Serological markers have the features of noninvasiveness and simple operation and thus have become a research hotspot in the diagnosis of hepatocellular carcinoma.This article briefly introduces the role of the conventional serological marker alpha-fetoprotein (AFP) in assisting the diagnosis and predicting the prognosis of HBV-related liver cancer, as well as the clinical value of new markers such as alpha-fetoprotein-L3 and abnormal prothrombin/des-γ-carboxy prothrombin.Based on literature review, the possibility of serum Golgi protein 73 used for laboratory auxiliary diagnosis of hepatocellular carcinoma has been denied.The results of the author′s experiment suggest that serum GP73 measurement can be used as a laboratory diagnostic index for progressive liver fibrosis and liver cirrhosis.

In recent years, great achievements have been made in the therapy of viral hepatitis B and viral hepatitis C, as majority of hepatitis C patients can be clinically cured.Though current antiviral therapy is still unable to eradicate hepatitis B virus in infected hepatocyte and few patients could achieve HBsAg loss or seroconversion, end-stage liver disease like cirrhosis, liver failure and hepatocellular carcinoma have been dramatically prevented.The advances in treatments have prompted the progress in laboratory diagnosis of viral hepatitis.Here we review the progress in the field.

In recent years,antiviral therapy for chronic hepatitis B infected patients has achieved great development along with the invention of nucleos (t) ide,nucleos (t) ide analogues,interferon α and pegylated interferon α.The development of antiviral medicine also proposes new demands for the clinical diagnosis and therefore promotes the development of laboratory diagnostic techniques in the detection of chronic hepatitis B.In this review,we focused on the clinical application in the quantitive detection of HBV DNA,and its significance on clinical evaluation,treatment options,follow-up and prognosis in antiviral therapy.

Objective To investigate the cause and countermeasures of frequent shocks in patients with implantable cardioverter defibrillators (ICD). Methods Eighty ICD patients with heart failure and malignant ventricular arrhythmias were followed up, including sixty-two male and eighteen female patients. There were 35 patients with single-chamber ICD, 23 with dual-chamber ICD and 22 with three-chamber ICD. Patients in this study were followed up for 1-6 years to analyze the reasons for ICD discharge. According to the specific circumstances, patients were treated. Results Twenty-three pa-tients in 80 patients suffered from shock treatment. Ten patients (12.5%) experienced frequent shocks. The causes of fre-quent shock included repeated episodes of ventricular tachycardia, invalid shock due to increased defibrillation threshold (DF) and false identification of the frequent episodes of paroxysmal ventricular tachycardia or arrhythmias. The management included the identification process adjustment of ventricular tachycardia and supraventricular tachycardia, increased num-bers of beats of ventricular tachycardia judgment and increase the basic pacing rate. The anti-arrhythmic drugs should be combinedly used, especially metoprolol and amiodarone. The ICD shock was significantly reduced after parameter optimiza-tion and anti-arrhythmic therapy. Conclusion The ICD shocks were effectively reduced with rational use of anti-arrhyth-mic drugs and valid ICD programming.

BACKGROUND:Many studies have demonstrated that FirebirdTM and Taxus Express2TM can effectively reduce intrastent restenosis.However,there are few data about long-term efficacy of two stents,and reports about middle and long-term follow up are rare.OBJECTIVE:To observe the safety and biocompatibility of FirebirdTM and Taxus Express2TM in percutaneous coronary intervention(PCI) for coronary artery disease.DESIGN,TIME AND SETTING:Non-randomized concurrent control clinical observation was performed at Department of Cardiology,Hongqi Hospital of Mudanjiang Medical College from April 2005 to April 2008.PARTICIPANTS:233 patients(268 lesions) undergoing PCI were divided into FirebirdTM(n =82),Taxus Express2TM group(n =80) and bare metal stent group(n =71).METHODS:Coronary arteriography was performed through femoral artery or radial artery.Vascular inner diameter was determined using quantitative computer analysis.The patients underwent FirebirdTM,Taxus Express2TM and bare metal stenting,respectively.The patients were reexamined and followed-up using telephone every 2-4 weeks after discharging and examined using coronary arteriongraphy after 9-12 months.The follow-up lasted for 24 months.MAIN OUTCOME MEASURES:Characteristics of arteriongraphy and stenting condition of all patients;biocompatibility of stent to host;major adverse cardiac events during hospitalization and follow-up,including death,angina pectoris attacks or heart failure;coronary artery diameter decreased ≥ 50% was regarded as restenosis.RESULTS:101 stents were implanted in Firebird group,98 in Taxus Express2 group and 85 in bare metal stent group.There was no stent defluxion,dislocation,or breakage.No noticeable platelet decrease,hemolysis or white blood cell increase was found.There were no significant differences among three groups in terms of Characteristics of arteriongraphy and stenting condition.The incidence of major adverse cardiac events and intravascular restenosis in Firebird and Taxus Express2 groups was fewer than bare metal stent group(P 0.05).CONCLUSION:No specific biocompatibility responses in treatment of coronary artery diseases using FirebirdTM and Taxus Express2TM.The two drug-eluting stents are superior over bare metal stent in reducing restenosis.The safety and efficacy of two drug-eluting stents are similar.

Objective To explore the cell frequency , phenotypes and in vitro cytotoxic effects of circulating CD56+T cells in the patients with chronic HCV infection .Methods Peripheral blood mononu-clear cells (PBMCs) were isolated from 33 patients with HCV chronic infection and 21 healthy subjects. Multi-color flow cytometry was used to analyze cell frequency , expressions of activating receptors ( NKG2C, CD16 and NKp46) and inhibitory receptors (NKG2A and CD158a) on CD56+T cells.The functional mark-er for cytotoxic effects (CD107a) on circulating CD56+T cells and their cytokines expression (IFN-γand TNF-α) with or without stimulation of K 562 human Leukemia cell line were also analyzed .Then the correla-tions among the expressing levels of CD 107 a, IFN-γand TNF-αwere investigated .Results The frequency of CD56+T cells in periphery lymphocytes were significantly decreased in the patients with chronic HCV in -fection as compared with that in healthy controls ( P=0.018 ).The expressions of activating receptors (NKG2C, CD16 and NKp46) on CD56+T cells from HCV infected patients were decreased (P=0.015 for NKG2C, P=0.036 for CD16 and P=0.001 for NKp46), while there was no significant change in the ex-pressions of inhibitory receptors (P>0.05 for both CD158a and NKG2A).The concentrations of IFN-γand TNF-αsecreted by CD56+T cells in the patients with chronic HCV infection were significantly decreased with or without K562 stimulation (P<0.0001).However, in the presence of K562 cells CD107a expression on CD56+T cells were sharply decreased in the patients (P<0.0001).In absence of K562 cells, there was no significant change in CD107a expression on CD56+T cells from patients and healthy controls (P>0.05). The expressions of CD107a, IFN-γand TNF-αwere closely related under the stimulation of K562(r>0.80, P<0.0001).Conclusion The frequency of CD56+T cells was reduced in patients with chronic HCV infec-tion.Moreover, cytotoxic effects and cytokines production mediated by CD 56+T cells were also significantly impaired, indicating that the dysfunction of circulating CD 56+T cells might be associated with the persist-ence of chronic HCV infection .

Objective To comparatively analyze serum levels of zinc , iron, magnesium, calcium, copper and phosphorus and their relationships with serum albumin and circulating HCV viral load in patients with chronic HCV infection , subjects with spontaneously resolved HCV infection and healthy subjects . Methods Serum levels of the six trace elements in patients with chronic HCV infection (n=59), subjects with spontaneously resolved HCV infection (n=65) and healthy subjects (n=48) were measured by a flame atomic absorption spectrophotometer and then a comparative analysis was performed to analyze the differences among the three groups .The relationships of the six trace elements with serum albumin and HCV viral load were analyzed among patients with chronic HCV infection .Results Compared with healthy subjects , the levels of serum zinc were significantly decreased , but serum levels of iron , copper , phosphorus were signifi-cantly increased in patients with chronic HCV infection .There was a significant positive correlation between the levels of zinc(r=0.4022, P=0.0016)and albumin in patients with chronic HCV infection with ALT no less than 40 IU/L, whereas negative correlations were presented between trace elements of iron ( r=-0.3001, P=0.0209), copper (r=-0.3856, P=0.0036), phosphorus (r=-0.3600, P=0.0075) and serum albumin.The circulating HCV viral load was negatively correlated with serum zinc (r=-0.4367, P=0.0005), but positively correlated with serum copper (r=0.3328, P=0.0139).The serum levels of six trace elements showed no significant differences between healthy subjects and spontaneous resolvers of HCV infection.Moreover, no significant differences of serum calcium and magnesium were found among the three groups.Conclusion Chronic HCV infection can induce abnormal serum levels of zinc , iron, copper and phosphorus and the abnormal serum levels of trace elements were closely related with liver function and HCV viral load.With the spontaneous clearance of HCV infection , the serum levels of trace elements could restore to normal .

Objective To investigate the effects of dexmedetomidine (DEX) on the mRNA expression of triggering receptor expressed on myeloid cells 1 (TREM-1) in peripheral blood mononuclear cells of rats with acute obstructive suppurative cholangitis (AOSC).Methods Sixty healthy male Wistar rat models of AOSC induced by complete common bile duct ligation and injection of E.coli into the bile duct through an intubation tube were replicated successfully.After modeling,the peripheral blood was collected and mononuclear cells were isolated and cultured.According to random number table method,the mononeuclear cells were divided into model group (no drug added in culture of mononuclear cells) and low,medium and high dose DEX groups (final concentrations 0.4,0.8,1.2 μg/L DEX were in low,medium and high DEX mononuclear cell cultures,respectively).After the mononuclear cells were cultured for 24 hours,the levels of tumor necrosis factor-α (TNF-α),interleukins (IL-1 and IL-6) in the supernatant of the cultured mononuclear cells were detected by enzyme linked immunosorbent assay (ELISA).The level of C-reactive protein (CRP) was detected by immunity transmission turbidimetry.The expression of TREM-1 mRNA in the mononuclear cells was detected by reverse trantscription-polymerase chain reaction (RT-PCR).Results Compared with the model group,the levels of TNF-α,IL-1,IL-6,CRP were decreased,the TREM-1 mRNA expressions were down-regulated in the different DEX dose groups,and the degrees of descent in medium and high dose groups were more significant than those in low dose group [TNF-oα (ng/L):95.5±8.6,88.9±5.3 vs.131.1 ± 14.2;IL-1 (ng/L):53.5±8.3,48.3 ± 6.7 vs.73.7 ± 12.8;IL-6 (ng/L):266.9±26.2,252.1 ± 17.7 vs.349.9±40.4;CRP (ng/L):4.3 ± 1.1,3.9 ±0.7 vs.5.6 ± 1.7;TREM-1 mRNA (A value):0.43 ± 0.18,0.39 ± 0.16 vs.0.65 ±0.25,all P ＜ 0.05].Conclusion DEX can down-regulate the expression of TREM-1 mRNA and inhibit the formation and secretion of inflammatory factors TNF-α,IL-1,IL-6 and CRP in peripheral blood mononuclear cells of rats with ASOC.

Objective To compare cellular immune responses in mice elicited by Chinese different AIDS candidate vaccines.Methods According to their different immunization procedures,BALB/c mice were immunized with 6 AIDS candidate vaccines,separately.Spleen cells were isolated for the detection of cellular immune response to HIV-specific peptides using enzyme-linked immunosorbent spot(ELISPOT)assay and intracellular cytokine staining(ICS)method.Results AIDS vaccines were evaluated by using potential T-cell epitopes(PTE)Gag,Env and Pol peptides pool and ELISPOT.The positive conversion rates for cellular immune response of 1#-6# vaccines fluctuated from 70% to 100%.The vaccine-induced cellular immune responses to specific peptides pool are different not only in magnitude but also in breadth.The Th1type cytokines,IFN-γand IL-2,were detected with ELISPOT in 1# and 2# vaccines.The productions of IFN-γand IL-2 induced by both of the two vaccines showed a moderate correlation(r1 =0.62,P1 ＜0.01 ;r2=0.79,P2 ＜ 0.01).The positive conversion rate of IFN-γ secreting cells of 1 # vaccine was 66.7%(10/15)mice detected with both ELISPOT and ICS.And the results tested by ELISPOT and ICS showed moderate correlation(r = 0.55,P ＜ 0.05).Conclusion The magnitude and breadth of cellular immune responses induced by different AIDS candidate vaccines are different.Being induced by different AIDS candidate vaccines,the IFN-γand other Th1 type cytokines detected by ELISPOT or ICS could be used to evaluate the cellular immune responses in mice.

Objective To evaluate the quality of domestic hepatitis C diagnostic reagents objectively,and to build up the quality control systems for assessment of hepatitis Cdiagnostic reagents.Methods4080 serum samples from blood donors were collected and detected with EIA kits.146anti-HCV positive and negative samples were selected and tested repeatedly by two different imported ( Murex and Ortho) and domestic anti-HCV EIA kits(InTec,ZHONGSHAN BIO-TECH,WANTAI and KHB),then confirmed by CHIRON RIBA HCV 3.0 and PCR qualitative reagents.The samples were tested by nucleic acid quantitative assay and the RNA positive samples were detected by genotyping reagents.ResultsThe quality control systems of diagnostic reagents of anti-HCV and HCV RNA were constructed.Each quality control system was consisted of 50 samples,including 20 anti-HCV/HCV RNA positive,20 anti-HCV/HCV RNA negative and 10 diluted specimens for sensitivity evaluation.The positive samples with dominant HCV genotypes in China contained strong,moderate and weak positive samples.The negative samples involved those S/CO value ( signal-to-cutoff ratios ) close to threshold.Conclusion The quality control systems established in this study are suitable for assessment of the new and improved domestic hepatitis C diagnostic reagents.