Objective To optimize the treatment of chronic hepatitis C recurrence.Methods During May 2008 to May 2012, 50 patients with chronic recurrent hepatitis C were chosen in the infectious department of our hospital.They were divided into two groups with 25 cases in each group.Group A was treated by standard extended treatment scheme,while Group B was treated by standard large dose scheme.The effect was estimated by the observation of sustained virologic response in the two groups (sus-tained virologic response,SVR).Results 32% SVR rate was found in group A and 23% SVR rate was found in Group B.38% re-currence rate appeared in group A after six months and 43% recurrence rate occurred in group B,there were significant difference between two groups(P <0.05).Conclusion The standard extended treatment schemes of pegylated interferon and ribavirin is su-perior to group B in SVR rate.

Objective To investigate the effects of interleukin -15 ( IL-15 ) on the cytotoxicity of Vδ2 γδ(Vδ2) T cells against K562 cells.Methods PBMCs were separated and cultured with zoledronate and interleukin-2 ( IL-2) to induce the proliferation of Vδ2 T cells.The obtained Vδ2 T cells were in vitro stimulated with IL-15.Flow cytometry analysis was performed to evaluate the changes of phenotypes of Vδ2 T cells and their cytotoxicity against K562 cells.Results Zoledronate effectively induced the massive prolifer -ation of V2δT cells.The Vδ2 T cells were highly activated and the expression of CD 107a and IFN-γby Vδ2 T cells were upregulated upon IL-15 stimulation.The cytotoxicity of Vδ2 T cells against K562 cells was greatly enhanced by the treatment with IL-15.Conclusion IL-15 could activate the Vδ2 T cells and en-hance their cytotoxicity against K562 cells.

Objective:To study the role of γδ T cells and Vδ1 and Vδ2 T subsets played in patients with chronic hepatitis C.Methods:The percentage of peripheral bloodγδT cells and Vδ1 and Vδ2 T subsets cells was assessed by flow cytometry ( FACS) . Results:There were no significant differences in the percentage of circulating γδ T cells and Vδ1 and Vδ2 T subsets between HCV-infected patients and healthy controls ( HCs).However,The number of peripheral blood Vδ2 T cells from HCV-infected patients was positively correlated with serum alanine aminotransferase ( ALT) levels,but showed no correlation with serum HCV RNA.Peripheral Vδ2 T cells from HCV-infected patients were in activated status.The expression of CD107a was enhanced in Vδ2 T cells from HCV-infected patients compared to HCs.Conclusion:Vδ2 T cells were involved in liver injury in chronic HCV-infected patients.

Objective To evaluate the clinical value of low-dose semicoronal computerized tomography (CT) of sacroiliac joints (SIJ) in the early diagnosis of ankylosing spondylitis (AS).Methods Patients who were diagnosed with AS and had received axial CT examination of SIJs over the past 2 years were recruited.All of them simultaneously underwent a low-dose semicoronal CT of SIJs.The clinical data were recorded.Radiation dose was compared between low-dose CT and the previous conventional axial CT.Image quality of low-dose CT was assessed and correlation between image quality and weight or body mass index (BMI) was analyzed.CT images of the two groups were graded by modified New York criteria, the Lee criteria and the Innsbruck criteria.The kappa coefficient was used to assess the consistency of grading between the two groups.Results Thirty-three patients were enrolled in this study.The effective dose (ED) of semicoronal SIJ CT was 3.37 mSv which was 49％ lower than conventional axial CT (6.56 mSv).Lower dose had the potential protection of gonads.The quality of images in male patients with BMI ＜ 25 kg/m2 and all female patients were good or excellent.There was a significant negative correlation between image quality and BMI (r =-0.746, P =0.000;r =-0.784, P =0.000;respectively).All patients were diagnosed as sacroiliitis by modified New York criteria and the grading of two groups was consistent.The consistency of grading between two groups was satisfactory no matter which classification criteria was used.(k =0.897 with Lee criteria;k =0.814 with Innsbruck criteria;P ＞ 0.05).Conclusions The radiation dose of semicoronal SIJ CT is significantly lower than that of the conventional axial CT with comparable efficacy of diagnosis.

Objective To study the prevalence and associated factors of loneliness in individuals with speech disability.Methods Using multi-stage stratified random cluster sampling method,170 community-residing ver-bally disabled persons were selected and administered with a general information questionnaire,one single -item loneliness self-rating question and social support scale.A total of 204 study questionnaires were distributed to the subjects;170 subjects(mean age:43.1±13.7 years)completed the survey.Results As high as 46.47% (79/170)of these verbally disabled individuals reported to feel lonely often.Females (OR=2.45),unemployment (OR=2.95), first and second degrees of disability (OR=4.35),co-existence of chronic illnesses (OR=6.50)and low utiliza-tion of social support (OR=2.58)were significantly associated with the increased risk of loneliness in persons with speech disability (P =0.002~0.046).Conclusion Loneliness is highly prevalent in individuals with speech disabili-ty.Verbally disabled persons,who are female,unemployed,severely disabled,and chronically ill and have a low use of social support,are the target population of mental health services.

Objective To investigate the indications and clinical effect of the low-big hole choledochoduodenostomy. Methods Two hundred and ninty-eight patients, had bile duct stone accompanied with common bile duct lower segment stenosis, were prospectively enrolled into the study and randomly divided into the low-big hole choledochoduodenostomy (improved CD ) group (n = 148 ) and the Roux-en-Y choledochojejunostomy (CJ) group (n = 150). Their perioperative period and long term effect indices were recorded and compared. Results Perioperative period indices:The time of cholangio-jejunostomy was much shorter in improved CD group than the CJ group ([31.0±10.5] min vs [53.0±12.3] min, P＜0.001);The anastomotic leakage was significantly less in improved CD group than the CJ group (2 vs 9, P ＜ 0. 001 ). The long term effect indices: The occurrence of peptic ulcer (3 vs 15 ) and the bile duct cecum or blind loop syndrome (5 vs 158) were significantly lower in group improved CD group than CJ group (Ps＜0.01);The occurrence of bile duct backflow (70 vs 42) was significantly higher in improved CD group than CJ group (P＜0. 0l). Conclusion The clinical effect of the low-big hole choledochoduodenostomy gastrointestinal had excellent effect for bile duct stone accompanied with common bile duct lower segment stenosis, especially for old,weak and critical patients,and it can not be replaced by the Roux-en-Y choledochojejunostomy.

Objective To investigate the effects of the wound isolation in prevention of abdominal wound infection. Methods 2549 patients who bearded abdominal operation in 3 years in our hospital were randomly divid-ed into wound isolation group (n=1300) and control group(n=1249). The wound infection rates were summarized by operation ways and major influencing factors. Results The overall wound infection rate of control group and wound isolation group was 5.9% (76/1300) and 2.6% (32/1249). The infection rate was 13.4% (40/300) and 3.1% (9/280) in gallbladder resection, 14.7 % (24/165) and 3.5 % (6/159) in radical operation for carcinoma of colon, 13.6% (15/108) and 3.2% (13/114) in intestine block operation, 9.6% (18/187) and 1.8% (3/169) in stomach resection (P<0.01);The infection rate was 9.3% (13/145)and 2.9% (4/153)in biliary exploration, 14.6% (8/55) and 1.8% (1/56) in WHIPPLE, 10.6% (9/85) and 2.3% (2/88) in cholecystectomy (P<0.05);The infection rate was 6.3% (6/95) and 2.3% (2/86) in liver resection, 5.3% (5/95) and 1.2% (1/87) in spleen resection, 4.6% (3/65) and 1.8% (1/57) in porto-azygos venous disconnection (P>0.05). The wound infection rate of type Ⅰ resection of control group and wound isolation group was 2.0% (6/305) and 1.4% (4/280) (P> 0.05);The infection rate of type Ⅱ and Ⅲ resection was 7.0% (70/995) and 2.9% (28/969), for old man (≥60) was 12.6% (36/286) and 3.6% (10/279), the emergency operation was 10.0% (38/381) and 2.8% (10/362), the operation time ≥3 h was 9.0% (39/435) and 2.8% (12/426), with diabetes was 14.5% (21/145) and 4.9% (6/123), with obesity was 12.3% (40/325) and 3.9% (12/310), with malnutrition was 8.5% (39/458) and 3.2% (14/433), with cancer was 8.6% (40/465) and 3.0% (15/496) (P<0.01).;undergoing unemergency operation was 4.1% (38/919) and 2.5% (22/887),for yong persons (<60) was 3.9% (40/1014) and 2.3% (22/970), with operation time<3 h was (37/865) and 2.4% (20/823), without diabetes was 3.9% (45/1155) and 2.3 % (26/1126), without obesity was 3.7 % (36/975) and 2.1% (20/939), without malnutrition was 4.4% (37/842) and 2.2% (18/816)and without cancer was 4.3% (36/835) and 2.3% (17/753) (P<0.05). Conclu-sions The wound isolation can decrease the wound infection rates by reducing the chance of bacterial contamina-tion.

Objective To establish rat models of polycystic ovary syndrome(PCOS) induced by different methods,to assess the serum levels of several related hormones,to examine the morphological changes in the ovaries,and to discuss their significance.Methods Letrozol,sodium prasterone sulfate,or sodium prasterone sulfate combined with human chorionic gonadotropin were used to establish rat models of PCOS.Radioimmunoassay was used to measure the serum levels of hteinizing hormone(LH),follicle-stimulating hormone(FSH),estrogen(E_2),progesterone(P),testosterone(T),prolactin(PRL),and insulin(INS).HE staining was used to examine the morphological changes of the ovaries.Results Comparing with the normal group A,the serum FSH was increased and the serum progesterone was reduced in the group B,with a statistically significant difference(P<0.05).The serum testosterone was significantly higher in the group B than in the group A(P<0.01).The levels of serum sex hormones and insulin were not significantly different in the group D and C(P>0.05).In comparison with the group C,the levels of serum testosterone and LH/FSH ratio was significantly increased in the group E.(P<0.05).Comparing with the group D,the serum levels of progesterone and testosterone were significantly increased in the group E(P<0.05).The ovaries in the rats of groups A and C showed almost a normal histyology,with mature follicles and dominant follicles.Polycystic changes were observed only in the ovaries of groups B,D and E.Conclusion At the aspect of affecting the level of sex hormones in serum and changing the ovarian morphology.adopting letrozol tablets or sodium prasterone sulfate combined with HCG to induce rat PCO model is more close to clinic manifestations and meets the criteria of PCO animals.In the rat PCOS models induced with letrozol or with sodium prasterone sulfate combined with HCG,either the serum levels of sex hormones and ovarian histology are quite similar to those of human clinical appearance,and may well meet the modeling requirements for future experimental studies of polycystic ovary syndrome.

Objective To assess the dignosis value of CT three-dimensional reconstruction with Fisher discriminant model in small solitary pulmonary nodules before operation.Methods CT data of 40 cases with SPN were retrospectively analyzed and divided into into malignant pulmonary nodules (25 cases),squamous cell carcinoma (4 cases),adenocarcinoma (13 cases),lung cancer (4 ca-ses),small cell lung cancer (2 cases),large cell carcinoma (1 case),metastases tumor (1 case),benign nodules (1 5 cases,6 cases of tuberculosis,2 cases of hamartoma,and 7 cases of non-specific inflammatory nodules)by pathology and follow-up results.The CT features of pulmonary nodules were evaluated through multi-planar reformation (MPR),curved-planar reformation (CPR),volume rendering (VR),maximum intensity proj ection (MIP)and other three-dimensional reconstruction.The three-dimensional data were divided into benign and malignant groups.In each of the two groups,the significant signs of morphological signs of discrimination indicators were adminstrated Fisher discriminant,and the probalitiy of false positives were estimated using cross-validation method. Results The positive features of pulmonary nodules in there-dismensional images were much more than in two-dimensional images. Fisher discriminant formula of solitary pulmonary nodules in three-dimensional images was Z=1.143X1 + 0.454X2+1.606X3-0.262X4+0.04X5+0.483X6+1.611X7-2.164.Discriminant boundary value Zc was-0.516.When Zcgreater than -0.516,nodules were proneed to considere as malignant nodules.In 25 cases of malignant nodules,4 cases mistook for benign.When Zc less than -0.516,nodules were proneed to considere as benign nod-ules.In 1 5 benign nodules,2 cases mistook for malignant.The total misdiagnosis and accuracy rate were 15 % and 85% respec-tively.Conclusion CT three-dimensional reconstruction combined with Fisher discriminant model have a high clinical value in dif-fereiating diagonsis of pulmonary nodules were proneed to considere as malignant nodules.In 25 cases of malignant nodules,4 cases mistook for benign.When Zc less than -0.516,nodules were proneed to considere as benign nodules. In 15 benign nodules,2 cases mistook for malignant.The total misdiagnosis and accuracy rate were 15 % and 85% respec-tively.Conclusion CT three-dimensional reconstruction combined with Fisher discriminant model have a high clinical value in differeiating diagonsis of pulmonary nodules.

Objective To study the characteristics of work disability and its influencing factors in patients with ankylosing spondylitis (AS). Methods The demographic data, work conditons and disease related characteristics of 277 patients with AS were recorded, and randomly selected from the Department of Rheumatology, Chinese PLA General Hospital from November 2014 to January 2016. Work and productivity activity impair-ment questionnaire (WPAI) was used to survey the work disability and productivity loss, then explore its in-fluencing factors and the relationships between patient-reported outcomes and WPAI scores. Logistic regression was used to analyze the associated factors of work disability. Multivariate linear regression was used to analyze the predictive factors of lose of work productivity. Results The prevalence of work disability was 30.3%. Twenty patients were unemployed because of working disability. Two hudreds patients were employed, with average 36.5 (24.0, 50.0) hours workingtime in the past week. Average AS related absenteeism was 4.4 (0, 10) hour. Average workproductivity loss was 26.4%(2.5%, 40.0%). Logistic multiple regression analysis showed that Bath AS disease activity index (BASDAI), SF-36 physical component summary (PCS) scores might be the important influencing factors among those clinical measures ( OR=1.270, 0.959). Presenteeism and overall work impairment were moderately correlated with patients' global assessment of disease activity (VAS), BASDAI, bath AS functional index (BASFI), SF-36 physical Functioning (PF), SF-36 body pain (BP) and SF-36 Physical Component Summary (PCS) (|r|=0.539-0.648). Linear multivariate analyses indicated that work presente-eismand absenteeismwere significantly associated with BASDAI (P<0.01). Conclusion High prevalence of work disability in patients with AS is noted, which is closely related with disease activity and body function;High attention should be paid to AS patients with work disability.