The core pathology of human immunodeficiency virus(HIV)is progressive impairment of CD4+T lym-phocyte function.Since the digestive tract is an important target organ of HIV infection,it is susceptible to oppor-tunistic infections.Although highly active antiretroviral therapy(HAART)can effectively inhibit viral replication and reduce the risk of infection,long-term use of HAART is prone to cause adverse reactions of the digestive tract,further weaken the patient's immune function,leading to a vicious circle of"virus invagination-immune im-balance-reinfection".Based on the theory of"integrating disease and syndrome differentiation with the ability to distinguish cold and heat",Professor Li Fazhi proposes that the essence of HIV infection complicated with gastro-intestinal complications is"the inversion of epidemic virus and the stagnation of qi apparatus",and emphases the importance of"through"to reconcile the deficiency and excess of cold and heat.This article summarizes the clinical pathway of treating HIV-infected digestive tract complications(such as infectious diarrhea,fungal esophagitis,etc.)with the use of meridian prescription from the perspective of infection immunology.

The core pathology of human immunodeficiency virus(HIV)is progressive impairment of CD4+T lym-phocyte function.Since the digestive tract is an important target organ of HIV infection,it is susceptible to oppor-tunistic infections.Although highly active antiretroviral therapy(HAART)can effectively inhibit viral replication and reduce the risk of infection,long-term use of HAART is prone to cause adverse reactions of the digestive tract,further weaken the patient's immune function,leading to a vicious circle of"virus invagination-immune im-balance-reinfection".Based on the theory of"integrating disease and syndrome differentiation with the ability to distinguish cold and heat",Professor Li Fazhi proposes that the essence of HIV infection complicated with gastro-intestinal complications is"the inversion of epidemic virus and the stagnation of qi apparatus",and emphases the importance of"through"to reconcile the deficiency and excess of cold and heat.This article summarizes the clinical pathway of treating HIV-infected digestive tract complications(such as infectious diarrhea,fungal esophagitis,etc.)with the use of meridian prescription from the perspective of infection immunology.

Objective:To analyze the prognostic factors of patients with Ⅰ B1-Ⅱ A cervical cancers after surgery and to assess the effects and adverse reactions of intensity-modulated radiotherapy(IMRT)combined with concurrent chemotherapy(CCRT). Methods:A retrospective analysis was performed based on the clinical and follow-up data of 362 patients with Ⅰ B1-Ⅱ A cervical cancers who were treated in Changzhou Second People′s Hospital from January 2009 to December 2019. Meanwhile, these patients suffered large primary tumors(LPT; tumors size: ≥4 cm), lymphatic vascular space invasion (LVSI), and deep stromal invasion(DSI; stromal infiltration depth: ≥1/2) after surgery and showed at least one intermediate-risk factor. Among these cases, 161 cases were treated with CCRT, 131 cases under-went single radiotherapy (RT), and 70 cases received unadjuvanted radiotherapy. The Kaplan-Meier method and the logrank test were adopted for univariate survival analysis, the binary logistic regression was used to analyze the recurrence risk, and Cox regression model was used for multivariate survival analysis. Results:The 3 and 5-year overall survival (OS) rates were 94.20% and 88.39%, respectively. The retrospective analysis showed that the risk factors of recurrence included tumor size ≥ 4 cm and poorly differentiated cancers( OR=3.287, 2.870, 95% CI: 1.366-7.905, 1.105-7.457, P<0.05). Compared with the treatment without adjuvant radiotherapy and RT, CCRT reduced the recurrence rate of tumors with tumor size of ≥ 4 cm, adenocarcinomas or adenosquamous carcinomas (pathological types), and poorly differentiated carcinomas( χ2=6.725-7.518, P<0.05). A multivariate analysis showed that the CCRT improved the recurrence-free survival ( HR=0.290, 95% CI: 0.128-0.659, P=0.003) and OS ( HR=0.370, 95% CI: 0.156-0.895, P=0.024). A subgroup analysis indicated that CCRT prolonged the OS of patients with tumor size ≥ 4 cm or poorly differentiated cancers compared to the patients receiving no radiotherapy or those treated with RT (χ 2=7.614, 5.964, P<0.05). Compared with the cases receiving single radiotherapy, those receiving CCRT did not suffer an increase in the incidence of hematology, radiation enteritis, and cystitis above grade 3 according to observation ( P>0.05). Conclusions:Among the intermediate-risk factors leading to the recurrence of postoperative cervical cancers, the factors of large primary tumors or poorly differentiated cancers affect the prognosis of patients.Compared with RT and the treatment without adjuvant radiotherapy, IMRT combined with concurrent chemotherapy can prolong the recurrence-free survival and overall survival of patients with large tumors or poorly differentiated cancers and adverse reactions induced are tolerable.

Objective To investigate the effect of high altitude hypoxia on chronic inflammation in rats.Methods Forty SD rats were randomly divided into 4 groups: control group (Con),chronic inflammation group (CI),high altitude hypoxia group (HH),high altitude hypoxia+chronic inflammation group (HH+CI).Rats in CI group were injected with lipopolysaccharide (LPS) (0.5 mg/kg) through the caudal vein twice a week for 4 weeks.Rats in HH+CI group were treated just as CI group was,but together with HH group rats were settled in a hypoxic environment of 6000 m altitude for three days.Pathological changes in lung tissues were observed by hematoxylin eosin stain.The peripheral white blood cell count and classification were measured.The levels of interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) in serum and lung tissues were detected by enzyme-linked immunosorbent assay (ELISA).Changes in IL-6 expression in rat lung tissues were observed by Western blotting.Results After LPS and high altitude hypoxia exposure,inflammatory cells infiltration and alveolar capillary expansion were observed in rats' lung tissue.Compared with Con group,not only the peripheral white blood cell count,but also the level of IL-6 and TNF-α in serum and lung tissue increased in CI and HH group(P<0.01).IL-6 expression levels observed by Western blotting were also increased in HH and CI group(P<0.01).High altitude hypoxia and chronic inflammation interacted(P<0.01).The peripheral white blood cell count was higher in HH+CI group than in other groups,and IL-6 and TNF-α expressions in lung tissue were increased(P<0.05).Conclusion An LPS-induced chronic inflammation model in rats is successfully obtained,and high altitude hypoxia could aggravate chronic inflammation.

Objective To investigate the protective effect of rosiglitazone on the rats with high altitude pulmonary edema.Methods Thirty-six SD rats were randomly (random number) divided into 6 groups (n =6 each):control group (Control),hypobaric hypoxia model group (HH),rosiglitazone groups (RSG) which were administered with 3 different doses [RSG-L:5 mg/ (kg · d),RSG-M:10 mg/ (kg·d),RSG-H:20 mg/ (kg· d)],dexamethasone group [Dex,4 mg/ (kg· d)].Rats were injected intraperitoneally with different doses of rosiglitazone (RSG),dexamethasone (Dex) or vehicle (Control and HH) for 3 days before placed in simulated altitude of 6 000 m hypobaric hypoxia animal chamber where the temperature and pressure were constant.After 72 h in the chamber,each rat was anesthetized.The water content of lung was determined with wet/dry weight ratio.Bronchoalveolar lavage fluid was measured by bradford method.The contents of GSH was measured by micro-ezymed labeled method.The contents of MDA was measured by TBA method.The enzymatic activities of SOD was measured by WST-1 method.The changes of the TNF-α,IL-6 and IL-10 in serum were determined by ELISA.Light microscope was used to observe the pathological changes of lung tissue.Results Compared with Control group,the wet/dry weight ratio of lung (5.08 ± 0.24) and total protein content of BALF (351.06 ± 44.55) μg/mL increased significantly (P ＜ 0.01) in HH group.There were red blood cells in the alveolar and interstitium,pink fluid exudation in the alveolar,the alveolar septum enhancement,and a large number of inflammatory cell infiltration;the SOD activity (10.65 ± 0.94) U/mgprot and the content of GSH (1.63 ±0.20) μmol/gprot in lung tissue were significantly decreased (P ＜ 0.01),the contents of MDA (2.1 5 ± 0.18) nmol/mgprot increased significantly (P ＜ 0.01),TNF-o (56.92 ± 2.87) pg/mL and IL-6 (217.80 ±48.01) pg/mL levels in serum were significantly increased (P ＜0.01),and IL-10 (76.85 ± 16.72) pg/mL level decreased (P ＜ 0.05).Compared with the HH group,the wet/dry ratio of lung and total protein content of BALF in different doses of rosiglitazone group significantly decreased (P ＜ 0.01),the pathological changes of the lung tissue was significantly improved,SOD activity and the content of GSH in lung tissue was significantly increased (P ＜ 0.01),the content of MDA decreased (P ＜ 0.01),The levels of TNF-α and IL-6 in serum were significantly decreased (P ＜ 0.01),while the IL-10 level was significantly increased (P ＜ 0.01).Conclusion Rosiglitazone could protect the high altitude pulmonary edema by alleviating the oxidative stress and inflammatory response.

Objective To obtain the recombinant corticotropin releasing hormone (CRH) protein with soluble, high purity protein through optimizing prokaryotic expression condition and purifying glutathione thiol transferase (GST)-CRH protein. Methods To detect the expression of soluble CRH protein through grope of the host strain GST-CRH temperature of induction expression, the host strain concentration (OD600), IPTG concentration and induction time, the purification of GST-CRH was performed by GST-CRH agarose gel. Western Blot assay was used for the expression identification of the target protein. Results The optimal conditions for the induction of CRH protein were determined: temperature of 30 ℃, IPTG induced concentration 0.1 mmol/L, bacteria density (OD600) 0.8, the induction time of 8 hours, purified GST-CRH>95% fusion protein was obtained. Conclusion The optimal expression conditions of GST-CRH are obtained, and the soluble protein of high purity GST-CRH is also obtained.

Objective To prepare the anti-TLR4 C-terminal domain monoclonal antibody and investigate its effect in treatment of sepsis.Methods TLR4 C-terminal polypeptide (amino acid sequence:368-579,named as TLR4-C) was obtained through prokaryotic expression and Sephacryl S-100 gel purification,and then was used to immunize female Balb/c mice (6-8 weeks old).After cell fusion,antibody screening and purification,monoclonal antibody specific for the C terminal of TLR4 was obtained.Specificity of monoclonal antibody was detected by Western blot and cell immunofluorescence.In vitro antibody activity test,NR8383 was cultured for 1 h with adding antibody (100 μg/ml) and then 12 h after adding lipopolysaccharide (LPS) (10 ng/ml),and level of tumor growth factor (TNF)-α in the culture medium was tested by ELISA.In vivo septic animal experiment,40 SD rats were assigned to control antibody group (n =20) and anti-TLR4 monoclonal antibody group (n =20) according to the random number table.Each group was rejected 50 mg/kg corresponding antibodies via caudal vein for 1 h,and then LPS (10 mg/kg) via intraperitoneal injection for 4 h.Blood samples from caudal vein of ten rats in each group were collect to test the serum level of TNF-α.The rest rats in each group were used to measure the animal survival rate within 72 h.Results Three highly specific anti-TLR4 monoclonal antibodies were obtained and could combined with TLR4-C and TLR4 holoprotein.In vitro cell activity study indicated only one monoclonal antibody could obviously inhibit the release of TNF-α.In vivo animal experiment showed serum TNF-α level in anti-TLR4-C antibody group was (1.54 ± 0.18) ng/ml,significantly lower than (0.51 ± 0.10) ng/ml in antibody control group (P ＜ 0.01).Animal survival rate in anti-TLR4-C antibody group was 70％,higher than 30％ in antibody control group (P ＜ 0.05).Conclusion Anti-TLR4-C monoclonal antibodies have great capacity to neutralize TLR4 and good protective effect on LPS-induced sepsis.

Objective To investigate the mechanism of oxidative damage caused by lipopolysaccharide (LPS)induced sepsis in rat brain.Methods The rats were randomly divided into control group and model group (low LPS group and high LPS group).Twenty-four hours after the modeling,the rats were sacrificed before their brain tissue was taken out and prepared for the test.The changes in malondialdehyde (MDA),superoxide dismutase (SOD),glutathione peroxidase (GSH-Px),total antioxidant capacity (T-AOC),hydrogen peroxide (H2 O2 )and succinate dehydrogenase (SDH)were detected.The expression level of JNK and Nrf2 protein in brain tissue was detected by qRT-PCR and Western blotting. Results Compared with the control group,the MDA,SOD,GSH-px,T-AOC,H2O2 and SDH level increased significantly in the model group,and the difference in expressions of JNK and Nrf2 was statistically significant (P <0.05). Conclusion The LPS induced septic oxidative brain damage model in rats is successfully established,and the process may be regulated through the Nrf2 and JNK signal pathways.

Objective To investigate the immunologic properties of osteogenic differentiated bone mesenchymal stem cells (BMSCs). Methods BMSCs were isolated from normal volunteers and induced in osteogenic medium for two weeks. Then,non-differentiated/osteogenic differentiated BMSCs were co-cultured with allogenic T cells and phytohemagglutinin (PHA).The proliferation of T cells was examined by MTT method.The concentrations of TGF-β1 in osteogenic differentiated BMSCs supernatants at week 2 and mixed lymphocytes reaction (MLR) supernatants at day 5 were determined by ELISA.Also,anti-TGF-β antibody was added into the MLR to detect the response of the mixed T cells. Results Non-differentiated and osteogenic differentiated BMSCs did not induce proliferation of the allogeneic T cells but both suppressed the proliferation of the T cells mediated by PHA.The TGF-β1 concentrations had significant elevation in the MLR.Anti-TGF-β antibody could counteract the immunosuppressive function of the osteogenic differentiated BMSCs. Conclusion Osteogenic differentiated BMSCs possess low immunogenicity and immunosuppressive property.