Volume 92  ·   Issue 12  ·  2012

Thyroid diseases represented by iodine deficiency disorders were once a public health problem that seriously affected the life and health of our people, and China was once one of the countries that was seriously threatened by iodine deficiency disorders. In the 1970s, there were 35 million patients with endemic goiter, 250,000 patients with typical cretinism, and 1~2 million patients with cretinism in China. The main harm of iodine deficiency disorders was to affect the brain development of fetuses and children, and the IQ of school-age children in the ward was 10~15 IQ points lower than that of normal people. Facing such serious health problems, the older generation of scholars engaged in iodine deficiency disorders in China made great efforts. On the basis of a large number of epidemiological studies, the large-scale prevention and treatment of salt iodization and iodine supplementation with lipiodol began in the 1960s, which stopped the large-scale epidemic of iodine deficiency disorders.

Thyroid diseases are a heterogeneous group of diseases, including thyroid dysfunction and morphological changes, which lead to hyperthyroidism (hyperthyroidism) and hypothyroidism (hypothyroidism), and the morphological changes are manifested as goiter, nodule and cancerous. The high prevalence of thyroid diseases, the rapid increase of morbidity in recent years and the serious consequences have been widely paid attention by many disciplines at home and abroad, including endocrinology, thyroid surgery, nuclear medicine, perinatal medicine, obstetrics and gynecology, pediatrics, etc. Today, with the emerging of new therapeutic concepts and methods for various diseases, the field of thyroid disease treatment has also made remarkable progress in recent years, and the following aspects are particularly worthy of attention.

Education is the cornerstone of national revitalization, and health is the foundation of people's all-round development. Medical education pays attention to both people's education and people's health, which is related to national economy and people's livelihood, and plays an extremely important role in economic and social development [1]. However, at present, due to the influence of traditional education, some higher medical education in China requires too narrow knowledge structure and ability structure of students in the standards of talent training, and there is a phenomenon of emphasizing medical specialty, neglecting humanities and science, emphasizing technology and neglecting medical ethics; Not adapted to the new model of "humanities-social sciences-biomedicine" [2-3]; In the teaching methods, injection is the main method, lacking the measures to cultivate students' creativity, self-learning ability and personality development.

Objective To explore the effects of nevirapine on the proliferation and expression of sodium-iodide symporter (NIS) mRNA in FRO cells in vitro. Methods The cells were incubated in different concentrations of nevirapine to evaluate the cell growth rate.And the expressions of NIS mRNA and TSHR mRNA were determined by real-time quantitative reverse polymerase chain reaction.Results Cell proliferation was inhibited after a 96 h nevirapine treatment.After incubating in the presence of 200 and 350 μmol/L nevirapine,the expression of NIS mRNA was ( 1.39 ± 0.04 ) and ( 1.85 ± 0.28 ) times versus the control cells ( P ＜ 0.01 ) while the expressions of TSHR mRNA was ( 2.23 ± 1.47 ) and ( 2.83 ± 0.78 ) times versus the control cells respectively (both P ＜0.05).Conclusion Nevirapine inhibits cell proliferation in FRO cell line. More importantly,the cells exposed to nevirapine may induce the up-regulations of NIS mRNA and TSHR mRNA.

Objective To explore the presence of a characteristic stem cell population (side population,SP) in human thyroid gland and perform sphere culture method for the isolation and proliferation of thyroid stem cell.Methods Flow cytometry and cell sorting were performed to identify and isolate the ABCG2-positive SP cells from primary thyroid cells. The comparison of gene profiles and morphology between SP and main population (MP) were performed. Primary thyroid cells were also cultured in neurosphere-like growth condition for sphere formation.Gene profile of developed spheres was determined by reverse transcriptase-polymerase chain reaction (RT-PCR) and thyroid lineage commitment was then induced in a differentiating condition. In stem cell-derived thyrocytes,embedded in collagen to form follicles,TSH-dependent 125I uptake was measured.Results The SP was identified as a population enriched in stem cells with typical morphology,and characteristics of self-renewal and differentiation.Nonadherent clonal spheres developed in thyroid cell cultures,displaying an expression pattern resembling that of SP cells and in response to TSH and serum these sphere cells differentiated into thyrocytes expressing PAX8,thyroglobulin,sodium iodide symporter,thyroid-stimulating hormone receptor and thyroperoxidase mRNA.And there was TSH-dependent 125I uptake.Conclusion It is shown first time that human thyroid contains an undescribed population of cells with SP phenotype and clonal expansion capacity.Moreover sphere culture method is developed for the isolation and proliferation of thyroid stem cell.

Objective To explore the correlations of the polymorphisms of phosphodiesterase 8B (PDE8B) gene with hyperthyrotropinemia in Chinese Han population.Methods A case-control study of genotype 657 366 SNPs was performed by Illumina Human660-Quad BeadChips in 98 hyperthyrotropinemia patients and 1300 controls.And 25 SNPs within PDE8B gene intron 1 were used for association analyses.Results Allele frequencies of 5 SNPS in PDE8B gene intron 1 showed significant differences between the case and control groups (P ＜ 0.05 ).In comparison with the control group,the genotypic distributions of rs7714529 (x2 =6.430,P=0.040),rs12514694 (x2 =7.191,P =0.027) and rs10066802 (x2 =9.213,P =0.010 ) in H-TSH group had significant differences. Haplotype AGTAG (rs7702192/ rs7714529/rs251421/rs12514694/rs 10066802 ) was over-represented in hyperthyrotropinemia cases versus the control group.Conclusion PDE8B gene polymorphisms may be correlated with hyperthyrotropinaemia in Chinese Han population.And it may provide new concepts for the treatment of thyroid dysfunction.

Objective To observe the short-term effect of clinical application of Cerec 3D anterior crowns.Methods A total of 16 patients were restored with 31 Cerec 3D anterior crowns.All restorations were stained before cementation.The evaluation started 1 week after luting.The restorations were examined in accordance with the modified US Public Health Service (USPHS) criteria at baseline and every 6 - 12 months.Results The observation period of 31 Cerec 3D anterior crowns varied from 8 to 33 months.The mean observation period was 22 months.All restorations scored A or B by modified USPHS standard.And 22 out of 31 restorations scored A for all criteria while 8 restorations scored B in color matching.Slight differences of translucency and chroma could be observed.Between baseline and follow-up examinations,insignificant shift from A-to B-rating occurred.Conclusion Cerec 3D anterior crowns may achieve favorable short-term esthetic effects.

Objective To explore the changes of bowel function in spinal cord injury (SCI) patients undergoing sigmoid augmentation cystoplasty.Methods From September 2005 to January 2011,30 SCI patients undergoing sigmoid augmentation cystoplasty were surveyed by follow-up questionnaires at Beijing Charity hospital and Affiliated Hospital of Nantong University.Results Among them,18 cases (60.0％ )believed their defecation became softer and 18 cases (60.0％)thought their defecation time became shorter.The postoperative profiles of patient defecation traits and defecation time were better ( P ＜ 0.05),especially traumatic SCI patients (P ＜ 0.05 ).Conclusions The subtotal resection of sigmoid colon improves the defecation of spinal cord injury patients. The SCI patients undergoing sigmoid augmentation cystoplasy may avoid urinary tract dysfunctions and improve bowel dvsfunction.

Objective To explore the clinical features,treatment and prognosis of multiple myeloma (MM) with extramedullary plasmacytomas (EM).Methods A total of 43 patients were enrolled and divided into 2 groups.Group-1 had 12 patients of EM occurring after the diagnosis of MM while Group-2 included 31 EM patients at the initial diagnosis of MM. Results The male-to-female proportion was 23∶20 and there was a median age of 53 years.The distribution of different isotypes was IgG ( n =15),IgA (n=9),IgD (n =2),κ light chain (n =6),λ light chain (n =6),biclonal myeloma (n =3) and nonsecretory myeloma (n =2).The sites of complicating plasmacytoma included skin,muscle and spinal canal. Nine patients received bortezomib plus DECP (cisplatin, etoposide, cyclophosphamide and prednisone) and 2 patients underwent traditional chemotherapy in Group-1.The outcomes were as follows:complete remission (CR,n =2 ),partial remission ( PR,n =4) and death ( n =5 ).And 11 patients received traditional chemotherapy in Group-2,7 attained PR and 4 died. Twenty patients received bortezomib plus other chemotherapeutic drugs in Group-2.The outcomes were as follows:CR (n =12),PR (n =7 ) and death (n =1 ).The median overall survival (OS) was 36 months (range:10- 120) in Group-1 and 23 months ( range:5 -52) in Group-2 respectively.In Group-1,the estimated 3- and 5-year OS were 54.21％ and 27.10％ respectively. And in Group-2,the estimated 3- and 4-year OS were 39.83％ and 13.28％ respectively.Condusions The EM patients show aggressive,complicated and diverse clinical courses and the unusual manifestation of multiple organ involvement by plasma cells. Traditional chemotherapy has a poor efficacy and the prognosis is unfavorable,especially for EM with concurrent MM.The combined treatment of bortezomib with second-line chemotherapy may achieve curative effects.

Objective To explore the timing and course of proteinuria in Chinese patients with Alport syndrome (AS).Methods This retrospectively study included 118 unrelated male AS patients at Department of Pediatrics,Peking University First Hospital between 1994 and 2009.The clinical data of the onset age of proteinuria,the degree of proteinuria and the prevalence of microalbuminuria were analyzed.Urinary total protein was detected by the pyrogallol red protein dye-binding assay,urinary microalbumin by immunoturbidimetric assay and urinary creatinine level by alkaline kinetics.Microalbuminuria was detected when the microalbumin:creatinine ratio was ＞ 30 mg/g on a single random midstream first morning urine sample.Results A total of 106 patients had proteinuria. The occurring or detecting age of proteinuria varied from 1 month to 27 years.Five patients (4.7％ ) were under 1 year of age and 15 patients ( 14.2％ ) at toddler's age. Among 43 cases with nephrotic-level proteinuria,21 cases (48.8％) presented with nephrotic-level proteinuria at age 6 - 12 year. Both urine total protein and morning urine microalbumin measurements within 7 days were made in 53 patients.Microalbuminuria occurred in 4 of 5 patients with normal daily urinary protein excretion.All 48 patients had daily proteinuria ＞ 0.15 g.Increased urinary microalbumin was detected in 4 of 5 patients with normal daily urinary protein excretion and 46 patients with daily proteinuria ＞0.15 g.The consistency of urine microalbumin concentration and urine microalbumin-to- creatinine ratio was excellent in 51 patients.However,in 2 patients with slightly increased daily urine total protein,urine microalbumin concentration was normal while the urine microalbumin-to-creatinine ratio abnormal ( ＞ 30 mg/g).Conclusions In AS males,proteinuria occurs earlier and progresses rapidly.Since microalbuminuria precedes the onset of proteinuria,either urine microalbumin concentration or urine microalbumin-to-creatinine ratio in morning specimens should be used for detecting microalbuminuria.And microalbuminuria may serve as an early endpoint in intervention trials.

Objective To explore the differences of antiprothrombin-Ⅲ ( AT-Ⅲ ) value in patients with acute coronary syndrome (ACS) and stable angina pectoris (SAP) and examine the association of AT-Ⅲ value with preprocedural thrombolysis in myocardial infarction (TIMI) flow in ACS patients.Methods This study prospectively included 121 hospitalized ACS patients between January 2011 to June 2011,including ST-segment elevation myocardial infarction (STEMI,n =50 ), non-ST segment elevation myocardial infarction (NSTEMI,n =32) and unstable angina (UAP,n =39).Meanwhile,50 SAP cases during the same period were selected as the control group.The AT-Ⅲ levels were measured by chromogenic substrate method before coronary angiography for all patients. Results (1) The AT-Ⅲ levels were significantly lower in the ACS patients than those in the SAP cases.(2) In the STEMI subgroup,the AT-Ⅲ levels were markedly lower in the patients with preprocedural TIMI flow grade ≤2 versus those with preprocedural TIMI flow grade 3 (86％ ± 11％ vs 93％ ±9％,P ＜0.05). (3) In the USTEMI/UAP subgroup,the mean levels of AT-Ⅲ were obviously lower in the patients with preprocedural TIMI flow grade ≤ 2 than those with preprocedural TIMI flow grade 3 ( 85％ ± 8％ vs 95％ ± 8％,P ＜ 0.01 ) and were notably lower in the patients with the culprit lesion stenosis ≥70％ versus those with stenosis ＜70％ ( 88％ ± 9％ vs 94％ ± 9％,P ＜ 0.01 ).(4) Multivariable analysis identified AT-Ⅲ value as an independent predictor of impaired preprocedural TIMI flow grade of culprit coronary artery in ACS patients.Conclusions The AT-Ⅲ levels were significantly lower in the ACS patients than those in the SAP patients.The activity of AT-Ⅲ is positively correlated with the TIMI flow grade in ACS patients.In contrast,the activity of AT-Ⅲ is negatively correlated with the severity of culprit vessel stenosis in the patients with NSTEMI.Thus AT-Ⅲ level may be used to distinguish high-risk populations in ACS patients at an early stage.

Objeaive To evaluate the effects of structured triglycerides in parenteral nutritionversus a physical medium-chain triglycerides (MCT)/long-chain triglycerides (LCT) mixture on severehemorrhagic shock patients after resuscitation. Methods In a randomized trial,we studied 20 criticalpatients with a total blood loss of over 3000 ml perioperatively and/or intraoperatively. The use oftriglycerides started from Day 3 postoperation and parenteral nutrition lasted for no less than 5 days.Theywere allocated to receive one of two nutrition regiments:structured triglycerides in Group A (n =10) andMCT/LCT in Group B (n =10).There were no significant differences of general conditions in two groups.Before the start of parenteral nutrition (d0),d1 d3 and d5 after start of infusion,the following parameterswere measured:hemoglobin ( Hb),platelet count ( Plt),alanine aminotrasferase ( ALT),total bilirubin(TB),direct bilirubin (DB),serum triglycerides (TG),prealbumin (PA) and transferrin (TF).Andmean artery pressure (MAP),heart rate (HR) and central vein pressure (CVP) were also recorded at thesame time-points.Then the post-TG changes of the above data were compared in both groups. ResultsAfter the use of triglycerides,there were no significant differences of MAP,HR,CVP,Hb and Plt in bothgroups(P＞0.05).At D3 and D5,the serum levels of TG((2.1 ±0.4) vs (1.6±0.6) mg/L,(2.3 ±0.7) vs (1.5 ±0.3) mg/L)and alanine aminotranferase(( 133 ±58) vs (97 ±26) U/L;(116 ±48) vs(77 ± 31 ) U/L)were significantly higher in Group B versus those receiving structured triglycerides in GroupA( P ＜0.05).TB ( ( 18 ± 15) vs ( 18 ± 11 ) μmol/L) and DB ( (8.9 ±3.2) vs (8.8 ±2.5) μmol/L) hadno significant differences in two groups ( P ＞ 0.05 ).The serum levels of such nutrition markers as PA((195±55) vs (166±55) mg/L,(245 ±53) vs (195 ±58) mg/L)and TF((2.6±0.5) vs (2.5±0.6) g/L,(3.3 ±0.8) vs (2.9 ±0.6) g/L) were significantly higher in Group A than those in Group B (P ＜0.05).Conclusion With regards to lipid metabolism,protein synthesis and hepatocyte protection,structured triglycerides in parenteral mutrition is advantageous to standard MCT/LCT emusion in severe hemorrhagic shock patients after resuscitation.

Objective To establish the diagnostic assays of quantitative real-time polymerase chain reaction (PCR) for the diagnosis of invasive fungal disease and evaluate their accuracy in clinical samples.Methods Three assays have been developed for the diagnosis of clinically prevalent fungi,Aspergillus spp.and Candida spp..Their analytical sensitivity and specificity were evaluated.Twenty-one serum samples from invasive fungal disease patients and non-invasive fungal disease patients were analyzed by the diagnostic assays and the accuracy was evaluated.Results Three assays were managed to run at the same condition.The universal fungi assay was able to detect,but not differentiate between most of the pathogenic fungi,including A.fumigatus,A.flavus,A. niger,C albicans,C. parapsilosis,C. tropicalis,C kruseii,C.glabrata,Cryptococcus neoformans,Rhizomucor variabilis,Rhizopus arrhizus and Penicillosis marneffei.The assays of Aspergillus spp. and Candida spp. were able to detect,but not differentiate between A.fumigatus,A.flavus,A.niger and C.albicans,C.parapsilosis,C.tropicalis.The detection limits of assays were 4 pg of A.fumigatus gDNA,2 copies of A.fumigatus and 2 copies of C albicans respectively.The results of quantitative real-time PCR matched well with each other and were identical to the classical procedures in all patients.Among the 11 patients with invasive fungal disease,the pathogens were identified down to a genus level in 2 invasive aspergillosis patients and 2 invasive candidiasis patients.And the other 7 patients could be diagnosed with invasive fungal disease by the universal fungi assay. All the 10 serum samples from non-invasive fungal disease patients were revealed as negative.Conclusion The universal fungi assay is helpful in screening while the assays of Aspergillus spp.and the Candida spp.may identify the pathogens down to a genus level.

Objective To explore the post-therapeutic change of cathelicidin LL-37 in asthmatics of different inflammatory phenotypes.Methods Thirty-four patients with initially diagnosed asthma (asthma group) and 14 normal subjects (control group) were recruited at Nanfang Hospital from August 2009 to August 2010 for this prospective study.Sputum and venous blood samples were collected and analyzed for cell differential.Eosinophilic asthma was defined as the count of sputum eosinophils ≥ 3％.The LL-37 concentrations in plasma and sputum supernatant were measured by enzyme-linked immunosorbent assay (ELJSA) kit.The subjects were treated with budesonide/formoterol (160/4.5 μg) one inhalation twice daily and re-examined after 1 month.Results Prior to treatment,there were no differences between the asthma and control groups in the levels of LL-37 in plasma and sputum supernatant (P =0.427,0.427 ).The plasma concentrations of LL-37 in asthma group were negatively correlated with baseline forced expiratory volume in one second ( FEV1,r =- 0.470,P =0.005 ),percent predicted of FEV1 ( FEV1 ％ pred,r=-0.421,P=0.013) and forced vital capacity (FVC,r=-0.367,P =0.033). After treatment,the plasma and sputum supernatant concentrations of LL-37 (M (QR)) in the asthma group (5.6(16.2),65.6 (184.0) μg/L) were significantly higher than those baseline concentrations (5.0(9.2),28.4(109.8) μg/L,P =0.005,0.015).In the eosinophilic asthma subgroup,the plasma and sputum supernatant concentrations of LL-37 ( M ( QR ) ) after treatment ( 5.3 ( 19.3 ),65.6 (185.2) μg/L) were significantly higher than those baseline concentrations ( 6.7 ( 8.9 ),35.3 ( 102.0 ) μg/L,P =0.021,0.014 ). And in the non-eosinophilic asthma subgroup,the changes of plasma and sputum supernatant concentrations of LL-37 showed no significant differences (P =0.139,0.386).In the asthma group,the correlations between plasma concentrations of LL-37 and FEV1,FEV1 ％ pred,FVC were not statistically significant ( P =0.283,0.706,0.272 ) after treatment. Conclusions LL-37 may participate in the aggravation of asthma. The elevated concentrations of LL-37 in eosinophilic asthma is probably due to the resolved suppression of LL-37 expression by eosinophilic inflammation. But its mechanism needs further researches.

Objective To explore the relationship between glycated albumin (GA) level and pancreatic β cell function in newly diagnosed type 2 diabetics. Methods The subjects sought the confirmation of diabetes diagnosis or underwent diabetes screening tests in high-risk patients from January 2008 to October 2010.All of them underwent 75 g oral glucose tolerance test (OGTT) and insulin releasing test.The levels of GA and hemoglobin Alc(HbAlc) were analyzed by liquid enzymatic method and high performance liquid chromatography respectively. Homeostasis model assessment (HOMA) was used to evaluate the basal insulin resistance (HOMA-IR) and pancreatic β cell function (HOMA-β).△I30/△G30 was used to evaluate early-phase insulin secretion after a glucose load.Results ( 1 ) Among 500 type 2 diabetics according to the diagnostic criteria of WHO ( 1999 ),279 were males and 221 were females.Average age was56.3 ± 12.3,GA (21.1 ±5.4)％ and HbAlc (7.0 ± 1.3)％.(2) A significantly positive relationship was shown between HbAlc and GA ( r =0.691,P ＜ 0.01 ).GA was also positively correlated with fasting plasma glucose ( FPG),0.5 hPG,1 hPG,2 hPG and 3 hPG after a glucose load of OGTT test ( r =0.511 - 0.627,P ＜ 0.01 ).(3) GA was negatively correlated with body mass index ( BMI ) (r =- 0.112,P ＜ 0.01 ),HOMA-β ( r =- 0.350,P ＜ 0.01 ) and △I30/△G30 ( r =- 0.263,P ＜0.01 ).(4) Multivariant stepwise regression analysis showed that HbAlc,FPG,3 hPG and △I30/△G30 were independent factors of GA level Conclusion Glycated albumin level is closely correlated with the function of early-phase insulin secretion in newly diagnosed type 2 diabetics.

Objective To explore the expression of endoplasmic reticulum stress (ERS) associated proteins in livers of severely burned rats and examine its potential significance.Methods Sixty-four Wistar rats were randomly divided into the control and burn groups (30％ total body surface area full-thickness thermal injury) (n =32 each).Livers were harvested at Day 1,4,7,14 post-burn.Western blot was used to detect the expressions of endoplasmic reticulum stress associated proteins glucose regulated protein 78 ( GRP78 ),C/EBP-homologous protein ( CHOP ),active caspase-12 and active caspase-3. Hepatic apoptosis was assessed by the assay of terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL).Results Compared with the control group,the expression of GRP78 became elevated at Day 1,4,7,14 post-burn (1.29 ±0.11 vs 1.00 ±0.00,1.28 ±0.12 vs 0.95 ±0.16,1.29 ±0.14 vs 0.93 ±0.06,1.41 ±0.17 vs 1.02 ±0.13 respectively) ; the expression of CHOP was higher at Day 1,4 ( 1.72 ±0.07 vs 1.00 ±0.00,1.82 ±0.18 vs 1.46 ±0.08 respectively) while active caspase-12 and active caspase-3 increased at Day 1,4,7 post-burn (2.05 ±0.65 vs 1.00 ±0.00,2.16±0.69 vs 0.95 ±0.21,1.98 ±0.56 vs 0.90 ±0.22; 1.96±0.15 vs 1.00 ±0.00,1.40±0.14 vs 1.07 ± 0.12,1.77 ±0.17 vs 1.15 ±0.21 respectively) ; the apoptotic index (％) of hepatocytes was higher at Day 1,4,7,14 post-burn (27.20±3.63 vs 5.00 ±0.71,16.40±1.52 vs 5.40 ±1.14,27.60±1.82 vs 7.40 ±1.14,10.20±1.92 vs 5.20 ± 1.64 respectively).All results were statistically significant ( all P ＜ 0.05).Conclusion ERS activates and expressions of associated proteins GRP78,CHOP,active caspase-12 and active caspase-3 increase in livers of severely burned rats.

Objective To explore the effects of CTLA4Ig gene-modified dendritic cells on the mechanism of immune regulation in asthma with Th2 superiority.Methods Newborn BALB/c mice are randomly divided into 2 groups of AdCTLA4Ig-DC intervention and AdGFP modified dendritic cells ( AdGFP- DC) intervention by randomization (n =10 each).CTLA4Ig gene-modified dendritic cells (AdCTLA4Ig- DC) and AdGFP-DC were infused separately. Newborn BALB/c mice in both groups were fed for 6 -8 weeks.Additional 6 - 8 weeks BALB/c mice were randomly divided into 2 groups of control and asthma (n =10 each).The saline-sensitized/challenged mice received an intraperitoneal injection while inhalation was administered in the control group.Ovalbumin (OVA) was used similarly in the remaining three groups.The manifestations of OVA challenged mice in each group,bronchoalveolar lavage fluid (BALF) eosinophils and pathological changes in airway were observed to examine the effects of CTLA4Ig gene-modified dendritic cells on airway inflammation.The levels of IgE,Interleukin( IL)-4,IL-10 and IFN-γ were detected by enzyme-linked immunosorbent assay ( ELISA ).Results Rapid respiration and pulmonary inflammatory infiltration were obvious in the asthma group.CTLA4Ig gene-modified dendritic cells transfused neonatally significantly improved the symptoms of asthma in adulthood and reduced the infiltration of inflammatory cells in bronchial submucosa.The levels of IgE and IL-4 in serum and BALF in the AdCTLA4Ig-DC intervention group were significantly lower than those in the asthma group ( IgE:( 3.9 ± 1.3 ) × 105 pg/ml vs (5.3 ± 1.7) ×105 pg/ml and (22.9±11.8) ×103 pg/ml vs (122.0 ±59.6) ×103 pg/ml,IL-4:(70.5 ±7.0)pg/ml vs (88.7 ±9.2) pg/ml and (46.9 ±2.9) pg/ml vs (73.3 ±8.7) pg/ml,all P ＜0.05).The levels of IL-10 in serum and BALF in the AdCTLA4Ig-DC intervention group were significantly higher than those in the asthma group( (442 ± 8) pg/ml vs (227 ± 11 ) pg/ml,(83 ±42) pg/ml vs (27 ± 11 ) pg/ml,both P ＜0.05).The levels of IFN-γ in serum and BALF in AdCTLA4Ig-DC intervention group showed no significant difference with those in the asthma group ( both P ＞ 0.05 ).The eosinophil level in BALF was significantly lower than that in the asthma group ( ( 18.5 ± 1.9 ) × 104/ml vs ( 62.3 ± 6.7) × 104/ml,P ＜ 0.05 ).Conclusions CTLA4Ig gene-modified dendritic cells transfused neonatally may reduce the secretion of Th2 cytokines in OVA-sensitized/challenged adult mice. The expression of CTLA4Ig gene induces immune tolerance in asthma.

The patient was a 60-year-old female. She was seen in a local hospital in December 2009 because she found a mass in the right parotid gland and neck for more than 3 years and a shadow in the lungs for 1 year. Three years ago, she accidentally found a mass in the right parotid gland area, but was not diagnosed and treated. After that, the mass gradually increased and multiple cervical lymph nodes swelled. B-ultrasound showed hypoechoic nodules in the right parotid gland area, and multiple hypoechoic nodules in the right submandibular and supraclavicular bone; CT of the lung showed large exudative consolidation in the upper lobe of the left lung, and small exudative foci in the lower lobe of the left lung and the right lung were mostly dispersed; Right parotidectomy and cervical lymph node biopsy were performed. The pathological report was that it was consistent with glandular mucosal lymphoid tissue (MALT) lymphoma, and no further treatment was performed.

mammalian target of rapamycin (mTOR) is an atypical highly conserved serine/threonine protein kinase. Its specific inhibitor is rapamycin, which can inhibit its kinase activity when combined with rapamycin. mTOR responds to growth factors, nutrients and body energy state, regulates cell growth, proliferation, metabolism and cell cycle, so it is related to many diseases. The following article summarizes the significance of mTOR signaling pathway and its significance for cardiovascular diseases, inflammation, tumors, metabolic diseases and neurological diseases. 1. mTOR signaling pathway: TOR has two complexes with different structures and functions: TOR complexes 1 (TORC1) and 2 (TORC2) [1]. Short-term treatment with rapamycin can only inhibit TORC1, but prolonged treatment can indirectly inhibit TORC2.

Dendritic cells (DC) are the most powerful antigen-presenting cells (APCs) found in the body, and play a key role in stimulating and controlling the extent and extent of acquired immune response. Many evidences show that DC is not only the initiator of immune response, but also plays an important role in inducing immune tolerance, which is closely related to the occurrence and development of AID. 1. Source and biological characteristics of DC In 1973, steinman first isolated DC from mouse lymphocytes and named it because of its dendritic protrusion when mature. According to the source, DC can be divided into two different subtypes: myeloid DC (mDC) and plasma cell-like DC (pDC).

A 41-year-old female was admitted to the hospital in August 2010 with full left chest and dry cough for 1 month. She was diagnosed with primary adenocarcinoma stage IV of left lung (T4N2M1a) by imaging and thoracocentesis pathology (Figure 1). In August 2010, she was given gemcitabine combined with cisplatin chemotherapy for 1 cycle, and intrathoracic infusion of cisplatin 80 mg/time, once a week, 3 times. After chemotherapy, the symptoms of cough and chest tightness were alleviated. Compared with before chemotherapy, the changes of lung mass and mediastinal enlarged lymph nodes were not obvious on CT reexamination, and pleural effusion disappeared, and the evaluation was stable. In September 2010, the treatment plan was changed to chemotherapy combined with cytokine-induced killer cell (CIK) therapy. The chemotherapy plan was: paclitaxel 175 mg/m2 intravenous drip on the first day, cisplatin 25 mg/m2 intravenous drip on the second, third and fourth days, and CIK cells were infused on the second to fourth days after chemotherapy.

The patient, a 75-year-old man, was admitted to the hospital on July 27, 2011 due to intermittent fever and cough for 20 days, aggravated with shortness of breath for 3 days. 20 days before admission, he developed fever without obvious trigger, with a body temperature of about 38℃, occasionally dry cough, accompanied by fatigue and chills. The local hospital gave cefmetazole intravenous drip (intravenous point) for 3 days, and the body temperature was normal. 12 days ago, he developed fever again, with a body temperature of about 38℃, and a slight dry cough. He was given ceftizoxime sodium intravenous point for 3 days, but there was no improvement. Chest X-ray showed flaky exudation in the right lung, which was replaced with levofloxacin intravenous point for 1 week. Three days before admission, the body temperature increased to 39.5℃, and shortness of breath appeared and progressively aggravated. Lung CT showed multiple ground glass shadows in both lungs and scattered consolidation shadows (Figure 1A). The patient had hypertension and diabetes for more than 10 years, and his blood pressure and blood sugar were well controlled. He did not keep pets or cultivate flowers and plants.