OBJECTIVE To investigate CD25 expression in peripheral blood T lymphocytes from patients with chronic hepatitis B,and explore its significance in the pathogenesis of chronic hepatitis B.METHODS To detect CD25 expression in peripheral blood T lymphocytes of patients with chronic hepatitis B by means of flow cytometry.CD25 expression was observed in chronic hepatitis B patients.In the meantime,CD25 expression in T cells from severe chronic hepatitis or acute hepatitis B patients and asymptomatic carriers of HBV was also observed.RESULTS Varying degrees of CD25 were expressed in T cells from hepatitis B patients.The expression in CD3+ T and CD8+T cells was higher than that in CD4+T cells.CD25 expression in CD4+T was lower.The average of CD25 expression in CD3+T cells from patients with chronic hepatitis B,acute hepatitis B,and chronic severe hepatitis B and asymptomatic carriers of HBV was(2.92?0.13)%,(0.51?0.36)%,(1.60?0.07)%,and(0.95?0.23)%,respectively.The average of CD25 expression in CD4+T cells from patients with chronic hepatitis B,acute hepatitis B and chronic severe hepatitis B and asymptomatic carriers of HBV was(2.58?0.50)%,(0.34?0.07)%,(1.45?0.02)%,and(0.83?0.13)%,respectively.CD3+T and CD4+T CD25 expression in patients with chronic hepatitis and,severe chronic hepatitis B was increased compared with that of acute hepatitis B patients and asymptomatic carriers of HBV.Compared with chronic severe hepatitis B,the expression of chronic hepatitis B was higher.CONCLUSIONS CD4+ CD25+T cells in chronic hepatitis B virus infection are increased compared with acute hepatitis,CD4+ CD25+T cells may be related to immune tolerance.

In response to the limitation of some medical image segmentation models for rectal cancer auxiliary diagnosis that are only applicable to single-modality images,a medical image segmentation method based on a cross attention mechanism that is applicable to both CT and MRI modalities is presented.Considering the different feature representations of CT and MRI images,a cross attention mechanism is proposed to unify the feature representations of the two types of images.In view of the small lesions on rectal cancer images,an improved Swin Transformer segmentation network with 3 branches is established,and the cross attention mechanism is incorporated into it,enabling the model to segment lesion areas in both types of images.The proposed method is validated using CT and MRI image data from patients with rectal cancer.Compared with ADDA,CycleGAN,and SIFA methods,the proposed method improves the accuracy by 2.94%,3.05%,0.71%on CT images,and 3.31%,4.55%,1.76%on MRI images,respectively,demonstrating its superior segmentation performance for both types of images.

Objective:To investigate the effects of antibiotic treatment and antibiotics combined with surgery treatment on the prognosis of patients with infective endocarditis (IE).Methods:The clinical data and prognosis of all patients diagnosed as IE discharged from Shanghai Jiao Tong University Affiliated Sixth People′s Hospital from June 2011 to May 2021 were collected. There were 240 IE patients, divided into antibiotic treatment group and the antibiotics combined with surgery group according to the treatment methods. The clinical characteristics and prognosis of the IE patients were compared between the two groups, so as to investigate the timing of surgery for IE patients and to analyze the effects of the two treatment methods on the prognosis of IE patients.Statistical analysis methods including Wilcoxon rank sum test, chi-square test, Kaplan-Meier survival analysis and Cox regression analysis were used when appropriate.Results:Of the 240 patients with IE, 63 cases were only treated with antibiotics and 177 cases were treated with antibiotics combined with surgery. After propensity score matching (PSM), one-year mortality rate of the IE patients in the antibiotics combined with surgery group was 11.1%(4/36), which was significantly lower than that in the antibiotic treatment group (33.3%(12/36), χ2=5.14, P=0.023). The median values of left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDD) and left ventricular fractional shortening (LVFS) in the antibiotics combined with surgery group were 59%, 47 mm and 31%, respectively, which were significantly lower than those before surgery (63%, 54 mm and 34%, respectively, Z=6.19, 9.36 and 6.11, respectively, all P<0.001). The most common surgical indication was moderate to severe heart failure, and there was no significant difference between the early operation group and the late operation group (both P>0.050). The one-year cumulative survival rate of antibiotics combined with surgery group was 94.9%, which was significantly higher than that in the antibiotic treatment group (83.2%, χ2=7.38, P=0.007). Heart failure and Pitt bacteremia scores≥4 were the independent risk factors for one-year all-cause death of the IE patients (hazard ratio ( HR)=5.668 and 19.392, respectively, both P<0.050). Hospital days and antibiotics combined with surgery were independent related factors for reducing the risks of one-year all-cause death ( HR=0.931 and 0.299, respectively, both P<0.050). Pitt bacteremia scores≥4 had the greatest impact on one-year prognosis of the IE patients. Conclusions:Surgery could significantly improve cardiac function and one-year prognosis of the IE patients. IE patients with heart failure and Pitt bacteremia score≥4 should be actively treated.