Objective:To explore the role of TNFSF14 and its receptors LTβR and HVEM in the pathogenesis of virus hepatitis.Methods:Marine fulminant viral hepatitis model was established by infecting mice with MHV-3.Liver tissue destruction in LIGHT KO and WT mice were analyzed by HE staining and ALT levels in serum by automatic biochemical analyzer .The mRNA levels of HVEM and LTβR in the liver and spleen tissues in the indicated time points ( 0 h, 12 h, 24 h, 48 h, 72 h ) were detected by quantitative-PCR.The expression of HVEM and LTβR on PBMC in patients with severe hepatitis were measured by flow cytometry.Results:In the MHV-3-induced murine fulminant hepatitis model ,liver injury in LIGHT KO mice was obviously decreased than that of WT mice,and ALT levels was also significantly lower than that of WT mice (P<0.01).The mRNA of HVEM and LTβR in the spleen were increased significantly after 48 h postinfection with MHV-3 ( P<0.05 );The level of LTβR mRNA in liver was significantly up-regulated in 12 h postinfection with MHV-3(P<0.01).Compared to healthy volunteers,the expression of both HVEM and LTβR on PBMC in patients with severe hepatitis was remarkably enhanced .Conclusion: TNFSF14 and its receptors LTβR and HVEM play a critical role in the pathogenesis of viral fulminant hepatitis .

OBJECTIVETo assess the risk of local transmission of Dengue caused by introduced cases with semi-quantitative method in 2015 in Zhejiang Province.

METHODSRisk indexes of local transmission of Dengue caused by introduced cases were reviewed. The weights of indexes were computed by analytic hierarchy process and further used to generate absolute risk values by multiplying indexes. Moreover, comprehensive indexes were computed to describe relative risk by combining analytic hierarchy process and TOPSIS methods.

RESULTSFour primary indexes and 19 secondary indexes were identified for risk assessment of local transmission of Dengue. The indexes with maximum and minimum weight were the number of immigration from countries with Dengue patients (weight value: 0.0678) and density of population (weight value: 0.0371) respectively. All CR values, statistics for measuring consistency of score matrix, were less than 0.1 (minimum: 0.000, maximum: 0.0922, average: 0.0251). The absolute risk of Zhejiang Province was within the range of 0.397-0.504 (the full score was 1.0). The risk orders of 11 municipalities sorted by relative comprehensive indexes and absolute risk values methods were similar. The three highest municipalities were Hangzhou, Wenzhou and Ningbo and the ranges of absolute risk value were 0.387-0.494, 0.404-0.511 and 0.392-0.499 respectively.

CONCLUSIONThe results provides scientific basis for preventing and controlling Dengue in Zhejiang Province. The indexes and weights may be used to assess risk of Dengue in future. In addition, the semi-quantitative method constructed in this study would be a significant reference for risk assessment of public health in emergencies.

China ; epidemiology ; Dengue ; epidemiology ; transmission ; Humans ; Risk Assessment

Critical ultrasonography(CUS) is different from the traditional diagnostic ultrasound,the examiner and interpreter of the image are critical care medicine physicians.The core content of CUS is to evaluate the pathophysiological changes of organs and systems and etiology changes.With the idea of critical care medicine as the soul,it can integrate the above information and clinical information,bedside real-time diagnosis and titration treatment,and evaluate the therapeutic effect so as to improve the outcome.CUS is a traditional technique which is applied as a new application method.The consensus of experts on critical ultrasonography in China released in 2016 put forward consensus suggestions on the concept,implementation and application of CUS.It should be further emphasized that the accurate and objective assessment and implementation of CUS requires the standardization of ultrasound image acquisition and the need to establish a CUS procedure.At the same time,the standardized training for CUS accepted by critical care medicine physicians requires the application of technical specifications,and the establishment of technical specifications is the basis for the quality control and continuous improvement of CUS.Chinese Critical Ultrasound Study Group and Critical Hemodynamic Therapy Collabration Group,based on the rich experience of clinical practice in critical care and research,combined with the essence of CUS,to learn the traditional ultrasonic essence,established the clinical application technical specifications of CUS,including in five parts:basic view and relevant indicators to obtain in CUS;basic norms for viscera organ assessment and special assessment;standardized processes and systematic inspection programs;examples of CUS applications;CUS training and the application of qualification certification.The establishment of applied technology standard is helpful for standardized training and clinical correct implementation.It is helpful for clinical evaluation and correct guidance treatment,and is also helpful for quality control and continuous improvement of CUS application.