The T helper cell 17 (Th17) has important relationship with liver failure caused by hepatitis B virus (HBV).Some studies found that mature,differentiation and proliferation of Th17 cells have a close relationship with interleukin 23,newly discovered in recent years,which function of immune and regulatory mechanism in chronic hepatitis B patients is still unclear.In our country,the main cause of liver failure is hepatitis viruses (mainly HBV),thus the study of immune pathogenesis that why acute exacerbation or liver failure happens in chronic hepatitis B patients has a realistic meaning for improving the prognosis of chronic hepatitis B.

Aim To establish a novel,highly sensitive,rapid and cost-effective HPLC method to simultaneously determine tri-cyclic antidepressant clomipramine and four benzodiazepines of diazepam,alprazolam,clonazepam,oxazepam in human plasma pretreated by solid phase extraction.Methods The assay was achieved by using C8 column (4.6 mm ×1 50 mm,5 μm)kept at 45 ℃,mobile phase 73.2:26.8 V/V (50 mmol·L -1 ,pH 3.0 phosphate buffer:acetonitrile)with flow rate of 1 .2 ml· min -1 ,and UV detection was set at λ220 nm.Solid phase ex-traction was performed on C1 cartridges.Results The calibra-tion curve was demonstrated to be linear (r >0.9994)in the ranges of 5 ~200 μg·L -1 for alprazolam and clonazepam,1 0 ~500 μg·L -1 for diazepam,20 ~500 μg· L -1 for clomipra-mine,and 7.5 ~2000 μg·L -1 for oxazepam;the limit of detec-tion (LOD)was 1 .5,1 .4,3.0,5.5 and 2.2 μg·L -1 for al-prazolam,clonazepam,diazepam,clomipramine and oxazepam respectively.Intra-day and inter-day precision revealed a coeffi-cient of variation of 2.2% ~1 2.6% and 2.1 % ~1 3.2%,re-spectively.Extraction yield ranged from 81 .1 % ~1 00.1 % for all analytes.Conclusion The developed method is accurate, reproducible,convenient,and suitable for routine therapeutic drug monitoring of clomipramine and the four benzodiazepines.

Objective To observe the clinical features,the complications and treatment effects of intermediate uveitis. Methods The clinical data of 36 patients(66 eyes)with intermediate uveitis were retrospectively analyzed,including the clinical features,fundus fluorescein angiography(FFA)features,complications,treatment effects and prognosis.The patients,21 males and 15 females,aged from 8 to 70 years,with the mean age of 34.8 years.There were 30 eases with bilateral lesions and 6 cases with unilateral lesions. Results The main clinical manifestation were vitreous opacity.peripheral retinal venous lesions,optic disc edema,macular edema and posterior subcapsular cataract.The results of FFA showed that peripheral retinal venous lesions,optic disc hyperfluorescence,cystoid maeular edema and retinal vein staining.After the treatment.the visual acuity of 31 cases(60 eyes,90.9%)were improved,4 cases(5 eyes,7.6%)were stable and 1 case(1 eye,1.5%)was worsening.The main complications were cystoid macular edema,posterior subcapsular cataract and vitreous hemorrhage which Ieads to visual damage. Conelusions Intermediate uveitis was a common bilateral and chronic progressive intraocular inflammation,the anterior vitritis,pars plana and peripheral retinal vascular changes were mainly involved.Early diagnosis and proper treatment may prevent the permanent visual damage.

Objective To examine the levels of interferon-γ(INF-γ).tumor necrosis factor-α (TNF-α)and interleukin-6(IL-6)in serum of patients with acute uveitis before and after treatment,and to explore the possible roles of those cytokines in the initiation and progression of the u,ieitis. Methods A series of 75 patients with acute uveitis.and 30 healthy persons from our hospital were investigated.The Ievels of INF-γ,TNF-α and IL-6 in acute phase and convalescent phase were measured by the enzymelinked immunosorbent assay. Result The serum 1evels of INF-γ,TNF-α and IL-6 in acute phase were significantly higher than that of the convalescent phase and the healthy controls(F=65.805/50.418/155.381,P=0.000).A significant negative correlation was found between the serum leveis of INF-γ,TNF-α and IL-6 in acute phase with their initiaI visual acuity(r=-0.656,-0.592 and-0.653,P＜O.01).There was also a positive correlation among the serum levels of INF-γ,TNF-α and IL-6(r=0.340,0.467 and 0.338,P＜0.05). Conclusions There are high serum levels of INF-γ,TNF-α and IL-6 in patients with acute uveitis,and the cytokines levels were decreased after the treatment.The results suggested that the INF-γ,TNF-α and IL-6 involved in initiation and progression of uveitis.

Objective To investigate the effect of mycophenolic acid (MPA) on the endotheline-1 (ET-1) induced proliferation, contraction and migration of pulmonary arterial smooth muscle cells (PASMCs)and to explore the mechanism of MPA on pulmonary arterial hypertension (PAH), and the effect of exogenous guanosine nucleotide reversing anti-proliferative effect of MPA. Paired-samples t-test was used for statistical analysis. Methods MTT test, scarification test, Millicell cell culture insertion and the length of PASMCs mcasured under microscope were used. Results The A values of group ET-1 + low concentration MPA decreased when compared with group ET-1 (0.348±0.036 vs 0.447±0.013, t=6.357, P=0.000) and the A values of group ET-1 + high concentration MPA was further decreased. The A values of group ET-1 + low concentration MPA + guanosine was higher than that of group ET-1 + low concentration MPA (0.390±0.018 vs 0.348 ±0.036, t=2.573, P=0.028). The average migration distance and the average migration numbers of PASMCs of groups MPA was decreased than that of group ET-1. The average cell length of PASMCs of groups MPA was increas ed than that of group ET-1. Conclusion MPA can effectively inhibit the proliferation,contraction and migration of PASMCs by ET-1 induction. The IMPDH may play a role in anti-proliferative effect of MPA on PASMCs, but is unnecessary to be the sole mechanism. These findings has provide new insight into the mechanisms of mycophenolate mofetil in the treatment of PAH.

Objective To investigate the characteristics of aminoglycoside resistance of extend-ed-spectrum β-lactamases(ESBLs)-producing Escherichia coli(E, cold and expression of aminoglyco-side-modifying enzyme genes. Methods The minimal inhibitory concentrations(MICs) of gentamicin,amikacin, kanamycin, tobramycin, netilmicin and neomycin for 37 strains of ESBLs-producing E. Coli were detected by agar dilution. In addition, six aminoglycoside-modifying enzyme genes were amplified by polymersae chain reaction(PCR) and verified by DNA sequencing. Results MICand MIC90 of gentamicin, amikacin, kanamycin, tobramycin and netilmicin for 37 strains of ESBLs-producing E. Co-Il all excelled 256 μg/mL, the resistance rates of the above antibiotics were 78.4%, 45.9%, 72.9%,83.8%and 64.90%, respectively. However, neomycin still had powerful antibacterial activity. In ad-dition, five modifying enzyme genes, including aac(3)-Ⅱ , aac(6′)-Ⅰ b, aac(6′)-Ⅱ , ant(2″)-Ⅰ and ant(3″)- Ⅰ genes, were found in 37 isoaltes except aac(3)- Ⅰ , and their positive rates were 56.8%,27.0 %, 2.7 %, 5.4 % and 13. 5 %, respectively. Conclusion The aminoglycoside resistance of ES-BLs-producing E. Coil may be associated with the expression of aminoglycoside-modifying enzyme genes.

Objective To investigate the characteristics of mesenteric vascular thrombosis (MVT) in patients with antiphospholipid antibody syndrome (APS).Methods The cases reports about MVT in patients with APS were searched in Pubmed and Chinese biomedical database (1983.1-2007.7) and then were analyzed.Results There were 13 males and 8 females in 21 patients.The average age was (37±17) years (5months～69 years).Three cases (14%) had a history of deep venous thrombosis and 4 (19%) had spontaneous abortions.The course of disease was 4 hours to 4 months.The clinical manifestations included abdominal pain 18 (86%),hemafecia or melaena 4 (19%),vomiting 3 (14%),diarrhea 2 (10%),hematemesis 2(10%).Physical signs included abdominal tenderness in 10(48%),peritoneal irritation signs in 5 (24%),shifting dullness in 3 (14%) anddecreased bowel sounds in 3 (14%).Mesenteric vascular thrombosis were detected through B uhrasonography (3/10,33%),abdominal CT (9/13,69%),MRI (4/4,100%),Doppler ultrasound (4/4,100%),angiography (6/6,100%).Eighteen cases (86%) had positive anti-cardiophospholipin antibody and 14 (67%) were IgG-subtype.Lupus anticoagulants were detected in 4 (19%).Sixteen cases reee-ived exploratory laparotomy,lsehemia or necrosis of intestine were found in 9(56%).In 21 cases,superior mesenteric vein thrombosis,suprior mesenteric artery thrombosis,inferior mesenteric vein thrombosis,inferior mesenteric artery thrombosis were discovered in 17 (81%),4 (19%),0 (0%),1 (5%)patients respectively.Portal vein was also involved in 7 (33%) cases who had superior mesenteric vein thrombosis.Conclusion Superior mesenteric vein is usually involved in patients with APS who have MVT.MVTs are always occurr in middle-age male patients.Some patients have deep vein thrombosis or spontaneous abortion before MVT.The disease may be fulminant or had is insidious in onset.Abdominal pain and intestinal obstruction are the most common manifestations.IgG-subtype anticardiophospholipin antibodiesare the common antibodies discovered in these patients.Combined more than one image methods can detect the thrombi effectively.Anticoagulation and essential exploratory laparotomy are effective interventions in most cases.

Objective To understand the cognitive status of urology medical staff about hematuria color.Methods The self-designed questionnaire about color cognition was adopted,and the concentration of hematuria samples were determined.The investigation was carried out in 50 health care workers about their cognition of hematuria color.Results The study found that there were differences in color perception between doctors and nurses,doctors and nurses with different titles,doctors and the standard sample,nurses and the standard sample.Conclusions There are differences in judgment and description of the urine sample color in medical personnel,they are more attempted to judge by virtue of work experience and subjective consciousness.Due to the lack of a uniform and objective standards,the medical staff can not accurately and objectively describe the development of patients' condition,thus patients' recovery was affected.Therefore,a unified objective criteria for clinical reference norms of hematuria should be developed as soon as possible to ensure that patients recover quickly and safely.

As a species of acute respiratory tract pathogen in mankind, Chlamydia pneumoniae can cause upper respiratory tract infection, pneumonia, it may also play an important role in bronchial asthma, chronic obstructive pulmonary diseases, sarcoid, lung cancer.

Objective　To explore the clinical characters and distributions of the endogenous uveitis.Methods　Both clinical examinations and immunologic investigations were performed in 354 patients with cases of uveitis within six years.Results　Among 354 uveitis, the anterior uveitis were 165 cases(46.6%), the posterior uveitis 118 cases (33.3%),the pan-uveitis 57 cases(16.1%) and the intermediate uveitis 14 cases(4.0%). The blind rate among the patients was 5.9%, the main causes were proliferative retinopathy, secondary glaucoma and complicated cataract. 167 cases(47.2%)of patients were related to the systemic changes, the bone-joints disease, Vogt-Koyanagi-Harada syndrome, Behcet syndrome and toxoplasma infection were common.Conclusion　Complete clinical and immunologic examinations can ensure the defined diagnosis and proper treatment for the patients with endogenous uveitis.