Objective To explore the ursodeoxycholic acid efficacy and safety analysis of nucleoside drugs for HBeAg-positive with high viral load in patients with liver cirrhosis, and its effect on peripheral blood Th17, Treg levels.Methods 80 patients with high viral load B HBeAg-positive from November 2012 to February 2014 were selected and randomly divided into control group and observation group, 40 cases in each group.Patients in control group received conventional treatment, observation group was treated with ursodeoxycholic acid based on the control group, antiviral efficacy and adverse reactions, peripheral blood Th17, Treg levels were compared between two groups.Results After treatment, the ALT, AST, ALB, TBil levels between two groups were significantly lower compared with before treatment(P<0.01), the ALT, AST, ALB, TBil levels in observation group were significantly lower than the control group ( P<0.01 ); HBV-DNA negative rate ( 85.0%) and decrease of HBV-DNA in observation group were significantly higher (7.5%) than those in control group, the difference was statistically significant (χ2 =48.322, t =11.490, P<0.01); ALT normalization rate (52.5%), HBeAg seroconversion rate (57.5%) in observation group was significantly higher than those in control group(15.0%, 17.5%), the difference was statistically significant (χ2 =12.579,χ2 =13.653, P<0.01);complications compared with the situation observed group of death, hepatocellular carcinoma, spontaneous bacterial peritonitis, gastrointestinal bleeding compared with control group, the difference was not statistically significant (χ2 =1.01, χ2 =2.05, χ2 =3.12, χ2 =0.21, P>0.05).After treatment, the Th17 levels elevated, Treg level decreased in two groups, Th17 level in observation group was significantly higher than control group, Treg levels were significantly lower than the control group, Th17/Treg ratio was higher than the control group (P<0.05).Conclusion Ursodeoxycholic acid can significantly improve liver function of patients with HBeAg positive with high viral load, increase the rate of HBeAg seroconversion, inhibit HBV viral replication and delay progression of the disease, and less adverse reactions.It can increase the number of Th17 cells, reduce the number of Treg cells in patients, which may be one of its antiviral mechanism.

Objective To determine the methylation level of P15INK4B gene promoter in different types of myelodysplastic syndromes (MDS) and its correlation with its prognosis.Methods Methylation frequency of the P15INK4B gene promoter in 44 cases of MDS were determined by methylation-specific polymerase chain reaction (PCR) and pyrosequencing,and its correlation with clinical classification and characteristics of MDS were statistically analyzed.Results Frequency of P15INK4B gene promoter methylation in myelodysplastic syndromes-refractory anemia with excess blasts Ⅱ (MDS-RAEB Ⅱ) patients was (46.89 ± 15.41) ％,significandy higher than that in other types of MDS (P ＜ 0.05),but no difference in promoter methylation frequency was detected among the other types of MDS (P ＞ 0.05) ; frequency of P15INK4B gene promoter methylation was found to be correlated with decline in platelet upon diagnosis (t =9.02,P ＜ 0.01),but showed no significant correlation with drop of hemoglobin or leukopenia (P ＞0.05).As for the correlation between P15INK4B gene promoter methylation and MDS risk stratification,no significant difference was detected between the low-risk and very low-risk groups (P ＞ 0.05),but significant differences were detected among the medium-risk,high-risk,and very high-risk groups (P ＜ 0.05).In addition,frequency of P15INK4B gene promoter methylation was (49.21 ± 8.78)％ in MDS patients that developed leukemia in the following two year,significantly higher than that in MDS patients who didn't (19.64 ± 6.24) ％ (P ＜ 0.05).Conclusions P15INK4B gene promoter methylation frequency is a valuable indicator of prognosis of MDS patients.

Objective To evaluate the advantages of confocal laser endomicroscopy(CLE)for function repairing of ulcerative colitis(UC). Methods Thirty patients with UC who were diagnosed and treated in the First Affiliated Hospital of Zhejiang University Medical College between July 2014 and December 2016 were enrolled in the study group. The control group consisted of 10 patients who were diagnosed as having colonic polyps with colonoscopy and underwent polypectomy in the same period. Both groups were examined with white light endoscopy and CLE,then the fluorescein leakage score was compared. Results There were 10 out of 30 cases in the study group whose whole intestinal mucosa were judged as normal under white light endoscopy. In the other 20 cases,there were parts of intestinal mucosa being judged as abnormal. All of the 10 cases in the control group were with normal colon mucosa. There was a significant difference on fluorescein leakage score by CLE between the study group which showed normal by white light endoscopy and the control group(P<0.05). The fluorescein leakage score by CLE was significant difference between the abnormal intestinal segment and normal intestinal segment in 20 patients with active UC(P<0.05). Spearman correlation analysis showed that there was non-ranked correlation between the fluorescein leakage score of CLE and histopathological findings of biopsy in UC patients with normal mucosa of the left colon under white light endoscopy(rs=0.394,P>0.05). Conclusion In the process of mucosal healing of UC patients,structural repair can be found firstly through CLE. Mucosal healing under white light endoscopy cannot represent the functional recovery. CLE is more effective than the histopathology in the evaluation of mucosal barrier function.

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder that is characterized by abdominal pain and disordered bowel habits. The etiology of IBS is multifactorial, including abnormal gut-brain interactions, visceral hypersensitivity, altered colon motility, and psychological factors. Recent studies have shown that the intestinal microbiota and its metabolites short chain fatty acids (SCFAs) may be involved in the pathogenesis of IBS. SCFAs play an important role in the pathophysiology of IBS. We discuss the underlying mechanisms of action of SCFAs in intestinal inflammation and immunity, intestinal barrier integrity, motility, and the microbiota-gutbrain axis. Limited to previous studies, further studies are required to investigate the mechanisms of action of SCFAs in IBS and provide more precise therapeutic strategies for IBS.

Objective:To analyze the factors related to the duration of chest compression pause time during the manual-mechanical conversion process in cardiopulmonary resuscitation (CRP).Methods:A retrospective study was devised in a cohort comprising patients with out-of-hospital cardiac arrest, who were assigned to receive mechanical CRP in the Department of Emergency of Huzhou First People's Hospital from January 2019 to December 2020. Patient’s general characteristics, CRP data and data on CRP-free intervals were collected multiple linear regression to analyze associations with the duration of chest compression pause time during the manual-mechanical conversion process in CRP. At the same time, the effect of CPR treatment qualification of nurses on CPR compression quality was evaluated.Results:The study selected 32 eligible patients. Patient's height, actual body weight, and body mass index showed a positive liner correlation with the duration of chest compression pause time ( r=0.61, 0.92, 0.49; P<0.01). Multiple stepwise regression analysis showed that actual body weight was an independent risk factor for prolonged duration of chest compression pause time ( P<0.01). Moreover, responsible nurses with advanced cardiac life support (ACLS) certification had significantly higher compression scores than those without ACLS certification (χ 2=0.002, P<0.01). Conclusions:The actual body weight of patients and the ACLS qualification of nurses on duty have a certain relationship with the duration of chest compression pause time during the manual-mechanical conversion process in CRP, which is worthy of further research.

The 11α-hydroxylation of 16α, 17-epoxyprogesterone (EP) catalyzed by Rhizopus nigricans is crucial for the steroid industry. However, lower conversion rate of the biohydroxylation restricts its potential industrial application. The 11α-steroid hydroxylase CYP509C12 from R. oryzae were reported to play a crucial role in the 11α-hydroxylation in recombinant fission yeast. In the present study, the CYP509C12 of R. oryzae (RoCYP) was introduced into R. nigricans using the liposome-mediated mycelial transformation. Heterologous expression of RoCYP resulted in increased fungal growth and improved intracellular reactive oxygen species content in R. nigricans. The H₂O₂ levels in RoCYP transformants were approximately 2-folder that of the R. nigricans wild type (RnWT) strain, with the superoxide dismutase activities increased approximately 45% and catalase activities decreased approximately 68%. Furthermore, the 11α-hydroxylation rates of EP in RoCYP transformants (C4, C6 and C9) were 39.7%, 38.3% and 38.7%, which were 12.1%, 8.2% and 9.4% higher than the rate of the RnWT strain, respectively. This paper investigated the effect of heterologous expression of RoCYP in R. nigricans, providing an effective genetic method to construct the engineered strains for steroid industry.