhance patients' self-efficacy and self-management level and improve patients' medical compliance by the application mobile APP "317 nurse" combined with WeChat group as continuous nursing measures for elderly patients with COPD, so as to improve patients' clinical symptoms.

OBJECTIVETo compare the difference between acupuncture and estazolam on arousal state in patients of primary insomnia, and to explore its nerve electrophysiology mechanism.

METHODSSixty-four patients of primary insomnia were randomized into an acupuncture group (32 cases) and a medication group (32 cases). After 3 patients were excluded, 31 cases in the acupuncture group and 30 cases in the medication group were included. Patients in the acupuncture group were treated with acupuncture at Sishencong (EX-HN 1), Anmian (Extra), Shenmen (HT 7), Sanyinjiao (SP 6), Zhaohai (KI 6), Shenmai (BL 62) as main acupoints, combined with supporting acupoints, once a day, five times per week, continuously for 4 weeks. Patients in the medication group were treated with oral administration of estazolam, once a day, continuously for 4 weeks. The Pittsburgh sleep quality index (PSQI) and mean sleep latency (MSL) of multiple sleep latency test (MSLT) were compared before and after treatment in the two groups; the polysomnography (PSG) was applied to monitor the indices regarding sleep structure.

RESULTSCompared before treatment, PSQI score was reduced after treatment in the two groups (both<0.01), which was more significant in the acupuncture group (<0.05). Compared before treatment, sleep onset latency (SOL), number of awakenings (NWAK) and wake after sleep onset (WASO) were reduced, while total sleep time (TST) and sleep efficiency (SE) were significantly increased in the two groups after treatment (all<0.01). Compared before treatment, the percentage of non-rapid eye movement period 1/2/3 (N1, N2, N3) and the percentage of rapid eye movement period (REM) to TST were not significantly changed after treatment in the medication group (all>0.05). Compared before treatment, the percentage of N1, N2 to TST was reduced, while the percentage of N3 and REM to TST was increased after treatment in the acupuncture group (<0.01). The SOL, NWAK, WASO, TST, SE were not statistically changed after treatment in each group (all>0.05). Compared with the medication group, the percentage of N1 and N2 was reduced while that of N3 and REM was increased after treatment in the acupuncture group (all<0.01). After treatment, MSL of MSLT were obviously decreased in the two groups (both<0.01), which were more significant in the acupuncture group (<0.05).

CONCLUSIONSAcupuncture can more effectively improve sleep quality of primary insomnia than estazolam, and is more beneficial for regulation of hyperarousal state.

OBJECTIVETo compare the difference in depression relief in the treatment of depressive disorder at the acute stage between the combined therapy of acupuncture and 5-HT (5-hydroxytryptamine) selective serotonini reuptake inhibitors (SSRIs) and the single application of SSRIs and explore the impact on the imbalance of 5-HT and TH1/TH2.

METHODSNinety cases of depressive disorder at the acute stage were randomized into a combined therapy group and a medication group, 45 cases in each one. In the medication group, SSRIs were prescribed forl oral administration, once or twice a day, continuously for 4 weeks. In the combined therapy group, on the basis of treatment as the medication group, acupuncture was combined. The main acupoints were Baihui (GV 20), Yintang (GV 29), Shenting (GV 24), Fengchi (GB 20), Dazhui (GV 14) and Sishencong (EX-HN 1), once every two. days, continuously for 4 weeks. Before treatment, and after the 1st, 2nd and 4th weeks of treatment, the Hamilton depression scale (HAMD) was used to evaluate the depression severity. Separately, before and after the 4 weeks of treatment, the levels of serum 5-HT, interleukin-1 beta (IL-1β), interleukin-6 (IL-6), interleukin-4 (IL-4) and interleukin-10 (IL-10) were determined and compared with those in 45 cases of the healthy group.

RESULTSHAMD score was reduced in the 1st, 2nd and 4th weeks of treatment as compared with that before treatment in the combined therapy group (all P<0 01). HAMD score was reduced in the 2nd and 4th weeks of treatment as compared with that before treatment in the medication group (all P<0. 01). HAMD scores in the combined therapy group were lower than those in the medication group in the 1st, 2nd and 4th weeks of treatment (all P< 0. 01). Before treatment, in the combined therapy group and the medication group, the levels of serum 5-HT, IL-4 and IL-10 were all lower than those in the healthy group (all P<0. 01); the levels of IL-1β and IL-6 were higher than those in the healthy group (all P<0. 01). In the combined therapy group and the medication group, the levels of 5-HT, IL-4 and IL-10 in 4 weeks of treatment were all increased as compared with those before treatment (all P<0. 01), and the levels of IL-1β and IL-6 were lower than those before treatment (all P<0. 01). In the combined therapy group, the levels of IL-1β and IL-6 in 4 weeks of treatment were lower than those in the medication group, and the levels of 5-HT, IL-4 and IL-10 were higher than those in the medication group (P<0. 01, P< 0. 05).

CONCLUSIONThe combined therapy of acupuncture and SSRIs achieves much quicker and more effective re-' sult for relieving depression in the patients of depressive disorder as compared with simple oral administration of' SSRIs, and much more contributes to adjust the imbalance of serum 5-HT and TH1/TH2.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Antidepressive Agents ; administration & dosage ; Combined Modality Therapy ; Depressive Disorder ; blood ; drug therapy ; therapy ; Female ; Humans ; Interleukin-10 ; blood ; Interleukin-1beta ; blood ; Interleukin-4 ; blood ; Interleukin-6 ; blood ; Male ; Middle Aged ; Serotonin ; blood ; Th1 Cells ; metabolism ; Th2 Cells ; metabolism ; Young Adult

Objective:To explore the gene frequencies of HLA-Cw and to analyze the recognition characteristic between HLA-Cw and KIR in Guangdong Han population.Methods:An auto semi-quantitative PCR-RSSO method was adopted to detect the HLA-Cw genotypes of a sample of 122 bone marrow donors.Results:The gene frequencies of HLA-CW 03,07,01,08,04,14,15,12,06,05,16 were 0.237 1 , 0.215 9 , 0.175 2 , 0.112 9 , 0.050 5 , 0.041 9 , 0.041 9 , 0.037 6 , 0.033 3 , 0.008 2 , 0.004 1 respectively.HLA-Cw 02,04,05,06 belong to “group 1” recognizing KIR-2DL1/2DS1.HLA-Cw 01,03,07,08 belong to “group 2” recognizing KIR-2DL2/2DL3;2DS2/2DS3.There was a significant difference between the two groups in total HLA-Cw gene frequencies in Guangdong Han population( P