Persistent infection of hepatitis C virus (HCV) remains as a worldwide threat to public health,which involves a complex interaction between virus- and host related factors.HCV is classified as six genotypes and many subtypes according to the sequence heterogenecity.HCV genotype should be determined prior to treatment initiation since it plays a key role in selection of therapeutic regimen for chronic hepatitis C.Development of the antiviral treatment with protease inhibitor in combination with pegylated IFN-α and ribavirin requires the accurate determination of subtypes,e.g. 1a and 1b,as well.Genotyping methods based onsequenceanalysis, reversehybridizationorreal-timePCRhavebeendevelopedand evaluated.Some issues,however,should be settled to standardize the utility and result interpretation of these methods.More recently,host genotypes of IL28B have been found to be closely associated with HCV spontaneous clearance and the response to antiviral therapy.Moreover,polymorphisms in inosine triphosphate pyrophosphatase gene affect ribavirin-induced anemia.Therefore, host genotyping will be beneficial in predicting the outcome of chronic hepatitis C and monitoring the drug-induced adverse events.

Objective To study the types of autoantibodies in patients with primary biliary cirrhosis.Methods There were 60 patients with primary biliary cirrhosis from January 1995 to December 2004 in People's Hospital. We analyzed those patients' autoantibodies results and clinical data.Results There were 75% patients with anti-mitochondrial antibody(45/60),and antinuclear antibodies were detected in 60%(36/60)PBC patients,with the following hierarchy of specificities:23%(14/60)speckled,20%(12/60)multiple nuclear dots,16%(10/60)nuclear membranous,6%(6/60)anti-centromere,1.6%(1/60)homogeneous,20%(12/60)anti-SSA,10%(6/60)anti-SSB and 1.6%(1/60)anti-RNP. Several patients showed multiple specificities. Comparing PBC patients with or without AMA,no statistically significant difference was found on ages,biochemical and immunological parameters.Conclusion AMA-negative PBC patients share the same clinical features with AMA-passive PBC. Except for AMA,other antibodies may present in PBC patients. Multiple nuclear dots and nuclear member antinuclear antibodies may be helpful for diagnosing PBC patients without AMA.

Objective To study the effect of sensory nerves on the expression of epidermal growth factor(EGF), basic fibroblast growth factor(bFGF) by fibroblasts in the granulation tissues in skin wound healing. Methods In vivo and in vitro studies were conducted. Fifty wistar rats were randomly divided into capsaicin group and control group. The rats in the capsaicin group were subcutaneously injected with neurotoxin dose of capsaicin(50 mg/kg for 3 days) to chemically destroy the sensory nerves. Full thickness skin incisive wound was made on the rat′s back on 8th day after last injection. The contents of substance P(SP), which was mainly released from afferent sensory nerve terminal, and EGF, bFGF in granulation tissue of skin lesion were determined using immunohistochemistry combined with computerized imaging analysis on 3rd, 6th, 9th, 12th days after the incision. In the control group no capsaicin was injected. In the in vitro study the fibroblasts from granulation tissue of rats were cultured with different doses of SP(10-9 ~ 10-5 mol/L), and the protein expression of EGF, bFGF by cultured fibroblasts was determined using Western blot. Results Immunoreactive SP was not only found around the small blood vessels and in the intercellular space, but also in the cytoplasm of fibroblasts in granulation tissue. SP content and the protein expression of EGF, bFGF in granulation tissue decreased in the capsaicin group, compared with those in the control group, which indicated that SP(10-7 mol/L) added into the culture medium for fibroblasts could upregulate the levels of EGF, bFGF expression. Conclusions Protein expression of EGF and bFGF by fibroblasts in granulation tissue in skin wound healing might be related with the SP released from sensory nerves.

Objective To explore the clinical diagnosis,medication,curative effect,and prognosis of lymhocyte subsets and humoral immunity in children with Kawasaki disease(KD)complicated with coronary artery dilatation.Methods One hundred and seventy-one children(age of 4 months to 9 years)from Jun.2000 to Dec.2007 with KD in Capital Institute of Pediatrics were taken as research objective,65 healthy children(age of 5 months to 7 years)were taken as controls,the difference of the level variation of lymhocyte subsets and humoral immunity was detected and analyzed between them.The flow cytometry and scattering turbidimetry method were used to detect the numbers of T cell subsets [CD3+,CD3+CD4+,CD3+CD8+,CD19+,natural killer(NK)cell] and levels of immune globulin(IgG,IgA,IgM)of the peripheral blood of 171 patients,compare them with those of the control group,and compare them between patients with and without coronary artery dilatation.Results Compared with control group,in the acute period of KD the levels of CD3+,CD3+CD4+ decreased significantly(t=0.01,0.02 Pa0.05);of all the 171 children patient,53 cases were coronary artery expansion patients.Compared with non-expansion patients,levels of CD4+/CD8+,CD3+CD8+,IgG of coronary artery expansion patients were significant different and had statistical difference(t=0.02,0.04,0.03 Pa

ObsjectiveTo investigate the clinical data,and to summarize the clinical experience of diagnosis and treatment of graft-versus-host-disease (GVHD) after liver transplantation.Methods 4 of 480 recipients undergone liver transplantation developed GVHD from Apr.2005 to Sep.2011.The 4 recipients'clinical courses and laboratory tests were recorded.ResultsThe diagnosis of GVHD depended on clinical syndrome involved skin rash,bone marrow depression and diarrhea.Skin biopsy and STR-PCR were matched.Among them,2 with successful treatment have been surviving for 7 and 24 months,and 2 died from infection.One recipient had the donor T lymphocyte microchimerism detected by STR-PCR.ConclusionsGVHD after liver transplantation can cause high mortality due to bone marrow depression.A reasonable treatment can be to reduce immunosuppressant and glucocorticoids and IVIG.

Objective To explore the roles of humoral immunity in severe acute respiratory syndrome (SARS). Methods The pathological changes in the SARS autopsy case and a case of lung puncture were observed by light microscopy and electron microscopy. The autoantibody and immune complexes in the sample tissues were detected by immunohistochemical staining and histochemical staining. Results There were severely diffusive damages in the lungs. The endothelial cells in blood were injured. Fibrinoid necroses of blood vessels were observed in several organs and injury of immune organs and massive autoantibody and immune complexes were found in pathologically changed tissues. Electron dense deposits were observed in the basement membrane of blood vessels and mesangial matrix of glomerulus by electron microscopy. Conclusion The SARS viruses not only cause direct damages to the tissues but also lead to immune complex mediated hypersensitivity which in turn gives rise to a large number of tissue lesions. This indicates that the humoral immunity plays an important role in the process of organ damages.

Objective To investigate the evolution of hepatitis C virus (HCV) quasispecies in persistent and self limited infection patients. Methods Peripheral blood HCV preserved for 10 years from 8 naive individuals once infected by HCV were analyzed. HCV hypervariable region 1 (HVR1) genes were cloned and sequenced. Entropy, genetic distances, nonsynonymous mutations per nonsynonymous site (K A ), synonymous mutations per synonymous site(K S ) were evaluated for evolutionary analysis. Results The entropy values and genetic distances of HCV quasispecies were lower in self limited infection indivi duals than that of persistent infection individuals. In 3 of the 4 persistent infection individuals there exist no difference between within group and between group genetic distances in HCV HVR1. The ratios of K A /K s were higher than 1 in 7 of these 8 individuals. Conclusions The complexity and diversity degree of HCV quasispecies may affect the outcome of HCV infection. Positive Darwinian selection may be the major cause for the change of HCV quasispecies distribution in hepatitis C infection natural history.

0.05). The peak of NAA was significantly different between high grade glioma and metastatic carcinoma(P0.05). The peak of AA was characteristic of brain abscess. The ratio of Cho/Cr0 in brain abscess was significantly lower than those in high grade glioma and metastatic carcinoma(P

Objective To discuss the protective effects and mechanisms of dexamethasone and Shenfu sepa-rate and joint administration of flap after ischemia-reperfusion injury. Methods 40-month-old fairly healthy rats were randomly divided into 4 group as A, B, C, D, and to product the abdominal island flap, then blocking the flow of blood of the pedicle artery respectively before 30 minutes when injecting with normal saline (1 ml/kg), dexametha-sone (1 ml/kg), Senate (10 ml/kg), joint injection with dexamethasone (1 ml/kg) and Shenfu (10 ml/kg). 4 groups of animals' blood samples were collected from the pedicle vein before the time of I hour when blocking vascu-lar pedicle and reperfusion after the time of 1 h, 6 h, 12 h, 24 h, respectively. Then the plasma concentration of TNF-α was measured. Results The concentration of TNF-α in the treatment group was significantly lower than the blank group(P <0.01). And the group D and the group B、C has significant differences either(P <0.01). Conclu-sion Using Dexamethasone, Shenfu injection in early can reduce the concentration of TNFα in repeffusion injury of flap and has a protective effect on the flap, but make better effect in combined.

Objective To investigate the effective regimen and security to treat the hepatitis C virus (HCV) recurrence after orthotopic liver transplantation (OLT).Methods The clinical data of 9 cases of HCV related end-stage hepatopathy after liver transplantation were retrospectively analyzed.Five patients with recurrent HCV after OLT were selected for treatment,and all of them were given pygylated interferon αα-2a and ribavirin.The treatment course was 48 weeks.The changes in hemoglobin,white blood cells,transaminase,and HCV RNA copies were observed before and after treatment.The early viral response (EVR),sustained viral response (SVR) and adverse reactions were assessed.Results Three cases out of 5 cases of HCV recurrence after OLT obtained EVR within 12 weeks,all of them obtained SVR after the treatment,and the function of the transplanted liver returned to normal; In one case,HCV RNA was declined by less than 102 copies after 12 weeks of treatment,and the treatment was terminated; In one case,HCV RNA was declined by greater than 102 copies after 12 weeks of treatment,and at 24th week,HCV RNA was still positive and the treatment was terminated,but HCV RNA remained at a low level at 48th week.Side effects occurred in all 5 cases after antiviral treatment,and alleviated after symptomatic treatment.Conclusion To treat the recurrence of HCV timely after OLT by pygylated interferon (in combination with ribavirin was safe,and the majority of patients could achieved sustained virological response.