To improve the curative effect in chronic hepatitis B is a major problem to be solved. With the development of technology, an increasing number of novel markers have been used to guide treatment selection, to predict the curative effect and prognosis of hepatitis B.This paper focuses on the characteristics, applications and developmental trend of serological, virological and immunological markers associated with curative effect of chronic hepatitis B.

Objective To explore the expression characteristic of T regulatory cell (Treg)/T help cell (Th)17 and the correlation to disease progression in chronic hepatitis B (CHB) patients undergoing antivirus treatment,and to explore their roles in pathogenesis of CHB.Methods A total of 53 patients with CHB (CHB group) and 21 healthy controls (healthy control group) were selected,CHB patients included mild 18 cases,moderate 16 cases and severe 19 cases.The expression of Treg and Th17 were detected by flow cytometry and compared.The levels of alanine aminotransferase (ALT),total bilirubin (TBIL),cholinesterase,albumin were measured by automatic biochemical machine and for correlation analysis.Results The levels ofTh17,Treg,Treg/Th17 were (2.13 ± 0.65)％,(2.99 ± 0.68)％ and (6.07 ± 1.18)％,(5.14 ± 0.96)％ and 2.86 ± 0.67,1.73 ± 0.45 in CHB group before and after treatment for 24 weeks and (3.59 ± 0.75)％,(4.02 ± 0.77)％,1.04 ± 0.34 in healthy control group.There were significant differences (F =14.78,10.12,17.19; P ＜ 0.01).The level of Th17 in mild,moderate and severe CHB was gradually decreased,but there was no significant difference (F =1.10,P =0.337).The level of Treg in mild,moderate and severe CHB patients was gradually increased,but there was no significant difference (F =0.54,P =0.585).The level of Treg/Th17 was gradually increased with aggravation (2.58 ± 0.59,2.76 ± 0.63,3.21 ± 0.71),and there was significant difference (F =3.15,P ＜ 0.01),the level of Treg/Th17 in severe CHB patients was significantly higher than that in mild,moderate CHB patients (P ＜0.05).The level of Treg/Th17 had significantly positive correlation with ALT,TBIL (r =0.272,P=0.000; r =0.226,P=0.000).Conclusion Treg/Th17 balance not only relates with the pathogenesis of CHB,but also with the related immune inflammatory of liver tissue.

Objective To elucidate the clinical features, diagnosis and treatment of Aspergillus necrotizing bronchitis. Methods Medical records and investigation data from 5 eases of Aspergillus necrotizing bronchitis were retrospectively analyzed, and related literatures were reviewed. Results Five patients (3 males and 2 females) with mean age of 63.6 y were enrolled in this study. All patients had histopathologically proved necrotizing aspergillosis of the large airways. Common presentations included cough, short of breath, sputum production, fever and haemoptysis. Tracheoscopy presentations included necrosis, mucous hyperemia, focal airway constriction and neoplasm. The CT findings included bronchial wall thickening, narrowing of the bronchial lumen, which was often associated with distal obstructive pneumonia. Conclusions The clinical manifestations of Aspergillus necrotizing bronchitis are nonspecific, and histopatholagical diagnosis is essential for a definite diagnosis and can be supported by tracheoscope or imaging techniques.

Objective To investigate the effect of Kangaroo care(KC)on diminishing neonatal pain during heel lancing. Methods Sixty neonates were divided randomly into two equal groups:intervention group and control group,which 30 cases in each group.In the intervention group,neonates were treated with KC(neonates were put in direct and continuous skin-to-skin contact with his/her mom)from 20 mins before heel lancing to 1 mins after the end of the lancing.In the control group,neonates were treated with regular care.The differences in heart rate,blood oxygen saturation,facial pain expression,crying duration and DAN(Douleur Aigue Nouveaune)scores between two groups were compared at 7 time points from 10s before the heel lancing to 10s after the lancing. Results The results of repeated measu te at 7 time points after heel lancing.There were significant interaction effect between time and main effect(P<0.01),which showed that the heart rate of two groups were not equal at different time points.Compared with the time effects(P<0.01)which showed that two groups of neonatal heart rate of the two groups would accelerate with time extension. There were significant differences(all P<0.05)in heart rate at 7 time points between two groups and smaller heart rate varied range in intervention group.The results of repeated measures analysis for neonatal blood oxygen saturation at 7 time points after heel lancing. There were significant interaction effect between time and main effects(P<0.01),which showed that the blood oxygen saturation of two groups were not equal at different time points.Compared with the time effect(P<0.01),which showed that two groups of neonatal blood oxygen saturation would reduce with time extension.There were significant differences(all P<0.05)in blood oxygen saturation of two groups at 30s,40s and 50s after heel lancing and smaller blood oxygen saturation varied range in intervention group.The crying duration and DAN scores in intervention group were significantly reduced compared with the controls(all P<0.05).Conclusions
Heel lancing could lead to moderate to severe pain of neonates.KC could effectively diminish the neonatal pain degree caused by heel lancing.

Objective To summarize the key points of nursing care to pregnant women with acute cholecystitis and gallstones. Methods The clinical data of twenty three pregnant women with acute cholecystitis and gallstones during August 2007 to January 2012 were reviewed and analyzed retrospectively,including 19 cases for conservative treatment,3 cases for surgical treatment,1 case for abortion.Results All patients were cured and discharged with hospital stay for 7 to 21 days,averaged(12.7±4.7)days. Conclusion For pregnant women with acute cholecystitis and gallstones,efforts should be focused on dynamic monitoring of vital signs and fetal conditions,psychological care and diet care in order to ensure the safety of the mathers and infants.

Objective To study the effect of comprehensive pain intervention on newborns' acute pain stimulus on heel's blood collection.Methods One hundred neonates were equally randomized into control group and treatment group.In the former,blood collection was done from heel without any intervention and in the latter the comprehensive intervention was done five minutes before blood collection from heel and 5 minutes after that.The two groups were compared in terms of heart rate,blood oxygen saturation,acute pain stimulus,crying time during collection and time for facial expressions 30 seconds before collection and 30 seconds after that.Results The score on pains and crying time during collection and time of pain face in the intervention group were significantly lower or shorter than those in the control group and the time for crying and painful facial expressions was both significantly shorter than those in the control group (P＜0.001).There was insignificant different in blood oxygen saturation (P＞0.05) and significant in the heart rate (P＜.0.01) 30 seconds before and after collection.Conclusion The comprehensive intervention by radiation warming,nipple or 10％ glucose sucking,caressing and curled-up position can relieve effectively the pains from neonatal invasive operation.

Objective To analyze the detection rate of HBV serological makers in non-hepatic inpatients in the past six years. Methods Serum samples of 70 582 non-hepatic inpatients from three large hospitals were collected during 2003 to 2008. Serological markers of HBV ( HBsAg, anti-HBs, HBeAg, antiHBe and anti-HBc) were detected by the AxSYM MEIA system (Abbott Laboratories,Abbott Park,IL).Combining the test results of serological makers with other clinical data, several analysis models for this retrospective study were set up to evaluate the year-to-year changes in serological makers and the detection rates of each model. Results The order from high to low of detection rate of the 5 HBV serological markers was anti-HBc (55. 17% ), anti-HBs (49. 57% ), anti-HBe (28.42%), HBsAg ( 8. 92% ) and HBeAg (2. 12% ), and all of them had a downward trend in the past six years. The positive rate of HBsAg went down from 9. 30% (2003) to 8.70% (2008). The positive rate of HBsAg among people who were born after 1992 (2. 28% ) were significantly lower than that of the overall population (8. 92% ) and fell from 3.57%(2003) to 1.85% (2008). Each detection rate of all serological makers had male sexual side effect [HBsAg ( 12. 38%/7. 25% ), HBeAg ( 2. 72%/1.58% ), anti-HBc ( 56. 57%/53.43% ), anti-HBe (41.50%/28. 35% ) and anti-HBs (65.48%/50. 00% ), male/female]. The differences were statistically significant (Chi-square values of HBsAg, HBeAg, anti-HBc, anti-HBe and anti-HBs were 509.74,105.78, 69.66, 1 321.61 and 1 726.91, respectively; all P ＜ 0. 01).Twenty-six models of HBV serological makers from 70 582 inpatients were summed up, and 8 models had positive rates geater than or equal to 1%. The "All Negative" model ranked No. 1 and had no significant change from year to year. During the past six years, models representing "A11 Negative" and "anti-HBs Positive alone" were mainly in individuals younger than or equal to 20-year-old, while the models representing "anti-HBc and/or anti-HBe,anti-HBs Positive" were mostly in people older than 20-year-old. The distribution curve of models representing "HBsAg, HbeAg and anti-HBc Positive" and "HBsAg, anti-HBc, anti-HBe Positive"etc. showed a bell-shape, covering the population from 20-year-old to 70-year-old. Conclusions The slowlydescending tendency of the detection rates of HBV serological makers was observed during the past six years.The detection rates of HBV in the younger generation decreased significantly. However, the HBV infection rates of overall population is still high, so it is a high time that we made continuous improvement for the serum HBV screening technique in order to reduce the HBV infection ratess.

Objective To investigate the effect of dietary and exercise on the incidence of GDM in women with pre-pregnancy obesity. Methods One hundred and sixty early pregnant women with BMI≥25 kg/m2 in our hospital from April 2013 to January 2015 enrolled in the study were divided into two groups: The eighty women hospitalized during June 2013 to January 2014 were assigned as the control group, while the other 80 women from February 2014 to January 2015 as the study group. In the former group, the routine pregnancy inspection and pregnancy health education seminars were conduced during pregnancy of 12 weeks , and in the study group weekly nutritional assessment , diet planning by a dietitian and exercise guidance by a professional nurse were performed apart from the same care as in the control group. The two groups were compared in terms of weight growth and GDM incidence. Result The weight increased and the GDM incidence in the study was both significantly lower than those in the control group ( P < 0 . 05 ) . Conclusion The dietary and exercise during pregnancy can effectively control the weight and decrease the incidence of GDM , which can ensure the health of pregnant women.

Objective To discuss the effectiveness of knowledge-attitude-practice(KAP)-based health management on type 2 diabetes in community residents.Methods From June 2010 to December 2011,930 type 2 diabetes patients living in Mishi Lane Community were enrolled and assigned to the intervention group(n=494) and the control group(n=436).The KAP mode was used for the intervention group,and the routine management mode was applied to the control group.Fasting blood glucose(FBG),PBG2 h,HbAlc,blood pressure(BP),triglyceride(TG) and body mass index(BMI) were tested and recorded.Student's t test or Chi-square test was used for data analysis.Results Age(t=0.124,P＞0.05),gender(x2=2.0,P＞0.05) and other demographics showed no statistically significant difference between the two groups(all P＞0.05).After one-year KAP-based health management,HbA 1 c of the intervention group reduced to(6.1 ± 1.2)％,FBG and PBG2 h reduced by 1.7 and 3.23 mmol/L,respectively(t=4.926,P＜0.05; t=4.306,P＜0.05; t=4.523,P＜ 0.05).Diet,physical exercises,medication,regular inspection,unhealthy habits and questionare test awaveness of the intervention group were improved(86.03％,82.19％,85.63％,70.45％ 76.11％ and 88.46％,respectively.Drinking,dietary structure,overweight and physical exercises of the intervention group were also improved(14.17％,15.79％,70.65％ and 68.83％,respectively; all P＜0.001).Conclusion The KAPbased health management is proved to be effective in the control of community diabetic patients.

Objective To discuss the effectiveness of community-based intensified health management on type Ⅱ diabetes patients.Metbods From June 2010 to December 2011,1 024 type Ⅱ diabetes patients in Mishi Lane community were enrolled and assigned to the intervention group (n=501,obtaining intensive health management) and the control group (n=523,obtaining routine community health management).Fastingbloodglucose (FBG),2-hour postprandial blood glucose (PBG2h),HbA1c,blood pressure (BP),triglyceride (TG) and body mass index (BMI) were tested and recorded before and after the intervention.Student's t test or Chi-square test were used for data analysis.Results Differences of age (t=0.124,P＞0.05) and gender (x2=2.0,P＞0.05) were not statistically significant (both P＞0.05).Following the intensive health management,the control rates of HbA1c,BP,TG and BMI were increased to 75.4％,30.4％,85.6％ and 49.0％,respectively (x2 values were 4.54,4.71,6.54 and 3.67; all P＜0.05).TG,FBG and PBG2h of the intervention group were (1.5 ± 0.9),(6.2 ± 1.3) and (8.3 ± 2.4) mmol/L,respectively,which were significantly lower than those of the control group (all P＜0.05).Conclusion Community-based intensive health management could be effective for diabetes patients.