Persistent infection with hepatitis B virus (HBV)is associated with host immune response.CD4 +T cells play an important role in HBV-specific immune response.The restoration of HBV-specific T-cell response after antiviral therapy using nucleoside and nucleo-tide analogues is also associated with CD4 +T cells.In recent years,two new subsets of CD4 +T cells,namely regulatory T cells (Tregs) and T helper 17 cells (Th17 cells),have been identified and shown to be related to disease progression and liver damage in patients with persistent HBV infection.Here we primarily summarized the differentiation and function of Tregs and Th17 cells and reviewed the interaction between the two types of cells in persistent infection and their changes after clinical antiviral therapy.We hope it will be helpful to clinical immunotherapy and prognostic assessment.

Objective To discuss clinical application of theory of TCM constitution on non-alcoholic fatty liver disease (NAFLD).Methods Literature of nearly 15 years was summarized to analyze the development of Chinese constitution theory and its application of on typing and treatment of NAFLD.Results Main types of constitution in patients with NAFLD were phlegm-dampness,deficiency of Qi and damp-heat.On tiis basis,treatment based syndrome differentiation of TCM could effectively prevent and treat NAFLD.Conclusion TCM constitution theory provide research ideas for NAFLD.

Objective To investigate effect of Qishen-Qinggan decoction on proliferation and apoptosis of human hepatocellular carcinoma cellline SMMC-7721.Methods SMMC-7721 cells were cultivated in vitro.Logarithmic growth phase cells were divided into a drug intervention group and a control group.SMMC-7721 cells were treated with Qishen-Qinggan decoction of 0.135、0.27、0.54、1.08、2.16 g/ml respectively for 12、24、48 hours in the drug intervention group while the control group remained untreated.The inhibition rate of SMMC-7721 cells were detected by MTT assay,cell apoptotic rate were measured by flow cytometry analysis.Results Qishen-Qinggan decoction of 0.135,0.27,0.54,1.08,2.16 g/ml had a significantly inhibitory effect on SMMC-7721 cells in a dose and time dependent manner.OD values of 12 hours were 0.89±0.05,0.85±0.05,0.80±0.06,0.78± 0.02,0.69±0.07,OD values of 24 hours were 0.77±0.07,0.74±0.07,0.59±0.07,0.50±0.09,0.39±0.08,OD values of 48 hours were 0.78±0.05,0.61±0.08,0.44±0.10,0.39±0.08,0.34±0.07 respectively.Each drug intervention group had significant difference compared with control group.Qishen-Qinggan decoction of 0.27,0.54 g/ml could induce apoptosis of SMMC-7721 were 11.19 ± 2.23,15.69 ± 2.51,compared with control group of 1.41 ± 0.22.Apoptotic rates of Qishen-Qinggan decoction of 1.08 g/ml had extremely significant difference with the control group (41.83 ± 7.11 vs 1.41 ± 0.22).Conclusion Qishen-Qinggan decoction could inhibit the proliferation of SMMC-7721 cells probably by inducing cell apoptosis.

Patients with chronic kidney disease (CKD) are susceptible to hepatitis C virus (HCV) infection due to hemodialysis and kidney transplantation. Despite the progress in treatment and new medicines for hepatitis C, the efficacy, tolerability, and safety of medicines in CKD patients remain unclear. This article reviews the current situation of HCV infection in CKD patients, methods for evaluating liver condition in HCV-CKD patients, and the latest progress in HCV-CKD treatment. More clinical practice is needed to verify the selection and dosage of medicines for HCV-CKD.

The previous pharmacokinetic methods can be only limited to drug analysis in vitro, which provide less information on the distribution and metabolismof drugs, and limit the interpretation and assessment of pharmacokinetics, the determination of metabolic principles, and evaluation of treatment effect. The objective of the study was to investigate the pharmacokinetic characteristics of gene recombination angiogenesis inhibitor Kringle 5 in vivo. The SPECT/CT and specific 131I-Kringle 5 marked by Iodogen method were both applied to explore the pharmacokinetic characteristics of 131I-Kringle 5 in vivo, and to investigate the dynamic distributions of 131I-Kringle 5 in target organs. Labeling recombinant angio-genesis inhibitor Kringle 5 using 131I with longer half-life and imaging in vivo using SPECT instead of PET, could overcome the limitations of previous methods. When the doses of 131I-Kringle 5 were 10.0, 7.5 and 5.0 g/kg, respectively, the two-compartment open models can be determined within all the metabolic process in vivo. There were no significant differences in t1/2α, t1/2β, apparent volume of distribution and CL between those three levels. The ratio of AUC(0 ? 1) among three different groups of 10.0, 7.5 and 5.0 g/kg was 2.56:1.44:1.0, which was close to the ratio (2:1.5:1.0). It could be clear that in the range of 5.0–10.0 g/kg, Kringle 5 was characterized by the first-order pharmacokinetics. Approximately 30 min after 131I-Kringle 5 was injected, 131I-Kringle 5 could be observed to concentrate in the heart, kidneys, liver and other organs by means of planar imaging and tomography. After 1 h of being injected, more radionuclide retained in the bladder, but not in intestinal. It could be concluded that 131I-Kringle 5 is mainly excreted through the kidneys. About 2 h after the injection of 131I-Kringle 5, the radionuclide in the heart, kidneys, liver and other organs was gradually reduced, while more radionuclide was concentrated in the bladder. The radionuclide was completely metabolized within 24 h, and the distribution of radioactivity in rats was similar to normal levels. In our study, the specific marker 131I-Kringle 5 and SPECT/CT were suc-cessfully used to explore pharmacokinetic characteristics of Kringle 5 in rats. The study could provide a new evaluation platform of the specific, in vivo and real-time functional imaging and pharmacokinetics for the clinical application of 131I-Kringle 5.

Objective:To establish a predictive equation for the osmolarity of parenteral nutritional prescription in China.Methods:From July 2019 to September 2019, 2 480 individualized samples of 328 different parenteral nutritional prescriptions (adult) of Peking Union Medical College Hospital were collected, and the osmolarity of parenteral nutritional solution samples was determined by a freezing point reduction method. Pearson χ2 test and a multiple linear regression analysis were utilized to establish a prediction equation for the osmolality of parenteral nutritional solution. Results:The average osmolarity of parenteral nutritional prescription was (1 164.20 ± 252.59) mOsm/kg, and the best fitting equation was (9.66A+ 7.88G+ 3.52F+ 36.4Na+ 27.55K+ 3.38P+ 7.46W-250)/V.Conclusion:The osmolarity is determined accurately and effectively by the fitting equation, which provide a benefit reference for the formulation, review and selection of clinical parenteral nutrition prescription especially in China.