Efficacy of consensus interferon in treatment of HbeAg-positive chronic hepatitis B: a multicentre, randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Consensus interferon (CIFN) is a newly developed type I interferon.</p> <p>Aims</p> <p>This multicentre, controlled trial was conducted to determine the efficacy of CIFN and to compare it with alpha-1b-interferon (IFN-α1b) in the treatment of patients with hepatitis B e antigen (HBeAg)-positive chronic hepatitis B.</p> <p>Methods</p> <p>144 Patients were randomly assigned to receive 9 μg CIFN (CIFN group) or 50 μg INF-α1b (IFN-alpha group) subcutaneously 3 times weekly for 24 weeks, followed by 24 weeks of observation. Efficacy was assessed by normalization of serum alanine transaminase (ALT) levels and the non-detectability of serum hepatitis B virus DNA or HBeAg at the end of treatment and 24 weeks after stopping treatment.</p> <p>Results</p> <p>There was no statistically significant difference in the serological, virological and biochemical parameters between CIFN and IFN-α1b groups at the end of the therapy and follow-up period (p > 0.05). Overall, at the end of treatment, 7.0% (5/71) and 35.2% (25/71) of patients in the CIFN group showed a complete or partial response compared with 7.4% (5/68) and 33.8% (23/68) of the IFN-alpha group (p = 0.10). At 24 weeks after stopping treatment, 6.9% (5/72) and 37.5% (27/72) of patients in the CIFN group showed complete response or partial response compared with 7.1% (5/70) and 34.3% (24/70) of the IFN-alpha group (p = 0.10).</p> <p>Conclusion</p> <p>These findings suggest that 9 μg CIFN is effective in the treatment of patients with HBeAg-positive chronic hepatitis B. It can gradually induce ALT normalization and HBV DNA clearance and HBeAg loss or HBeAg/HBeAb seroconversion.</p

1-Diphenyl­methyl-4-[3-(4-fluoro­benzo­yl)prop­yl]piperazine-1,4-diium dichloride monohydrate

In the title compound, C27H31FN2O2+·2Cl−·H2O, the piperazine ring adopts a chair conformation and both N atoms are protonated. The Cl− anions form strong hydrogen bonds to these protons. O/N—H⋯Cl and C—H⋯O hydrogen bonds link the anions, cations and water of hydration into a three-dimensional network

Land-use changes from arable crop to kiwi-orchard increased nutrient surpluses and accumulation in soils

The potential environmental risk associated to nutrient surpluses after changing arable crops to kiwi-orchards was assessed in the Yujiahe catchment of Shaanxi, China. This was achieved by surveying 242 kiwi-orchards and 21 croplands and determining their nutrient inputs and outputs as well as the soil nutrient status for the over 2 years. The total inputs of nitrogen (N), phosphorus (P) and potassium (K) from fertilizers, manures, deposition, and irrigation in kiwi-orchards were 1201, 268 and 615 kg ha−1 yr−1, respectively, which were higher than the rates of 425, 59 and 109 kg ha−1 yr−1 in wheat-maize fields. The mean annual apparent nutrient surpluses in kiwi-orchards were 1081 kg N ha−1 yr−1, 237 kg P ha−1 yr−1 and 491 kg K ha−1 yr−1. Within comparison to the croplands, the soil organic matter (SOM) and total N (TN) in the topsoil (0–20 cm) increased in kiwi-orchards, and soil pH decreased. The average contents of Olsen-P, and available K in 0–20 cm soils of the orchards were 86 mg kg−1, and 360 mg kg−1, which were higher than recommended levels. The nitrate-N accumulation in the 0–100 cm and 0–200 cm soil layers in kiwi-orchards were 466 and 793 kg N ha−1, respectively. The high proportion of nitrate-N in deeper soil profiles of kiwi-orchards poses a great risk for nitrate leaching and subsequent ground water pollution. It is concluded that changing arable crops to kiwi-orchards increased the environmental burden of the catchment due to excessive fertilizer application in kiwi-orchards

Patient-centred care and patient autonomy: doctors' views in Chinese hospitals

Background: Patient-centred care and patient autonomy is one of the key factors to better quality of service provision, hence patient outcomes. It enables the development of patients’ trusts which is an important element to a better doctor-patient relationship. Given the increasing number of patient disputes and conflicts between patients and doctors in Chinese public hospital, it is timely to ensure patient-centred care is fully and successfully implemented. However, limited studies have examined the views and practice in different aspects of patient-centred care among doctors in the Chinese public hospitals. Methods: A quantitative approach was adopted by distributing paper-based questionnaires to doctors and patients in two hospitals (Level III and Level II) in Jinan, Shandong province, China. Results: In total, 614 doctors from the surgical and internal medicine units of the two hospitals participated in the survey yielding 90% response rates. The study confirmed the inconsistent views among doctors in terms of their perception and practice in various aspects patient-centred care and patient autonomy regardless of the hospital where they work (category II or category III), their unit speciality (surgical or non-surgical), their gender or seniority. The high proportion of doctors (more than 20%) who did not perceive the importance of patient consultation prior to determining diagnostic and treatment procedure is alarming. This in in part due to the belief held by more than half of the doctors that patients were unable to make rational decisions and their involvement in treatment planning process did not necessarily lead to better treatment outcomes. Conclusion: The study calls for the development of system level policy and organisation wide strategies in encouraging and enabling the practice of patient-centred care and patient autonomy with the purposes of improving the quality of the service provided to patients by Chinese hospitals

Doctors in Chinese public hospitals: demonstration of their professional identities

Background: An increase in the number of medical disputes and violence against doctors indicates a lack of trust in the medical profession by society in Chinese public hospitals. Empirical evidence confirms that one cause is the lack of professional identity demonstrated by doctors. Medical professionals are required to maintain high standards of competence and moral responsibility, and demonstrate qualities such as respect, compassion, integrity, responsiveness to needs, and commitment to sound ethical practice in order to maintain professional privilege. These principles and appropriate professional conduct are the foundation of the professional identity of the medical profession. Methods: A quantitative approach was adopted by distributing paper-based questionnaires to doctors and patients in two hospitals (Level III and Level II) in Jinan, Shandong province, China. Findings: In total, 614 doctors and 1184 inpatients on discharge from the surgical and internal medicine units of the two hospitals participated in the survey yielding 90% response rates. The study confirmed the variation amongst doctors in demonstrating their professionalism in terms of respecting patients’ views and preferences when determining diagnostic procedures and treatment plans, and when making ethical decisions. Although 90% patients indicated that they showed respects to doctors, close to 20% of the doctors disagreed that they received high respect from patients. About 12% of doctors prescribed unnecessary diagnostic procedures to patient for the purpose of generating profit and more than 20% of patients indicated that they gave gifts to doctors in order to receive better treatment. Conclusions: Although about 80% of doctors demonstrated certain aspects of professionalism required by practitioners, the inconsistency across the medical workforce may exacerbate tense doctor-patient relationships. A review of medical curricula and focus of the internship program is required in order to assist medical graduates with forming required professional identity in order to improve patient satisfaction and better clinical outcomes. To be effective, a more systematic approach is recommended

Winnowing the Chaff: Designing and Building a Grain Milling and Processing Web Library

Kansas State University (K-State) offers a unique curriculum in the milling, baking and industrial (i.e. nontraditional) utilization of grain products. The program targets a diverse audience from academics to amateur bakers to industry professionals to researchers looking at non-traditional fuel and other uses of grains. The range in the audience reflects the multidisciplinary subject areas, ranging from basic sciences (chemistry, biochemistry, food science), applied sciences (baking, milling), engineering (chemical, industrial), business, economics and so on. Given the possible subjects and the variety of audiences, information available on the Internet is widely dispersed and often difficult to find. Our desire to provide organized access to the above information received additional impetus from the AgNIC Alliance and the request that K-State develop a site for Grain Milling and Processing. An initial design was developed based on meetings and feedback with faculty in the Grain Science and Industry Department. Subject categories and subcategories were identified and templates for the initial static pages designed. Given the interdisciplinarity of the subjects, it became clear that selected sites could and would appear on several subject pages. Rather than try to update links on multiple pages individually, we investigated our options and selected creating a database as the best solution. Design of the database led to more standardization of page organization and data elements. The database may be used to generate static or dynamic web pages. A selected site is entered only once, but can be profiled for as many pages as needed. Currently the database provides static pages that are updated monthly. Real time dynamic update of the web pages is in development. We are also developing a search interface for users who do not want to scroll the pages individually for sites of interest. This presentation will discuss many of the issues we encountered issues regarding standards, technology, web usability, selection and display of content, and campus politics