Objective To analyze the characteristics of lymphocyte subsets and interleukin-2 re-ceptor (CD25) in patients with severe fever with thrombocytopenia syndrome (SFTS) in Zhoushan island. Methods Automated blood analyzer , automatic biochemical analyzer and flow cytometry were used to meas-ure hematological parameters , biochemical parameters and lymphocyte subsets in patients with SFTS before and after treatment .The dynamic changes and correlation analysis were statistically analyzed .Results The counts of white blood cells (WBCs), platelets, total T cells and CD4+T cells in patients with SFTS before treatment were significantly lower than those in healthy subjects .The counts of WBCs and platelets were sig-nificantly increased after ten days of treatment , and the level of CD25+cells was higher than that in control group, but the level of total T cells and CD 4+T cells were still lower than those in healthy subjects ( P<0.05).Patients died of SFTS had significantly lower counts of total T cells , CD4+T cells, CD8+T cells and CD25+cells than cured patients (P<0.05).The level of CD25+cells and B cells were positively correlated with WBC level (P<0.05).Platelet level was positively correlated with the percentage of CD 4+T cells (P<0.05).The level of alanine aminotransferase and creatine kinase were positively correlated with the number of CD3+T and CD8+T cells (P<0.05).Conclusion SFTS virus infection affected the percentage of body′s immune cells, especially the level of CD4+T cells.The imbalanced immune system was correlated with the counts of WBCs , platelets and various enzymes in serum and it might be one of the factors causing extensive damage of multiple organs and tissues .

Objective To analyze the relationship between cytotoxic T cells Perforin level, IFN-γand IL-10 in patients with chronic hepatitis B. Methods After a short-term cultivation of peripheral blood collected from 50 patients with chronic hepatitis B, a flow cytometry was employed to detect the levels of Per-forin, IFN-γ and IL-10 in CD8~+ cells to compare with those of the health donors the HBV DNA copies in their blood were also measured by RT-PCR to analyze the relationship with Perforin, IFN-γ, and IL-10 in CD8~+ cells. Results In patients with chronic hepatitis B, the levels of Perforin, IFN-γ and IL-10 in CD8~+ ceils were (5.30 ± 2.62)%, (4.05 ± 2.25) % and (0.77 ± 0.50) %, respectively, which were statistical-ly lower than health donors(the t values were 4.50, 4.56 and 4.20 respectively; P < 0.01) ; Of 26 cases of chronic hepatitis B patients with HBeAg-positive Pefforin and IFN-γ in CD8~+ T cells were (4.54 ± 1.93) % and (3.32 ± 1.59)%, respectively, significantly lower than those of the 24 chronic hepatitis B patients with HBeAg-negative (the t values were 2.22 and 2.54, respectively; P <0.05) ; And the levels of Perforin, IFN-γ had a negative relation with the HBV DNA copies (the coefficient correlations-0. 539 and-0. 340; P < 0.01 and P < 0.05). Conclusion In patients with chronic hepatitis B, the reduced levels of Pefforin, IFN-γ and IL-10 may be related with the long-term existence of HBV, and the protracted course of disease.

Objective To assess the morphological characteristics of bone marrow in patients of severe fever with thrombocytopenia syndrome ( SFTS) and its value in diagnosis.Methods The bone marrow morphology was retrospectively reviewed in 28 laboratory confirmed patients with SFTS from Zhoushan Hospital during January 2012 and December 2015.The correlation between bone marrow -derived macrophage and peripheral blood cells was analyzed with t test.Results All patients presented leukocytopenia and thrombocytopenia.Poor bone marrow hematopoietic function was observed in 23 patients (82%) showing granulocyte, erythrocyte and megakaryocyte hypoplasia , but no pathological hematopoietic disorder was observed.Eighteen patients (64%) had various degrees of increased amount of macrophage in the bone marrow; peripheral white blood cell count and platelets in patients with macrophage ≥0.5% were lower than those with macrophage <0.5%, and the difference was of statistical significance (t =3.836 and 4.499, P<0.01).Conclusion SFTS patients have characteristic bone marrow morphology , and bone marrow examination is beneficial for differentiation of SFTS from blood lymphatic system diseases and other virus infection.

OBJECTIVETo investigate the health status of the thyroid and related influencing factors in the seamen in Zhoushan, China.

METHODSA total of 136 coastal seamen (coastal group), 104 deep-sea seamen (deep-sea group), and 272 base staff (base group) who underwent physical examinations in 2014 were selected. Questionnaire survey and ultrasound were performed, and levels of thyroid hormone and urinary iodine were measured.

RESULTSCompared with the coastal group and the base group, the deep-sea group had a significantly higher rate of abnormal ultrasound findings (49.04% vs 30.88%/28.67%, P<0.05), as well as a significantly higher rate of abnormal serum free thyroxine (FT4) (25.00% vs 9.56%/6.25%, P<0.05). The logistic regression analysis showed that in the coastal group, the risk factors for thyroid abnormality on ultrasound were obesity shown by body mass index (BMI) (OR=2.55, 95% CI=1.13~4.13) and annual working time>6 months (OR=4.25, 95% CI=2.02~8.26) (both P<0.05); in the deep-sea group, the risk factors for thyroid abnormality on ultrasound were obesity shown by BMI (OR=3.45, 95% CI=1.28~7.02) and annual working time>6 months (OR=5.33, 95% CI=3.18~9.23) (both P<0.05).

CONCLUSIONThe thyroid abnormality in deep-sea seamen is caused by various reasons and is correlated with annual working time, working environment and area, and iodine nutritional status.

Body Mass Index ; China ; Health Status ; Humans ; Iodine ; urine ; Male ; Naval Medicine ; Occupations ; Risk Factors ; Surveys and Questionnaires ; Thyroid Function Tests ; Thyroid Gland ; diagnostic imaging ; pathology ; Thyroxine ; blood ; Ultrasonography

Objective To analyze the changes of hematological parameters and coagulatory function in sever fever with thrombocytopenia syndrome (SFTS) in Zhoushan island.Methods Automated blood analyzer and automatic coagulation analyzer were used to measure hematological parameters and coagulatory function in SFTS patients before and after ten days treatment.Results The counts of white blood cells (WBC),neutrophils and lymphocytes and platelets of the 27 cases with SFTS were significantly lower than those of normal controls (P ＜ 0.05) ; Moreover,the counts of platelets was significantly higher in the cases who recovered as compared with those who died (P ＜ 0.05).Prothrombin time (PT),activated partial thromboplastin time (APTT) and thrombin time (TT) of SFTS patients before treatment were longer than normal controls,whereas fibrinogen (FIB) was lower (P ＜ 0.05).Pearson correlation analysis showed that APTT and platelet (PLT) of SFTS patients before treatment had significantly negative correlation (P ＜ 0.05),as well as PT,APTT and TT were negatively correlated with PLT of SFTS patients with 10 d treatment.Conclusion Paying close attention to the hematological parameters and coagulation function,especially PLT and APTT,has important clinical significance in diagnosis and monitoring of disease progression in patients with SFTS.

Objective: To investigate the clinical value of blood routine tests (RT) and coagulation function in differential diagnosis of mild and severe patients infected with bunyamwera virus. Methods: Twenty-five mild patients and 25 severe patients infected with bunyamwera virus were selected and their blood RT and coagulation function tests were performed. Results: The earliest prothrombin time (PT-early) and activated partial thromboplastin time(APTT-early) were significantly lower than those of severe patients(t=-2.43, P<0.05; t=-2.53, P<0.05). The lowest values of white blood cells (WBC-low) of mild patients were significantly higher than those of severe patients (t=5.66, P<0.01). The highest value of D-dimer (DD-high) of mild patients were significantly lower than that of severe patients (z=1.35, P<0.05). When mild patients values were set as outcome variable, AUC of APTT-early was the highest (AUC=0.713, P<0.05). When values of severe patients were set as outcome variable, AUC of DD-high was the highest (AUC=0.874, P<0.01). Conclusions APTT-early and DD-high are suitable for differential diagnosis of mild and severe patients infected with bunyamwera virus.