Objective To study the activation induced cell death(AICD) in peripheral blood T lymphocytes(PBL T) from patients with chronic hepatitis B(CHB), and the role of AICD in the pathogenesis of chronic hepatitis B. Methods The PBL Ts of 14 patients were isolated with negative selection by magnetic beads, and cultured with or without anti CD3 mAb in the presence of PMA and ionomycin. The apoptosis of PBL T was observed by TUNEL staining and assessed by Flow Cytometry. Results In CHB patients, the apoptotic rate of PBL T activated with anti CD3 mAb was significantly higher than that of without activation (16.73%?0.99% vs. 9.74%?1.14%, P 0.05), and a negative correlation existed between the level of INF? and apoptotic rate of T cell( r =-0.87126, P

Objective To compare the effects of desflurane and sevoflurane on somatosensory evoked potentials (SEP) in patients undergoing spine neurosurgery. Methods Thirty patients with ASA grades I-Ⅱand undergoing spinal deformity orthopaedic surgery were selected and divided into two groups: desflurane group and sevoflurane group (n=30) . Bispectral index (BIS),the state of muscle relaxation, SEP and hemodynamics were monitored during operation. By maintaining the BIS in the range of 35-45,the state of muscle relaxation disappeared and hemodynamic became stable. Adjust the concentration of anesthetic step by step from 0 to 0.3, 0.6 and 0.9 maximum alveolar concentrations (MAC), then inhaled different concentrations of drugs. Record the incubation period and amplitude of SEP before inhaling anesthetics (based on the value), in the moment of achieving each inhaled concentration ( T1, T2 and T3) , and the moment that the inhaled anesthetics blows completely (regression value) . The percentages of T1, T2, T3, and the regression value compared with basic value were calculated.Results Compared with the basic value, T1, T2 and T3 of left arm, left leg and right leg in desflurane group, T2 and T3 of right arm in desflurane group, T2 and T3 of left arm, left leg and right arm in sevoflurane group,and T2 and T3 of right leg in sevoflurane group showed incubation period delaying ( <0.05) . And the incubation period extended along with the increase of inhaled anesthetics dosage. Compared with the basic value,T1,T2 and T1 of left arm and left leg in desflurane group,T1 of right arm in desflurane group, T1 and T2 of right leg in desflurane, T3 of left arm in sevoflurane group, T1 and T3 in left leg in sevoflurane group had decreased amplitude ( < 0.05), especially T1. Compared with desflurane, sevoflurane showed a weaker inhibition effect on the incubation period and amplitude of T1,T2,T3 of left arm and left leg,T2 and T3 of right arm and right leg, and the amplitude of T1 of right leg ( < 0.05) . Conclusion Both of desflurane and sevoflurane have inhibition effect on SEP. The inhibition effect gradually strengthens along with the increasing of dose. The inhibition effect of desflurane is stronger than sevoflurane.

OBJECTIVE To explore the characteristics of the clinical distribution and drug resistance of non-fermentative Gram-negative bacilli in nosocomial infection.METHODS The bacteria were identified by API 20NE.Antibiotic susceptibility test was performed by K-B disk diffusion method.RESULTS The rate of non-fermentatives in Gram-negative bacilli was 17.6%.The dominant strains were Pseudomonas aeruginosa(43.8%),Acinetobacter spp(39.9%),Stenotrophomonas maltophilia(6.7%),and Burkholderia cepacia(2.7%).The resistant rates of P.aeruginosa to cefoperaxone/sulbactam,amikacin,cefepime and meropenem were less than 20%.The resistant rates of Acinetobacter spp to imipenem,meropenem,cefoperaxone/sulbactam and minocycline were less than 20%.The resistant rates of S.maltophilia to minocycline,cefoperaxone/sulbactam,piperacillin/tazobactam and levofloxacin were less than 20%.The resistant rates of B.cepacia to minocycline,piperacillin/tazobactam and cefoperaxone/sulbactam were less than 20%.CONCLUSIONS The sensitivities of non-fermentative Gram-negative bacilli to cefoperaxone/sulbactam,piperacillin/tazobactam,minocycline,imipenem and meropenem were the highest.These antibiotics may be chosen first for the clinical treatment.

Objective To deepen the understanding of chronic eosinophilic leukemia (CEL).Methods The course of diagnosis and treatment in a case of FIP1L1/PDGFRα fusion gene negative CEL was reported. Flow cytometry was used to analyze the immunophenotype of the cells in peripheral blood and pleural fluid. Karyotype was analyzed with G-banding. The expression of FIP1L1/PDGFRα fusion gene was detected by RT-PCR technique. Routine pathological examination of the tissues from bone marrow, lung and spleen were performed. Result A sixteen-year-old girl had severe anemia, fever, splenomegaly,thrombocytopenia and dominant hypereosinophilia lasting for 22 months. Trephine biopsy showed a hypercellular marrow with eosinophilic proliferation and moderate reticular fibrosis. Eosinophilic infiltration was found in lung and spleen and embolism was also found in spleen. She had a clonal chromosomal abnormality t(5;12)(q31;p13). The expression of FIP1L1/PDGFRα was negative. An abnormal clone of T cells expressing CD3-,CD4-,CD8- was found in peripheral blood and pleural fluid, in which the cional T cell accounted for 5.43% and 1.66% of the total lymphocytes respectively. The patient was refractory to treatment with hydroxyurea, prednisone and interferon alpha. She had poor response to a combination of therapy with low dose cytosine arabinoside, mitoxantrone, vincristine, cyclophosphamide, methotrexate and prednisone. She did not respond to imatinib and died of multiple organ failure. Conclusion The present case fulfilled the WHO diagnostic criteria of FIP1L1/PDGFRα(-) CEL which did not respond to routine treatment and imatinib. Allogenic stem cell transplantation should be considered as early as possible in this case. It is noteworthy that clonal CD3-,CD4-,CD8- T-cell abnormality is related to the pathogenesis of CEL.

Sinisan is a widely used traditional Chinese medicine (TCM) in treating various diseases; however, the in vivo metabolic profile of its multiple components remains unknown. In this paper, ultra-high performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF/MS) was applied to identify the metabolites of Sinisan extract in rat plasma, urine, feces and bile after intragastric administration. Using MS(E) and mass defect filter techniques, 41 metabolites of 10 parent compounds (naringin, naringenin, hesperidin, neohesperidin, liquiritin, liquiritigenin, glycyrrhizic acid, glycyrrhetinic acid, saikosaponin a and saikosaponin d) were detected and tentatively identified. It was shown by our results that these compounds was metabolized to the forms of hydroxylation, glucuronidation, sulfation, glucuronidation with sulfation and glucuronidation with hydroxylation in vivo.

Objective To investigate the clinical distribution and antimicrobial resistance of common gram-positive cocci in author's hospital.Methods Identification of these bacteria were done with API analysis system,disc diffusion tests were employed to study the antimicrobial resistance.Results A total of 25 052 clinical isolates were collected in 8 years,of gram-positive cocci accounted for 7907(31.9%).Staphylococcus aureus(3549 strains,44.9%),enterococcus(1760 strains,22.3%)and coagulase-negative staphylococcus(1558 strains,19.7%)were the most common isolates.The prevalence of MRSA increased from 59.6% in 2001 to 76.3% in 2008,and MRSCoN increased from 64.2% to 77.0%.The resistant rate of MRSA to gentamicin,clindamycin,erythromycin and levofloxacin were over 90%,to trimethoprim/sulfamethoxazole and chloramphenicol were less than 20%.The resistant rate of MSSA to gentamicin,levofloxacin,trimethoprim/sulfamethoxazole and chloramphenicol were low 20%,and to beta-lactamase antibacterial agents except penicillin were 0.The resistant rates of MRSCoN to all antimicrobial agents were lower than MRSA,but to trimethoprim/sulfamethoxazole(71.2%)was higher than MRSA(21.2%).No staphylococcus strains were resistant to vancomycin,teicoplanin and linezolid.2.1% enterococcus feacium and 4.4% other enterococcus were resistant to vancomycin.No strains of enterococcus were found resistant to teicoplanin and linezolid.Conclusion The resistant rate of gram-positive cocci were increasing obviously,the prevalence of MRS was high.Vancomycin,teicoplanin and linezolid were the most active agents against severe infection induced by multidrug-resistant gram-positive cocci.

Objective: To understand the awareness of palliative care and its influencing factors in community residents in Hangzhou,so as to provide basis for the development of palliative care service. Methods: By convenient sampling method,the residents in the urban-rural junction of Xihu District were recruited. A self-designed questionnaire was used to investigate their awareness of palliative care. The logistic regression model was employed to analyze the influencing factors. Results : A total of 519 questionnaires were recovered,with a response rate of 97.92%. There were 227 males and 292 females,accounting for 43.74% and 56.26%,respectively. There were 43,218 and 258 residents with more,basic and little understanding about palliative care, accounting for 8.29%,42.00% and 49.71%. The residents learned about palliative care mainly through television and radio,with 245 cases accounting for 47.21%;and they thought that the main reason for low awareness of palliative care was a lack of related knowledge,with 396 cases accounting for 76.30%. The results of multivariate logistic regression analysis showed that 50-59 years old（OR = 0.467,95% CI：0.285-0.767）,primary school education and below（OR = 2.248,95%CI：1.239-4.079）and experience of caring for dying patients（OR = 1.551,95% CI：1.094-2.199）were the influencing factors for the awareness of palliative care. Conclusion The residents in Hangzhou had relatively low awareness of palliative care,which were associated with age,education level and experience of caring for dying patients.

Objective To investigate the association of interferon (IFN) γ gene polymorphisms and risk and prognosis of HPV cervical infection.Methods PCR-ASP was used for detectiug IFN-γ rs2430561 polymorphism in 179 HPV positive patients and 328 HPV negative normal controls.Results The frequency of A allele of 63.7％ (228/358) was significantly higher than the frequency of T allele of 36.3％ (130/358) in HPV positive group (P =0.045).The frequencies were 41.3％ (74/179) in AA genotype and 14.0％ (25/179) in TT genotype,women carrying AA genotype increased the risk of HPV infection compare with those with TT genotype (OR =1.784,95％ CI:1.031-3.088,P =0.039).During follow-up,the rate of HPV positive again in AA genotype was 83.8％ (62/74),while TT genotype was 20.0％ (5/25).In the analysis of Kaplan-Meier,the cumulative HPV negative rates of AA,TA and TT genotype exhibited significantly different (P =0.008).The cumulative HPV negative rate of AA genotype was the lowest (1.1％-5.9％).Conclusions IFN-γ rs2430561 polymorphisms confer the susceptibility to HPV infection.Women with AA genotype exhibited higher risk of infection and inclined to be continuous status and recurrence after HPV infection.

Objective To reconstruct the absorbed dose for the individual who was accidentally exposed in uterus 16 years ago.Methods Peripheral blood samples were taken from the victim and her mother.The dicentric and centric ring chromosome aberrations were analyzed with conventional method,the micronucleus was observed with cytokinesis-block micronucleus method,and fluorescence in situ hybridization (FISH) with chromosomes 1,2 and 4 painting probes were used for translocation detection.Dose was estimated according to the standard dose-response curves previously established.Results No unstable chromosome aberrations and normal micronucleus frequencies were observed in two persons 16years after the accident.Against the established dose-response curves with FISH,the doses to the mother and her daughter were 0.76 Gy (95% GI 0.41-1.00 Gy) and 0.61 Gy (95% CI 0.44-0.86 Gy),respectively.Because the biological dose estimated for the mother 1 month after the accident was 2.30 Gy (95% CI 2.07-2.50 Gy),the dose correction factor was 3.03 for dose estimation 16 years later.The estimated dose in uterus to the victim was 1.85 Gy (95% CI 1.33-2.61 Gy).Conclusions The estimated dose to the individual accidentally exposed in uterus 16 years ago can be obtained according to the dose correction factor of the mother with FISH method.

Objective:To analyze clinical characteristics of scabies.Methods:The clinical data of 747 patients with scabies who visited Department of Dermatology, Affiliated Hospital of Jining Medical College from January 2018 to December 2019 were retrospectively analyzed.Results:There were more males (73.09%, 546/747) than females (26.91%, 201/747); most of patients had a age of 13-24 year (55.96%, 418/747); students account for 50.33% (376/747) of all patients; there were more patients living in dormitory than those living at home (61.45% (459/747) vs. 38.55% (288/747)). The cases began to rise from October, reaching the peak in December and remaining at relatively high level in January and February, then decreasing to the lowest during March to September. The number of patients living in rural areas is higher than that in urban areas. Patients took average 30 (15, 90) days from onset of disease to seeing a doctor, and itching was the main complain for visiting. The locations of lesion were most common on the abdomen (63.19%, 472/747), fingertips and wrists (53.41%, 399/747), vulva (37.22%, 278/747), and extremities (30.25%, 226/747). The lesions were characterized by erythematous papules (71.62%, 535/747), nodules (47.12%, 352/747), papules (24.50%, 183/747), wheals (6.02%, 45/747), secondary infections (3.61%, 27/747), tunnels (3.08%, 23/747) and small pustules (2.14%, 16/747); the male scrotal nodules were common (48.17%, 263/546). More patients (471/747, 63.05%) first visited non-dermatology outpatient clinics, and less first visited dermatology outpatient clinics (276/747, 36.95%); the misdiagnosis rates were 55.41% (261/471) and 27.54% (76/276), respectively; 127 cases (17.00%) were misdiagnosed as eczema, 54 cases (7.23%) as allergic dermatitis, 41 cases (5.49%) as prurigo nodularis, and 35 cases (4.69%) as urticaria pulosa. Conclusions:There is a certain discrepancy in the incidence of scabies among different populations, regions and seasons, the lesions of scabies are polymorphic involving different parts of the body surface and it is easy to be misdiagnosed.