Costimulatory molecule CD_(40) is extensively expressed by immune, hematopoietic, epithelial, and a wide range of tumor cells. As a potential target for novel cancer therapy, CD_(40)/CD_(40L) may mediate tumor regression through both an indirect effect of immune activation and a direct cytotoxic effect on the tumor. Several drug formulations that target the CD_(40)/CD_(40L) pathway have undergone phase I clinical evaluation in advanced-stage cancer patients, and initial findings show objective clinical responses immune modulation function and have not serious toxicity.

Th17 cells are CD4 + effector T cells.Many studies have confirmed that Th17 cells and their related cytokines exist in many kinds of tumors,and play critical roles in inflammation related tumors.But the expression and differentiation in tumor microenvironment,the immune regulation mechanisms and functional effects of Th17 cells remains controversial.

Objective:To observe the effect of Shuxuetong Injection on unstable angina pectoris in diabetic pa- tients after coronary stent implantation.Method:40 diabetic patients after coronary stent implantation were randomly divid- ed into two groups.The patients in the two groups were treated with basic drugs.17 patients in the controlled group were venously treated with Danshen injection 6 milliliters dissolved in 250 milliliters 0.9% sodium chloride injection once daily. 23 patients in the treatment group were venously treated with Shuxuetong injection 6 milliliters dissolved in 250 milliliters 0.9% sodium chloride injection once a day.The treatment course was fifteen days in both groups.The clinical effect and the frequency of angina attack were observed in both groups.The concentrations of plasma fibrinogen(FBG)and serum C- reactive protein(CRP)were measured before and after the treatment.Result:Compared with those of the controlled group, the frequency of angina attack and the indication of myocardial ischema in electrocardiogram greatly improved(P

Objective To analyze the clinical effect of pedicle screw fixation in the treatment of multi-segmental lumbar fracture and dislocation under the guidance of visualization technique. Methods A total of 21 patients with multi-segmental lumbar fracture and dislocation were selected from November 2012 to November 2013. Before the screw implantation, the structure of bilateral pedicle was observed through Mimics software and the implantation parameters were measured. The position of pedicle screws by postoperative CT scan, operation time, and the satisfaction of the patients were assessed. The percentages of anterior vertebral height and Cobb′s angle were measured before operation, 2 weeks and 8 months after operation. Results All patients were satisfied with informed consent score and the way of pedicle screw and the selection of plant were more reasonable. With better screw position, shorter operative time and less blood loss and adverse reactions, pedicle screw fixation achieved good effect. Conclusion With high security and considerable clinical value, pedicle screw fixation in the treatment of multi-segmental lumbar fracture and dislocation under the guidance of visualization technique has exact and good effecct.

Perfluorinated compounds (PFCs), a group of persistent organic pollutants, have been widely detected in environmental media and posed great threat to human health. The researches on environmental pollution and health concern of PFCs are the hotspot areas. Because PFCs contain lots of homologs and isomers which are detected at trace levels (ng/g or μg/L) in environment, advanced and reliable analytical methods for determination of PFCs in environment are urgently needed. At present, studies on analytical methods of trace PFCs in environmental samples have been widely carried out in China and abroad. However, systematic review on the sample pretreatment, analytical method, and matrix effect of PFCs determination in complex environmental matrixes is relatively scarce. Therefore, this paper reviews the pretreatment methods, martix effects, and detection techniques (especailly isomers) of PFCs in environment samples (water, sediment/sluge, soil and plant). We hope that this review may provide valuable reference for the enviromental researches on PFCs.

Objective CD4 +IL-17 +cells are a group of newly discovered effector CD4 +T cells, which may play a key role in the pathogenesis of cancer.This study aims to investigate the expres-sion of CD4 +IL-17 +cells in pancreatic cancer and its correlation with the clinicopathological characteristics and prognosis of the dis-ease as well as the clinical significance of the cells in the microenvironment of pancreatic cancer. Methods We collected tumor tis-sue and tumor-adjacent normal tissue samples from 51 pancreatic cancer patients.We determined the expressions of CD34 and vascular endothelial growth factor ( VEGF) and measured the proportion of IL-17 +cells in the cancer tissue using immunohistochemistry and the fluorescence activated cell sorter, respectively, followed by analysis of their correlation with tumor angiogenesis, clinicopathological pa-rameters, and survival time of the patients. Results The percentage of CD4 +IL-17 +cells in tumor tissue was positively correlated with microvessel density (r =0.534, P<0.05) and the expression of VEGF in the tumor tissue (r=0.356, P<0.05).IL-17 +cells were expressed more highly in the tumorous than in the tumor-adjacent normal tissue (P<0.05), and the expression level was correla-ted with the stage of tumor, node, and metastasis (TNM) and lymph node metastasis (P<0.05), but not with the patients′gender or age, tumor size, tumor location, histological grade, or local invasion (P>0.05).Fifty (98.0%) of the patients were successfully followed up for 2-67 months, which revealed a median survival time of 16.6 ±4.8 months, significantly longer in those with a higher expression of intratumoral IL-17 +cells (P<0.05).Univariate analysis showed an association of the survival rate with the tumor size, TNM stage, lymph node metastasis, and level of intratumoral IL-17 +cells, while multivariate analysis showed the TNM stage to be an independent prognostic factor for the survival of the pancreatic cancer patients. Conclusion The expression of CD4 +IL-17 +cells in the tumor tissue is positively correlated with tumor angiogenesis, while that of IL-17 +cells with the clinicopathological parameters and survival time of the patients and therefore may serve as an important immune indicator for the prognosis of pancreatic cancer.

Ankylosing spondylitis (AS) combined with spinal fractures with thoracic and lumbar fracture as the most common type shows characteristics of unstable fracture, high incidence of nerve injury, high mortality and high disability rate. The diagnosis may be missed because it is mostly caused by low-energy injury, when spinal rigidity and osteoporosis have a great impact on the accuracy of imaging examination. At the same time, the treatment choices are controversial, with no relevant specifications. Non-operative treatments can easily lead to bone nonunion, pseudoarthrosis and delayed nerve injury, while surgeries may be failed due to internal fixation failure. At present, there are no evidence-based guidelines for the diagnosis and treatment of AS combined with thoracic and lumbar fracture. In this context, the Spinal Trauma Academic Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate the Clinical guideline for the diagnosis and treatment of adult ankylosing spondylitis combined with thoracolumbar fracture ( version 2023) by following the principles of evidence-based medicine and systematically review related literatures. Ten recommendations on the diagnosis, imaging evaluation, classification and treatment of AS combined with thoracic and lumbar fracture were put forward, aiming to standardize the clinical diagnosis and treatment of such disorder.