Objective:To investigate the characteristics of peripheral circulating lymphocyte subsets in severe hepatitis patients with chronic HBV infection(SHPCHI).Methods: The numbers of circulating lymphocyte subsets,including CD3~(+),CD4~(+) and CD8~(+),NK cells(CD3~(-)/CD16~(+)/CD56~(+)),and NKT cells(CD3~(+)/CD16~(+)CD56~(+)),were determined in SHPCHI((n=61),)patients with chronic hepatitis B(CHB,n=21),patients with cirrhosis(LC,n=26) and healthy volunteers(n=10) by flow cytometry.The absolute values of each lymphocyte subset were calculated and statistically analyzed.Results: The absolute numbers of circulating CD3~(+),CD4~(+)and CD8~(+) T cells were significantly reduced in SHPCHI group compared with those in the other 3 groups(P

Current therapies for chronic hepatitis caused by hepatitis C virus (HCV) are limited . DNA vaccination may constitute a new immunotherapeutic strategy for various hepatitis virus infections by promoting specific cellular and humoral immunity. In this review we present the advances in choice of antigen gene, vaccine adjuvants and the methods of intracellular delivery, unresolved questions and therapeutic potential of HCV DNA vaccine.

Objective To investigate the value of liver function indexes(AApea index) in evaluation of chronic hepatitis pathohistological grading.Methods The biochemical tests and histopathological data of 800 patients who underwent liver biopsy with step discriminant screen,serum ALT,TBil,AST,A/G,EP,PA,and ALB were assayed.A liver function index(AApea index) was calculated according to these biochemical tests,and compared with histopathological data in each patient.Results The AApea index had a significantly positive correlation with the histological inflammatory grading,fibrosis staging,and severe degree(correlation coefficient were 0 559,0 545 and 0 529 respectively,P

Objective To explore the clinical features of severe acute respiratory syndrome (SARS). Methods Clinical data of 70 patients with SARS were retrospectively analyzed. Results The age of the patients ranged from 10 to 74 years old (mean age 33.81?12.73 years). Severe type of SARS was diagnosed in 38 patients and 32 as common type of SARS. The most common symptoms included fever(98.57%), malaise(80.00%), cough(74.28%), shortness of breath (55.71%), headache(38.57%). The fever lasted for 7.20?4.57d. Based on the symptoms and chest X-ray examination, the disease was classified into early stage, progressive stage, and recovery stage with a mean duration of 3.19?2.32d, 8.18?4.36d, and 8.82?7.01d, respectively. It was found that the incidence of severe type of SARS was higher with the increase of age. Compared with common type of SARS, the fever in patients with severe type of SARS was more difficult to control (the mean highest fever 38.74?0.97℃, 38.02?0.14℃, respectively). The duration of fever after treatment (4.12?3.19d, 2.37?1.75d, respectively) was longer in the illness course (27.78?9.99d, 14.93?5.80d, respectively). The ALT, LDH and HBDH in patients with severe type of SARS were higher than those in patients with common type of SARS (ALT:78.95%,50.00%, respectively; LDH, HBDH:42.11%, 18.75%, respectively). Advanced age, pre-existing chronic disease, and elevation of LDH and HBDH were the factors of poor prognosis. Combination therapy was the first choice for the treatment of SARS. Empirical use of glucocorticoid was useful in preventing progression of the disease. Conclusion Although severe type of SARS had a high mortality, combination therapy could be very effective in the treatment of the majority of patients.

Objective To study the influence of ENH Ⅰ of HBV on immune response of HBV DNA vaccine. Methods DNA fragments of HBsAg and HBsAg-ENH Ⅰ region of HBV, after being amplified by PCR using the complete genome DNA of HBV adr subtype, were inserted into VR1012 vectors. The recombinant plasmids were transfected into COS-7 cells and HepG2 cells, and injected into Balb/C mice. The expression of COS-7 cells, HepG2 cells and the cellular and humoral immune response of mice were determined with Western blot, ELISA and ELSPOT. Results HBsAg was expressed by transfected HepG2 cells and COS-7 cells. The quantity of expression by HepG2 cells increased apparently when transfected by that combined with ENH Ⅰ. In transfected COS-7 cells, there was no significant difference in the expression of HBsAg between those transfected by two recombinant plasmids. The HBsAb and the HBsAg specific CTL were found in mice in the second week after immunization, and there was no marked difference between those immunized by two recombinant plasmids. Conclusions When inserted into HBV DNA vaccine, ENH Ⅰ can promote the expression of HBsAg in transfected HepG2 cells, but can not affect the expression of transfected COS-7 cells and the immune response of immunized Balb/C mice.

Objective:To investigate the mechanism by which indomethacin inhibits the expression of matrix metalloproteinase-9 in abdominal aortic aneurysm(AAA) in rats. Methods: Male Wistar rats underwent intraluminal perfusion of the abdominal aorta with 50 units of porcine pancreatic elastase followed by treatment with indomethacin (1.6 mg/d) subcutaneously (n=8) for 7 d or with normal saline(NS,n=8).Aortic wall elastin and collagen concentrations were measured with an imaging analysis system, and fixed aortic tissues were examined by light microscopy for inflammation. The expression of MMP-9 in aortic tissues was observed with immunohistochemistry technique. Results: AAAs developed in all NS treated rats and in none of indomethacin treated rats on d 7(P

ObjectiveTo determine the possible causes for functional delayed gastric emptying (FDGE) and its diagnosis and treatment. MethodsThe clinical data of 53 FDGE patients after subtotal gastrectomy from 1987 to 2001 were retrospectively analysed. ResultsAll the 53 patients were recovered and discharged. Among them, 11 were misdiagnosised as mechanical ileus and were reoperated on. ConclusionsThe main cause of FDGE may be the disturbance of gastrointestinal motility which may be caused by vegetative nerve injury during the operation. The main therapy is non-surgical treatment and reoperation should be avoided at the early stage.

Objective To investigate the characteristics of HBsAg and HBcAg in combination pulsed monocyte-derived DCs(MoDC) derived from patients with HBV-associated hepatocellular carcinoma(HCC).Methods MoDCs were generated from 20 HBV-associated HCC patients,and pulsed with recombinant human serum albumin(rHSA)as conDC(control DC),or pulsed with HBsAg andHBcAg in combination as scDC.Phenotypic patterns of MoDCs were characterized by flow cytometry,and the levels of cytokines releasedby MoDCs were analyzed by ELISA,and frequencies of IFN-γ-producing antigen-specific autologous T cells were measured by Elispotassay.HBV-specific CD8 T cells proliferation was determined by pentamer staining.Results 1.The levels of MHC and costimulatorymolecules expressed on scDC were significantly higher than those on immature MoDC(imaDC)in two groups,and the levels of MHC andcostimulatory molecules expressed on imaDC,conDC and scDC in HBsAg+,anti-HBe+,anti-HBc+patients(1-4-5 positive group)were significantly higher than those in HBsAg+,anti-HBc+patients(1-5 positive group);2.The levels of IL-12 and IL-10 produced byscDC were higher than those produced by imaDC and conDC in both groups,and the levels of IL-12 produced by imaDC,conDC and scDCin 1-4-5 positive group were higher than those in 1-5 positive group.3.The frequencies of IFN-γ-producing T cells induced by scDC werehigher than those by conDC in 1-4-5 positive group.4.scDCs from 4 cases of HLA-A2+patients in 1-4-5 positive group could induceautologous T cells to generate HBVcore18-27-specific CD8 T cells.Condusions HBsAg and HBcAg pulse in combination couldsubstantially reverse the impaired function of MoDCs in HBv-associated HCC patients,and boost MoDC to induce HBV-specific T cellsresponse,especially in HBsAg+,anti-HBe+ and anti-HBe+ patients.

Acute-On-Chronic Liver Failure ; diagnosis ; Humans

Objective To explore the function of the baseline model for end-stage liver disease (MELD) scores,MELD-Na scores and iMELD scores in short-term prognosis in the initial treatment of hepatitis B virus (HBV) related acute-on-chronic liver failure (ACLF) patients.Methods 232 HBV-related ACLF patients who received initial treatment in 302 Military Hospital of China from January 2011 to January 2013 were enrolled in this prospective clinical follow-up.The relationship between the baseline MELD scores,MELD-Na scores,iMELD scores and clinical outcomes were analyzed,and the value of these three models for short term prognosis was assessed.Results Finally the 12-week clinical follow-up was completed in 191 patients,with the completion rate of 82.33％.Eighty-five patients died,with the fatality rate of 44.50％.Compared with the survival group,in non-survival group,the baseline of MELD scores (26.65 ± 7.75 vs.21.19 ± 5.42,t=-5.720,P=0.000),MELD-Na scores (29.16 ± 11.35 vs.21.72 ± 6.33,t=-5.729,P=0.000),iMELD scores (47.19 ± 10.96 vs.38.02 ±7.01,t=-7.011,P=0.000),total bilirubin [TBil (μmol/L):374.3 ± 150.1 vs.305.5 ± 147.1,t=-3.182,P=0.002],creatinine [Cr (μmol/L):110.7 ±90.1 vs.71.1 ± 35.1,t=-4.157,P=0.000] and international normalized ratio (INR:2.3 ± 0.9 vs.2.0 ± 0.6,t=-2.754,P=0.006) were significantly increased,but the baseline of serum Na+ (mmol/L:132.8 ± 6.1 vs.136.7 ± 5.1,t=4.861,P=0.000) was significantly lowered.It was shown by Spearman correlation analysis thai the baseline MELD scores,MELD-Na scores and iMELD scores all had positive correlation with the short-term prognosis of patients (r value was 0.398,0.404,and 0.470,respectively,all P=0.000),the baseline of serum Na+ had a negative correlation with the short-term prognosis of patients (r=-0.365,P=0.000).It was shown by receiver operating characteristic curve (ROC curve) that the cut-off scores of the baseline of MELD scores,MELD-Na scores and iMELD scores were 25.07,25.43 and 43.11 respectively,and the area under ROC curve (AUC) of the baseline of MELD scores,MELD-Na scores and iMELD scores were 0.731,0.735 and 0.773,respectively.The sensitivity of the three models was 55.3％,57.7％,63.5％,and the specificity was 84.9％,84.0％,84.9％ respectively.The value of the three models had no difference in short-term prognostic prediction.According to the respective cut-off score,the three prediction models were divided into four groups,and all of them had differences in fatality rate on the whole (x2 for MELD scores was 34.740,P=0.000; x2 for MELD-Na scores was 36.861,P=0.000; x2 for iMELD scores was 50.127,P=0.000).The mortality was elevated gradually as the equation scores increased.Conclusion The baseline of MELD scores,MELD-Na scores and iMELD scores can predict well the short-term prognosis of the initial treatment in HBV-related ACLF patients,and have relatively good clinical value for guiding therapy.