Volume 92  ·   Issue 16  ·  2012

The discovery of Helicobacter pylori (Hp) has made people have a new understanding of the pathogenesis and treatment of many upper gastrointestinal diseases such as chronic gastritis and peptic ulcer. Since Krajden et al. [1] isolated and cultured Hp from dental plaque and saliva in 1989, and speculated that the oral cavity may be another certain habitat of Hp, scholars have used different methods to isolate Hp from the oral cavity of Hp-positive gastropathy patients or detect specific genes of Hp, which show that oral Hp has a certain correlation with gastric Hp; The results of gene detection and fingerprint analysis of bacteria extraction and culture suggest that the bacteria in the two places have homology [2-3]; In recent years, Eskandari et al. [4] used PCR to detect Hp in dental plaque of patients without gastric Hp infection, indicating that human oral environment is also suitable for Hp aggregation and colonization. At present, the diagnostic detection methods, diagnostic criteria, eradication criteria and triple or quadruple eradication therapy of proton pump inhibitor (PPI) for Hp infection are all proposed for gastric Hp infection. The third domestic consensus added the judgment criteria for Hp infection outside the stomach [5], so as to standardize the research on Hp infection outside the stomach and improve the scientificity. The judgment of Hp infection outside the stomach is positive for any of the following: in situ morphology (pathological staining, immunohistochemistry, in situ hybridization, in situ tissue immunourease detection), in situ tissue bacterial culture and gene detection (including sequencing). The

From the early right cardiac catheterization to the interventional therapy of coronary heart disease, cardiac electrophysiological examination and radiofrequency ablation of arrhythmia, the interventional diagnosis and treatment of cardiovascular diseases have made great progress in technical means, disease indications and therapeutic effect. The interventional therapy of valve disease and interventional therapy of refractory hypertension have injected new vitality into the interventional therapy of cardiovascular diseases. The reason why the rapid and huge progress of cardiovascular interventional diagnosis and treatment technology is mainly the minimal invasiveness. This not only reduces the trauma and risk of surgery, but also expands the number of people who can get treatment, so that patients who cannot tolerate surgery can get better therapeutic effect. This article will briefly introduce the progress of interventional therapy of coronary heart disease, interventional therapy of aortic valve stenosis and radiofrequency ablation of renal sympathetic nerves in refractory hypertension.

Objective To explore the clinical characteristics of relapsing polychondritis (RP) for its early diagnosis and treatment.Methods A retrospective analysis was performed for the clinical data and prognoses for 23 RP patients from April 1996 to October 2011 at Departments of Respiratory Medicine,Rheumatism and Otorhinolaryngology,First Affiliated Hospital,Zhengzhou University. Results Lesion locations included auricle (n =19),joints (n =17),nose (n =14),respiratory tract (n =10 ),eyes ( n =6 ),inner ear ( n =4),costal cartilage ( n =3 ) and kidney ( n =1 ).Laboratory examinations revealed elevated erythrocyte sedimentation rate (ESR) ( n =18 ),elevated C-reactive protein (CRP) ( n =16 ) andpositive rheumatoid factor (n =2).Laryngeal mucosa was edematous and the vocal cords were paralyzed in the cases with airway involvement under laryngofiberscopy. Tracheal mucosa was highly edematous and tracheal lumen narrowed in the cases examined under bronchofibroscope. Laryngeal mucosa was swollen,glottic chink narrowed,laryngeal cartilage partially absorbed and deformed in the cases examined with neck computed tomography (CT). Tracheal mucosa was thickened,tracheal lumen narrowed and tracheal cartilage was deformed and calcified in the cases on chest CT.Pathological examination on tracheal cartilage showed that cartilage tissue was degenerative and fibrotic.And the proliferation of granulation tissue and the infiltration of inflammatory cells were present around cartilage tissue.Twenty-three RP patients received the therapies of antibiotics, glucocorticosteroid, immunosuppressive agent, tracheotomy or tracheal stent implantation.Two cases died of asphyxia.One casc died of myocardial infarct.The symptoms of other 20 cases improved in different degrees.Conclusion The clinical manifestations are diverse in RP patients.The prognoses of patients with airway involvement are worse and may be improved by an early diagnosis and correct treatment.

Objective To evaluate the expression of proteasome β5 subunit in human atherosclerotic plaque.Methods The specimens of carotid endarterectomy were collected from 16 carotid stenosis patients,For the case group,they were divided into 2 groups:plaque (group A) and arcas adjacent to plaque (group B).And carotid endarterium was obtained from 6 patients undergoing aortic replacement surgery.Relatively normal arterial intima ( subclavian artery & innominate artery) was selected as the control group (group C).Content of proteasome β5 subunit was evaluated by hematoxylin & eosin (HE) staining,immunohistochemistry and Western blot. Results (1)In patients with diabetes, hyperlipidemia and probable smoking,proteasome β5 subunit was enhanced in all groups; (2) Proteasome β5 subunit was demonstrated in both cytoplasm and nucleus of vascular smooth muscle cells,but mainly confined to cytoplasm; (3)The positive expression rate of β5 was 9/16 in group A,11/16 in group B and 6/6 in group C. There was significant divergence in the expression of β5 in different sample sub-groups:group A ( atherosclerotic plaque) ＜ group B ( areas adjacent to plaque) ＜ group C ( control group).Conclusion The exprcssion of β5 decrease markedly in human atherosclerotic plaques.

Objective To summarize our clinical experiences of delayed massive hemorrhagc (DMH),a rare but fatal complication,after pancreaticoduodenectomy (PD).Methods The clinical data of 14 DMH patients at our medical center were collected and analyzed to evaluate the risk factors and to compare the efficacies of different therapies.Results A total of 1008 PD patients were treated since April 1993.Fourteen DMHs occurred post-operatively (1.4％).In these cases,10/14 (71.4％) were complicated with pancreatic fistula. Sentinel bleeding was observed in 10 (71.4％) cases.The clinical manifestations of DMH included simple abdominal hemorrhage (n =6,42.9％ ), alimentary tract hemorrhage (n =6,42.9％ ) and both (n =3,21.4％ ).Shock (n =2,14.3％ ) might also be the initial symptom.Thirteen cases achieved post-therapeutic hemostasis while 1 patient died before re-admission.The therapeutic modalities included interventional therapy ( n =8 ) and surgery ( n =5 ).According to the therapeutic modalities,the re-bleeding rate,morbidity and final mortality of two groups were 50.0％ vs 40.0％ ( P =0.83 ),75.0％ vs 60.0％ ( P =0.96 ) and 50.0％ vs 80.0％ ( P =0.62) respectively.Five patients survived at the end of treatment.The mortality rate was 71.4％.Conclusion As a rare but fatal complication after PD,DMH is difficult to diagnose and treat.Postoperative pancreatic fistula remains a possible but undetermined risk factor. Sentinel bleeding is of great predicative value for DMH. Regular interventional arteriography is an effective method of improving diagnosis and treatment.Both interventional therapy and surgery may be used to treat DMH.

Objective To assess the effects of short-term continuous positive airway pressure (CPAP) upon un-treatment hour glucose control via a continuous glucose monitoring system (CGMS) in patients with obstructivc sleep apnea hypopnea syndrome and type 2 diabetes (OWD).Methods A total of 23 case of hospitalized OWD were recruited.CGMS was applied for 2 days before and 4 days during CPAP treatment.The treatment hour ( 6 h,0:00 - 6:00 ) and un-treatment hour ( 14 h,6:00 - 22:00 ) glucose level and glucose variability were analyzed.Insulin resistance was asscsscd with fasting plasma blood glucose (FPG), plasma insulin (FINS) and homeostatic model assessment of insulin resistance index (HOMA-IR).Results The short-term CPAP treatment corrected sleep-disordered breathing and induced significant decreases of treatment and un-treatment hour glucose level ( (7.07 ± 2.02 ) mmol/L vs (6.34 ±1.57) mmol/L,( 8.04 ± 1.99) mmol/L vs (7.64 ± 1.81 ) mmol/L,both P ＜ 0.05 ).Glucose variability of treatment and un-treatment hours significantly decreased after CPAP treatment (0.41 ± 0.24 vs 0.29 ±0.18,1.02 ± 0.50 vs 0.78 ± 0.45,all P ＜ 0.05 ).Short-term treatment also induced an increase of insulin sensitivity,as indicated by a significant decrease of HOMA-1R (4.02 ± 2.07 vs 3.08 ± 1.58,P ＜ 0.05).Conclusion Short-term CPAP treatment in OWD may improve not only insulin resistance but also blood glucose and glucose variability during treatment and un-treatment hours.

Objective To explore the effects of fast-track surgery on postoperative humoral immune function in patients undergoing elective colorectal resection.Methods Seventy patients with colorectal carcinoma requiring colorectal resection were randomized into fast-track group ( n =35 ) and conventional care group (n =35 ).The clinical parameters and markers of humeral immune function were evaluated in both groups postoperatively.Results Sixty-two patients finally completed the study,including 32 in the fast-track group and 30 in the convcntional care group. There was a significantly faster recovery of postoperative humoral immunity:blood levels of globulin ( 24.1 ± 2.4 vs 22.1 ± 3.3 g/L,P =0.025 ),immunoglobulin G ( 10.79 ± 2.39 vs 8.66 ± 2.09 g/L,P =0.007 ) and complement 4 ( 0.24 ± 0.09 vs 0.17 ± 0.05 g/L,P =0.035 ) at Day 3 postoperation were higher in the fast-track group than in the conventional care group.And there was also a significantly shorter length of postoperative stay (6.0 ± 1.0 vs 11.7 ± 3.8 d,P ＜ 0.001 ) in patients undergoing fast-track rehabilitation.Conclusion Fast-track surgery accelerates the recovery of postoperative humoral immune function in elective surgery for colorectal carcinoma with a shorter length of postoperative hospital stay.

Objective To analyze the clinical features and pathogenic gene of the patients with hereditary hemorrhagic telangiectasia (HHT).Methods The clinical features of 3 HHT families were collected.And the patients were diagnosed according to clinical diagnostic analyzed criteria of HHT,the ACVRL1 gene screened and the conservation of mutation protein.Results Three probands and 1 patient were diagnostic for HHT and 2 patients were suspected.In family Ⅰ,there was a missense mutation of ACVRL1 gene in c.287A ＞ G on 2 patients,leading to the transferal of amino acids from Asn to Ser at 96th place.In family Ⅱ,there was a missense mutation of c.1271C ＞ T on ACVRL1 in 2 patients,leading to the transfer of amino acids from Pro to Leu at 424th place. In family Ⅲ,there was a deletion mutation of c.147delC on ACVRL1 so as to produce only the former 53 amino acids of ALK1 protein. Through an analysis of multi-species conservation,the mutations were conserved between multiple species.By querying the National Center for Biotechnology Information (NCBI) databasc,wc confirmed that the mutation was not of a single nucleotide polymorphism (SNP). Conclusion The genetic screening of HHT patients may identify their virulence gene.And genetic screening of their offspring is helpful for the early diagnosis and prevention before disease onset.

Objective To explore the serum levels of MMP-2 in early breast cancer and its clinical significance and correlation with the circulating tumor cells in the patients.Methods The serum levels of MMP-2 in breast fibroadenoma ( n =10 ) and breast cancer ( n =72 ) were detected by cnzyme-linked immunosorbent assay ( ELISA ). And CK19 mRNA was measured by quantitative reverse transcription-polymerase chain reaction in blood as an index of circulating tumor cells in the patients.Results The serum level of MMP-2 in breast cancer was significantly higher than that in breast fibroadenoma ( 12.24 vs 2.21μg/L,P =0.003 ). Subgroup analysis showed that the serum levels of MMP-2 were higher in HER-2 positive patients than those in HER-2 negative ones ( 16.77 vs 10.02 μg/L,P =0.022).CK19 mRNA was found in blood samples from 30 cases of breast cancer and the positive rate was 41.7％.However,it was not detected in the patients with breast fibroadenoma.The mean levels of serum MMP-2 were ( 15.48 ± 2.02)and (7.16 ± 1.55 ) μg/L in CK19 positive and negative patients respectively.Significant difference existed between two groups (P =0.013).Conclusion The serum level of MMP-2 in early breast cancer is closely correlated with blood micrometastasis. And its high level may be an important contributing factor for themetastasis of breast cancer.

Objective To explore the effects and mechanism of bone marrow stromal cells (BMSCs) on the drug resistance of multiple mycloma (MM).Methods Fresh untreated MM patient (5 samples) and health donor (5 samples) bone marrow samples were collected from May 2011 to July 2011 al our hospital.Their BMSCs were separated respectively.The supernatant expression of cytokines in BMSCs was detected by enzyme-linked immunosorbent assay (ELISA).Myeloma cells were co-cultured with BMSCs and treated with melphalan or bortezomib.Cell proliferation and miRNA-15a/-16 expression of myeloma cells were measured in different culture conditions with thiazoyl blue tetrazolium bromide (MTT) assay and quantitative real-time PCR (qRT-PCR). miRNA-15a was transfected into myeloma cells. And the miRNA-15a functions on cell cycle and cell apoptosis were detected by flow cytometry.Results ELISA assay showed that cytokine IL-6 and VEGF were at higher levels in MM-BMSCs than healthy BMSCs ( (189 ±9) vs( 115 ± 15) pg/ml,( 1497 ±40) vs(1239 ±21) pg/ml,both P ＜0.05).The miRNA-15a/-16 expressions of myeloma cells were up-regulated after the treatment of melphalan and bortezomib ( all P ＜0.05 ).However,the miRNA-15a/-16 up-regulation by melphalan or bortezomib became inhibited when MM cells were co-cultured with MM-BMSCs ( melphalan:4.690 ± 0.050 vs 34.440 ± 4.100,0.760 ± 0.070 vs 12.030 ± 1.020,bortezomib:1.440 ± 0.230 vs 11.480 ± 1.488,0.880 ± 0.040 vs 3.680 ± 0.420,all P ＜0.05). Furthermore,IL-6 suppressed the expression of miRNA-15a/-16 in a dose and time-dependent pattern.The transfection of miRNA-15a led to the arrest of MM cell cycle iu G1/S phase. Conelusions BMSCs suppress the proliferation of myeloma cells and regulate the drug sensitivity of myeloma cells through the inhibited expression of miRNA-15a/-16.IL-6 plays a pivotal role in the occurrence of drug resistance.

Objective To explore the effect of arsenic trioxide (ATO) and daunorubicin (DNR)on phosphatidylserine (PS) exposure and related procoagulant activity of acute promyelocytic leukemia (APL) cells.Methods Mononuclear cell and neutrophil isolated from whole blood of 12 healthy volunteers were used as control group while APL cells obtained from 12 newly diagnosed APL patients at First Affiliated Hospital,Harbin Medical University from March 2007 to February 2009 were used as experimental group.APL cells were treated with 1 μmol/L ATO and 1 μmol/L DNR for 24 h.PS exposure of APL cells were measured by flow cytometry and confocal microscopy.And the related procoagulant activity was detected by the assays of coagulation time and coagulation factor formation.Lactadherin was used as a probe for PS exposure and anticoagulant on the cells of 12 APL patients. Results ATO induced a decrease of PS exposure on APL cells by flow cytometry and no staining with lactadherin was observed under confocal microscopy.However,DNR induced the significantly elevated PS exposure and staining green with a rim pattern on membrane of APL cells was obtained.Coagulation time was ( 180 ± 25 ) s and (220 ± 41 ) s before and after treatment with ATO,respectively ( P ＜ 0.05 ). The formation of coagulation factors decreased after treatment with ATO ( P ＜ 0.05 ).While coagulation time was ( 180 ± 25 ) s and (80 ± 20) s before and after treatment with DNR,respectively ( P ＜ 0.05 ). The formation of coagulation factors increased after treatment with DNR ( all P ＜ 0.05 ).Lactadherin inhibited the procoagulant activities of DNR-treated APL cells (all P ＜0.05 ).Conclusions Procoagulant activity is positively correlated with the exposed PS of APL cells.ATO and DNR inhibited and enhanced procoagulant activity with decreased and increased PS exposure,respectively.

Objective To determine the prevalence and influencing factors of pulmonary arterial hypertension (PAH) in patients with congenital heart disease (CHD).Methods Between May 2007 and December 2008,a total of 692 CHD patients admitted into Fuwai Hospital were prospectively enrolled.Doppler echocardiograpy was employed to measure the level of pulmonary artery systolic pressure (PASP).PAH occurred when there was an increase in PASP ＞ 40 mm Hg (1 mm Hg =0.133 kPa) at rest.Eisenmenger syndrome was defined when there was a reversed (pulmonary-to-systemic) or bidirectional shunt.The clinical characteristics between the patients with/without PAH and Eisenmenger syndrome were compared and their risk factors analyzed with a multivariate Logistic model. Results The underlyingconditions included atrial septal defect ( n - 187,27.0％ ),ventricular septal defect ( n =456,65.9％ )and patent ductus arteriosus ( n =49,7.1％ ).The numbers of patients with PAH-CHD and Eisenmenger syndrome were 329 (47.5％ ) and 105 (15.2％) respectively.Amongthe PAH-CHD patients,31.9％ of them had Eisenmenger syndrome.The patients with large shunts were at an elevated risk of PAH.Logistic regression analysis showed that advanced age was an independent risk factor of PAH ( OR =1.04,P ＜0.001 ).Compared with atrial septal defect,ventricular septal defect and patent ductus arteriosus increased the risks of PAH (OR=2.78,P＜0.001 and OR=2.50,P＜0.001 respectively).Conclusions PAH is a common complication in CHD patients.And ventricular septal defect is the most common pathogenic type of PAH.Advanced age,ventricular septal defect and patent ductus arteriosus are the risk factors of PAH.

Objective To explore the antitumor effects of multiple antigen peptide (MAP) vaccine from α-fetoprotein (AFP) through AFP-specific cytotoxic T lymphocyte (CTL) against hepatoma in vitro and ex vivo.Methods Dendritic cells ( DC ) were generated from human perpheral blood mononuclear cells (PBMC) and HLA-A2.l-transgenic murine bone marrow.The AFP-specific CTL were induced by MAPloaded DC and the corresponding linear peptides from human AFP.The lysis rate of effectors to hepatoma cells were tested by 4h51Cr release assay.And enzyme-linked immunosorbent spot(ELISPOT) was used to test the interferon (IFN) -γ release of effector cells.Results The specific lysis rate of effectors induced by AFP epitopic MAP vaccines to Hep3B cells (AFP+,HLA-A2.1+ ) at the highest effector/target (E/T)ratio was significantly higher than linear peptide vaccine (73.5％ ±7.9％ vs 45.6％ ±6.9％,P ＜0.01 ).The effectors induced by AFP epitopic MAP vaccine and linear peptide vaccine could not lyze the AFP-negative PLC/PRF/5 liver cancer cells versus the negative control group at the highest E/T (9.3％ ±3.9％,8.1％ ±2.8％ vs 8.3％ ±2.6％,both P ＞0.05).But the effectors induced by AFP epitopic MAP vaccine and linear peptide vaccine could lyse PLC/PRF/5 liver cancer cells transfected with cDNA of AFP versus the negative control group (74.8％ ± 10.5％,51.4％ ± 12.6％ vs 4.2％ ± 1.3％,both P ＜0.01 ).And the specific lysis rate of effectors induced by AFP epitopic MAP vaccines was significantly higher than the corresponding linear peptide vaccine ( P ＜ 0.01 ). Compared with the negative control group,the effectors could not lyse HepG2 liver cancer cells,a HLA-A2.1 negative cell line ( both P ＞ 0.05 ).But the effectors could lyse HepG2 cells transfected with cDNA of HLA-A2.1 (71.8％ ± 8.6％,46.5％ ± 6.5％ vs 4.1％ ± 1.1％,both P ＜ 0.01 ). And the specific lysis rate of effectors induced by MAP vaccine was significantly higher than the corresponding linear peptide vaccine (P ＜ 0.01 ).ELISPOT test showed that the capability of enhancing IFN-γ release of human AFP MAPs was stronger than that of the AFP linear peptides.The spots count of MAP vaccine group ( ( 158 ± 23 ) spots/105 cells ) or linear peptide vaccine group ((78 ± 12) spots/105 cells) were significantly higher than the negative control group ((3 ± 1)spots/105 cells) ( all P ＜ 0.01 ).The spots count of the positive control group ( ( 166 ± 32) spots/105 cells)showed no significant difference with the AFP MAP vaccine group ( P ＞ 0.05 ).And the spots count of MAP vaccine group were significantly higher than the corresponding linear peptide vaccine group ((78 ± 12)spots/105 cells,P ＜ 0.01 ).Conclusions AFP multiple antigen peptides elicit not only more powerful specific anti-tumor immune responses but also stronger non-specific anti-tumor immune activities than their corresponding linear peptides. These findings will provide theoretical rationales for their clinical applications.

Objective To explore the in vitro effects of anti-proliferation and apoptosis-inducing with different sequence regimens of zoledronic acid plus paclitaxel in human nasopharyngeal carcinoma cell line HNE1 so as to explore the optimal sequence regimen of these two drugs and related mechanism.Methods The cytotoxic effects of different sequence schemes of zoledronic acid plus paclitaxel on HNE1 cells were detected by methyl-thiazol-tetrazolium (MTT) assay.Annexin V-FITC/PI double staining flow cytometry (FCM) and terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) assay were used to measure the effects of zoledronic acid plus paclitaxel upon apoptosis. The expressions of mRNA of Bcl-2,Bax,Caspase3 and Caspase9 gene were detected by real-time quantitativepolymerase chain reaction (PCR) and protein was detected by Western blot. Results All experiment groups enhanced the effect of anti-proliferation by MTT assay( P ＜ 0.05 ) ; the treatment of zoledronic acid followed by paclitaxel was superior to the other two regimens ( P ＜ 0.05 ).As detected by FCM,the early apoptotic rate of control group was 2.59％ ± 0.28％ and the experiment groups were 13.89％ ± 0.69％,11.73％ ± 0.54％,23.97％ ± 0.68％,10.45％ ±0.16％ and 8.59％ ± 0.74％ respectively( P ＜ 0.05).TUNEL assay detected the late apoptosis of HNE1 cells and the experiment groups enhanced the effect of apoptosis-inducing(P ＜ 0.05 ).The treatment of zoledronic acid followed by paclitaxel was superior to the other regimens( P ＜ 0.05 ).Such an effect was due to the down-regulation of anti-apoptotic protein Bcl-2 and up-regulations of pro-apoptotic proteins Bax,Caspase3 and Caspase9 at the expression levels of mRNA and protein.There was a greater regulation in the group of zoledronic acid followed by paclitaxel.Conclusion Zoledronic acid can enhance the in vitro effects of anti-proliferation and apoptosis-inducing for paclitaxel on HNE1 cell.The treatment of zoledronic acid followed by paclitaxel may be the optimal regimen.Synergistic induction of apoptosis is via the effects of Bcl-2 family and through the mitochondrial pathway.

Objective To evaluate the expression of interleukin (IL) -21 in a cigarette smoke-induced micemodel of emphysema and explorc its effects on the differentiation of CD4+T cell.Methods Twenty male Balb/c mice were randomly divided into two groups:control group and smoke-exposed group.Morphological changes were evaluated by mean linear intercepts and alveolar destructive index. The proportion of CD4+IL-21R+T cells in lungs of mice was determined by flow cytometry.And the levels of IL-21 in lungs of mice were analyzed by enzyme-linked immunosorbent assay (ELISA). Fresh lung mononuclear cells were isolated from the smoke-exposed group and divided further into two sub-groups:blank sub-group and co-culture sub-group.Two sub-groups were cultured in medium with or without IL-21 for 24 h and 48 h.The proportions of Th1 and Th17 cells in cell culture medium were determined by flow cytometry.Results Mean linear intercepts and alveolar destructive index in the smoke-exposed group ( (48.6 ± 4.8 )μm and 44.9 ± 2.8 ) were significantly higher than the control group ( ( 32.4 ± 4.0 ) μm and 28.1 ± 2.1,both P ＜0.05).In lungs,the percentage of CD4+IL-21R+T cells in the smoke-exposed group (4.1％ ±1.5％ ) significantly increased than that in the control group ( 1.4％ ± 0.4％ ) ( P ＜ 0.05 ).The levels of IL-21 in lung of the smoke-exposed group ( (851 ± 28 ) ng/L) were higher than those in the control group ((415±39) ng/L,P ＜0.05).In lungs,the levels of IL-21 had positive correlations with mean linear intercepts and alvcolar destructive index ( r =0.892 and 0.955,both P ＜ 0.05 ).The percentages of Th1and Th17 cells in cell culture medium of the co-culture suh-group for 24 h and 48 h significantly increased versus those in the blank group ( all P ＜ 0.05 ).Conclusion IL-21 may participate in the occurrence and development of emphysema through the induced differentiation of CD4+T cells and the promotion of Th1 and Th17-cell responses in lungs.

Abstract of medical records @ @ A 19-year-old male was admitted to the hospital on February 17, 2011 due to "lip cyanosis, shortness of breath after movement for 4 years, aggravated for 2 years". The patient began to develop lip cyanosis, shortness of breath after movement, no palpitation, chest pain, hemoptysis, cough or expectoration 4 years ago. In the past 2 years, the activity endurance has decreased significantly, and the lips and nail bed have continued to be cyanotic, accompanied by pestling fingers and toes. He has been diagnosed and treated in many hospitals, but the effect is poor. In January this year, he went to a tertiary hospital in Jiangxi Province, and the routine blood test showed hemoglobin 156 g/L, blood gas pH 7.41, oxygen partial pressure 4.79 kPa (1 kPa =7.5 mm Hg), carbon dioxide partial pressure 3.33 kPa, and oxygen saturation 70%.

Acute liver injury refers to the abnormalities of liver structure and function caused by various causes.There are many causes of acute liver injury, mainly including infection, drugs, food additives, excessive intake of ethanol, contact or ingestion of toxic substances, liver trauma and radioactive injury [1]. Aquaporin (AQP) is a molecular channel of water, which is on the cell membrane.It has high selectivity and specific pores for efficient transport of water molecules [2]; Since Agre et al. discovered AQP1 from erythrocyte membrane in 1992, the research on the structure and function of AQP has progressed rapidly; AQP is expressed in hepatocytes, cholangiocytes, gallbladder epithelial cells and intrahepatic vascular walls. The research progress of AQP in acute liver injury is summarized.

Myelodysplastic syndrome (MDS) is a group of malignant clonal diseases of hematopoietic stem cells with obvious heterogeneity, which are characterized by ineffective hematopoiesis, increased apoptosis of hematopoietic stem/progenitor cells of bone marrow, decreased one or more lineages of blood cells with varying degrees, and high risk of conversion to acute myeloid leukemia. In 2008, the World Health Organization (WHO) clearly listed MDS as the five major myeloid malignant tumors together with acute myeloid leukemia (AML) and myeloproliferative tumor (MPN).

A 32-year-old male, from Longyan City, Fujian Province, was admitted to our hospital in July 2008 due to painful nodules in his limbs with fever for more than 20 days. More than 20 days ago, 6 nodules of different sizes with obvious swelling and pain gradually appeared in both forearms and lower limbs, with repeated chills and fever. He had a history of dermatomyositis for 4 and a half years, and was given maintenance therapy with prednisone 10 mg/d. Before the onset of the disease, he had a history of eating sugarcane after rat bites. He denied a history of traveling and living in other places, and had no history of trauma or surgery. Physical examination: body temperature 39℃, weight loss, no palpable swelling of superficial lymph nodes in the whole body, no abnormalities in heart and lungs, and no swelling of liver and spleen.

A 51-year-old male was admitted to Wuhan University People's Hospital on February 22, 2011 due to "chills and fever for 1 week and melena for 3 days". After dinner on February 15, the patient developed chills and high fever, with a maximum body temperature of 39 2℃, accompanied by dizziness, fatigue, bright red bloody stool once, no nausea, vomiting, abdominal pain, abdominal distension, etc. The next morning, he went to the local hospital for anti-inflammatory treatment for 1 week (details unknown), but he still had high fever with melena, 1~2 times/d, the amount was small, and no mucus was still formed, so he was transferred to our hospital. After the onset, his spirit, sleep and appetite were poor, and his physical strength and weight decreased slightly; The patient was in good health, had no tobacco and alcohol habit, and had no history of special family genetic diseases and infectious diseases.