Although adhesion molecules have long been recognized to be differentially expressed on naive and effector/memory T cells,it has recently been found that a number of chemokine receptors are also differentially expressed on T cells,depending on their Ag experience and type of polarization. Recent data suggests that chemokines and their receptors are essential elements that regulate the positioning of T cells and their partners for priming and T helper 1 (Th1)- or Th2-mediated responses,therefore,are probably the most promising targets for treating immune diseases.

Objective:To isolate and establish long term T cell clones derived from bone marrow(BM) of a patient with severe aplastic anemia(sAA).Methods:CD34 + cells and CD3 +T cells were enriched from BM aspirates,respectively by positive and negative immunomagnetic sorting protocol.BM of exicised rib of a non hematological patient was used as control. Irradiated CD34 + cells together with T cells were subject to one way autologous mixed lymphocyte culture(AMLC).Viable T cells surviving from AMLC were limit diluted and single cell was plated into microtitier wells along with feeder cells.Then all wells were screened for the growing cell wells and they were transferred into new wells to be expanded and maintained.Each clones obtained were primarily assessed CD4/CD8 phenotype and their homogeneity by immunocytochemical analysis.Results:The purity of sorted CD34 + and T cells was more than 90%. On AMLC,a total of 4?10 3 cells were viable with sAA,but 65 cells viable with control.Upon single cell seeding it 11 growing cell wells were found for sAA,and no one growing cells for control.The actual plating rate(2.1%) was within Poisson theoretic value range (

Objective To review the survival outcomes in patients with endometrial stromal sarcoma(ESS)in Cancer Hospital，Peking Union Medical College，Chinese Academy of Medical Sciences，and to discuss prognostic factors and the role of post-operative adjuvant radiotherapy and chemotherapy.Methods Hospital records and pathology reports for 97 patients with ESS were reviewed.Among 97 patients，69 had low-grade ESS(LGESS)，16 had high-grade ESS(HGESS)and 12 had unclear grade.The median age at diagnosis was 44.0 years.The median follow-up time was 62 months(5-277 months).Atypical vaginal bleeding(43％)and prolonged and increased menses(36％)were the main symptoms.Results Totally 2-year and 5-year cumulative survival rates were 93％and 84％，respectively.Cumulative survival curves were significantly different between LGESS and HGESS，and so did cumulative survival curves between stage Ⅰ-Ⅱ and stage Ⅲ-Ⅳ(P＜0.05).Totally，34 patients(37％)had local or distant recurrence.The median time-to-recurrence(TTR)was 27 months.The recurrence rates of the patients with or without preserve of ovary were 89％and 24％，respectively(P=0.000).The local-control-rates of the patients who received or did not receive post-operative radiotherapy were 81％and 43％，respectively(P=0.011).Conclusions The prognosis of HGESS is obviously worse than that of LGESS.The risk of recurrence of patients with preserve of ovary was remarkably higher than that of patients without preserve of ovary.Postoperative radiotherapy could increase the local-control-rates.

Objective To investigate the miss rate of adenoma with colonoscopy and assess the features and risk factors for missed diagnosis.Methods Patients with colorectal adenoma received a second colonoscopy within 120 days after adenoma was detected and removed on the initial colonoscopy.The findings of two colonoscopies were reviewed and analyzed.The features of adenoma (including size, location, shape, number and pathology) , clinical characteristics of patients (including age, sex, reasons of colonoscopy, history of diverticular disease, history of abdominal or pelvic surgery and colonoscopy with sedation) and endoscopists were recorded.Miss rate and features of different types of missed adenoma were analyzed.We also assessed the effects of adenoma features, patients' characteristics and endoscopists on missed diagnosis of adenoma.Results Adenoma missed diagnosis was found in 271 patients out of 809 recruited subjects (33% ).A total of 425 adenomas were missed out of 2134 (20% ) adenomas detected by repeated colonoscopy.A large diameter was associated with a decrease in the miss rate for adenoma (P < 0.01).Conversely , sessile or flat shape (P < 0.01) , locations at sigmoid, hepatic flexure, cecum and ascending colonic ( P < 0.05) were significantly associated with a higher miss rate of adenoma, as was the number of adenomas (P <0.01).A higher adenoma missed diagnosis rate was observed in beginner colonoscopists, as compared with experienced ones (P < 0.01).Conclusion A marked miss rate of adenoma exists on colonoscopy, which is significantly associated with the size, shape, location and number of adenomas and endoscopists.

Objective:Based on the theory of demand analysis theory, to build teaching resources of human physiology course and explore its application effect.Methods:The three-year nursing junior college students of Batch 2018 were selected as the research objects. According to the principle of randomization, the students were divided into the observation group (97 cases) and control group (99 cases). Students in the observation group used integrated teaching resources from the perspective of demand analysis, while students in the control group used traditional curriculum resources. After the end of the course, the differences between the two groups of students' theoretical and practical assessment results and teaching experience were compared SPSS 20.0 was used for t test. Results:The results of theoretical [(73.67±8.76) vs. (70.48±8.36)] and practical skills [(84.41±4.83) vs. (83.63±4.27)] in the observation group were significantly different from those in the control group ( P<0.05). The overall scores of 9 teaching effect sub-items, such as learning awareness of inquiry, independent learning ability and critical thinking ability, were significantly higher than those of the control group ( P<0.01). Conclusion:The construction of human physiology teaching resources based on demand analysis theory can improve the effectiveness and pertinence of resource construction, and the effective use of resources in teaching can significantly improve the teaching effect, stimulate students' subjective initiative, cultivate their comprehensive ability and improve classroom efficiency.

OBJECTIVETo investigate the possibility of multi-unit ribozymes to purge bone marrow of chronic myelocytic leukemia (CML), its in vitro cleavage ability and the reversal effect on CML cell's malignant phenotype.

METHODSAs bcr-abl fusion gene plays an important role in CML pathology, three single-unit ribozymes were designed and synthesized in 44 base pairs near the fusion point, two enzyme cleavage sites on bcr gene and one on abl gene. Multi-unit ribozymes' in vitro transcription and retroviral vector through gene recombination were constructed. Then, its in vitro cleavage ability was tested and the retroviral vector was transfected into K562 cell. Through MTT assay, the incorporation rate of (3)H-TdR, RT-PCR, Southern and Northern blot hybridization, flow cytometry, transmission and scanning electron microscopy were used to study the effect of multi-unit ribozymes on CML cell proliferation, cell structure, cell cycle and the induction of apoptosis.

RESULTSMulti-unit ribozymes had in vitro cleavage efficiency of 70.8%. After the transfection of multi-unit ribozymes retroviral vector into K562 cell, cell proliferation and DNA synthesis were greatly reduced with an inhibition rate of about 50% after 96 hours of transfection. Multi-unit ribozymes could cleave K562 cell's RNA with a reduction rate about one 1 000 th of the original. By flow cytometry (FCM), 18.4% cells underwent apoptosis after 72 hours transfection with most of the cells blocked in the G phase. Here, the ratio in S phase was lowered by 41.9%. Under transmission and scanning electron microscope, compaction of nuclear chromation and apoptosis bodies were observed in the transfected cells.

CONCLUSIONMulti-unit ribozymes possess high cleavage ability in vitro. The ribozymes, whose retroviral vector being transfected into CML cell, are able to express a lasting ability to cleave the fusion gene, induce apoptosis, reduce cell proliferation, revert the malignant phenotype. It is possible to make use of multi-unit ribozymes to purge CML bone marrow. Therefore, multi-unit ribozymes may very well be valuable in the gene therapy of CML.

Apoptosis ; Cell Division ; drug effects ; Fusion Proteins, bcr-abl ; genetics ; metabolism ; Humans ; K562 Cells ; RNA, Catalytic ; metabolism ; pharmacology

Objective To evaluate the efficacy of different treatment options for cholecysto-choledocholithiasis (CCL),and try to find the ideal treatment.Methods From January 2006 to January 2016,a total of 3 107 patients with CCL from the Affiliated Hospital of Inner Mongolia Medical University were enrolled.Among them,1 283 patients were in open cholecystectomy (OC) and open common bile duct exploration (OCBDE) group,964 patients were in laparoscopic cholecystectomy (LC) and laparoscopic common bile duct exploration (LCBDE) group,and 860 patients were in endoscopic retrograde cholangiopancreatography (ERCP) + LC group.The clinical data of the three groups were analysed.One-way analysis of variance and chi-square test were performed for statistical analysis.Results From 2006 to 2010,the percentage of patients treated with OC + OCBDE,LC + LCBDE,and ERCP + LC were 56.05％ (829/1 479),25.15％ (372/1 479) and 18.80％ (278/1 479),respectively;from 2011 to 2016,the percentage of patients received the above three treatments were 27.89％ (454/1 628),36.36％ (592/1 628) and 35.75％ (582/1 628),respectively.The difference in the proportion of the same treatment at different times was statistically significant (x2 =4.775,4.168 and 0.669,all P ＜ 0.05).The success rate of surgery in the OC + OCBDE group was 100.00％ (1 370/1 370);while the success rate of surgery in the LC + LCBDE group was 94.26％ (920/976),and 56 patients converted to OC + OCBDE;the success rate of surgery in the ERCP + LC group was 95.00％ (817/860),and 31 patients converted to OC + OCBDE,and 12 patients to LC + LCBDE.The intraoperative complication in OC + OCBDE,LC + LCBDE and ERCP + LC were 2.85％ (39/1 370),3.48％ (32/920) and 1.22％ (10/817),respectively.The incidence rates of postoperative complication were 4.89％ (67/1 370),5.34％ (50/920) and 5.51％ (45/817),respectively.The incidence rates of intraoperative complication of the ERCP + LC group was lower than that of OC + OCBDE group and LC + LCBDE group,and the differences were statistically significant (x2 =6.203 and 3.001;both P ＜ 0.05).However there was no significant difference in incidence rate of postoperative complications among the three groups (all P ＞ 0.05).The hospital stay of the OC + OCBDE group,the LC + LCBDE group and the ERCP + LC group were (6.7 ± 1.3) days,(5.6 ± 1.2) days and (10.9 ± 1.6) days,respectively,and the differences were statistically significant (F =90.010,P ＜ 0.01).The hospitalization expenses of OC + OCBDE group,LC + LCBDE group and ERCP+LC group were (13 720±1 910) yuan,(18 150±1 490) yuan and (25 830 ± 2 430) yuan,respectively,and the differences were statistically significant (F =302.991,P ＜ 0.01).Conclusion The first choice of patients with CCL is endoscopic minimally invasive treatment and open surgery can be used as a remedial method for endoscopic treatment.

Objective To compare the positioning accuracy between personalized polyurethane foam with wing boards and negative pressure vacuum bag in radiotherapy for lung cancer using kilovoltage cone beam computed tomography(CBCT). Methods Thirty-nine patients with lung cancer who received chest radiotherapy in our hospital from 2015 to 2016 were enrolled as subjects. In those patients, 20 were immobilized by negative pressure vacuum bags(VB group)and the others by personalized polyurethane foam with wing boards(PF group).CBCT images were acquired weekly and registered with planning CT images. Setup errors in the left-right, superior-inferior, and anterior-posterior directions, three-dimensional(3D) displacement vector,and setup time were recorded. The margin of the planning target volume(PTV)was calculated using the Van Herk formula(2.5∑+0.7σ). Between-group comparison was made by paired t test. Results The PF group had a significant smaller setup error in the y-direction than the VB group (2.54±1.79 vs.3.19±2.14 mm,P=0.03),while there were no significant differences in setup errors in the x-or z-direction between the two groups(1.80± 1.48 vs. 1.90± 1.41 mm, P=0.46;2.14± 1.75 vs. 2.25± 1.75 mm,P=0.35). There were no significant differences in rotational setup errors in the Rx-,Ry-,or Rz-direction between the two groups(1.15°±0.76°vs. 1.15°±0.85°, P=0.50;0.71°±0.60°vs. 0.72°±0.43°, P=0.45;0.62°±0.54° vs. 0.46°±0.30°,P=0.06). The PTV margins in the x?,y?,and z?directions were expanded by 5.56, 8.57, and 7.02 mm, respectively, in the PF group, and by 5.62, 9.27, and 7.23 mm,respectively,in the VB group. The proportion of patients with 3D displacement vectors larger than 5 mm was 40% in the PF group and 45% in the VB group.Conclusions For patients undergoing radiotherapy for lung cancer,personalized polyurethane foam with wing boards can,to a certain extent,reduce the setup error in the superior-inferior direction and PTV margin expansion.[Key words] Lung neoplasms/radiotherapy; Polyurethane foam; Vacuum bag; Setup errors;Margin