Objective To investigate the early diagnostic methods for sub-clinical hepatic encephalopathy (SHE).Methods 46 hepatocirrhosis patients without hepatic encephalopathy (SHE group) were recruited to perform P300, brainstem auditory evoked potential (BAEP), numeral connection teat (NCT),mini-mental state examination (MMSE)and electroencephalogram (EEG), compared with 43 unhepatopathy patients (control group) and within following up.Results The P300 delitescence and the NCT value in SHE group were obviously longer than those of the control group (allP

Objective To explore the relationship between serum HBV DNA level , expression of PD-1 on CTL and liver functions in patients with hepatitis B virus cirrhosis. Methods 109 HBV hepatic cirrhosis patients with , HBV DNA positive , HBeAg positive and HLA-A2 positive were divided into two groups according to their HBV DNA levels,52 cases in group A, HBV DNA 2-4 log10 copies/mL, 57cases in group B, HBV DNA 5-7 log10 copies/mL , differences of HBV specific CTL surface PD-1 expressions , HBV specific CTL levels and liver functions were compared between two groups. Results HBV specific CTL surface PD-1 expressions of group A were lower than that of group B (t = 11.101, P < 0.01), HBV specific CTL levels of group A were higher than that of group B (t = 24.424, P < 0.01), ALT of group A were lower than that of group B (t = 2.652, P < 0.01), ALB of group A were higher than that of group B (t = 2.347, P < 0.05). Child-pugh rating, grade C of group A was lower than that of group B (χ2= 4.262,P < 0.05). Conclusions HBV specific CTL surface PD-1 expression levels were higher in those hepatic cirrhosis patients with , high level of serum HBV DNA, and HBV specific CTL levels were lower, liver functions damage were much serious. So, lower HBV DNA levels , lower HBV specific CTL surface PD-1 expression levels and higher HBV specific CTL levels can product relatively good effect of anti-viral treatment.

Objective To investigate the effects ofZhenqi-Fuzheng capsule combined with highly active antiretroviral therapy (HAART) the Thl/Th2, Tcl/Tc2, and CD4+ T lymphocytes in patients with advanced AIDS.Methods A total of 70 patients with advanced AIDS were randomly divided into a treatment group and a control group, with 35 patients in each group. The treatment group was treated withZhenqi-Fuzheng capsule combined with HAART, while the control group was treated with HAART only. The patients in both groups were treated for 24 weeks. The Thl, Th2, Tcl, Tc2 and CD4+ T lymphocytes in peripheral blood were detected by flow cytometer.Results After treatment, the ratios of Th1/Th2 (6.27 ± 0.70vs. 5.39 ± 0.64;P<0.05) and Tcl/Tc2 (10.70 ± 0.68vs. 10.16 ± 0.85;P<0.05) in the treatment group showed significantly higher than those in the control group. The CD4+T lymphocytes after the treatment in both groups showed significantly increased than that before the treatment (treatment group: 289.2 ± 101.5/mlvs. 121.1 ± 77.5/ml,P<0.01; control group: 231.6 ± 97.6/mlvs. 118.9 ± 76.2/ml,P<0.01). The CD4+T lymphocytes in the treatment group showed significantly increased than that in the control group after the treatment (P<0.05).ConclusionsZhenqi-Fuzhengcapsule combined with HAART may regulate the Thl/Th2 and Tcl/Tc2, and increase the CD4+ T lymphocytes in patients with advanced AIDS.

Objective To investigate the impairment mechanism of learning and memory function induced by arsenite exposure through studying the effects of sodium arsenite on gliotransmitter release from astrocytes.Methods Primary cultured astrocytes were isolated from neonatal (0-3 days) Wistar rats and determined by glial fibrillary acidic protein (GFAP) immunofluorescence staining.The primary cultured astrocytes were randomly divided into four groups,in which astrocytes were exposed to 0.0,2.5,5.0,or 10.0 μmol/L sodium arsenite,respectively,for 24 h.Intracellular free Ca2+ concentration ([Ca2+]i) in astrocytes was measured by fluorescence dual wavelength spectrophotometer;,concentrations of glutamate,D-serine,glycine and γ-aminobutyric acid were measured by high performance liquid chromatography (HPLC).Results More than 95％ cells were positive for GFAP immunofluorescence staining.The difference of [Ca2+]i among groups treated with sodium arsenite was statistically significant (F =20.030,P ＜ 0.05).[Ca2+]i increased significantly in group treated with 10.0 μmol/L sodium arsenite [(263.27 ± 14.80)nmol/L] compared with those in groups treated with 0.0,2.5,5.0 μmol/L sodium arsenite [(204.24 ± 27.21),(214.49 ± 21.85),(232.74 ± 23.14)nmol/L,all P ＜ 0.05].The differences of the levels of D-serine,glycine and γ-aminobutyric acidamong groups treated with sodium arsenite were significant (F =26.599,33.539,5.599,all P ＜ 0.05).The levels of D-serine [(21.580 ± 1.313),(21.936 ± 1.539),(23.401 ± 1.648)μmol/L],glycine [(26.353 ± 2.449),(29.711 ± 1.530),(29.234 ± 2.057)μmol/L] and γ-aminobutyric acid [(27.277 ± 3.421),(30.213 ± 2.098),(29.364 ± 2.588)μmol/L] released by astrocytes increased significantly in groups treated with 2.5,5.0,10.0 μmol/L sodium arsenite compared with those in groups treated with 0.0 μmol/L sodium arsenite [(16.017 ± 1.046),(16.763 ± 3.007),(22.736 ± 4.139)μmol/L,all P ＜ 0.05].Conclusion Arsenite could affect gliotransmitter release from astrocytes,and further impair learning and memory function.

Objective To investigate the correlation between the mierosatellite polymorphism of heme oxygenase-1(HOX-1)gene promoter and susceptibility to chronic obstructive pulmonary disease(COPD)in Han nationality of Southwest China and CT imaging.Method The alleles frequencies with varying number of(GT)n repeatings in the Hox-1 gene in 180 smokers with COPD and in 150 healthy smokers were analyzed.Results Polymorphisms of the(GT)n repeats were grouped into three classes:S(≤25 repeats),M(26-31 repeats),L(≥32repeats).The proportion of genotypic frequencies in the group with class L alleles(L/S,L/M,I/L)was significantly higher in the smokers with COPD than in healthy smokers(29.4%vs18.7%,P=0.023,OR=1.8,95%CI 1.1-3.1).However,there was no relationship between the polymorphism of HOX-1 gene and subtypes of COPD by CT imaging in COPD patients(P＞0.05).Conclusion Genetic polymorphism in Hox-1 is associated with development of COPD in Han nationality of Southwest China.But the polymorphism of HOX-1 gene is not associated with subtypes of COPD by CT imaging.

Objective To investigate the relationship between the variation of endothelial progenitor cells (EPC) number and cardiovascular diseases (CVD) in maintenance hemodialysis (MHD) patients ,and discuss the function of EPC in the progression of CVD in MHD. Methods One hundred and fifteen MHD patients over 18 years whose dialysis vintage was over six months from Department of Nephrology, Renji Hospital, Shanghai Jiao Tong University School of Medicine were enrolled. They were divided into CVD group and non ? CVD group by medical history, electrokardiographie (EKG), cardiac ultrasound, peripheral vascular imaging and cardiovascular imaging. Peripheral blood (5 ml) was collected for detecting EPC number by flow cytometry as CD34/CD133/vascular endothelial growth factor receptor 2 (VEGFR2) cells. The EPC number between CVD group and non?CVD group was compared. The relationship between the decrease of EPC number and CVD risks in MHD patients was analyzed by logistic regression analysis. In a three?year follow?up, the death and new CVD events of the two groups were compared in order to discuss the relationship between EPC number and adverse events. Results Among 115 MHD patients, the average age was 61.57 ± 12.76, male/female was 71/44, the average dialysis vintage was (86.24 ± 56.31) months, the average Kt/V was 1.69 ± 0.29 and average ultrafiltration volume was (2.48 ± 0.90) L. Forty?four patients in 115 (38.3%) were with concurrent CVD. The EPC number in CVD group was significantly lower than that in non CVD group (P=0.015). The CVD group had higher serum phosphate (P=0.013), higher glycosylated hemoglobin (P<0.001), but serum calcium, intact parathyroid hormone (iPTH) and other indicators had no significant difference between two groups. Multiple Logistic regression analysis showed that older age (OR=1.061), history of diabetes (OR=9.796), dialysis vintage (OR=1.015), serum phosphate (OR=3.766), decrease of EPC number (OR=0.909) were the independent impact factors of CVD events in MHD patients. There were 22 patients of the 115 MHD patients had encountered a new CVD event in a three?year follow?up between December 2012 and December 2015, 9 patients from the CVD group and 13 patients from the Non?CVD group, and there was no significant difference between two groups (P=0.776). Nine patients from the CVD group and 7 patients from the Non?CVD group died in the follow?up, and there was no significant difference (P=0.111). Seventy?one MHD patients from the non?CVD group were divided into two groups by the median of EPC number. There were 3 patients in the higher EPC number group encountered CVD events and 10 patients in the lower EPC number group encountered CVD events, which had significant difference (P=0.024). Conclusion The decrease of circulating EPC number may be related with CVD events in MHD patients. Even adjusted by age, sex, diabetes, dialysis vintage and serum phosphate, decreased EPC number is still the independent risk factor of CVD events in MHD patients. The decrease of EPC number in MHD patients may be used to predict the occurrence of cardiovascular events.

Objective To study the correlation between pain, lower limb strength and physical function in patients with primary osteoporosis. Methods Fifty-seven female patients diagnosed with menopause-related low bone mass or primary osteoporosis using a GE calcaneus bone density detector were involved in this study. The muscle strength of their lower limbs was tested with a Biodex system 4 machine. Pain was assessed with a visual analogue scale, and physical function (PF) with the SF-36 instrument. Results Low back pain was significantly correlated with PF, and so was leg pain. Leg pain was also significantly correlated with the strength of the extensors of the dominant leg during low velocity and medium velocity movement. Leg pain was not, however, significantly correlated with the strength of the flexors of the dominant leg during low and medium velocity movement. Conclusions Pain predicts poor physical function in patients with primary osteoporosis or low bone density. During low and medium velocity movement, leg pain significantly predicts poor muscle strength in the extensors of the dominant lower leg, but it has no correlation with the muscle strength of the flexors.

Background:The pathogenesis of irritable bowel syndrome(IBS)is not fully known,social psychological factor is the important factor of IBS,especially the relationship with anxiety and depression. Aims:To investigate psychological stress factor,anxiety and depression in IBS patients among soldiers in northeast area. Methods:A total of 11 400 soldiers in northeast area were enrolled by multistage,stratified,cluster random sampling method asking to fulfill a questionnaire on IBS. Zung self-rating anxiety scale(SAS)and Zung self-rating depression scale(SDS)were assessed,and the relationship with anxiety,depression and stress was analyzed. Results:The incidence of IBS was 15. 9% . Prevalences of anxiety and depression in IBS group were significantly higher than those in non-IBS group(22. 9% vs. 9. 6% ,26. 6% vs. 12. 4% ,P< 0. 05). Score of SAS and SDS in IBS group were significantly higher than those in non-IBS group(50. 86 ± 7. 27 vs. 36. 54 ± 6. 97,53. 47 ± 7. 86 vs. 38. 25 ± 9. 83,P < 0. 05). Positive correlation was found between score of SAS and SDS and stress factors such as feeling lonely,depression,intensive training,working pressure,poor relationship with colleagues,solving emergency event or participating in military exercises in IBS group(P < 0. 05). Conclusions:IBS in soldiers is related with stress and psychological factors.

Objective To validate the Memorial Sloan-Kettering Cancer Center(MSKCC)score model and evaluate the clinical efficacy of vascular endothelial growth factor(VEGF)-targeted agents in the treatment of advanced renal cell carcinoma(RCC)in China.Methods Three hundred and forty-five patients with advanced RCC and average age of 57(17-90)years were treated with VEGF-targeted agents.There were 306 cases of clear cell RCC,20 cases of papillary RCC,4 cases of chromophobe RCC,5 cases of renal collecting duct carcinoma,3 cases of medullary carcinoma and 7 cases of unclassified RCC.The main metastatic lesions were located at lung,bone and lymph nodes.Of them,205 cases were given the treatment of sorafenib 400 mg bid without off treatment,while 140 cases received sunitinib treatment in repeated six week cycles consisting of four weeks of sunitinib 50 mg daily followed by two weeks off treatment.Overall survival(OS)was estimated by the Kaplan-Meier method.Log-rank test and Harrell concordance index analysis were used to validate the MSKCC score model.Results The median follow-up period were 23(1-68)months in the whole group.The OS was 33 months,and survival rates at 1,2,3 year were 77.6％,59.3％,46.6％,respectively.According to the MSKCC score model,the patients were segregated into three risk categories: the favorable-risk group(no prognostic factors;n =169;49.0％),in which median OS(mOS)was 46 months and 2 year OS was 75.8％;the imtermediate-risk group(one or two prognostic factors;n =150;43.5％),in which mOS was 24 months and 2 year OS was 47.7％;and the poorrisk group(three to five prognostic factors;n =26;7.5％),in which mOS was 8 months and 2 year OS was 10.1％(log-rank P ＜ 0.01).The concordance index was 0.687.Conclusions VEGF-targeted agents are effective in Chinese advanced RCC patients.The MSKCC score model can be incorporated into judging individualizing tumor prognosis and communicating about the treatment options with patients who are using VEGF-targeted agents.

Objective To explore the relationship between viral load and expression of CD 226 on the surface of peripheral blood T follicular helper cells (Tfh) in patients with chronic hepatitis C (CHC) . Methods One hundred and thirty-five CHC patients hospitalized at Wuxi Fifth People′s Hospital from March 2015 to April 2017 were collected ,and another 30 healthy blood donors were set as healthy control group .CHC patients were divided into two groups based on hepatitis C virus (HCV) RNA level ,with 49 cases (36 .3％ ) in low viral load group and 86 cases (63 .7％ ) in high viral load group .Expression of CD226 on the surface of peripheral blood Tfh cells , Tfh cells ,interleukin (IL )-21 and HCV specific cytotoxic lymphocyte (CTL) levels of two patient groups were compared .Categorical data were compared with chi-square test and normally distribute continuous data were compared with t test .Correlations between different factors were analyzed by Pearson correlation analysis .Results Expression of CD226 on the surface of peripheral blood Tfh cells in 135 cases of CHC patients was (77 .69 ± 5 .42)％ ,which was lower than that of healthy control ([90 .06 ± 5 .83]％ ) ,and the difference between the two groups was significant (t= 7 .541 , P < 0 .01) .The CD226 expression on the peripheral blood Tfh cells in low viral load group was (88 .75 ± 6 .68)％ ,which was higher than that of high viral load group ([69 .23 ± 5 .86]％ ) ,and the difference between the two groups was significant (t = 19 .232 , P< 0 .01) .The viral load was negatively correlated with Tfh cell surface CD 226 expression (r = - 0 .705 , P < 0 .01) .The peripheral blood Tfh cell level in 135 CHC patients was higher than that of healthy control ,and the difference between the two groups was significant (t= 13 .878 , P< 0 .01) .The peripheral blood Tfh cell level in low viral load group was higher than that in high viral load group ,and the difference between the two groups was significant (t= 26 .993 , P< 0 .01) .The IL-21 level of 135 CHC patients was lower than that of healthy control ([70 .35 ± 1 .6]％ ) ,and the difference between the two groups was significant (t=18 .322 , P< 0 .01) .The IL-21 level in peripheral blood of low viral load group was higher than that of high viral load group ,and the difference between the two groups was significant (t= 84 .54 , P< 0 .01) . HCV specific CTL level in peripheral blood of low viral load group was higher than that of high viral load group ,and the difference between the two groups was significant (t = 29 .869 , P< 0 .01) .The viral load was negatively correlated with levels of HCV specific CTL (r= -0 .734 ,P< 0 .01) .Conclusions In patients with chronic hepatitis C ,different levels of viral load can result in different levels of CD 226 expression on the peripheral blood Tfh cells .Patients with low viral load has high CD226 expression on Tfh cell surface , resulting in rise of Tfh cell level ,IL-21 level and HCV specific CTL level .