Objective To study the relationship between serum interleukin‐17(IL‐17) ,acidophil cationic protein(ECP) ,immuno‐globulin E(IgE) and the severity of asthma .Methods A total of 84 patients with asthma were enrolled as asthma group ,who were divided into remission group and acute episode group .In addition to that 84 healthy persons were recruited as control group .The concentrations of serum IL‐17 ,ECP and IgE in different groups were compared .Results The concentrations of serum IL‐17 ,ECP and IgE in asthma group were statistically significantly higher than those in control group(P< 0 .05) .Among the patients with bronchial asthma ,serum levels of ECP and IgE in acute episode group were statistically significantly higher than those in remission group(P<0 .05) .There was positive correlation between serum ECP level and serum IgE level in asthma group(r=0 .432 ,P<0 .05) ,there was no significant correlation between serum IL‐17 level and serum levels of ECP and IgE ,but in acute episode group , serum IL‐17 level positively correlated with serum levels of ECP and IgE(r= 0 .327 ,0 .349 ,P< 0 .05) .Conclusion IL‐17 is in‐volved in mediating eosinophilic inflammation of asthma ,ECP and IgE levels have important clinical significances for predicting and treating asthma patients .

OBJECTIVETo explore the efficacy of anti-viral drug in combination with immunoregulatory agent in treatment of chronic hepatitis B.

METHODSTotally 98 patients with chronic hepatitis B were divided at random into 3 groups. In groups A (42 cases) lamivudine was used in combination with thymopentin to treat chronic hepatitis B. Lamivudine or thymopentin was used alone in groups B (38 cases) and C (18 cases), respectively. The dynamic changes in serum parameters reflecting HBV replication and liver function were observed.

RESULTSAt the end of the treatments, the rates of negative conversion of HBeA g and positive conversion of anti-HBe in the serum were significantly higher in group A than in group B (P<0.05). There was no significant difference between group A and group C (P>0.05). The rate of negative conversion of HBV DNA was markedly higher in group A than in group C (P<0.05). However, there was no remarkable difference between group A and group B (P>0.05). The changes in parameters of viral replication in 6 and 12 months after the treatments were not significantly different from those at the end of the treatments. The effective rate and total effective rate were markedly higher in group A than in the ther 2 groups. Meanwhile, the rate of ALT normalization of remained higher than 85% in group A.

CONCLUSIONSLamivudine in combination with thymopentin can exert great and lasting effects on HBV and is effective in normalization of ALT.

Adjuvants, Immunologic ; therapeutic use ; Adult ; Antiviral Agents ; therapeutic use ; Drug Therapy, Combination ; Female ; Hepatitis B virus ; genetics ; immunology ; Hepatitis B, Chronic ; drug therapy ; Humans ; Lamivudine ; therapeutic use ; Male ; Middle Aged ; Thymopentin ; therapeutic use ; Treatment Outcome

Objective Objective to investigate the changes of D-dimer and hypersensitivity C reactive pro-tein(CRP)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECPOD)and their effects on prognosis.Methods From January 2014 to January 2016,104 cases of AECOPD patients were en-rolled in the study.According to the prognosis,they were divided into death group and survival group.D-di-mer and CRP were detected and the concentration changes were observed.Results There was no significant difference in CRP and D-dimer between the two groups on day 1 after admission(P> 0.05).While On the third day,the fifth day and the end of discharge,the concentrations of CRP and D-dimer in the death group were significantly higher than those in the survival group(P<0.05).Conclusion The continuous elevation of D-dimer and CRP suggests that the prognosis of AECOPD patients is poor,so the concentrations of D-dimer and CRP can reflect the severity of the patient′s condition and is helpful in the prognostic estimation.

Objective:To investigate the study on the diagnostic value of multimodal ultrasound technique for the lesion of extensor carpi ulnaris(ECU)tendon in patients with rheumatoid arthritis(RA).Methods:A total of 175 RA patients who were confirmed by the department of rheumatology of Yantaishan Hospital of Yantai city from December 2021 to January 2023 were selected,and them were included into the RA group.Other 50 patients without RA but with clinical symptoms of wrist were included into the non-RA group,and 50 healthy volunteers were included into the healthy control group.All subjects underwent routine ultrasound and shear wave elastography(SWE)examination on wrist,and then,the characteristics of ultrasound images of wrists and the blood flow distribution of ECU power Doppler ultrasonography(PDUS)were recorded.SWE was used to measure ECU to obtain elastic modulus index(EI)and velocity modulus index(VI).The differences between three groups were compared,and the receiver operating characteristic(ROC)value of RA patients were drawn,so as to confirm the area under curve(AUC)value and optimize cutoff value.Results:There were significant differences in EI and VI of the ECU tendon among three groups(F=61.15,61.28,P<0.05),respectively.The optimal cut-off values of EI and VI were respectively 319.35 kPa and 10.55 m/s in RA patients.In RA patients,age and disease course had significant influences on EI(r=0.19,0.21,P<0.05),and age,disease course,ultrasound score of wrist joint,and grade of power Doppler ultrasonography PDUS of the ECU tendon(ECUPDUS)had significant influences on VI(r=0.19,0.15,-0.16,-0.17,P<0.05).Conclusion:SWE is able to quantitatively and non-invasively assess the stiffness information of the ECU tendon in RA patients.After the supplement of gray-scale ultrasound and PDUS,multimodal ultrasound technique can clearly judge the correlation of the lesions of ECU tendon of RA patients.

ObjectiveTo analyze the failure of antiretroviral therapy (ART) and drug resistance characteristics among the newly reported HIV-infected patients in Taizhou City from 2020 to 2022. MethodsBlood samples, sociodemographic characteristics and ART information of the newly reported HIV-infected patients who received ART for ≥6 months in Taizhou City from 2020 to 2022 were collected for the detection of recent infections and HIV-1 genotypic drug resistance. Multivariate logistic regression analysis was used to analyze the influencing factors of treatment failure. The gene sequences of cases with failed ART were submitted to the HIV drug resistance database of Stanford University to determine the drug resistance mutation sites and drug resistance characteristics. ResultsAmong the 1 023 newly reported HIV-infected patients receiving ART, the median age （P₂₅，P₇₅） was 47 (33, 58) years, 81.4% were male, 66.4% (679/1 023) were infected through heterosexual transmission, 74.7% had a WHO clinical stage Ⅰ/Ⅱ, 62.2% had a baseline CD4 count of >200 cell·μL^-1, 94.4% (966/1 023) received an immediate ART, and 78.7% were long-term infected. Among the 66 patients with treatment failure (6.5%), the likelihood of treatment failure was lower in those with homosexual transmission (OR=0.39, 95%CI: 0.17‒0.84) and without history of sexually transmitted disease (STD) (OR=0.45, 95%CI: 0.24‒0.92), but higher in those with a baseline CD4 count of ≤200 cell·μL^-1, delayed ART (OR=3.19, 95%CI: 1.24‒7.52), and primary drug resistance (OR=4.69, 95%CI: 1.68‒11.89). Among the 36 HIV-infected patients with virological failure, 27 sequences were successfully amplified, with a successful amplification rate of 75.0% (27/36). The total drug resistance rate was 55.6% (15/27), of which the drug resistance rates of nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs) and protease inhibitors (PIs) were 37.0% (10/27), 51.9% (14/27) and 3.7% (1/27), respectively. Among the NNRTIs, the degree of resistance to efavirenz and nevirapine was consistent, with a majority (51.9%) of highly drug-resistant. K103N and M184V were the most common mutation sites, but PIs mutations occured less frequently. A total of 8 genotypes of HIV-1 were detected, in which subtype CRF01_AE accounted for 37.0% (10/27), followed by CRF07_BC [14.8% (4/27)], CRF08_BC [14.8% (4/27)] and subtype C [14.8% (4/27)]. ConclusionDuring the period from 2020 to 2022, the newly reported HIV-infected individuals in Taizhou City were predominated by long-term infections. Immediate initiation of ART can reduce the risk of treatment failure in HIV-infected individuals. Virological treatment failures are primarily associated with resistance to NRTIs and NNRTIs. It is recommended to strengthen active detection and promptly initiate ART to minimize the occurrence of ART failure. Simultaneously, there is a need to intensify drug resistance detection targeted for those with treatment failure, so as to provide a scientific guidance for drug replacement.