第五次全国幽门螺杆菌感染处理共识报告

The fifth national consensus conference on the management of Helicobacter pylori (H.pylori) infection organized by Chinese Medical Association,Chinese Society of Gastroenterology,H.pylori and Peptic Ulcer Study Group was held at Hangzhou,Zhejiang Province on December 15-16,2016.More than 80 members of the study group and experts in the field of H.pylori research and gastroenterology attended the meeting.Consensus preparatory group was established to draft the related statements.The quality of evidence and strength of recommendation were evaluated by GRADE system.The Delphi method using an anonymous electronic system was adopted to develop the consensus of relevant statements.Expert advices about the established statements were firstly consulted through the emails.After two rounds of consultation,the preliminary statements of consensus were discussed and modified in the conference item by item.A total of 21 core members voted for the final version,which contained a total of 48 statements and was divided into 6 parts,including indications for H.pylori eradication,diagnosis,treatment,H.pylori and gastric cancer,H.pylori infection in special populations,H.pylori and gastrointestinal microbiota.

天然杀伤T细胞对多树突状细胞的调节作用

慢性乙肝病毒感染的诊断和治疗研究动向—与中国学者学术探讨之我见

The infection and its management A high proportion of hepatitis B virus (HBV) infections, which lead to chronicity rather than being resolved, are infections occuring at birth or early childhood[1]. Despite successful vaccination programs, the number of chronic carriers increases worldwide. Hepatocellular carcinoma (HCC) develops late in the course of a chronic infection, with its concomitant overall decrease in viral replication. However, stages associated with a particularly high risk to develop cancer are not described to this date. A still attractive model for the progression of infection points to a persistence of hepatocytes that contain chromosomally integrated, as well as free viral DNA, over hepatocytes containing only free replicating DNA[2]. Specifically, it is suggested that the process of integration depends on structural differences of replication complexes, whereby newly-synthesized viral DNA is rendered accessible to nucleases. Apart from integrated viral DNA, thus far identified only in tissue material, a marker characteristic of a chronic infection is still lacking. Stages of cryptic replicative or non-replicative HBV infection have been described[3], and are thought to represent either late stages of a chronic infection or cases of infection that has resolved without a preceding phase of chronicity[4].

Objective: To evaluate the role of MHC Ⅱ expression in posttrauma immune disturbances and infections.Methods: In experimental study, peritoneal macrophages were harvested from traumatized mice and treated with GM-CSF, Ia molecules were determined by flow cytometry. In 24 trauma patients, monocyte HLA-DR expression was measured by APAAP technique.Results: Marked inhibition of MHC Ⅱ molecule expression was found in both traumatized mice and patients. In traumatic patients with infection, the inhibition was more severe. Treatment with GM-CSF in mice partially restored the Ia expression.Conclusions: Inhibition of MHC Ⅱ molecules plays an important role in postrauma immune disturbances.There is a close relationship between HLA-DR inhibition and clinical infections.