Hepatitis C virus (HCV) accounts for the majority of cases of transfusion acquired hepatitis and may cause chronic hepatitis, cirrhosis and hepatocellular carcinoma. Currently, there is no vaccine against HCV and treatment is expensive and not always effective.The adaptive host immune response in viral clearance of HCV infection was described and the recent progress in vaccine development of HCV, focusing on the fields of DNA vaccine candidates, recombinant viral vectored vaccine candidates and combined (prime-boost) vaccine candidates were summarized. Some challenges and limitations of developing a HCV vaccine were also analysed. In summary, a promising approach of developing an experimental HCV vaccine to induce extremely potent and broad T-cell responses based on prime-boost strategy was presented.

Objective To study the feasibility of the treatment of tubule pregnancy by interventional technique. Methods By using Seldinger′s method, 40 cases of tubule pregnancy received superselective angiography of uterine artery,followed by perfusion of methotrexate (MTX) through the catheter and embolization of uterine artery with gelatin sponge. The concentration of serum ? HCG, the change of pelvic cavity, and the open condition of oviduct were regularly monitored postoperatively. Results Angiographic findings of tubule pregnancy were classified into 3 types. Type Ⅰ, no abnormal vascular appearance were found in 3 cases (7.5%). Type Ⅱ, patchy vascular staining of villi in parauterine area was observed in 4 cases (10.0%). Type Ⅲ, a round vascular staining of villi surrounded by small blood vessels in parauterine area occurred in 33 cases (82.5%). The cure rate in total 40 cases achieved 97.5% (39/40). After treatment, the mean time that the serum ? HCG concentration returned to normal was (7.66?2.01) d and the mean time that the menstruation returned to normal was (29.78?7.14) d. In 21 cases who hoped their fertility remaining intact, the oviduct were verified open by hysterosalpingography (HSG) in 20 cases, the open rate was 95.24%. Conclusion The treatment of tubule pregnancy by interventional technique was proved no harmful effect to reproductive organs and would expect to preserve fertility. This method could resolve the difficult problem of celiac hemorrhage which making conservative treatment impossible and internal hemorrhage happened in the course of traditional conservative therapy leading to treatment failure finally. This method might be a new conception and a choice to treat tubal pregnancy through artery.

Objective To study the expression and the role of interleukin (IL)-23/IL-17 axis in colonic tissue of trinitrobenzene sulphonic acid (TNBS) induced eolitic mice.Methods Mice were divided into four groups:control (n=24),TNBS (n= 24),TNBS 48 hours + mlL-17 antibodies (n=24),TNBS 48 hours + normal rat blood-serum (n= 24).TNBS-induced colitis model was constructed.The mice in control group and TNBS colitis group were sacrificed at 24 hours,48 hours,7th day,respectively.In TNBS 48 hours + mlL-17 antibodies group and TNBS 48 hours + normal rat blood-serum group,a single injection with the polyclonal mlL-17 antibodies or serum were given intraperitoneally at two hours before enema with TNBS,respectively,and the mice were killed at 48 hours after enema with TNBS.The histological score of colon and myeloperoxidase (MPO) activity of colonic tissue were evaluated in each group.IL-23p19 and IL-17 concentrations in colonic tissue were measured by enzyme-linked immunosorbent assay (ELISA).Expression of nuclear factor (NF)-κBp65in colonic tissue was detected by immunohistochemistry method.Expression of IL-23p19,IL-17 and IL-12p35 mRNA in colonic tissue were detected by real-time fluorescent quantitative reverse transcriptase polymerase chain reaction (RT-PCR) with SYBR Green I.Results The protein levels of IL-23p19 in colonic tissue in TNBS colitis groups at 24 hours,48 hours and 7 days were (15.53±3.32),(31.16±4.98) and (14.03±3.56) ng/mg,respectively,and their mRNA level were (4.09±0.34),(3.39±0.46) and (6.54±1.82),respectively.The protein levels of IL-17 were (0.35±0.06),(0.38±0.08),and (0.26±0.05) ng/mg,respectively,and their mRNA level were (4.21±2.61),(2.65±0.91) and (5.63±1.43),respectively.The expression levels of IL-23p19 and IL-17 in colitis model were significantly higher than those in control group and the peak was at 48 hours.Moreover,expression of IL-23p19 and IL-17 and their mRNA were positively correlated to their mRNA levels.In TNBS 48 hours + mIL-17 antibodies group,the expression levels of NF-κBp65,the microscopic scores and MPO (1.86 % ± 0.36 %,0.63 ± 0.52,0.40 ± 0.03 U/g,respectively) were significantly lower than those in TNBS 48 hours group (4.35% ±0.37%,5.13±0.64,2.29±0.40 U/g tissue,respectively).Neutralization of IL-17 was significantly protected against TNBS-induced colonic inflammation and MPO and expression of NF-κB p65.The results indicated that neutralization of IL-17 significantly reduced colonic inflammation and suppressed NF-κBp65 activation.This protection occurred in the presence of equivalent induction of local IL-23 p19 and high levels of IL-12p35 in the polyclonal raiL-17 antibodies-treated mice.Conclusions IL-23/IL-17 axis plays a critical role at the early acute phase of TNBS-induced inflammation.IL-17 may represent a new target for therapeutic intervention for inflammatory bowel disease.

The application of medical network education system has created favorable conditions for the network education in our hospital. This paper describes the system and resource database construction, educational application and some problems confronted. Construction improvement and widely application of the system are also thoroughly discussed.

Objective To evaluate the factors influencing the reproducibility and validity of food group intakes measured by a food frequency questionnaire (FFQ) for Chinese men. Methods A total of 214 adult men were randomly selected from the Shanghai Men Health Study (SMHS), an ongoing cohort study conducted in urban Shanghai. Each subject who had completed the first FFQ survey at recruitment took 24-hour dietary recall (24-HDR) surveys which were conducted once a month for 12 consecutive months and a second FFQ at the end of the study. Two FFQs were administered approximately 1.2 years apart. The food items listed in FFQ and obtained from 24-HDR were categorized into 11 food groups. The factors influencing the reproducibility of the FFQ was assessed by comparing the Pearson correlation of intake levels from the two FFQs, while the factors influencing the validity was evaluated by comparing intake levels from the second FFQ with the multiple 24-HDRs. Results A total of 195 men completed all 12 times of 24-HDR and twice FFQ surveys. The median Pearson correlation coefficients of the food groups between the two FFQs in older vs younger age group were 0.62 vs 0.50;in higher vs lower education level group were 0.58 vs 0.50;in higher vs lower income group were 0.51 vs 0.50;in higher vs lower BMI group were 0.50 vs 0.49. The median Pearson correlation coefficients of the food groups between the second FFQ and 24-HDRs in older vs younger age group were 0.61 vs 0.45;in higher vs lower education level group were 0.49 vs 0.47;in higher vs lower income group were 0.43 vs 0.57;in higher vs lower BMI group were 0.48 vs 0.51. Conclusions Age is the main factor influencing the reproducibility of the food group intakes by a FFQ used in the SMHS, while the factors influencing the validity are age and family income.

Objective To identify whether the branches of cervical nerve roots joined into the accessory nerve trunk or not.Methods In 10 adult cadavers (7 males and 3 females, including 20 laterals of brachial plexus nerves), we observe source of cervical plexus branches to the accessory nerve anatomically.In 10 clinical cases of males with brachial plexus nerve injures, in the supraclavicular approach of brachial plexus exploration, the part of the supraclavicular cutaneous nerve for histological specimen were cut off;in the posterior approach, electrical stimulation of the trunk and branches of cervical plexus were performed to observed istaltrapezius muscle contraction.After accessory nerve transfer, the residual terminal accessory nerve and branch of cervical plexus were taked for histological specimens;and observed and judged of each nerve sample by acetylcholinesterase (AchE) immunohistochemical staining.Results In 10 of 20 lateral cases, cervical plexus communicating branches were derived from the fourth cervical nerve root.The intraoperative electrical stimulation of the accessory nerve trunk, 10 cases of distal trapezius muscle were significantly shrink;electrical stimulation of the cervical plexus branch, 2 cases after stimulation of the mild distal trapezius contraction, the remaining 8 cases without trapezius muscle contraction.10 cases of supraclavicular nerve staining for AchE were negative, 10 cases of accessory nerve terminal branches of AchE staining were mixed,10 cases of branch AchE cervical plexus to the accessory nerve staining were negative.Conclusion The branches of the fourth cervical nerve root constantly joins into the accessory nerve, participating in the trapezius muscle inner vation, the fibers of the branches are sensorial fibers.

Objective To explore the prognostic significance in monitoring minimal residual disease (MRD) in childhood acute lymphoblastic leukemia (ALL) by a simple method,and to detect cloned immunoglobulin H (IgH) and T cell receptor γ (TCRγ) gene rearrangements by using multiplex polymerase chain reaction (PCR) and automated fragment analysis.Methods Bone marrow samples were collected from 86 newly diagnosed cases of childhood ALL at the Department of Pediatrics,the First Affiliated Hospital of Sun Yat-Sen University,from May of 2009 to August of 2013.IgH and TCRγ gene rearrangements were amplified by qualitative multiplex PCR.The clonality of PCR production was analyzed by GENEMAPPERID software.Only those carried monoclonal IgH/TCRγ on diagnosis were arranged to monitor MRD.Detectable monoclonal IgH/TCRγby the end of induction was defined as MRD positive.All patients were treated with GD2008 ALL protocol.Clinical data of all newly-diagnosed ALL patients in the corresponding period were reviewed.The final follow-up on May 31,2014.Survival rates and event free survival (EFS) curves were estimated by the Kaplan-Meier,and compared by using the log-rank test.Results The percent age of 94.2 (81/86 cases) patients was at least 1 marker positive.Subsequent MRD was monitored in 79 cases.The median follow-up time was 20 months (9-61 months).By the end of induction,20 cases were MRD positive and 59 cases were M RD negative,and the 3-year EFS were 56.4％ ± 14.7％ and 94.0％ ± 3.4％ (x2 =8.563,P =0.003),respectively.According to the traditional prognostic stratification criteria,MRD was detected 65 cases in the non-high risk group:23 cases in standard risk group and 42 cases in intermediate risk group,and the difference of 3-year EFS had no statistical significance (95.3％ ±4.7％ vs 76.6％ ±9.0％,x2 =0.934,P =0.334).While using MRD by the end of induction as a risk stratification criterion,there was a statistical significant difference compared with the 3-year EFS for MRD-negative (n =52) group and MRD-positive (n =13) group (93.1％ ± 3.8％ and 59.5％ ± 16.2％,x2 =7.128,P =0.008).Conclusions It is a simple but feasible method to monitor MRD in childhood ALL by using this qualitative multiplex PCR with automated fragment analysis for monoclonal IgH/TCRγ gene rearrangements.MRD by the end of induction can be used as a more accurate risk stratification criterion than the traditional one.It is worth of further research.

Objective To develop a suitable forcep for reduction and internal fixation of sagittal fracture of mandibular condyle (SFMC) and evaluate its role in clinical practice.Methods Twenty patients with SFMC diagnosed by three-dimensional CT undergone open surgery were divided into experimental group and control group with 10 patients per group,according to the random number table.Patients in experimental group were reduced and fixed using the new reduction forcep,while in control group by the classical vascular clamp and nerve retractor.Operation time,three-dimensional CT before operation and 2 weeks after operation,and occlusion,maximum mouth opening (MMO),visual analogue scale (VAS),joint clicking as well as noise before operation and 1 and 6 months after operation were recorded.Results Operation time was obviously lower in experimental group than in control group [(0.90 ± O.11)hours vs (1.34 ±0.10)hours,t =-10.8,P ＜0.01].MMO in experimental group revealed significant improvements compared to control group at postoperative 1 month [(32.6 ± 1.6) mm vs (29.7 ±1.6)mm,t =-10.1,P＜0.01] and at postoperative 6 months [(34.3 ± 1.2)mm vs (33.3 ± 1.1)mm,t =3.4,P ＜0.01].VAS between experimental group and control group also differed significantly at postoperative 1 month [(3.6 ± 0.7) mm vs (5.1 ± 0.7) mm,t =-12.5,P ＜ 0.01] and at 6 months [(3.5±0.9) points vs (4.8±0.6) points,t=-3.3,P＜0.01].Conclusion The new reduction forcep can shorten operative time and improve mouth opening and pai for SFMC.

Objective To analyze the separation and displacement of bone fragments in sagittal fracture of the mandibular condyle (SFMC),understand the motion type and guide clinical treatment and development of related surgical instruments.Methods Forty-five patients (52 sides) with SFMC treated between October 2008 and October 2012 were enrolled; 32 patients (36 sides) were males and 13 patients (16 sides) were females.According to the Neff classification,there were 20 sides with type A,28 sides type B and 4 sides type M.All the patients underwent CT scan and were classified based on measurements of distance and angle of displaced bone fragments.Results Patients were categorized into type Ⅰ on 20 sides (type Ⅰ A on 14 sides and type Ⅰ B on 6 sides),type Ⅱ on 27 sides (type Ⅱ A on 11 sides and type ⅡB on 16 sides),type ⅢB in 1 side and type Ⅳ in4 sides.Mean displacement of bone fragments was 12 mm (range,4-16 mm) ; mean deviation angle was 34°(range,11°-43°) ; mean descending distance was 13 mm (range,6-18 mm).Conclusion CT analysis results show that,mast bone fragments in SFMC move slightly.

Four qi theory is an important part of property theory of traditional Chinese medicine. Current researches mainly focus on two aspects of cold and heat properties, which are not only important elements of treating diseases, but also are factors of causing adverse reaction. In this article, through the study on the toxicity mechanism of cold and hot properties, authors put forward to the control measures of toxic and side effects of traditional Chinese medicine with cold and hot properties, and pointed out that the importance of controlling toxicity of traditional Chinese medicine with cold and hot properties lies in the modernization and internationalization of traditional Chinese medicine.