Objective To study the changes in the percentage of CD+4 CD+25 regulatory T (Tr) cells in peripheral blood and deciduas in unexplained recurrent spontaneous abortion (URSA) patients, normal non-pregnant and pregnant women respectively. Methods The percentage of CD+4 CD+25 Tr cells in deciduas and peripheral blood from 25 URSA patients, 22 normal non-pregnant (NNP) women, and 34 normal early pregnant (NP) women were measured by double-staining followed by flow cytometric analysis. Results (1) The percentage of CD+4 CDbright25 T cells in peripheral blood in both URSA and NP [ ( 1.55±0.77 ) %, (2. 65±1.10)%, respectively] women were increased significantly than that in NNP women [ (0. 39± 0.14)% P<0.05]. The percentage of CD+4 CDbright25 T cells in peripheral blood in URSA women was significantly lower than that in NP women (P<0.05 ). (2) The percentage of CD+4 CDbright25 T cells in decidua in URSA women was significantly lower than that in NP women [ ( 0. 59±0. 23 ) %, ( 1.24 ± 0. 55)%, respectively, P <0. 01 ]. There was no significant difference in the percentage of CD+4 CDdim25 T cells in decidua between URSA women and NP women [ (4. 23±1.52)%, (3.75±1.88)%, respectively, P>0.05]. (3) The proportion of CD+4 CDbright25/CD+4 cells in deeiduas was significantly higher than that in peripheral blood in NP women [(13. 10±10. 25 ) %, ( 5.59±2.62 ) %, respectively, P < 0. 05 ] . However, a significant difference in the proportion of CD+4 CDbright25/CD+4 between decidua and peripheral blood was not found in URSA patients [ (5. 16±2. 83 ) %, ( 4. 64±2. 07 ) %, respectively, P>0.05)].Conclusions The number of CD+4 CD+25 Tr cells is increased in normal pregnancy and decreased in URSA. Therefore, CD+4 CD+25 Tr cells may play an important role in maintaining maternal-fetal tolerance and may be involved in the pathogenesis of URSA.

Objective To evaluate the efficacy of biliary tract prosthesis and pancreatic duct stents for advanced periampullary carcinoma. Methods A total of 36 patients were diagnosed as advanced periampullary carcinoma pathologically or clinically, with strictures both in pancreatic and biliary ducts confirmed by imaging. Teflon stents were firstly implanted through endoscopy to the narrowed pancreatic ducts, expansible metal prosthesis were then implanted to the biliary tract. If failed, the metal stents were given through percutaneous transhepatic biliary drainage (PTCD) pathway. Serum levels of liver enzymes, amylase and clinical manifestations were observed before and after operation. Results Teflon stents were successfully implanted into pancreatic ducts in all patients. Metal prostheses into bile ducts were endoscopically implanted in 29 cases, and via PTCD in 7, including 2 cases of Billroth Ⅱ gastrectomy. The levels of liver enzymes significantly decreased (P<0.01) after stents implacement. The levels of amylase (plasma and urine) and lipase increased in 15 cases, but they were corrected to normal levels after adequate treatments. Rates of abdominal pain relieving and diahhrea improvement were 82.4% (28/34) and 88.2% (15/17), respectively. Conclusion The combined implacement of biliary tract prosthesis and pancreatic duct stents is safe and effective in relieving malignant obstruction in periampullary carcinoma.

【Objective】 To investigate the clinical application of self-developed magnetic anchoring device for assisting thoracoscopic pulmonary resection. 【Methods】 Eleven patients underwent thoracoscopic pulmonary assisted with resection magnetic anchoring technique at the Department of Thoracic Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, from March to May 2019. Their clinical data were retrospectively analyzed. The operation time, blood loss, blood transfusion volume, postoperative hospital stay, and postoperative complications were recorded. 【Results】 There were seven male and four female patients, with the average age of (51.6±13.9) years (range from 22 to 69 years). Three single-port and eight single-utility-port thoracoscopic surgeries were performed. Magnetic instruments provided good surgical field exposure in all operations. Among 11 surgeries, one was converted to thoracotomy and one to three-hole surgery due to enlargement and adhesion of hilar lymph nodes. The operation time was (107.8±63.1) minutes (range of 27-182 minutes). The blood loss was 50 (10-50)mL (range of 5-1 000 mL). No blood transfusion was needed during the operation. The postoperative hospital stay was (5.0±1.8) days (range of 3-9 days). No postoperative complications occurred in all the patients. 【Conclusion】 Magnetic anchor technique can effectively alleviate the "chopstick effect" in thoracoscopic surgery. Magnetic anchor technique is safe and feasible in assisting thoracoscopic pulmonary resection.

Objective    To investigate the feasibility of using magnetic beads to locate small pulmonary nodules. Methods    Twelve rabbits were randomly divided into two groups, 6 in each group. One group underwent thoracotomy after anesthesia and the other group underwent percutaneous puncture under the guidance of X-ray. One and two cylindrical tracer magnets (magnetic beads) with a diameter of 1 mm and a height of 3 mm were injected adjacent to the imaginary pulmonary nodules in left lung in each group. The magnetic beads beside the imaginary nodules were attracted by a pursuit magnet with a diameter of 9 mm and a height of 19 mm. The effectiveness of localization by magnetic beads were determined by attraction between tracer and pursuit magnets. Results    All processes were uneven in 12 rabbits. There was micro hemorrhage and no hematoma in the lung tissue at the injection site of the magnetic beads. When tracked with the pursuit magnets, there was one bead divorce in cases that one bead was injected, but no migration or divorce of the magnetic beads in cases that two magnetic beads were simultaneously injected to localize the small pulmonary nodules. Conclusion    The feasibility of using magnetic beads to locate small pulmonary nodules has been  preliminarily verified.