Background Researches showed that CD4+CD25+ natural regulatory T cells (nTregs) play an important role in maintaining peripheral immune tolerance, while immunotherapy using in vitro-expanded induced regulatory T cells (iTregs) suppresses allograft rejection in multiple organ transplantation.The inducing method of iTregs still needs to be optimized.Furthermore,the effect of iTregs on grafts of keratoplasty is unclear.Objective This study was to investigate the inducing and expansion method of iTregs and explore its inhibitory effects on corneal allograft rejection.Methods Bone marrow-derived dendritic cells (BMDCs) were isolated from C57BL/6 mice femora and cultured.CD4+ CD25+ T cells and CD4+ CD25-T cells were isolated from mouse spleen and separated using flow cytometry.The CD4+CD25-T cells were divided into negative control group (CD4+CD25-T cells), CD3/ 28 antibody bead group (CD4+CD25-T cells+CD3/28 antibody bead) ,2.5 ng/ml transforming growth factor (TGF)-β1 induced group and 10.0 ng/ml TGF-β1 induced group.The iTregs was formed after induction of different concentrations of TGF-β1 and CD3/CD28 antibody bead (1 : 1).CD3/CD28 antibody bead (1 : 2) , interleukin-2 (IL-2) and TGF-β1 were used to expand iTregs.The phenotype and proliferation of iTregs were assayed by flow cytometry,and the inhibitory effect of iTregs on effector T cells (Teffs) was analyzed by mixed lymphocyte reaction.Allogenic keratoplasty model (C57BL/6→BALB/c) was build,and 0.1 ml iTregs or nTregs suspension or PBS was injected via posterior venous plexus of fellow eyes to assess the graft survival time.The use and care of the mice followed the ARVO statement.Results The CD4+CD25+ T cell proportions were (6±3)％ ,(91±4)％ ,(91±3)％ and (86± 6) ％ in the negative control group,CD3/CD28 antibody bead group, 2.5 ng/ml TGF-β1 induced group and 10.0 ng/ml TGF-β1induced group, showing significant increases in the CD3/CD28 antibody bead group, 2.5 ng/ml TGF-β1 induced group and 10.0 ng/ml TGF-β1 induced group compared with the negative control group (all at P＜0.01).The Foxp3+ T cell proportions of the CD3/CD28 antibody bead group,2.5 ng/ml TGF-β1 induced group and 10.0 ng/ml TGF-β1 induced group were (1.18 ±0.20) ％ , (8.70± 1.80) ％ and (21.80±3.36) ％ , showing significant increases in the 2.5 ng/ml TGF-β1 induced group and 10.0 ng/ml TGF-β1 induced group compared with the CD3/CD28 antibody bead group (both at P＜0.01).Compared with the nTregs, the expression of CD69 was lower, and the expressions of PD-1 and Foxp3 were raised in the iTregs (all at P＜0.01).The proliferation of Teffs were decreased when cocultured with iTregs in comparison with nTregs at 1 : 1,1 : 2,1 : 4,1 : 8,1 : 16 Tregs/Teffs rations (all at P＜ 0.01).The survival time of mouse corneal grafts was 4 weeks with the permanent tolerance of 50％ in the iTregs injected group,which was superior to the 3 weeks survival time and 17％ permanent tolerance in the nTregs injected group(P＜0.05).Conclusions TGF-β1 can induce CD4+ CD25-T cells to form iTregs, which highly express Foxp3.iTregs show a stronger inhibitory effect on the growth of lymphocytes than nTregs, and therefore suppress the graft rejection after keratoplasty.

This paper presents successful surgical treatment of a-trial fibrillation by a simplified maze procedure (SMP) in 3 patients. All of them suffered from rheumatic heart valvular diseases complicated with atrial fibrillation (AF) for 3 to 10 years. Their heart function were in class III-IV(NYHA). The diameter of the left atrium varied from 52-58 mm and the cardiothoracic ratio 0. 64-0.70. The open heart operation was performed under conventional cardiopulmonary bypass combined with systemic hypothermia and using cardio-plegia for myocardial protection. After finishing the modified maze operation,mitral valve replacement was performed in 2 cases and mitral and aortic valve replacement together with tricuspid annuloplasty in one. Sinus rhythm recovered after cardiac ressuscitation and was maintained in the early postoperative period in all 3 cases. However, with in 3 months after the operation, one patient died of cerebrovascular accident, probably a complication of anticoagulant therapy. The other 2 patients remained well with normal sinus rhythm and their heart function was in class I 3 years after the operation. The clinical results indicate that mitral valve or mitral and aortic valve replacements plus simplified maze procedure to abolish atrial fibrillation may improve the postoperative hemodynamics by recovery of the sinus rhythm.

Objective To investigate the distribution features of upper limb involved nerves in patients with diabetic peripheral neuropathy (DPN).Methods The sensory nerve conduction velocity (SCV)and amplitude(SNAP),motor nerve conduction velocity(MCV)and amplitude(CAMP)of median,ulnar and radial nerves were examined in 98 DPN patients (DPN group) and 32 normal controls(NC group).The distributive ferture of involved upper limb nerves in DNP patients were analysed.Results (1) Comparing to NC group,the SCV and MCV of median,ulnar and radial nerves in DPN group were significantly slower (P

Objective To compare the neonatal outcomes of different gestational age at which elective cesarean sections at term were performed. Methods All the cases of cesarean section registered in Peking Union Medical College Hospital from September 2002 to November 2009 were collected. Women with viable singleton pregnancies delivered before the onset of labor and without recognized indications for cesarean section after 37 weeks at term were included and their general information and outcomes were compared with one-way ANOVA. All the maternal data and neonatal adverse events were compared with Cochran-Armitage test among different gestational weeks, including respiratory complications (respiratory distress syndrome or transient tachypnea of the newborn), infections, admission to the neonatal intensive care unit (NICU), and hospitalization in NICU＞5 d. Results Of 8122 primary cesarean sections and 594 repeat cesarean sections at term, 4565 and 409 cases were performed electively as the primary or repeat cesarean section. Among the 4565 women underwent primary elective cesarean sections, 2194 (48.1%) were before 39 gestational weeks,and 1828 (40.0%) at 39-39+6 weeks. While, among the 409 repeat elective cesareans sections, these figures were 275 (67.2%) and 120 (29.3%), respectively. No fetal or neonatal death occurred during perinatal period. Compared with births at 39-39+6 weeks, births at 37-37+6 weeks or 38-38+6 weeks were associated with increased risk of the neonatal adverse events. For the primary cesarean section cases, the odds ratio (OR) for births at 37-37+6 weeks and 38-38+6 weeks was 1.4 (95% CI: 0.9-2.0) and 1.1 (95% CI: 0.9-1.4), respectively. For the repeat cesarean section cases, OR for births at 37-37+6 weeks and 38-38+6 weeks was 2.5 (95% CI: 1.1-5.8) and 1.3 (95% CI: 0.6-2.7) respectively. Conclusions Elective cesarean section before 39 weeks of gestation is popular and associated with adverse neonatal outcomes. Elective cesarean section performed after 39-39+6 gestational weeks might decrease the risk of adverse neonatal outcomes.

This paper introduces the history of Ilizarov technology,led to the design and application of Bone Lengthening Growth Diary,and describes the specific application effect.On this basis,to think about Bone Lengthe-ning Growth Diary’ clincial application:constantly improve the nurses’ professional level; follow the basic princi-ples of medical ethics;strengthen the doctor-patient communication and humanstic care.

05). Conclusion The maternal serum level of ADAM 12 in the first-trimester is a potential marker for aneupolyhaploid screening and early fetal loss prediction, and is suggested to be tested at 9-12 gestational weeks as part of prenatal screening.

Objective To explore the role of chemokines and ehemokine receptors in the etiopathog-enesis of diffuse proliferative lupus nephritis (LN). Methods ① Total RNA from the kidney tissues and peripheral blood cells of 12 patients with diffuse proliferative LN and 10 normal controls were prepared simultaneously and reverse transcribed into complementary DNA. Sybr green dye based real-time quantitative PCR method was used to compare the expression levels (indicated as-AACt value) of MCP-1, CCL19,CXCLg, CXCL10 and CCR2, CCR7, CXCR3. ② Immunofluoresceee labeling and immunohistochemical staining technique were used to observe the distribution of chemokines MCP-1, CCL19, CXCL9 and CXCL10 in normal and patients kidney tissues. Results The 4 chemokines genes (MCP-1, CCL19, CXCL9 and CXCL10) were consistently highly expressed in kidney tissues and peripheral blood ceils of diffuse proliferative LN patients compared with normal controls. The 2 chemokine receptors, CCR2 and CXCR3 were also overexpressed in peripheral blood cells of diffuse proliferative LN patients. There was nearly no expression of these 4 chemokine proteins in normal kidneys. But they were found in glomeruli of diffuse proliferative LN patients. Conclusion The expression of chemokines in the peripheral blood cells may be used as biomarkers for LN. Further study maybe lead to the development of specific drugs targeting at them for the treatment of systemic lupus erythematosus (SLE).

Objective To compare and analyze clinical effects of Bipolar transurethral plasma kinetic enucleation of prostate (PKEP) and transurethral resection of the prostate(TURP) on the treatment huge benign prostatic hyperplasia.Methods Nine-six cases of huge benign prostatic hyperplasia were selected in this hospital from March 2012 to March 2015.All the patients were divided into two groups according to different operation method,namely PKEP group and TURP group.Then the operative time,bleeding amount,bladder washing time,hospital stay,complications between two groups were compared,and the international prostate symptom score (IPSS),quality of life score (QOL),maximal urinary flow rate (Qmax),residual urine volume 6 months before and after operation were compared between the two groups.Results The operative time [(100.0 ± 3.5)min],bleeding amount [(161.0 ± 9.2) mL],bladder washing time[(15.2 ± 1.2) h],hospital stay[(10.8 ± 2.6) d],complications (6 cases) in PKEP group were less than that in the TURP group,which were(132.0±4.2)min,(198.0±12.1)mL,(36.8±1.3)h,(13.6±2.9)d,complications (18 cases)respectively(P＜0.05).The IPSS,QOL,Qmax,residual urine volume in both group were significantly improved compared with surgery before(P＜0.05),and there were no significant differences between the two groups(P＞0.05).Conclusion PKEP and TURP both are effective surgeries for the treatment of huge BPH,while PKEP has short operation time,less intraoperarive bleeding and low incidence of complications,it is worthy of further clinical promotion.

Objective To research the clinical effect of transurethral plasmakinetic enucleation of prostate (PKEP) in the treatment of high-risk huge benign prostate hyperplasia(BPH).Methods Fifty-two cases of high-risk huge(＞120 g) BPH in this hospita1 from May 2010 to May 2015 were selected and performed PKEP.International prostate symptoms score(IPSS),quality of life(QOL) score,residual urine(RUV) and biggest urine flow rate(Qmax) were observed after operation.Results The mean operation time was (130.12 ± 12.14) min,the mean intraroperation bleeding amount was (120.24±9.81) mL,the mean hospital stay was (14.52 ± 1.82)d,the mean weight of resected prostate tissues was (113.42 ± 12.53)g.Follow-up lasted for 6 months without serious complications.IPSS、QOL,RUV and Qmax after operation were improved obviously,the difference was statistically significant compared with before operation(P＜0.05).Conclusion PKEP is safe and effective in the treatment of high-risk huge BPH.

Objective To explore the application and effects of bone lengthening growth diary in self management of patients after lower limb lengthening. Methods A total of 54 cases applying lower limb lengthening were divided into the experimental group (n=28) and the control group (n=26) with random digit table. The basic treatment was consistent, the control group was given routine guidance, the experi-mental group implemented self- management with bone lengthening growth diary. Self- recognition of disease was assessed and compared between the two groups 12 weeks after operation. Self- efficacy and self- manage ment were assessed and compared between the two groups 2 and 12 weeks after operation. Results The self- recognition of disease in the observation group was better than that of the control group, for patients with higher self- recognition degree (21 cases vs. 10 cases), χ2=8.64, P<0.05, the difference was significantly different. The total scores of self- efficacy and self- management in the observation group were higher than those of the control group,(48. 42±3.43) vs.(34.14±4.13),t=11.750, P<0.01;(55.35±2.69) vs.(42.15±3.67), t=15.130, P<0.01, the difference was significantly different. Conclusions Bone lengthening growth diary plays a beneficial role on self-management of patients with lower limb lengthening.