[ ABSTRACT] AIM:To observed the correlation between Th17 cell level and the symptom severity and prognostic factors of chronic obstructive pulmonary disease ( COPD) , and to explore the clinical application value of Th17 cell level in assessing the prognosis of patients with COPD.METHODS:The patients with diagnosed COPD ( n=110) in our hospital during May 2013 to December 2014, and 40 healthy subjects were enrolled in the study.According to the Global Initiative for Chronic Obstructive Lung Disease ( GOLD) , the COPD patients were divided into group A ( low risk, less symptoms) , group B (low risk, more symptoms), group C (high risk, less symptoms) and group D (high risk, more symptoms), which were given inhaled corticosteroid/long-acting β2 agonist or corticosteroid/long-acting β2 agonist +long-acting anti-muscarinic agent treatment for 3 months.The proportion of Th17 cells, cytokines (IL-17 and IL-6), the COPD assessment test ( CAT) score, age, body mass index, pulmonary function and the times of acute exacerbation of COPD in previous 1 year were observed before and after treatment.The correlation analysis between the level of Th17 cells and other clinical characteristics was performed.RESULTS:Th17 cell, IL-17 and IL-6 levels in COPD group were significantly higher than those in control group (P<0.05).With the increase in the severity of COPD symptoms, Th17 cells, cytokines (IL-17 and IL-6) and CAT score in groups B and D were significantly higher than those in groups A and C (P<0.05).The univariate analysis showed that the levels of Th17 cells in groups B and D before treatment were positively correlated with the CAT score (P<0.05), which were negatively correlated with FEV1, FEV1%Pred, FVC and FVC%Pred.The levels of Th17 cells were not correlated with the CAT score, FEV1 , FEV1%Pred, FVC and FVC%Pred in groups A and C.The levels of Th17 cells after treatment were positively correlated with the CAT score, which were negatively correlated with FEV1 , FEV1%Pred, FVC and FVC%Pred (P<0.05).CONCLUSION:The peripheral Th17 cell level has a good correlation with IL-17, IL-6, CAT score and pulmonary function in COPD patients, suggesting a potential value to predict the symptom severity and prognosis of COPD.

Objective Macrophages are important innate immune cells,and are also the main target cells of Mycobacterium tuberculosis.Macrophages express many kinds of Toll like receptors.TLR2 is a structural component of macrophages in the identification of Mycobacterium tuberculosis.Activation of TLR2 signaling pathway can activate cell signal transduction,induce specific gene expression and secretion of cytokines.Immune function decline in old people and the function of macrophages was also changed.In this article,The role of immunity mediated by TLR2 in macrophages against tuberculosis in the elderly is reviewed.

Long non-coding RNAs are important regulators of gene expression.ANRIL which was coded on the Chr9p21.3 loci participates in the pathogenesis of tumor, coronary artery disease, type 2 diabetes mellitus and oth-er diseases.Multiple ANRIL isoforms are tissue-specific.ANRIL mainly functions through Polycomb proteins, while there are also other downstream targets.The mechanism of each isoform and the downstream pathways are hotspots incurrent researches.

Breast cancer is the most common malignant tumor in women, bone related events (SREs), such as bone pain, pathological fracture and so on, can affect seriously the quality of life.Experts in Chinese Anti-Cancer Association, Committee of Breast Cancer Society (CACA-CBCS) discussed the Consensus on the Diagnosis and Treatment of Bone Metastasis and Skeletal Related Diseases in Breast Cancer (2014 version), here reflections on several hot issues were explored.

Objective To study the clinical efficacy of lateral collateral ligament reconstruction surgery com-bined with arthroscopy in treatment of chronic lateral ankle instability.Methods 60 cases with chronic lateral ankle instability were selected,the patients were divided into the study group and the control group according to a random number table,which has 30 cases in each group.The control group was received conservative treatment, the study group was underwent exploratory arthroscopic ankle cleanup combined with peroneus brevis tendon lateral ligament reconstruction surgery.Scores before and after treatment of the two groups were detected in American bare foot and ankle surgery-hindfoot score system( AOFAS) .And excellent rate,the recurrence rate and complication rate between the two groups were compared.Results AOFAS score before treatment of the two groups had no significant difference (P>0.05),AOFAS score after treatment of two groups were significantly higher,and that of the study group was sig-nificantly higher than the control group,the difference was statistically significant (t=9.837,10.873,8.789,all P<0.05);Excellent rate of the study group was 96.7% (29/30) significantly higher than the 73.3% (22/30) in the control group,recurrence rate of the study group was 0.0% (0/30),significantly lower than the 13.3% (4/30) in the control group,the complication rate of the study group was 3.3%(1/30),significantly lower than the 20.0%(6/30)in the control group,the difference was statistically significant (χ2 =13.982,15.037,13.298,all P<0.05). Conclusion Lateral collateral ligament reconstruction surgery combined with arthroscopy in treatment of chronic lat-eral ankle instability has better clinical efficacy,the recurrence rate is low,and has less complications.

Manual Muscle Testing is a widely used muscle power testing method in rehabilitation practice. Although it's a key content in rehabilitation medicine and rehabilitation therapy, there are some disagreements in lots of books introducing the development and rating system of it. This article reviewed the development of Manual Muscle Testing and different rating systems.

Biliary atresia(BA) is a destructive inflammatory obliterative cholangiopathy of neonates affecting both intrahepatic and extrahepatic bile ducts.BA is more common in east Asia.Genetic susceptibility,viral infections,and immune dysregulation may be related to BA,but immune dysregulation may play a key hole in the pathogenesis of BA.A current view of the pathogenesis of BA is that it may involve both a primary perinatal hepatobiliary viral infection and a secondary generation of an autoimmune-mediated bile duct epithelial injury.The etiology of BA is unknown,but there is evidence for the involvement of immunologic dysregulation mechanisms,which will be discussed in this review.

Ageing of population is now a phenomenon of the world and has considerable consequences for public services.Ageing is always accompanied with dysfunction of multiple organs,including hypothalamic-pituitaryadrenal axis.Here,we summarized alterations of hormone secretion of adrenal glands in the elderly and their relationships with Alzheimer' s disease.Moreover,we discussed characteristics of pheochromocytoma,primary aldosteronism,and Cushing's syndrome in the elderly.Lack of typical manifestations usually makes difficulty in diagnosis.

Objective To analyze the occurrence rate,positive rate,and other related factors influencing interpectoral lymph nodes in breast cancer patients,and to explore the significance and indications of the surgical dissection of interpectoral lympy nodes.Methods Clinical and pathological data from 148 breast cancer patients were retrospectively analyzed.All patients were subjected to modified radical mastectomy,and interpectoral lympy nodes were pathologically examined.The occurrence rate and metastasis of interpectoral lympy nodes were recorded,and the relationship between the interpectoral lympy nodes positive rate and tumor size,axillary nodes,clinical stages,neo-adjuvant chemotherapy,hormone receptors,human epidermal growth factor receptor-2 (Her-2) expression,and molecular subtypes of breast cancer were determined.Results The occurrence rate,overall metastasis rate,and the positive rate of interpectoral lympy nodes in patients with axillary lymph node metastasis were 13.5％(20/148),4.7％(7/148),and 10.9％ (7/64),respectively.I nterpectoral lympy nodes metastasis was significantly correlated with axillary node metastasis and clinical stages (P＜ 0.05).However,interpectoral lympy nodes metastasis was not significantly related with hormone receptor and Her-2 expressions(P ＞ 0.05).Interpectoral lympy nodes metastasis rate was not affected by neo-adjuvant chemotherapy.Patients with interpectoral lympy nodes metastasis were characterized by larger tumors,more positive axillary lymph nodes,and later chnical stages.Conclusions Interpectoral lympy nodes metastasis usually occurs in patients with larger tumors,more positive axillary lymph nodes,later clinical stages,as well as those with locally advanced cancer that meets the standard of neo-adjuvant chemotherapy.These indications suggest that the surgical dissection and pathological examination of interpectoral lymph nodes should be routinely performed.

In patients with chronic myeloid leukemia (CML) in chronic phase who have achieved complete molecular remission on imatinib therapy,whether and when to discontinue the drug become a hot topic.The famous clinical trials of discontinue tyrosine kinase inhibitor (TKI) from France and Australia have demonstrated that long-term monotherapy with TKI is not curative in the majority of patients with CML.This has focused attention on strategies to eradicate residual disease in CML patients,which should result in cure and long-term treatment-free remission and leukemia-free survival.This review provides a brife summary of the 55th ASH annual meeting,focusing on the potential combination therapeutics in the era of TKI.