Objective To investigate the changes of follicular regulatory T cells ( Tfr cells) and follicular T helper cells ( Tfh cells) in peripheral blood of children with myasthenia gravis ( MG) . Methods We recruited 28 MG patients and 20 healthy subjects in this study. The percentages of Tfh and Tfr cells in peripheral blood samples were measured by flow cytometry. Real-time PCR was performed to detect the ex-pression of transcription factors and regulatory factors of Bcl-6, c-MAF, Blimp-1 and PD-1 at mRNA level. ELISA was used to detect the levels of IL-2, IL-6, IL-10 and IL-21 in plasma samples and the titers of Ach-Rab and PsMab. Results Compared with the healthy subjects, the MG patients showed higher percentages of Tfh cells and lower percentages of Tfr cells before receiving treatment. The expression of Bcl-6 and c-MAF on CD4+T lymphocytes cells at transcriptional level were significantly enhanced, while the expression of Blimp-1 on CD4+T cells and the expression of PD-1 on Treg cells at transcriptional level were inhibited in the MG patients in comparison with those in healthy subjects. Moreover, decreased levels of IL-2 and increased levels of IL-21 were found in plasma samples collected from the MG patients. Conclusion The decreased percentages of Tfr cells and increased percentages of Tfh cells in patients with MG resulted in abnormal ratios of Tfr/Tfh cells, which might be involved in the immunological pathogenesis of MG. Several changes in the patients with MG might be responsible for the imbalanced ratio of Tfr/Tfh cells, which included changes of IL-2 and IL-21 in microenvironment, enhanced expression of Bcl-6 and c-MAF at mRNA level and inhibited expression of Blimp-1 at mRNA level on CD4+T cells as well as over-expression of PD-1 at mRNA level on Treg cells.

Objective To evaluate the clinical value of computer-aided detection (CAD) system in the diagnosis of breast cancer on mammograms. Methods The mammograms of 136 pathology-proved breast cancer cases were analyzed by CAD system. The results of CAD were compared with that made by radiologists. Results The sensitivity, specificity, and accuracy of CAD system to microcalcification lesions were 93.2% (41/44), 22.8%(21/92), and 45.6%(62/136), respectively. The sensitivity, specificity, and accuracy of CAD system to mass lesions were 82.9%(107/129), 71.4%(5/7), and 82.4%(112/136), respectively. There was middle level agreement between the detection of CAD system and that of the radiologists (Kappa_(mass)=0.424, P_(mass)=0.000; Kappa_(cal)=0.365, P_(cal)=0.013). Conclusion CAD system has the characteristics of high sensitivity and low specificity. It could be the aid of radiologists in breast cancer detection on mammograms.

Objective:To explore the immunosuppression effects and tocolysis of fructus polygoni orientalis on abortion mice induced by LPS.Methods:Mice of Kunming (55 mice) were divided into control group (group A ,10 mice) and experimental group. Experimental group were divided into group B ( intraperitoneal injection LPS ) , group C ( ingestion fructus polygoni orientalis ) , and group D (ingestion fructus polygoni orientalis and intraperitoneal injection LPS ),each group of 15 mice.Then the pregnancy results were observed ,the positive of α-NAE+and the varity of CD 14+and CD204+macrophages ,TNF-αin the uteri were identified by enzyme-histochemistry ,immunohistochemistry and ELISA.Results:The abortion rate and the embryo resorbing rate were all 100%( P<0.01 ) in group B.But there was the decreased abortion rate of 13.33% in group D .The embryo resorbing rate decreased to 10.39%.The number and positive cell area of α-NAE+and CD14+macrophages in the uteri of gestation mice of group B was greatly increased comparing with group A ( P<0.01 ) .These effects outside of myometrium of group D were remarkably increased comparing with group A (P<0.01),but there was no distinct difference in the inside of myometrium and function layer.The number and positive cell area of CD204+macrophages in group C and D was greatly increased comparing with group A and B ( P<0.01 ) .The TNF-αcontents in the uteri of mice in group B were greatly increased comparing with group A (P<0.01),but the positive cell area of CD14,CD204 were close to normal levels in group D.Conclusion:The effect of miscarriage induced by LPS is antagonized by fructus polygoni orientalis through inhibiting the phenotype ,activity and function characteristics of macrophages in the uteri of gravidity mice.

Objective To investigate the influence of IVIG on immunologic function and cytokines levels in children with EV71 infection associated high-risk pulmonary hemorrhage. Methods According to the inclu-sion criteria , 64 children were enrolled and randomly divided into two groups: 39 cases in the IVIG treatment group and 25 cases in the general treatment group. The alternations of blood and immune cytokine markers before and after treatment were detected in the patients. Results (1) Before treatment, the peripheral blood T cells, TH and B cells in the IVIG group were higher than those in the general group , but the peripheral blood IgA was lower than that in the general group(P < 0.05); (2) In the IVIG group, the NK cells and IgG increased and T cells, TH cell and B cells significantly decreased after receiving IVIG therapy (P < 0.05); (3)No significant difference was observed in the levels of IL-6 and IL-10 in the two treatment groups before treatment. However , after IVIG treatment, IL-6 and IFN-γ levels reduced, IL-10 level increased (P < 0.05). After the general treat-ment, no significant difference was found in levels of IL-6,IL-10 and IFN-γ in peripheral blood (P > 0.05). Conclusion Disorders of cellular immunity and humoral immunity appeared in children with EV71 infection-re-lated high-risk pulmonary hemorrhage. It has clinical value to use IVIG timely to regulate the immune disorder.

Clinical competence was estimated for grades 2011-2013 general practitioners (GPs)trained by the DxR Clinician software.Clinical cases were solved on computer.And the abilities of diagnosis,thinking and handling were assessed.The average score of all GPs was 61.68 ± 10.69.The average score of diagnostic ability was the highest at 71.82 ± 15.47 (weighted score of 25.1).The average score of thinking ability was 62.36 ± 10.40 (weighted score of 28.1).And the average score of handling ability was the least at 42.27 ± 18.22 (weighted score of 8.5).Significant differences in average scores existed between grades 2011 and 2013 (P ＜ 0.05).Significant differences in score of clinical thinking ability existed between grades 2011,2012 and 2013 (P ＜ 0.01) respectively.None of them passed the part of handling.The longer period of training,the higher scores the residents obtained.Since the ability of clinical handling fared the worst,targeted training should be strengthened.

Objective The purpose of this study is to investigate the apoptosis mechanisms of glioblasto-ma cell line U87 induced by sodium cantharidinate ( SCA) in vitro.Methods Growth inhibition of U87 by 0.625μg/mL,1.25μg/mL,2.5μg/mL,5μg/mL SCA at 24 h,48 h,72 h were analyzed by MTT assay respec-tively.Morphological changes of U 87 nuclear were detected by fluorescence microscope .U87 cell apoptosis and cell cycle arrest were detected after SCA treatment for 24 h and 48 h by flow cytometry.The changes of apoptosis-related genes Bcl -2,Bax,Caspase-3 expression were analyzed after 24 h of SCA treatment by RT -PCR as-say.Results MTT assay showed that growth inhibition of U 87 cell induced by SCA was accompanied with the in-creased drug concentration ,Hoechst33258 staining showed the morphology of apoptotic U 87 cells nucleui ,chromo-some condensation ,nuclear condensation ,some nuclear fragmentation and formation of apoptotic bodies .Flow cy-tometry showed that SCA could induce cell cycle arrest at the G 2/M phase,and could induce apoptosis of U87.RT-PCR results showed that after 24 h of SCA treatment caspase -3,bax expression of U87 was significantly higher than the control group(P<0.05),bcl-2 expression was significantly decreased (P<0.05),and P53 expression was not significantly increased(P>0.05).Conclusion Our results demonstrate that SCA can inhibit U87 pro-liferation and induce apoptosis of U 87 .

Objective To analyse the effect of dual-antiplatelet drugs on S100β,IL-1β, adiponectin(ADPN)and NIHSS score in patients with acute cerebral infarction.Methods 58 patients diagnosed with acute cerebral infarction in first hospital of Qinhuangdao.All patients were collected and randomly divided into experimental group and control group according to random number table , 29 cases in each group.Both group were given the treatrnent of improvng the cerebral vascular circulation, protect brain cells, control blood pressure, blood glucose, oxygen when necessary.On the basis of conventional treatment, control group was treated with aspirin 200 mg, one time per day,orally.And experimental group was treated with clopidogrel 75 mg/d on the basis of control group,one time per day,orally.After treatment, the serum levels of S100β, IL-1β, ADPN and NIHSS score were detected in all patients.ResuIts After treatment, compared with control group,the serum S100βprotein level was significantly lower in the experimental group (P<0.05); the serum IL-1βlevel in experimental group was significantly lower (P<0.05);ADPN level in experimental group was significantly higher (P<0.05); NIHSS score of patients in experimental group was significantly lower (P<0.05).ConcIusions Dual antiplatelet drugs can reduce serum S100βprotein,IL-1βin serum of patients with acute cerebral infarction, increase the level of serum adiponectin, decrease NIHSS score, can effectively improre neurological function in patients with acute cerebral infarction.

Objective To analyse the effect of dual antiplatelet drugs on fibulin-5, vWF and P-selection in serum of patients with acute cerebral infarction.Methods Diagnosed 60 patients with acute cerebral infarction in our hospital and collected. All patients were randomly divided into experimental group and control group, 30 cases in each group.The control group was treated with conventional treatment and aspirin, and the experimental group was treated with clopidogrel on the basis of control group.After treatment, the serum levels of Fibulin-5, vWF, P-selection and adverse reactions were detected in all patients.ResuIts After treatment, compared with control group, the serum Fibulin-5 level was significantly lower in experimental group ( P<0.05 );the serum vWF level in experimental group was significantly lower ( P<0.05 );the serum P-selectin level in experimental group was significantly lower (P<0.05);there was no significant difference in the incidence of adverse reactions between two groups. ConcIusion Dual antiplatelet drugs can reduce serum vWF, P-selectin and fibulin-5 in serum of patients with acute cerebral infarction, adverse reactions do not significantly increase, have guiding significance to clinical application.

Objective To evaluate the diagnostic value of dermoscopy and reflectance confocal microscopy (RCM) alone or in combination for melanocytic nevus.Methods A total of 37 patients with clinically diagnosed melanocytic nevus were collected.Skin lesions were firstly examined by dermoscopy and RCM,then were resected to be subjected to histopathological examination for final diagnosis.The imaging features of melanocytic nevus were summarized.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of different skin imaging techniques were calculated,and the consistency was analyzed between skin imaging techniques and histopathological examination.Results Based on the dermoscopic and RCM findings,2 kinds of nevus cells with different morphological features were observed in the dermis of intradermal nevus.One kind of nevus cells was characterized by a nonfusional,highly-refractive round structure in the papillary dermis under RCM,and by a brown or light brown homogenous pattern under dermoscopy,which was observed in 5 skin lesions.The other kind of nevus cells appeared as irregular,highly-refractive cell clumps in the papillary dermis under RCM,and by a cobblestone or globular pattern under dermoscopy,which was observed in 31 skin lesions.For the diagnosis of melanocytic nevus,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of RCM combined with dermoscopy were 91.7％,87.5％,90.9％,97.1％ and 70％ respectively,those of RCM were 86.1％,75％,84％,93.9％ and 54.5％ respectively,and those of dermoscopy were 77.8％,87.5％,75％,96.3％ and 41.2％ respectively.All the diagnostic indices of RCM combined with dermoscopy were higher than those of RCM or dermoscopy alone,except that the specificity was equal to that of dermoscopy alone.RCM showed higher sensitivity,accuracy and negative predictive value,but lower specificity and positive predictive value compared with dermoscopy.There were no significant differences in the diagnostic yield in melanocytic nevus between RCM combined with dermoscopy or RCM alone and histopathological examination (x2 =0.25,0.57,P =0.63,0.45,Kappa value =0.72,0.53,respectively).However,a significant difference in the diagnostic yield in melanocytic nevus was observed between dermoscopy and histopathological examination (x2 =5.81,P =0.012).Conclusion RCM combined with dermoscopy shows higher diagnostic accuracy for melanocytic nevus compared with RCM or dermoscopy alone.

Objective:To investigate the changes of expressions of NOD-like receptor family pyrin domain containing 3 (NLRP3) inflammasome in the peripheral blood mononuclear cells and downstream factors interleukin-1β (IL-1β) and interleukin-18 (IL-18) in serum in the children with asthma, and to explore their significances on assessing the condition of the children.Methods:A total of 176cases of children with asthma were divided into acute exacerbation group (n=91) , chronic persistent group (n=49) and clinical remission group (n=36) according to the clinical manifestation.During the same period, 60healthy children were selected from the outpatient physical examination center as control group.The pulmonary function of children was checked with lung function instrument.The expression levels of NLRP3, apoptosis-associated speck-like protein containing a CARD (ASC) and cysteinyl aspartate-specific proteinase-1 (Caspase-1) mRNA in peripheral blood mononuclear cells of the subjects in various groups were detected by using real-time quantitative PCR.The serum levels of IL-1βand IL-18of the subjects in various groups were detected by using enzyme-linked immunosorbent assay (ELISA) .Results:Compared with control group, the forced expiratory volume in 1second percentage of predicted value (FEV1％) and fixed ratio of forced expiratory volume in the first second/forced vital capacity (FEV1/FVC) of the children in acute exacerbation, chronic persistent and clinical remission groups were decreased (P＜0.05) ;acute exacerbation group＜chronic persistent group＜clinical remission group, and there were significant differences between various groups (P＜0.05) .The levels of NLRP3, ASC and Caspase-1mRNA in the peripheral blood mononuclear cells and serum levels of IL-1βand IL-18in the children with asthma were higher than those in control group (P＜0.01) .The expression levels of NLRP3, ASC and Caspase-1mRNA in the peripheral blood mononuclear cells of the children in acute exacerbation group were higher than those in chronic persistent and clinical remission groups (P＜0.05) , and the expression levels of NLRP3, ASC and Caspase-1mRNA in chronic persistent group were higher than those in clinical remission group (P＜0.05) .Pearson correlation analysis showed that the expression level of NLRP3mRNA in the peripheral blood mononuclear cells of asthmatic children was positively correlated with the expression levels of ASC, Caspase-1 mRNA and the serum levels of IL-1βand IL-18 (P＜0.05) , while it was negatively correlated with FEV1％and FEV1/FVC;the expression level of ASC mRNA was positively correlated with the expression level of Caspase-1mRNA and the serum levels of IL-1βand IL-18 (P＜0.05) , while it was negatively correlated with FEV1％and FEV1/FVC (P＜0.05) ;the expression level of Caspase-1 mRNA was positively correlated with the expression level of Caspase-1mRNA and the serum levels of IL-1βand IL-18 (P＜0.05) , while it was negatively correlated with FEV1％and FEV1/FVC (P＜0.05) ;the serum level of IL-1βwas negatively correlated with FEV1％and FEV1/FVC (P＜0.05) , and the serum level of IL-18was negatively correlated with FEV1％and FEV1/FVC (P＜0.05) .Conclusion:The expression levels of NLRP3inflammasome and the downstream factor IL-1βand IL-18in peripheral blood of the children with asthma are increased, and they are related to the clinical stage of the children with asthma.NLRP3inflammasome pathway might promote the pathogenesis of asthma in the children.