Objective To determine the immunophenotypic features of peripheral lymphocytes in adult patients with Epstein-Barr virus (EBV)-associated infectious mononucleosis (IM) and chronic active EBV infection (CAEBV).Methods Eighteen IM patients,12 CAEBV patients and 18 healthy donors were included.Lymphocyte subsets including CD3-CD+19 B cells,CD3-CD+16/56 NK cells,CD4+ and CD8+T cells in peripheral blood were measured by flow cytometry.The expression of activation markers (HLA-DR and CD38) on CD8+T cells and CD28 expression on T cells were also determined.Kruskal-Wallis H and MannWhitney U tests were used to compare variables among groups.Results IM patients had dramatically increased CD8+T cell counts than healthy donors (5.22 × 109/L vs 0.54 × 109/L,P ＜ 0.001).B cell counts moderately reduced in patients with IM than in healthy donors.No difference was found in absolute CD4+T cell and NK cell counts between IM and healthy donors.The levels of HLA-DR and CD38 on CD8+T cells significantly increased in IM patients compared with those in healthy controls.The intensity of CD28 on CD8+T cells significantly decreased,which was not seen on CD4+T cells.The median cell counts of B,NK,CD4+T and CD8+T subsets in CAEBV patients were 0.02 × 109/L,0.06 × 109/L,0.26 × 109/L and 0.21 ×109/L respectively,which were significantly lower than those in healthy donors (0.22 × 109/L,0.38 ×109/L,0.78 × 109/L,0.54 × 109/L) and IM patients (0.12 × 109/L,0.40 × 109/L,0.91 × 109/L,5.22 ×109/L).The positive rates of HLA-DR and CD38 on CD8+T cells in CAEBV patients were higher than those in healthy controls,but lower than those in IM patients.Conclusions The immunophenotypic pattern in adult patients with IM is characterized by a dramatic increase of extensively activated CD8+ T cells,a moderate reduction of CD+19B cells and no significant change of CD4+T cells and CD+16/56NK cells.CAEBV is featured by an immunosuppression status as demonstrated by significantly decreased B,NK,CD4+T and CD8+T subsets.

Objective To evaluate the relationship between fatty liver disease and liver metastases from colorectal cancer.Methods Eight hundred and ninety patients with colorectal cancer,who were submitted to hospital from 1993 to 2002 and had complete clinical data,were retrospectively analyzed.Of 890 patients,127 were diagnosed as fatty liver(FL)by ultrasonography,and the other 763 who were without fatty liver were served as controls(NFL).The clinical data including pathology,liver matastasis or mortality after surgery were analyzed.The survival rate and liver matastasis after surgery were followed up and statistically analyzed.Results The liver metastases was lower in FL group than that in NFL group(7 cases vs 102 cases,P=0.012).The tumor size was smaller in FL group than that in NFL group[(4.15±1.80)crn vs(4.77±2.25)cm,P=0.0016].The Dukes B(247/732,33.74%)and C(232/732,31.83%)patients were more common in NFL group,whereas Dukes A(41/121,33.61 %)and B(40/121,32.77%)were more common in FL group with significant difference(P＜0.05).No significant difference was found in 7-year survival rate between two groups who had been followed up(P=0.3024).Conclusion The lower incidence of liver metastases is found in FL group,which indicate that fatty liver disease may inhibit liver metastases from colorectal cancer by underlying mechanisms.

Objectives To investigate the T cell subsets changes in hemorrhagic fever with renal syndrome (HFRS) patients. Methods 22 HFRS patients who were diagnosed in Qin Huang Dao Third Hospital from April 2005 to July 2005 were enrolled in this study and divided into two groups according to clinical manifestations. T cell subsets of the 22 patients were monitored at week 1, 4 and 12. Another 56 subjects were enrolled as healthy controls. Results B cell count was normal during the 12 weeks in all the subjects. NK cell decreased significantly at week 1, and recovered at week 4 rapidly. CD4+ T cell count was normal throughout the course of the disease, but the percentage of memory phenotypy increased at week 1and4, reaching(64.1±17.5)% and (59.9±10.1)%, but recovered at week 12. CD4+CD28+T cells were normal throughout the entire study. CD8+ T cell count increased dramatically at week 1 and 4, but finally recovered at week 12. The count of CD8+ CD28-T cells increased significantly at week 1 in low-grade goup, but in median-grade group, this increase lagged to week 4 and was not as significant as in low-grade group. The percentage of CD38+ or HLA-DR+ subsets of CD8+ T cell increased at week 1, 4. Conclusion The results confirmed the relationship between HFRS progression and cellular immunity. It revealed that, at the early stage of HFRS, rapid and effective cytotoxicity T lymphocyte response my contribute to clear Hantavirus away and improve HFRS symptom.

Objective To investigate the significance and characteristics of T lymphocyte subsets and co-stimulatory CD28 in peripheral blood of patients with primary biliary cirrhosis. Methods Tri-colour flow-cytometry was used to detect the levels of T lymphocyte subsets in peripheral blood in 98 patients with primary biliary cirrhosis and 30 age and gender matched healthy controls. Results Compared to control group the percentage of CD4+ T increased and CD8+ T lymphocyte decreased in the PBC group. The CD4+/CD8+ ratio in the PBC group was higher than that in the control group (P<0.05). And the percentage of CD4+CD28- T cells and CD8+CD28- T cells increased, too (P<0.05). Conclusion There are immunological abnormalities in PBC and the expression of co-stimulator CD28 is significantly decreased. CD8+CD28-T lymphocytes may have immune regulatory effect in PBC.

We collected the clinical information of 21 in-patients diagnosed as Lyme disease in Peking Union College Univemity Hospital from Apr. 1994 to Jan. 2008. The clinical manifestations, laboratory tests, therapy and prognosis were analyzed retrospectively. 16 of 21 (76%) patients had fever, 14 of 21 (67%) eases had skin lesion, 17 patients had nervous symptoms, 10 cases showed arthrosis and only 2 of 21 eases involved in heart. The antibiotics of penieilin,ceftriaxone and doxyeycline were used for therapy. All of the 21 patients improved clinically and discharged. 12 cases were followed up for 1 month to 12 years and 2 of them relapsed, both of whom were in Stage Ⅲ. 8 cases remained persistent symptoms. As the manifestations of Lyme disease are complicated, for clinical borderline cases the prompt detection of etiological agent may be useful for early diagnosis. The antibiotic therapy should begin as early as possible to avoid developing chronic Lyme disease.

Objective To evaluate the accuracy of lymphocyte count as a surrogate for CD4+T cell count in treatment-na(i)ve HIV-infected adults.Methods A total of 2 013 HIV-infected patients were screened at 23 sites in China.CD4+ T cell counts were measured by flow cytometry.Correlation between CD4+ T cell count and peripheral lymphocyte count were analyzed by spearman coefficient.AUCRoc were used to evaluate the performance of lymphocyte count as a surrogate for CD4+ T cell count.Results The lymphocyte count and CD4+T cell count of these 2 013 patients were (1 600±670) × 106/L and (244 ± 148) × 106/L respectively.CDa+ T cell count were positively correlated with lymphocyte count(r =0.482,P ＜0.000 1).AUCROC of lymphocyte count as a surrogate for CD4+ T cell counts of ＜ 100 × 106/L,＜200 × 106/L and ＜ 350 × 106/L were 0.790 (95％ CI 0.761-0.818,P ＜ 0.000 1),0.733 (95％ CI 0.710-0.755,P ＜ 0.000 1) and 0.732 (95％ CI 0.706-0.758,P ＜ 0.000 1) respectively.Conclusion Lymphocyte count could be considerad as a potential surrogate marker for CD4+ T cell count in HIV/AIDS patients not having access to T cell subset test by flowcytometry.

Objective To evaluate the clinical value of the combination of S-shaped urethral dilator and nephro-scope for the treatment of male urethral stricture disease. Methods Guidewires were inserted into bladder through the nephroscope under direct vision. The urethral dilation with S-shaped urethral dilator was carried out by nephroscope in 41 male patients. All catheters were located across the strictures and remained for 4-6 weeks. The regular follow-up was done on all cases to assess the clinical effect on urine flow. Results All surgeries were successful without serious complications. The mean operative time was (40.16 ± 5.78) min. The voiding symptoms were significantly improved after catheter removal compared with those of preoperation in all cases. Patients were followed up after surgery and were regularly urethral dilation at least 6 weeks. The mean follow-up time was (34.75±6.42) weeks.There were incontinence, diminished sexual function and other complications after operation in all cases. Conclusion Nephroscope combined with S-shaped urethral dilator for the treatment of male urethral stricture disease is feasible, minimally invasive and safe, which is worthy of recommendation.

Objective To analyze the correlation between CD4+ T cell count and HLA-DR or CD38 expression on peripheral CD8+ T cells in treatment-naive Chinese HIV/AIDS patients.Methods A total of 471 treatment-naive HIV-infected patients and 53 healthy volunteers were enrolled.HLA-DR or CD38 expression on peripheral CD8+ T cells, CD4+ T cell count, naive CD4+ T cell subsets and CD28 expression on T cells were measured by flow cytometry.Plasma HIV RNA load was quantified by real-time PCR (COBAS TaqMan RT-PCR).Mann-Whitney U test and Spearman's rank correlation test were used for statistical analysis.Results CD38 expression intensity on CD8+ T cells was negatively correlated with CD4+ T cell count (r =-0.53, P ＜ 0.001) and naive CD4+ T cell count (r =-0.48, P ＜ 0.001).CD38 expression on CD8+ T cells also displayed significantly negative correlation with CD28 expression on CD8+ T cells (r =-0.46, P ＜ 0.001).HLA-DR expression on CD8+ T cells did not show significant correlation with CD4+ T cell count.Only weak positive correlation was found between CD38 intensity on CD8+ T cells and plasma HIV RNA load.Conclusions Compared with HLA-DR, CD38 expression on CD8+ T cells shows more significant negative correlation with CD4+ T cell count in treatment-naive patients.CD38 and HLA-DR may play different roles on the persistent immune activation in HIV infection.

Objective To investigate the effects of endogenous estrogen on blood glucose level,serum insulin level,and plasma total antioxidant capacity in streptozotocin-induced diabetic female mice,and to explore possible protective effects of estrogen on pancreatic islet cells.Methods Female mice were randomly according to body weight divided into four groups:( 1 ) Sham( Sham operation and vehicle administration) ; ( 2 ) Ovx( ovariectomy and vebicle administration ) ; ( 3 ) Sham + STZ ( Sham operation and STZ administration ) ; and ( 4 ) Ovx + STZ ( ovariectomy and STZ administration).The diabetic mice were induced by intraperitoneal injection of streptozotocin (STZ,50 mg/kg ).Blood glucose levels were measured once a week.Results The blood glucose level and malondialdehyde of Ovx group were higher than that in Sham group,while total anti-oxidant capacity ( T-AOC ) was lower than those in Sham group.the blood glucose level and MDA of Ovx+ STZ group were higher than those in Sham +STZ group,while T-AOC and serum insulin level were lower than those in Sham + STZ group.Conclusions Endogenous estrogen may have some protective effects on pancreatic islet function from streptozotocin-induced diabetes mellitus in female mice.

objective To summarize the clinical characteristics of AIDS phobia patients and establish the preliminary clinical diagnostic criteria.Methods The clinical information of 46 AIDS phobia patients was collected and summarized.General demographic data,clinical manifestations and laboratory results were analyzed.Results The clinical characteristics of AIDS phobia patients include:(1)With or without high-risk behavior of HIV-1 infection;(2)Patients repeatedly demanded HIV/AIDS related laboratory tests,suspected or believed in HIV-1 infection with daily life affected;(3)The main complaints were non-specific including influenza-like symptoms(headache,sore throat and so on),fasciculation,formication,arthrodynia,fatigue and complaint of fever with normal body temperature;physical examination did not reveal any positive physical sign except white coated tongue;(4)Symptoms mainly appeared 0-3 months after the high-risk behavior while HIV-1 antibody kept negative;(5)T lymphocyte subsets test was carried out in 23 patients and showed 19(82.6%)with CD4+ T lymphocyte count>500/μl,the remaining 4 were 300-500/μl,with the lowest count of 307/μl.Few patients had inversed CD4+/CD8+ ratio but without excessive CD8+T lymphocyte activation.Conclusion AIDS phobia is a complicated physical and mental disease,whose diagnosis and treatment still need further investigation.