Objective To explore the possible role of CD28 +/CD152 +:B7 eostimulators in immune pathophysiology of severe pneumonia.Methods 22 severe pneumonia peripheral blood sample were used to analyze the expression of CD3+ T cell CD28+,CD152+,CD14++ on mononuelear cell CD86+,and HLA - DR + by FACS expression.The relationship between CD28+,CTLA4,CD86+ and the HLA-DR +,and the relationship between APACHE Ⅱ Grading,CD28+,CD152+,CD86+ and HLA-DR + were analyzed.Results Compared with the control group,the expression of CD3 + T cell,CD86+ and HLA - DR + were remarkably reduced while the expression of CD28+ and CD152+ were markedly increased in patients with severe pneumonia who were hospitalized in 24 h(P＜0.05).However,T cells with positive CD8+ CD3+ and CD4+ CD3+ had no significant change between two groups(P＞0.05).For patients with severe pneumonia who survived,the APACHE Ⅱ scores were significantly reduced while the expression of CD28+,CD152+,CD86+,HLA-DR + and CD3+ + cells were significantly increased after 10 days from admission(P＜0.05).By contrast,T cells with positive CD8+ CD3+ and CD4+CD3+ had no significant change between two groups(P＞0.05).There were no relation between costimulators CD28+ and HLA - DR + (r=-0.12,P=0.54)and APACHE Ⅱ scores(r=-0.30,P=0.19) in control group.CD86+ and HLA - DR + showed positive correlation(r=0.65,P=0.00).CD86+ and APACHE Ⅱ scores had no correlation(r=-0.38,P=0.09).Conclusion The costimulators expressed abnormally in circumference blood of patients with severe pneumonia,CD86+ decreased,but CD28+,CD152+ increased.T cell of circumference blood was at the condition of "anergy".The increase of CD28+,CD86+,CD86+ and HLA - DR + during convalescence stages in patient with severe pneumonia showed that spocific immunity was advantageous for restoration in these patients.The relationship among CD86+,CTLA4 and HLA - DR + indicated that CD28+/CD152+:B7 play an role in the occurrence and development of severe pneumonia.

Fibrinogen (Fib) is one of the most common coagulation proteins,plays an important role in the coagulation cascade,and has a closed relationship with tumor.Studies indicate that the level of Fib has elevated in many kinds of cancer,and Fib is also closely correlated with the progression,metastasis and prognosis of tumor.Though the mechanism of the interaction of Fib and tumor is still unclear,Fib as a tumor marker and new therapy for these malignancies has been a new hotspot.

Objective:To investigate the association between the parameters of thin-section computed tomography and the invasion and histological subtypes of subsolid nodules measuring 1-2 centimeters in diameter as lung adenocarcinoma.Methods:We retrospectively reviewed the cases with subsolid nodules measuring 1-2 centimeters on thin-section computed tomography and histologically confirmed as lung adenocarcinoma.Results:A total of 135 patients were enrolled in this study, including 23 with pure ground glass nodules and 112 with part-solid ground glass nodule. We observed significant differences of nodule size, solid component size, consolidation-to-tumor ratio, nodule attenuation and attenuation ratio( P<0.0001). The receiver operating curve indicated certain predictive value of solid component size, nodule attenuation and attenuation ratio: AUC were 0.838(0.756-0.919)、0.823(0.729-0.917) and 0.820(0.726-0.914), respectively. Of the invasive adenocarcinoma, those with solid or micropapillary components merely showed a significance in solid component size( P=0.024). Conclusion:The parameters of thin-section computed tomography of 1-2 centimeters subsolid nodules showed significant differences in varied invasiveness of lung adenocarcinoma, and these could have certain predictive value.

Objective:To analyze the patients′ clinical and genetic characteristics with pseudohypoparathyroidism (PHP) and investigate the correlation between clinical phenotypes and genotypes.Methods:Twenty PHP patients were ascertained at Children′s Hospital Zhejiang University School of Medicine from January 2011 to July 2020. Clinical manifestation, laboratory examination and gene test results were retrospectively analyzed.Results:In these twenty patients, eighteen cases showed resistance to parathyroid hormone (PTH) and thirteen cases had Albright′s hereditary osteodystrophy (AHO) phenotype. Gene abnormalities were found in all the twenty PHP patients, which included seven patients with GNAS gene variations (six frameshifts and one missense) and thirteen patients with GNAS gene methylation defects. Moreover, twelve children with both PTH resistance and AHO phenotype were clinically diagnosed as PHP-Ⅰa, meanwhile, seven carried GNAS variations and five had methylation abnormalities with a correct diagnosis of PHP-Ⅰb.Conclusions:Patients with AHO phenotype and PTH resistance may have a high genetic diagnosis rate. Because PHP-Ⅰb clinical phenotype may be similar to PHP-Ⅰa, early genetic detection is required for the differential diagnosis. In addition, children without PTH resistance should also be followed up regularly, which may help the early diagnosis.