Objective To study the influence of HBV replication regulator,enhancer I and Pre- S2,on the immune response of HBV DNA vaccine.Methods DNA fragments of HBsAg,PreS2 HBsAg,HBsAg-enhancer I and PreS2-HBsAg-enhancer I region of HBV were amplified by PCR using the complete genome DNA of HBV adr subtype,and inserted into VR1012 vectors,respective- ly.The recombinant plasmids were transfected into HepG2 cells,and injected into Balb/C mice.The expression of HepG2 cells and the cellular and humoral immune response of mice were tested by cell immuno-chemistry,ELISA and ELISPOT.Results The target protein were expressed by transfected HepG2 cells,enhancer I and Pre-S2 can promote the expression of HBsAg in transfected cells.The HBsAb and the HBsAg specific CTL in inoculated mice were found in the second week after injection, PreS2 but not enhancer I can promote the immune response in inoculated mice.Conclusions When inserted into HBV DNA vaccine,enhancer I and PreS2 can promote the expression of HBsAg in transfected HepG2 cells,PreS2 can promote the immune response in inoculated Balb/C mice.

Objective To explore an effective treatment for lactation complications after augmenta-tion mammoplasty with polyacrylamide hydrogel (PAHG). Methods 13 cases with lactation complica-tions after augmentation mammoplasty with polyacrylamide hydrogel (PAHG) were treated with taking out PAHG and the pathological tissue through the periareolar incision, using continual drainage and medi-cation that can choke back hypergalactia. Results All cases were cured and followed up for 3 months to 4 years with satisfactory results. Conclusion This method for the treatment of lactation complications after augmentation mammoplasty with PAHG is effective, safe and simple.

Objective To explore the effects of Medpor in surgical treatment of craniofacial de-pressed deformities. Methods Combining with other surgical methods, 37 patients with craniofacial de-pressed deformities were treated with Medpor. Of them, 29 cases of craniofacial depression and defects subjected to trauma, 6 cases were progressive facial hemiatrophy and 2 case were angle of mandible de-formity. All were followed up from three months to four year. Results Facial configurations and func-tions of all the 37 cases were greatly improved after the treatment, without any complication of infection or rejection;patients were all very satisfactory or relatively satisfied with the results. Conclusion Med-por is an ideal implant material to correct the deformity of earaniofacial, and combining with others methods, the treatment of earaniofacial deformity can obtain good results.

Objective To explore the differences in clinical and pathological characteristics of idiopathic membranous nephropathy between elderly and non elderly patients.Methods The clinical and pathological data,which were used for biopsy diagnosing idiopathic membranous nephropathy in elderly patients (aged ≥65 years) versus non elderly patients (aged ＜65 years) in our hospital during the recently 10 years,were retrospectively analyzed and compared.Results The elderly patients with idiopathic membranous nephropathy accounted for 26.29％ and patients aged less than 45 years with idiopathic membranous nephropathy accounted for 25.26％.The proportions of idiopathic membranous nephropathy in the two different age groups were similar.The occurrence rate of hypertension and microscopic hematuria as well as levels of blood serum creatinine and urinary N-acetyl-β-D-glucosaminidase were higher,while the urinary osmotic pressure,estimated glomerular filtration rate (eGFR) and blood albumin were lower in elderly group than in non-elderly group (all P＜0.05).The proportions of glomerulosclerosis,tubulointerstitial lesions and vascular lesions were higher in elderly group than in non-elderly patients (all P＜ 0.05).There were no significant differences in the immunofluorescence intensity of IgG,positive rates of IgA,C3,C4 and Fi between the two groups,while the positive rate of C1q was lower in elderly group than in non elderly.Among 51 patients receiving IgG4 immunohistochemical staining,the positive rate of IgG4 staining and the intensity were higher in elderly group than in non-elderly [100.00％ vs.81.25％,(2.11±0.46) vs.(1.59 ± 0.95),both P ＜ 0.05].Conclusions The proportion of idiopathic membranous nephropathy is increased in non-elderly patients.Elderly patients are more susceptible to hypertension,hematuria and renal dysfunction.The positive rate and the intensity of IgG4 are higher and the positive rate of C1q is lower in elderly group than in non-elderly group,which indicate that patients with negative IgG4 and positive C1q have secondary causes which have not yet been demonstrated,and they should be closely observed during the follow-up.

Objective To comparative analysis the intracytoplasmic sperm injection (ICSI)result and rate of sperm DNA in-tegrity (DNA fragmentation index,DFI)about testicular and epididymis sperm.Methods Totally 183 obstructed azoospermia pa-tients were choosed to use ICSI.80 cycles by PESA and 103 cycles by TESA,compared two groups of sperm DNA integrity rate and ICSI outcome.Results Sperm DNA integrity rate,fertilization rate,cleavage rate,good-qualityembryo rate and pregnancy rate com-pared with no difference by ICSI(P >0.05).Conclusion DNA integrity rate and ICSI outcomes of the testis and epididymis sperm have no significant differences,clinicians can be based on personal experiences or patients,wills to select sperm for ICSI.

Objective To study the modulation in number and function of endothelial progenitor cell ( EPC ) in multiple organ dysfunction syndrome ( MODS ) after trauma in swine, and to investigate its pathogenesis. Methods Forty pigs were divided into sham group and MODS group ( each, n = 20 ). The model of MODS of two-hit injury, namely hemorrhagic shock and endotoxemia, was reproduced. The peripheral blood was collected before hemorrhage ( T1 ) and endotoxin injection ( T2 ), and 1 hour ( T3 ), 24 hours ( T4 ), 48 hours ( T5 ) after endotoxin injection. Phosphorylation of p38 mitogen-activated protein kinase ( p-p38MAPK ) in mononuclear cell was determined by Western Blot, the content of tumor necrosis factor-α ( TNF-α) was determined with enzyme linked immunosorbent assay ( ELISA ), and the number of EPC was determined with flow cytometry. Results Model of MODS was successfully reproduced in 17 pigs. In model group, the expression of p-p38MAPK ( A value ) peaked at T3 ( 4.83±0.52 ), and gradually declined at T4 and T5 ( 4.36±0.43, 1.93±0.33 ), and the expression of p-p38MAPK at T3-T5 was significantly higher than that at T1 ( 1.00±0.22, all P<0.01 ). The plasma concentration of TNF-α( ng/L ) at T3 in MODS group was obviously elevated compared with that of sham group ( 532.43±52.17 vs. 129.03±20.45, t=31.163, P<0.001 ), and it peaked at T3, it then gradually lowered, and it was significantly higher at T4 and T5 than that in sham group ( T4: 398.93±35.75 vs. 131.12±29.53, t = 26.562, P < 0.001; T5: 287.48±27.26 vs. 126.44±26.96, t=17.861, P<0.001 ). The number of EPC ( ×107/L ) was apparently increased in MODS group at T3 compared with sham group ( 4.832±0.624 vs. 3.545±0.363, t=9.542, P<0.001 ), and it peaked at T3, then gradually decreased, and the number of EPC at T4 and T5 was significantly lower than that in sham group ( T4:2.628±0.627 vs. 3.442±0.325, t=5.043, P<0.001;T5:2.203±0.711 vs. 3.471±0.323, t=2.972, P<0.001 ). Conclusion Phosphorylation of p38MAPK could increase the plasma concentration of TNF-αand decrease the quantity of EPC in MODS,which may be one of the mechanisms of MODS.

Background Even though the change in wavefront aberrations with correction modality is well documented in the literature,little is known about the underlying mechanism.Complete understanding of the causes responsible for the wavefront change in the combined lens-eye system is important since it provides basic knowledge for further improving the technique to correct refractive error by correcting lenses.Objective The aim of this study was to investigate the influence of refractive correction lens on optical property of the eye by analyzing Zernike aberrations in myopic eyes with contact lens correction.Methods This study was approved by the Ethic Committee of Wenzhou Medical College.Written informed consent was obtained from each subject before entering this study.Zernike aberrations of 52 myopic eyes of 26 subjects with the spherical equivalent-1.75 to-8.50 D were measured using a Hartmann-Shock wavefront sensor.The human eye aberrations were examined at the uncorrected condition,rigid-gas-permeable contact lens (RGP-CL) corrected condition and soft contact lens (Soft-CL) corrected condition.The differences of wavefront aberrations and Zernike coefficients were compared by repeated measurement of single factor variance analysis,and correlation of the aberration changes between uncorrected condition and RGP-CL corrected condition or Sofi-CL corrected condition,between the right eyes and left eyes in different conditions were analyzed by Pearson linear correlation.Results Mean total root-mean-square (tRMS) was (0.71 ± 0.30)μm,(0.54±0.19)μm and (0.74±0.32)μm in the uncorrected condition,RGP-CL corrected condition and Soft-CL corrected condition,with a significant difference (F =8.758,P＜0.001),and tRMS was significant declined under the RGP-CL corrected condition compared with uncorrected condition (t =2.746,P =0.008),and tRMS in RGP-CL corrected condition was significantly lower than that in Soft-CL corrected condition (t =3.428,P =0.001).The high RMS (hRMS) was (0.34±0.12) μm,(0.28 ±0.12) μm,(0.40±0.14) μm in the uncorrected condition,RGP-CL corrected condition and Soft-CL corrected condition,with a significant difference among them (F =10.681,P＜0.001).An insignificant decrease of hRMS was seen in the RGP-CL corrected condition compared with uncorrected condition (t =1.987,P=0.053),but hRMS value was significant higher in the Soft-CL corrected condition than that in the uncorrected condition (t=2.101,P=0.041) and RGP-CL corrected condition (t=4.266,P＜0.001).Compared with uncorrected condition,the axis astigmatism (C5) and spherical aberration (C12) in the RGP-CL corrected condition and spherical aberration (C12) in the Soft-CL corrected condition were significantly reduced (P＜0.05),and the absolute values of trefoil (C6),vertical coma (C7) and tetrafoil (C10) in the RGP-CL corrected condition were lower than those of the uncorrected condition,but vertical coma (C7) absolute value in the Soft-CL corrected condition was increased (P＜0.05).A significantly positive correlation was seen in the spherical aberration (C12) between the RGP-CL corrected condition and uncorrected condition (r =0.763,P＜0.001),and less significant correlation was in the secondary astigmatism (C11) between the Soft-CL corrected condition and uncorrected condition(r=0.469,P＜0.001).Conclusions Different contact lens corrected conditions exert their effects on ocular wavefront structure due to its unique interaction with the eye.RGP-CL wearing has strong modification on wavefront aberrations probably due to its molding effect on corneal surface,which reduces the bilateral symmetry.High order wavefront aberration can be modified by Soft-CL wearing.

Objective To evaluate the application of matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS) technology in the identification of filamentous fungi,and analyze the susceptibility of filamentous fungi to commonly used antibiotics.Methods A total of 100 strains of filamentous fungi were collected and identified rapidly by MALDI-TOF MS.The obtained results were compared with those from microscopic examination.The susceptibility of filamentous fungi was detected by the Etest method.Results Among 100 strains of filamentous fungi identified by MALDI-TOF MS,61 reached to the species level(score≥2.000),36 to the genus level(score between 1.700 and 1.999),and 3 failed to be identified (score ＜ 1.700).There was inconsistent results for one strain of filamentous fungi between MALDI-TOF MS and microscopic examination.The MIC90 of amphotericin B against Epidermophytonfloccosum was 0.19 μg/mL,while that against Aspergillus flavus was above 32 μg/mL.The MIC90 of itraconazole against Trichophyton tonsurans,Microsporum canis and Epidermophytonfloccosum were all below 0.38 μg/mL,while that against Aspergillus niger was above 32 μg/mL.The MIC90 of fluconazol were above 256 μg/mL for most of strains.The MIC90 of voriconazole and caspofungin against Aspergillus fumigatus,Aspergillus flavus,Aspergillus niger,Trichophyton rubrum,Trichophyton tonsurans and Microsporum canis were ≤0.38 μg/mL and ≤ 1 μg/mL,respectively.Conclusion The MALDI-TOF MS technology may be used to identify the filamentous fungi isolated from clinical specimens quickly,accurately and high-throughput.Voriconazole and caspofungin have effective anti-filamentous fungi activity.

OBJECTIVETo explore the expression level of corticotropin-releasing hormone receptor type-1 (CRHR-1) in intrahepatic cholestatic placental (ICP) tissue.

METHODSHuman placental samples were collected from 10 ICP patients and 10 healthy controls after parturition at 37-40 weeks of gestation. CRHR-1 protein and mRNA expression was assessed by western blotting and nested-real-time fluorescence quantitative PCR, respectively. Normally distributed data were summarized as mean +/- standard deviation, and intergroup comparisons were made by two-tailed Student's t-test. Non-normally distributed data were presented as median with interquartile range, and intergroup comparisons were made by Wilcoxon test. For all statistical analyses, a two-tailed P-value of less than 0.05 was considered statistically significant.

RESULTSThe CRHR-1 fluorescence intensity was lower in ICP tissues (1.55 +/- 0.28) than in placental tissues from healthy controls (1.60 +/- 0.37), but the difference did not reach statistical significance (t = 0.349, P = 0.732). The CRHR-1 mRNA content was slightly higher in the ICP tissues [0.139(0.268)] than in the placental tissues from healthy controls [0.031(0.245)], but the difference did not reach statistical significance (t = 1.504, P = 0.136).

CONCLUSIONCRHR-1 expression is decreased in ICP tissues, which may lead to a smaller volume of placental lobular villi vessels and restrict the CRH positive feedback loop, ultimately promoting acute hypoxic stress and possible harm to the fetus.

Adult ; Case-Control Studies ; Cholestasis, Intrahepatic ; metabolism ; Female ; Humans ; Liver Cirrhosis, Biliary ; metabolism ; Placenta ; metabolism ; Pregnancy ; Pregnancy Complications ; metabolism ; Receptors, Corticotropin-Releasing Hormone ; metabolism

Objective To analyze functioning and disability, unmet needs and the service for people with disabilities in Shenzhen, Guangdong, China. Methods Based on International Classification of Functioning, Disability and Health (ICF) and World Report on Disabil-ity, the theoretical framework had been constructed, and the unmet needs and service status for people with disabilities in Shenzhen in 2015 had been statistically analyzed. Results For the statistics of disability by categories, physical disability composed of 42.5%, speech disability composed of 1.5%;people with severe and extremely severe disabilities composed of 52.8%;Futian District composed of 19.7%, Yantian District composed of 2.2%;people aged 0 to 18 years composed of 17.4%, and people aged over 60 years (27.0%) were the larger group. For the unmet needs of people with disabilities, 25%needed rehabilitation therapy, 18.8%needed functional training, 23.2%needed assis-tive devices, and 32.9%had no need. For rehabilitation sevice in Shenzhen, 24.4%received rehabilitation therapy, 17.4%received function-al training, 20.4%received assistive devices, and 37.6%did not receive any service. For the barrier-free reconstruction, 4.6%needed bath-room reconstruction, and 0.7%needed internet access screen software. Conclusion The status of functioning and disability, unmet needs and service development of rehabilitation in Shenzhen had been analyzed. There was still a gap between unmet needs and services of rehabilita-tion. It recommended to construct precise services delivery based on unmet needs, improve the full coverage and quality of service of reha-bilitation.