Objective Toinvestigatetheclinicalfeaturesofrecurrentbiliarypancreatitisandrelatedpredisposingfactors.Methods Ato-tal of 272 patients with biliary pancreatitis who were admitted and treated in Jiangbei District People′s Hospital from January 2008 to Decem-ber 2014 were enrolled and divided into recurrence group (56 patients with recurrent biliary pancreatitis)and primary group (216 patients with primary biliary pancreatitis).Clinical features and predisposing factors were compared between the two groups.Comparison of continu-ousdatabetweenthetwogroupswasmadebyttestandcomparisonofcategoricaldatewasmadebychi-squaretest.Results Therewere no significant differences in age and mortality between the two groups (both P>0.05 ).Compared with the primary group,the recurrence group had a significantly higher proportion of males,a significantly increased APACHE-Ⅱscore,significantly increased incidence rates of moderate-to-severe pancreatitis and common bile duct stones,significantly higher rates of stenosis of the common bile duct orifice and hy-perlipidemia,and a significantly higher rate of surgical treatment (all P<0.05).In the recurrence group,the type of pancreatitis differed significantly between patients with 2 times of recurrence and those with >2 times of recurrence (recurrence for more than 2 times)(P=0.040).Compared with the primary group,the recurrence group had a significantly higher proportion of patients with known predisposing factors (80.36%vs 58.33%,P=0.002),as well as significantly higher rates of high-fat diet and drinking (both P<0.05).However, the rates of biliary tract infection and oral administration of drugs showed no significant differences between the two groups (both P>0.05). Conclusion Recurrentbiliarypancreatitisiscommonandsevereinmales,andisoftencomplicatedbycommonbileductstones,stenosisof the common bile duct orifice,and hyperlipidemia,with a high rate of surgical treatment.High-fat diet and drinking are important predispo-sing factors for recurrent biliary pancreatitis.

Post-hepatitis cirrhosis (PHC),which results from either hepatitis B virus (HBV) or hepatitis C virus (HCV) infection,and its associated with hemodynamic changes may cause the spleen to become functionally hyperactive-a condition known as hypersplenism.Hypersplenism is associated with anemia,leukopenia,thrombocytopenia and splenomegaly.There are several effective methods to treat hypersplenism with the development of medical technology and the main purpose is the remission of hypersplenism,reducing the portal hypertension and decreasing the risk of hemorrhage.However,complete splenectomy or partial treatment of the hyperactive spleen is still controversial all over the world.This may be caused by the lack of the knowledge on the pathophysiological characteristics and clinical significance of treating hypersplenism.This review is a comprehensive discussion on the recent research which investigates hypersplenism caused by PHC.

mTOR signaling pathway is closely related to cell proliferation,cell cycle and other pathological processes about tumor.Rapamycin plays an anti-tumor effect through inhibiting mTOR,but it prone to drug resistance,which leads to limited clinical application.Its resistant mechanism is related with the activation of PI3K-Akt,which is regulated with negative feedback.Dual inhibitors of related proteins of mTOR pathway are expected to reverse the drug resistance.

Aim To investigate the immunoregulative action of polysacchrides of Spirulina platensis ( PSP ) on peripheral blood mononuclear cells ( PBMCs) in pa-tients with chronic hepatitis B virus infection. Meth-ods Proliferation and cycle of PBMCs from patients with chronic hepatitis B virus infection were measured by MTT colorimetry and flow cytometry respectively. The concentration of IFN-γ, IL-2 , IL-4 in supernatants of PBMCs were examined by ELISA. The mRNA ex-pression of IFN-γin PBMCs from patients with chronic hepatitis B virus infection was detected by RT-PCR. Results PSP could induce proliferation of PBMCs in patients with chronic hepatitis B virus infection. In ad-dition, PSP could increase the protein expression of IFN-γ and IL-2 in supernatants of PBMCs in patients with chronic hepatitis B virus infection, and PSP could also enhance the mRNA expression of IFN-γof PBMCs in patients with chronic hepatitis B virus infection. However, PSP inhibited the protein expression of IL-4 of PBMCs in patients with chronic hepatitis B virus in-fection. Conclusion PSP can promote the immune function and plays an important immunoregulation function on patients with chronic hepatitis B virus in-fection.

The risk factors of diastolic heart failure include among others: hypertension,diabetes,myocardial ischemia and aging.The underlying mechanisms for this cardiac complication are incompletely understood.With the increase of aging of the population,the prevalence and mortality of diastolic heart failure is rising gradually.It seriously affects the life quality and life span of people.In order to more truly reveal the underlying mechanisms of diastolic heart failure and to develope novel therapeutic strategies,the experimental animal models are extremely important.The present review focuses on providing an overview of the characteristics of these models for the growing number of investigators who seek to understand the pathology of diastolic heart failure.

Objective To investigate the changes of plasma microRNA-223 (miR-223) in pediatric severe pneumonia patients and its relationship with severe pneumonia.Methods There were 50 children with severe pneumonia enrolled in the study (observation group),and 50 healthy children were selected as control group (normal control group).The expression levels of plasma miR-223 were detected by real time polymerase chain reaction.The relationship between miR-223 and procalcitonin (PCT),C-reactive protein (CRP),tumor necrosis factor-α (TNF)-α,and interleukin (IL)-10 were analyzed.The predictive value of miR-223 in plasma,PCT,and CRP to severe pneumonia was evaluated by receiver operating characteristic (ROC) curve.The relationship between miR-223,T cells,TNF-α,and IL-10 was analyzed.Results The plasma miR-223 expression levels in observation group were upregulated compared to those in the normal control group [(16.01 ± 5.17) × 10-4 mg/L vs (5.44 ± 2.21) × 10-4 mg/L,t =7.46,P ＜ 0.01].The CRP and PCT expression levels in severe pneumonia patients were higher than those of the normal control group [z =5.496,5.198,P ＜0.05,orP ＜0.01].The expressions of CD4+ CD25+Treg,miR-223,and IL-10 in observation group were higher than those of normal control group (P ＜0.05).The expression of CD4 + CD25 + Treg,miR-223,and IL-10 in the death children were higher.There was a positive correlation between miR-223 and IL-10 (r =0.335,0.571,P ＜ 0.01).The sensitivity and specific degrees to predict the severe pneumonia in mir-223,PCT,and CRP were 83.79％,86.12％,66.68％,91.05％,78.01％,and 44.23％,respectively.miR-223 was better than PCT and CRP to predict severe pneumonia in children.Conclusions The expression levels of plasma miR-223 in children with severe pneumonia could reflect the immunity,and it can be used as early prognostic markers to reflect the severity of inflammation in some degree.

Objective To investigate the role and action mechanism of chemokine (C-X-C motif)receptor 3 (CXCR3)in hepatic ische-mia-reperfusion injury (IRI).Methods Forty-eight mice were divided into operation group and sham-operation group.The operation group was treated to establish a mouse model of IRI.Liver tissues were obtained at 3,6,12,and 24 h after IRI,with 6 mice at each time point.The expression of chemokine (C-X-C motif)ligand 9-1 1 (CXCL9-1 1 )and their receptor CXCR3 were measured by real-time PCR and Western blot.The effect of CXCR3 was blocked by its specific antagonist C6.Hepatic injury was estimated based on the activity of hepatic transaminase and morphological indices.The distribution of subsets of infiltrating T cells was analyzed by flow cytometry.All data were expressed as mean ±standard deviation.Comparison between groups was made by one-way analysis of variance.Results Compared with the sham-operation group,the operation group had significantly upregulated expression of CXCL9-1 1 and CXCR3 at all time points after IRI (P<0.05).Blocking CXCR3 significantly protected liver function and morphology (P<0.05).Antagonist C6 significantly re-duced Th1 cell infiltration (P<0.01),but significantly increased Treg infiltration (P<0.01).Conclusion CXCR3 is an ideal therapeu-tic target in IRI treatment due to its relationship with immunoregulation.

OBJECTIVE:To provide reference for reasonable iron supplement during pregnancy. METHODS:5023 iron sup-plement prescriptions for 800 delivery women receiving antenatal care and childbearing in our hospital in 2014 were analyzed retro-spectively. According to international authoritative guideline for gestational iron supplement,the rationality of iron supplement for pregnant women in our hospital was investigated in terms of timing,duration and dosage. RESULTS:The iron supplement timing and duration of 800 pregnant women all met the criteria;among 5023 iron supplement prescriptions,62 prescriptions of preventive iron supplement and 3875 prescriptions of iron supplement for iron deficiency were up to the standard. CONCLUSIONS:The dos-age of gestational iron supplement are unreasonable in our hospital at a certain extent. It is necessary to strengthen clinical medica-tion management to guarantee safe and rational iron supplement in pregnant women.

Objective To test the reliability and validity of the Chinese version of Quality-of-Life Questionnaire for Mechanically Ventilated Patients (QOL-MV). Methods The English version of QOL-MV was revised and translated into Chinese version. The reliability and validity of the Chinese version of QOL-MV was tested in 120 mechanically ventilated patients. Results The Cronbachαcoefficient of the Chinese QOL-MV was 0.904. The item-level content validity index of Chinese QOL-MV were 0.86-1.00 and the scale-level content validity index of Chinese QOL-MV was 0.92. Two factors were extracted by factor analysis and the cumulated variance was 80.18%. The dimensional factor loading of each item was greater than 0.565. The correlation coefficient between the score of Chinese QOL-MV and the Euroqol Group′s 5-domain 3 Level Questionnaire (EQ-5D) and Richards Campbell Sleep Questionnaire (RCSQ) was 0.947 and 0.561 respectively (P<0.01). Conclusions The Chinese version of QOL-MV has been proved to be reliable and valid.It can be used to measure the quality-of-life for mechanically ventilated patients.

Objective To evaluate the effectiveness of multiple quantitative fluorescence PCR ( QF-PCR) as a rapid technique for prenatal diagnosis of common chromosome aneuploidies , in order to optimize the prenatal diagnosis and shorten the period of diagnosis.Methods Totally 731 amniotic fluid samples of pregnant subjects ,who were referred to the Women′s Hospital School of Medicine Zhejiang University during August 2013 and September 2015, were analyzed with conventional karyotype and the QF-PCR technique by short tandem repeat(STR) markers to detect chromosomes 13,18,21,X and Y aneuploidies.There were 558 samples detected by single blind method , 173 samples detected by double blind method.Results All of the 731 amniotic fluid samples were tested in this study by QF-PCR and the results were compared to the conventional cytogenetic analysis results of the same sample.Totally 558 samples with single blind method detected 5 trisomy 21, 2 trisomy 18, 1 trisomy 13, 1(45,X), 1(47,XXY), 1(47,XYY), 1(47,XXX) and 1(69,XXX), 173 samples with double blind method detected 1 trisomy 21 and 1 trisomy 18.The rapid QF-PCR assay was successful to detect all aneuploidies involving chromosomes 21, 18, 13, X and Y in prenatal diagnosis , which were verified by chromosome karyotype analysis.The results of QF-PCR method were compared with the results of chromosome karyotype analysis , the positive rate was 15/16, the negative rate was 100%(715/715).Non chimeric chromosome abnormality detection rate was 15/15.Conclusions The multiple QF-PCR was a reliable method of detecting common chromosome aneuploidies for rapid prenatal diagnosis.As an important supplement of karyotype analysis , it was of great significance to optimize and improve the prenatal diagnosis system , and might provide more appropriate diagnostic methods for pregnant women.