Objective To observe the expression of CD8 + CD28-T cells in the peripheral blood of non-small-cell lung cancer (NSCLC) patients,and to investigate the effect of chemotherapy on CD8 + CD28-T cells expression and its clinical significance.Methods Flow cytometry was used to evaluate the level of CD8 + CD28-T cells in peripheral blood of 70 untreated NSCLC patients and 60 healthy controls.The association between CD8 + CD28-T cells and the clinical features was analyzed.We also investigated the changes of CD8 + CD28-T cells in 30 NSCLC patients who received chemotherapy by GP (gemcitabine,cisplatin) and NP (navelbine,cisplatin).Results The proportion of CD8 + CD28-T cells in lung cancer group was significantly higher than that in healthy group (59.003％ ± 15.329％ vs.41.036％ ± 15.435％,t =35.904,P =0.001).No correlation was found between CD8 + CD28-T cells expression and the gender (F =1.374,P =0.697),pathological pattern (F =0.779,P =0.509) and clinical stage (F =0.070,P =0.933).But CD8 + CD28-T cells expression was correlated with the age (F =15.038,P =0.001).The level of CD8 + CD28-T cells after NP chemotherapy was lower than that before chemotherapy (55.293％ ± 14.637％ vs.58.793％ ± 12.510％,t =2.017,P =0.044).And the level of CD8 + CD28-T cells after GP chemotherapy was lower than that before chemotherapy (54.127％ ± 13.924％ vs.60.700％ ± 16.401％,t =3.007,P =0.009).Conclusion CD8 + CD28-T cells express highly in NSCLC patients peripheral blood.Chemotherapy down-regulates CD8 + CD28-T cells expression,which provides a new reference for combination with chemotherapy and immunotherapy in NSCLC patients.

Objective To study the effects of endoplasmic reticulum stress on liver damage in young rats fed with high-fat diet.Methods We divided 48 male weaned young rats randomly into high-fat diet group and control group,which were separately fed with high-fat diet and normal diet.After feeding 8,12 and 1 6 weeks,the body weight and visceral fat of the rats were measured.The serum liver function was measured.The morphology of livers was observed by HE and transmission electron microscopy. The mRNA expressions of ATF6 and GRP78 in hepatocytes were measured with RT-PCR.Results ① The body weight and visceral fat weight of rats in high-fat diet group increased compared with those in control group (P <0.05).② Alanine aminotransferase and aspartate aminotransferase in high-fat diet group increased slightly over time (P >0.05);alanine aminotransferase at week 1 6 was increased significantly compared with that in controls (P < 0.05 ).③ Liver cells in high-fat diet group had steatosis at week 8 and the steatosis became more serious between week 12 and week 1 6.④ In high-fat diet group at week 8 there were a large number of lipid droplets in the cytoplasm,and the cell structure was close to that of normal cells;rough endoplasmic reticulum was nearly normal and the ribosome was visible.At week 12 and week 1 6,besides a large number of lipid droplets,we could also see that some substances with line-like structure deposited in rough endoplasmic reticulum pool.⑤ The expressions of ATF6 and GRP78 mRNA in hepatocytes in high-fat group at weeks 8, 12 and 1 6 were significantly increased compared with those in control group (P <0.05). Conclusion High-fat diet in infants can cause visceral fat accumulation,fatty degeneration of hepatocytes and liver injury.ATF6-mediated endoplasmic reticulum may be closely related to the liver injury which results from highfat diet.

Objective To observe the changes of CD+8CD+28,CD+8CD-28 and CD+4CDhigh25CDlow127 regulate T (Treg)cellsin peripheral blood of lung cancer patients,and to analyze the correlation between CD+8CD-28 and CD+4CDhigh25CDlow127 Treg cells to reveal the role and clinical significance of them in lung cancer patients.Methods Flow cytometry was applied to evaluate the level of CD+8CD+28,CD+8CD-28 and CD+4CDhigh25CDlow127 Treg cells in peripheral blood of 60 untreated lung cancer patients and 60 healthy controls group.The association of each term with clinical features was analyzed.Results The percentage of CD+8CD-28 and CD+4CDhigh25CDlow127 Treg cells in lung cancer group[(58.430:15.749) ％,(7.365±2.025) ％]was significantly higher than those in healthy group [(41.057±15.436)％,(6.648±1.669)％,(t=6.102,P＜0.05;t=2.115,P＜0.05)],while the percentage of CD+8CD+28cells is lower(41.570±15.739)％ than that in healthy group[(58.700±15.298)％,(t=-6.043,P＜0.05)].No close associations were found between three index and gender,age,and biological characteristics.With the increase of TNM stage,The percentage of CD+4CDhigh25 CDlow127 Treg cells increased gradually,which was remarkably higher in patients rith stage Ⅳ than that with stage ⅢA(t=-3.898,P＜0.05).The percentage of CD+4CDhigh25 CDlow127 Tregcells was uncorrelated with CD+8CD-28 cells(r=-0.169,P＞0.05).Conclusion The higher percentage of CD+8CD-28 and CD+4CDhigh25 CDlow127 Treg cells,the lower percentage of CD+8CD+28 cells may be the important reasons of immune suppression in lung cancer patients.Though there is no correlation between CD+8CD-28 and CD+4CDhigh25 CDlow127 Treg cells,it is may be helpful to understand immunologic function and it may look for more specific therapy and provide a new reference in the prognosis of lung cancer.

Objective To investigate the clinical and imaging features of mild encephalitis/encephalopathy with a reversible splenial lesion of corpus callosum (MERS) in children.Methods Four patients of MERS, who were diagnosed and treated in the First Hospital of Jilin University during 2013-2014, were collected retrospectively.Their clinical, laboratory, radiologic data and the related literatures were reviewed.Results Four patients onsetted as gastrointestinal symptom (3 cases) or respiratory (1 case) symptom, in accompany with disturbance of consciousness (3 cases of drowsiness, 1 case of lethargy), convulsions (4 cases), headache (1 case) as the main symptoms.Abnormal neurological signs included positive cervical resistance (3 cases), positive bilateral Babinski sign (3 cases), bilateral chemosis (2 cases).Laboratory test showed the average blood sodium was 131.6 mmol/L, while the cerebrospinal fluid test only showed abnormality in 1 case.In etiology examination, 2 cases showed human rotavirus antigen positive, and Mycoplasma pneumoniae antibody was found positive in 2 cases.Cranial MRI showed reversible lesion in the splenium of corpus callosum (patchy iso-or hypo-intensity on T1 WI and apparent diffusion coefficient, hyper-intensity on T2WI, FLAIR and DWI, clear boundary).After active treatment, clinical symptoms disappeared within 1 week, and cranial MRI lesions disappeared within 2 weeks.Conclusion The clinical presentations of MERS, which is a clinical-radiological syndrome, are sudden onset and mild, with characteristic changes in brain MRI and good prognosis.

Objective To analyse the clinicopathological characteristics of synovial sarcoma (SS) from histomorphology,immunohistochemical (IHC) and fluorescence in situ hybridization (FISH),and to investigate the related factors influencing the prognosis of SS patients.Methods 94 cases were collected,including 60 SS cases and 34 in dined to SS cases.The expressions of common antibodies related to the diagnosis of SS Vimentin,CD99,AE1/AE3,EMA,CD34,Calponin,Ki-67 were detected by IHC,and the SYT-SSX fusion gene was detected by FISH.The clinical pathologic factors that affecting the prognosis of patients were analyzed through the statistical method.Results The positive rates of Vimentin,CD99,AE1/AE3,EMA,CD34,Calponin,Ki-67 were 100.00 ％,74.47 ％,36.17 ％,28.72 ％,17.02 ％,90.43 ％ and 60.64 ％ respectively.FISH results showed that 81 patients were tested with SYT gene translocation,including 54 cases who were considered as SS,and 27 cases who were suspected/inclined to SS,and the number of positive cells surpassed 80 ％.The gene translocation was not related with the patient' s age,sex,tumor position,histological type,differentiation of the cancer (all P ＞ 0.05).Single factor survival analysis showed that the degree of differentiation,tumor diameter,the recurrence and metastasis had certain influences on patients' survival time (all P ＜ 0.05).Multiple factors regression analysis showed that the degree of differentiation and tumor diameter were the risk factors influencing the prognosis of SS (risk coefficients ＞ 1,P ＜ 0.05).Conclusions IHC combined with FISH SYT-SSX fusion gene detection have the vital significance in the diagnosis of SS.The degree of differentiation and tumor size are the risk factors influencing the prognosis of SS.

Objective To explore the curative effects of endoscopic band ligation combined with drug injection in the treatment of hepatic cirrhosis complicated with upper gastrointestinal hemorrhage. Methods 76 patients with hepatic cirrhosis complicated with upper gastrointestinal hemorrhage were divided into 2 groups by random double blind method, with 38 cases in each group. The control group were treated by conservative regimen alone while the experimental group were treated by endoscopic band ligation combined with drug injection, based on the control group. The clinical curative effects, adverse reactions, hemostasis time, hospitalization time , rebleeding , haemodynamics and other indexes before and after the treatment in the 2 groups were compared. Results The total effective rate, rebleeding rate and the incidence of fever in the experimental group were 2.6% and 10.5%, respectively. Compared with those in the control group (71.1%, 21.1%, 28.9%), the differences were statistically significant (P < 0.05). The differences in volume of blood transfusion, hemostasis time , time of improvement of symptoms and hospitalization time between the experimental group and the control group were significant (P < 0.01). The blood flow of portal vein(550.2 ± 143.4)mL and splenic vein (284.3 ± 96.4)mLin the experimental group was significantly less than that in the control group [(628.1 ± 156.0)mL, (332.6 ± 100.3)mL] (P < 0.05). Condusions Endoscopic band ligation combined with drug injection in the treatment of hepatic cirrhosis complicated with upper gastrointestinal hemorrhage is effective and can significantly improve the varicose hemodynamics in patients. The rate of rebleeding is low.

Objective To investigate the correlation of pathology factors and prognosis of gastrointestinal stroma tumors (GIST). Methods The expression of CD117, CD34, SMA, S-100 and Ki-67 in 91 GIST cases were studied by Envision method of immunohistocbemistory;Sequently, the relationship of the location, the size, the hemorrhage, cellular necrosis, stroma mucus, the mitosis, Ki-67 expression and the prognosis were analyzed by SPSS 12.0. Results The positive rate of CD117, CD34, SMA, S-100 were 80.21%, 73.63 %, 34.07 %, 7.69 % respectively. There had significant difference between the location, the mitosis, Ki-67 expression and the prognosis; but no significant difference between the location, the hemorrhage, cellular necrosis, stroma mucus, CD117 expression and the prognosis. Conclusion The tumor's size, mitosis, and Ki-67 expression are associated with prognosis; CD117 expression and prognosis. Even more, Ki-67 expression may be a more precise factor to judge the tumor's biological behaviour compared to the mitosis. As a wally classified method, the Flecther classification is worth to spread.

Objective To investigate the changes of anti-cyclic citrullinated peptide antibody ,rheumatoid factor (RF) ,erythrocyte sedimentation rate(ESR) and C reactive protein(CRP) levels in the patients with early rheumatoid arthritis (RA) and their applica-tion value in the diagnosis and treatment.Methods A total of 210 cases of early RA in sixth affiliated hospital of Guangzhou Medi-cal University from December 2015 to June 2016 were selected as the RA group ,including 28 males and 182 females ,at the same time 115 cases of other rheumatism were selected as the non-RA group ,male ,including 38 males and 77 females.85 persons under-going the healthy physical examination were taken as the health group ,including 46 males and 39 females.The latex enhanced im-mune turbidimetry was adopted to quantitatively detect anti-cyclic citrullinated peptide antibody.The RF and CRP levels were quan-titatively detected by using the immune turbidimetry.The Westergren method was used to test the ESR ,their content changes in RA ,non-RA arthritis and other autoimmune diseases were detected.Results The sensitivity ,specificity ,positive predictive value , negative predictive value and Youden index of anti-cyclic citrullinated peptide antibody in the RA group were 60.95% ,97.64% , 98.46% ,50.30% and 0.59 respectively ,which of RF test were 52.38% ,95.29% ,96.49% ,44.75% and 0.48 respectively ,which of CRP test were 30.48% ,89.41% ,87.67% ,87.67% ,34.23% and 0.20 respectively ,which of ESR test were 49.52% ,87.06% , 90.43% ,41.11% and 0.37 respectively.Anti-cyclic citrullinated peptide antibody detection in the RA group was obviously higher than that of the RF test ,their test results were obviously higher than those of the non-RA group and healthy group ,the differences were statistically significant (P<0.05).CRP and ESR detection had no statistical difference between the RA group and non-RA group (P>0.05).Conclusion Anti-cyclic citrullinated peptide antibody level is higher in the patients with RA ,which is signifi-cantly superior to the RF test ,and anti-cyclic citrullinated peptide antibody detection has higher value for early diagnosis of RA.

Objective To explore the clinical efficacy on hyperbaric oxygenation combined with 0.025% ipratropium bromide inhalation in treatment of patients with stable chronic obstructive pulmonary disease( COPD) .Methods 86 elderly patients with stable COPD were divided into control group (n=42)and observation group(n=44)according to therapeutic methods.The patients in both groups were firstly given the conventional treatment such as oxygen inhalation, anti-infection, eliminating phlegm and reliving asthma, nutritional support, spasmolysis as well as a balance of water, electrolyte and PH.And the patients of the observation group were given hyperbaric oxygenation combined with 0.025% ipratropium bromide inhalation on basis of the conventional treatment.The clinical effects of the two groups were compared.Results In the control group, there were no statistical differences in parameters of pulmonary function before and after the treatment.However, after treatment, the relative index level of pulmonary function in the observation group was significantly higher than that of pre-treatment and that of the control group after treatment(P<0.05).After treatment, PaO2, SaO2 and pH of the two groups were significantly higher than those of pre-treatment(P<0.05).The level of PaCO2 in the two groups was significantly lower than that of pre-treatment(P<0.05).Also, the difference in PaO2, PaCO2 and SaO2 level was statistically significant before and after treatment between thw two groups(P<0.05).The scores of each dimension in PSQI scale of both groups were significantly lower than those of pre-treatment(P<0.05).And the scores of each dimension in PSQI scale of observation group was significantly lower than those of the control group after treatment(P<0.05).Whole blood cholinesterase activity of both groups was obviously greater than before treatment between theo two groups(P<0.05).Serum creatinine level of both groups were obviously lower than those of pre-treatment(P<0.05),and the differences in two groups in both blood cholinesterase activity and serum creatinine level were statistically significant ( P<0.05 ) .Conclusion The combination of high pressure oxygen and 0.025%ipratropium bromide for patients with stable COPD has a very significant clinical efficacy.It can effectively improve cholinesterase activity and lower serum creatinine level.

We reported a rare case of protoplasmic astrocytoma presenting small muscle atrophy of the right hand as an initial sign.A 39-year-old male was admitted to hospital complaining of chronic muscle atrophy and subtle headache.Electromyography(EMG) showed brief small denervation and no signs of sensory-motor conduction impairment.CT and MRI revealed multiply expansive intracranial lesion in left hemisphere,which was highly suspected of cerebral echinococccus or Balo disease.The patient underwent surgical excision and pathological report was protoplasmic astrocytoma,with glial fibrillary acidic protein(GFAP,+++) of immunohistochemical method.We reviewed clinical features,radiological manifestations and pathology of protoplasmic astrocytoma with medical literature documents.