Objective:To determine the spectrum drift characteristics of CI4+CD25+Tregs TCR β chain CDR3 in patients with different phases of acute hepatitis B (AHB) and chronic hepatitis B (CHB) patients before and after the entecavir treatment.Methods:Anticoagulation venous blood was collected from 4 normal control subjects,3 AHB patients with acute phase and convalescent phase,and 4 CHB patients before and after the entecavir treatment;and peripheral blood mononuclear cells were isolated;CD4+ CD25+ Tregs were separated by using the magnetic beads,and total RNAs were extracted from CD4+ CD25+ Tregs and used for reverse transcription.The TRBV CDR3 was amplified by polymerase chain reaction (PCR) with forward primers specific for 24 TRBV families and one fluorescence-labeled common reverse primer specific for the BC region.The PCR products were sent out for Genescan,and results were analyzed for the TRBV family CDR3 spectrum characteristics by using the Peak Scanner Software vl.0.Data were analyzed with the comparative t-test to perform the statistical analysis.Results:The CDR3 spectral types of the TRBV family showed drift characteristics in 3 cases of AHB patients with acute and convalescent phases;single/oligo peak spectral type family was observed in most of patients with acute phase;multiple peak spectral type was seen in patients with convalescent phase;and the common spectrum shift of TRBV4,10,14,16,19 families seen in patients with acute phase was changed to multiple peak spectral type.The clonal expansion of TRBV family in the CD4+CD25+Tregs in PBMC from AHB patients with convalescent phase was significantly lower than AHB patients with acute phase (t =9.456,P =0.011).The clonal expansion of Tregs TRBV13.2,15,16,18,20 family seen in C HB patients before treatment may interfere the virus removal through down-regulating the body's immune response;and with the decline of viral load in serum after the antiviral treatment,the clonal expansion of Tregs TRBV1,5.2,6,12,14,24 family may help body induce immune tolerance and result in the HBV persistence.The clonal expansion of TRBV family in the CI4+CD25+Tregs in PBMC from of CHB patients after antiviral treatment was increased (t =-0.666,P =0.553).Conclusion:TRBV4,10,14,16,19 family of spectrum shift seen in AHB patients with acute phase was changed to multiple peak spectral type in patients with convalescent phase,suggesting this transition may be associated with HBsAg and HBeAg turning to negative.The clonal expansion of Tregs TRBV13.2,15,16,18,20 family seen in CHB patients before treatment may interfere the virus removal through down-regulating the body's immune response;and with the decline of viral load in serum after the antiviral treatment,the clonal expansion of Tregs TRBV1,5.2,6,12,14,24 family may help body induce immune tolerance and result in the HBV persistence.

CD4-Positive T-Lymphocytes ; Hepatitis B virus ; Hepatitis B, Chronic ; Humans ; Interleukin-2 Receptor alpha Subunit ; Sequence Analysis

OBJECTIVETo study the correlation between the expression levels of phagocytic NADPH oxidase p22phox subunit and left ventricular mass index (LVMI) in patients with non-valvular chronic heart failure and explore the role of oxidative stress caused by NADPH oxidase p22phox subunit in left ventricular remodeling.

METHODSSemi-quantitative RT-PCR was used to examine the expression levels of phagocytic NADPH oxidase p22phox in 59 patients with non-valvular chronic heart failure and 20 control subjects. All the subjects underwent ultrasonic cardiography to record their IVST, LVPWT, LVEDd, LVEDs, and EF. Based on the calculated LVMI, the patients were divided into heart failure without LV hypertrophy (LVH) group and heart failure with LVH group.

RESULTSThe patients with heart failure showed significantly higher expression of phagocytic NADPH oxidase p22phox than the control subjects (0.91∓0.37 vs 0.68∓0.33, P=0.039), and the patients with LVH had significantly higher p22phox expression than those without LVH (1.58∓0.20 vs 0.71∓0.24, P=0.026). LVMI showed a positive correlation with the expression of p22phox in these patients (r=0.508, P<0.05).

CONCLUSIONNADPH oxidase p22phox expression level is positively correlated with LVMI and can be indicative of the level of left ventricular remodeling in patients with non-valvular chronic heart failure.

Adult ; Aged ; Case-Control Studies ; Female ; Heart Failure ; metabolism ; physiopathology ; Humans ; Hypertrophy, Left Ventricular ; metabolism ; physiopathology ; Male ; Middle Aged ; NADPH Oxidases ; metabolism ; Ventricular Remodeling

Objective To explore the effect of mitral valve morphology on short-term and long-term outcomes in elderly patients with rheumatic mitral stenosis(MS)undergoing percutaneous balloon mitral valvuloplasty(PBMV).Methods In the prospective study,elderly patients with rheumatic mitral stenosis undergoing PBMV between February 1996 and June 2007 were followed up for 10 years.One hundred and twenty-four patients with full follow-up data were included in the study.According to echocardiography Wilkins score,83 cases of patients (Wilkins score ≤ 8)were selected as Wilkins score ≤ 8 group,and 41 cases were selected as Wilkins score＞ 8 group.The pressure gradient in mitral valve(MV△P),mitral valve area(MVA),left atrial diameter(LAD),left ventricular end-systolic diameter(LVESd),left ventricular end-diastolic diameter(LVEDd),pulmonary artery systolic blood pressure(sPAP),ejection fraction(EF)and mitral regurgitation were measured before and after the operation.Results In both Wilkins score ≤ 8 group and Wilkins score＞ 8 groups,MVA and EF were increased immediately after PBMV operation versus before PBMV operation,and MV△P,LAD,LVEDd,LVEDs and PAPs were decreased immediately after PBMV operation versus before PBMV operation(all P ＜0.05).Severe mitral regurgitation was not found in both two groups.The clinical effects of the Wilkins score≤8 group were stable after 10 years,which had no significant difference in the indexes compared with those in the Wilkins score≤ 8 group immediately after PBMV(P＞0.05).MVA and EF in the Wilkins score＞8 group were decreased,and MV△P,LAD,LVEDd,LVEDs and PAPS were increased after 10 years as compared with those immediately after PBMV(P＜0.05).The incidence of NYHA functional class Ⅲ or Ⅳ was lower in the Wilkins score ≤8 group than in the Wilkins score＞8 group(26.5％ or 22/83 vs.46.3％ or 19/41,x2 =4.879,P=0.027).And the incidence of mitral restenosis was lower in the ≤8 group than in the Wilkins score＞8 group(34.9％ or 29/83 vs.61.0％ or 25/41,x2 =7.567,P=0.006).There was no significant difference in the incidence of moderate or severe mitral regurgitation between the two groups(10.8％ or 9/83 vs.12.3％ or 5/41,x2=1.278,P=0.258).Conclusions The short-term and long-term outcomes are good in elderly individuals with rheumatic mitral stenosis undergoing PBMV operation,and the curative effect of PBMV operation is better in patients with Wilkins score ≤8 than in patients with Wilkins score ＞8.

OBJECTIVETo investigate the role ofCD4+CD25+ T regulatory (Treg) cells, T helper (Th)17cells and interleukin (IL)-6 in the progression of hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF) and determine their value as prognostic markers.

METHODSThe Chinese National Knowledge Infrastructure (CNKI), WanFang, Chinese Scientific Journals (VIP), PubMed, Embase and Web of Science databases were searched for English language case-control studies on the relationship between regulatory T lymphocytes and ACLF.The quality of included studies was assessed using the Newcastle-Ottawa scale. The meta-analysis was designed according to the PICOS approach recommended by the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. RevMan software, version 5.1, was used to perform the meta-analysis.

RESULTSNine case-cohort studies were selected for inclusion in the metaanalysis.The results of the meta-analyses showed that the level of CD4+CD25+ Treg cells was not significantly different between patients with HBV-related ACLF and patients with chronic hepatitis B (CHB) (mean difference (MD)=0.59, 95% confidence interval (CI)-1.68, 2.85, P=0.61) nor between patients with HBVrelated ACLF and healthy controls (MD=1.12, 95% CI:-1.42, 3.66, P=0.39). Thus, it appears that ACLF patients do not have a higher level of CD4+CD25+ Treg cells than CHB patients or healthy controls. However, the ACLF patients did appear to have a significantly higher level of Th17 cells than both the CHB patients (MD=1.73, 95% CI:0.21, 3.26, P=0.03) and the healthy controls (MD=1.62, 95% CI:(0.52, 2.72, P=0.004). In addition, the ACLF patients also had significantly higher level than both the CHB patients (MD=11.69, 95%CI:1.98, 21.40, P=0.02) and the healthy controls (MD=13.17, 95% CI:1.38, 24.95, P=0.03).

CONCLUSIONCD4+CD25+ Treg cells may be an important protective factor in the progression and prognosis of HBV-related ACLF, while Thl7 cells and IL-6 may be risk factors for further progression and worsened prognosis.

Acute-On-Chronic Liver Failure ; diagnosis ; immunology ; CD8-Positive T-Lymphocytes ; Case-Control Studies ; Disease Progression ; Hepatitis B virus ; Hepatitis B, Chronic ; complications ; Humans ; Interleukin-6 ; immunology ; Prognosis ; T-Lymphocytes, Regulatory ; immunology ; Th17 Cells ; immunology