Objective: To discuss the impact and practicability of pluralistic management when puerpera with hepatitis B virus (HBV) in hospital. Methods: By review researching and convenient sampling, two groups of puerpera with HBV were studied comparatively by the index of the time of breast milk, the breastfeeding rate and the satisfaction rate in hospital.The control group (411 cases, January to December, 2017) carried on the normal regulations nursing and the observation group (411 cases, January to October, 2018) carried on the pluralistic management in the Obstetrics and Gynecology Department of the Fifth Medical Center of PLA General Hospital. Results: The rate of the starting time of milk secretion (<24, 24-48, 49-72, >72 h) was 29.4%(121/411), 36.0%(148/411), 24.6%(101/411), 1.0%(41/411) in the observation group, and 13.6%(56/411), 21.7%(89/411), 33.3%(137/411), 31.4%(129/411) in the control group. The differences between the two groups were significant (χ² value was 7.66-57.43, all P<0.01). Postpartum hospital stay in 3 days and 6 days, the breastfeeding rate and average rate was 90.4%(198/219), 95.3%(183/192), 92.7%(381/411) in the observation group, and 79.0%(180/228), 84.2%(154/183), 81.3%(334/411) in the control group, the differences between the two groups were significant (χ² value was 11.13, 12.7, 23.61, all P<0.01). The total satisfaction rate in hospital was 99.5%(409/411) in the observation group, and 91.2%(375/411) in the control group, the difference between the two groups was significant (χ² value was 31.93, P<0.01). Conclusions Pluralistic management can raise the rate of breastfeeding of puerpera with HBV and the satisfaction of puerpera with HBV and her family.

Objective:To investigate the characteristics of lymphocyte subsets and the correlation between the immune imbalance of T helper 17 cell/regulatory T cell (Th17/Treg) and cytokines in peripheral blood of patients with Beh?et's disease(BD).Methods:From January 2018 to November 2019, 82 outpatient and inpatient with BD of the Department of Rheumatology and Immunology of the Second Hospital of Shanxi Medical University with complete data were enrolled. The disease activity was evaluated according to BD Current Activity Form(BDCAF), and 66 age and matched healthy people were selected as the control group. The absolute numbers of lymphocyte subsets and T cell subsets dominated by Th17 and CD4 +CD25 +Foxp3 + Treg in patients with BD and healthy controls were detected by Flow cytometry. The levels of interleukin (IL-2), IL-4, IL-6, IL-10, IL-17, Interferon (IFN)-γ and Tumor necrosis factor-α (TNF)-α in patients with BD were measured by Cytometric Beads Array (CBA). The correlations between the ratio of Th17/Treg with inflammatory index, the number of organ involved and the levels of cytokines were analyzed. Data were analyzed by Mann-Whitney U test, Kruskal Wallis H test, Spearman correlation analysis and multiple linear regression. Results:①The absolute numbers of Th17 cells in peripheral blood of patients with active BD [13.9(7.7, 21.1) cells/μl] and patients with stable BD [8.7(6.1, 14.0) cells/μl] were higher than those of healthy controls [6.8(4.4, 8.5) cells/μl] ( P<0.01); The ratio of Th17/Treg was significantly increased ( P<0.01). The absolute co unts of Treg cells in BD group [24.79(15.64, 37.91) cells/μl] were sign-ificantly lower than those in healthy controls [30.59(23.04, 42.08) cells/μl], the difference was statistically significant ( P=0.016). ② The ratio of Th17/Treg was positively correlated with BDCAF ( r=0.298, P=0.007) and the number of organ involved ( r=0.304, P=0.006) was negatively correlated with age ( r=-0.254, P<0.05), and not correlated with the duration of disease and ESR ( P>0.05) in patients with BD. In addition, multiple linear stepwise regression showed that the ratio of Th17/Treg was positively correlated with BDCAF ( β=0.228, P=0.036) and negatively correlated with age ( β=-0.219, P=0.043), R2=0.101. ③ The levels of IL-2, IL-6, IL-10, IFN-γ in patients with BD were stati-stically higher than those of healthy controls ( P<0.01). The ratio of Th17/Treg was positively correlated with the levels of IL-2 ( r=0.307, P<0.01) and IL-4 ( r=0.301, P<0.01) in patients with BD. Conclusion:There is immune imbalance of Th17/Treg in patients with BD, which is closely related to disease activity, the number of organ involved, and the levels of cytokines such as IL-2 and IL-4. IL-2 and IL-4 may play an important role in the immune imbal-ance of Th17/Treg in patients with BD.