The T helper cell 17 (Th17) has important relationship with liver failure caused by hepatitis B virus (HBV).Some studies found that mature,differentiation and proliferation of Th17 cells have a close relationship with interleukin 23,newly discovered in recent years,which function of immune and regulatory mechanism in chronic hepatitis B patients is still unclear.In our country,the main cause of liver failure is hepatitis viruses (mainly HBV),thus the study of immune pathogenesis that why acute exacerbation or liver failure happens in chronic hepatitis B patients has a realistic meaning for improving the prognosis of chronic hepatitis B.

Aim To establish a novel,highly sensitive,rapid and cost-effective HPLC method to simultaneously determine tri-cyclic antidepressant clomipramine and four benzodiazepines of diazepam,alprazolam,clonazepam,oxazepam in human plasma pretreated by solid phase extraction.Methods The assay was achieved by using C8 column (4.6 mm ×1 50 mm,5 μm)kept at 45 ℃,mobile phase 73.2:26.8 V/V (50 mmol·L -1 ,pH 3.0 phosphate buffer:acetonitrile)with flow rate of 1 .2 ml· min -1 ,and UV detection was set at λ220 nm.Solid phase ex-traction was performed on C1 cartridges.Results The calibra-tion curve was demonstrated to be linear (r >0.9994)in the ranges of 5 ~200 μg·L -1 for alprazolam and clonazepam,1 0 ~500 μg·L -1 for diazepam,20 ~500 μg· L -1 for clomipra-mine,and 7.5 ~2000 μg·L -1 for oxazepam;the limit of detec-tion (LOD)was 1 .5,1 .4,3.0,5.5 and 2.2 μg·L -1 for al-prazolam,clonazepam,diazepam,clomipramine and oxazepam respectively.Intra-day and inter-day precision revealed a coeffi-cient of variation of 2.2% ~1 2.6% and 2.1 % ~1 3.2%,re-spectively.Extraction yield ranged from 81 .1 % ~1 00.1 % for all analytes.Conclusion The developed method is accurate, reproducible,convenient,and suitable for routine therapeutic drug monitoring of clomipramine and the four benzodiazepines.

Objective To investigate the characteristics of aminoglycoside resistance of extend-ed-spectrum β-lactamases(ESBLs)-producing Escherichia coli(E, cold and expression of aminoglyco-side-modifying enzyme genes. Methods The minimal inhibitory concentrations(MICs) of gentamicin,amikacin, kanamycin, tobramycin, netilmicin and neomycin for 37 strains of ESBLs-producing E. Coli were detected by agar dilution. In addition, six aminoglycoside-modifying enzyme genes were amplified by polymersae chain reaction(PCR) and verified by DNA sequencing. Results MICand MIC90 of gentamicin, amikacin, kanamycin, tobramycin and netilmicin for 37 strains of ESBLs-producing E. Co-Il all excelled 256 μg/mL, the resistance rates of the above antibiotics were 78.4%, 45.9%, 72.9%,83.8%and 64.90%, respectively. However, neomycin still had powerful antibacterial activity. In ad-dition, five modifying enzyme genes, including aac(3)-Ⅱ , aac(6′)-Ⅰ b, aac(6′)-Ⅱ , ant(2″)-Ⅰ and ant(3″)- Ⅰ genes, were found in 37 isoaltes except aac(3)- Ⅰ , and their positive rates were 56.8%,27.0 %, 2.7 %, 5.4 % and 13. 5 %, respectively. Conclusion The aminoglycoside resistance of ES-BLs-producing E. Coil may be associated with the expression of aminoglycoside-modifying enzyme genes.

Objective To investigate the characteristics of mesenteric vascular thrombosis (MVT) in patients with antiphospholipid antibody syndrome (APS).Methods The cases reports about MVT in patients with APS were searched in Pubmed and Chinese biomedical database (1983.1-2007.7) and then were analyzed.Results There were 13 males and 8 females in 21 patients.The average age was (37±17) years (5months～69 years).Three cases (14%) had a history of deep venous thrombosis and 4 (19%) had spontaneous abortions.The course of disease was 4 hours to 4 months.The clinical manifestations included abdominal pain 18 (86%),hemafecia or melaena 4 (19%),vomiting 3 (14%),diarrhea 2 (10%),hematemesis 2(10%).Physical signs included abdominal tenderness in 10(48%),peritoneal irritation signs in 5 (24%),shifting dullness in 3 (14%) anddecreased bowel sounds in 3 (14%).Mesenteric vascular thrombosis were detected through B uhrasonography (3/10,33%),abdominal CT (9/13,69%),MRI (4/4,100%),Doppler ultrasound (4/4,100%),angiography (6/6,100%).Eighteen cases (86%) had positive anti-cardiophospholipin antibody and 14 (67%) were IgG-subtype.Lupus anticoagulants were detected in 4 (19%).Sixteen cases reee-ived exploratory laparotomy,lsehemia or necrosis of intestine were found in 9(56%).In 21 cases,superior mesenteric vein thrombosis,suprior mesenteric artery thrombosis,inferior mesenteric vein thrombosis,inferior mesenteric artery thrombosis were discovered in 17 (81%),4 (19%),0 (0%),1 (5%)patients respectively.Portal vein was also involved in 7 (33%) cases who had superior mesenteric vein thrombosis.Conclusion Superior mesenteric vein is usually involved in patients with APS who have MVT.MVTs are always occurr in middle-age male patients.Some patients have deep vein thrombosis or spontaneous abortion before MVT.The disease may be fulminant or had is insidious in onset.Abdominal pain and intestinal obstruction are the most common manifestations.IgG-subtype anticardiophospholipin antibodiesare the common antibodies discovered in these patients.Combined more than one image methods can detect the thrombi effectively.Anticoagulation and essential exploratory laparotomy are effective interventions in most cases.

Aim To investigate the chemical constituents of the secondary metabolites of the roots of Daphne genkwa. Methods The roots of D. genkwa were extracted with 95% ethanol at 60 - 70 ℃ for 7 days to obtain the crude extract. The crude extract was purified by silica gel and Sephadex LH-20 column chromatography as well as the HPLC techniques. The structures of the isolates were elucidated by combined spectroscopic methods including 1D and 2D NMR, MS, UV, IR and CD. Results Three new biflavonoids were isolated from the ethanol extract of the roots of D. genkwa and their structures were identified as daphnodorin H-3-methyl ether (1), daphnodorin H-3"-methyl ether (2) and daphnodorin G-3"-methyl ether (3). Conclusion Compounds 1, 2 and 3 are three new biflavonoids.

As a species of acute respiratory tract pathogen in mankind, Chlamydia pneumoniae can cause upper respiratory tract infection, pneumonia, it may also play an important role in bronchial asthma, chronic obstructive pulmonary diseases, sarcoid, lung cancer.

Objective　To explore the clinical characters and distributions of the endogenous uveitis.Methods　Both clinical examinations and immunologic investigations were performed in 354 patients with cases of uveitis within six years.Results　Among 354 uveitis, the anterior uveitis were 165 cases(46.6%), the posterior uveitis 118 cases (33.3%),the pan-uveitis 57 cases(16.1%) and the intermediate uveitis 14 cases(4.0%). The blind rate among the patients was 5.9%, the main causes were proliferative retinopathy, secondary glaucoma and complicated cataract. 167 cases(47.2%)of patients were related to the systemic changes, the bone-joints disease, Vogt-Koyanagi-Harada syndrome, Behcet syndrome and toxoplasma infection were common.Conclusion　Complete clinical and immunologic examinations can ensure the defined diagnosis and proper treatment for the patients with endogenous uveitis.

Objective　The retrospective case-control study was applied to investigate the crossing characteristics and the distance between the disc and the first crossing site in super-temporal branch retinal vein obstruction.Methods　Fifty-three cases of branch retinal vein obstruction and 53 cases of controls were collected to observe the artery-vein crossing characteristics and to measure the distance between the disc and the first crossing site.Results　The average distances of super-temporal and infer-temporal branch in case group were significantly different. The distance of the super-temporal branch in case group was significantly different from that in the control group. The distances of the super-temporal branch and infer-temporal branch were not significantly different in control group. The numbers of the arteries over the veins in the super-temporal branch in case and control group were significantly different. Conclusion　The mechanism of super-temporal branch retinal vein obstruction is related with the near distance between the disc and the first crossing, and is also related with the numbers of the arteries over the veins in the crossing site.

Objective To investigate the effect of mycophenolic acid (MPA) on the endotheline-1 (ET-1) induced proliferation, contraction and migration of pulmonary arterial smooth muscle cells (PASMCs)and to explore the mechanism of MPA on pulmonary arterial hypertension (PAH), and the effect of exogenous guanosine nucleotide reversing anti-proliferative effect of MPA. Paired-samples t-test was used for statistical analysis. Methods MTT test, scarification test, Millicell cell culture insertion and the length of PASMCs mcasured under microscope were used. Results The A values of group ET-1 + low concentration MPA decreased when compared with group ET-1 (0.348±0.036 vs 0.447±0.013, t=6.357, P=0.000) and the A values of group ET-1 + high concentration MPA was further decreased. The A values of group ET-1 + low concentration MPA + guanosine was higher than that of group ET-1 + low concentration MPA (0.390±0.018 vs 0.348 ±0.036, t=2.573, P=0.028). The average migration distance and the average migration numbers of PASMCs of groups MPA was decreased than that of group ET-1. The average cell length of PASMCs of groups MPA was increas ed than that of group ET-1. Conclusion MPA can effectively inhibit the proliferation,contraction and migration of PASMCs by ET-1 induction. The IMPDH may play a role in anti-proliferative effect of MPA on PASMCs, but is unnecessary to be the sole mechanism. These findings has provide new insight into the mechanisms of mycophenolate mofetil in the treatment of PAH.

Objective To compare the effects of invert sugar versus 10% glucose on the blood glucose concentrations of patients in neurosurgical intensive care unit .Methods This is a prospective ,randomized ,double blind and compared study .A total of 40 in-sulin-requiring neurosurgical critical patients were randomized to receive intravenous ,1 000 mL ,either 10% invert sugar (experi-mental group) or 10% glucose(control group) on their first day when they were admitted to the intensive care unit (ICU ) .Blood glucose concentrations were measured every four hours and liver and kidney function indicators were recorded respectively .We’ve also compared the difference of the blood glucose concentrations changes between the two groups .Results There were significant differences in the glucose concentration between the two treatment groups (P<0 .05) ,whereas no significant differences in the inci-dences of hypoglycemia ,renal failure and hepatic damage were observed .No allergic reactions were found in both groups .Conclusion 10% invert sugar is a better choice for neurosurgical critical patients who need regular insulin infusion to control blood glucose .