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Objective:To assess the effects of low-dose ionizing radiation on the thyroid of medical radiation workers.Methods:Based on the inclusion and exclusion criteria, 27 articles, involving 22 937 individuals, were screened finally from relevant literature published from 1996 to 2022. Meta-analysis was carried out using Stata 16.0 for serum levels of triiodothyronine (T 3), free triiodothyronine (FT 3), thyroid hormone (T 4), free thyroid hormone (FT 4), thyrotropin-stimulating hormone (TSH) and thyroid nodule rates. As well, subgroup analysis were carried out of thyroid function in different types of radiation workers. Results:The standardized mean difference (SMD) at T 3 and T 4 levels for radiation workers was -0.19 (-0.37, -0.01) and -0.34 (-0.38, -0.30), lower than that of control group ( Z=2.07, -16.06, P<0.05). The SMD at FT 4 levels for radiation workers was 0.22 (0.06, 0.39), higher than control group ( Z=2.61, P<0.05). The relative risk of thyroid nodules in radiation workers was 1.47 (1.19, 1.82), higher than that of control group ( Z=-3.58, P<0.05). The analysis result for subgroup showed that the SMD for T 3, T 4 and TSH levels in the interventional radiology workers were -0.29 (-0.51, -0.07), -0.31 (-0.47, -0.15) and -0.43 (-0.73, -0.13) ( Z=-2.55, -3.86, -2.82, P<0.05), respectively, and the SMD for T 4 levels in the nuclear medicine workers was -0.26 (-0.45, -0.07), which meaned a reduced risk compared to the control group ( Z=-2.70, P<0.05). Conclusions:Long-term low doses of ionising radiation may have adverse effects on thyroid hormone and thyroid nodule in radiation workers, particularly in interventional radiology workers, and attention should be focused on their radiation protection.
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@#<b>Objective</b> To investigate radiation resources in medical diagnosis and treatment and their use frequency in medical institutions in Hangzhou, China, and to provide a basis for relevant departments to rationally allocate and scientifically supervise the resources. <b>Methods</b> From April 1, 2019 to March 31, 2020, a survey was conducted on the basic information, radiation staff, equipment configuration, and frequency of radiation diagnosis and treatment of all medical institutions in Hangzhou using a questionnaire. <b>Results</b> There were 1001 institutions with radiation services in Hangzhou, with 6714 radiation staff members and 2742 pieces of radiation equipment. The frequency of conventional X-ray diagnosis was 788.43 per 1000 population. The frequency of computed tomography diagnosis was 531.93 per 1000 population. The frequency of mammography and dental photography diagnosis was 246.34 per 1000 population. The frequency of interventional diagnosis and treatment was 10.01 per 1000 population. The frequency of radiotherapy was 2.39 per 1000 population. The frequency of nuclear medicine diagnosis was 8.90 per 1000 population. The frequency of nuclear medicine treatment was 0.99 per 1000 population. <b>Conclusion</b> Medical institutions have developed rapidly in Hangzhou, but with an unbalanced situation. In order to better protect the health of examinees, we recommend relevant departments optimize resource allocation and strengthen supervision on radiation protection in medical institutions.
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Objective To explore the absorbed dose to the common tissues of subjects in four clinical CT scanning modes and the spatial distribution of the radiation field in chest scanning, in order to provide a basis for the radiation protection of subjects and the space in the machine room. Methods A thermoluminescence detector (TLD) was used to measure the absorbed doses to the eye lens, thyroid gland, gonad, chest and abdominal skins of the anthropomorphic phantom in four CT scanning modes. The TLD was used to monitor the air kerma at different positions from the CT diagnostic table during chest spiral scanning. Results The absorbed doses to the eye lens, thyroid gland, gonad, chest and abdominal skins of the anthropomorphic phantom in four CT scanning modes were 0.040-64.818 mGy, 0.154-10.155 mGy, 0.028-0.154 mGy, 0.443-17.141 mGy, and 0.093-14.346 mGy, respectively. The maximum air kerma value of the space radiation field during chest scanning was 0.049 mGy, and the farther the distance from the CT tube, the smaller the value. Conclusion The absorbed doses to the common tissues of subjects examined by the four CT scanning modes generally do not exceed the threshold doses. The dose received by the companion of the subject during a single chest CT scan was small. In order to minimize radiation hazards, shielding measures can be taken in CT scanning to reduce the absorbed doses to the tissues of the subject, and the companion of the subject should appropriately increase the distance from the tube and the diagnostic table.
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@#<b>Objective</b> To explore the quality control results of Digital Diagnost digital radiography (DR), and also to analyze the differences in signal transfer characteristics (STP) of DR from different manufacturers, in order to provide a reference for quality control of testers and daily supervision of administrative staff. <b>Methods</b> According to WS 76—2020 “Specification for testing of quality control in medical X-ray diagnostic equipment”, the test items such as automatic exposure control (AEC) repeatability, AEC response, detector dose indication (DDI), STP, high-contrast resolution, and low-contrast resolution of Digital Diagnost DR were qualitatively controlled, and several common DRs on the market were selected to analyze their STP functional relationships. <b>Results</b> The baseline values of DDI, high-contrast resolution, and low-contrast resolution of Digital Diagnost DR were 19733, 2.8 Lp/mm, and H5 of image central pixel value, respectively; the quality control results of other test items met the requirements of WS 76—2020. The STP functional relationships of common DRs were mainly linear and logarithmic, but different models of DR from the same manufacturer might also have different STP functional relationships. <b>Conclusion</b> When testing some special test items of DR, attention should be paid to the influence of a variety of factors, while refining the test steps and condition settings for the test items. The simulation should be performed in accordance with the functional relationship provided by the manufacturer when analyzing the STP.
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Objective The purpose of this study is to grasp the current situation of radiation protection in some non-medical institutions in Hangzhou, and to provide basis and reference for the relevant authorities departments to make the radioactive hazard factors monitoring plan for non-medical institutions. Methods The configuration of the personnel protective equipment and radiation level of radiation sources and radiation devices in 5 non-medical monitoring institutions in Hangzhou were investigated and analyzed by means of questionnaire survey and on-site detection. Results The radiation workers of 5 monitoring institutions have carried out personal dose monitoring, and their annual individual dose equivalent meets the requirements of relevant national standards. The ambient dose equivalent rates around the radiation source and radiation device room are lower than the minimum detection limit of the instrument. When the source is stored, the maximum ambient dose equivalent rates at 5 cm and 100 cm away from the external surface of the source container were 22.2 μSv/h and 2.0 μSv/h, respectively. When the source is in use, the maximum ambient dose equivalent rates at 5 cm and 100 cm away from the external surface of the source container were 44.3 μSv/h and 5.0 μSv/h, respectively. Conclusion Under normal operation, the radiation dose level of some non-medical monitoring institutions in Hangzhou is at a low level, while the ambient dose equivalent rates around the external surface of the source container is at a high level. Therefore, non-medical institutions should improve their awareness of radiation protection and strengthen radiation management.
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Objective To investigate effect of high dose irradiation on the performances of thermolumines-cence detectors (LiF:Mg, Cu, P). Methods The high-dose irradiated thermoluminescence detector was annealed by a thermoluminescence annealing furnace until the annealing was completed, and then the annealed thermoluminescent detector was irradiated 0.5Gy by 137Cs irradiator to verify the accuracy of the thermoluminescentdetector. Results The thermoluminescence detector after high-dose irradiation could not be completely annealed under the temperature condition of 240 ℃, and it could be completely annealed at a high temperature as 400℃. After 0.5 Gy irradiation by 137Cs irradiator, the measurement results of the annealed thermoluminescence detector were significantly smaller, and the dose response and dispersion of the detector were also changed significantly. Conclusions After a more than 5 Gy irradiation, the crystal structure of the thermoluminescence detector has changed, and a high temperature peak above 240 ℃ has appeared, which leads to the failure to completely anneal at normal temperature. Therefore, the thermoluminescence detector can no longer be used for dosimetry after high-dose irradiation.
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Objective@#To evaluate the real-world safety and curative effect of ombitasvir combined with dasabuvir for the treatment of chronic hepatitis C 1b genotype infection in non-cirrhotic or compensated cirrhotic patients.@*Methods@#A real-world research method was adopted, and the research was conducted at three medical centers of mainland China. Non- cirrhotic or compensated cirrhotic patients with HCV genotype 1b infection who were initially treated with IFN/PEG-IFN-alpha combined with ribavirin, and ombitasvir combined with dasabuvir for 8 or 12 weeks were taken. Sustained virological response (SVR) and the incidence of adverse events during treatment and follow-up were evaluated after 12 weeks of drug withdrawal at OBV/PTV/r 25/150/100mg once daily and DSV 250mg, twice daily. Median and range were used for description of non-normally distributed data.@*Results@#80 cases of GT1b were included in this study. Of these 88.8% (71/80) were newly diagnosed, 12.5% (10/80) were compensated cirrhotic, 97.5% (78/80) received 12 weeks treatment, and 2.5% (2/80) received 8 weeks treatment. The rate of HCV RNA negative at EOT (end of treatment) was 100% (64/64). A total of 67 patients completed the treatment within 12 weeks, and 43 patients returned to the hospital for further consultations, and SVR12 was 100%(43/43). No patient discontinued the drugs because of an adverse event during treatment.@*Conclusion@#In the real world, Ombitasvir combined with dasabuvir for the treatment of chronic hepatitis C 1b genotype infection in China has 100% rates of EOT and SVR12 with well- tolerability and safety.
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Objective@#To evaluate the efficacy and safety of DCV-based DAAs therapy for chronic HCV infected Chinese patients.@*Methods@#An open-label, non-randomized, prospective study was designed. Fifty-two patients with chronic HCV infection were enrolled. Among them, there was one patient after liver transplantation, 2 patients after kidney transplantation, 3 patients with hepatocellular carcinoma, and 4 patients with HBV infection. Thirteen cases with chronic hepatitis C (one compensated cirrhosis) who were negative for resistance-related variants [NS5A RAS (-)] of gene 1b and NS5A were treated with daclatasvir (DCV) + asunaprevir (ASV) for 24 weeks. Twenty-five cases of CHC (six compensated cirrhosis) with GT 1b, 2a, 3a, 3b, 6a were treated with DCV + SOF ± RBV for 24 weeks. 8 cases with decompensated cirrhosis of gene 1b and NS5A RAS(-) were given DCV + SOF + RBV regimen for 12 weeks. Six cases with decompensated cirrhosis, of gene 2a, 1b, 2a, 3a, 3b, were given DCV + SOF + RBV regimen for 24 weeks. HCV RNA, blood routine test, liver and kidney function, and upper abdominal ultrasound/MRI were measured at baseline, 4 weeks of treatment, end of treatment, and 12 weeks of follow-up. The incidence of adverse events and laboratory abnormalities during treatment were recorded. A t-test was used to compare the measurement data between two groups, and analysis of variance was used to compare the measurement data between multiple groups.@*Results@#Sixteen patients (100%) achieved SVR12 after treatment, with 0% recurrence rate. Rapid virological response (RVR) of the four treatment regimens were 76.92%, 54.17%, 87.50%, and 83.33%, respectively, and 32 patients achieved 100% virological response after the completion of treatment. The incidence of adverse events of chronic hepatitis C with cirrhosis and decompensated cirrhosis was 62.5% and 64.29%, respectively. The most common adverse event was fatigue in CHC (25.00%), and elevated indirect bilirubin in decompensated cirrhosis (42.86%). No serious adverse drug events, deaths or adverse reactions occurred.@*Conclusion@#DCV-based DAAs regimen is promising option for the treatment of HCV genotypes, compensated cirrhosis, decompensated cirrhosis, hepatocellular carcinoma, and HCV infection after liver/kidney transplantation in china. Above all, it has high SVR12 with good tolerability and safety profile.
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Objective To study the effect of Shenqi Fuzheng injection on proliferation of gastric cancer cell line SGC7901, and to explore its mechanism associated with the STAT3 pathway. Methods The human gastric cancer cell line SGC7901 was used as the research object, the effects of different concentrations of Shenqi Fuzheng injection on the activity of SGC7901 cells were observed by MTT method, the levels of interleukin(IL)-6,IL-8 and IL-11 were detected by enzyme-linked immunosorbent assay(ELISA), and the expressions of Janus kinase 2(JAK2), STAT3 and phosphorylated-STAT3(p-STAT3) were detected by Western blot. Results Compared with the control group,the activity of SGC7901 cells in the treatment group decreased significantly, and the concentration of Shenqi Fuzheng injection reached 0.1 mg/ml, the inhibitory rate of SGC7901 cells reached (10.8±0.7) %, and the difference was statistically significant (P< 0.01). With the increase of Shenqi Fuzheng injection concentration, the inhibition rate of SGC7901 cells increased gradually (F =12.319, P =0.000). Compared with the control group, with the increase of Shenqi Fuzheng injection concentration, IL-6, IL-8 and IL-11 contents were decreased in SGC7901 cells, the differences were statistically significant (IL-6: F = 31.256, P = 0.000; IL-8: F = 16.857, P = 0.000; IL-11: F = 21.319, P =0.000);JAK2 and p-STAT3 protein levels were significantly reduced(JAK2:F =12.315,P =0.000;p-STAT3:F= 16.728, P= 0.000) in the treatment groups. Conclusion Shenqi Fuzheng injection can inhibit the proliferation of SGC7901 cells,and the mechanism may be related to the inhibition of STAT3 pathway.
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Objective To evaluate the radiation protection of occupational hazards in a hospital Clinac 23EX medical electronic accelerator construction project so as to ensure the health and safety of the relevant people involved.Methods According to the relevant laws,regulations and standards of China,combined with the relevant materials provided by the construction unit,the radiation protection tests and comprehensive assessment of this project were carried out.Results The performance test results of the medical electron accelerator met the requinements of GB/T 19046-2013 The ambient dose equivalent rate in the workplace was between the background dose rate (0.10 μ,Sv/h) and 11.5 μSv/h,which suggested the computer room shielding met the requirements of radiation protection.The total body effective dose,the for 7 radiation workers were 0.85,1.19,1.64 mSv,respectively,which were lower than the dose management control values of the construction unit and the national standards.Radiation protection supplies and the management system of the construction unit met the national requirements.Conclusions The construction project can effectively control the radioactive occupational hazard factors in normal operation,and the radiation protection facilities have reached the completion requirements.
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Objective To investigate the guidance of the endoscopic ultrasonography for the surgery selec-tion of patients with low rectal cancerthrough analyzing the accuracy of endoscopic ultrasonography in preoperative TN staging. Methods Eighty-seven cases with low rectal cancer received preoperative endoscopic ultrasonography examination,the preoperative staging and the postoperative pathologic comparison. The EUS accuracy of preopera-tive staging of rectal cancer was evaluated. Results The preoperative staging with endoscopic ultrasonography for patients with low rectal cancer,100% in T1 stage,96.0% in T2 stage,85.7% inT3 stage,and 100% in T4 stage. The preoperative staging and the postoperative pathologic comparison in T stage were consistent(Kappa = 0.903, P < 0.05). The preoperative staging with endoscopic ultrasonography for patients with low rectal cancer ,87.0% in N0 stage,78.6% in N1 stage,and 100% in N2. The preoperative and the postoperative pathologic comparisons in N stage were consistent(Kappa = 0.768,P < 0.05). Conclusion The endoscopic ultrasonography had a certain advantage in the clinical preoperative evaluation for patients with low rectal cancer ,especially for invasion depth and the judgment of lymph node metastasis ,with a higher accuracy.
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Objective To evaluate the CT and MR features of renal oncocytoma in order to improve the ability for recognition and ima-gingdiagnosis.Methods The CT and MR findings of renal oncocytoma in 12 patients proved by pathology were retrospectively analyzed.Results CT scans were performed in 12 patients,one of which was accompanied with the contralateral renal angiomyoliptoma.In all lesions, seven were in the right kidney and five in the left.The lesions were round or oval in shape with the diameter 1.5 cm-12.3 cm.On pre-contrast scan,the homogeneous density was found in 3,calcification in 2,and central scar tissue in 5.On post-contrast images,the parenchyma of tumor was obviously enhanced in the cortical phase.However,the enhancement was attenuated in the parenchymal phase.Seven patients underwent MRI at the same time,exhibiting iso-or hypointensity on T1 WI in 4 and heterogenous hyperintensity on T2 WI in 5.Dynamic contrast enhanced MRI demonstrated homogenous enhancement in 1 and heterogenous enhancement in others with delayed enhancement of the central scar.Conclusion Most renal oncocytomas show certain characteristics on CT or MRI, which are helpful for preoperative diagnosis and surgical therapy.
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<p><b>OBJECTIVE</b>To determine the prevalence of mutations in the non-structural protein 5B (NS5B) of the hepatitis C virus (HCV),which are associated with natural resistance to non-nucleoside and nucleoside polymerase inhibitors (PIs),in treatment-naive hepatitis C patients in south China.</p><p><b>METHODS</b>A nested PCR protocol that amplified three different regions of NS5B was used to detect the naturally occurring drag-resistant substitutions.Direct PCR sequencing was performed to analyze the sequences.</p><p><b>RESULTS</b>NS5B mutations known to confer resistance to nucleoside PIs,such as A15G,S96T and S282T,were mainly detected in HCV genotype 6a (20/88,22.73%).Of the NS5B mutations known to confer resistance to non-nucleoside PIs,C316N and S365A were detected in HCV genotype lb (60/60,100% and 2/60,3.33%, respectively) and I482L and V499A were mainly detected in HCV genotype 2a (9/9,100% and 4/4,100%, respectively) and HCV genotype 6a (9/9,100% and 4/4,100%, respectively).Other NS5B mutations found in the study population included A1 5S,S365F,S365P,S368A and S368L;although none of these has been previously shown to confer resistance to PIs.</p><p><b>CONCLUSION</b>Naturally occurring dominant PI resistance mutations in NS5B exist in treatment-na(i)ve hepatitis C patients in south China and may be related to the virus genotype.</p>
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Humans , Antiviral Agents , Pharmacology , China , Drug Resistance, Viral , Genotype , Hepacivirus , Genetics , Hepatitis C , Drug Therapy , Virology , Mutation , Viral Nonstructural Proteins , GeneticsABSTRACT
Objective To explore the association between interleukin (IL)-28B variation and spontaneous clearance of hepatitis C virus (HCV) infection.MethodsA total of 280 HCV infected patients including 200 chronic hepatitis C (CHC) patients and 80 spontaneous clearance patients of HCV infection were enrolled in the study.The rs8099917 single nucleotide polymorphyism (SNP) of IL-28B gene was detected and the association between IL-28B variation and spontaneous clearance of HCV infection was analyzed.The data were compared using chi square test.ResultsThe genotype frequencies of TT and non TT (TG and GG) of IL-28B rs8099917 between CHC patients and spontaneous clearance patients were not significantly different ( x2 =15.874,P ＜ 0.01 ). The prevalence of TT genotype in the spontaneous clearance group was 86.2％,which was higher than that in CHC group (62.0％).T and G allele frequencies in CHC group were 78.0％ and 22.0％,respectively,and those in spontaneous clearance group were 92.5％ and 7.5％,respectively,which indicated that T allele was dominant in spontaneous clearance patients. The allele frequency of rs8099917 was statistically different between the two groups (P＜0.01).The spontaneous HCV clear rate in rs8099917 TT patients was 2.84 folds of non-TT patients,while the risk of chronicity of non-TT (TG+GG) patients was 1.36 folds of TT patients.Conclusion The IL-28B (rs8099917) TT genotype is associated with spontaneous clearance of HCV infection,which can be an important factor to predict the spontaneous clearance of HCV.
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Objective To investigate the genotype distribution of hepatitis C virus (HCV) in Guangdong Province by linear probe assay (LiPA) and core,non-structural protein 5B (NS5B) sequence analysis,and to evaluate the accuracy of LiPA for genotyping.MethodsOne hundred and ten HCV specimens from chronic hepatitis C (CHC) patients in Guangdong Province were genotyped by both core,NS5B sequence analysis and INNO-LiPA 2.0.The data were then analyzed with SPSS 10.0 software.ResultsAmong the 110 specimens,core and NS5B fragment could be amplified from 97 and 62 specimens,respectively,while both fragments were obtained from 57 specimens. The results of genotyping by core sequence analysis were completely consistent with the results of NS5B sequencing.One hundred and two specimens were classified into five subtypes,i.e.genotype 1a,2a,3a,3b,6a,with frequencies of 61.8％ (64),9.8％ (10),3.9％ (4),3.9％ (4),20.6％ (21),respectively.All but genotype 6 strains can be genotyped correctly by using INNO-LiPA 2.0.However,only subtype 1b and 3b could be genotyped accurately.81.5％ genotype 6a strains were genotyped as 1b by mistake. Conclusions Genotype 6a has become the second most prevalent genotype in Guangdong Province.The LiPA cannot distinguish genotype 6a from 1b strains accurately which needs further investigation.
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Objective To investigate the efficacy of pegylated interferon (PEG-IFN)+ ribavirin (RBV) treatment in patients with chronic hepatitis C (CHC),and to evaluate the predictors of treatment response.Methods One hundred and thirty CHC patients treated with PEG-IFN a-2a 180 μg weekly or PegIFNα-2b 80 μg weekly plus RBV 900-1200 mg/d for 48 weeks in Guangdong Province were enrolled.The clinical data including age,gender,body mass index (BMI),spleen index (SPI),the diameter of portal vein (PV),hepatitis C virus (HCV) genotype,HCV RNA level were collected at baseline,week 4,12,24,48 of treatment and week 24 of follow-up.Patients obtained sustained virological response (SVR) were compared to those with non-sustained virological response (NSVR).The related factors of SVR were analyzed.The data were compared by t test,chi square test or Logistic regression.Results The total SVR rate was 84％ (109/130),among which rapid virological response ( RVR ),early virological response ( EVR ),and end-of-treatment virological response (ETVR) were 21％ (27/130),72％ (94/130) and 93％ (121/130),respectively.HCV genotype was determined in 70 patients and the SVR rate was 82 ％ (45/55) in the genotype 1 patients and 87％ (13/15) in the genotype non-1 patients.Age,baseline HCV RNA,BMI and SPI were all negatively associated with SVR rate (regression coefficient＜0,all OR＜1,all P＜0.05),while EVR and total cumulative treatment dose of RBV were positively associated with SVR rate (regression coefficient＞0,both OR＞ 1,both P＜0.05).However,RVR,PV and total cumulative treatment doses of PEG-IFN were not associated with SVR rate (P＞0.05).Conclusions The SVR rate of PEG-IFN plus RBV combined treatment is high in CHC patients and more than 80％ of patients can be cured.However,the SVR rates are lower in patients elder than 35 years,with previous treatment failure history,baseline HCV RNA＞6 × 105 IU/mL,BMI＞26 kg/m2,SPI＞40 cm2,or the total cumulative treatment doses of RBV less than 80 ％ of standard dose.
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Objective To investigate the effect of Peg-Interferon α-2a therapy on the quality of life (QOL) of patients with chronic hepatitis C,and to evaluate the effect of healthcare insurance policy in Guangzhou city on these patients.Methods Totally 102 patients with chronic hepatitis C were enrolled.Forty-two patients (group A) were treated with Peg-Interferon α-2a plus ribavirin whose medical expenses were covered by medical insurance; 30 patients (group B ) received the same therapy but at their own expenses ; and the other 30 patients ( group C) were not treated with Peg-Interferon α-2a.QOL of patients in three groups were investigated using the general quality of life inventory questionnaire (GQOLI-74) before and after Peg-Interferon α-2a treatment.Wilcoxon test was used to compare on all scales and total scores before and after treatment in each group,and Kruskal-Wallis test was performed to compare on all scales and total scores among three groups.Results Before treatment,the physical function,psychological function,social function,material life and total score of group A were 55.3,58.8,61.9,60.6 and 58.5 ; those of group B were 57.5,60.4,61.1,55.2 and 58.3; those of group C were 58.6,60.3,57.5,54.8 and 56.4.There was no statistic difference on all scales and total scores among three groups (Z =- 1.177,- 0.846,- 1.062,-0.377 and - 1.085,P ＞ 0.05).After treatment,group A had higher QOL on all scales (67.1,76.4,68.1,70.1) and total score (72.6) than group C (54.6,54.0,53.3,57.5 and 54.6,P ＜0.01) ; group B had higher QOL (P ＜0.05) on three scales (65.1,65.0 and 69.6) and total score ( 64.3 ) except material life ( 56.3 ) than group C ; group A had higher QOL on psychological function,material life and total score than group B ( P ＜ 0.05 ).Conclusions QOLs of chronic hepatitis C patients treated with Peg-Interferon α-2a are higher than those without Peg-Interferon α-2a treatment.Patients whose medical expenses are covered by medical insurance may have higher QOLs than those at their own expenses.
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Objective To investigate the relationship between serum levels of alanine aminotransferase (ALT)or aspartate aminotransferase (AST)apportioned by the same hepatic parenchyma cell volume and liver histological necroinflammation grades in HBeAg-negative chronic hepatitis B (CHB)patients.Methods A total of 145 CHB patients were divided into four groups:Gl,G2,G3 and G4 based on the liver histological necroinflammation grade.The serum ALT and AST levels were determined by automatic biochemical instrument in these four groups.Furthermore,serum ALT and AST levels were then apportioned by the same hepatic parenchyma cell volume.The data were analyzed by ANOVA.Results Mean serum ALT levels in G1,G2,G3 and G4 groups were (35.3±29.1),(91.6±120.4),(111.6± 116.1)and (118.0±122.1)U/L,respectively,and the serum ALT levels apportioned by same hepatic parenchyma cell volume were ( 54.0 ± 45.1 ),( 144.2 ± 184.9 ),(191.3± 204.8)and (215.1 ± 226.5)U/L,respectively.The pairwise comparison between G1 and other three groups all showed statistically significant difference (P＜0.05).Meanwhile,AST levels in G1 to G4 groups were (35.5± 29.0),(64.9±71.7),(96.0±81.9)and (102.8±77.0)U/L,respectively and the serum AST levels apportioned by the same hepatic parenchyma cell volume were (54.3±44.6),(102.3± 107.9),(165.2±148.7)and (189.4±145.4)U/L,respectively.The pairwise comparison between G1 and G3,G1 and G4,G2 and G3,G2 and G4 all showed statistically significant difference (P＜0.05).Conclusion Both AST and ALT levels are sensitive indicators for liver inflammation grading in HBeAg-negative CHB patients during the natural history of the disease.
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The research is focused on the current situation and shortcomings in teaching of practical physical diagnostics.In the experimental group regular teachers are in charge of teaching and strengthening the physical examination training of students,and in the contrast group the teaching missions are distributed to different teachers in different departments,and the differences of the teaching effects between the two groups are thus discussed.The result reveals that the scores of the physical examination test in the experimental group is better than that in the contrast group,and the difference is significant(P
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Diagnostics is the bridge of basic medicine and clinical medicine.Teaching method with the idea of evidence-based medicine is benefit to cultivate the students' ability on clinical practice.To establish this educational mode,teachers should learn a teaching method guided by ideas of evidence-based medicine,and students should be taught a tool for solving clinical problems with ideas of evidence-based medicine.