Chimeric antigen receptor T-cell (CAR-T) technology is based on genetic modification technology to express T-cell expression tumor specific chimeric antigen receptor bind tumor antigen in an antigen-dependent anti-MCH way. Single chain antibody fragment (scFv) of tumor-associated antigen (TAA) combines with up-stream activating sequence of T-cell in vitro. The forming recombinant plasmid transfects the purified and large scale proliferating T-cell in vitro by transfection technique. This process starts and activates specific killing reaction of tumor. The clinical application of cell therapy shows high efficiency and good anti-tumor effect in treatment of malignant neoplasm, such as leukemia, lymphoma, melanoma, which made CAR-T become the mainstream method of cell therapy.

TORCH infection during pregnancy is a group of infectious diseases resulting from viruses and other microorganisms. According to the past over 20-year experiences in serum screening in China, several infections which should be performed in the first trimester, or even much earlier in pregnant period, are hepatitis B, syphilis, HIV, and these three infections are confirmed to be harmful to the fetus or infants and also diagnostic methods and treatment are available. Screening for rubella should be better performed before conception and no specific management is required with IgM+, while immunization is recommended before pregnancy with IgM-. Screenings for cytomegalovirus, toxoplasmosis and herpes virus are not recommended. Scnography is warranted if fetal abnormalities were resulted from the above infections and amniocentesis or cordocentesis might be required for further investigations.

Objective: To explore a novel method for cultivation of the endothelial cells(EC) from infantile hemangiomas (IH) in vitro and observe the biological character of cultured endothelial cells. Methods: Fresh operative specimens were obtained from infantile hemangiomas. The endothelial cells of IH were cultured by explant combined with trypsin-digestion technique. Immunohistochemical staining of EnVision method was carried out to identify the cultured cells. The purity of endothelial cell was examined by flow cytometry analysis of FITC-CD34. The biologic characters of endothelial cells were observed under inverted phase contrast microscope. Results: Endothelial cells were successfully cultured from 8 IH specimens of all the 14 explants. The morphology of cultured endothelial cells included two types:polygonal cells and fusifourm cells. The cultured cells were homogenously positive for EC markers-vWF or CD34, indicating their EC origin. Tube formation was found in endothelial cells of 1H. The proportion of CD34+ cells was 76.28% in cultured endothelial cells as detected by flow cytometry analysis. Conclusion: ECs can be successfully isolated and cultured from infantile hemangiomas by explant combined with trypsin-digestion technique; the cultured cells have some characters of endothelial cells.

Objective: To examine the expression of Fas and Fas ligand(FasL) in cultured infantile hemangioma endothelial cells (IHECs). Methods: IHECs were isolated and cultured by explant combined with trypsin-digested techniques. Then the expression of Fas and FasL on cultured endothelial cells (ECs) were detected by flow cytometry (FCM) and fluorescent quantitative polymerase chain reaction (FQ-PCR) 2-ΔΔCT method,and the results in ECs were compared with those in Jurkat cells (positive control) and Human umbilical vein endothelial cells(HUVECs,negative control). Results: The positive rate of Fas in cultured IHECs was (90.97±2.36)% as detected by FCM,similar to that in the Jurkat cells ([93.87±1.64]%,P>0.05) and significantly higher than that in the HUVECs (P<0.01). Fas mRNA expression in the cultured IHECs was 1.260±0.721 as detected by FQ-PCR,and was 1.448±0.059 in Jurkat cells,with their ratio being 0.87 and with on significant difference found between the 2 group(P>0.05); the ratio of IHECs to HUVECs (0.354±0.170) was 3.56 and there was significant difference between the 2 groups (P<0.01). The expression of FasL mRNA in cultured IHECs,Jurkat cells and HUVECs was too low as detected by FCM and FQ-RCR to have any biological significance. Conclusion: Fas mRNA is highly expressed in cultured IHECs and FasL is rarely expressed in IHECs, which indicates that apoptosis of IHECs is associated with high expression of Fas in IHECs.

Objective: To discuss the treatment for hemangiomas and vascular malformations. Methods: A retrospective study was conducted on 381 patients with hemangiomas and vascular malformations (January of 1998 to June of 2006). The patients consisted of 167 males and 214 females, with an age range from 1 year to 78 years (median age 16 years). According to the biological classification system introduced by Mulliken in 1982, 98 patients had hemangiomas, 38 had capillary malformations,203 had venous malformations, 27 had arteriovenous malformations and 15 had lymphatic malformations. In all patients with hemangiomas,71 patients were treated with intralesional steroids, 20 patients underwent surgical excision, 7 patients were carefully monitored by doctors. In 38 patients with capillary malformations, 27 underwent sclerosant, others were subjected to laser therapy or surgery. In 203 patients with venous malformation, 136 received sclerotherapy, 21 received surgical excision, and 11 underwent sclerotherapy conjunction plus surgical excision. Twenty-seven patients with arteriovenous malformations received sclerotherapy,interventional therapy,or sclerotherapy conjunction plus surgical excision. Fifteen patients with lymphatic malformations received sclerotherapy conjunction plus surgical excision. Results: All patients were followed-up for 0.5-6 years. Follow-up result showed that 199 patients were cured, 125 were greatly improved,and 46 were partly improved; 10 patients showed no obvious improvement; and 1 patient died. Conclusion: Correct diagnosis and the classification, along with correct treatment strategy, are the keys to increase the treatment outcome and decrease complication of patients with hemangiomas and vascular malformations.

Objective: To investigate the changes of local skin temperature in congenital arteriovenous malformations (CAVM) patients before and after treatment, and to assess the relationship between the changes of skin temperature and the outcomes of surgical treatment. Methods: From Sept. 2002 to Apr. 2006, skin temperatures around the lesions were measured in 22 CAVM patients with WMY-01 digital thermometer before and after surgical treatments, and the opposite side or adjacent skins were taken as controls. Furthermore, changes of flow signals and blood flow velocities in the lesions were measured by color Doppler ultrasonography pre- and post-operatively. Results: Skin temperatures of local lesions decreased from (35.58 ±0.68)°C pre-operatively to (34.76±0.63)°C post-operatively(P<0.01); however, the post-operative skin temperature of the lesions was still higher than that of normal skin(34.23±0.83)°C (P<0.05). Post-operatively, color Doppler flow image showed 100% occlusion of blood flow in 1 patient, more than 66.7% occlusion in 14 patients, more than 33.3% but less than 66.7% occlusion in 6 patients, and no occlusion in 1 patient; there was significant difference between those pre- and post-operation(P<0.01). The average blood flow velocity decreased from (80.86±6.97) cm/s pre-operatively to (50.72±5.85) cm/s post-operatively (P<0.01). Conclusion: A significant reduction of surface temperature in CAVMS lesions can be achieved by surgical treatment, and the temperature decrease of the lesion may be used as an indicator for the evaluation of treatment outcomes.

Objective To investigate the optimal regimen of narrow-band ultraviolet B (NB-UVB) phototherapy in the treatment of chronic actinic dermatitis (CAD),and to analyze factors influencing treatment compliance.Methods Demographic data,results of photobiological tests,treatment parameters and clinical responses were collected from CAD patients who received NB-UVB phototherapy in Huashan Hospital affiliated to Fudan University from January 2008 to June 2015,and were reviewed retrospectively.Statistical analysis was done by using two independent samples t-test and chi-square test with SAS9.3 software to compare the clinical data between patients who completed and did not complete the NB-UVB phototherapy.Results A total of 79 CAD patients with Fitzpatrick skin type Ⅳ received NB-UVB phototherapy.Of these patients,61 (77％) completed the whole treatment,while 18 (23％) dropped out because of intolerance to the NB-UVB radiation.Among the 61 patients who completed the treatment,the average initial,final and cumulative radiation doses of NB-UVB were (0.08 ± 0.01) J/cm2,(0.32 ± 0.08) J/cm2and (5.9 ± 2.5) J respectively,and patients received (28 ± 8) times of treatment in average.When the radiation dose went up to 0.30 J/cm2,most skin lesions were cleared in 52 (85％) patients.A total of 19patients received phototesting again after the end of phototherapy.Among 16 patients sensitive to ultraviolet A (UVA) before the treatment,6 had normal minimal erythema dose to UVA (UVA-MED),and another 6 had improved UVA-MED after the treatment.Among 16 patients sensitive to UVB before the treatment,11 got normal UVB-MED and another 3 had improved UVB-MED after the treatment.Univariate analysis showed no significant differences in gender,age,duration of the disease,sensitivity to UVA and UVB radiation,results of photopatch test and patch test between the patients who completed and did not complete the treatment (all P ＞ 0.05).Conclusions The appropriate NB-UVB phototherapy for CAD patients should start at an initial radiation dose of 0.08 J/cm2 in spring and end at a final radiation dose of 0.30 J/cm2 for about 28 sessions,which can effectively reduce the photosensitivity to both UVA and UVB in CAD patients.Additionally,NB-UVB phototherapy can be applied in CAD patients of different gender,age,disease duration and photosensitive condition.

Objective To enhance the understanding of hemophagocytic syndrome(HPS)by analyzing the clinical manifestations, diagnosis and therapy. Methods The clinical data of 12 patients with HPS were retrospectively collected in the People's Hospital of Jiangsu Province from 2000 to 2007. The relevant literature were reviewed. Results Twelve patients were diagnosed as secondary hemophagocytic syndrome most secondary to virus and bacteria infection. Some patients condition was associated with systemic lupus erythematosus or histiocytic necrotizing lympheadenitis. All of the 12 patients had high fever, abnormal liver function and showed a decrease in the number of blood cells in a short time. After antivirus and antibiotic treatment, 11 patients'condition were improved and 1 patient died. Conclusion Hemophagocytic syndrome is not a common clinical condition but with poor prognosis. When patient presents with fever without apparent reasons and pancytopenia, bone marrow examination should be done and sometimes repeated bone marrow examinations are needed. The diagnosis of secondary haemophagocytic syndrome needs multidisciplineary cooperation. Aggressive diagnostic procedures are needed to clarify the diagnosis and prompt treatments are warranted to improve prognosis.

Objective The study was to evaluate DWI for quantifying liver fibrosis. Methods A total of 12 volunteers, 47 patients who had chronic HBV or HCV hepatitis and underwent liver biopsy [Scheuer score for fibrosis(S) and inflammation(G)] were enrolled in this study. They were scanned using a 1.5 T MR unit with b value of 0,250,500,750, 1000 s/mm~2. ADCs at b_(250-1000) and b_(500-1000) were the average ADCs of b=250, 500, 750, 1000 s/mm~2 and b=500, 750, 1000 s/mm~2. The studied the correlation between Scbeuer scores and ADC values, and conducted Mann-Whitney U test and Logistic regression to evaluate ADC for prediction of fibrosis scores. Results The average ADCs were (1.41± 0.11),(1.37±0.09), (1.27±0.05), (1.26±0.04), (1.22±0.06) mm~2/s respectively from SO to S4, stage at b=750 s/mm~2 (F=18.31, P<0.01). With the increase of fibrosis score, the average ADC decreased gradually, the two were better negatively correlated at b_(250-1000)(r=-0.727, P<0.01) than other b values. Using b_(750) and the two combined b values, the found significantly lower ADCs in S2 or greater versus S1 or less and in S3 or greater versus S2 or less fibrosis (P<0.01). The best predictor for S2 or greater was b_(750) with the largest AUC of 0.909, sensitivity of 85.7%, and specificity of 100.0% (ADC ≤1.35×10~(-3) mm~2/s). The best predictor for S3 or greater was b_(250-1000) with the largest AUC of 0.864, sensitivity of 69.6%, and specificity of 95.8% (ADC≤1.53×10~(-3) mm~2/s). Conclusion DWI can be a good predictor for scoring liver fibrosis for S2 or S3 stage above, while b_(750) and the combined b values are suitable for evaluation.