Immunosenescence is a process characterized by alterations and progressive deterioration of the structure and function of the immune system.Manifestations of immunosenescence include damage to both innate and adaptive immunity,reduction of immune responses to antigen stimulation,quantitative and functional changes of immune cells and alterations of cytokine activities,all of which may result in attenuated responses to vaccines,enhanced chronic inflammatory reactions,an elevated risk of infections and an increased susceptibility to cancer among old individuals.In recent years,it has been increasingly recognized that oxidative stress plays a vital role in immunosenescence.This review is focused on the influences of oxidative stress on the structure,function and generation of immunecells and the major mechanisms underlying immunosenescence.

Objective To investigate the distribution and drug resistance of bacteria in 1 -6 months infants with lower respiratory infection(LRI).Methods Induced sputum was extracted from 326 infants with LRI who were 1 -6 months.Antibiotic susceptibility tests were performed after bacteria had been identified.Results 61 cases were detected pathogenic bacteria and the detection rate of bacteria was 18.71%.5 cases were detected two kinds of bacte-ria.66 bacterial strains were isolated among which gram -positive bacteria(33 strains)accounted for 50.00% and gram -negative bacteria(33 strains)accounted for 50.00%.Staphylococcus aureus was the most common gram -pos-itive bacteria and Streptococcus pneumoniae was the second.13 strains were methicillin -resistant Staphylococcus au-reus(MRSA).Hemophilus influenzae was the most common gram -negative bacteria,followed by Klebsiella pneumo-nia and Escherichia coli among which ESBL positive Klebsiella pneumonia were 5 cases and ESBL positive Escherich-ia coli were 4 cases.The common gram -positive bacteria had higher rate of penicillin resistance.MRSA had higher rate of penicillin,oxacillin,erythomycin and clindamycin resistance.Resistant strains to vancomycin and rina thiazole amine were not found.The common gram -negative bacteria had higher rate of ampicillin,ampicillin/shu tan,cefazo-lin and ceftriaxone resistance and had lower rate of cefepime,ceftazidime,piperacillin/he azole temple and imipenem resistance.Conclusion The common pathogenic bacteria in 1 -6 months infants with lower respiratory infection were Staphylococcus aureus,Hemophilus influenzae,Streptococcus pneumoniae,Klebsiella pneumonia and Escherichia coli. We should pay attention to the common antibiotic resistance.MRSA and ESBL positive bacteria were the common mul-tiple drug resistant bacterias.Reasonable selection of antibiotics should be based on susceptibility results earlier.

Objective To understand the awareness of children snoring disease knowledge and demand of health education and appropriate health education methods from the parents whose children were in hospital by snoring, and provide basis for health education in clinic. Methods On the basis of literature search and expert consultation, 276 parents whose children in hospital by snoring were investigated by self-designed questionnaire. The questionnaire included the awareness of children snoring disease knowledge and demand of health education and appropriate health education methods were carried out. Results The awareness rate of children snoring disease knowledge was 2.54%-55.07% in parents whose children in hospital by snoring. The average demand rate of health education surpass 80%, major reason and symptom and main therapy and surgical outcomes of snoring were more concerned with 100.00%(276/276). The average demand rate of the impact on the intelligence was 96.38%(266/276). Acceptable methods of health education from high to low were as follows, consulting a doctor was 93.48%(258/276), posting publicity column in the halls or ward hallway was 74.28% (205/276), attending health education lecture was 66.30% (183/276), through QQ group or micro letter platform was 61.96%(171/276), through community healthy knowledge publicity column was 56.52%(156/276), through broadcast radio and television programs when see a doctor or in hospital was 53.62%(148/276), through telephone counseling was 36.96%(102/276), through hospital health prescription was 36.23% (100/276), through audiovisual teaching materials was 32.25% (89/276), communication between parents was 7.97%(22/276). Conclusions The awareness rate of children snoring disease knowledge from the parents whose children in hospital by snoring is low, the medical staff need take various ways of health education to improve snoring children′s parents′overall understanding level of children sleep apnea, effectively prevent various influencing factors of sleep apnea and snoring related complications, to reduce the dangers caused by snoring.

Objective To investigate the relative percentage of normal cognitive function (NCF),age associated memory impairment (AAMI),mild cognitive impairment (MCI) and Alzheimer's disease (AD) in the elderly,and the correlation between cognitive function and ApoE genotypes.Methods A total of 2666 elderly people aged ≥65 years (2132 males and 534 females)were divided into 3 groups according age:65-74-year age group (925 cases),75-84 year age group (1054 cases) and 85-100-year age group (687 cases).ApoE genotypes were determined in the controls and patients with AAMI and MCI.The degrees of fundus arteriosclerosis were detected in all subjects except for patients with AD.Results There were 867 cases with NCF,860 cases with AAMI and 782 cases with MCI.The incidence of AAMI was higher in 65-74-year age group than in the other two groups (42.0％ vs.31.1,20.96).The incidences of MCI and AD were higher in 85-100-year age group than in the other groups (42.5％,13.3％).The major degrees of fundus arteriosclerosis were Ⅰ+,Ⅰ-Ⅱ°,Ⅱ in subjects with AAMI (34.7％,x2=10.02,P＜0.01) and were Ⅱ °/ Ⅱ + / Ⅲ° in subjects with MCI (34.9 ％,x2 =23.39,P＜0.001).The APOEε4 allele frequency was significantly higher in patients with MCI than in the controls (x2=8.31,P＜0.05).However,no significant differences in APOEε4 allele frequency were found between patients with AAMI and the controls.Conclusions The incidence of AAMI is highest in 65-74-year age group,while the incidences of MCI and AD are highest in 85-100-year age group.Compared to patients with AAMI,the more serious fundus arteriosclerosis and higher allele frequency of APOEε4 appear in patients with MCI.

0.05). Conclusions In comparison with mammography,PET/CT has a higher degree of sensitivity and specificily in detecting breast cancer,and higher positive predictive value.PET/CT can provide more aspects of in vivo diagnostic information which may be useful in selecting therapeutic strategy and may supplement the inadequacies of mammography.

Objective To evaluate the use of PET/CT in the diagnosis of breast cancer. Methods In this study,33 patients with suspicious breast tumor underwent PET/CT imaging. The images of the breast were analyzed for qualitative assessment of increased tracer uptake and blood perfusion with PET/CT. Results Among 27 cases with pathology proved breast cancer,25 was judged as PET/CT positive,2 was false-negative. Sensitivity, specificity and accuracy of PET/CT in identifying breast cancer were 92.6%,100%,93.9%. Conclusion PET/CT is a reliable and sensitive measure in the diagnosis of breast cancer in vivo.

Objective To explore the pregnancy outcome and obstetric management of pregnancy and delivery after vaginal radical trachelectomy (VRT).Methods Forty-two cases of VRT from December 2003 to May 2012 in Peking Union Medical College Hospital were analyzed retrospectively.Among them ten cases got pregnant successfully.Results The average age of patient at VRT surgery was (30.6 ± 3.7) years old and average follow-up time was 29.5 months.There were 31 patients attempted conception.Ten of them got fourteen conceptions successfully.Overall conception rate was 45％ (14/31).There were four cases of first trimester abortion.Among them,two were miscarriage,two were elective abortion.There was one case of ectopic pregnancy operation and non of second trimester loss.Nine cases reached the third trimester.The total preterm delivery rate was 4/9.There were two cases delivered before 32 gestational weeks (2/9).Cesarean section was performed through a transverse incision in all of nine cases.No uterine rupture and postpartum hemorrhage occurred.All newborns had good outcomes.The average follow-up time after postpartum was 22.9 months.All cases were disease-free.Conclusions The conception rate of patients after VRT in our series is 45％.The preterm birth rate of pregnancy after VRT is higher.Routine cerclage of cervix during VRT procedure and pregnancy is not necessary.Cesarean section shortly after full term pregnancy through a transverse incision should be considered as a suitable and safe procedure.

Objective:To investigate the effect of optimized construction of green channel under plan-do-check-action (PDCA) on shortening the door-to-needle time (DNT) and improving early neurological improvement in patients with acute ischemic stroke (AIS) treated with intravenous thrombolysis.Methods:The clinical data of 120 patients with AIS treated with intravenous thrombolysis from June 2018 to September 2019 in Liangxiang Teaching Hospital of Capital Medical University were retrospectively analyzed. Among them, 60 patients were admitted to hospital before optimized as non-optimized group, and 60 patients were admitted to hospital after optimized as optimized group. The time from visit to CT examination completion, time from CT examination completion to informed consent, time from informed consent to intravenous thrombolysis, DNT, DNT ≤ 60 min ratio, National Institutes of Health stroke scale (NIHSS) score 2 h after intravenous thrombolysis and at discharge from hospital, early neurological improvement (ENI) rate, hospital stays, adverse outcomes and mortality were compared between 2 groups.Results:The time from CT examination completion to informed consent and DNT in optimized group were significantly shorter than those in non-optimized group: 29 (14, 36) min vs. 37 (21, 54) min, 55 (45, 67) min vs. 76 (54, 93) min, the DNT ≤ 60 min ratio was significantly higher than that in non-optimized group: 68.3% (41/60) vs. 35.0% (21/60), the ENI rate was significantly lower than that in non-optimized group: 28.3% (17/60) vs. 46.7% (28/60), and there were statistical differences ( P<0.05 or<0.01). There were no statistical differences in the time from visit to CT examination completion, time from informed consent to intravenous thrombolysis, NIHSS score 2 h after intravenous thrombolysis, hospital stays, NIHSS score at discharge from hospital, adverse outcomes rate and mortality between 2 groups ( P>0.05). Conclusions:The optimized construction of green channel under PDCA can effectively shorten the DNT of intravenous thrombolysis in patients with AIS, and may be significantly important for improving the long-term prognosis of patients.

Purpose: We aimed to explore whether the prognosis of patients treated with capecitabine and oxaliplatin (XELOX) or S-1 and oxaliplatin (SOX) regimens who received fewer cycles of chemotherapy after D2 radical resection for gastric cancer (GC) would be non-inferior to that of patients who received the standard number of cycles of chemotherapy. Materials and Methods: Data on patients who received XELOX or SOX chemotherapy after undergoing D2 radical resection at Harbin Medical University Cancer Hospital between January 2011 and May 2016 were collected. Results: In patients who received 4, 6, and 8 cycles of chemotherapy, the 5-year overall survival (OS) rates were 59.4%, 64.8%, and 62.7%, respectively. Compared to patients who received 4 cycles of chemotherapy, those who received 6 cycles (hazard ratio [HR], 0.882; 95% confidence interval [CI], 0.599–1.299; P=0.52) or 8 cycles (HR, 0.882; 95% CI, 0.533–1.458; P=0.62) of chemotherapy did not exhibit significantly prolonged OS. The 3-year disease-free survival (DFS) rate of patients who received 4, 6, and 8 cycles of chemotherapy was 62.1%, 67.2%, and 60.8%, respectively. Compared to patients who received 4 cycles of chemotherapy, those who received 6 cycles (HR, 0.835; 95% CI, 0.572–1.221; P=0.35) or 8 cycles (HR, 0.972; 95% CI, 0.606–1.558; P=0.91) of chemotherapy did not show significantly prolonged DFS. However, the 3-year DFS and 5-year OS rates of patients who received 6 cycles of chemotherapy appeared to be superior to those of patients who received 4 and 8 cycles of chemotherapy. Conclusions For patients with stage III GC, 4 to 6 cycles of XELOX or SOX chemotherapy may be a favorable option. This study provides a rationale for further randomized clinical trials.

Objective To study the effect of vagus nerve stimulation (VNS) on the expression of multidrug resistance-associated protein (MRP1) in brains of rats with drug refractory epilepsy.Methods Rat models based on the lithium-pilocarpine epileptic rats were induced with sodium phenobarbital (PB).Then,the rats were randomly divided into three groups:VNS group (n=7),sham-VNS group (n=6) and control group (n=6); VNS through stimulation device was given to the rats in the VNS group,stimulation device without VNS was given to the rats in the sham-VNS group,and rats in the control group were only given conventional feeding.Behavioral changes and number of seizures were recorded by continuous video monitoring during the whole process.And the amount of MRP1 over-expression in each group was detected following a four-week VNS.Results (1) The seizure frequency in VNS group (2.6±1.0 per week) was significantly decreased as compared with that in sham-VNS group (5.3±1.1 per week) or control group (5.2±1.3 per week) after a four-week VNS (P＜0.05).(2) The MRP1 expression in VNS group had significantly statistical differences as compared with that in the sham-VNS group and control group (the absorbance values:9120±1496,19556±1462 and 20231±1710,P＜0.05).Conclusion VNS can effectively decrease the seizures frequency through reducing the MRP1 over-expression.