CD4 + CD25 + regulatory T- cell (Treg) play essential roles in maintaining self- tolerance, immune homeostasis and cancer immune system. Treg can suppress immune responses against self antigens or non-selfantigens such as tumor antigens. The immunosuppressive functions of Treg are widely acknowledged and have been extensively studied. Recent studies demonstrate the existence of Treg at tumor sites, implying that these Treg may induce antigen-specific and local immune tolerance. This review will discuss the ligands, mechanisms of immune suppression of Treg and its potential roles in cancer therapy.

Objective Probe the value and the operation risk for HIV/AIDS patients with surgical compli-cations. Methods Investigated 27 HIV-infected patients(male 26, female 1, age 27-74 years) were investi-gated. All patients had pre-operative detection of immune function, standardized surgical procedures, careful surgical process to reduce the operation damage, continuous infusion of coagulation factors for haemophilia during operation, conventional application of antibiotics to prevent infection and prompt treatment of compli-cations. Results No incision infected in 8 cases of class one incision, 1 incision infected in 6 cases of class two incision, 3 cases were not healed in 30 days after operation in 13 cases of class three incision. One case died of severe sepsis 12 days after operation, the others discharged with recovery or improvement. Conclu-sion Suitable operation and treatment method may obtain curative effect for HIV-infected patients.

Objective To investigate the expression and significance of MMP-3 in knee joint synovium of different stage in osteoarthritis (OA) patients. Methods MMP-3 protein were detected by immunohistochemical method in knee synovial tissues from 90 OA patients (the OA group) and OA group was divided into 3 subgroups according to Kellgren and LawrenceX-ray diagnosing standards: the gradeⅠ(n = 30), gradeⅡ (n = 30) and grade Ⅲ subgroups (n = 30). 30 patients were enrolled as control group. Immunohistochemistry was used to detect the expression of MMP-3 protein in the tissue. Results The expression level of MMP-3 protein in OA group was significantly higher that in the normal synovium (P < 0.05). There existed significant difference in the expression of MMP-3 protein between the grade Ⅲ subgroup and the gradeⅠ, or Ⅱsubgroups (P < 0.05). The expression of MMP-3 protein related positively to the severity of OA (r = 0.912, P < 0.05). Conclusion The expression of MMP-3 protein related closely to the pathogenic mechanism of OA. It may serve as an important indicator of early diagnosis and the activity of OA.

Although significant advances have been made in both the development of therapeutic strate-gies and the understanding of pathophysiological mechanisms of sepsis, the mortality of severe sepsis and septic shock still remains unacceptably high worldwide. Current prediction models based on socio-demo-graphic and clinical risk factors fail to explain fully why a particular patient either develops or succumbs to sepsis. In recent years epidemiological studies have suggested a strong genetic relationship on the suscepti-bility and outcome of sepsis. With the completion of Human Genome Project and International HapMap Pro-ject, the identification of susceptibal genes contributing to sepsis may allow more precise use of interven-tions, such as targeted therapy of sepsis is an appealing strategy. In this review, we summarize a broad over-view of genetic nomenclature, study designs, and problems of these genetic association studies.

Objective To evaluate the expression and clinical significance of matrix metalloproteinase 14(MMP-14) in osteoar-thritis(OA) patients in synovium and synovial fluid of knee joint .Methods Semi-quantitative RT-PCR were used to detect the ex-pression of MMP-14 mRNA in 32 case of OA (experimental group)and 26 non-OA patients(control group)synovium ;protein level expression of MMP-14 in synovial fluid were analyzed by ELISA .Results The expression of MMP-14 mRNA in experimental group synovium of knee joint was significantly increased compared with control group (P<0 .05);but the protein level of MMP-14 was low in experimental group synovial fluid compared with control group (P<0 .05) .Conclusion The expression of MMP-14 is increased in OA patients synovium and maybe promote the progress of OA directly ;the protein level of MMP-14 is decreased in OA synovial fluid ,indicated the function of MMP-14 in OA synoviocyte indirectly .

Objective To explore the association between tumor necrosis factor receptor associated factor 6 (TRAF6) polymorphisms and the susceptibility to sepsis. Method Haplotype tagging single nucleotide polymorphisms (htSNPs) were selected from the HapMap database. The htSNPs were genotyped in 255 patients with sepsis and 260 control subjects by the Beckman SNP stream genotyping platform. The association with susceptibility to and severity of sepsis were estimated by logistic regression with adjustment for age, sex, smoking, drinking,chronic diseases status, APACHE Ⅱ score and critical illness. Results Of 13 TRAF6 ANPs, 7 were tagged by htSNPs. Of them, 5 htSNPs (rs5030496, rs5030411, rs5030416, rs5030445 and rs3740961) were used for final genotyping analysis. Genotype frequencies of those htSNPs were conformed to the Hardy-Weinberg law in both patients and controls. There were no significant association found between the 5 htSNPs and susceptibility to sepsis.Also, there was no significant association between the TRAF6 polymorphisms and the septic shock, death from sepsis as well as organ dysfunction. Conclusions The TRAF6 gene polymorphisms might not play a major role in severity of sepsis.

Background: Cardiopulmonary resuscitation (CPR) strategies in COVID-19 patients differ from those in patients suffering from cardiogenic cardiac arrest. During CPR, both healthcare and non-healthcare workers who provide resuscitation are at risk of infection. The Working Group for Expert Consensus on Prevention and Cardiopulmonary Resuscitation for Cardiac Arrest in COVID-19 has developed this Chinese Expert Consensus to guide clinical practice of CPR in COVID-19 patients. Main recommendations: 1) A medical team should be assigned to evaluate severe and critical COVID-19 for early monitoring of cardiac-arrest warning signs. 2) Psychological counseling and treatment are highly recommended, since sympathetic and vagal abnormalities induced by psychological stress from the COVID-19 pandemic can induce cardiac arrest. 3) Healthcare workers should wear personal protective equipment (PPE). 4) Mouth-to-mouth ventilation should be avoided on patients suspected of having or diagnosed with COVID-19. 5) Hands-only chest compression and mechanical chest compression are recommended. 6) Tracheal-intubation procedures should be optimized and tracheal-intubation strategies should be implemented early. 7) CPR should be provided for 20-30 min. 8) Various factors should be taken into consideration such as the interests of patients and family members, ethics, transmission risks, and laws and regulations governing infectious disease control. Changes in management: The following changes or modifications to CPR strategy in COVID-19 patients are proposed: 1) Healthcare workers should wear PPE. 2) Hands-only chest compression and mechanical chest compression can be implemented to reduce or avoid the spread of viruses by aerosols. 3) Both the benefits to patients and the risk of infection should be considered. 4) Hhealthcare workers should be fully aware of and trained in CPR strategies and procedures specifically for patients with COVID-19.