OBJECTIVE:To observe the short-term efficacy and ADR of tenofovir disoproxil fumarate(TDF)in the treatment of multi-drug resistant chronic hepatitis B(CHB). METHODS:32 patients with multi-drug resistant CHB were analyzed retrospec-tively,and HBV drug-resistant genes were detected before treatment;there were a number of points to resistance;they were gave TDF orally. The recovery rate of serum alanine aminotransferase(ALT),HBV-DNA conversion rate,lactic acid and renal function were observed before and after treatment. RESULTS:The recovery rate of ALT reached 100% at 3 months,and the conversion rate of HBV-DNA reached 96.88%. The lactic acid levels and renal dysfunction was not found during treatment. CONCLUSIONS:TDF take effect quickly on multi-drug resistant CHB,and no obvious ADR is found.

Picture of the tongue was observed in 44 cases of malignant hematopathy before and after transplantation of heniopoietic stem cells. Results showed that before transplantation, 28/ 44 cases were thin fur and after transplantation the picture of the tongue had obvious change, at the early stage 29/44 cases were thick and greasy fur, 14/44 cases were dark - purplish proper of tongue, and at the late stage of transplantation 15/ 44 cases were thick and greasy fur, and 14/44 cases were brown, grey or black fur. From the point of view of traditional Chinese medicine, this therapy has effect on the organism in the series of patients and has a certain directive significance for clinical treatment based on differentiation of symptoms and signs.

Objective To investigate the correlation between the expression of peripheral blood CD8 + T lymphocytes and the severity degree of hand,foot and mouth disease( HFMD)in children infected by enterovirus( EV)71 at different ages,and further to predict the role of the expression of CD8+ T lympho-cytes played in the occurrence of neurological complications infected by EV71. Methods A total of 138 pe-ripheral blood samples derived from the confirmed HFMD cases were collected in the department of infectious disease at Kunming Children′s Hospital between March and September in 2014,including 33 mild cases,45 severe cases,and 60 critical cases. Patient ages were 9 months to 5 years old. Flow cytometry was used to detect the expression of peripheral blood CD8 + T lymphocytes in all of above patients. Results Compared to the reference value of CD8 + T lymphocytes in normal healthy children at different age groups,the percentage of peripheral blood CD8 + T lymphocytes elevated or increased slightly in patients of all ages,except the obvi-ously increasing expression in the age group of ~2 years and decreasing expression in critical cases of the age group of ~5 years. The expression of peripheral blood CD8+ T lymphocytes significantly increased in mild and severe patients but slightly increased in critical patients of the age group of 9 to 15 months,gradually de-creased in the age group of ~2 years and slightly increased in mild and severe cases but decreased in critical patients of the age group of ~5 years. There were significant differences between the patients in mild condi-tion and in severe condition or critical condition respectively within the age group of ~2 years( P﹤0. 05 ), and there were no significant differences in other age groups between different severity of disease. Conclusion
There are correlations between the expression of CD8+ T cells and the severity of HFMD in patients at different ages. Especially,the patient′s condition developing into severe degree is associated with the rapid decreasing of CD8 + T cells in HFMD patients of the age group of ~2 years. CD8+T cells play an important role in antiviral immune response in HFMD patients of ~2 years old.

Objective To investigate the action mechanism of Qingjin Huatan Decoction on regulating COPD rats with mucus hypersecretion in airway. Methods Fifty 6-8 week old Wistar male rats were randomly divided into healthy group, model group, Qingjin Huatan Decoction group, clarithromycin group, 10 rats in each group. Except for healthy group, all the other groups were used the combination method of injecting LPS and smudging to establish COPD models. The last three groups were fed with normal saline, Qingjin Huatan Decoction, clarithromycin respectively for 30 days. On the 31st day of the experiment, the rats were put to death to take lung tissue. 6 rats from each group were chosen randomly, and the protein expressions of NE, EGFR and MUC5AC mRNA in lung tissue were detected by real-time fluorescent quantitative PCR. Results The expressions of NE, MUC5AC mRNA in lung tissue of COPD rats were higher than the healthy group. Compared with model group, the expressions of NE mRNA and MUC5AC mRNA in Qingjin Huatan Decoction group and clarithromycin group were markedly lower, while the expressions of NE, MUC5AC mRNA in Qingjin Huatan Decoction group were significantly lower than those in clarithromycin group. The expression of EGFR mRNA in Qingjin Huatan Decoction group was lower than that in model group. Conclusion Qingjin Huatan Decoction can inhibit mucus hypersecretion in airway through NE/EGFR/MUC5AC signal transduction pathway.

ObjectiveTo summarize the clinical features of ulcerative eolitis (UC) complicated by toxic megacolon for early diagnosis and proper treatment. MethodsSix cases of toxic megacolon in the patients suffered from UC in Peking Union Medical College Hospital from 1983 to 2010 were analyzed,and related literature was searched and reviewed.ResultsThe incidence of the toxic megacolon in the patients with UC in our center was 0.7％ (6/824),which was lower than those reported in the literature.There were always risk factors triggering the disease.The prognosis of the patients was poor,even after medical care and surgery intervention.Evaluation of the patients and making right timing to perform the surgery would improve the prognosis of the patients in foreign literature. ConclusionIt's crucial to make early diagnosis of the toxic megacolon in the patients suffered from UC. The right choice and timing to perform urgent surgery or selective surgery may improve their prognosis.

【Objective】To observe the therapeutic effect of Qi-strengthening and yin-nourishing,stasis-removing and regeneration-promoting therapy for clinical diabetic nephropathy(CDN)and to explore its mechanism.【Methods】Eighty CDN patients with Qi-yin deficiency and stasis blocking kidney collaterals were randomized into groups A and B at the proportion of 3∶1 by using random number table.Group B(n=20)was given routine western treatment involving decreasing blood glucose,blood pressure and blood lipid,taking good quality diet with low protein,regulating water-electrolyte disturbance and acid-base balance,and preventing and curing complicated infection.Group A(n=60)was treated with Qi-strengthening and yin-nourishing,stasis-removing and regeneration-promoting herbal medicine(mainly composed of Radix Astragali,Fructus Mori,Radix Scrophulariae,Radix Angelicae Sinensis,Radix Salviae Miltiorrhizae,Radix et Rhizoma Rhei,Stigma Maydis and Rhizoma Chuanxiong).After treatment,the therapeutic effect was compared in the two groups.Meanwhile,the changes of fasting blood glucose,renal kidney,24-hour urinary protein,blood rheology,blood lipid and fibrinogen(FIB),as well as plasma endothelin 1(ET-1),tumor necrosis factor ?(TNF-?)and interleukin 1(IL-1)were observed.【Results】Qi-strengthening and yin-nourishing,stasis-removing and regeneration-promoting herbal medicine relieved the symptoms and signs of the patients,decreased 24-hour urinary protein content,and improved the renal function parameters in renal compensatory and decompensatory stages.The herbal medicine could also decrease blood lipid and fasting blood glucose levels,improve blood rheology indexes,and decrease serum IL-1 and ET-1 levels(P

Objective: To determine the role of interleukin-10 (IL-10) secreted by peripheral blood mononuclear cells (PBMC) in the maintenance of hemodialysis in patients with immune deficiency and to evaluate thot if IL-10 can bea biocompatibility index of dialyzer. Methods: Twenty patients with end-stage renal disease were divided into maintenance hemodialysis group (MHD group) and non-hemodialysis group (NHD group). Patients in MHD group were dialyzed with cellulose (CA group) and polysulfone (PS group) dialyzers respectively. Ten healthy persons were as controls (CON group). The levels of IL-10 in supernatants of PBMC cultured with or without lipopolysaccharide (LPS) were measured by using ELISA method in all groups. Results: There was no spontanous IL-10 secretion in all groups. The level of IL-10 in all supernatants secreted by PBMC cultured with LPS increased significantly, and the increased levels of IL-10 in MHD and NHD patients were lower than that in controls. The PBMC stimulated by LPS secreted more IL-10 in patients dialyzed by PS with better biocompatibility than those of CA dialyzers with poor biocompatibility. Conclusion: Patients immune deficiency could be improved by using better biocompatible dialyzers more than poor ones, particularly in humoral immunity induced by urimia. The IL-10 could be a parameter in evaluating the biocompatibility of dialyzer.

Objective To investigate the cognition of basic doctors on essential drugs in Luo County. Methods The random sampling was used to investigate the basic doctors in Luoping County, and 200 copies questionnaire were distributed. Results The questionnaire response rate was 98%. The survey results indicated that the cognition on essential drugs among basic doctors was poor, but most basic doctors have positive attitudes and behaviors in essential drugs. Conclusion It is necessary to improve the awareness of essential drugs among basic doctors in Luo County.

Objective To prepare and characterize monoclonal antibody against a malaria vaccine candidate, PfCP-2.9 chimeric protein of Plasmodium falciparum. Methods BALB/c mice were immunized with PfCP-2.9,and the spleen cells were used for fusion with SP2/0 cells. The monoclonal antibodies were analyzed by ELISA,Western blotting as well as growth inhibition assay. Result A monoclonal antibody was obtained. It interacted with the PfCP-2.9 recombinant protein by ELISA and Western blotting. The interaction of the monoclonal antibody with the protein was reduction-sensitive,indicating that the antibody recognized a conformational epitope. Moreover,the antibody also recognized the cultured parasites of P.falciparum by indirect immunofluorescent antibody test(IFA). When tested by growth inhibition assay,the antibody significantly inhibited parasite growth in vitro of 56% inhibition rate at the antibody concentration of 0.3 mg/ml. Conclusion A monoclonal antibody against PfCP-2.9 malaria vaccine candidate has been obtained,which recognizes a conformational epitope of the protein and natural protein.

Objective To construct a programmed cell death ligand 1(PD-L1) co-expression network in lung squamous cell carcinoma,screen potential PD-L1 co-expression biomarkers,and try to find the genes and pathways participating in PD-L1-regulated tumor immune response.Methods The lung squamous cell carcinoma dataset extracted from TCGA was used to screen the co-expression genes of PD-L 1 at the whole-genome transcriptional level by Venny analysis,and the target genes were screened by multiple types of cluster and molecular network analysis to construct a PD-L1 co-expression network.Results A total of 126 genes moderately co-expressed with PD-L1 were retrieved,most of them are plasma membrane targeting genes participating in immune response.Three transcription factors (IRF2/NFKB1/IRF1) were involved in more than 30％ the regulation of the PD-L1 genes transcription.By screening the core molecules of co-expression of PD-L1 gene set and analyzing the connectivity of network node,6 network nodes genes with the highest connectivity were retrieved as follows:IFNG,JAK2,STAT1,CTLA4,CD80 and CCR5.Analysis of the relations of the different expression levels of these genes to the survival situation of patients with lung cancer revealed that CCR5 was a significant prognostic marker.Analysis of the PD-L1 expression and CCR5 gene spectrum data showed the Pearson correlation coefficient is 0.47(P＜0.05);GO-BP cluster analysis showed that the function of CCR5 mainly focused on immune regulation,T cell regulation and signal transduction,in accordance with the PD-L1 function of network regulation.Conclusions The main nodes of PD-L1 co-expressing gene set are immune-related molecules,among which IFNG/CCR5/NFKB1 play the most significant regulatory effects in the gene network.This finding lays a foundation for the research and immunotherapy for lung squamous cell carcinoma.