A combination vaccine which consists of ≥2 immunogens is intended to provide protection against two or more diseases or against multiple serotypes of a single disease. The use of combination vaccines decrease the number of vaccine injections in the regular immunization schedules. However,the development of combination vaccines is more complicated than monovalent vaccines,preservatives and adjuvants used with one component may alter the potency of other components. Physical,chemical,and biological interactions between the components of combination vaccines must be considered to avoid detrimental effects on safety or efficacy. Therefore combination vaccines present unique challenges for product evaluation. This paper presents a review of research application status,the evaluation of effectiveness and safety,as well as development prospects on combination vaccines.

Cholangiolocellular carcinoma (CLC) is a rare type of primary liver cancer,which is thought to originate from hepatic progenitor cells.CLC is categorized as a different tumor type from the conventional intrahepatic cholangiocarcinoma (cICC) due to its unique histological and embryological features.This review summarizes the clinical,radiological and pathological characteristics and surgical outcomes of cICC and CLC.This pathological classification may provide important clinical implications for the treatment and outcome evaluation of this disease.

Polypoidal choroidal vasculopathy(PCV) is a common disease of the retina,the disease is more found in colored race.In China,the mainly nosogenic population is the female about 60 years old.The pathogenesis of PCV is unknown and there is no specific medicine at present.The funduscopic present is orangered lesions,bleed and exudation.Indocyanine green angiography(ICGA) could make a definite diagnosis of PCV.In recent,the main treatment of PCV includes photodynamic therapy,intravitreal anti-VEGF therapy,surgery for treatment of complications and combined therapy.We review the treatment and diagnosis of PCV,and propose the further research direction.

Objective To study the clinical characteristics by using CT, MRI and biochemistry test on the X linked adrenoleukodystrophy (X ALD) Methods The clinical,neuro imaging and determinations of plasma very long chain fatty acids (VLCFAs) of 12 cases with X ALD were analysed Results The main clinical features consisted of the childhood onset,progressive auditory, visual and/or intelligent impairment, behavioural changes,epileptic seizures and melanodermia. CT or MRI scans demonstrated that the demyelinating lesions were located on the bilateral white matter in occipital,posterior parietal and temporal lobes.The levels of hexacosanoic acid (C 26:0 ) and the ratio of C 26:0 to docosanoic acid (C 22:0 ) were increased. Conclusions ALD is an inherited disease as an X linked trait.The childhood X ALD is characteristiced by progressive auditory, visual and intelligent deterioration.The abnormalities of CT or MRI scan and the levels of the plasma VLCFAs are crucial to the diagnosis of X ALD.

Objective To evaluate the clinical application of HLA matching in highly sensitized recipients of renal allografts.Methods Recipient's panel reactive antibody (PRA) was detected by using ELISA test with Lambda antigen tray (LAT).Donor and recipient HLA classⅠtyping was performed with special monoclonal tray,and HLA classⅡgene typing with micro-sequence specific primers (Micro-SSP).Results There were 104 recipients with anti-HLA class-ⅠIgG antibody,76 with anti-HLA class-ⅡIgG antibody,and 44 with both anti-HLA class-1 and anti HLA class-ⅡIgG antibody respectively in 136 sensitized recipients.HLA class-ⅠIgG antibody positive rate was 11%-97 %,with an average of 49.6%?23.8%;The common public epitopes antibody was not found in each recipient of 13 cases with PRA＜20%,but was found in I2 recipients in 44 cases with PRA be- tween 20%-50%,and 39 recipients in 47 cases with PRA＞50%.HLA class-ⅡIgG antibody posi- tive rate was 17%-100%,with an average of 28.2%?63.8%.The number of cases of 0,1,2,3, 4 MM was 7 (5.1%),26 (19.1%),47 (34.6%),39 (28.7%) and 17 (12.5%) respectively by the standard of conventional HLA antigen matching;however the number of the recipients with 0,1, 2,3 MM was 31 (22.8%),53 (39.0%),36 (26.5%) and 16 (11.7%) respectively according to the rule of HLA CREGs matching and none with 4 MM.Rates of acute rejection in sensitized recipi- ents with 2MM and 3MM HLA-CREGs were 25.0% and 37.5% respectively and were significantly higher than those with 0MM (P＜0.05,＜0.05 respectively).Kidney year-survival was decreased when the number of MM of HLA CREGs matching increased.Conclusion The HLA CREGs matching can improve the ratio of well-matched significantly.Good HLA matching can reduce the incidence of acute rejection in sensitized recipients and increase the survival rate of grafts.

Objective To explore the difference of clinical features and laboratory indexs with different vasovagal responses in(head-up) tilt test(HUT) in children with vasovagal syncope(VVS).Methods Forty consecutive children diagnosed with VVS by HUT were analyzed.The vasovagal responses were divided into vasodepressor,cardioinhibitory and mixed patterns.The distribution and different clinical features and laboratory indexs of different response patterns in the VVS were studied.Results The most common vasovagal response was vasodepressor.There was no significant difference in their clinical features,including the motivation,presymptom,frequency and duration of syncope,baseline heart rate and blood pressure,and serum electrolytes among the children with different vasovagal respon-ses.Conclusion Vosodepressor response is the most common hemodynamic pattern in vasovagal syncope in children.

AIM:To investigate the effects of microRNA ( miRNA)-126 on the proliferation , migration and in-vasion of human lung cancer cell lines , and to explore its mechanism .METHODS:The A549 cells were transfected with miRNA-126 agomir by Lipofectamine 2000.The expression of miRNA-126 was detected by real-time PCR.The cell activity was detected by MTT assay .The number of viable A549 cells was counted by the method of Trypan blue exclusion .The cell colony-forming capability was determined by cell colony formation test .The cell migration and invasion abilities were assayed by wound healing and Transwell methods , respectively.The protein levels of p-EGFR, EGFR, p-AKT, AKT, p-mTOR and mTOR were determined by Western blot .RESULTS:The expression level of miRNA-126 was significantly in-creased in the A549 cells compared with negative control ( NC) group and control group ( P<0.01 ) .The proliferation of A549 cells was decreased extremely after transfected with the miRNA-126 agomir (P<0.01), so did the result of the cell colony-formation test.The migration and invasion abilities of the lung cancer cells were also significantly inhibited .The protein levels of p-EGFR, p-AKT and p-mTOR were significantly down-regulated compared with NC group and control group ( P<0.01) .CONCLUSION:Over-expression of miRNA-126 significantly inhibits the proliferation , migration and invasion ability of human lung cancer A 549 cells by down-regulation of EGFR/AKT/mTOR pathway .

ABSTRACT:Objective To study the expressions of C-Met and hepatocyte growth factor (HGF)in tongue squamous cell carcinoma and their clinical significance.Methods We analyzed 46 patients (the treatment group) with tongue squamous carcinoma and 27 patients (the control group)with benign tumor treated in our hospital between June 201 1 and May 2013.The expressions of C-Met and HGF were detected by immunohistochemistry. Results In the experimental group,C-Met negative expression rate was 21.7% (10/46),weak positive expression rate was 26.1% (12/46),and strong positive expression rate was 52.2% (24/46).The above expression rates were 77.8% (21/27),1 5.8% (5/27),and 3.7% (1/27)in the control group.The two groups differed significantly (P <0.001).In the experiment group,the negative expression of HGF protein was 1 7.4% (8/46 ),weak positive expression rate was 58.7% (27/46),and strong positive expression rate was 23.9% (1 1/46).The above expression rates in the control group was 63.0% (1 7/27 ),37.0% (10/27 ),and 0.0% (0/27 ).The two groups differed significantly (P <0.001).The expression of C-Met protein was significantly related to lymph node metastasis (P <0.05).The expression of HGF protein was significantly related to pathological grading and lymph node metastasis (P <0.05).Conclusion The expressions of C-Met and HGF in tongue squamous cell carcinoma are significantly higher.And the occurrence and development of tongue squamous cell carcinoma are closely related to the expressions of C-Met and HGF.

Objective To evaluate the clinical effects of platelet-rich plasma in treatment of DeepⅡburn wounds. Methods Sixty eight cases of inpatients with Deep Ⅱburns were selected, whose age were from 1 to 65 years and their burn areas were between 5%~62%of total body surface area (TBSA). Deep gradeⅡburn of each sample was divided into two parts. Part A was the treatment group and part B was the control group.The burn wounds in the treatment group were treated with platelet-rich plasma and the counterpart in the control group were treated with SD-Ag. Healing time ,recovering rate and the frequency of dressing changes,frequency of changing the most innerlayer gauze and the rate of wound infection were also analyzed. Finally the laboratory abnormalities and adverse effect were monitored regularly. Results The healing time of the treatment group (16.5±3.1 ) d was shorter than that of the control group (19.5±3.8 ) d. The recovering rate of the treatment group was higher than that of the control group on the 14th and 17th day after treatment. There were statistically sig?nificant differences between these two groups (P<0.05). After two weeks’treatment, the internal and external dressing per?meability into wet gauze layers were 20.6 ± 1.7, which were significantly decreased than that in the control group 23.3 ± 5.9. The frequency of dressing changes was(7.2±1.1)times in treatment group versus(9.2±1.4)times in control group and the frequency of changing the inner most layer gauze was( 2.3±0.6)times in the treatment group versus(5.3±1.3)times in con?trol group. There were 5 inflammation reaction cases in the treatment group, but 13 cases in the control group. However, there was no statistic significance between the two group in the outcomes of bacterial culture, the laboratory abnormalities and the adverse effect. Conclusion Platelet-rich plasma can remarkably shorten the healing time,improve healing rate,re?duce frequency of dressing change and promote wound healing for deepⅡburn wound. PRP is a potential safety reagent in treating deepⅡburn wound.

Objective To develop a computer-aided diagnosis(CAD)system with automatic contouring and morphologic and tex-tural analysis to aid on the classification of breast nodules on ultrasound images .Methods A modified Level Set method was pro-posed to automatically segment the breast nodules(46 malignant and 60 benign nodules) .Following ,16 morphologic features and 17 texture features from the extracted contour were calculated and principal component analysis(PCA)was applied to find the optimal feature vector dimensions .Fuzzy C-means classifier was utilized to identify the breast nodule as benign or malignant with selected principal vectors .Results The performance of morphologic features was 78 .30% for accuracy ,67 .39% for sensitivity and 86 .67%for specificity ,while the latter was 72 .64% ,58 .70% and 83 .33% ,respectively .After the combination of the two features ,the re-sult was exactly the same with the morphologic performance .Conclusion This system performs well in classifying the malignant breast nodule from the benign breast nodule .