AIM: To explore the immunologic effect of extra bacillus calmette guerin (EBCG) on asthmatic patients. METHODS: 58 asthmatic patients in acute exacerbation were randomly enrolled into two groups: EBCG group (n=34) and control group (n=24). Before treatment, the levels of interleukin 4 (IL 4) and interleukin 12 (IL 12) in blood plasma were examined in both groups. The patients in EBCG group inhaled budesonide aerosol according to asthmatic ladder treatment program and injected with EBCG. Spasmolytic could be used if necessary (excluding theophylline) .The patients in control group only used budesonide aerosol and spasmolytic. The level of IL 4 and IL 12 in blood plasma were determined again after three months. RESULTS: After the drug intervention, the level of IL 4 significantly decreased in EBCG group ( 29.0 ? 5.6 vs 22.6 ? 6.5 ng?L -1 ,P 0.05 ). Before drug intervention, no significant differences were found between two groups in IL 4 and IL 12 concentrations; However, there were markedly differences after drug intervention (P

ObjectiveTo observe the short-term and long-term efficacies of acupuncture at phenomaxillary ganglia in treating allergic rhinitis.MethodThe recruited subjects were intervened by acupuncture at phenomaxillary ganglia, once a week and 6 times asa treatment course. Visual Analogue Scale (VAS) was adopted to evaluate the general condition and nasal symptoms, and the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) was used to estimate the quality of life (QOL). The evaluations were performed before and after intervention, as well as 2 years after the intervention.ResultThe subjects all had significant improvements in the clinical symptoms after 6 sessions, and the VAS scores of the general conditional nasal symptoms and RQLQ score were significantly decreased (P<0.01); in the follow-up study conducted 2 years later, except for the scores of the non-nasal/eye symptoms, all symptoms scores were significantly lower compared to that before intervention (P<0.05,P<0.01), and the results were insignificantly different from that after intervention (P>0.05).ConclusionAcupuncture at phenomaxillary ganglia is effective in treating allergic rhinitis, and the efficacy lasts stably within 2 years.

Objective To analyse the therapeutic effect of methylprednisolone combined with anterior decompression and internal fixation in the treatment of cervical spine hyperextension injury. Methods 42 patients who were diagnosed with cervical hyperextension injury in orthopaedics department of the First Hospital of Jiaxing were collected.All patients were randomly divided into experimental group and control group, 21 cases in each group.Patients in control group received anterior cervical decompression and internal fixation only , patients in experimental group received methylprednisolone combined with anterior decompression and internal fixation, after treatment, the serum levels of TNF-α, SOD and American Spinal Injury Association (ASIA) score were detected in all patients.Results After treatment, compared with control group, the serum levels of TNF-αwas lower, SOD was higher and ASIA score was higher in experimental group, and the differences were statistically significant (P<0.05).Conclusion The methylprednisolone combined with anterior decompression and internal fixation could significantly reduce the serum level of TNF-α, and increase the serum level of SOD and ASIA score in patients with cervical spine hyperextension injury, could reduce the inflammatory damage, improve the antioxidant capacity, which has a good clinical effect.

BACKGROUND: Anterior decompression and internal fixation for treatment of cervical spondylotic myelopathy has been widely accepted. However, there are few clinical case reports regarding this.OBJECTIVE: To investigate the curative efficacy of anterior cervical decompression combined with bone grafting and titanium plate internal fixation in treatment of cervical spondylotic myelopathy.METHODS: A total of 118 patients with cervical spondylotic myelopathy who underwent anterior cervical subtotal vertebrectomy,iliac bone grafting (or bone grafting with titanium cage) and anterior locking titanium plate internal fixation at the Department of Orthopedics, Huang Gang Central Hospital of Hubei Province between January 2001 and August 2007 were retrospectively analyzed. According to the X-ray photographs taken before, immediately after surgery and during postoperative follow-up periods,Cobb's angle, anterior vertebral height and posterior vertebral height of fused segments. Bone graft fusion was evaluated.Neurological function was assessed according to Japanese Orthopaedic Association (JOA) scores.RESULTS: During the follow-up period (6-32 months, mean 19 months), three patients presented with slight titanium mesh sinking, and no fragmentation or loosening during internal fixation was observed in all patients, with a final bone fusion rate of 100％. JOA scores obtained immediately after surgery and during last follow-up were significantly greater compared with those obtained prior to surgery (P ＜ 0.05). The excellent and good rate of neurological function recovery during the last follow-up was 86.2％. After surgery, sagittal Cobb's angle, anterior and posterior vertebral heights of fused segments were significantly improved(P ＜ 0.05). These findings indicate that anterior cervical subtotal decompression combined with bone grafting and titanium plateinternal fixation for treatment of cervical spondylotic myelopathy can thoroughly decompress, effectively correct cervical vertebrae malformation, and achieve stable bone fusion and reconstruction, with satisfactory clinical efficacy.

Objective: Interleukin-10 (IL-10) is an anti-inflammatory helper T cell type 2 (Th2) cytokine that modulates Th1-type cytokine production. The purpose of present study was to detect the expression and changes of IL-10 in the rats heart transplantation, as determine the role of IL-10 in the acute rejection of rats heart transplantation. Methods: Hearts from DA rats were transplanted into the necks of Wistar recipients. Allografts was divided into five groups: group A (control, n=12), group B (DST treated, n=12), group C (IL-2 Mab treated, n=12), group D (IL-4 Mab treated, n=12), group E (IL-2 Mab treated, n=12). The local expression of IL-10 was analyzed at day 1,3,5,7,9,11,14 by reversed transcripition polymerase chain reaction (RT-PCR). Results: Allografts survival time was (8.3±1.7) days, (29.2±7.1) days, (26.4±5.7) days, (10.2±1.9) days and (55.0±10.6) days (P＜0.05， P＜0.01), respectively. When compared with group A, the level of IL-10 was upregulated in group B, group C and group E, especially in group E. The upregulation of IL-10 was related to the grafts survival time. Conclusion: IL-10 plays an important role in the development of acute transplantational rejection, suggests that Th-2 type deviation may contribute to the prolongation of graft survival.

Objective To investigate the relationship between angiotensin Ⅱ ( AngⅡ) and transformation of vascular fibroblasts phenotype .Methods Eighteen rats were randomly assigned into the untreated group , mini-pump infusion of saline group and mini-pump infusion of AngⅡgroup which was used as the hypertension model .Their systolic pressure and vascular morphology were examined .The expression of catalase ( CAT ) and 4HNE was examined by immunohistochemistry .Western blotting was used to examine the expression of CAT of adventitial fibroblasts which were cultured by different incubation times and concentrations of Ang Ⅱ.Results Compared with untreated and mini-pump infusion of saline groups , the systolic pressure and carotid media thickness stained by HE of mini-pump infusion of AngⅡgroup were significantly higher (P<0.01).The results of immunohistochemistry showed that the expression of CAT ofAngⅡgroup was significantly lower than that of untreated group , however the expression of 4HNE of AngⅡgroupwas higher than that of untreated group (P<0.05).Furthermore, the results of Western blotting indicated that the effect of Ang Ⅱ on down-regulation of CAT function was in a dose and incubation time dependent manner .Conclusion AngⅡdown-regulates adventitial CAT expression and promotes fibroblasts phenotypic transformation which leads to pathological arterial vascular remodeling .

BACKGROUND:Studies have shown that thymosinβ4 can improve the anti-apoptotic ability of a variety of cells, but the reports describing the changes in the anti-apoptotic ability of bone mesenchymal stem cells modified with thymosinβ4 gene in the hypoxic environment are rare.
OBJECTIVE:To observe the change in the apoptotic rate of bone mesenchymal stem cells modified with thymosinβ4 gene in the hypoxic environment, and to explore whether thymosinβ4 affects the apoptosis of bone marrow mesenchymal stem cells via regulating the expression of Bax and Bcl-2.
METHODS:Bone marrow mesenchymal stem cells were transfected with the recombinant lentiviral vector over-expressing the thymosinβ4 gene, and then we observed the expression of thymosinβ4 using western blot assay. cells were divided into three groups:thymosinβ4 transfection group, control virus group, and untreated group. Al three groups were placed in a hypoxic environment. The apoptotic rate of bone marrow mesenchymal stem cells was evaluated by the flow cytometry assay. The expression of Bax and Bcl-2 protein was detected by western blot.
RESULTS AND CONCLUSION:Thymosinβ4 gene was expressed successful y in the bone marrow mesenchymal stem cells showed by the western blot. The apoptotic rate of bone marrow mesenchymal stem cells in the hypoxic environment was lower in the thymosinβ4 transfection group than the control virus group and untreated group;while there was no difference between the latter two groups. Western blot results showed that the expression of Bcl-2 protein was higher in the thymosinβ4 transfection group than the control virus group and untreated group, and the expression of Bax protein was lower in the thymosinβ4 transfection group than the control virus group and untreated group. No difference in the expression of Bax and Bcl-2 was found between the control virus group and untreated group. These findings indicate that thymosinβ4 overexpression can improve the anti-apoptotic ability of bone mesenchymal stem cells modified in the hypoxic environment, and its possible mechanism is through regulating the expression of Bax and Bcl-2 protein.

Objective To explore the efficacy of neoadjuvant chemoradiotherapy (CRT) followed by surgery for locally advanced esophageal squamous cell carcinoma (ESCC),and to investigate the correlation between a clinical complete response (cCR) and a pathologic complete response (pCR).Methods One hundred and fifty-eight patients with locally advanced thoracic ESCC from 2001 to 2013 were retrospectively analyzed.All patients received concurrent chemoradiotherapy followed by surgery.Platinumbased chemotherapy regimens were adopted in chemotherapy and a prescribed dose of 40 Gy in 20 fractions,5 fractions per week,was used in radiotherapy.The overall survival (OS) and disease-free survival (DFS) rates were calculated using the Kaplan-Meier method,and pairwise comparisons and univariate prognostic analyses were performed using the log-rank test.Multivariable prognostic analyses were performed using the Cox regression model.Results The pCR rate was 41.1％ in all patients.After the treatment with neoadjuvant CRT,32(72.7％) out of 44 patients with a cCR had a pCR,but only 33(28.9％) out of 114 patients with a non-cCR had a pCR (P =0.000).The sensitivity,specificity,positive predictive value,and negative predictive value of a cCR in predicting a pCR were 49.2％,87.1％,72.7％,and 71.1％,respectively.The 3-year sample size was 91.The 3-year OS and DFS rates in all patients were 53.9％ and 48.6％,respectively.Patients with a cCR had significantly higher 3-year OS and DFS rates than those with a non-cCR (P =0.012;P =0.026),while patients with a pCR had significantly higher 3-year OS and DFS rates than those with a non-pCR (P =0.000;P =0.000).The multivariate analyses demonstrated that the pathologic response after CRT and chemotherapy regimen were the influencing factors for OS.The most common grade ≥3 acute adverse reaction was leucopenia (34.2％).Conclusions With a high pCR rate and tolerable adverse reactions,neoadjuvant CRT followed by surgery is a safe and effective option for locally advanced ESCC.The cCR rate after CRT is closely correlated with the pCR and OS rates.

Objective To study the indication of pelvic autonomic nerve preservation(PANP)for patients undergoing rectal carcinoma resection and evaluate the operative procedure and post-operative urine function.Methods Materials of 18 cases of middle and lower rectum carcinoma,receiving PANP radical resection from Jan. 2000 to Nov. 2002 were reviewed. The perioperative urodynamic index and postoperative long-term sexual function were analyzed.Result Pelvic autonomic nerve was preserved in all 18 patients and they have normal urine function and satisfactory long-term sexual function.Conclusion Male patients aged younger than 60 yrs., with rectal carcinoma of Ducks A to C are suitable for receiving PANP radical resection for better maintenance of the urinal and sexual function.

ObjectiveTo investigate the number of γδT cells in the peripheral blood from patients with systemic lupus erythematosus(SLE) and their correlation to disease activity.MethodsγδT cells were detected in the peripheral blood from 42 SLE patients and 20 normal controls by flow cytometry.Anniex-V/Pl double-staining flow cytometry was employed to observe the proportion of the apoptotic γδ and CD3+ T cells in 6 SLE patients with active disease and 6 normal controls,respectively.The levels of plasma anti-nuclear antibody and anti-dsDNA antibody were determined by using enzyme-linked immunosorbent assay.Data were analyzed with t test and Pearson's correlation test.ResultsThe percentages of γδT cells were remarkably down-regulated in SLE patients [(3.0±1.8)％ ] with active disease compared with that of those patients with inactive[(5.3±3.0)％] disease and normal controls [(6.8±2.8)％](t=-3.071 and -5.913 respectively,both P＜0.01 ).The absolute number of γδT cells decreased significantly in SLE patients with active disease[ ( 1.7± 1.6)× 107/L ] than those with inactive SLE [ (5.3±3.6)× 107/L ] (t=-3.292,P＜0.01 ),and both were lower than the normal controls [ (10.1±5.0)×l 07/L] (t=-7.247 and -2.905 respectively,both P＜0.01 ).There was a negative correlation between systemic lupus erythematosus disease activity index (SLEDAI) andT cell counts in 30 SLE patients with active disease (r=-0.365,P=0.047).γδT cell percentage (r=-0.336,P=0.030) and counts (r=-0.410,P=0.007) were both inversely correlated with the erythrocyte sedimentation rate,but positive correlation were found between hemoglobulln and γδT cell counts (r=0.409,P=0.007).The apoptosis ofγδT cells in SLE patients was more common than in normal controls(t=2.886,P＜0.05 ).The number of apoptotic γδT cells was higher than that of CD3+ T cells in SLE patients (t=2.952,P＜0.05 ).Conclusion γδT cells of the peripheral blood of SLE patients are down-regulated partially due to excessive apoptosis,which may correlate with the disease activity.