Immunosenescence is a biological process featured by the structural and functional decline of immunity in ageing people,which favors the carcinogenesis by rendering the body's immune surveillance and tumor escape.Decreasing clearance of tumor cells by macrophages and natural killer cell reflects the immunosenescence of innate immune,also,the tumor antigen presentation ability of dendritic cell is decreased.While,the decline of the CD8 + T cells cytotoxic effect and the secretion of tumor growth factor accounts for the immunosenescence of adaptive immunity.Intervention of immunosenescence may produce the novelty ideas of prevention and treatment of cancer.

Metastasis is the leading cause of death in patients with lung cancer .Circulating tumor cells (CTCs)play a key role in the process of distant metastasis .In recent years,research results have shown that CTCs may become a emerging marker and new target in the treatment of lung cancer .In this article,we elaborate the clinical significance of CTCs in lung cancer from the way of diagnosis and clinical staging ,metastasis and recur-rence,individual treatment and prognosis and so on ,so that we can provide a new direction for the treatment of lung cancer .

Objective To investigate the clinical effect of the compound flaps of foot with joint transplantation bridging severed segmental damage type finger.Methods Eleven cases with segmental composite tissue damaged fingers,emergency free with plantar metatarsal or metatarsophalangeal,interphalangeal joint of the foot com posite tissue flap transplantation and bridging replanted finger form February,2006 to September,2011 were retrospective reviewed in our study.The therapeutic effect was evaluated according to the assessment standard of Chinese Medical Association of Hand Surgery.Results All patients were followed-up for 6 to 48 months.The composite flap and amputated fingers in the 11 cases were survived after surgery,with satisfactory appearance.Range of motion of interphalangeal joints from 40° to 90°,and metacarpophalangeal joints from 45° to 65°.There was no nonunion or refracture.Two-point discrimination of finger pulp was 5-8 mm.According to the Chinese Medical Society of Hand Surgery Trial upper part of the standard evaluation function assessment,the results were excellent in 3 cases,good in 6 cases,may in 2 case.Conclusion Compound flaps of foot with joint transplantation bridging severed segmental damage type finger could recover the appearance and functions of amputated fingers to satisfy the daily need of patients in a maximum degree.

OBJECTIVE:To observe clinical efficacy and safety of Qizhi qushi jianpi prescription in the treatment of chronic synovitis of knee joint in middleaged and elderly patients after debridement under arthroscope. METHODS:A total of 80 mid-dleaged and elderly inpatients with chronic synovitis of knee joint were selected and randomly divided into treatment group and con-trol group,with 40 cases in each group. Clinical efficacy,VAS,swelling score of modified Cincinnati knee joint score system, Lysholm score of knee joint function,the occurrence of ADR were observed in 2 groups. RESULTS:Total effective rate of treat-ment group(92.5%)was significantly than that of control group(77.5%),with statistical significance(P<0.05). Before debride-ment under arthroscope,there was no statistical significance in VAS score of knee joint,swelling score and Lysholm score between 2 groups(P>0.05). On the first day after surgery,VAS score of 2 groups decreased significantly,and there was statistical signifi-cance compared to before surgery (P<0.05). One month after surgery,VAS score of 2 groups decreased significantly,and the treatment group was significantly lower than the control group,with statistical significance(P<0.05). Swelling score of knee joint 1 month after surgery and Lysholm score 3 months after surgery increased significantly in 2 groups,and the treatment group was significantly higher than the control group,with statistical significance(P<0.05). 5 patients of treatment group suffered from stom-ach discomfort,and the symptom was relieved after adding the ingredient of comforting stomach and removing dampness through diuresis. CONCLUSIONS:Qizhi qushi jianpi prescription is effective for chronic synovitis of knee joint in middleaged and elderly patients after debridement under arthroscope,and can relieve pain, remove swelling and recover knee joint function with good safety.

Objective To investigate the influence of cartilage degeneration grades of patellar on the clinical outcomes after total knee arthroplasty (TKA) without patellar resurfacing.Methods 151 patients performed TKA without patellar resurfacing from February 2007 to January 2010 were retrospective studied.There were 65 males and 86 females,with the mean age of 65±5.0 years (range,56-82 years).The mean duration of follow-up was 3.5 years (range,2-5 years).Intraoperatively,the cartilage degeneration was classified according to Outerbridge classification.At the final follow-up,the patients' satisfaction was evaluated,and the incidence of anterior knee pain was assessed using visual analogue scale (VAS).If VAS was more than 3 points,patient was defined suffered anterior knee pain.Compare KSS and patella score of patients with different grades of cartilage degeneration.Results The articular cartilage of the patella was graded according to Outerbridge:grade Ⅰ in 18 patients,grade Ⅱ in 36 patients,grade Ⅲ in 62 patients,and grade Ⅳ in 35 patients.At the final follow-up,the patients' satisfaction rate and the anterior knee pain rate was 96.7％ 046/151) and 4.0％ (6/151),respectively.In the patients with different grades of cartilage degeneration,the patient satisfaction rate (H=5.54,P=0.14),anterior knee pain rate (H=0.56,P=0.91),KSS (knee score:F=1.95,P=0.12； function score:F=2.11,P=0.10) and patella score (F=1.35,P=0.26) were not found to be significantly difference.Conclusion The differentiae grades of cartilage degeneration may not affect the clinical outcomes of TKA.TKA without patella resurfacing appears to be a reasonable option for degenerative osteoarthritis.

Objective:To explore the effect of KCa3.1 activating NLRP3 inflammasome in paraquat PQ treated-alveolar epithelial cells.Methods:The A549 cells were cultured in vitro and divided into the control group, TRAM-34 (specific inhibitor of KCa3.1) group, PQ group and PQ+TRAM-34 group. The expression of KCa3.1 was detected by immunofluorescence in A549 cells. Western blot was used to detect the level of the proteins related with the NLRP3 infammasome and NEK7 protein. And the level of cell potassium was detected by cell potassium concentration kit.Results:The level of KCa3.1 was significantly increased in A549 cells after PQ treatment by immunofluorescence. The expressions of NLRP3 infammasome-related proteins (NLRP3, ASC and Caspase-1) and NEK7 protein were increased after PQ treatment, and the expressions of NLRP3 infammasome-related proteins and NEK7 protein were decreased after inhibition of KCa3.1, and the difference was statistically significant [NLRP3/β-actin (control group vs TRAM-34 group vs PQ group vs PQ+TRAM-34 group): [ (0.02±0.00) vs (0.03±0.00) vs (0.74±0.00) vs (0.32±0.01) , ASC/β-actin (control group vs TRAM-34 group vs PQ group vs PQ+TRAM-34 group): [ (0.12±0.01) vs (0.11±0.03) vs (0.46±0.02) vs (0.17±0.03) ];Caspase-1/ β-actin (control group vs TRAM-34 group vs PQ group vs PQ+TRAM-34 group): [ (0.05±0.00) vs (0.04±0.00) vs (0.34±0.03) vs (0.15±0.01) ]; NEK7/ β-actin (control group vs PQ group vs PQ+TRAM-34 group);[ (0.38±0.03) vs (0.83±0.02) vs (0.51±0.01) , P<0.01]. The potassium level was decreased after PQ treatment and the degree could be declined by the KCa3.1 inhibitor by colorimetric detection with statistically significant difference (control group vs PQ group vs PQ+TRAM-34 group:[ (1.00±0.00) vs (0.60±0.05) vs (0.86±0.02) , P<0.01]. Conclusions:The KCa3.1 could promote the outflow of intracellular potassium and up-regulate the expression of NEK7, thereby activate the NLRP3 inflammatory in PQ-induced pulmonary fibrosis.

OBJECTIVE To evaluate the ameliorative effect of Juanbi Tongluo Oral Liquid on sciatic neuronal apoptosis in Type 2 diabetic model mice.METHODS The Type 2 diabetes mouse model was established by feeding with high-fat and high-sugar diet combined with intraperitoneal injection of streptozotocin(STZ).The mice were treated with metformin(200 mg·kg-1·d-1),low dose(3.9 g·kg-1·d-1)and high dose(7.8 g·kg-1·d-1)Juanbi Tongluo Oral Liquid for 35 days.The latency of response to thermal stimu-lation was detected by hot plate,and the values of blood glucose insulin and glycosylated hemoglobin were determined.Biochemical kits were used to detect the expression of serum total cholesterol(T-CHO),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),superoxide dismutase(SOD),catalase(CAT),glutathione peroxidase(GSH-Px)and oxidation product malondialdehyde(MDA).The expression of tumor cytokine α(TNF-α),interleukin(IL)-1β,IL-6 and IL-10 in serum of mice were detected by ELISA method;the injury of sciatic nerve of model mice was detected by HE staining;the apoptosis of sciatic nerve was detected by TUNEL method;and the expression of neurofilament protein NF-L,apoptosis(cleaved Caspase-3,Caspase-3)and oxidative stress(Nrf2,HO-1)signal pathway proteins in sciatic nerve of model mice were detected by Western blot method.RESULTS High-dose Juanbi Tongluo Oral Liquid shortened the latent period of heat pain response in model mice(P<0.01);downregulated fasting blood glucose and glycated hemoglobin(P<0.01),and upregulated fasting plasma insulin in model mice(P<0.01);downregulated serum T-CHO,TG,and LDL-C levels(P<0.01),upregulated HDL-C levels(P<0.01);downregulated serum pro-inflammatory factors TNF-α,IL-1β and IL-6 levels(P<0.05),upregulated the anti-inflammatory cyto-kine IL-10 level(P<0.01);inhibited sciatic nerve structural damage and apoptosis(P<0.05);downregulated the ratio of cleaved Caspase-3 to Caspase-3 in the apoptosis pathway(P<0.01);upregulated the expression of neurofilament proteins NF-L and NF-H in sciatic nerve tissue(P<0.05,P<0.01);and upregulated the expression of antioxidant stress proteins Nrf2 and HO-1(P<0.01).CONCLUSION Juanbi Tongluo Oral Liquid can improve sciatic neuronal apoptosis of Type 2 diabetic mice,which may be related to its effect on improving oxidative stress and inflammatory stress.

AIM:To elucidate the possible biological mechanism of silica-induced acute lung injury in rats.METHODS:Sixteen Male Sprague-Dawley rats were divided into control and acute silicosis model groups,and instilled intratracheally with 1 mL of normal saline and 50 g/L silica suspension,respectively.After 7 d,the rats were sacrificed for collection of lung tissue and serum.The serum levels of interleukin-1β(IL-1β),IL-18 and tumor necrosis factor-α(TNF-α)were measured by using ELISA.The protein expression levels of nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)and gasdermin D(GSDMD)were measured by immunohistochemistry.Bacterial DNA was ex-tracted from the lung tissue for 16S ribosomal RNA gene sequencing to characterize changes in the composition of lung flo-ra.The differences in the structure of bacterial flora between control and model groups were analyzed by bioinformatic analy-ses.RESULTS:Immunohistochemical analysis showed that the protein expression levels of NLRP3 and GSDMD were higher in the lungs of the rats in model group.In addition,serum cytokine profiling showed that IL-1β,IL-18 and TNF-α levels were significantly higher in model group.The most abundant bacterial genera in the lung flora of the rats in model group were Bifidobacterium,Clostridium sensu stricto 1,and Parasutterella.The NLRP3 and GSDMD levels in the lung tissue and IL-1β and TNF-α levels in serum were positively correlated with the abundance of Parasutterella.CONCLU-SION:The alterations in lung flora structure and increased inflammation levels may be the actual biological mechanisms underlying silica-induced acute lung injury.The modulation of lung flora may provide a basis for the prevention and treat-ment of silica-induced acute lung injury.