Objective To investigate the difference between S region gene epitope and gene mutation of hepatitis B surface antigen (HBsAg) and hepatitis B surface antibody (HBsAb) coexistence patients with genotype B and C,and to study the correlation of HBsAg and HBsAb coexistence. Methods A total of 5 HBsAg and HBsAb coexistence patients were enrolled,and 51 S region clones were collected. S regions were amplified and sequenced. Result There were 3 patients with genotype C and 2 patients with genotype B. The amino acid mutation rate in S region of 30 clones with genotype C was higher than that of 21 clones with genotype B,and differences were found in S region N-terminal,C-terminal and major hydrophilic region(MHR). The mutation loci of clones with genotype C were mainly concentrated in locus 194,68 and 3,while the mutation loci of clones with genotype B were mainly concentrated in locus 40,200,129 and 5. Conclusions There is difference in amino acid mutation in S region among HBsAg and HBsAb coexistence patients(mutation loci and frequencies) between different genotypes,so epitopes with different genotypes are different. Amino acid mutations within epitope region could lead to the antigenicity changes of HBsAg and potential subsequent failure of neutralization by HBsAb,leading to the coexistence of HBsAg and HBsAb.

Objective To investigate the coorelation of pathological diagnosis,TNM stage and the levels of tumor markers with different scenarios of traditional Chinese medicine syndrome in patients with lung cancer.Methods A total of 196 patients had been diagnosed with lung cancer.The correlation analysis of pathological diagnosis [non-small cell lung cancer(squamous carcinoma,adenocarcinoma,large cell carcinoma and mixed cell carcinoma) and small cell lung cancer],TNM stage and tumor markers[cytokerantin-19-fragment(CYFRA21-1),carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125),pro-gastrin-releasing peptide(ProGRP) and squamous cell carcinoma antigen(SCC Ag)] with different scenarios of traditional Chinese medicine syndrome in patients with lung cancer was performed.Results Most of the traditional Chinese medicine syndromes in lung cancer patients were lung and spleen deficiency syndrome(119 cases,60.71%),Qi and Yin deficiency syndrome(76 cases,38.7%) and spleen and kidney deficiency syndrome(1 case,0.52%).However,the distribution of the traditional Chinese medicine syndrome among the different pathological diagnosis in lung cancer patients showed no significant difference(P=0.325).Lung and spleen deficiency syndrome was concentrated in TNM stage Ⅰ-Ⅲ patients,while Qi and Yin deficiency syndrome was concentrated in TNM stage Ⅳ patients.The CYFRA21-1 levels in Qi and Yin deficiency syndrome patients were higher than those in lung and spleen deficiency syndrome patients(P=0.017).The differences of CEA,CA125,ProGRP and SCC Ag levels were not significant(P0.05).Conclusions Most of the lung cancer patients are deficiency syndrome.It indicates that advanced stage lung cancer patients would be in unstable conditions and have bad prognosis when Qi and Yin deficiency.CYFRA21-1 and other tumor markers could be the microscopic evidence to traditional Chinese medicine syndrome diagnosis.

To explore the clinical significance of the expression of CD4+CD25+ regulatory T cells,IL-10 and other T cell subsets in blood of patients with advanced lung cancer,serum levels of IL-10 in 92 patients with advanced lung cancer and 62 normal controls were measured by ELISA.CD4+CD25+ regulatory T cells other T cell subsets(CD3+,CD4+,CD8+ and CD8+CD28+) and NK cells were measured by flow cytometry.The results showed that the serum IL-10 levels in patients were significantly higher than that in control group(P0.01).The percentage of CD4+CD25+ regulatory T cells in patients increased significantly than that in the control group(P0.01).The percentage of CD3+cells,CD4+cells,CD8+CD28+ cells and NK cells in patients decreased significantly compared with those in the control group(P0.01).The percentage of CD8+cells in patients significantly increased compared with that in the control group(P0.01).There was significant negative correlation between CD4+CD25+ regulatory T cell IL-10 and CD8+CD28+ cell and NK cell.The results indicate that the increased levels of CD4+CD25+regulatory T cell and IL-10 may impair immune function in patients with advanced lung cancer.