AIM: To evaluate the effect of TDF withdrawal time on changes of serum HBV-M, HBV DNA and ALT level in the mother-to-child blocking of the maternal population. METHODS: A prospective, randomized and controlled study was conducted. The 120 pregnant women with HBV who took TDF during 24 to 28 weeks of gestation were randomly divided into group A (withdrawal at delivery) and group B (withdrawal at 4 weeks postpartum), levels of HBV-M, HBV DNA, and ALT at different times were detected. The results were statistically analyzed by Wilcoxon Rank-sum test and χ

Objective: Comparing the benefit of Abidor, lopinavir/ritonavir and recombinant interferon α-2b triple combination antiviral therapy and lopinavir/ritonavir and interferon dual combination antiviral therapy to hospitalized novel coronavirus pneumonia 2019 in Zhejiang province. Methods: A multi-center prospective study was carried out to compare the effect of triple combination antiviral therapy with dual combination antiviral therapy in 15 medical institutions of Zhejiang Province. All patients were treated with recombinant interferon α-2b (5 million U, 2 times/d) aerosol inhalation. 196 patients were treated with abidol (200 mg, 3 times/d) + lopinavir / ritonavir (2 tablets, 1 time/12 h) as the triple combination antiviral treatment group. 41 patients were treated with lopinavir / ritonavir (2 tablets, 1 time/12 h) as the dual combination antiviral treatment group. The patients who received triple combination antiviral therapy were divided into three groups: within 48 hours, 3-5 days and > 5 days after the symptom onset. To explore the therapeutic effects of triple combination antiviral drugs and dual combination antiviral drugs, as well as triple combination antiviral drugs with different antiviral initiate time. SPSS17.0 software was used to analyze the data. Results: The time of virus nucleic acid turning negative was (12.2 ± 4.7) days in the triple combination antiviral drug group, which was shorter than that in the dual combination antiviral drug group [(15.0 ± 5.0) days] (t = 6.159, P < 0.01 ). The length of hospital stay [12 (9, 17) d] in the triple combination antiviral drug group was also shorter than that in the dual combination antiviral drug group [15 (10, 18) d] (H = 2.073, P < 0.05). Comparing the antiviral treatment which was started within 48 hours, 3-5 days and > 5 days after the symptom onset of triple combination antiviral drug group, the time from the symptom onset to the negative of viral shedding was 13 (10,16.8), 17 (13,22) and 21 (18-24) days respectively (Z = 32.983, P < 0.01), and the time from antiviral therapy to the negative of viral shedding was (11.8±3.9) , (13.5±5.1) and (11.2±4.3) d. The differences among the three groups were statistically significant (Z=32.983 and 6.722, P<0.01 or<0.05). Conclusions The triple combination antiviral therapy of Abidor, Lopinavir/Litonavir and recombinant interferon α-2b showed shorter viral shedding time and hospitalization time compared with the dual combination antiviral therapy. The earlier the time to initiate triple antiviral treatment, the shorter the time of virus shedding.

Objective:To explore the imaging rate and diagnostic rate of positioning the fetal conus medullaris by three-dimensional ultrasound method to detect atlantoaxial intervertebral space, comparing it with the traditional two-dimensional and three-dimensional ultrasound methods.Methods:Consecutively 318 singleton fetuses received routine ultrasound screening during the second trimester were enrolled from November 2017 to December 2018 in Shenzhen Luohu People′s Hospital and Shenzhen People′s Hospital. These fetuses included 276 normal cases and 42 abnormal cases. The abnormal group contained 11 cases tethered cords fetuses(tethered cords group) and 31 cases non-tethered fetuses(non-tethered group). A new ultrasound method named detecting atlanto-axial intervertebral space with three-dimensional ultrasound and traditional two-dimensional and three-dimensional ultrasound methods were used to acquire and store the images. The positions of the fetal conus medullaris were analyzed blindly and recorded by three experienced physicians using three different methods with off-line software.Results:①The χ 2 test comparing multiple sample rates was used to compare the imaging acquisition success rate of fetal conus medullaris by three ultrasound methods. The test level was adjusted to be α′=0.05/4=0.0125, the results showed that there were no statistically significant differences between the three methods in the normal group (χ 2=7.39, P=0.025) and the abnormal group (χ 2=5.32, P=0.070). ②The χ 2 test comparing multiple sample rates was used to compare the diagnostic accuracy of fetal conus medullaris position in normal group by three methods, it showed there was no significant difference in the correct rate of conus medullaris position in the normal group (χ 2=2.52, P=0.284). ③The χ 2 test comparing multiple sample rates was used to compare the diagnostic accuracy of the fetal conus medullaris in tethered cord group and non-tethered group using 3 methods, the difference was not statistically significant in tethered cord group (χ 2=1.22, P=0.543), while the difference was statistically significant in non-tethered group(χ 2=9.69, P=0.008). Conclusions:The method of detecting atlanto-axial intervertebral space with three-dimensional ultrasound has a high imaging rate and diagnostic accuracy in positioning the fetal conus medullaris. Positioning of fetal conus medullaris by detecting atlanto-axial intervertebral space with three-dimensional ultrasound is better than traditional two-dimensional and three-dimensional ultrasound in the abnormal non-tethered fetuses, which can provide more valuable information for prenatal diagnosis consultation and prenatal and postnatal care.

Objective:To compare the efficacy of the combination of abidol, lopinavir/ritonavir plus recombinant interferon α-2b (rIFNα-2b) and the combination of lopinavir/ritonavir plus rIFNα-2b for patients with COVID-19 in Zhejiang province.Methods:A multicenter prospective study was carried out to compare the efficacy of triple combination antiviral therapy and dual combination antiviral therapy in 15 medical institutions of Zhejiang province during January 22 to February 16, 2020. All patients were treated with rIFNα-2b (5 million U, 2 times/d) aerosol inhalation, in addition 196 patients were treated with abidol (200 mg, 3 times/d) + lopinavir/ritonavir (2 tablets, 1 time/12 h) (triple combination group) and 41 patients were treated with lopinavir/ritonavir (2 tablets, 1 time/12 h) (dual combination group). The patients who received triple combination antiviral therapy were further divided into three subgroups: <48 h, 3-5 d and >5 d according the time from the symptom onset to medication starting. The therapeutic efficacy was compared between triple combination group and dual combination group, and compared among 3 subgroups of patients receiving triple combination antiviral therapy. SPSS 17.0 software was used to analyze the data.Results:The virus nucleic acid-negative conversion time in respiratory tract specimens was (12.2±4.7) d in the triple combination group, which was shorter than that in the dual combination group [(15.0±5.0) d] ( t=6.159, P<0.01). The length of hospital stay in the triple combination group [12.0 (9.0, 17.0) d] was also shorter than that in the dual combination group [15.0 (10.0, 18.0) d] ( H=2.073, P<0.05). Compared with the antiviral treatment which was started within after the symptom onset of in the triple combination group, the time from the symptom onset to the viral negative conversion was 13.0 (10.0, 17.0), 17.0 (13.0, 22.0) and 21.0 (18.0, 24.0) d in subgroups of 48 h, 3-5 d and >5 d, respectively ( Z=32.983, P<0.01), while the time from antiviral therapy to viral negative conversion was (11.8±3.9), (13.5±5.1) and (11.2±4.3) d, respectively( Z=6.722, P<0.05). Conclusions:The triple combination antiviral therapy of abidol, lopinavir/litonavir and rIFNα-2b shows shorter viral shedding time and shorter hospitalization time, compared with the dual combination antiviral therapy; and the earlier starting triple combination antiviral therapy will result in better antiviral efficacy.

Objective To evaluate the clinical value of combined detection of T cell receptor rear-rangement excision circles ( TRECs) and CD31+ regulatory T ( Treg) cells for accessing the recent thymic output in patients with chronic hepatitis B. Methods Four groups involving 135 subjects were set up in this study as follows: mild chronic hepatitis B ( Mild CHB, n=35 ) , moderate chronic hepatitis B ( Moderate CHB, n=35 ) , severe chronic hepatitis B ( Severe CHB, n=35 ) and healthy control ( HCs, n=30 ) groups. CD4+CD25+Treg cells in these subjects were sorted out using magnetic cell separation. The ratio of peripheral CD31+Treg cells to Treg cells in each group was analyzed by flow cytometry. Real-time PCR was performed to detect TRECs in CD4+CD25+Treg cells. The percentages of CD3+, CD4+ and CD8+T cell sub-sets were also measured. Results The ratios of CD31+Treg/Treg cells and the numbers of TRECs in pe-ripheral blood of the Moderate CHB and Severe CHB groups were significantly lower than those of the Mild CHB and HCs groups (P<0. 05), while no statistical difference was found between the mild CHB and HC groups (P>0. 05). No significant difference in the percentages of CD3+, CD4+ or CD8+ T cell subsets was observed between the four groups (P>0. 05). CD31+ Treg/Treg cell ratio had a positive correlation with the number of TRECs (r=0. 551, P=0. 014). Conclusions Both CD31+Treg/Treg cell ratio and the number of TRECs were reduced in the peripheral blood of patients with moderate or severe CHB. CD31+Treg/Treg cell ratio and the number of TRECs were positively correlated and could be used as new indices to evaluate recent thymus output.

Cerebral ischemia,brain tumor,and spinal cord injury (SCI) are the central nerve disease which usually cause irreversible,severe neurologic deficits or death.Inflammation plays a key role in the associated secondary damage after central nervous system (CNS) injury.Epidermal growth factor receptor (EGFR) excessive activation has been closely implicated in the initiation and progression of inflammation.Previous studies have shown that through depressing CNS inflammation,EGFR inhibitors may play a role in the therapeutic treatment of CNS disorders.We mainly reviewed the mechanisms of EGFR signaling pathway activation mediating inflammatory damage in CNS.

In the era of digital information,internet plus mode provides new opportunities for the development of traditional medical education.This paper introduces the application patterns of internet plus mode in the medical education,including the following aspects,such as the construction of medical quality resources sharing class,the implementing of medical massive open online courses and other kinds of open online courses,making comprehensive construction of textbooks,using social interactive software and some new wearable devices such as Google glass,distance education and so on.And from the construction of autonomy,sharing,dynamic teaching atmosphere and building a new relationship between teachers and students,it explores the application advantage of Internet plus in medical education,emphasizes thatInternet plus mode and traditional medical education should be organically integrated and financed.At the same time,we should improve the evaluation of information quality,study the integrity test,and the application of big data processing,so as to provide some ideas for the sustainable development.

Objective:To evaluate the therapeutic effect of CXCL1 monoclonal antibody on dextra sulfate sodium (DSS)-induced acute ulcerative colitis (UC) in mice,and to elucidate its effect on the expressions ofTNF-α,IFN-γ,,IL-17 and IL-10 as well as neutrophil infiltration.Methods:Female BALB/c mice were randomly divided into a normal group (DSS-),a disease group (DSS+saline),an anti-CXCL1 antibody group (DSS+anti-CXCL1 Ab) and a treatment control group (DSS+IgG Ab).The DSS+saline,DSS+anti-CXCL1 Ab and DSS+anti-CXCL1 Ab groups were given 3.5％ DSS solution as drinking water to induce acute intestinal inflammation,while the normal control was given distilled water freely.The DSS+anti-CXCL1 Ab mice were intraperitoneal injected with anti-CXCL1 Ab (4 mg/kg) on the 3rd and 6th day.Same amount of rat IgG Ab was given in the DSS+IgG Ab group.The normal group and the disease group were injected with 0.9％ sodium chloride solution.The value of disease activity index (DAI) and the injury of colorectal tissue were measured.The levels of TNF-α,IFN-γ,IL-10 and IL-17 in colonic tissues of mice were detected by RT-PCR.Myeloperoxidase (MPO),a specific marker of neutrophils was measured by immunohistochemistry.Results:Compared with the normal control group,DAI score and colorectal injury score in the disease group were significantly increased,but the DAI and colorectal in the mice with acute ulcerative colitis tissue damage score were significantly reduced after anti-CXCL1 Ab intervention.Compared with the normal control group,mRNA levels of TNF-α,IFN-γ and IL-17 in the colorectal tissues were significantly elevated (P＜0.05) in the disease group while the IL-10 was decreased;these effects were attenuated by anti-CXCL1 Ab intervention (P＜0.05).Immunohistochemistry showed that the infiltration of neutrophils (MPO+) in the colon tissue was significantly increased in the disease group,while the anti-CXCL1 Ab treatment could significantly reduce the neutrophil infiltration in colon tissue (P＜0.05).Conclusion:Anti-CXCL1 Ab relieves the progression of DSS-induced acute ulcerative colitis by suppressing proinflammatory expression and neutrophil infiltration.

OBJECTIVE: To analyze the association between serum levels of S100A8/S100A9 and clinicopathological features of colorectal cancer patients.
 METHODS: A total of 82 patients with CRC and 14 healthy controls were enrolled for this study. The levels of S100A8 and S100A9 in serum were detected by ELISA assay. The association between S100A8/S100A9 and clinicopathological features was analyzed by student-t test and one-way ANOVA. Receiver Operating Characteristic curve was used to analyze diagnostic efficiency of serum S100A8 and S100A9 for colon rectal cancer. Logistic regression model was also established to analyze the possible risk factors for elevation of S100A8/S100A9.
 RESULTS: The levels of S100A8 and S100A9 were (1 403.3±593.7) and (2 890.3±994.9) pg/mL in patients with colon cancer, and (712.8±265.3) and (1 492.7±564.6) pg/mL in controls, respectively, with significant difference between the two groups (P<0.01). The similar results were found in rectal cancer patients, with a level of S100A8 and S100A9 at (1 417.7±666.5) and (3 026.7±887.6) pg/mL, respectively. Diagnostic sensitivity and specificity of S100A8 and S100A9 are better than traditional biomarkers. The levels of S100A9 in serum of CRC patients were correlated with clinical stages and distant metastasis. Serum levels of S100A9 in patients of stage III [(3 111.9±178.5) pg/mL] and stage IV [(3 831.4±278.5) pg/mL] were significantly (P<0.01) higher than that in stage I [(2 276.1±167.4) pg/mL], whereas there was significant change in S100A8 levels. Logistic regression showed the possible risk factors for the elevation of S100A9, including depth of invasion, lymphatic metastasis and degree of differentiation (P<0.05).
 CONCLUSION Serum level of S100A8 and S100A9 in CRC patients were significantly increased and serum level of S100A9 was positively correlated with the malignant features of CRC.
Calgranulin A ; Calgranulin B ; Colorectal Neoplasms ; Enzyme-Linked Immunosorbent Assay ; Humans ; Lymphatic Metastasis ; Risk Factors

Objective To evaluate the performance of ELISA by detecting low quantitative HBsAg in serums.Methods 305 serum samples that the quantitation range was from 0.05 IU/ml to 9.99 IU/ml were collected,and then detected by ELISA. Results The rate of patients with low quantitation of HBsAg was 18.12% in patients with positive HBsAg.The total de-tected rate of ELISA was 87.87%,and the rate of 0.05~0.11,0.12~0.20,0.21 ~0.50,0.51 ~ 1.00,1.01~5.00 IU/ml and 5.01~9.99IU/ml were 36.00%,61.11%,78.38%,84.62%,99.11% and 100.00%,respectively.The differences were statistically significant between the detected rates of each group(χ2 =99.84,P =0.000).There was high correlation coeffi-cient between the results detected by ELISA and by CMIA(r = 0.874,P = 0.000).Conclusion The clinical laboratory should be careful to apply the method of ELISA to detect HBsAg for its missing detection in samples with low quantitation of HBsAg.