Objective:This study was to analyze the changes of CD4~+ T lymphocytes and their subtypes,Th1 and Th2 cells,in the peripheral blood of patients with pulmonary tuberculosis disease and to investigate their clinical significance in the pathologic process of pulmonary tuberculosis.Methods:For polarization measurement of T-helper cells,1∶100 diluted Ionomycin and 1∶10 diluted Monensin were added in sequence into the equivalent volume mixture of heparin anti-coagulated whole blood and RPMI-1640 culture liquid.After being well mixed,the mixture was incubated at 5% CO_2,37℃ for 4 hours or overnight.To 100 μl of the mixture and in sequence,the antibodies of CD3-PerCP,CD8-APC,mIgG1-FITC,Rat IgG1-PE,IL-4-PE or IFN-γ-FITC were added.The stained CD4~+ IL-4~+ (Th2) and CD4~+ IFN-γ~+ (Th1) were analyzed by flow cytometry.Results:Compared with those from healthy controls,the peripheral blood of pulmonary tuberculosis patients contained significantly fewer Th1 (P＜0.01) but significantly more Th2 cells (P＜0.05).Th1 cells in the peripheral blood of the patients with miliary pulmonary tuberculosis were obviously fewer (P＜0.05) than in infiltrative pulmonary tuberculosis patients.The amount of Th2 cells in the peripheral blood of the patients with miliary pulmonary tuberculosis was significantly more (P＜0.05) than in either infiltrative pulmonary tuberculosis or tuberculous pleurisy patients.The ratio of CD4~+/CD3~+ tended to decrease in all these patients,and it was much lower (P＜0.05) in the patients of miliary pulmonary tuberculosis than in infiltrative pulmonary tuberculosis patients.Patients suffering from both pulmonary tuberculosis and diabetes had significantly lower levels of Th1 cells and CD4~+/CD3~+ (P＜0.05) and more Th2 cells,compared with those of pulmonary tuberculosis patients without diabetes.Levels of Th1 and Th2 cells restored significantly (P＜0.05) in 15 severe pulmonary tuberculosis patients after receiving tuberculosis chemotherapy and microcalorie theropy for three months.Patients with positive sputum examination tended to have decreased Th1 and CD4~+/CD3~+ (P＞0.05) and significantly increased Th2 (P＜0.05).Conclusion:Immunosuppression existed,in different extents,in patients of infiltrative pulmonary tuberculosis,tuberculous pleurisy,miliary pulmonary tuberculosis as well as patients with both pulmonary tuberculosis and diabetes.Analysis of Th1,Th2 and CD4~+/CD3~+ may be benefit for the judgments of disease conditions and therapeutic effects.

Objective To observe the effects of inverse ratio ventilation on respiratory mechanics and postoperative pulmonary com-plications in morbidly obese patients during laparoscopic sleeve gastrectomy Methods A total of 62 morbidly obese patients for a laparo-scopic sleeve gastrectomy were scheduled(18-65 years old,BMI≥35kg/m2 in combination with diabetes,hypertension,hyperlipemia,and other metabolic diseases,or BMI≥40kg/m2,ASA Ⅱ or Ⅲ).Patients were randomly assigned to two groups:inverse ratio ventilation group(IRV)and control group(PVG).Two groups were adjusted with an actual tidal volume(VT)of 7-8ml/kg,and respiratory rates of 12 breaths/min.In the IRV group,the ratio of I∶E was 2∶1;in the control group,the ratio of I∶E was 1∶2.We recorded the indexes of respiratory mechanics and the blood gas at the baseline(T0),5min after anesthesia(T,),15min after pneumoperitoneum(T2),30min after pneumoperitoneum(T3),60min after pneumoperitoneum(T4)and the end of surgery(T5),and the occurrence of pulmonary com-plications on day 1,day 2 after operation was observed,and the cumulative incidence of PPCs at 7 days was counted.Results Compared to the control group,the dynamic lung compliance(Cdyn),mean airway pressure(Pmean),positive end expiratory pressure(PEEP),and the PaO2 at T,-T5 of the inverse ventilation group were increased significantly(P＜0.05),the Ppeak、Pplat at T2-T5 and dynamic lung compliance(VD/VT)at T3-T5 were decreased significantly(P＜0.05),and no difference in the PaCO2 and PETCO2 in the two groups.Grade 1 pulmonary complications occurred in both groups,and there was no difference in the total occurrence of pulmonary com-plications at 7 days.Conclusion Inverse ventilation effectively may improve respiratory mechanics and oxygenation in morbidly obese pa-tients undergoing laparoscopic sleeve gastrectomy.

Objective: To investigate the epidemiological characteristics and the causes of two outbreaks of upper respiratory tract infection in our city. Methods: The epidemiological investigation was carried out on the outbreaks and the pharyngeal swabs were collected to do the pathophysiologic examination by using real-time PCR. Hexon gene of adenovirus was amplified by PCR. Then the positive products were sequenced and BLAST searching was done in GenBank. Results: The clinical symptoms of the two cases were high fever, sore throat and cough, etc, while the main signs were pharyngeal congestion and tonsil swelling; 32 students of a class in Yunxing primary school had respiratory infection related symptoms, of which the incidence rate was 55%; while 12 of 38 students in a class of Fangcun primary school were infected. All these students were on school in the same class, and the incidence was aggregate without proliferation. The duration of the disease was about 5 days and the prognosis was good, no death occurred. The positive result of real-time PCR showed adenovirus. BLAST search analysis on hexon gene showed AdV14. Conclusions According to epidemiological investigation and laboratory test results, the cause of these two outbreaks of upper respiratory tract infection was adenovirus type 14.

OBJECTIVETo investigate the influence of interferon-alpha on the variation of cytotoxic T lymphocytes (Tc) and suppressor T lymphocytes (Ts) in the peripheral blood of 32 patients with chronic hepatitis B, and to analyse the relationship between the efficacy of interferon-alpha and the variation of Tc and Ts cells.

METHODSThe peripheral blood Tc and Ts cells were detected by the double-staining immunocytochemistry technique.

RESULTSAt the end of the treatment with interferon-alpha, there were 9 complete responders (CR), 12 partial responders (PR) and 11 non-responders (NR). Tc cells significantly increased and Ts cells markedly decreased in CR or PR group compared with the healthy control group. There was no significant difference in the level of Tc and Ts cells between CR and PR groups, and no significant difference in the level of Tc cells in NR, CR and PR groups, The Ts cells was significantly higher in NR group than in CR or PR group.

CONCLUSIONSThe treatment of interferon-alpha can result in the change of Tc and Ts cells in patients with chronic hepatitis B. The variation of Ts cells may play an important role in the efficacy of interferon-alpha against hepatitis B virus.

Adult ; Antiviral Agents ; therapeutic use ; Female ; Hepatitis B, Chronic ; blood ; drug therapy ; Humans ; Interferon-alpha ; therapeutic use ; Lymphocyte Count ; Male ; Middle Aged ; T-Lymphocytes, Cytotoxic ; cytology ; drug effects ; T-Lymphocytes, Regulatory ; cytology ; drug effects ; Time Factors ; Treatment Outcome

Chronic hepatitis B virus (HBV) infection will greatly contribute to raising the occurrence probability of cirrhosis and hepatocellular carcinoma in patients. Although existing antiviral treatment regimens have a certain effect on delaying disease progression and improving prognosis, it is still not effective in attaining functional cures. Hepatitis B virus DNA integration may be one of the reasons for this phenomenon. Therefore, this paper reviews the possible mechanisms of HBV DNA integration in maintaining chronic inflammation of the liver, evading existing antiviral treatment methods, and inducing hepatocellular carcinoma so as to further deepen the understanding of the role of HBV DNA integration in the occurrence and development of chronic hepatitis B, providing ideas and references for formulating better treatment strategies.