To improve the curative effect in chronic hepatitis B is a major problem to be solved. With the development of technology, an increasing number of novel markers have been used to guide treatment selection, to predict the curative effect and prognosis of hepatitis B.This paper focuses on the characteristics, applications and developmental trend of serological, virological and immunological markers associated with curative effect of chronic hepatitis B.

Objective To explore the work value and its relation with vocational interest types among medical college students.Methods 352 medical college students were investigated by the Work Value Inventory and Medical Vocational Interest Inventory,and the results were analyzed statistically.Results The five highest scores of the work value items were 4.51±0.87,4.34±0.79,4.03±0.90,3.96±0.91,and 3.88±0.55,respectively.Among them,the factor of individual growth and development was the most important follows by the factor of compensation and reward,which had significant differences compared with the factor of social status and reputation included the five lowest scored items(P<0.01,P<0.05).There was no significant difference between male and female,while there were differences among students in various subjects and students with different occupational interest types.Conclusion The factor of individual growth and development is more important than other factors when medical student selecting vocation,and the vocational interest type has effect on the work value.

Humans ; Pneumoconiosis ; diagnostic imaging ; Radiography, Thoracic ; standards ; X-Ray Film

Objective To invesgate hepatitis B c antigen(HBeAg)as the carrier to construct mixed hepatitis C virus(HCV)therapeutic vaccine.Methods Fused the pTrc-core gene with two synthetic T-epitope antigen gene of HCV,expressed the plasmids pTrc-core-T1 and pTrc-core-T2, applied sucrose density gradient centrifugation to get the fusion protein HBcAg-T1 and HBcAg-T2, dialysised and concentrated the protein,mixed and immunized them in mice using the protein HBcAg (expressed by pTrc-core)as control.The tumor regression trial in mice was evaluated at appropriate time.After immunized four times,got the blood and spleen of mice.Interleukin(IL)-12 in serum were detected by enzyme-linked immunosorbent assay(ELISA),nonspecific T lymphocytes prolifera- tion response of splenic lymphocytes was respectively examined by thiazolyl blue(MTT)assay.T cell subset of splenic lymphoeytes,IL-5 in serum,IL-4 and interferon(IFN)-?in lymphocyte were evalu- ated by FACS.Results Tumor regression trial showed the experimental group formed only one tumor(diameter=0.1 cm),smaller than the T_1T_2 peptides group(diameter=0.9 cm)and blank group(diameter=1.3 cm).FACS indicated that CD8~+ T cell percentage of spleen cells from HBcAg- T_1T_2 group(20.21?2.01)% was higher than T_1T_2 peptides group(15.33?1.45)% and blank group(5.09?1.66)%,the percentage of IFN-?positive cells in these three groups were(1.58?0.05)%,(0.88?0.02)% and(0.53?0.03)%.The ELISA discovered that the level of IL-12 in the experimental group was the highest.Different from above,the IL-4 and IL-5 were lower in the exper- imental group.The detection of eytotoxic T lymphocyte(CTL)activity showed that the quantity of Hela cells infected by HCV in HBcAg-T1T2 stimulated group was different obviously from T1T2 peptides group. Conclusion The mixed protein HBcAg-T1 and HBcAg-T2 can induce stronger cellular immunity and it is able to serve as a therapeutic vaccines candidate specific for HCV.

Objective To investigate the species distribution and the difference of virulence gene spectra of Aeromonas isolated from intestinal tract and extraintestinal body fluid,and the correlation of their pathogenicity with infection sites.Methods A total of 156 Aeromonas strains isolated from the fecal specimens of patients with acute diarrhea and extraintestinal specimens were collected during May 2013 and September 2015.Eighteen virulence genes in these strains,including hlyA,aerA,act,alt,ast,aexT,ascV,aopP,ascF-G,gcat,tapA,fla,Ser,exu,ahyB,eprCAl,lip and laf,were detected by polymerase chain reaction(PCR).Last,the differences of virulence gene spectra between intestinal and extraintestinal Aeromonas were analyzed.Results Among 156 Aeromonas strains,79 were from fecal specimens,and 77 from extraintestinal specimens.Aeromonas caviae(A.caviae,51.9％) was the most common species in the intestinal strains,while Aeromonas hydrophila(A.hydrophila,48.1％) and A.caviae(39.0％) were the main pathogens in extraintestinal infections.The most prevalent virulence genes in intestinal and extraintestinal Aeromonas were gcat,act,fla,ahyB,exu and lip (＞ 45.57 ％),while aexT,aopP,ascF-G and ascV were less frequently detected (＜ 20.78％).The detection rates of gcat,ahyB,laf,ast,exu,lip,hlyA and aerA genes in intestinal Aeromonas were significantly lower than those in extraintestinal isolates (P ＜ 0.05).The detection rates of gcat,ahyB,exu,lip,eprCAl and hlyA genes in extraintestinal A.hydrophila were significantly higher than those in intestinal A.hydrophila (P ＜ 0.05).The detection rates of lip and hlyA genes in extraintestinal A.caviae were significantly higher than those in intestinal A.caviae (P ＜ 0.05),while that of aopP gene was just the reverse.There was no significant difference in the detection rates of virulence genes between intestinal and extraintestinal Aeromonas veronii.Conclusion There are significant differences in the species distribution and virulence genes of Aeromonas isolated from intestinal and extraintestinal specimens,indicating that clinicians should treat them differentially.

Objective To evaluate the accuracy of bispectral index (BIS) in predicting outcomes in patients with cerebral hemorrhage.Methods A total of 103 patients of either sex with acute cerebral hemorrhage,aged 18-77 yr,with body mass index of 17-29 kg/m2,of American Society of Anesthesiologists physical status Ⅱ-Ⅳ,undergoing craniotomy for evacuation of hematoma,were enrolled in this prospective study.BIS electrodes were adhered to the forehead of patients,and the BIS value was continuously recorded for 20 min.The maximum BIS value (BISmax) and minimum BIS value (BISmin) were recorded,and the mean BIS value (BISmean) was calculated.The patients were divided into 2 groups according to Glasgow Outcome Scale (GOS) scores assessed at 6 months after surgery:good outcome group (GOS score≥ 3) and poor outcome group (GOS score 1 or 2).The receiver operating characteristic curve of BIS in predicting outcomes was plotted,and the area under the curve (AUC) and 95％ confidential interval (CI) were calculated.The best cut point and sensitivity and specificity were calculated according to the BIS value when Youden index reached the maximal value.Results The AUC (95％ CI) for BISmax in predicting outcomes was 0.903 (0.830-0.976),the best cut point 79,the sensitivity 84％,the specificity 86％,and Youden index 0.695.The AUC (95％ CI) tor BISmin in predicting outcomes was 0.841 (0.760-0.921),the best cut point 43,the sensitivity 86％,the specificity 71％,and Youden index 0.577.The AUC (95％ CI) for BISmean in predicting outcomes w() 0.883 (0.800-0.958),the best cut point 60,the sensitivity 90％,the specificity 76％,and Youden index 0 562.Conclusion BIS can accurately predict outcomes in patients with acute cerebral hemoorrhage,and BISmax provides the highest accuracy.

Objective To explore the clinical characteristics and diagnosis of autoimmune pancreatitis(AIP) with the aim to raise awareness of AIP.Methods Clinical data of 32 patients with AIP were retrospectively analyzed,including clinical manifestations,imaging features,laboratory examination,histopathology and treatment from November 2009 to April 2013 in the First Affiliated Hospital of Medical School,Zhejiang University.Results All 32 AIP patients including 25 males and 7 females had a median age of (62.5 ± 12.6) years (27-84 years).The initial symptoms included obstructive jaundice in 50.0％patients (16/32),abdominal pain in 43.8％ (14/32),fatigue and weight loss in 12.5％ (4/32),and bloody stool in 6.3％ (2/32).Laboratory findings revealed abnormal liver function in 6.3％ (2/32)patients,increased immunoglobulins in 71.9％ (23/32)patients and elevated IgG4 in 8/10 patients.Computerized tomography(CT) scan and ultrasonography were performed in all patients.Diffusely enlarged pancreas were found in 62.5％ (20/32) patients and focally enlarged in 37.5％ (12/32),additionally main pancreatic duct stenosis in 62.5％ (20/32) patients.Nineteen patients obtained histopathological examination,indicating pancreatic interstitial fibrosis,and infiltration of lymphocytes and plasma cells.Conclusions Autoimmune pancreatitis is an autoimmune disease which may be misdiagnosed as pancreatic cancer.The clinical features,laboratory findings,imaging characteristics,and typical histopathologic presentation,as well as good response to glucocorticoids provide supportive evidence for the diagnosis of AIP.

Objective To evaluate the effect of compound K ( CK) on spinal Toll?like receptor 4 ( TLR4) expression during morphine?induced hyperalgesia in rats. Methods Thirty?six healthy male Spra?gue?Dawley rats in which intrathecal catheters were successfully implanted were randomly divided into 3 groups ( n=12 each) using a random number table: control group ( group C) , morphine?induced hyperal?gesia group ( group M) , and morphine + CK group ( group M+CK) . Starting from 5 days after successful implantation, normal saline 10 μl, morphine 10 μg, and morphine 10 μg + CK 10 μg were injected in?trathecally twice a day for 7 consecutive days. Tail?flick latency ( TFL) to a thermal nociceptive stimulus was measured at 1 day before administration ( T0 , baseline) and at 30 min after the initial administration on 1st, 3rd, 5th and 7th days (T1?4), and the percentage of maximum possible effect (MPE) was calculated. The rats were sacrificed after the last measurement of tail?flick latency, and the lumbar segment ( L3?5 ) of the spinal cord was removed for determination of the expression of TLR4 by Western blot. Results MPE was significantly lower at T3,4 than at T1 in M and M+CK groups ( P<0?05) . Compared with group C, MPE was significantly lower at T2?4 , and the expression of TLR4 was up?regulated in M and M+CK groups ( P<0?05). Compared with group M, MPE was significantly increased at T1?4, and the expression of TLR4 was down?regulated in group M+CK ( P<0?05 ) . Conclusion The mechanism by which CK alleviates mor?phine?induced hyperalgesia is associated with down?regulation of TLR4 expression in rats.

Objective To determine whether repeated cold-stress stimulation could activate rennin-angiotensin system in rats and lead to a PIH-like phenomena in pregnant rats.Methods Adult Wistar female rats were randomly divided into 4 groups: non-pregnant control group(NN), non-pregnant cold-stress group(NC), pregnant control group(PN) and pregnant cold-stress group(PC). Rats were kept for 4 hours in (4?2)℃(NC?PC) and in 25℃ (NN?PN) every day respectively, from the 1st day to the 19th day of pregnancy. The AngⅡlevels of plasma?uterus and placentas were determined by radioimmunoassay. The expression of angiotensin Ⅱ type 1 receptor (AT1R) and angiotensin Ⅱ type 2 receptor (AT2R) mRNA were determined in uterus and placentas of rats by RT-PCR. Results The AngⅡlevels of plasma, uterus and placentas were increased significantly in NC and PC compared with those in NN and PN. AT2R was the predominant type in the rat non-pregnant uterus. Downregulation of AT2R and upregulation of AT1R were observed during pregnancy. And at last, AT1R was the predominant type in pregnant uterus. The AngⅡ receptors in the rat placenta are predominantly AT1R. After cold-stress stimulation, the expression of AT1R mRNA in uterus and placentas of rats were higher than that of control groups(P0.05). Conclusions Repeated cold-stress stimulation could activate the renin-angiotensin system(RAS), and lead to a PIH-like phenomena in pregnant rats at last.