Objective To study the clinical value of combined detection of serum interleukin(IL)-8 ,tumor necrosis factor(TNF)-α,alvedar cell surface antigen Ⅱ(KL-6) and surface protein D(SP-D) in the diagnosis of idiopathic pulmonary fibrosis(IPF) .Meth-ods Seventy three patients with IPF were selected as the research subjects ,other 73 patients with bacterial pneumonia were taken as the bacterial pneumonia group .The levels of serum IL-8 ,TNF-α,KL-6 and SP-D were detected by enzyme-linked immunosorbent assay (ELISA) .The serum levels of IL-8 ,TNF-α,KL-6 and SP-D were compared between the IPF group and bacterial pneumonia group .The sensitivity and specificity of IPF detection were compared between the 4-index combined detection and single item de-tection .Results The levels of IL-8 ,TNF-α,KL-6 and SP-D in the IPF group were significantly higher than those in the bacterial pneumonia group (P<0 .05) .The positive rate of single detection of four indexes in the IPF group was significantly higher than that in the bacterial pneumonia group (P<0 .05) .The sensitivity and specificity of the 4-index combined detection for diagnosing IPF were 90 .4% and 93 .2% respectively ,which were significantly higher than the those of single index detection (P<0 .05) .Con-clusion The combined detection of IL-8 ,TNF-α,KL-6 and SP-D has better sensitivity and specificity in IPF diagnosis compared with single detection of IL-8 ,TNF-α,KL-6 and SP-D .

CTL responses by autologous colorectal cancer cells were observed in five cases. The specific CTL was induced from two cases, in which tumor associated antigen, CA-Hb_3, was strongly positive. The CTL could not induced from other three cases in which CA-Hb_3 antigen was weakly positive. Weakly positive tumor cells in the three cases were loaded CA-Hb_3 antigen into cytoplasmas by the cationic liposomes and tested by immunohistochemical assay. The results showed that CA-Hb_3 antigen of tumor cells in two cases changed to strongly positive, and could induce CTL responses successfully. With blocking agents BFA and anti-MHC-I monoclonal antibody, CTL responses could be blocked. Our results suggested that soluble CA-Hb_3 antigen could enhance the immunogenity of colorectal cancer cells and induce effective anti-tumor cellular immune responses.

[Summary] A more conservative approach for endometrial cancer ( EC ) is desirable in women who have requirement to preserve fertility, without compromising their survival .In this article, we tried to formulate clinical recommendations of preserving fertility based on suggestions of European Society of Gynaecological Oncology ( ESGO) in 2015 and relevant research progress .

Objective To discuss the cause and treatment strategy for open laryngotracheal trauma.Methods The clinical data of 38 cases with open laryngotracheal trauma admitted from 1998 to 2012 were collected and analyzed.Of them,one patient died in emergency department despite energetic resuscitation,37 were hospitalized and given advanced treatment after life support measures in emergency department.They were treated with tracheotomy before or during operation.Of them,32 patients were regularly followed up for imaging studies.Result Except 1 patient died of exsanguination from carotid artery rupture,the other 37 survived after successful treatment.Twenty patients were treated with debridement and suture of the wounds and laryngoplasty (20/37,54.1％),8 patients were operated with laryngoplasty plus intraluminal stents implanted (8/37,21.6％) ; the rest 9 patients (9/37,24.3％) were separately given placement of nickel-titanium shape memory alloy stent (n =2),laryngofissure with rubber gloves throat models implanted and laryngoplasty (n =3),linear silicone tube implanted and laryngoplasty with trans-cervical approach (n =1) and tracheoesophageal fistula neoplasty with laryngoplasty and laryngofissure (n =3).The operated patients were followed-up for 0.5 to 3 years after discharge.Of them,35 patients (35/37,94.6％) had successful decannulation,breathing smoothly and swallowing normally,23 patients (23/37,62.2％) had almost normal pronunciation,12 patients (12/37,32.4％) had different degrees in hoarseness of voice,and 2 patients (2/37,5.4％) were referred to other hospital because of failure in extubation with severe stenosis of laryngotrachea.Conclusions When the patients with open laryngotracheal trauma were treated,the essential strategy was to prevent shock,hemorrhage,and asphyxia.In the case of patent respiratory tract and stable vital signs,laryngotracheal reconstruction should be carried out as soon as possible to prevent complications,thereby obtaining good therapeutic effect.

Objective To analyze implanted children's production of vowels and to investigate the features of vowels production .Methods Thirty CI children averaged 32 .65 ± 5 .97 months were enrolled in this study .Using 19 Chinese vowels as test materials ,accuracy rates were statistically analyzed to get the difficulty gradient and main error patterns .Results /a/and /e/were the easiest vowels and /üe/,/uai/,/ü/were the most difficult vowels for CI children .From the mouth shape of vowels ,the difficulty gradients from easy to difficult were open -mouths →e-ven-teeth → close-mouths → pursed -mouths .From the structures of vowels ,triphthongs were the most diffi-culty ,while single vowels and diphthongs shared the same difficulty level .High vowel's nasalization ,the deletion of diphthongs and triphthongs ,the separation of diphthongs and triphthongs and the substitution of /o/,/ü/,and /ai/were the main error patterns .Conclusion The difficulty levels of vowels'production for CI children at average age of 31 months are rather obvious .Compared with aided children ,they show some common developmental sequences and error patterns ,but also reflect their own characteristics .When in vowel articulation therapy for little CI children ,we should provide targeted training according to error patterns on the basis of following their sequences of difficulty level to fa-cilitate their efficiency .

Background The biomeasurement and imageology of retinal nerve fiber layer(RNFL) thickness showed the damage of retinal structure in the early and middle stage of glaucomatous eye,however,the subtle functional damage of glaucoma can not be timely reflected only with automatic static perimeter.Microperimetry is a method of quantitatively assessing mean sensitivity (MS) of macular zone.Objective This study was to evaluate and compare the macular functional change in early and middle stage of primary open angle glaucoma (POAG) and chronic angle-closure glaucoma (CACG) with MP-1 microperimeter.Metbods This trail protocol was approved by Ethic Committee of Peiking University Third Hospital,and written informed consent was obtained from each subject prior to entering the study group.A cross-sectional and case-controlled study was designed.A total of 126 eyes from 126 subjects were enrolled in the trail,including 53 eyes of 53 normal subjects,50 eyes of POAG patients and 23 eyes of CACG patients.A macular 10° program was set with MP-1 microperimetry to record the MS of various subareas.The macula was zoned into central 2°,6°,and 10° visual fields and 4 quadrants in each ring.The MS of different rings and subareas was detected and compared among POAG patients,CACG patients and normal controls.Results The MS values of central 2°,6°,10° and whole macular area were (15.09 ± 3.03),(15.72 ± 3.22),(13.99 ± 3.63) and (14.91±3.07)dB in the POAG group,which were significantly lower than those of (17.29±1.59),(18.05±1.24),(16.76±1.89) and (17.37±1.46)dB in the normal control group (all at P=0.000).The MS values of central 2°,6°,10° and whole macular area was (16.00±2.39),(15.83±2.63),(14.45±3.15) and (15.42±2.54) dB in the CACG group,and the reduced MSs were seen at the 6°,10° rings and whole macular area in the CACG group compared with the normal control group (P =0.004,0.013,0.011).Within the 6° ring,the MS values in the inferotemporal quadrant were declined in the POAG group and CACG group compared with the normal control group (P =0.000,0.022),but the difference was not statistically significant between the POAG group and the CACG group (P =0.311).In addition,the MS value in the inferonasal quadrant was significantly lower than that of the normal control group (P =0.005); while that in the CACG group was not significantly different in comparison with the normal control group (P=0.119).In the POAG group,the MS value of the inferotemporal quadrant was significantly lower than that of the superonasal or superotemopral quadrant (P =0.043,0.016),but no significant differences were found among the 4 quadrants in the CACG group (all at P＞0.05).Conclusions The mild damage of retinal function appears in the early and middle stage of POAG and CACG.More serious MS reducing occurs in the inferotemporal and inferonasal quadrants of POAG.

Objective:To explore the influence of mindfulness on perceived stress in psychiatric nurses and the mediating effect of resilience.Methods:A total of 427 psychiatric nurses from a psychiatric hospital in Beijing were selected.Five-facet mindfulness questionnaire(FFMQ), Chinese-version perceived stress scale (CPSS) and Connor-Davidson resilience scale (CD-RISC) were used in this survey.Pearson correlation analysis and multiple stepwise regression analysis were performed using SPSS 24.0.And mediating effect was performed using AMOS 24.0.Results:The total score of psychiatric nurses' perceived stress was (37.89±7.16). Among all psychiatric nurses, 66.74% were under high pressure and 20.84% were under great pressure.The perceived stress was negatively correlated with mindfulness(123.69±10.82, r=-0.65, P<0.01) and resilience(85.40±17.87, r=-0.67, P<0.01), and mindfulness was positively correlated with resilience ( r=0.50, P<0.01). The direct effect of mindfulness on perceived stress was -0.15, the indirect effect was -0.34, and the total effect was -0.49. Conclusion:Resilience plays a partial mediating role between mindfulness and perceived stress psychiatric nurses.

In order to improve the precision and robustness in determination of soluble solids content ( SSC) of ‘Fuji ’ apple by NIR spectroscopy and eliminate the effect of origin variability on the accuracy of NIR calibration models for the SSC, sample set partitioning based on joint x-y distances ( SPXY) was used to select representative subset from the apple samples of 4 different origins. As a comparison, partial least square ( PLS) was used to establish local origin and hybrid origin models for the prediction of SSC in apple. Competitive adaptive reweighted sampling ( CARS ) and successive projections algorithm ( SPA ) were implemented to select effective variables of the NIR spectroscopy of SSC of apple. The results indicated that the PLS model established based on the 4 origin apple samples performed better than local origin and other hybrid origin models. The model could be effectively simplified using 16 characteristic variables selected by CARS-SPA method from full-spectrum which had 3112 wavelengths. The correlation coefficient (Rp) and root mean square error of prediction (RMSEP) were 0. 978 and 0. 441 oBrix, respectively for SSC. It was found that the model developed by more samples of different origins combined with effective wavelengths showed good prediction ability for apple sample of unknown origin, which indicated that it could significantly reduce the origin effect on the robustness of NIR models for SSC of apple.

Objective To detect the expression of miR-26a/b in the aorta and serum of mice so as to explore the role of miR-26a/b in vascular remodeling of hypertension.Methods C576L/BJ male mice were randomly divided into AngⅡ group and control group.Mini-osmotic pump was implanted subcutaneously into the back of mice, and the model of blood vessel remodeling in mice was established by continuous infusion of AngⅡ(2.0mg/kg·d).The mice in control group were injected with saline.Blood pressure was taken before the intervention and at 3, 5, 7, 10 and 14 days after the intervention.After 2 weeks, the mice were killed, the serum and aorta tissues were collected, and the expression of miR-26a/b was determined by RT-PCR.HE staining, Masson staining and immunohistochemistry were performed to observe changes in vascular morphology, fibrosis and protein expression.Results After the intervention, systolic blood pressure and diastolic blood pressure were significantly higher in AngⅡ group than in control group (P<0.05).HE staining showed that the vessel wall of AngⅡ group was thicker than that of control group.Masson staining showed more blue collagen deposition in the middle of aorta in AngⅡ group but no obvious collagen deposition in control group.RT-PCR showed that the expression of miRNA-26a/b in the serum and aorta of AngⅡ group was significantly lower than in control group (P<0.05).Immunohistochemistry indicated that the expressions of CTGF, collagen Ⅰ and collagen Ⅲ all increased after AngⅡ infusion (P<0.05).Conclusion MiR-26a/b, CTGF, collagen Ⅰ and collagen Ⅲ may be involved in AngⅡ-induced vascular remodeling in hypertension.MiR-26a/b may be a new therapeutic target of vascular remodeling in hypertension.

With the development of immunotherapy in clinical application, immunotherapy also takes advantage in esophageal squamous cell carcinoma (ESCC). Immune checkpoint inhibitors such as programmed death-1 (PD-1) and its ligand PD-L1 and cytotoxic T lymphocyte antigen-4 show significant antitumor activity and safety in immunotherapy for patients with advanced ESCC.