Objective To investigate impacts of chronic hepatitis B virus (HBV) co-infection on immune responses and clinical manifestations in acute infection of dengue virus type 1.Methods The serum levels of interferon (IFN)a,IFNβ,IFNγ,interleukin (IL)-10 and tumor necrosis factor (TNF)α of 310 dengue serotype 1 (DENV1)-infected patients were assessed by enzyme linked immunosorbent assay (ELISA),among which 8％ (25/310) were chronic HBV co-infection.Meanwhile,serum samples from 41 healthy adults and 47 chronic HBV infected subjects were recruited as controls.Comparisons among groups were done by one factor analysis of variance and correlation analysis of results was done by spearman rank correlation test.Results The serum level of IFN-α [(95.1 ± 279.3) pg/mL] was significantly higher than IFN-β[(2.8 ± 16.2) pg/mL] during acute dengue infection,while IFN-α level [(86.5±358.1) pg/mL] reduced in patients with HBV co-infection.The secretion kinetics of IFNα,IFNγ (pro-inflammatory cytokine) and IL-10 (anti-inflammatory cytokine)were analyzed.The medians of IFNα,IFNβ and IL-10 level were elevated to peak on day 2,day 3-4and day 6 after fever onset,respectively.Additionally,IFNα levels in patients with only dengue infection were negatively correlated with the platelet counts and serum alanine aminotransferase levels (r=-0.2327,0.2122,both P＜0.01).Conclusions Chronic HBV co-infection alters human immune responses elicited by acute dengue viral infection.Moreover,IFNα secretion may be associated with hemorrhagic tendency,while protective against inflammatory damage of liver.

Objective To investigate the features of immune response of human immunodeficiency virus type-1 (HIV-1) antigen specific T lymphocytes in HIV-1 monoinfected or HIV 1/hepatitis C virus (HCV) coinfected individuals.Methods Twenty-six HIV-1 monoinfected and 23 HIV-1/HCV coinfected individuals were enrolled.Immunomagnetic microbeads were used to isolate T lymphocyte subpopulation CD4+ T cells and CD8+ T cells from human peripheral blood mononuclear cells (PBMC).Frequencies of interferon-γ (IFN-γ) secreting cells of CD4+,CD8+ T lymphocytes and PBMC stimulated by a peptide pool containing 12 overlapping peptides in HIV-1 P24 from 49 patients were assessed by enzyme-linked immunospot (ELISPOT) assay.HIV-1 RNA levels of these patients were also detected by real-time fluorescence quantitative polymerase chain reaction.The data were compared by one-way ANOVA and Mann-Whitney U test,and Spearman test was used for correlation analysis.Results Frequencies of HIV-1 antigen specific CD4+ T lymphocytes [median =25 spot-forming cells (SFC)/106 cells] were significantly lower than those of CD8+T lymphocytes (median=38SFC/106 cells,F=4.592,P=0.037) and PBMC (median=53 SFC/106 cells,F=5.436,P=0.025) in HIV-1 monoinfected group.Frequencies of HIV-1 antigen specific CD4+ T lymphocytes (median=5 SFC/106 cells,Z=-2.432,P=0.015),CD8+T lymphocytes (median=5 SFC/106 cells,Z=-1.996,P=0.046) and PBMC (median=10 SFC/106 cells,Z=-2.306,P=0.021) in HIV-1/HCV coinfected group were significantly lower than those in HIV-1 monoinfected group.Conclusions In HIV-1 infection,antigen specific immune response of CD4+ T cells can be activated,but weaker than that of CD8+ T cells.Co-infection with HCV might down-regulate the responses of HIV-1 antigen specific T lymphocytes in HIV-1 infected individuals.

Objective:To analyze the problems existing in the cases of hospitals infringing upon patients′ informed consent right after the promulgation of the Civil Code of the People′ s Republic of China, and to provide reference for improving the legal system of informed consent. Methods:Search for judgment documents published from January 1, 2021 to June 30, 2023 on the China Judgment Document Network using the keyword " liability dispute for infringing on patients′ informed consent rights", and conduct descriptive and textual analysis on the cases in the judgment documents.Results:68 judgment documents were included in total.There were 11 judgment documents on infringement of patients′ right to informed consent, and all related cases have undergone appraisal. The content of infringement mainly included infringement of patients′ right to know their condition (12/20), infringement of patients′ right to access their medical records (6/20), infringement of patients′ right to bodily integrity without consent (2/20). There were 15 judgment documents which judge that the right of informed consent of patients wasn′t infringed, and only one case in the document has been appraised. The main focus of controversy was the issue of the priority of the exercise of the right to informed consent (2/15), the fulfillment of the obligation to inform the right to informed consent (5/15), the issue of surgery without notification (1/15), and the issue of determining the authenticity of medical records and providing medical materials (7/15).Conclusions:The legal protection of patients′ right to informed consent still faces judicial difficulties such as unclear order of the exercise of rights subject, insufficient specificity of the scope of the exercise of the right, conflicts between the right to informed consent and medical intervention, and lack of unified identification methods for infringement liability. It is suggested to standardize the order of the exercise subject of the right to informed consent, clarify the content of the obligation of the medical party to inform, construct a system for medical intervention, and unify the identification methods for disputes related to the right to informed consent.

Objective:Using quantitative analysis to explore the health care industry policy documents of the Yangtze River Del-ta,reveal the exising policies problems,and provide scientific references for the healthy development of the health care industry.Methods:It uses the open coding method of qualitative research to code health care industry policy texts of Zhejiang,Jiangsu,Anhui and Shanghai,and carries out quantitative analysis based on the policy tool and health care format.Results:The policies and measures related to the health care industry in the Yangtze River Delta are scattered in the policy documents such as health pen-sion,health care,health care travel,etc.There is no special policy to guide the overall development of the health care industry.In the use of policy tools,there is a shortage of environmental tools,supply tools and demand tools,and there is an imbalance in the internal structure of various policy sub-tools;In terms of industrial format,the Yangtze River Delta can develop the advanta-geous format of health care industry based on local resource endowment,but there was insufficient attention to health and culture.Conclusion:The Yangtze River Delta should speed up the formulation of special policies for health care industry,strengthen the construction of health care service standards and product quality evaluation system,increase the proportion of demand-oriented tools,increase the supply of health care and culture policies,and promote the development of health care industry.

Objective:Using quantitative analysis to explore the health care industry policy documents of the Yangtze River Del-ta,reveal the exising policies problems,and provide scientific references for the healthy development of the health care industry.Methods:It uses the open coding method of qualitative research to code health care industry policy texts of Zhejiang,Jiangsu,Anhui and Shanghai,and carries out quantitative analysis based on the policy tool and health care format.Results:The policies and measures related to the health care industry in the Yangtze River Delta are scattered in the policy documents such as health pen-sion,health care,health care travel,etc.There is no special policy to guide the overall development of the health care industry.In the use of policy tools,there is a shortage of environmental tools,supply tools and demand tools,and there is an imbalance in the internal structure of various policy sub-tools;In terms of industrial format,the Yangtze River Delta can develop the advanta-geous format of health care industry based on local resource endowment,but there was insufficient attention to health and culture.Conclusion:The Yangtze River Delta should speed up the formulation of special policies for health care industry,strengthen the construction of health care service standards and product quality evaluation system,increase the proportion of demand-oriented tools,increase the supply of health care and culture policies,and promote the development of health care industry.

Objective:Using quantitative analysis to explore the health care industry policy documents of the Yangtze River Del-ta,reveal the exising policies problems,and provide scientific references for the healthy development of the health care industry.Methods:It uses the open coding method of qualitative research to code health care industry policy texts of Zhejiang,Jiangsu,Anhui and Shanghai,and carries out quantitative analysis based on the policy tool and health care format.Results:The policies and measures related to the health care industry in the Yangtze River Delta are scattered in the policy documents such as health pen-sion,health care,health care travel,etc.There is no special policy to guide the overall development of the health care industry.In the use of policy tools,there is a shortage of environmental tools,supply tools and demand tools,and there is an imbalance in the internal structure of various policy sub-tools;In terms of industrial format,the Yangtze River Delta can develop the advanta-geous format of health care industry based on local resource endowment,but there was insufficient attention to health and culture.Conclusion:The Yangtze River Delta should speed up the formulation of special policies for health care industry,strengthen the construction of health care service standards and product quality evaluation system,increase the proportion of demand-oriented tools,increase the supply of health care and culture policies,and promote the development of health care industry.

Objective:Using quantitative analysis to explore the health care industry policy documents of the Yangtze River Del-ta,reveal the exising policies problems,and provide scientific references for the healthy development of the health care industry.Methods:It uses the open coding method of qualitative research to code health care industry policy texts of Zhejiang,Jiangsu,Anhui and Shanghai,and carries out quantitative analysis based on the policy tool and health care format.Results:The policies and measures related to the health care industry in the Yangtze River Delta are scattered in the policy documents such as health pen-sion,health care,health care travel,etc.There is no special policy to guide the overall development of the health care industry.In the use of policy tools,there is a shortage of environmental tools,supply tools and demand tools,and there is an imbalance in the internal structure of various policy sub-tools;In terms of industrial format,the Yangtze River Delta can develop the advanta-geous format of health care industry based on local resource endowment,but there was insufficient attention to health and culture.Conclusion:The Yangtze River Delta should speed up the formulation of special policies for health care industry,strengthen the construction of health care service standards and product quality evaluation system,increase the proportion of demand-oriented tools,increase the supply of health care and culture policies,and promote the development of health care industry.

Objective:Using quantitative analysis to explore the health care industry policy documents of the Yangtze River Del-ta,reveal the exising policies problems,and provide scientific references for the healthy development of the health care industry.Methods:It uses the open coding method of qualitative research to code health care industry policy texts of Zhejiang,Jiangsu,Anhui and Shanghai,and carries out quantitative analysis based on the policy tool and health care format.Results:The policies and measures related to the health care industry in the Yangtze River Delta are scattered in the policy documents such as health pen-sion,health care,health care travel,etc.There is no special policy to guide the overall development of the health care industry.In the use of policy tools,there is a shortage of environmental tools,supply tools and demand tools,and there is an imbalance in the internal structure of various policy sub-tools;In terms of industrial format,the Yangtze River Delta can develop the advanta-geous format of health care industry based on local resource endowment,but there was insufficient attention to health and culture.Conclusion:The Yangtze River Delta should speed up the formulation of special policies for health care industry,strengthen the construction of health care service standards and product quality evaluation system,increase the proportion of demand-oriented tools,increase the supply of health care and culture policies,and promote the development of health care industry.

Objective:Using quantitative analysis to explore the health care industry policy documents of the Yangtze River Del-ta,reveal the exising policies problems,and provide scientific references for the healthy development of the health care industry.Methods:It uses the open coding method of qualitative research to code health care industry policy texts of Zhejiang,Jiangsu,Anhui and Shanghai,and carries out quantitative analysis based on the policy tool and health care format.Results:The policies and measures related to the health care industry in the Yangtze River Delta are scattered in the policy documents such as health pen-sion,health care,health care travel,etc.There is no special policy to guide the overall development of the health care industry.In the use of policy tools,there is a shortage of environmental tools,supply tools and demand tools,and there is an imbalance in the internal structure of various policy sub-tools;In terms of industrial format,the Yangtze River Delta can develop the advanta-geous format of health care industry based on local resource endowment,but there was insufficient attention to health and culture.Conclusion:The Yangtze River Delta should speed up the formulation of special policies for health care industry,strengthen the construction of health care service standards and product quality evaluation system,increase the proportion of demand-oriented tools,increase the supply of health care and culture policies,and promote the development of health care industry.

Objective:Using quantitative analysis to explore the health care industry policy documents of the Yangtze River Del-ta,reveal the exising policies problems,and provide scientific references for the healthy development of the health care industry.Methods:It uses the open coding method of qualitative research to code health care industry policy texts of Zhejiang,Jiangsu,Anhui and Shanghai,and carries out quantitative analysis based on the policy tool and health care format.Results:The policies and measures related to the health care industry in the Yangtze River Delta are scattered in the policy documents such as health pen-sion,health care,health care travel,etc.There is no special policy to guide the overall development of the health care industry.In the use of policy tools,there is a shortage of environmental tools,supply tools and demand tools,and there is an imbalance in the internal structure of various policy sub-tools;In terms of industrial format,the Yangtze River Delta can develop the advanta-geous format of health care industry based on local resource endowment,but there was insufficient attention to health and culture.Conclusion:The Yangtze River Delta should speed up the formulation of special policies for health care industry,strengthen the construction of health care service standards and product quality evaluation system,increase the proportion of demand-oriented tools,increase the supply of health care and culture policies,and promote the development of health care industry.