Expert Consensus on Clinical Diseases Responding Specifically to Traditional Chinese Medicine：Aural Vertigo / 中国实验方剂学杂志

Aural vertigo frequently encountered in the otolaryngology department of traditional Chinese medicine （TCM） mainly involves peripheral vestibular diseases of Western medicine， such as Meniere's disease， benign paroxysmal positional vertigo， vestibular neuritis， and vestibular migraine， being a hot research topic in both TCM and Western medicine. Western medical therapies alone have unsatisfactory effects on recurrent aural vertigo， aural vertigo affecting the quality of life， aural vertigo not relieved after surgery， aural vertigo with complex causes， and children's aural vertigo. The literature records and clinical practice have proven that TCM demonstrates unique advantages in the treatment of aural vertigo. The China Association of Chinese medicine sponsored the "17th youth salon on the diseases responding specifically to TCM： Aural vertigo" and invited vertigo experts of TCM and Western medicine to discuss the difficulties and advantages of TCM diagnosis and treatment of aural vertigo. The experts deeply discussed the achievements and contributions of TCM and Western medicine in the diagnosis and treatment of aural vertigo， the control and mitigation of the symptoms， and the solutions to disease recurrence. The discussion clarified the positioning and advantages of TCM treatment and provided guidance for clinical and basic research on aural vertigo.

Trends and influencing factors of endurance performance of Han college students in Hunan Province during 1985-2019 / 中国学校卫生

Objective@#To analyze the trends and influencing factors of endurance performance of 19-22 years old college students in Hunan Province from 1985 to 2019, so as to provide objective and scientific basis for sports and health work in colleges and universities.@*Methods@#A retrospective analysis was conducted on the data of 14 490 college students aged 19-22 in Hunan Province from 8 consecutive National Student Physical Fitness and Health Surveys conducted from 1985 to 2019. The analysis indexes were 1 000 m running for boys and 800 m running for girls.@*Results@#From 1985 to 2019, the endurance running time of 19-22 years old Han college students in Hunan Province showed an obvious trend of decline. The 1 000 m running time of urban and rural male students increased by 41.9 and 45.4 s on average, and the 800 m running time of urban and rural female students increased by 29.5 and 30.6 s on average, respectively. Multiple linear regression analysis showed that age ( β =0.17), urban students (rural students as reference; β =0.44), GDP ( β =0.94) and urbanization level ( β = 0.44 ) were positively correlated with the average endurance running time of males. Urban students ( β =0.92), GDP ( β = 1.38 ) and Engel coefficient ( β =0.93) were positively correlated with the average endurance running time of females. BMI ( β =-0.47) was negatively correlated with the females mean time of endurance running ( P ＜0.05).@*Conclusion@#The endurance performance of Han college students in Hunan Province showed a declining trend from 1985 to 2019,which is associated with age, urban and rural distribution, regional GDP, Engel s coefficient, urbanization level and BMI. Effective measures should be taken to improve the physical quality of college students.

Association of single nucleotide polymorphism of IL-6 gene with susceptibility to hepatitis B virus / 中华实验和临床病毒学杂志

Objective@#Leukocyte mediated IL-6 (IL-6) plays an important role in chronic viral hepatitis pathogenesis and related liver diseases, We did a large sample-size case-control study and clinical data analysis to find association between IL-6 single nucleotide polymorphism and HBV susceptibility, and to achieve the detection of the body on the expression of IL-6 for the prevention and treatment of HBV infection.@*Methods@#Totally 848 HBV patients and 894 healthy controls in Shenzhen were selected and rs1800796 genotypes were determined by TaqMan assays.@*Results@#The result showed that rs1800796 polymorphism was associated with susceptibility to HBV infection (P=0.0003, odds ratio (OR)=1.43, the difference was statistically significant.@*Conclusions@#The single nucleotide polymorphism of IL-6rs1800796 locus was associated with the susceptibility of HBV infection in Chinese population, and the rs1800796 G allele is a protective gene for HBV infection.

Effect of treatment of allergic rhinitis on quality of life in patients with asthma / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the effect of the treatment of allergic rhinitis on the quality of life of patients with bronchial asthma.METHODS Fifty-three patients with moderate-severe allergic rhinitis and mildmoderate asthma were included in this study and all of them had not yet received treatment for allergic rhinitis.There were 20 males and 33 females with an age ranged from 18 to 76 years.They had been treated with Salmeterol/Fluticasone propionate(seretide) 50/100 μg twice a day and combined with Ventolin if needed.On this basis,they were treated with loratadinel0 mg and Fluticasone proplonate nasal spray 200 micrograms once daily for 12 weeks.The visual analog scale,the asthma control test and Juniper's asthma quality of life questionnaire were recorded before and after treatment.RESULTS After treatment of allergic rhinitis,the rate of full asthma control was 28％,the rate of partial asthma control was 63％,and the rate of uncontrolled asthma was 9％.There was a significant improvement in asthma control after treatment of allergic rhinitis(P＜0.05).The scores after treatment were higher than that before treatment in all dimensions of asthma quality of life questionnaire(P＜0.01).CONCLUSION Allergic rhinitis and bronchial asthma are two closely related diseases,treatment of allergic rhinitis is benefit to bronchial asthma control and can improve the quality of life of the patients.

Current status of cleaning and disinfection of digestive endoscopes in medi-cal institutions in Suzhou City / 中国感染控制杂志

cleaning and disinfection.Results All 28 surveyed medical institutions had separate endoscope disinfection rooms, 89.29% of which had integrated endoscopic cleaning station,17.86% had automatic endoscope washer/disinfector;100% used multi-enzymatic detergent,chose the right disinfectant,monitored disinfectant concentration every day, and implemented standard disinfection time.But only 39.29% changed multi-enzymatic detergent for each endo-scope,cleaning and disinfection personnel in 78.57% of medical institutions wore personal protective equipment correctly.77 digestive endoscopes were detected,the qualified rate was 88.31%.Conclusion Cleaning and disin-fection management of digestive endoscope in secondary and above medical institutions in Suzhou City is generally standardized,there are still some problems in the manipulation procedures,relevant national regulations should be strictly complied with,efficacy of cleaning and disinfection of digestive endoscope should be further improved.

Fatigue in patients receiving maintenance dialysis: a review of influence factors andinterventions / 中国实用护理杂志

Fatigue is commonly experienced in patients with advanced kidney disease and associated with poor outcomes. The purpose of this review was to discuss the prevalence, assessment methods and contributing factors of fatigue in patients with end-stage renal disease (ESRD), and also examined possible interventions to improve fatigue and concludes by defining some future research directions.

Cross-sectional survey and analysis of cleaning quality of dental handpieces in Suzhou City / 中国感染控制杂志

Objective To explore the cleaning status and cleaning quality of dental handpieces in various types of medical institutions in Suzhou City.Methods On October 26-31, 2015, dental clinics in the whole city were sampled according to cross-sectional survey and proportional sampling method, the cleaning quality of dental handpieces in each clinic was detected by ATP bioluminescence assay.Results 72 medical institutions, 201 handpieces, 402 samples in 10 administrative regions of the city were sampled, 42 samples was unqualified, unqualified rate was 10.45％, unqualified rate of cleaning of dental handpiece surface was higher than waterline of dental handpiece(17.91％ vs 2.99％, P<0.05).Cleaning quality of dental handpieces in different grades of medical institutions was different(P<0.05), tertiary medical institutions were all ualified, medical institutions without grade was 14.45％.According to the classification based on name of different medical institutions, cleaning quality of handpieces was statistically significant(P<0.05), cleaning efficacy of dental handpieces in department of stomatology of public hospitals was best(unqualified rate was 4.31％), while private dental clinics had the worst cleaning efficacy(unqualified rate was 13.81％).Conclusion Education and training of dental handpieces cleaning in the whole city should be strengthened, especially the management of cleaning of dental handpieces in low grade and private dental clinics.

Study of sequential strategy for hepatitis B e antigen (HBeAg) positive chronic hepatitis B (CHB) patients with suboptimal early response to Peg-interferon-α / 中国基层医药

Objective To investigate the efficacy of entecavir (ETV) sequential therapy in the treatment of hepatitis B e antigen(HBeAg) positive chronic hepatitis B(CHB) patients with suboptimal early response to Peginterferon-α(Peg-IFN-α).Methods The cases of HBeAg-positive CHB who were treated with Peg-IFN-α for 12 to 24 weeks and serum HBsAg ＞ 20 000 IU/mL were enrolled into observation group.Treatment naive HBeAg positive CHB with serum HBsAg ＞ 20 000IU/mL were enrolled into control group.Both two groups received ETV for 96 weeks.Hepatitis B virus (HBV) virological and serological data were collected every 12 weeks.Results At the end of 48-week and 96-week,the rates of HBeAg seroconversion in the observation group were 23.3％ (10/43),30.2％ (13/43),respectively,which in the control group were 23.1％ (12/52),28.8％ (15/52),respectively.The HBsAg decline at 24-week was observed in both two groups.Conclusion Sequential strategy for patients with suboptimal early response to IFN is preferable.

Risk factors of surgical site infection in patients with colon or rectal cancer / 中国感染控制杂志

Objective To investigate the occurrence and risk factors of surgical site infection(SSI)in patients with colon or rectal cancer.Methods Patients who were diagnosed with colon or rectal cancer and underwent emergency or elective surgery in a hospital between January 1,2008 and December 31,2013 were monitored prospectively.General data,operation condition,and antimicrobial use of patients were analyzed,occurrence of SSI was observed every day and followed up after operation,risk factors of SSI were analyzed by univariate and multivariate analysis.Results A total of 694 patients with colon cancer(n=380)or rectal cancer(n=314)were monitored,SSI occurred in 125 patients,including 15 incisional infection and 110 organ/space infection,incidence of SSI was 18.01%;incidence of SSI in colon cancer patients and rectal cancer patients were 17.11%(65/380)and 19.11%(60/314)respectively.Univariate analysis showed that among colon cancer patients,incidence of SSI was higher in those with co-infection of other sites during perioperative period,underlying diseases,phase Ⅰcancer,and relaxation suture(all P2 hours,stoma,drainage,relaxation suture,rinsing during operation,and use of antimicrobial agents>72 hours(all P<0.05);logistic regression analysis showed that the independent risk factors for SSI in colon cancer patients were underlying disease,co-infection of other sites during perioperative period,and relaxation suture(all P<0.05);independent risk factors for SSI in rectal cancer patients were underlying disease,co-infection of other sites during perioperative period,and stoma(all P<0.05).Conclusion Prevention and control measures should be taken according to risk factors of SSI in patients undergoing colon cancer and rectal cancer surgery,especially those who with chronic underlying diseases and other site infection during perioperative period;in addition,patients with colon or rectal cancer should also pay attention to relaxation suture and stoma respectively.

Analysis on Tn17/Treg cells in patients with pelvic tuberculousis / 临床检验杂志

Objective To investigate the cellular immunologic response of TH 17/Treg cells in the peripheral blood of pelvic tuberculosis patients and explore their roles in the pathogenesis of pelvic tuberculosis.Methods The intracellular flow cytometry was performed to evaluate the expressions of TH 17 and Treg cells in 46 pelvic tuberculosis patients and 25 healthy controls in childbearing age.Twenty-eight of the 46 pelvic tuberculosis patients were followed up to monitor the variation of the TH17/Treg cells after 3 months and 6 months of anti-tuberculosis treatment.Results The percentage of TH 17 cells in the peripheral blood of pelvic tuberculosis patients was (3.26 ± 1.30) ％ which was significantly lower than that of healthy controls [(4.92 ± 1.71) ％,P ＜ 0.01].The percentage of Treg cells in the patients was (5.18 ± 1.53) ％ which was significantly higher than that of healthy controls [(3.26 ± 1.10) ％,P ＜ 0.01].The percentage of TH17 cells in the pelvic tuberculosis patients after 6 months of treatment was (4.67 ± 1.75) ％ which was significantly higher than that in the patients before treatment and after 3 months treatment [(3.26 ± 1.30) ％,P ＜ 0.01 and (3.70 ± 1.06) ％,P ＜0.01,respectively].The percentage of Treg cells in pelvic tuberculosis patient after 6 months of treatment was (3.93 ±0.94)％ which was significantly lower than that in the patients before treatment and after 3 months of treatment [(5.18 ± 1.53)％,P ＜0.01 and (4.94 ± 1.51) ％,P ＜ 0.01,respectively].The percentage of Treg cells in the patients after 6 months of treatment was still significantly higher than that of controls (P ＜ 0.05).The TH 17/Treg ratio before treatment was significantly lower than that of healthy controls (P ＜ 0.01),and the TH 17/Treg ratio was increased after 3 months of treatment but it did not show significant difference compared with that before treatment.The TH 17/Treg ratio after 6 months of treatment (1.18 ± 0.34) ％ was significantly increased in contrast to those after 3 months of treatment and before treatment [(0.77 ± 0.21) ％,P ＜ 0.01 and (0.55 ± 0.13) ％,P ＜ 0.01,respectively].The TH 17/Treg ratio could not rise to the normal level even after 6 months of treatment.Conclusion Both the TH 17 and Treg cells may involve in the immunologic responses of pelvic tuberculosis patients and the imbalance of TH1T/Treg cells may remain persistently.

Relevant influential factors for cleaning quality of dental handpieces / 中国感染控制杂志

Objective To understand the cleaning quality of dental handpieces in Suzhou City, analyze the relevant factors that influencing cleaning effect.Methods A cross-sectional study was performed with the proportional system sampling method, questionnaires were adopted to investigate the cleaning location, cleaning method and process of dental handpieces, the ATP fluorescence detection method was conducted to detect cleaning quality.Results In 10 administrative regions of this city, a total of 72 medical institutions were selected, 25 were public medical oral diagnosis and treatment institutions, 47 were private clinics.Cleaning effect of automatic handpiece cleaning machine was better than traditional manual cleaning (unqualified rate :3.95% vs 11.96%, P0.05).The quality of cleaning of handpieces could be improved if waiting time of cleaning ≤30 minutes, enzymes were used during cleaning, and purified water was used at the end rinse(all P<0.05);whether there was drying process and used lubricant, difference were both not significant.Conclusion Using automatic handpiece cleaning machine, cleaning personnel with adequate knowledge, cleaning waiting time ≤30 minutes, enzyme use during the cleaning process, and purified water use at the end rinse can improve the quality of cleaning of dental handpieces.

Allele-31 C>T regulates binding activity to IL-1βgene promoter of nuclear transcription factor C/EBPβand PU.1 induced by Mycobacterium tuberculosis infection / 中华临床感染病杂志

Objective To investigate the effects of allele-31 C>T on the binding activity to IL-1βpromoter of the nuclear transcription factor C/EBPβand PU.1 induced by Mycobacterium tuberculosis infection.Methods The electrophoretic mobility shift assay ( EMSA) was performed to explore whether the nuclear transcription factor C/EBPβand PU.1 could bind to -31 region in IL-1βpromoter.The C/EBPβ-and PU.1-expressing vectors were constructed and co-transfected into HeLa cells with IL-1βpromoter luciferase vector.The expression of C/EBPβand PU.1 was confirmed using Western blotting assay, and the promoter activity was determined using Dual-Glo Luciferase system under various transfection conditions. Lentivirus-mediated RNA interference was used to explore the effects of C/EBPβand PU.1 on IL-1βexpression.GraphPad Prism 5.0 was used for data analysis.Results EMSA results showed that both C/EBPβand PU.1 could bind to -31 region in IL-1βpromoter.Both C/EBPβand PU.1 induced by Mycobacterium tuberculosis infection could increase IL-1βpromoter activity, especially for the -31 T allele (t=22.33 and 7.98,PT can induce IL-1βpromoter activity and gene transcription through regulation of binding activity to C/EBPβand PU.1 induced by Mycobacterium tuberculosis infection.

Clinical diagnosis and treatment of allergic pharyngitis / 临床耳鼻咽喉头颈外科杂志

Although the concept of united airway disease has been widely accepted, most scholars emphasize only the effect of rhino-sinusitis while ignoring the pharyngeal factors to the lower airway, especially to the allergic pharyngitis (AP), which still lacks enough awareness. First of all, absence of unified diagnostic standard leads to the lack of epidemiological data, which, results in doctors' personal experience but no guideline in treatments. In addition, it is still not clear that the role of AP in the allergic airway diseases and its relationship with asthma. However, the number of patients with AP has been increasing obviously in daily clinic practice. Combined with the previous observation, this paper does a systematic review about the clinical problems of AP, expecting to give a hand to the clinical diagnosis and treatment of AP.

Involvement of MAPK signal transduction pathways in regulating the expression of glucocorticoid receptor isoforms in nasal polyp epithelia in vitro / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the upstream signal transduction mechanism responsible for the decrease of the ratio of the two glucocorticoid receptor (GR) subunits (GRα and GRβ) in nasal polyp in vitro.</p><p><b>METHODS</b>The GRα/GRβ decrease cell model was established by lipopolysaccharide (LPS)-induced human nasal epithelia (HNE) of nasal polyp in vitro. Changes in the protein and mRNA expression of GRα, GRβ and the key enzymes in the p38MAPK, ERK and JNK signal pathways were measured, respectively, before and after being induced with different doses of LPS and specific inhibitors of p38MAPK, JNK and ERK. SPSS 16.0 software (Analysis of variance, ANOVA) was used to analyze the data.</p><p><b>RESULTS</b>With the LPS induction, the GRα/GRβ ratio declined in both a time-dependent manner and a concentration-dependent manner in HNE, which demonstrated the successful establishment of a GRα/GRβ decrease model in vitro. After cultured HNE were induced with the same set of LPS, the p38MAPK, ERK and JNK signal pathways were also activated. The mRNA expression of p38MAPK and JNK in each LPS-induced group (17.14 ± 1.50, 22.34 ± 2.78, 30.12 ± 1.07; 2.51 ± 0.13, 3.79 ± 0.67, 4.41 ± 0.83; 25.62 ± 1.77, 31.33 ± 1.97, 37.25 ± 2.46) was significantly higher than that (7.39 ± 0.31, 2.04 ± 0.34, 2.38 ± 0.35) in the control group (χ² value was 15.347, 18.331, 14.671, all P < 0.01). Either a specific inhibitor (SB203580) of the p38MAPK pathway or a specific inhibitor (SP600125) of the JNK pathway increased the GRα/GRβ ratio at the meantime of inhibiting their pathways. SB203580 exhibited a much stronger increase effect on GRα/GRβ ratio than SP600125. The specific inhibitors (PD98059) of ERK had no influence on the expression of GR isoforms.</p><p><b>CONCLUSIONS</b>The above results demonstrated that the decrease of GRα/GRβ ratio in HNE induced by LPS in vitro is mediated through the p38MAPK and JNK signal pathways. It is possible to improve the treatment effect of GC resistance in nasal polyp by targeting these specific signal pathways.</p>

Clinical characteristics of patients with acute-on-chronic liver failure and splenomegaly / 南方医科大学学报

<p><b>OBJECTIVE</b>To observe the clinical characteristics and short-term survival of patients with splenomegaly and acute-on-chronic liver failure related to chronic HBV infection.</p><p><b>METHODS</b>Electronic medical records of patients with acute-on-chronic liver failure were collected to analyze the clinical parameters and 4-week survival of patients with or without splenomegaly.</p><p><b>RESULTS</b>Of the 149 patients enrolled, the overall 28-day mortality rate was 48.3%, which was lower in patients with enlarged spleen than those without (34.2% vs 54.1%, P=0.034). Compared with patients without splenomegaly, patients with splenomegaly had lower platelet counts (P=0.001), lower ALT levels (P=0.005) and lower PT-INR (P=0.010). Although the occurrence of hepatic encephalopathy was comparable between patients with or without splenomegaly, severe conditions were more frequent in those without splenomegaly. Hepatic encephalopathy grades, serum creatinine levels, neutrophil percentages over 70%, PT-INR and splenomegaly were independent factors associated with the 28-day survival, and this novel model was superior to model of end-stage of liver disease in predicting the 4-week survival (P=0.017).</p><p><b>CONCLUSION</b>Patients with splenomegaly that evolves into acute-on-chronic liver failure have unique clinical characteristics and further clinical observations are warranted.</p>

Rejection of insulin therapy among patients with type 2 diabetes in China: reasons and recommendations / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Insulin injection therapy is one of the most effective treatments for type 2 diabetes mellitus (T2DM). Many people with T2DM in western countries resist starting insulin therapy; whether the same is true in China is unknown. This survey-based study assessed acceptance and rejection of insulin therapy among individuals with T2DM in China and self-reported reasons for these therapy choices. It also examined what methods may be useful for increasing the rate of insulin acceptance.</p><p><b>METHODS</b>A multi-center, cross-sectional survey was conducted between April and July 2010 to a convenience sample of inpatients and outpatients at 50 medical centers across 29 administrative divisions in China. Data were collected on sociodemographic and T2DM characteristics, therapy regime, and attitudes toward insulin therapy.</p><p><b>RESULTS</b>A total of 6 043 patients were surveyed, and 5 961 complete questionnaires (98.6%) were used in the analysis. Just over half the respondents (3 460, 58.0%) reported negative attitudes to insulin therapy, including 2 508 of the 4 469 patients (56.1%) whose physicians had recommended it to them. Of the patients counseled to use insulin, 800 (17.9%) were unwilling to start therapy and cited the following reasons: inconvenience (64.3%); concerns over addiction (24.6%); pain (14.3%); side effects (14.1%); and high cost (13.6%). Logistic regression suggested that respondents would be more willing to undertake insulin therapy if they had received diabetes education, had positive attitudes to the treatment, had higher glycosylated hemoglobin level, or had suffered diabetes for a longer period or with more complications.</p><p><b>CONCLUSIONS</b>Patients with T2DM in China are often resistant to insulin therapy if they have been diagnosed with the disease for a relatively short time or if the disease has been relatively mild. Educating patients on the benefits of insulin therapy, not only at the initial diagnosis with T2DM but also when insulin therapy becomes necessary, will likely increase their willingness to undertake it.</p>

Endoscopic skull base surgery under the guidance of image navigation technology / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the feasibility of image navigation technology in endoscopic skull base surgery.</p><p><b>METHODS</b>This study consisted of 75 patients who underwent the endoscopic operations with the help of the image navigation system by the same surgeon between March 2010 and March 2013. The time to prepair image navigation system, identifying anatomical structure, complications, tumor resection, and follow-up results were analysed.</p><p><b>RESULTS</b>The application of image navigation technology in the endoscopic skull base operations was both safe and reliable for delineation of tumors and identification of vital structures hidden or encased by the tumors, such as internal carotid artery, optic canal, comb, saddle bottom, foramen rotundum, foramen ovale, foramen lacerum, jugular foramen, cerebral dura mater. The tumor was removed completely, subtotally, or partially. All patients were successfully registered with accuracy, and the preoperative time was 8-15 minutes for preparation, 11 minutes in average. The target error was less than or equal to 1.5 mm. With guidance of the image navigation system, all patients were successfully operated on without serious complication. There were 13 cases with anterior skull base tumor, all were removed completely. There were 28 cases with sella region tumor, 21 totally resected, 7 subtotally resected. There were 20 cases with petroclival region tumor, 12 totally resected, 5 subtotally resected, 3 partially resected. There were 14 cases with pterygopalatine fossa and/or infratemporal fossa region tumor, 11 totally resected, 3 subtotally resected. All patients were available for follow-up (mean = 26 months) except 6 cases.</p><p><b>CONCLUSION</b>Image navigation technology can be applied in endoscopic skull base operations with advantages of accurately locating, clearly marking, significantly decreasing incidence of complications, and maximally removing the lesions.</p>

Expression level and clinical significance of multifunctional CD8 T cells of patients with tuberculosis / 实用医学杂志

Objective To explore the expression level and clinical significance of multifunctional CD8 T cells in patients with tuberculosis (TB). Methods The expression levels of MTB antigen specific and non-specific multifunctional CD8 T cells among peripheral blood mononuclear cells (PBMCs) and pleural fluid mononuclear cells (PFMCs) in TB patients, latent tuberculosis infection patients (LTBI) and healthy controls (HC) were measured by flow cytometry. Results The expression level of multifunctional CD8 T cells (IL-2+IFN-γ+TNF-α+CD8 T cells) among PBMCs stimulated by non-specific MTB antigen in TB patients was (5.72 ± 4.32)%, which was significantly lower than those in HC and LTBI [(22.3 ± 15.7)%, q=7.455, P<0.001;(14.2 ± 7.72)%, q=3.110, P<0.05]. Under the stimulation by specific MTB antigen, the expression level of multifunctional CD8 T cells among PBMCs in TB patients was (0.33 ± 0.83)%, which was significantly higher than those in HC and LTBI [(0.017 ± 0.03)%, q=3.97, P<0.05;(0.019 ± 0.035)%, q=3.39, P<0.05]. In patients with tuberculous pleurisy, the expression level of multifunctional CD8 T cells among PFMCs was (0.623 ± 1.033)%, which was significantly higher than that among PBMCs [(0.034 ± 0.066)%, P<0.001]. The expression level of multifunctional CD8 T cells in TB patients was negatively correlated with HRCT score (r=-0.265 8, P=0.015 8). Conclusion The expression level of multifunctional CD8 T cells was contributed to discriminate TB patients from latent tuberculosis infection patients , and was closely related to the degree of damage in lung.

Detection of multifunctional Th1 cells in peripheral blood and pleural effusion in TB patients / 国际检验医学杂志

Objective To investigate the level of IL-2+ IFN-γ+ TNF-α+ multifunctional Th1 cell in peripheral blood and hydro-thorax of the TB patients and its clinical significance .Methods 49 patients with tuberculosis(TB) including 14 cases of tuberculous pleurisy and 27 individuals with latent TB infection were selected and 66 healthy individuals were selected as the controls .PMA and ionomycin were adopted to stimulate mononuclear cells in whole blood and pleural effusion .The secretion status of CD4+ T cells cy-tokines was detected by using the intracellular cytokine staining and the flow cytometric analysis .Results According to the differ-ent cytokines generated by CD4+ T cells ,which were divided into 7 cell subgroups :IL-2+ IFN-γ+ TNF-α+ ,IL-2+ IFN-γ+ ,IL-2+TNF-α+ ,IFN-γ+ TNF-α+ ,IL-2+ ,TNF-α+ and IFN-γ+ cell subgroups .The proportion of peripheral blood IL-2+ IFN-γ+ TNF-α+multifunctional Th1 cells in the TB patients was significantly lower than that in the healthy controls and the individuals with latent TB infection(P<0 .01) ,the expression levels of IL-2+ IFN-γ+ cells and IFN-γ+ TNF-α+ cells were significantly lower than those in the individuals with latent TB infection and the healthy controls (P<0 .05);TNF-α+ cells was higher than that in the healthy con-trols and the individuals with latent TB infection (P<0 .05) .The other subgroups had no obvious change .The response level of IL-2+ IFN-γ+ TNF-α+ multifunctional Th1 cells in the pleural effusion mononuclear cells (PEMC) was higher than that in the peripher-al blood mononuclear cells(P<0 .05);IL-2+ cells in peripheral blood mononuclear cells (PBMC) was lower than that in PEMC (P<0 .01) .Conclusion The response of non-specific Th1 cells is related with the clinical outcome of TB infection ,IL-2+ IFN-γ+TNF-α+ multifunctional Th1 cells plays a certain role in the protective immunoreaction of TB .

Association between haplotype of interleukin-22 gene promoter and susceptibility to pulmonary tuberculosis / 中华临床感染病杂志

Objective To investigte the association between haplotype of the promoter of interleukin-22 (IL-22) gene and the susceptibility to pulmonary tuberculosis.Methods Clinical data of 479 patients with pulmonary tuberculosis was collected from Shenzhen Third People's Hospital during January 2009 and December 2010,and 358 healthy controls were also enrolled in the study.Single nucleotide polymorphisms (SNPs) of IL-22 (rs2227472,rs2227473,rs2227478,rs2227483,rs2227485,rs2227486,rs2227487 and rs2227513) were genotyped using the Sequenom MassARRAY iPLEX Platform.The allele frequency and odds ratio (OR) of genotypes of SNPs and haplotypes of IL-22 were calculated; the association between the haplotypes of IL-22 and the susceptibility to pulmonary tuberculosis was analysis.Results rs2227472,rs2227473,rs2227478,rs2227483 and rs2227485 were associated with the susceptibility to tuberculosis (OR =0.796,0.653,0.769,0.762 and 0.816 ; x2 =4.594,6.921,5.256,5.089 and 3.827 ; P ＜0.05 or P ＜ 0.01).The frequencies of haplotypes (CTFAA and TATGG) in case group were significantly different from those in control group (CTFAA:0.004 vs.O.032,OR =0.04,x2 =384.623,P＜0.01; TATGG:0.522 vs.0.460,OR=1.49,x2 =6.690,P=0.01).Conclusions Five SNPs of IL-22 (rs2227472,rs2227473,rs2227478,rs2227483,rs2227485) and 2 haplotypes (CTTAA and TATGG) are associated with the susceptibility to pulmonary tuberculosis.Haplotype CTTAA is a protective factor for susceptibility to pulmonary tuberculosis,whereas haplotype TATGG is a risk factor.