Objective To observe the clinical efficacy of ganciclovir in treatment of children with viral encephalitis.Methods 80 children with viral encephalitis were randomly divided into observation group and control group.All patients received the comprehensive treatment including anti-spasm,dehydration,control of body temperature,decreased intracranial pressure and drugs of improving brain metabolism.40 children in the observation group received intravenous ganciclovir.40 patients in the control group received intravenous ribavirin.The clinical effect of the two groups was compared.Results The total effective rate of observation group was 92.5％,that of the control group was 70.0％,the difference was statistically significant (x2 =6.721,P ＜ 0.05).In the observation group,the main clinical symptoms including fever,headache,vomiting,convulsions and the disappearance time of unconsciousness were significantly shorter than the control group(t =5.270,9.730,5.749,5.903,5.421,all P ＜ 0.05).The incidence rate of adverse reactions in the observation group was 7.5％,which was lower than 17.5％ in the control group,but the difference was not statistically significant (all P ＞ 0.05).Conclusion Ganciclovir in the treatment of children with viral encephalitis can improve clinical symptoms in a short time,and adverse reactions are mild,which can be used as the ideal choice for treatment of children with viral encephalitis.

objective To determine the relationship between immunohistochemical stain assay of liver tissue and prognosis of viral hepatitis.Methods 132 patients with chronic hepatitis B diagnosed 6 to 8 years ago by liver biopsy had been followed up by the retrospective and prospective study.The serum hepatitis B virus markers(HBVm)?alpha-fetoprotein(AFP)?Alanine aminotransferase(ALT) and Aspartate aminotransferase(AST)have been detected and B-scan ultrasound of liver and spleen have performed when they stayed at hospital and during follow-up-time,their symptom and physical sign have been recorded simultaneously.Results 4 of 104(3 85%) patients died of cirrhosis;of 100 survival patients,2 patients(2%,2/100) were typical cirrhosis and 16 (16%,16/100) patients were early stage cirrhosis and parenchyma of liver diffuse lesion diagnosed by ultrasound.The serum ALT of patients whose HBcAg and HBsAg were positive in liver tissue was easier fluctuation than those of negative case.Conclusion The status of patients with HBsAg and HBcAg positive in liver tissue is easier fluctuation than those negative,HBsAg and HBcAg positive in liver tissue maybe have no effect on the prognosis of the chronic hepatitis B.

OBJECTIVE: To investigate the expression and clinical significance of BUB1 protein in laryngeal squa mous cell carcinoma (LSCC) tissues. METHOD: The expression of BUB1 protein was measured by immunohistochemistry (EliVision two steps) in 55 cases of LSCC tissues,30 cases of adjacent normal laryngeal mucosa tissues, the relationship of BUB1 expression with clinical pathologic factors in LSCC was also analyzed. RESULT: The positive rate of BUB1 protein in LSCC tissues (50.9%, 28/55) was significantly lower than that in adjacent normal laryngeal mucosa tissues (83.3%, 25/30), P < 0.01. The positive rate of BUB1 protein was correlated with differentiation grading and lymph node metastasis of LSCC (P < 0.05, respectively), but not with patient's sex, age, smoking, tumor site, T-stage and clinical stage(P > 0.05, respectively). CONCLUSION The low expresssion of BUB1 protein is closely related to the tumorigenesis and development of LSCC, and can be a molecular marker for prognosticating metastasis and prognosis of LSCC.
Adult ; Aged ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Female ; Humans ; Immunohistochemistry ; Laryngeal Mucosa ; metabolism ; Laryngeal Neoplasms ; metabolism ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Proteins ; metabolism ; Prognosis ; Protein-Serine-Threonine Kinases ; metabolism

Objective:To elucidate the relationship between HLA-DQB1 allele polymorphism as well as the expression level of Th1/Th2 cytokines with familial clustering of hepatocellular carcinoma ( HCC) to provide some evidence for the seeking susceptibility gene or resistant gene of HCC in Guangxi yao,China.Methods:With the same sexuality,age ±5 year,40 members whose families have had two or more HCC patients( high-occurrence families) were selected as the case group,and 40 members whose families have no any cancer patient were selected as the controls.Peripheral blood samples were collected to extract DNA,PCR-SSP was used to detect HLA-DQB1 alleles and ELISA was used to detect IL-2,IL-4 and IL-10.Results:(1) The gene frequency of the HLA-DQB1*02/09 alleles in the case group was higher than that in the controls(P<0.05);but the gene frequency of the HLA-DQB1*04/05/06/07/08 alleles were never significant difference between two groups ( P>0.05 ).( 2 ) The gene frequency of alleles HLA-DQB1 in HBsAg positive group and HBsAg negative group were never significant difference (P>0.05).(3)The expression levels of IL-4,IL-10 in the case group was higher than that in the control ( P<0.05 ).( 4 ) The expression level of IL-10 in the positive group of the HLA-DQB1*02 allele was higher than that in the negative group of the HLA-DQB1*02 allele ( P<0.05 ).( 5 ) The expression level of IL-4 in the positive group of the HLA-DQB1*09 allele was higher than that in the negative group of the HLA-DQB1*09 allele( P<0.05) .Con-clusion:(1) HLA-DQB1*02/09 seem to be susceptibility genes of hepatocellular carcinoma in high HCC incidence areas of Guangxi yao.(2) There may be not significant correlation bewteen HLA-DQB1 alleles and the susceptibility of HBV infection in high HCC incidence areas of Guangxi yao.( 3 ) The imbalance of IL-4, IL-10 might be associated with familial clustering of hepatocellular carcinoma in Guangxi yao.(4)The imbalance of IL-10 might be due to the carrying of HLA-DQB1*02;the imbalance of IL-4 might be due to the carrying of HLA-DQB1*09.Through the same approaches,these might lead to the phenomenon of familial aggregation of HCC in Guangxiyao.

Objective To investigate the role of CD4 ~+ CD25~+ regulatory T lymphocytes (Treg)in modulating the cellular immune response and pathogenesis of murine pulmonary tuberculosis.Methods Inactivation of Treg was achieved by intraperitoneal injection anti-CD25 (clone PC61,50 μ/mouse) in PC61 group, and rat-IgG (50 μ/mouse) was injected intraperitoneally in control group. All the mice were inoculated intravenously with H37Rv 0. 1 mL (1 × 10~6 CFU) 3 days after Treg inactivation. The effects of Treg inactivation in different tissues were analyzed by flow cytometry. The cellular immune response, pulmonary histopathology and bacterial load were determined in vitro at different time points. The data were compared using homogeneity of variance F test and non-paired t test. Results In spleen, the percentages of Treg/CD4 T lymphocytes in PC61 group and control group were (21. 13± 3. 58)% and (30. 42± 4. 20)%, respectively at day 10 of inoculation (t = 2. 38, P < 0. 05), and those were (16. 12 ± 1. 26)% and ( 17. 34± 1. 62)%,respectively at day 30 of inoculation (t = 0. 84,P>0. 05). The percentages of Foxp3~+/CD4~+ T lymphocytes in PC61 group and control group were (32. 07 ± 3. 95)% and (60. 55 ± 5. 48)%,respectively at day 10 of inoculation (t = 5. 96, P<0. 05). Similar results were achieved in the peripheral blood. Bacillus calmette-guerin (BCG)-specific 1L-17 (ng/L) secreted by murine spleen cells in PC61 group and control group at day 10, 30 and 60 of inoculation were 5. 1± 0.9 vs 0, 43. 1± 10.0 vs5. 9± 2. 8 and 124.8 ± 5.8 vs 102. 5±8. 1, respectively (t = 7. 90, t=5. 10,t = 3. 19; all P<0.05); those of BCG-specific IFN-γ (ng/L) were 28. 4 ± 8. 2 vs 4. 0±1. 3, 685. 9± 128. 6 vs418. 7±20.4 and 310.9±119. 7 vs 32. 8±7. 5, respectively(tO = 4. 21,t = 8. 43, t = 3. 27; all P<0.05);those of TNF-a (ng/L) were 38. 6±5.0 vs 16. 3±4. 0, 112. 9 ±12. 3 vs 71. 5±12. 6 and 86. 2±8. 2vs0, respectively(t = 4. 95, t=3. 33,t/=14.8; all P<0. 05). The lung bacterial load at day 10 of inoculation in PC61 group was lower than that in control group (t = 4. 63, P < 0. 01), but the differences were not significant thereafter. The changes of lung histopathology at late stage of infection (day 120) in PC61 group were less severe than those in control group. Conclusions Murine Tregs increase dramatically after Mycobacterium tuberculosis infection. Treg could inhibit the specific cellular immunity against Mycobacterium tuberculosis, and therefore, may facilitate the persistent infection of Mycobacterium tuberculosis and development of tuberculosis.

Objective To investigate the effect of Th1/Th2 cytokines and immune state on the occurrence and familial aggregation of hepatocellular carcinoma(HCC).Methods Ninety-five members whose families have had two or even more HCC patients(high-occurrence families) were selected as the case group,by matching with the same nationality,gender,residential area,age±5 years old,95 members whose families had no any cancer were selected as the control.The level of peripheral blood Th1 type cytokines such as interferon-γ(IFN-γ),interleukin-2(IL-2) and Th2 type cytokines such as interleukin-4(IL-4),interleukin-10 (IL-10) were detected by enzyme linked immunosorbent assay(ELISA).Results There was a Th1/Th2 serum cytokine imbalance profile in members of HCC high-occurrence family.The levels of IFN-γ and IL-2 were significantly lower in members of HCC high-occurrence family than that of the controls.The levels of IL-4 and IL-10 were higher in members of HCC high-occurrence family than that of the controls.Conclusion There was a poor cellular immune state in members of HCC in the high-occurrence families.Th1 type cytokines was inhibited,and Th2 type cytokines was enhanced,so more susceptible to HBV chronic infection.It might be the mechanism of HCC occurrence and familial aggregation.

Objective:To investigate the effect of HLA-DRB1*07,13 allelic genes on the immune response to hepatitis B vaccination.Methods:896 healthy college students of Han nationality from Guangxi province,who had received standard courses of vaccination with recombinant hepatitis B virus vaccine,were tested the level of anti-HBs with ELISA method at the sixth month after their last vaccination.The non- or hypo-responders were selected to receive another 20 μg doses of recombinant vaccine and were examined anti-HBs once more four weeks later.99 non- or hypo-responders and 136 medium or hyper-responders were selected for the study subjects.HLA-DRB1*07,13 allelic genes of the subjects were detected by polymerase chain reaction using sequence specific primer (PCR-SSP) method.Results:The frequencies of HLA-DRB1*07 gene in the non- or hypo-responders group were significantly higher than that in the medium or hyper-responder group (16.16% vs 4.41%,P＜0.05). No significant difference of HLA-DRB1*13 gene between the two groups (1.01% vs 3.68%,P=0.389).Conclusion:There is a close relationship between the expression of HLA-DRB1*07 gene and the non- or hypo-response to HB vaccine;No relationship between HLA-DRB1*13 gene expression and the response to HB vaccine is found.

Objective: The study aimed to explore the recommended treatment for toxicosis of botulism toxin type A. Methods: From January 2016 to August 2017, 8 patients with toxicosis of botulism toxin type A were hospitalized in Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine. All patients were female, 21-33 years of age, with an average age of 26.4 years. All patients showed progressive myasthenia and abnormal electromyography. The clinical manifestations and treatment outcomes of 8 patients in antitoxin group or non-antitoxin group were retrospectively analyzed. Five patients treated in plastic and reconstructive surgery department were included in the antitoxin group. They received skin test before injection, followed by intramuscular injection of 10 000-20 000 U antitoxins once a day for 2-3 days. Three patients treated in neurology department were included in the non-antitoxin group. They received only intravenous drip of neurotrophic drugs. After treatment, the improvement of clinical symptoms such as myasthenia and blepharoptosis was observed, and the electromyogram was followed up. Results: The symptoms of myasthenia of the 5 patients in antitoxin treatment group were significantly improved, and the electromyogram signal returned to normal. However, for the 3 patients in non-antitoxin group, the symptoms of myasthenia did not significantly improve, and their electromyogram signal did not return to normal, even after 5 days′continuous treatment. Conclusions To regulate the cosmetic medical market is the key to prevent the accident of toxicosis of botulism toxin type A. It is necessary to make a definite diagnosis and medical intervene in time for the toxicosis. Antitoxin has a better curative effect, but further research is needed, to verify its safety and effectiveness.

Objective To evaluate the role of multi-disciplinary team (MDT) in improving the diagnosis and treatment of human herpes virus-6B (HHV-6B) encephalitis after liver transplantation. Methods MDT consultation was delivered for one rare case of HHV-6B encephalitis after liver transplantation to establish an effective individualized treatment regime. Results On the 16 d after liver transplantation, the patient developed headache, and suddenly presented with unresponsiveness, unconsciousness, coma complicated with involuntary limb twitching on the 18 d. Blood ammonia level was increased. Brain CT scan showed cerebral ischemic changes. Electroencephalography prompted the epileptic seizure. After MDT consultation, the possibility of nervous system infection after liver transplantation was considered, and medication therapy was given to control the epileptic seizure. Cerebrospinal fluid examination via lumbar puncture hinted increased intracranial pressure. Real-time fluorescent quantitative polymerase chain reaction (RT-qPCR) of the cerebrospinal fluid demonstrated that the patient was tested positive for HHV-6B nucleic acid, which confirmed the diagnosis of HHV-6B encephalitis. The immunosuppressant regime was adjusted, intravenous ganciclovir was given for antiviral treatment, and active interventions were delivered to prevent and treat relevant complications. Epileptic seizure disappeared after 4 d, and neurological symptoms were significantly alleviated after 2 weeks. After 4-week antiviral treatment, the patient was tested negative for virology testing, and the neurological function was restored to normal. Conclusions HHV-6B encephalitis rarely occurs after adult liver transplantation, which is primarily associated with the virus reactivation after use of immunosuppressant. MDT pattern may be employed to deepen the understanding of the patient's condition, formulate more effective individualized treatment regime, and enhance the clinical efficacy and safety.

Objective:In the process of fat grafting, there is no good solution to achieve delicate filling while retaining the viability of fat particle. There was still no research on the composition and activity of delicate fat particle. In this study, two different methods for delicate fat process were established to explore the feasibility and clinical efficacy.Methods:From December 2015 to June 2016, 5 patients (22-31 years old, with average 26.2 years) with abdominal liposuction in Shanghai Ninth People's Hospital were inclueded. The fat particles were obtained by floating method and filtration method respectively, and compared with emulsified fat/nanofat and traditional fat grafts. The cell viability and composition of adipose tissue were compared in each group through cell viability test, flow analysis and tissue staining.Results:The fat particles obtained by floating and filtration methods, emulsified fat could pass through OT needle. Cell viability test revealed the presence of living cells in the fat obtained by both methods, but not in the emulsified fat. Flow analysis showed that the expression of CD90 in floating group was higher than that in control group ( P=0.048). Conclusions:The delicate fat particle can be obtained by floating or filtration method, which can preserves the tissue integrity and cell viability; meanwhile it can achieve fine needle injection and clinical application.