ObjectiveTo further explore the occurrence of occult hepatitis B virus (HBV)infection m patients with hepatitis B e antibody (anti-Hbe) positive alone and analyze the possible reasons of occult infection.MethodsSera of 61 patients carrying anti Hbe alone (absorbance≤0.1) were collected and real time polymerase chain reaction (PCR) was used to detect HBV DNA level.HBV markers were detected again by Abbott reagent,preS/S amplification products were obtained by PCR,and clonal sequencings were done in HBV DNA positive samples.ResultsTwo samples were HBV DNA positive in 61 samples with anti-Hbe positive alone,with the hepatitis B surface antigen (HBsAg) miss rate of 3.3％.Sequencing disclosed preS deletion mutations,preS2 initiatior codon mutations and co-existence of the different mutant types in one sample with anti-Hbe positive alone by repeated Abbott detection.No preS/S mutations were found in the other sample with HBsAg and hepatitis B core antibody (anti-HBc) weakly positive by repeated Abbott detection except for anti Hbe strongly positive. Conclusions Occult HBV infection and HBsAg serological test failure exist in patients with anti-Hbe positive alone.The failure of HBsAg detection may be due to preS/S gene mutations as well as low level of circulating HBsAg.

AIM: To explore the serum levels of visfatin (VF) and tumor necrosis factor-alpha (TNF-α) in the patients with pre-eclampsia (PE) and their correlation with insulin resistance (IR).METHODS: The severe PE pa-tients (n =30), mild PE patients (n =30) and normal pregnant women (n =40) were selected according to the classifica-tion standard of PE.The serum levels of VF and TNF-αwere measured by ELISA.Fasting plasma glucose (FPG) and fasting insulin (FIns) were detected by glucose oxidase method and radioimmunoassay, respectively.Triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol ( HDL-C) and low-density lipoprotein cholesterol ( LDL-C) were measured by an automatic biochemical analyzer.According to calculating the mean arterial pressure (MAP), body mass index (BMI) and homeostatic model assessment for insulin resistance index (HOMA-IR), the correlation between IR and the levels of serum VF as well as TNF-αwere analyzed.RESULTS: The levels of VF and TNF-αin severe PE group and mild PE group were significantly lower than those in normal pregnancy group (P <0.05).In addition, the levels of VF and TNF-αin severe PE group were lower than those in mild PE group (P <0.05).Linear correlation analysis showed that serum VF was positively correlated with TNF-αand HDL-C (P <0.05), and negatively with MAP and FIns (P <0.05). The serum TNF-αwas positively correlated with HDL-C (P <0.05), and negatively with BMI, TG, MAP and FIns (P <0.05).Multiple stepwise regression analysis showed that FBG, FIns and HOMA-IR were relative independent factors of se-
rum VF and TNF-α(P <0.05).CONCLUSION: Serum levels of VF and TNF-αare closely related to IR.

ABSTRACT:Objective To investigate the effect of PDCA nursing model in children with mycoplasma pneumonia.Methods 120 children with mycoplasma pneumonia treated with Tanre-qing combined with azithromycin were randomly divided into the observation group (PDCA nursing model)and the control group (usual care)with 60 cases in each group.Clinical compliance,effica-cy,clinical symptoms,hospitalization time and adverse reactions were compared in two groups.Re-sults The clinical compliance in the observation group was higher than that in the control group(P<0.05).The effective rate in the observation group was 98.33%,which was significantly higher than that in the control group(88.33%)(P <0.05).Cooling time observation group,cough time, rales disappeared time,tonsils congestion disappear time and length of hospital stay in the observa-tion group were significantly less than those in the control group (P <0.05).Incidence of adverse reactions in the observation group was 15.00%,which was significantly lower than that in the con-trol group(31.67%)(P <0.05).Conclusion PDCA nursing model significantly improves compli-ance and clinical efficacy in children with mycoplasma pneumonia,and shortens the time of clinical symptoms and hospitalization and reduces adverse side effects.

Objective To detect and analyze the levels of 27 serum cytokines expression in EV71-induced Hand Foot and Mouth Disease(HFMD) in Jinan and revealed their correlations with disease severity based on the platform of liquid chip.Methods 43 serum samples were collected from EV71-infected HFMD patients in Jinan in 2009-2014,including 16 mild cases and 27 severe cases.10 serum specimens from healthy people were also collected as controls.27 serum cytokines were analyzed on Bio-Plex liquid chip platform.Results Compared to healthy controls,22 cytokines expression levels increased in severe groups,including IL-1 ra,IL-2,IL-4,IL-5,IL-6,IL-7,IL-8,IL-9,IL-10,IL-12 (p70),IL-13,IL-15,IL-17,etotaxin,G-CSF,IFN-γ,IP-10,MCP-1,PDGF-BB,MIP-1β,RANTES and TNF-α(P ＜ 0.02).21 cytokines expression levels elevated than healthy controls (P ＜ 0.02).GM-CSF was found decreased levels in both mild and severe groups than in the healthy controls(P ＜ 0.02).The correlation analysis showed that 12 cytokines (IL-1 ra,IL-7,IL-9,IL-10,IL-13,IL-17,etotaxin,IP-10,PDGF-BB,MIP-1β,RANTES and TNF-α) were moderately correlated with the severity of EV71-infected HFMD.GM-CSF was negatively correlated with HFMD.Conclusions Many kinds of serum cytokine changed obviously in the EV71-infected HFMD patients and cytokine levels were closely associated with the severity of HFMD.The analysis of liquid chip for serum cytokines provides an efficiently method.

ABSTRACT:Objective To investigate the effect of PDCA nursing model in children with mycoplasma pneumonia.Methods 120 children with mycoplasma pneumonia treated with Tanre-qing combined with azithromycin were randomly divided into the observation group (PDCA nursing model)and the control group (usual care)with 60 cases in each group.Clinical compliance,effica-cy,clinical symptoms,hospitalization time and adverse reactions were compared in two groups.Re-sults The clinical compliance in the observation group was higher than that in the control group(P<0.05).The effective rate in the observation group was 98.33%,which was significantly higher than that in the control group(88.33%)(P <0.05).Cooling time observation group,cough time, rales disappeared time,tonsils congestion disappear time and length of hospital stay in the observa-tion group were significantly less than those in the control group (P <0.05).Incidence of adverse reactions in the observation group was 15.00%,which was significantly lower than that in the con-trol group(31.67%)(P <0.05).Conclusion PDCA nursing model significantly improves compli-ance and clinical efficacy in children with mycoplasma pneumonia,and shortens the time of clinical symptoms and hospitalization and reduces adverse side effects.

ObjectiveTo explore the mechanism of modified Xiehuangsan in treating tic disorders （TD） based on microglial polarization and the Toll-like receptor 4 （TLR4）/myeloid differentiation factor 88 （MyD88）/nuclear factor （NF）-κB pathway. MethodsSeventy-two Sprague-Dawley （SD） rats were randomly assigned into six groups： control， model， tiapride （0.025 g·kg^-1）， and low-， medium-， and high-dose （12， 24， 48 g·kg^-1， respectively） modified Xiehuangsan， with 12 rats in each group. Except the control group， the other groups received intraperitoneal injection of 3，3'-iminodipropionitrile （IDPN） for 7 consecutive days for the modeling of TD. After successful modeling， the control and model groups were given normal saline via gavage， and the other groups were administrated with corresponding drugs by gavage. After 28 days of continuous intervention， rat behaviors were observed， and the modified Xiehuangsan group showing the best anti-TD effect was selected for deciphering the treatment mechanism. Hematoxylin and eosin staining was conducted to observe morphological changes in the rat striatum. Immunohistochemistry was employed to detect the expression of CD16 and CD206 in the striatum. Real-time PCR was employed to measure the mRNA levels of interleukin-1β （IL-1β）， tumor necrosis factor-α （TNF-α）， IL-4， TLR4， MyD88， and NF-κB p65 in the striatum. Western blot was employed to determine the protein levels of ionized calcium-binding adapter molecule 1 （Iba1）， Fc receptor family for immunoglobulin （Ig）G type Ⅲ （CD16）， mannose receptor （CD206）， TLR4， MyD88， and NF-κB p65 in the striatum. ResultsCompared with the control group， the model group showed increased stereotyped behaviors， locomotor activity， total movement distance， and movement speed， shortened resting time （P<0.01）， and noticeable pathological changes in the striatum. Compared with the model group， the tiapride group and modified Xiehuangsan groups exhibited reduced stereotyped behavior， locomotor activity， total movement distance， and movement speed， prolonged resting time （P<0.05， P<0.01）， and alleviated pathological changes in the striatum. Among the modified Xiehuangsan groups， the high-dose group had the best intervention effect and the mildest pathological changes. Therefore， the high-dose group was selected for further research. Compared with the control group， the modeling of TD increased Iba1 and CD16 expression （P<0.05， P<0.01）， up-regulated the mRNA levels of IL-1β and TNF-α （P<0.05， P<0.01）， down-regulated the mRNA level of IL-4 （P<0.05）， up-regulated the mRNA and protein levels of TLR4 and MyD88 （P<0.05， P<0.01）， and up-regulated the protein level of NF-κB p65 （P<0.01）. Compared with the model group， modified Xiehuangsan reduced Iba1 and CD16 expression （P<0.05， P<0.01）， up-regulated the protein level of CD206 （P<0.05， P<0.01）， down-regulated the mRNA levels of IL-1β and TNF-α （P<0.05）， up-regulated the mRNA level of IL-4 （P<0.01）， and down-regulated the mRNA and protein levels of TLR4， MyD88， and NF-κB p65 （P<0.05， P<0.01）. ConclusionModified Xiehuangsan demonstrated a definite therapeutic effect on TD in rats. It may reduce neuroinflammation in TD rats by regulating the polarization of microglia in the striatum via the TLR4/MyD88/NF-κB signaling pathway.