Objective To develop a rapid expansion assay and determine the predominant epitope for HBV-specific CD8 T cells from peripheral blood mononuclear cells(PBMC) of patients with acute hepatitis B(AHB).Methods PBMC were isolated from a patient with HLA-A2 positive AHB,and the frequency of HBV-specific CD8 T-cells was determined using 3 kinds of HLA-A2 antigenic peptide florescence-labeled pentamer agents,i.e.S183-191 and S335-343 derived from HLA-A2 restricted HBsAg epitope,and C18-27 derived from HBcAg epitope.Cytokines and corresponding epitopic peptides were used for induction of positive CD8 T-cell expansion and enrichment in PBMC for 1-2 weeks.T epitope-specific CD8 T-cells were quantified and sorted by flow cytometry.Results After cultivation with antigenic peptide stimulation and proper cultural condition,the frequency increased significantly in the pentamer positive HBV-specific CD8 T cells in total CD8 T cells.The peak value was observed in 2-week cultivation.At the time the HBV-specific CD8 T cell frequencies increased from 0.21% to 15.17% for S183-191,and from 0.44% to 1.79% for S335-343,representing 73.8-folds and 3.1-folds increase for each epitope respectively.However,the frequency of C18-27-specific CD8 T-cells was negative and without obvious proliferation after stimulation.Conclusions Under stimulation of HBV epitopic peptide in proper culture condition,the specific CD8 T lymphocytes may be induced and expanded in quantity via sort-term conditioned culture.CD8 T cells specific for S183-191 may play an important role in the control of acute HBV infection.

0.05,respectively).The effect of test groups on the bacteria and fungi compared with that of control groups in dynamically monitoring showed significance(P

Objective:To analyze the perception and evaluation of rural patients with hypertension and diabetes on the health management services , thereby identifying the problems and proposing countermeasures .Methods:570 rural patients with hypertension and diabetes were investigated by the stratified random sampling method .Descriptive statistic method and logistic regression analysis were applied to analyze the rural patients'perception and evaluation on the health management services .Results: The majority of rural patients with chronic diseases such as hypertension and diabetes were alerted of the health management service .The satisfaction rate on the disease control effect was 82.28%, and that among patients below the age of 60 years old was lower than that of the others ( P <0.05 ) . 77 .24%of patients deemed that some services such as on-site visit , physical examination and prevention of complica-tions were deficient (the selection rates among patients were 11.90%, 10.41% and 9.29% respectively).The health management services problems mainly included deficiency of on-site visits, incomplete medical equipments and service items ( the selection rates among patients were 16.36%, 9.29%and 8.92%respectively ) .Conclusions:In order to improve the quality and positive effect of health management for patients with hypertension and diabetes , the collaborative mechanism between township institutions should be developed , the government should increase invest-ment in rural public health , strengthen the rural heath personnel brainstorming , and on-site visits and debates on health should be reasonably arranged according to the needs of rural patients , and the quality and effectiveness of the management of hypertension and diabetes together with other chronic diseases should be improved .

ObjectiveTo understand the urban preference for outpatient pre-registration in large hospitals,and probe into the influencing factors,for recommendations to improve outpatient preregistration at the hospitals.Methods With Nanjing City as an example,the authors used tailoreddesigned questionnaire and qualitative interviews to investigate the preference of 1200 households of local residents regarding outpatient clinical pre-registration service at the tertiary hospitals.Results Age,education and economic factors are found to be the most important influential ones for urban preference in their outpatient pre-registration at large hospitals.Other factors include traditional approaches to outpatient clinic,inconvenience for outpatient pre-registration,and concerns for appointment breaking.Conclusion in order to increase their preference for outpatient pre-registration at large hospitals,hospitals should work to explore and improve approaches for outpatient pre-registration,and better their service quality,which will involve greater participation of both the hospital staff and residents.

Objective To probe into the feasibility of establishing a uniform reimbursement plan for hospitalization expenses under NRCMS in Nanjing city. Methods Hospitalization expenses in 2005 for peasants under NRCMS from the sour suburb districts and county in Nanjing were sampled. Based on this study, a reimbursement ratio was designed for such peasants as classified by "grades, sections and accumulated reimbursement". Results A uniform NVRMS reimbursement plan for hospitalization expenses may not be practical for all peasants in Nanjing. Yet such a plan of relative uniformity is worthy of experimenting as follows: no minimum for reimbursement;within the same expense range, reimbursement ratio may be measured and fixed accordingly among districts and county in the city, ranging 20%-70%;a uniform ceiling and reimbursement range are recommended. Conclusions A uniform city-wide plan requires by-step and planned implementations. With support from government finance, fund-raising gaps among these areas can be narrowed gradually, cutting back differences in their reimbursement plans in the end.

Objective To explore the efficacy of conventional physical therapy,acupuncture and hormone intervention for treating Bell's palsy so as to suggest an optimal treatment in clinical practice.Methods Clinical data on 1170 patients with Bell's palsy (BP) treated at the First Affiliated Hospital of Jinan University between October 2012 and November 2015 were collected and analyzed retrospectively.The Kruskal-Wallis test was used to compare the differences in disease course and in total cost among the patients.Seasons of the year,age,treatments,as well as the presence of immune-related diseases were the covariates studied.Multivariate logistic regression equation was used to test for any significant relationships.Results Physical therapy and hormones were found to have shortened the average course of treatment,but immune-related complicating diseases were shown to be risk factors.Patients receiving acupuncture for more than 1 month had longer courses of the disease than those without.Patients whose treatment combined hormones with physical therapy had the shortest disease course and lower total cost on average.Conclusion Early hormone intervention combined with physical therapy can shorten the course of BP and lower the cost of treatment.

In recent years, the relationship between working memory and language comprehension received more and more attention by many researchers, especially those of psychology and pedagogy. This article reviewed the researches on the working memory and language comprehension disorder in aphasia, including the theoretical model of working memory, assessment and brain positioning, etc., and discussed the process of working memory and comprehension disorder in rehabilitation.

ObjectiveTo study the morphology, normal values and lateral asymmetry of Chinese calcarine sulcus on MRI. Methods High-resolution and transverse MRI were obtained from 40 female volunteers. Brainvisa software was used to reconstruct the calcarine sulcus and measure its average length, depth and width automatically. Results The posterior branch of calcarine sulcus showed six types in the median sagittal plane: bifurcation(32.50%), single peak(25.00%), flat (16.25%), S-shaped (15.00%), double peak(7.50%) and other shape (3.75%); its location had three types: inferior(72.50%), middle(21.25%)and superior(6.25%). The depth of left calcarine sulcus was (15.24±2.67)mm, and the right one was (16.97±3.25)mm, which revealed great statistical significance (P＜0.000 1). The width of left calcarine sulcus was (3.14±0.91)mm, and it was (3.19± 0.83)mm in the right side. The bottom length of calcarine sulcus: the left was (86.47±16.85)mm, the right was (83.62±17.10)mm. The top length of calcarine sulcus: the left was (70.52±12.40)mm, the right was (64.90±15.17)mm. There were not statistical significance in width, bottom length and top length between left and right calcarine sulci. More than half of the end part of calcarine sulci turned to the lateral surface of cerebral hemisphere.Totally 63 cases (78.75%) were found with prominent calcar avis. Conclusion Significant difference of depth between left and right calcarine sulcus of female was found. Three-dimensional reconstruction is an effective method to study the anatomy of calcarine sulcus.

Objective To investigate the morphology and relationships with the adjacent structures in the pineal region on the thin sections and to provide anatomic data for imaging diagnosis and surgical treatment of diseases in this region. Methods By CT and MRI examination, one normal head specimen was selected for this study. Using the computerized freezing milling technique, the specimen was sliced from anterior to posterior. The in vivo MR images were obtained from ten normal Chinese male adult volunteers using a 3.0 T GE scanner. The base lines of the sectioning and the MR scan were perpendicular to the AC-PC line. Then primary sections were contrasted with the corresponding MR images. Results By the appearance of the pineal peduncle and the disappearance of the pineal gland, the pineal region could be divided into three parts from anterior to posterior, and the shape changed from an inverted triangle to a trapezoid and a triangle gradually. The first interspace was getting wider in the anterior and middle parts of the pineal region, while in the posterior part of the pineal region, it was getting narrower and disappeared finally. From anterior to posterior, the bilateral internal cerebral veins were always in the midline of the pineal region and descended gradually.Conclusion By the computerized freezing milling technique, the anatomic details and adjacent relationships of the pineal region could be exhibited clearly in the thin serial sections, which could help the imaging diagnosis and surgical treatments for minute diseases in this region.

Objective:To investigate the current situation and analyze the influencing factors of job satisfaction of infectious disease physicians in Jiangsu Province.Methods:From April to May 2021, a stratified random sampling method was used to select 10 municipal level infectious disease hospitals in Jiangsu province. An electronic questionnaire survey was conducted on the infectious disease physicians of these hospitals using an online questionnaire platform. The questionnaire mainly included the job satisfaction scale developed by Greenhaus and Wormley, and a self-designed job satisfaction influencing factor scale based on resource conservation theory. At the same time, semi-structured interviews were made with relevant insiders on such issues as salary and benefits, and career development among others. Descriptive analysis was conducted on the questionnaire data, while single factor analysis and multiple linear regression analysis were used to identify the factors that affect their job satisfaction, and the results of the interviews were studied with Colaizzi 7-step analysis.Results:A total of 457 valid questionnaires were recovered. The job satisfaction score of infectious disease physicians was (3.38±0.76). The results of univariate analysis showed significant differences in job satisfaction scores among infectious disease physicians of different ages, educational backgrounds, professional titles, and positions. The results of multiple linear regression analysis showed that salary and benefits ( B=0.141, P<0.001), work environment ( B=0.128, P<0.001), leadership support ( B=0.112, P=0.014), development security ( B=0.117, P<0.001), self-efficacy ( B=0.084, P=0.045) and social support ( B=0.285, P<0.001) were both influencing factors of their job satisfaction. The interview results identified such problems as low salary, insufficient salary security, large gap in social security levels between in-staff and off-staff physicians, and insufficient career development potential. Conclusions:The job satisfaction of infectious disease physicians in Jiangsu Province was found at an average level. It is recommended that the government increase the investment in personnel expenses for infectious disease physicians, optimize the salary and benefits structure, pay attention to the career development needs of middle-aged and young physicians, and care about the social relationship needs of infectious disease physicians to improve their job satisfaction.