Objective To investigate the character of peripheral blood T lymphocyte subset of tuberculosis patients with type 2 diabetes mellitusas providing evidence to support clinical care.Methods Use flow cytometry to analysis peripheral blood lymphocyte subsets of 41 patients with type 2 diabetes mellitus patients with pulmonary tuberculosis (DM + LTB group),and 60 cases of simple pulmonary tuberculosis (LTB group),and in healthy adults as a control group.The test results were analyzed statistically.Results Absolute lymphocyte subsets value of DM + LTB group and LTB group were significantly lower than the control group (P ＜ 0.05),CD3 + CD4 +/CD3 + CD8 + ratio of DM + LTB group was significantly higher than the LTB group (P ＜ 0.05).Conclusion Tuberculosis patients with type 2 diabetes show more severe T lymphocyte immune dysfunction.Nurses should improve the patient's immunity from strengthening health education,strengthen psychological care and diet care.

Objective: To analyze the distribution of HCV genotype in eastern Zhejiang Province and its correlation with sex, age, viral load, antiviral effect and so on. Methods: A total of 501 cases of HCV infection seen in Ningbo No. 2 hospital from January 2011 to April 2018 were included. The HCV genotypes and HCV RNA were detected by gene chip method and RT-PCR respectively. The liver function and blood routine tests were performed and the APRI index was calculated. The factors affecting the SVR were analyzed for the patients who were partially treated with pegylated interferon and ribavirin (PR). Results: The HCV genotypes of 501 cases were 1b、6、2a、3a、3b、1a from the higher to lower ranks, and genotype 1b was more than 50%.The distribution of HCV genotypes in different age groups was significantly different (χ²=95.433, P<0.001). The age of patients with 1a, 1b and 2 A was significantly higher than that of 3a, 3b, and type 6 (F=11.879, P<0.001). There were significant differences in viral load, AST, PLT and APRI index among different genotypes (F=2.920, χ²=12.400, F=6.294, χ²=12.700, all P<0.013), but ALT had little difference (χ²=7.994, P>0.157); 179 patients with PR standard regimen were followed up. The result showed that there was no significant difference in the overall efficacy of different genotypes (χ²=6.598, P=0.252), but the rate of sustained virological response in type 3 A was significantly higher than that of the 1b type (χ²=4.193, P=0.041). Conclusions The HCV genotypes are mainly 1b and 6 in eastern Zhejiang Province. There were significant differences in age, viral load, AST, PLT and APRI indices among patients with different HCV genotypes, and the therapeutic effect of PR regimen was better for genotype 1b than that of 3a.

Objective: To explore the effect of hepatitis C virus (HCV) on the expression of serine protease inhibitor Kazal1 (SPINK1) and its clinical implication. Methods: mRNA and protein expression of SPINK1 in Huh7.5.1 cells infected by HCV JFH-1 and the control cells were measured by RT-PCR and western blotting, SPINK1 levels in the cell supernatants and sera of HCV patients were measured by enzyme-linked immunosorbent assay (ELISA), the difference of SPINK1 levels between healthy controls and HCV patients was analyzed. Results: Expression of SPINK1 mRNA and protein was higher in Huh7.5.1 cells infected by HCV JFH-1 than in the control cells, serum SPINK1 levels was much higher in HCV patients than in healthy controls (P=0.016). Conclusions HCV can upregulate the expression of SPINK1.

Objective:To investigate the expression of alpha fetoprotein (AFP)-L3 in chronic liver disease and its diagnostic value for hepatocellular carcinoma.Methods:From October 2013 to March 2019, 341 patients with liver diseases in Huamei Hospital, University of Chinese Academy of Sciences were selected, including 88 cases of chronic hepatitis, 97 cases of cirrhosis, 145 cases of hepatocellular carcinoma (60 cases of initial onset, 39 cases of recurrence, 23 cases treated by transcatheter arterial chemoembolization, 23 cases treated by surgery and radiofrequency therapy) and 11 cases with acute-on-chronic liver failure. The difference of AFP and AFP-L3 (%) levels between different groups was compared. The diagnostic efficacy of AFP-L3 (%) for hepatocellular carcinoma was analyzed by using receiver operating curve (ROC).Results:There were significant differences in serum AFP-L3 (%) and AFP between patients with hepatitis, cirrhosis, acute-on-chronic liver failure and hepatocellular carcinoma (initial onset) (Hc=28.384, 9.913, P=0.001, 0.019). Post hoc multiple comparisons showed that the serum AFP-L3 (%) levels of patients with hepatocellular carcinoma (initial onset) were higher than those of patients with hepatitis and cirrhosis (all P<0.05). The level of serum AFP in patients with hepatocellular carcinoma (initial onset) was higher than that of patients with cirrhosis ( P<0.05), but there was no significant difference between patients with hepatocellular carcinoma (initial onset) and patients with acute-on-chronic liver failure for AFP-L3 (%) and AFP (all P>0.05). The levels of AFP-L3 (%) and AFP in patients with recurrence of hepatocellular carcinoma were significantly higher than those in patients undergoing hepatocellular carcinoma surgery and radiofrequency therapy ( P<0.05). Tumor size and TNM stage affected serum AFP level (all P<0.05), but etiology, tumor size and number, tumor thrombus, CTP score and TNM stage had little relationship with serum AFP-L3 (%) (all P>0.05). The diagnostic value of serum AFP-L3 (%) was better than that of AFP ( Z=2.637, P=0.008); the best cut-off value of AFP-L3 in the diagnosis of hepatocellular carcinoma was 6.10%, and the specificity and sensitivity were 76.63% and 61.29%, respectively. Conclusions:The diagnostic value of serum alpha-fetoprotein heterogeneity in hepatocellular carcinoma is better than that of AFP, which is less affected by pathological factors. In order to improve the diagnostic efficiency, we can establish reliable cut-off value by validating large samples in the laboratory.