Objective To determine the expression of CD38 and HLA -DR on CD +8 T cells in patients with chronic hepatitis B and HBV carriers,and to disscuss the relation between immune activation and disease progression of HBV infection.Methods Thirty -two chronic hepatitis B patients receiving adefovir dipivoxil treatment,31 HBV carriers and 28 normal controls were collected.The counts of CD +4 and CD +8 T cells and the percentage of CD +8 CD +38 and CD +8 HLA -DR +T cells were tested by flow cytometry.HBV DNA and liver function were tested in the central laboratory of our hospital.Results The percentage of CD +8 CD +38 T cells in CHB patients was (58.4 ±12.7)%,and was higher than that in HBV carriers (46.8 ±8.5)% and normal controls (46.8 ±8.5)%,and decreased after adefovir dipivoxil treatment (34.2 ±9.4%)(F =8.27,P =0.000).The percentage of CD +8 CD +38 T cells in HBV carriers was (43.3 ±12.5)%,and was much higher than that in normal controls (9.8 ±5.7)%(F =13.48,P =0.000).The percentage of CD +8 HLA -DR + T cells in CHB patients was higher than that in normal controls,but similar to that in HBV carriers (37.1 ±11.3)%.CD +8 HLA -DR + T cells in CHB patients also decreased after adefovir dipivoxil treatment (P <0.05 ).Conclusion Our study demonstrates that activation of CD +8 T cells is increased in HBV infection but decreased by adefovir dipivoxil treatment.The percentages of CD +8 CD +38 and CD8 +HLA -DR +T are good markers for disease progression of HBV infection.

100 patients suffering from cancer of the tonsil were treated by radiation therapy from May 1972 through 1988. All were proved by pathology as: anaplastic carcinoma 31(31%), poorly differentiated carcinoma 33(33%),squamous cell carcinoma 31(31%), adenocarcinoma 1(1%), papilloma with malignant change 1 and unclassifiable 3. Cliniral staging (1987,UICC) stage Ⅰ4(4%), stage Ⅱ6(5%), stage Ⅲ 21(21%) and stage Ⅳ 69(69%). N 0 18(18%),N 1～3 82(82%).Telecobalt was given to 50～70 Gy/6～8wk in 88% of patients. It was

Objective To estimate the prevalence of thyroid dysfunction and thyroid autoantibodies in adults with alopecia areata (AA), and to analyze the relationship between alopecia areata (AA) and thyroid autoimmunity in adults.Methods A predesigned questionnaire was used to collect data on demographic information, medical history,and family history of AA in first-degree relatives from patients with AA.Thyroid function was evaluated, and anti-thyroid peroxidase antibody (TPO-Ab) was screened in all the patieuts.Statistical analysis was carried out by the chi-square test and Fisher's exact test.Results Totally, 209 patients with AA were enrolled.Of these patients, 6.7％ were complicated by thyroid diseases, 20.6％ were positive for TPO-Ab.Compared with the patients without TPO-Ab, those with TPO-Ab showed a significant increase in the proportion of patients with early-onset (＜ 18 years) AA (x2 =5.589, P =0.025),prevalence rate of alopecia totalis/alopecia universalis (x2 =9.990, P=0.006) and thyroid diseases (x2 =12.279, P =0.002), and incidence rate of AA in first-degree relatives (x2 =14.426, P =0.001).Conclusions The positive rate of TPO-Ab is increased in patients with AA.It is recommended to evaluate thyroid function and to screen for thyroid autoantibodies in patients with AA despite of the absence of clinical manifestations of thyroid diseases.

Objective:To investigate the expression change of blood plasma miRNA-210 (miR-210) in blood plasma for patients with esophageal squamous cell carcinoma (ESCC) before and after radiotherapy and its effect on cell proliferation, cycle, apoptosis of ESCC cells in vitro.Methods:The blood specimens from 22 patients with newly diagnosed ESCC (ESCC group) before and after radical radiotherapy between December 2013 and March 2015 in Linyi People's Hospital of Shandong Province as well as 15 healthy controls (the healthy control group) were collected. miRNA-21 (miR-21) was treated as the positive controls. The real-time polymerase chain reaction (RT-PCR) was used to detect the expression level of miR-210 and miR-21 in blood plasma before and after radiotherapy for patients, and the expression of miR-21 in ESCC Eca109 cells at normoxia and hypoxia time. The cell proliferation, cycle and apoptosis of Eca109 cells in untransfected group (the blank control group), miR-21 transfected mimics negative control RNA group (negative control group) and miR-210 transfected mimics RNA group (miR-210 group) were detected by using EdU cell proliferation assay and flow cytometry.Results:A total of 59 plasma samples from ESCC group and the healthy control group were collected. The relative expression level [median ( P25, P75)] of blood plasma miR-210 and miR-21 in ESCC group before radiotherapy was higher than that in the healthy control group, and the difference was statistically significant [4.04×10 -4 (2.06×10 -4, 6.68×10 -4) vs. 0.54×10 -4 (0.28×10 -4, 0.77×10 -4), 397.07×10 -4 (181.77×10 -4, 742.93×10 -4) vs. 127.43×10 -4 (21.97×10 -4, 184.65×10 -4); U value was 37.0, 49.0, respectively, all P < 0.01]. The expression level of miR-210 and miR-21 before radiotherapy in ESCC group was not related with tumor location and differentiation degree (all P > 0.05). After the radical radiotherapy one week later, the relative expression level of miR-210 and miR-21 in blood plasma of ESCC group was 65.33×10 -4 (22.15×10 -4, 160.87×10 -4), 437.23×10 -4 (327.18×10 -4, 749.09×10 -4), respectively, which was higher compared with that before radiotherapy ( U value was 32.0, 154.0, respectively, both P < 0.05), and the increase of miR-210 was more significant. The expression level of miR-210 after hypoxic cultured Eca109 cells for 12 h was increased compared with the normal oxygen with the peak value 12 h later, and the difference was statistically significant ( P < 0.01). EdU cell proliferation assay showed that the Eca109 cell proliferative activity after transfection of 24 h and 48 h in miR-210 group was decreased compared with the negative control group and the blank control group, and the difference was statistically significant (all P < 0.01). Flow cytometry analysis showed that the proportion of G 2/M phase of Eca109 cells in miR-210 group after transfection of 24 h was increased compared with the negative control group and the blank control group, and the difference was statistically significant ( P < 0.05). After transfection of 48 h, the increased proportion in G 2/M phase was more obvious ( P <0.01); there was no statistically difference in the apoptotic cell proportion among three groups after transfection of 24 h and 48 h (all P > 0.05). Conclusions:miR-210 is highly expressed in the blood plasma of ESCC patients, especially the significant increase in the expression level of miR-210 in blood plasma after radical radiotherapy. miR-210 is highly expressed in hypoxic ESCC Eca109 cells. The overexpression of miR-210 can inhibit cell proliferation and its mechanism may be related with cell arrest in G 2/M phase.

Ovarian cancer is the most fatal malignant tumor in female reproductive system tumors.In most women, it is diagnosed in a late stage, which largely leads to the poor prognosis of ovarian cancer.Breast cancer susceptibility gene (BRCA) is an important DNA homologous repair gene, which plays a major role in the normal cellular DNA repair mechanism.Its mutation will lead to homologous recombination defects, which will affect the stability of the genome and lead to occurrence of tumors.In recent years, BRCA genetic testing has become a key step in the risk assessment, prognosis, treatment and prevention of ovarian cancer.

Background and purpose: XB130 protein plays an important role in proliferation and invasiveness of tumor cells. However, there is little research on the role of XB130 protein in hepatocellular carcinoma (HCC) and the effect of XB130 is still unclear. This study investigated the role of XB130 gene in the proliferation of HCC cell and its potential mechanism. Methods: The protein expressions of XB130 in HCC cell lines, Huh7, HepG2 and SNU449, and liver cell line HL7702 were detected by Western blot. Huh7 cells were transfected with XB130-siRNA. Then cell viability was measured using cell counting kit-8 (CCK-8), and cell cycle was examined by flow cytometry. Protein expressions of p-AKT, p-GSK3β, cyclin D1 and p-Rb were detected by Western blot, while mRNA expression levels of E2F/DP1 target genes (cyclin E1, c-Myc and PCNA) were measured by reverse transcription-polymerase chain reaction (RT-PCR). Results: The relative protein expressions of XB130 in Huh7, HepG2, SNU449 and HL7702 cells were 0.66±0.10, 0.78±0.11, 0.83±0.08 and 0.32±0.06, respectively. The difference between HCC cell lines and HL7702 cell line was statistically significant (P＜0.01). The transfection efficacy of XB130-siRNA was confirmed to be highly effective in Huh7 cells, and the viability of XB130-siRNA transfected Huh7 cells declined 72 h after transfection (P＜0.001). The ratio of Huh7 cells in G0/G1 phase was increased, while the ratio in S or G2/M was decreased 48 h after XB130-siRNA transfection (P＜0.01). In addition, compared with negative control, protein expressions of p-AKT, p-GSK3β, cyclin D1 and p-Rb, and mRNA expression levels of cyclin E1, c-Myc and PCNA were all decreased in XB130-siRNA transfected Huh7 cells (P＜0.001). Conclusion: XB130 promotes the proliferation of HCC cells by regulating cell cycle-related proteins and downstream transcription factors.

Objective To compare proximal humeral internal locking system (PHILOS) combined with fibular strut allograft versus simple PHILOS for the treatment of Neer 3-and 4-part factures of proximal humerus in the elderly.Methods A retrospective study was conducted of 157 elderly patients with Neer 3-or 4-part facture of proximal humerus who had been treated at Department of Orthopaedics,Ningbo No.6 Hospital from May 2013 to October 2016.They were 76 males and 81 females,aged from 60 to 88 years (average,76.1 years).According to the Neer classification,100 cases were 3-part fractures and 57 4-part fractures.Of them,35 were treated by PHILOS combined with fibular strut allograft (group A) and 122 by PHILOS alone (group B).At the last follow-up,the 2 groups were compared in terms of shoulder joint activity (anteflexion,abduction,internal rotation and external rotation),visual analogue scale (VAS),American Shoulder and Elbow Surgeons (ASES) score,Constant-Murley score,postoperative height loss of the humeral head,humeral head varus angle,complication rate and secondary surgery rate.Results The 157 patients were followed up for 12 to 22 months (mean,16.8 months).The fracture healing time was 13.0 ± 3.8 weeks in group A and 15.6 ± 4.2 weeks in group B,showing a statistically significant difference (P ＜ 0.05).At the last follow-up,for groups A and B respectively,anteflexion was 135.6° ± 17.7° versus 125.4° ± 23.6°,abduction 132.5°±22.7° versus 117.5°±32.7°,external rotation 30.2°± 18.7° versus 21.6°± 17.2°,internal rotation T9 versus T11,VAS score 0.6 ±0.9 points versus 0.9 ± 1.2 points,ASES score 90.2 ±6.8 points versus 82.2 ± 12.3 points,Constant-Murley score 88.5 ±3.6 points versus 72 ±4.9 points,postoperative height loss of the humeral head 0.9 ± 0.1 mm versus 4.2 ± 0.4 mm,and humeral head varus angle 1.2° ± 0.2° versus 4.5° ± 1.9°.The differences between the 2 groups were all statistically significant (P ＜ 0.05).There were no significant differences between the 2 groups in complication rate [14.28％ (5/35) versus 22.13％ (27/122)] or in secondary operation rate[2.85％ (1/35) versus 8.19％ (27/122)] (P ＞ 0.05).Conclusions In the treatment of Neer 3-and 4-part factures of proximal humerus in the elderly,PHILOS combined with fibular strut allograft can improve therapeutic efficacy,because it can provide good support for the medial column of the proximal humerus and the humeral head and thus facilitate the intraoperative reduction of the fracture.

Objective:To investigate the clinical effect of perforated kirschner wire tension band in the treatment of olecranon fractures in adults.Methods:A retrospective case-control study was conducted on 56 adult patients with olecranon fractures admitted in Ningbo NO.6 Hospital from May 2013 to February 2017. The perforated Kirschner wire tension band fixation was used in Group A ( n=24), while the common Kirschner wire tension band fixation was used in Group B ( n=32). Group A was composed of 16 males and 8 females at age of (34.0±12.1)years, and Group B was composed of 19 males and 13 females at age of (36.5±11.4)years. According to the Mayo classification, there were 7 patients with type I and 17 with type II in Group A, 15 with type I and 17 with type II in Group B. The operation time, bleeding volume, X transmission times, postoperative visual analogue score (VAS), fracture union time, loosening or failure of internal fixation, skin irritation and elbow joint function Broberg-Morrey score were compared between the two groups. Results:All patients were followed up for 15-21 months (mean, 18 months). In Group A, the operation time, bleeding volume, Xray transmission times, fracture union time and skin irritation were (79.6±22.5)minutes, (111.3±26.2)ml, (7.2±2.2)times, (3.7±0.6)months, 1 case, respectively. In Group B, the operation time, intraoperative hemorrhage, transmission times, fracture healing time and skin irritation were (94.3±27.5)minutes, (152.0±31.4)ml, (11.0±3.4)times, (4. 7±2.2)months, 9 cases, respectively. The difference between the two groups were all significant ( P<0.05). There were no significant difference in VAS, failure of internal fixation and elbow function Broberg-Morrey score between the two groups ( P>0.05). Conclusions:Compared with the anatomic plate, the perforated Kirschner wire tension band in the treatment of adult patients with olecranon fractures cannot only reduce the operation time and transmission times, reduce the intraoperative bleeding volume, but also shorten the fracture union time and avoid the occurrence of skin irritation and other complications.

Objective:To compare 3 internal fixation methods for the treatment of distal femoral fractures of Müller types C2 and C3.Methods:The clinical data of 58 patients were retrospectively analyzed who had been treated for distal femoral fractures of Müller types C2 and C3 at Department of Orthopaedic Trauma, Ningbo No. 6 Hospital from February 2013 to February 2017. They were divided into 3 groups according to the internal fixation method they had used. In the single incision locking plate group (group A) of 21 cases, there were 13 males and 8 females with an age of 50.6 years±12.9 years. In the double-incision locking plate combined with reconstruction plate group (group B) of 18 cases, there were 11 males and 7 females with an age of 53.5 years±13.0 years. In the single incision locking plate combined with reconstruction plate group(group C) of 19 cases, there were 10 males and 9 females with an age of 48.1 years±12.2 years. The 3 groups were compared in terms of operation time, intraoperative blood loss, intraoperative C-arm fluoroscopy, fracture healing time, incidence of postoperative complications, range of motion of the knee and knee functional recovery.Results:The 3 groups were compatible because there were no significant differences between them in their preoperative general data ( P>0.05). There were no significant differences between groups in the frequency of C-arm fluoroscopy, follow-up time, or incidence of postoperative complications ( P>0.05). The operation time in groups A and C (96.7 min±16.4 min and 101.9 min±16.5 min) and intraoperative blood loss for groups A and C (237.8 mL±47.5 mL and 253.6 mL±46.6 mL) were significantly less than in group B (114.9 min±20.1 min and 290.1 mL±60.9 mL) ( P<0.05); the fracture healing time for groups B and C (6.9 months±1.6 months and 6.6 months±1.7 months) was significantly shorter than for group A (8.4 months±1.9 months) ( P<0.05); the ranges of knee motion 12 months after operation in groups B and C (91.7°±16.7° and 90.9°±14.4°) were significantly larger than that in group A (78.8°±14.4°) ( P<0.05); the excellent and good rates of knee function 12 months after operation in groups B and C [77.8% (14/18) and 73.7% (14/19)] were significantly higher than that in group A [57.1%(12/21)] ( P<0.05). Conclusion:In the treatment of distal femoral fractures of Müller types C2 and C3, application of lateral locking plate and additional anterior locking reconstruction plate via the anterolateral incision at the distal femur can achieve rigid fixation without much damage to the surrounding soft tissues and lead to fine functional recovery of the knee joint because it has the advantages of single incision locking plate and double incision medial and lateral locking plates.

Objective To improve the compliance of nurses in ICU standard specimen collection of blood culture by six sigma quality management method, so as to improve the quality of blood culture sample submission, to ensure the accuracy of inspection results. Methods A total of 158 nurses in ICU from February 2016 to January 2017 were selected as the research objects. The six sigma quality management method was used to analyze the operation of blood culture samples collected by ICU nurses,and the improvement plan was worked out and implemented. The compliance rate of blood culture samples collected by nurses before and after implementation and the feedback information of laboratory about blood culture specimen quality were compared. Results Before the application of six sigma quality management method, the compliance rate of blood culture specimens collected by ICU nurses was 54.1％(152/281), and the compliance rate after improvement was 88.6％(271/306), and the difference was statistically significant (χ2=86.45, P<0.01). Among the factors influencing nurses' blood culture,the importance of blood culture was not enough, the operation process was not mastered, the relevant knowledge of blood culture was not mastered, and the allocation of related consumables was unreasonable. After implementation,the composition ratio was reduced from 50.4％(65/129), 24.0％(31/129), 45.7％(59/129), 21.7％(28/129) to 17.1％(6/35), 8.6％(3/35), 25.7％(9/35), 2.9％(1/35), and the difference was statistically significant (χ2=4.00- 12.39, P<0.01 or 0.05). The contamination rate of blood culture specimens after six sigma management was 6.2％(19/306) and significantly lower than that of 16. 4％(46/281) before implementation,and the difference was statistically significant (χ2=15.36, P<0.01). Conclusions The six sigma quality management method can improve the nurses' attention to the correct collection of blood culture samples, reveal the defects in the operation, and reduce the irregular behavior of blood culture process. Therefore, the compliance of ICU nurses with standardized blood culture samples is improved, and the contamination rate of blood culture specimens is effectively reduced.