Objective To study the alternations of regulatory T cells in early HIV infected patients and its association with disease progression.Methods Fifty-one untreated HIV infected patients were enrolled and divided into 3 groups according to their infection time and CD+4 T cell levels(30 early HIV infected patients,15 typical progressors,6 AIDS patients).Twenty normal controls were enrolled.There were no significant differences between the age and sex among four groups.Blood was drawn by venipuncture from each subject in EDTA tubes and the levels of CD+4 CD+25 Foxp3 + regulatory T cells were detected by FACSAria flow-cytometry.Spearman correlation was used to detect association between CD+4 CD+25 Foxp3 + regulatory T cells and the absolute CD+4 T cells,viral load and activation of T cells.Results The levels of CD+4 CD+25Foxp3+ regulatory T cells showed the tendency of increasing tendency from normal control to early HIV infected patients,asymptomatic HIV infected patients and AIDS patients.Early HIV infected patients was significantly lower than that in AIDS group [3.79(2.11 - 5.43) % vs 8.09(4.90 - 8.90) %,Z = - 2.29,P = 0.022].The levels of CD+4 CD+25 Foxp3 + Treg cells were associated with viral set point(r = 0.479,P =0.038) and inversely associated with CD+4 T cells(r = -0.455,P =0.011) and closely associated with HLA-DR expression on CD+3 T cells(r = 0.533,P = 0.002).Conclusions The ratio of CD+4 CD+25 Foxp3 +regulatory T cells of early HIV infected patients was significantly increased and associated with viral set point and CD+4 T cell counts,which indicate that alternation of regulatory T cell may be an important factor contributing to the disease progression in early HIV infection.

OBJECTIVE To find the differences in QOL between patients treated with total laryngectomy with voice rehabilitation or without voice rehabilitation and subtotal laryngectomy, to analysis the factors affecting QOL of patients after laryngectomy by HNQOL. METHODS With HNQOL,a survey was conducted in patients treated with total laryngectomy (30cases) with voice rehabilitation, 30 cases without voice rehabilitation, and 30 cases treated with subtotal laryngectomy for laryngeal cancer. We discuss changes of QOL with time went by,and analysis the factors affecting QOL of patients after laryngectomy. RESULTS There is no difference between patients treated with total laryngectomy with .voice rehabilitation and the one treated with subtotal laryngectomy in their quality of life, however, there is difference between patients treated with total laryngectomy without voice rehabilitation and the one treated with subtotal laryngectomy. CONCLUSION Through voice rehabilitation ,we could advance quality of life of the patients treated with total laryngectomy. Through the integration of psychological, clinical and social intervention, the quality of life of patients may have an overall improvement.

Objective To further investigate the accuracy of the real-time three-dimensional echocardiography(RT-3DE) in evaluating right ventricular(RV) systolic function.Methods RT-3DE,MRI and SPECT were used to study a total 30 patients including 10 with coronary artery disease,7 with hypertension,5 with cardiomyopathy,5 with atrial septal defect,and 3 with pulmonary hypertension.The RV end-diastolic volume(RVEDV),RV end-systolic volume(RVESV),RV stroke volume(RVSV) and RV ejection fraction(RVEF) were measured.The correlation and the difference between different modalities were compared.Results RT-3DE had a good correlation with MRI in RVEDV,RVESV,RVSV and RVEF (rEDV =0.811,rESV =0.837,rSV =0.818,and rEF =0.701).Also RT-3DE had a correlation with SPECT in RVEDV,RVESV,and RVSV(rEDV =0.526,rESV =0.493,rSV =0.514),but there was no correlation between RT-3DE and SPECT in RVEF (rEF =0.235).Conclusions RT-3DE can assess RV systolic function accurately.

Objective To investigate the killer cell lg-like receptors (KIR) gene frequency of HIV-1 infected slow progressors(SP) and typical progressors(TP), and to analyze the interaction between KIR alleles and the progression of HIV-1 infection in Chinese population. Methods Eighty-one HIV-1 posi-tive individuals including 43 SPs and 38 TPs were recruited. Carriage of KIR genes was assessed using poly-merase chain reaction sequence-specific primers (PCR-SSP) assays. Results KIR2DS3 gene frequency was significantly lower in SP group (3.6%) than that in TP group (14.2%), P =0. 018 ,OR =0. 210,95% CI =0.053-0.833. The number of activating KIR genes was less in SP group than that in TP group, but was not significant (P = 0. 208). Conclusion Lower KIR2DS3 gene frequency may potentially be associated with slower progression to AIDS in Chinese population.

Objective:To study the relationships between neutralizing antibody response against autologous virus and disease progression of HIV-1 B'/C infected individuals in China.Methods:Twenty-four primary HIV-1 isolates were incubated with autologous plasma collected either freshly or at approximately six months intervals thereafter.Normal human peripheral blood mononuclear cells were incubated with the virus-serum mixtures for 7 days and then the production of p24 antigen was measured.The neutralizing titer of a particular plasma and virus was defined as the reciprocal of the highest dilution giving a 50% reduction in p24 Ag compared with NHP control wells.More than 1∶8 were considered significant and were scored as positive.Results:In neutralizing antibody(Nabs) response against contemporaneous virus,Nabs were produced in all slow progressors(SP) individuals,while only four in 21 of HIV group had.There was statistically significance of the neutralizing antibody titers between SP and HIV.When plasma samples of six months later were tested for their ability to neutralize autologous virus,all of SPs had higher neutralizing antibody titers and the titers of neutralizing antibody in HIV group had increased in different rate.Among the twenty-one individuals of HIV group,12 of these individuals had neutralizing antibody response against autologous virus and other 9 of these individuals had not.NAb titers of SP in six months later plasma were higher than those of HIV.There was a negative correlation between the generation of the neutralizing titer against autologous virus and the plasma HIV RNA level in HIV-1 B'/C infected individuals(including SP,HIV).Conclusion:Neutralizing antibody against autologous viruses in HIV-1 B'/C infected SP is higher than those of HIV group,suggesting that neutralizing antibodies play a vital role in delaying disease progression in these individuals.

Objective To study the relationships between neutralizing antibody response against heterologous virus and disease progression in Chinese HIV-1 B'/C infected individuals. Methods Plasmas from HIV-1-infected individuals, grouped as HIV chronically infected or AIDS according to CD4+ count and clinical symptom, were tested for neutralizing activity against the three HIV-1 isolates with very low homology in vitro. Six two-fold dilutions of each plasma sample (from 1/10 to 1/320) were tested against each virus from the panel. Giving a 50% reduction in p24Ag compared with normal human plasma control wells was defined as positive. The breadth of the cross-neutralizing response was defined based on the number of viruses that were effectively neutralized by any given patient-derived plasma sample. The magnitude of the crossneutralizing response was defined based on the average neutralizing titer against all heterologous viruses. Resuits We found that there revealed a significant difference between HIV chronically infected and AIDS group in the breaths and magnitudes of neutralizing heterologous virus. There was higher prevalence for the frequency of neutralizing heterologous virus in HIV chronically infected than AIDS. The results showed that there was positive correlation between the breadths and magnitudes of neutralizing response against heterologous virus and the plasma HIV RNA level in HIV chronically infected group, while not in AIDS group. There was no association between the breadth of the neutralizing responses against heterologous virus and CD4 T cell counts. Conclusion The capacity of neutralizing antibodies against heterologous virus varied among different disease stage. There were higher titers of neutralizing antibodies in HIV chronically infected than AIDS group. The loss of neutralizing antibodies in plasma from AIDS group appears to be associated with a narrowing of the antibody response during disease progression. These suggest that the presence of neutralizing antibodies against hetreologous virus was associated with disease progression.

Objective:To explore the journey map of patients with chronic constipation during fecal microbiota transplantation.Methods:This study adopted phenomenological methods. From October to December 2023, purposive sampling was used to select chronic constipation follow-up patients who underwent fecal microbiota transplantation at the Intestinal Microecology Center of Shanghai Tenth People's Hospital as respondents for semi-structured interviews. Colaizzi 7-step analysis method and NVivo 11.0 software were used for data analysis.Results:A total of 15 interviewees were interviewed. During fecal microbiota transplantation, the journey map of constipation patients included stages, mood changes, touchpoints, themes, emotional experiences and opportunities. The patient's experience and needs were summarized into three themes and ten sub-themes, including pre-transplant adaptation disorders to new environments (unfamiliarity and confusion-admission coordination disorders, anxiety and expectations-diverse complex emotions, puzzle and helplessness-asymmetric doctor and patient information), effectiveness-related psychological and social experiences in transplantation (attention and expectations-longing for positive efficacy, perception of benefits and risk avoidance, shame and inferiority-treatment stigmatization experience, questioning and despair-unrealized expectations, treatment resistance-sensitive economic burden), post-transplant transition dilemmas (inaccessible medical services-lack of continuous treatment and nursing, disease recurrence troubles) .Conclusions:This study visualizes the experiences and needs of constipation patients during microbiota transplantation through a patient journey map and identifies multidimensional issues and needs of patients. Clinical medical and nursing staff should pay attention to the needs of patients at different stages of the treatment process when formulating intervention programs to improve the quality of fecal microbiota transplantation nursing.

Traumatic brain injury (TBI) is a central nervous system disease with increasing incidence,morbidity and mortality worldwide.TBI can affect the integrity of neuron,causing neuronal axons damage or death of neurons,which results in serious sequelae.After TBI,astrocytes (AST) in the cerebral cortex will be activated into reactive astrocytes (RAS).RAS in the early stage of TBI has a certain repair effect on the injury.However,RAS will proliferate to form glial scars,which has adverse effects on nerve function repair after injury.Therefore,controlling the status of RAS is the key to the treatment of TBI.In recent years,it has been proved that RAS can be transdifferentiated into neurons by transdifferentiation technology,which can not only remove glial scars,but also integrate with the microenvironment at the injury site to replace the injured neurons,which is of great significance for the repair of nerve function after TBI.This article reviews the types of transdifferentiation and the different pathways of RAS transdifferentiation into neurons,aiming to have a better understanding of the research progress of RAS transdifferentiation into neurons to repair TBI.

Objective:To evaluate the efficacy and safety of anti-programmed cell death 1 (PD-1) receptor monoclonal antibody (MoAb) in patients with advanced hepatocellular carcinoma (HCC) after treatment of transcatheter arterial chemoembolization (TACE) combined with tyrosine kinase inhibitor (TKI).Methods:From February 2019 to February 2020, 56 HCC patients who relapsed after TACE-TKI treatment in Department of Interventional Radiology, The Second Affiliated Hospital of Guangzhou Medical University were enrolled. All patients received anti-PD-1 MoAb (sintilimab injection) and followed up every 6 weeks. According to mRECIST, the curative effect was evaluated as complete response (CR), partial response (PR), stable disease (SD) or progressive disease (PD). Objective response rate (ORR) and disease control rate (DCR), progression-free survival (PFS) and treatment-related adverse events (TRAEs) were recorded. Univariate analysis by Chi-square test and binary logistic regression model was used to determine the influencing factors of DCR. The Kaplan-Meier method and Cox proportional hazard regression model were used to analyze the survival data.Results:A total of 48 patients were enrolled in this study including 42 males and 6 females, with a median age of 55 years (29-71 years). ECOG scores comprised of 0 in 24 cases, 1-2 in 24 cases. Thirty-six patients were in Child-Pugh grade A of liver function and 12 cases were grade B. The median follow-up time was 4.5 months. There were 2 patients achieved CR, 12 patients with PR and 16 with SD. ORR was 29.2%, DCR was 62.5%. The independent influencing factors of DCR was ECOG score and AFP level ( P=0.031, P=0.012). Median PFS was 4.1 months (95% CI 2.7-5.4 months), and ECOG score was the independent influencing factor of PFS ( P=0.042). Treatment-related adverse events were reported in 70.8% (34/48) patients. Incidence of grade Ⅲ-Ⅳ TRAEs was 22.9% (11/48). Conclusion:In patients with HCC who relapse from TACE and TKI treatment, anti-PD-1 monoclonal antibody is efficacious safe especially in those with ECOG 0 score.

Objective:To evaluate the performance of two-dimensional fundamental sonosalpingography combined with saline infusion pelvic sonosalpingography(abbreviated as "2DFS+ SIPS" in this article) for assessing fimbrial part′s morphology and function of fallopian tubes.Methods:A total of 246 infertile women were collected from Zhejiang Provincial People′s Hospital from May 2018 to December 2019. They underwent dynamic three-dimensional harmonic sonosalpingography(abbreviated as "4DHS" in this article) first. Cases which were diagnosed as bilaterally tubal obstruction would be excluded. 2DFS+ SIPS was performed in 230 patients. Among them, 21 underwent laparoscopy and dye test(LDT) within 6 months and the results were regarded as golden standard.Results:①Tubes which were diagnosed as complete obstruction would be excluded. The total display rate of remaining fimbrial parts by using 2DFS+ SIPS and 4DHS were 77.4% and 24.0% respectively, which had statistically difference( P<0.001). ②According to 2DFS+ SIPS, fimbrial parts were classified into 3 types: normal, suspected abnormal and abnormal.Normal fimbrial parts accounted for 86.4% while suspected abnormal ones accounted for 13.6% under the condition of patency; abnormal fimbrial parts accounted for 81.2% while suspected abnormal ones accounted for 18.8% under the condition of partial obstruction. The difference in the proportion of normal and abnormal fimbrial parts according to different tubal patency was statistically significant( P<0.001). ③Fimbrial parts were classified into normal (normal fimbrial parts) and abnormal (suspected abnormal and abnormal fimbrial parts) further according to 2DFS+ SIPS, the results were compared with LDT. Accuracy, sensitivity, specificity, positive predictive value, negative predictive value and Youden′s index were 92.0%, 100%, 88.2%, 80.0%, 100%, 0.88, respectively. The consistency analysis showed the results of 2DFS+ SIPS and LDT were highly consistent (Kappa=0.828). ④All the side effects occured during the procedure or within 30 minutes after the procedure were self-limited.No serious complications were observed. Conclusions:2DFS+ SIPS is a preferred method for assessment of fimbrial part′s morphology and function, with its advantages of non-invasiveness, intuition, and accuracy. This combination could provide objective imaging basis for choosing clinical treatment strategies and predicting prognosis.