Chronic hepatitis B is a world-wide health problem and now at least 250 million people have been infected with hepatitis B virus. Current treatment of hepatitis B rarely achieves a cure because the viral replication template which called covalently closed circular DNA (cccDNA) are resistant to conventional therapies. The phenotype and function of natural killer cells from chronic hepatitis B patients are different to those from acute hepatitis B patients, suggesting that the function of NK cells may be related to clearance of HBV. Some studies have suggested that the differentiation, development and activation of natural killer cells are controlled by the mammalian target of rapamycin. The present review will mainly focus on the biology of hepatitis B virus, the differentiation and development of natural killer cells, and the progress of metabolism of natural killer cells.

Calmodulin(CaM),as major intracellular Ca 2+ signal transductor,is a ubiquitous, multifunctional protein in eukaryotic cells,invovled in a wide variety of cellular processes . Study of the structure and molecular recognition mechanism of CaM helps better understanding intracellular Ca 2+ signaling system and molecular recognition of protein-protein interaction,giving new insight into medicine development and clinical therapy. This paper reviews progress in the studies of molecular recognition of calmodulin in recent past years.

Objective To explore the guidance value of cerebrospinal fluid(CSF)and serum procalcitonin(PCT)in the ventricular catheter indwelling time of intracranial pressure monitoring(ICP).Methods Fifty-eight cases patients with moderate and severe craniocerebral trauma who were given ICP ventricular catheter and external ventricular drainage(EVD)were selected,5 ml CSF and 2 ml venous blood were collected at operation,1st,7th,14th d after operation.The change of CSF and serum PCT and WBC levels were compared among different time,the correlation among each indicators and diagnosis value for intracranial infection were analyzed.Results The level of CSF and serum PCT and WBC increased with the lengthen of ventricular catheter indwelling time(CSF PCT:(0.09±0.02)μg/L of operation,(1.17±0.25)μg/L of 14 d after the operation;CSF WBC:(24.33±12.75)×106/L of operation,(431.52±140.26)×106/L of 14 d after the operation;serum PCT:(0.16±0.05)μg/L of operation,(4.57±1.41)μg/L of 14 d after the operation;serum WBC:(4.14±0.46)×106/L of operation,(14.24±3.05)×106/L of 14 d after the operation;P＜0.05).The CSF PCT was positively correlated with CSF WBC and serum PCT(r=0.614,0.711,P＜0.05).The diagnostic sensitivity of CSF and serum PCT for prognosis of intracranial infection were 95.2％,81.0％,the specificity were 94.6％,78.4％,the specificity of CSF PCT was significantly higher than that of serum PCT(P=0.041).Conclusion CSF and serum PCT has high early diagnosis value for intracranial infection in patients with ICP ventricular catheter,which can contribute to guide the reasonable timing of tube drawing,brings out the best of ICP and cerebrospinal fluid drainage,improve the level of treatment in patients with traumatic brain injury.

Objective: To analyse the level of glucose concentration in saliva and to study the relationship between the level of blood glucose and that of salivary glucose.Methods: Blood glucose level and the glucose concentration in unstimulated mixed saliva taken from testee were measured with Beckman SYNCHRON CX7 System in 60 patients with diabetes mellitus and 60 healthy subjects. Results: The average value of salivary glucose concentration in experimental group was (1.950?0.179) mmol/L, that in control group was (0.953?0.124) mmol/L(P

Objective To discuss the role of interleukin (IL)-12 in capillary bronchiolitis disease.Methods Fifty-nine cases of capillary bronchiolitis children under 2 years old were enrolled as the bronchiolitis group Ⅰ(n =28) and bronchiolitis group Ⅱ(n =31),36 cases of children with bronchopneumonia of the same age and 31 cases of children suffered from non-infectious diseases such as hernia and renal calculus of the same age were enrolled as bronchopneumonia control group and normal control group respectively.The peripheral blood IL-12 levels of four groups were detected by enzyme-linked immunosorbent assay.Results The levels of the peripheral blood IL-12 in bronchiolitis group Ⅰ,bronchiolitis group Ⅱ,bronchopneumonia control group and normal control group were (34.72±7.96) pg/ml,(55.30 ±6.72) pg/ml,(56.79±10.36) pg/ml and (61.23 ± 11.51) pg/ml respectively.The level of the peripheral blood IL-12 in bronchiolitis group I was significantly lower than that in bronchiolitis group Ⅱ,bronchopneumonia control group and normal control group respectively (P ＜0.05),and the level of the peripheral blood IL-12 in bronchiolitis group ⅡⅡ was significantly lower than that in bronchopneumonia control group and normal control group respectively (P ＜ 0.05),but there was no significant difference between bronchopneumonia control group and normal control group (P ＞ 0.05).Conclusion The level of IL-12 is one of the important factors for bronchiolitis disease,the reducing of serum level of IL-12 in children who have a high risk factor of capillary bronchiolitis is more obvious.

Objective To compare the efficacy of sequential therapy combined with probiotics,pure sequen-tial therapy and standard triple therapy for Helicobacter pylori eradication.Methods Selected the clinical data of 240 patients admitted.The 240 patients were randomly divided into 3 groups.Group A received standard triple thera-py,group B received sequential therapy and Group C received sequential therapy in combination with probiotics. Then,we compared the eradication rate,the score of gastrointestinal tract symptoms before and after treatment,and the side effects among 3 groups.Results The eradication rate was 72.5% in groupA,87.5% in group B,and 96.3% in group C.The eradication rate of group C was significantly better than group A and group B (χ2 =18.531,P <0.001).There was no difference in the score of gastrointestinal tract symptoms before treatment(F =0.206,P >0.05),but they all significantly decreased after treatment among 3 groups(P <0.05),with group C a better result(F =25.581,P <0.05).The side effects of 3 groups were 16.3%,13.8%,3.8%,respectively.There were a significantly differencec between group C and the other 2 groups(χ2 =7.011,P =0.030).Conclusion Sequential therapy in combination with probiotics can achieve a higher eradication rate,improve the score of gastrointestinal tract symptoms, and decrease side effects.

Objective To explore the changes of serum interleukin-6 (IL-6),and interleukin-8 (IL-8) in patients with gastric cancers and the clinical relationships with Helicobacter pylori (Hp) infection.Methods Totally 62 cases of patients who were diagnosed gastric cancer in our hospital from January 2013 to September 2015 were selected as the study group,who did not accept anti-tumor therapy.The patients were divided into the Hp positive group (with 53 cases) and Hp negative group (with 9 cases) according to whether the merger of Hp infection.Another 60 normal healthy volunteers of the same age in our hospital for health examination during the same period were selected as the control group.The serum IL-6 and IL-8 levels were detected,and the changes of the factors in the study group and control group were compared and analyzed,as well as the U values of Hp infection.The clinical relationships between the expression levels of the two in patients with gastric cancer and the U values of Hp infection were confirmed.Results The serum IL-6 and IL-8 levels and the U values of Hp infection of the study group were significantly higher than those of the control group (P ＜ 0.05),which in the Hp positive group were significantly higher than those in the Hp negative group (P ＜ 0.05).The levels of serum IL-6 and IL-8 in patients with gastric cancer showed positive correlations with the U value of Hp infection (r =0.457,0.531,P ＜ 0.05).Conclusions The serum IL-6 and IL-8 levels in patients with gastric cancer are much higher than those in normal healthy people,and there are significant positive relationship with Hp infection.It can improve the curative effect of gastric cancer patients by improving the eradication rate of Hp.

Objective:To study the boiling water brewing extraction of astragalus polysaccharides in order to solve the problems of long cycle , high energy consumption and poor clarity in the traditional extraction , and lay foundation for the industrial production . Methods:Using the extraction yield of astragalus polysaccharide as the evaluation index and phenol -sulfuric acid method applied to de-termine the content of astragalus polysaccharide , the boiling water brewing extraction was used for astragalus polysaccharides .The effects of brewing time , boiling water amount and brewing times on the polysaccharide content were studied by single factor experi -ments, and then an orthogonal design method was used to screen the optimum technology parameters .The traditional water decoction extraction process was employed as the control .Results:The optimum conditions of boiling water brewing were as follows:adding 9-fold amount of water and soaking 60 min for three times.The astragalus polysaccharides extraction yield (4.81) of the optimal technology was higher than that of the traditional water decoction extraction (4.06%).Conclusion:Boiling water brewing method used to extract astragalus is with high extraction yield , simple operation , short cycle and low energy consumption , the color of astragalus polysaccha-ride is light, and it is clear after dissovled in water , which is superior to the traditional water decoction extraction method , and provide a new method with broad application prospect for the preparation of astragalus related preparations .

Objective To study on the measurement of glycyl-proline dipeptidyl aminopeptidase (GPDA) in urine and its clinical application. Methods GPDA in urine was measured by continuously monitoring method using substrate. The assay conditions and interference factors were investigated. GPDA activities in urine specimens from 334 healthy persons, 55 diabetes mellitus patients and 36 hypertension patients were measured. The differences between the kidney injured and non-kidney injured groups were analyzed. Results The linearity of the method was up to 350 U/L. The intra CV and inter CV were 1.27% and 1.33% respectively. The GPDA activity in urine specimen was stable for 7 days at 4℃. There was no interference of bilirubin, glucose, vitamins, dimethylbiguanide and gliben-clamide. No significant interference was found by hemoglobin less than 500 mg/L. GPDA level in urine specimens of 334 healthy persons were (12.9?4.2) U/g?Cr. The GPDA levels of diabetes mellitus and hypertension groups combined with kidney injured were obviously higher than that of the control group and the non-kidney injured group ( P

Objective:To explore the validity of the effective arterial elastance (Ea) before and after fluid challenge in evaluating the fluid challenge in septic shock patients.Methods:A retrospective study was conducted in the medical intensive care unit (MICU) of Peking Union Medical College Hospital from October 2016 to October 2020. 116 septic shock patients were enrolled. All patients received fluid challenge by 500 mL Gelatin or normal saline under invasive hemodynamic monitoring. Heart rate (HR), mean arterial pressure (MAP), cardiac output (CO) and other hemodynamic variables were collected at 10 minutes before and immediately after fluid challenge. An increase in CO greater than 10% after fluid challenge was defined as the positive preload responsiveness, as well as the definition of positive pressure responsiveness was an increase in MAP greater than 10%. Receiver operating characteristic curves (ROC curves) were established to evaluate the predictive abilities of baseline Ea and other arterial load indices in detecting the preload responders and pressure responders. The correlation of the baseline Ea with CO changes after fluid challenge as well as MAP changes were tested by Pearson correlation analysis. Patients with positive preload responsiveness were divided into two groups according to the pressure responsiveness. The changes in Ea and other arterial load indices were analyzed.Results:A total of 116 patients were finally analyzed. Sixty-three patients were preload responders and 53 patients were preload non-responders. There was no significant difference in demographics and baseline physical variables between the two groups. Ea in preload responders was higher than that in preload non-responders (mmHg/mL: 2.51±1.08 vs. 1.87±0.68, P < 0.01). ROC curve analysis showed that the baseline Ea could predict the preload responsiveness at an area under ROC curve (AUC) = 0.71 [95% confidence interval (95% CI) was 0.62-0.81, P < 0.001]. The cut-off value was 1.97 mmHg/mL with a sensitivity of 71.4% and a specificity of 60.4%. The baseline Ea did not present the predictive ability to detect the pressure responders and pressure non-responders (AUC = 0.52, 95% CI was 0.41-0.63, P = 0.73). Pearson correlation analysis showed that the changes in CO after fluid challenge was moderately correlated to the baseline Ea ( r = 0.47, P < 0.001), meanwhile a weak positive correlation between the changes in MAP and baseline Ea was found ( r = 0.20, P = 0.03). In preload responders, 27 (42.9%) of 63 patients were pressure responders and 36 (57.1%) patients were pressure non-responders. No statistical difference was found in the baseline Ea or other arterial load indices between the two groups. Fluid challenge decreased Ea both in pressure non-responders and pressure responders (mmHg/mL: 2.13±0.94 vs. 2.51±1.08, P < 0.01; 2.47±1.18 vs. 2.69±1.30, P < 0.05). Moreover, the changes in CO and changes in MAP were strongly correlated with the changes in Ea ( r values were -0.50 and 0.58, respectively, both P < 0.001). Conclusions:The Ea > 1.97 mmHg/mL before fluid challenge could predict fluid responsiveness in septic shock patients. The baseline Ea was not able to predict the subsequent changes in arterial pressure through fluid challenge. A significant decrease in Ea inducing by fluid administration explained why patients increased their CO without improving blood pressure.