Hepatitis B virus （HBV） infection is the primary cause of viral hepatitis and represents a substantial disease burden in China. However， effective and safe agents capable of completely eliminating HBV DNA are still lacking. In modern medicine， anti-HBV strategies mainly target covalently closed circular DNA （cccDNA）， among other mechanisms， and multiple novel drugs are currently under clinical investigation. Traditional medicine has been shown to exert anti-HBV effects through direct pathways， such as blocking viral entry， as well as indirect pathways， including the regulation of programmed cell death. Studies have confirmed that the integration of traditional Chinese medicine （TCM） and Western medicine in treating HBV infection and its related complications offers complementary advantages， particularly in enhancing HBV clearance rates， improving liver function， preventing various complications， and delaying the progression from hepatic fibrosis to hepatocellular carcinoma. This review focuses on advances in anti-HBV research involving TCM， Western medicine， and their integrated application， aiming to provide a basis for integrated HBV therapy and new drug development.

A 43-year-old female patient received Fuyanshu capsules 1.6 g orally thrice daily for pelvic inflammation. The traditional Chinese medicine decoction was added 1 week later. After 10 days of combination therapy, the patient developed fatigue, which was gradually aggravated, and yellowish skin and sclera appeared. Seven days later, laboratory tests showed alanine aminotransferase (ALT) >1 000 U/L, aspartate aminotransferase (AST) >750 U/L, gamma-glutamyltransferase (γ-GT) 148 U/L, alkaline phosphatase (ALP) 153 U/L, and total bilirubin (TBil) 56.3 μmol//L. After excluding viral hepatitis, autoimmune liver disease, obstructive jaundice, and other causes, liver injury caused by Fuyanshu capsules combined with traditional Chinese medicine decoction was considered. After Fuyanshu capsules and traditional Chinese medicine decoction were discontinued, reduced glutathione, glycyrrhizic acid preparation, and ursodeoxycholic acid were given. Seven days later, the patient′s symptoms were improved obviously and laboratory tests showed ALT 323 U/L, AST 125 U/L, γ-GT 149 U/L, ALP 109 U/L, and TBil 35.8 μmol/L. Twenty-seven days later, the patient′s symptoms disappeared and laboratory tests showed ALT 62 U/L, AST 42 U/L, γ-GT 67 U/L, ALP 67 U/L, and TBil 18.7 μmol/L. There are 7 same components in Fuyanshu capsule and traditional Chinese medicine decoction. It was considered that the liver injury was related to the increase of hepatotoxicity caused by the combination of the two drugs.

A 43-year-old female patient received Fuyanshu capsules 1.6 g orally thrice daily for pelvic inflammation. The traditional Chinese medicine decoction was added 1 week later. After 10 days of combination therapy, the patient developed fatigue, which was gradually aggravated, and yellowish skin and sclera appeared. Seven days later, laboratory tests showed alanine aminotransferase (ALT) >1 000 U/L, aspartate aminotransferase (AST) >750 U/L, gamma-glutamyltransferase (γ-GT) 148 U/L, alkaline phosphatase (ALP) 153 U/L, and total bilirubin (TBil) 56.3 μmol//L. After excluding viral hepatitis, autoimmune liver disease, obstructive jaundice, and other causes, liver injury caused by Fuyanshu capsules combined with traditional Chinese medicine decoction was considered. After Fuyanshu capsules and traditional Chinese medicine decoction were discontinued, reduced glutathione, glycyrrhizic acid preparation, and ursodeoxycholic acid were given. Seven days later, the patient′s symptoms were improved obviously and laboratory tests showed ALT 323 U/L, AST 125 U/L, γ-GT 149 U/L, ALP 109 U/L, and TBil 35.8 μmol/L. Twenty-seven days later, the patient′s symptoms disappeared and laboratory tests showed ALT 62 U/L, AST 42 U/L, γ-GT 67 U/L, ALP 67 U/L, and TBil 18.7 μmol/L. There are 7 same components in Fuyanshu capsule and traditional Chinese medicine decoction. It was considered that the liver injury was related to the increase of hepatotoxicity caused by the combination of the two drugs.

Objective The objectives of this study were to use Nutrition Risk Screening 2002( NRS2002) to conduct nutri-tional assessment research on patients with advanced cancer in our hospital,and to assess the patients′nutritional deficiencies,nutri-tional risk and nutritional support,and to discuss the nutritional status and clinical indicators of patients with different tumor types in order to provide a scientific evidence for individualized nutritional support. Methods Patients with advanced tumors met the require-ments were enrolled from January 2016 to February 2017. Nutritional questionnaires and anthropometry were conducted and recorded the information of measurements and relevant laboratory tests. NRS2002 was used to screen nutritional risk of patients. Results The nutritional insufficiency rate was 19. 54% in 517 patients with advanced cancer and 49. 52% in nutrition risk. The proportion of nutri-tion-free patients receiving nutritional support was 14. 56% ,and the nutritional support patients with nutritional support were 63. 67%.Theaveragelengthofhospitalstaywas(14.43±11.82)daysforpatientswithnutritionalrisk,and(8.29±6.93)daysforpa-tients without nutritional risk. The incidence of nutritional risk in patients with digestive tract cancer was higher than other tumor types. Conclusion As an effective nutritional screening tool,NRS2002 can help clinicians to screen the potential nutritional risk of patients in oncology and provide the basis for patients to develop rational nutrition support.

Objective The benefit of short-term dual antiplatelet therapy (DAPT) following second-generation drug-eluting stents implantation has not been systematically evaluated. To bridge the knowledge gap, we did a meta-analysis to assess the efficacy of ≤6 months versus ≥12 months DAPT among patients with second-generation drug-eluting stents.Methods We searched online databases and identified randomized controlled trials that assess the clinical impact of short-term DAPT (≤6 months) published before March 3, 2016. The efficacy endpoints included the incidence of all-cause death, myocardial infarction, cerebrovascular accidents, and definite or probable stent thrombosis. Safety endpoint defined as major bleeding was also evaluated and discussed.Results We included 5 trials that randomized 9473 participants (49.8%, short-term DAPT duration vs. 50.2%, standard duration). A total of 9445 (99.7%) patients reported the efficacy endpoints, and the safety endpoint was available from 4 studies (n=8457). There was no significant difference in efficacy endpoints between short-term and standard DAPT duration (≥12 months) [risk ratio (RR) 0.96; 95% confidence intervals (CI), 0.80-1.15]. Short-term DAPT duration did not significantly increase the individual risk of all-cause death, myocardial infarction, cerebrovascular accidents, or definite or probable stent thrombosis. Although short-term DAPT obviously reduced risk of major bleeding compared with standard DAPT (RR 0.53; 95% CI, 0.29-0.96), significant publication bias was found when accessing the safety endpoint of the 4 studies (Egger's test, P=0.009).Conclusions The efficacy of short-term DAPT was comparable with that of standard duration DAPT. DAPT less than 6 months may be appropriate for patients receiving second-generation drug-eluting stents implantation.
Drug-Eluting Stents ; Humans ; Myocardial Infarction ; chemically induced ; Platelet Aggregation Inhibitors ; adverse effects ; therapeutic use ; Randomized Controlled Trials as Topic ; Stroke ; chemically induced ; Thrombosis ; chemically induced ; Time Factors

Objective To evaluate the clinical utility of interferon-gamma (IFN-γ) in serum and cerebrospinal fluid in the diagnosis of tuberculous meningitis .Methods IFN-γlevels in serum and cerebrospinal fluid were analyzed by ELISA method in 25 patients with tuberculous meningitis ,31 patients with viral meningitis and 12 patients with suppurative meningitis .Results The IFN-γlevels in cerebrospinal fluid were significantly higher in the patients with tuberculous meningitis (386 .3 ± 83 .5) ng/L than in the patients with viral meningitis (63 .4 ± 16 .2) ng/L or the patients with suppurative meningitis (116 .8 ± 22 .6) ng/L (P<0 .01) .The overlap was very small .In contrast ,the serum IFN-γ levels were very similar among the three groups (P>0 .05) .The sensitivity ,specificity and accuracy of IFN-γ level in cerebrospinal fluid for diagnosis of tuberculous meningitis were 92 .0% ,95 .3% and 94 .1% ,respectively .Conclusions Measurement of IFN-γlevel in cerebrospinal fluid may be helpful for the diagnosis of tuberculous meningitis .

Objective To discuss the clinic value of γ-IFN,ADA in diagnosis and treatment of tuberculous peritonitis. Methods The level of γ-IFN,ADA in pleural effusion of all the patients (29 cases of tuberculous peritonitis effulion and 22 cases of malignant ascites effusion) were detected and compared. Result The level and activity of tuberculous peritonitis group, interferon gamma, adenosine deaminase were higher in malignant ascites group (P<0.05).The combined detection of 2 indexes in the diagnosis of tuberculous peritonitis sensitivity was 86.2%, specificity 95.5%. Compared with the single detection of ADA, the sensitivity was similar, and the specificity increased. Conclusion Ascites effusion,γ-IFN and ADA all have the clinical significance on the identification between tuberculous peritonitis effusion and malignant ascites effusion, which can be used for differential diagnosis. At the same time, IFN-γand ADA examination can improve the diagnosis specificity of tuberculous pleural peritonitis.

ObjectiveTo analyze the application of β-lactam antibiotics and bacterial drug resistance in our hospital for providing basis of the rational use of antibiotics.MethodsThe DDDs,total consumption sum,DDC and bacterial drug resistance of β-lactam antibiotics during 2008-2009 were analyzed statistically.ResultsCephem Antibiotics was the most extensive application,and the DDC of Benzylpenicillin Sodium was the minimum in the β-lactam antibiotics.There had bacterial drug resistance of most β-lactam antibiotics,but the differences were not significant.ConclusionThere was irrational use of β -lactam antibiotics,and it was important to enhance antibiotics supervisal and drug sensitivity before use for decreasing the abuse of antibiotics.