Objective To investigate the expression and significance of Th9, Th17 and CD4+CD25+Foxp3+regulatory T (Treg) cells as well as the related cytokines (IL-9, IL-17, TGF-β) in peripheral blood of patients with adult primary immune thrombocytopenia ( ITP) . Methods Peripheral blood samples were collected from 47 patients with ITP and 39 age-and sex-matched healthy subjects. The percentages of Th9, Th17 and CD4+CD25+Foxp3+Treg cells in peripheral blood samples were detected with flow cytometry. The levels of IL-9, IL-17 and TGF-βin serum samples were detected by enzyme linked immunosorbent assay ( ELISA) . Results Compared with healthy subjects, the percentages of Th9 and Thl7 cells and the concen-trations of IL-9 and IL-17 in patients with ITP were significantly increased [(1. 27±0. 31)% vs (0. 71± 0. 26)%, P<0. 05;(2. 01±0. 42)% vs (0. 97±0. 32)%, P<0. 05. (26. 52±7. 48) ng/L vs (16. 16± 5. 27) ng/L, P<0. 05;(10. 97±3. 94) ng/L vs (7. 14±2. 73) ng/L, P<0. 05]. The percentages of CD4+CD25+Foxp3+ Treg cells and the concentrations of TGF-β in patients with ITP were lower than those in healthy subjects [(4. 69±0. 85)% vs (7. 16±1. 92)%, P<0. 05. (3. 76±1. 28) μg/L vs (6. 41±1. 83)μg/L, P<0. 05]. Moreover, the blood platelet counts in patients with ITP were negatively correlated with the percentages of Th9 and Th17 cells and the concentrations of IL-9 and IL-17 (γs=-0. 349, P=0. 037;γs=-0. 392, P=0. 031;γs=-0. 436, P=0. 014;γs=-0. 401, P=0. 027), but were positively correlated with the percentages of CD4+CD25+Foxp3+ Treg cells and the concentrations of TGF-β (γs=0. 411, P=0. 024;γs=0. 407, P=0. 026). Conclusion The imbalanced distribution of Th9, Th17 and Treg cells and the abnormal expression of related cytokines (IL-9, IL-17 and TGF-β) in patients with ITP might be the possible immunological pathogenesis of ITP.

Mobile reading has greatly impacted the use of printed Chinese books in academic libraries.It is the most important task to introduce the users-needed books in order to improve their utilization.Acquisition of Chinese books should be arranged closely around the need of users by studying the reading features of users under mobile reading environment and establishing the open channels for book recommendation and feedback information in order to improve its quality .

BACKGROUND: The frequency of body ailments combined with depression is relatively higher, and hence post stoke depression(PSD) has gained more and more concentration.OBJECTIVE: To investigate the morbidity, related factors and pathophysiological mechanism of PSD.DESIGN: Case analysis and observation study.SETTING: Department of eurology in a hospital of a university; Third department of internal medicine in a hospital of Chinese People' s Armed Police Force; Department of neurology in a province hospital.PARTICIPANTS: This study was carried out at the Neurological Department of First Clinical Hospital Affiliated to Harbin Medical University and the General Hospital of Armed Police Army in Heilongjiang Province from January 2001 to May 2004. A cohort of 312 stroke patients was followed up in this study.METHODS: All 312 patients scored for Hamilton rating scale for depression (HAMD) and European stroke scale(ESS) within 48 hours of hospitalization. Meanwhile their clinical presentations and social-psychological factors were also collected.MAIN OUTCOME MEASURES: The stroke morbidity in patients with different sex, age, personality, educational degree, as well as stroke type, lesion location and extent of neurological functional deficit.RESULTS: The morbidity of PSD was 40. 1%, predominated by mild and medium stroke; amongst which PSD was found more frequent in women than men( P ＜ 0.01), as well as in elders than youngers( P ＜ 0.01); Patients who has diffidence personality are liable to suffer from PSD; and it was found more common in patients with over middle school education than those received only elementary school education ( P ＜ 0.01 ); depression was more frequent in left-sided stroke than right-sided stroke( P ＜ 0.01 ), especially in frontal lobal stroke; PSD was found negatively correlated with the scores for ESS(r= -0.846, P ＜0.05).CONCLUSION: As the result of the interaction of multiple factors, the development of PSD is found accorded with biology-psychology-society mode.

The results of different interventions administered in 118 cases with impaired fasting glucose (IFG) for 3 years were investigated. The rates of transformation of IFG to diabetes mellitus in metformin treatment groups and rosiglitazone treatment groups were significantly lower than that in life style intervention group. This study suggested that metformin or rosiglitazone treatment could effectively reduce transformation of IFG to diabetes as compared with life style intervention.

Objective To investigate the percentages of Th17 and CD4+CD25+FoxP3+ regulatory T(Tr) cells and the levels of related cytokines IL-6,IL-23,IL-17 and TGF-β in serum of patients with anlylosing spondylitis(AS).Methods Forty patients with AS and 37 age-matched healthy donors were studied.Flow cytometry Was used to analyze the percentages of blood Th17 and CD4+CD25+FoxP3+Tr cells.The levels of serum IL-6,IL-23,IL-17 and TGF-β were assayed by enzyme-linked immunosorbent assay ( ELISA).Results The proportion of Th17 cells in AS group was significantly higher than those in normal group [ (1.02±0.34)％ vs (0.68±0.29)％,P＜0.05) ],and the proportion of CD4+CD25+FoxP3+ cells was lower in AS group comparing with normal group [(3.77±0.81)％ vs (4.69±1.23)％,P＜0.05)].Meanwhile,serum levels of IL-6,IL-23 and IL-17 were significantly higher in AS group than those in normal group [ (6,15±2.71) ng/L vs (3.31±1.65) ng/L; (9.44±3.12) ng/ml vs (5.82±2.61) ng/ml;(10.53±4.97) ng/L vs (6.78±3.26) ng/L,all P＜0.01 ].In contrast,TGF-β level was decreased in AS group compares with the normal group [ ( 4.76±2.15) ng/ml vs (5.16±2.02) ng/ml,P＞0.05 ],but the difference was not significant.No associations of serum eytokine levels with clinical and laboratory parameters were found in AS.Conclusion The abnormality Th17 cells and Tr cells and their related cytokines IL-6,IL-23,IL-17 and TGF-β changes in patients with AS,which may be involved in immunological pathogenesis of AS.

Objective To evaluate and compare the clinical efficacy and safety of intense pulsed light (IPL) versus 595-nm pulsed dye laser (PDL) for the treatment of post-acne erythema.Methods A randomized split-face clinical trial was conducted.A total of 20 patients with post-acne erythema were enrolled,and randomized to receive treatment with IPL on one half of the face and 595-nm PDL on the other facial side once every 4 weeks for 3 sessions.Digital photographs were taken using the VISIA,and erythema index was recorded before each treatment and one month after the last treatment.The severity of bilateral facial erythema was evaluated based on a 4-point grading scale before the first treatment and after the last treatment.Pain scores and adverse reactions were recorded using a visual analogue scale (VAS) after each treatment,and a patient satisfaction survey was conducted by questionnaire at the last follow-up.Results The mean erythema index on the IPL side before and after treatment was 472.25 ± 86.02 and 357.15 ±82.71 respectively,and that on the PDL side before and after treatment was 476.40 ± 74.25 and 360.05 ± 64.83 respectively.Repeated measures analysis of variance (ANOVA) showed that the erythema indices on both treated sides significantly decreased over time (F =197.666,P ＜ 0.001),and the efficacy of IPL was better than that of PDL (F =1 173.909,P ＜ 0.001).Erythema severity grades on the IPL side as well as on the PDL side significantly differed between before and after treatment (Z =28.735,31.450,respectively,both P ＜ 0.001).As VAS showed,the pain score on the PDL side was significantly lower than that on the IPL side (t =2.468,P ＜ 0.05).Among the 20 patients,17 and 15 assessed their improvement as good or excellent after PDL and IPL treatment respectively,but there was no significant difference between the two groups (Z =2.696,P ＞ 0.05).The adverse reactions included erythema,burning sensation,tense sensation,blistering and hyperpigmentation on IPL-treated side,and erythema and purpuric reactions on the PDL-treated side,which all disappeared in a few hours to several days.Conclusions Both IPL and 595-nm PDL are effective and safe for the treatment of post-acne erythema,and are worthy of clinical promotion and application.IPL shows superiority in the efficacy,but elicits higher pain sensation compared with PDL.

Objective: To explore the effect of the aortic arch type on technical indicators in patients with carotid artery stent implantation.
Methods: We retrospectively analyzed 224 consecutive patients treated in Fu Wai hospital for unilateral carotid artery stent implantation from 2011-01 to 2012-12. We summarized the catheter category, type and the operating techniques including ① retracement, turn and insertion of the catheter, ② retracement, turn of catheter+the guidance of guide wire,③ retracement, turn of catheter+the guidance of guide wire+the supporting of another catheter, ④ using special graphic catheter+the guidance of guide wire+the supporting of another catheter. The procedural X-ray exposure time, dosage of contrast agent and operation related complications were recorded. According to Myla classiifcation, the aortic arches were divided into Myla I, Myla II and Myla III types.
Results: There were 7/224 (3.1%) patients with Myla I aortic arch, 113 (50.4%) with Myla II aortic arch and 104 (46.4%) with Myla III aortic arch. A total of 48/104 (46.2%) Myla III patients used special techniques (tech③, tech④), it was more than the patients with Myla I, (1/7,14.3%) and Myla II (17/113, 15.0%), P<0.01. The patients with Myla III aortic arch had the longer X-ray exposure time and used the higher dose of contrast agent, all P<0.01. The procedural success rate in patients with
Myla III was 96.2%, it was lower than those with Myla I (100%) and Myla II (100%), P=0.045. The procedural complication rate in patients with Myla III was 22.1%, it was higher than those with Myla I (0%) and Myla II (8.9%), P=0.007.
Conclusion: The aortic arch type is the important inlfuential factor for the techniques used in carotid stent implantation. There were more dififculties and complications for stent implantation in patients with Myla III aortic arch.

Objective:To analyze the incidence of human papillomavirus (HPV) infection in 1 902 patients and to evaluate the efficacy of drug treatment in 266 patients, aiming to provide reference for the treatment of HPV infection.Methods:The subtypes of HPV isolated from 1 902 patients aged 15-86 years visiting the venereology outpatient clinic of Tianjin Medical University General Hospital from October 2019 to May 2021 were identified by polymerase chain reaction-reverse dot blot hybridization. Drug treatment efficacy in 266 patients of them was retrospectively analyzed.Results:The overall incidence of HPV infection in the 1 902 patients was as high as 53.84% (1 024/1 902). It was 52.60% (689/1 310) in males and 56.59% (335/592) in females. There was no significant difference in the incidence between males and females ( P>0.05). The most common HPV genotype in males and females was HPV6 [15.27% (200/1 310) and 21.96% (130/592)], followed by HPV16 [10.61% (139/1 310) and 9.46% (56/592)], HPV11 [9.31% (122/1 310) and 8.61% (51/592)], HPV52 [6.79% (89/1 310) and 8.95% (53/592)] and HPV43 [5.64% (87/1 310) and 8.45% (50/592)]. The majority of HPV-positive patients were aged between 20 and 39 years. There were 476 cases (25.03%, 476/1 902) of single-type infection and 548 cases (28.81%, 548/1 902) of multiple infection. The incidence of multiple infection was higher than that of single-type infection ( P<0.05). The incidence of multiple infection in females was higher than that in males ( P<0.05). Among the 266 patients, 106 were treated with Paiteling, a traditional Chinese medicine (TCM) preparation, and 68 of them tested negative (64.15%) after treatment. Fifty-eight patients were treated with recombinant human interferon α2b and 22 of them (37.93%) tested negative after treatment. Twenty out of the 56 subjects treated with imiquimod tested negative after treatment. Eight out of the 46 patients without treatment also turned negative. Conclusions:The incidence of HPV infection in the 1 902 patients visiting the venereology outpatient clinic was very high, and most of them were young adults. Multiple infection was more common than single-type infection. Topical application of drugs such as Paiteling, recombinant human interferon α2b and imiquimod was effective in treating HPV infection.

Objective To analyze the relationship between hepatitis B virus genotyping and primary liver cancer (PHC) in Wuhan, and to provide a theoretical basis for the early prevention and diagnosis of PHC. Methods Patients with chronic hepatitis B (CHB) from Wuhan Sub-heart General Hospital for treatment from February 2020 to February 2021 were selected and divided into PHC group (182 cases) and control group (189 cases) according to whether they were complicated with primary liver cancer. 5ml of fasting elbow venous blood was taken from all subjects at admission. HBV genotyping was determined by real-time fluorescence quantitative PCR. The DNA of CHB virus was determined by fluorescence probe hybridization and PCR amplification, and genotyping and drug-resistant mutation points were detected according to the product sequencing analysis. Spearman linear correlation analysis was used to analyze the correlation between genotyping and mutation rate of PHC patients. Results The proportion of C genotype in PHC group was significantly higher than that in non-PHC group (P<0.05). There was no significant difference in the proportion of B genotype and mixed B and C genotype between 2 groups (P>0.05). The proportion of HEPATITIS B virus mutation in PHC group (114/182) was significantly higher than that in control group (84/189) (χ²=12.331, P<0.05). There was no significant difference in the proportion of HBV B type and B, C mixed mutation between the two groups (P>0.05). The proportion of HBV C mutant in PHC group was significantly higher than that in control group (P<0.05). The proportion of HBV C mutation in PHC group was significantly higher than that of HBV B and B, C mixed type (P<0.05). Spearman correlation analysis showed that the mutation rate of C genotype and C genotype was positively correlated with the occurrence of PHC, and the correlation coefficients were (r₁=0.349, r₂=0.305, P<0.05). Conclusion The HBV genotype of PHC patients is mainly TYPE C, and has a high mutation rate of C genotype. It can be used for diagnosis of PHC by detecting the genotyping of CHB and mutation rate of C genotype in clinic.

【Objective】 To investigate the effect of phenotypes of Duffy blood group on chemokine storage and chemokine scavenging function of erythrocytes. 【Methods】 Twenty-four erythrocyte samples were collected and tested Duffy blood phenotype using the anti-human globulin method, and erythrocyte CCL2, CCL5, CXCL8, and CCL11 content and their chemokine scavenging function using ELISA. The expression of Duffy antigens on erythrocytes was detected using a flow analyzer. 【Results】 The difference in CCL2 content(41.1±14.7 pg/mL vs 63.1±20.8 pg/mL)of erythrocyte lysate between Fy(a+b-) and Fy(a+b+) phenotype was statistically significant (P<0.05), however, the difference in the content of CCL5(794.5±320.1 pg/mL vs 846.9±359.4 pg/mL), CXCL8(59.5±34.2 pg/mL vs 49.1± 11.9 pg/mL), and CCL11(109.1±25.1 pg/mL vs 158.6 ±56.0 pg/mL) were not statistically significant (P>0.05).The difference in the scavenging function of CCL2(1471±202.1 pg/mL vs 1860±267.5 pg/mL)and CCL5 (848.5±461.7 pg/mL vs 1797±546.1pg/mL) between Fy(a+b-) and Fy(a+b+) phenotype were statistically significant (P<0.05), however, for CXCL8(1851±180.7 pg/mL vs 1 862± 248.3 pg/mL) and CCL11(691.0±125.7 pg/mL vs 781.7 ±293.8 pg/mL) scavenging function the difference were not statistically significant (P>0.05).The difference in Duffy antigen expression (mean fluorescent intensity:105.3±20.45 vs 111.9±18.30)on erythrocytes between Fy(a+b-) and Fy(a+b+) phenotype was not statistically significant (P>0.05). 【Conclusion】 The Fy(a+b+) and Fy(a+b-) phenotypes of the Duffy blood group can affect the chemokine storage and scavenging function of erythrocytes. Fy(a+b+) phenotypes are able to store more chemokines and have a stronger chemokine scavenging function than Fy(a+b-) phenotypes.