Interleukin 7 receptor (IL7R) is a transmembrane receptor that belongs to the typeⅠcytokine receptor fami-ly. It consists of the cytokine-specific α-chain (IL7Rα, CD127) and the shared common cytokine γ-chain (γc, CD132). IL-7R is expressed in various cell types, including lymphoid precursor cells, pro-B cells, T cells, thymocytes, dendritic cells, myeloid cells and monocytes. Under physiological conditions, IL7R is a vital cytokine for development and survival of T and B cells. IL7R plays a key role in the pathogenesis of multiple sclerosis (MS). Single nucleotide polymorphisms (SNPs) in the gene encoding IL7Rαhave emerged through genetic studies of MS patients. In experimental autoimmune encephalomy-elitis (EAE) mouse model of MS, treatment with neutralizing anti-IL7Rαantibody results in significant improvement of EAE. Therefore, IL7R may serve as a novel target for MS therapies.

Tumor necrosis factor (TNF)-αis a pleiotropic inflammatory cytokine, which is produced chiefly by acti?vated macrophages. Two forms of TNF-α, soluble and transmembrane, can bind tumor necrosis factor receptor (TNFR) 1 or TNFR2, respectively. Recently, a concept has emerged that TNF-α/TNFR pathway plays an important role in the pathogene?sis of multiple sclerosis and remyelination. TNFR1 induces death of oligodendrocytes via death receptor-mediated apoptosis, which leads to demyelination or other neurodegenerative changes. However, TNFR2 has a positive effect on multiple sclero?sis. It facilitates the proliferation and differentiation of oligodendrocyte precursor cells, thus promoting remyelination.

BACKGROUND: Experiment suggests that the active component of Danggui Buxue decoction, i.e. polysaccharides, can significantly promote proliferation and differentiation of hematopoietic stem cells and hematopoietic progenitor cells, and regulate hematopoietic microenvironment.OBJECTIVE: To investigate the effect of serum containing Danggui Buxue decoction on granulocyte colony-stimulating factor (G-CSF) and interleukin-3 (IL-3) secretion in mice bone marrow stromal cells (BMSCs). METHODS: BMSCs were isolated and cultured in 96-well culture plate. BMSCs morphology and growth were observed by phase contrast microscopy. The cells were divided into four groups and cultured with different concentrations of the serum containing Danggui Buxue decoction. MTT method was used to observe the proliferation of BMSCs, and ELISA method was used to observe the expression level of G-CSF and IL-3. RESULTS AND CONCLUSION: Serum containing Danggui Buxue decoction significantly promoted BMSCs proliferation, and increased the expression level of G-CSF and IL-3 secreted from BMSCs in a dose-dependent manner. Notably, serum containing equivalent dose drugs significantly promoted BMSCs proliferation, and G-CSF and IL-3 expression compared with other groups. Higher concentration weakens cell proliferation and secretion effects.

Objective:To explore the application of high-throughput sequencing (HTS) technology in pathogens detection for spinal infection.Methods:From January 2019 to May 2020, a total of 41 patients including 31 males and 10 females with an average age of 59.7±11.9 years (29-75 years) were suspected of spinal infections. There were 37 patients with local pain, 15 with fever (≥38 ℃) and 18 with neurological dysfunction. The infected sites were as follows, 4 cases of cervical spine, 8 cases of thoracic spine and 29 cases of lumbar spine. There were 36 patients met the surgical indications and underwent open debridement, bone grafting, fusion and internal fixation, while the other 5 patients underwent conservative treatment (three received drug therapy and two were transferred to the internal department for chemotherapy). Lesions obtained from open surgery patients were underwent pathology and HTS examination. In 5 cases with conservative treatment, two of them underwent CT guided percutaneous puncture for samples, while one case underwent ultrasound guided percutaneous puncture for pus, one case for venous blood, and one case received lumbar puncture for cerebrospinal fluid. The samples were sent for pathological and HTS examination, while liquid specimens were sent for bacterial culture and HTS. The sensitivity and specificity of HTS results were determined according to pathological examination which was regarded as the "gold standard". Based on HTS results combined with the clinical manifestations, imaging examination and pathological results of the patients, targeted antibiotics or anti-tuberculosis drugs were selected for postoperative drug therapy. Patients with bacterial infection received anti-infection treatment for 3 months after operation. For tuberculosis patients, "tetrad" (isoniazid+rifampicin+pyrazinamide+ethambutanol) anti-tuberculosis treatments were underwent for one year. Inflammation indicators from the blood samples were observed before and after treatment, including white blood cell count (WBC), C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). These indicators were used to monitor disease progression and the curative effects. All patients were followed up for at least 3 months after surgery.Results:A total of 41 patients with suspected spinal infection were included in this study. The HTS pathogen detection results were obtained within 48 h. For the initial 5 patients, first-generation sequencing verification was conducted with coincidence rate 100%. Further, no further verification was conducted in the rest patients. Among the 41 cases, a total of 26 cases had positive results with a positive rate of 63.4%(26/41). Among them, thirteen cases were with mycobacterium tuberculosis (31.7%) and 6 cases with staphylococcus (14.6%). Fungi and Brucellosis were diagnosed in 2 cases respectively, accounting for 4.9% respectively. The test were negative in 15 patients (36.6%), including 2 patients with tumor or tumor-like lesions (1 hematologic tumor and 1 eosinophilic granuloma). A total of 38 patients underwent pathological examination, which confirmed 7 cases of suppurative infection, 12 cases of tuberculosis, 2 cases of tumor or tumor-like lesions and the remaining 17 cases of inflammatory lesions. The sensitivity and specificity of HTS were 80%(16/20) and 55.6% (10/18) with positive predictive value (PPV) 66.7% (16/24) and negative predictive value (NPV) 71.4% (10/14). All patients were followed up for 3 months. The inflammation indicators of blood at 3 months were all lower than that at admission. WBC decreased from (7.50±3.26)×10 9/L at admission to (6.22±2.53)×10 9/L at 3 months after treatment without statistically significant difference ( t=1.082, P=0.290). The CRP decreased from (32.2±34.1) mg/L to (4.5±10.5) mg/L, and ESR from (44.2±26.5) mm/1 h to (18.6±12.1) mm/1 h with statistically significant difference ( t=8.963, P<0.001; t=5.421, P<0.001). Conclusion:High-throughput sequencing technology can be used in detection of spinal infection pathogens, due to its relatively high positive rate, satisfied sensitivity and good diagnostic value.

Objective To evaluate the difference in coronary microcirculation and short term prognosis in patients with different collateral circulation and underwent elective percutaneous coronary intervention ( PCI) with complete occlusion of coronary artery. Methods The study included 42 patients who had been admitted in our hospital for NSTEMI or STEMI between 01/2012 to 12/2015 without receiving revascularization treatment and whose symptoms persisted for over 6 months. According to the results of coronary angiography and the Rentrop grade, the patients were divided into 2 groups: poor collateral circulation formation group (group A, Rentrop=0 -1, n=17) and well established collateral circulation group (group B, Rentrop=2-3, n=25). The basic clinical data and the result of coronary angiography were compared. A pressure-temperature sensor wire was used to measure index of mierocirculatory resistance ( IMR) immediately after PCI. An echocardiograph was used to measure left ventricular end systolic diameter ( LVEDd) and left ventricular ejection fraction ( LVEF) postoperatively and again at 3 months after operation to evaluate the changes in cardiac function. Results The IMR value of group A was significantly higher than group B (P﹤0. 05), the grade of collateral circulation had negative correlation with IMR value (r=-0. 671, P﹤0. 05). The mean changes in LVEDd in 3 months in group B was -0. 28 mm, while in group A was 5. 76 mm (P﹤0. 05). The mean changes in LVEF in 3 mouths in group B was 5. 36% and in group A was -3. 82% (P﹤0. 05). The grading of coronary collateral circulation had negative correlation with the changes of LVEDd in 3 months (r= -0. 669, P﹤0. 05), but had positive correlation with the changes of LVEF (r=0. 657, P ﹤0. 05). The IMR value had positive correlation with the changes of LVEDd in 3 months (r=0. 686, P﹤0. 05), but had negative correlation with the changes of the LVEF (r= -0. 664, P﹤ 0. 05 ) . Conclusions Patients with poor collateral circulation was more prone to coronary microcirculatory injury than patients with good collateral circulation. Patients with good collateral circulation and microcirculation had better prognosis after the revascularization of the infarction-related vessel.

Objective To evaluate cerebral parenchymal atrophy of patients with Alzheimer's disease(AD)through the compara-tive analysis of the volume and morphology of the brain ventricle between patients with AD and normal elderly.Methods 20 patients with AD and 20 normal elderly people were scanned at 3.0T MR,and lateral ventricle section images were achieved,and the lateral ventricle volume and the anterior horn,posterior horn and temporal horn of the lateral ventricle were calculated by analyzing the re-construction of section images with MIMICS software from Belgian.Results As compared with normal elderly group,the patients with AD exhibited significantly increased the volume of left ventricular volume(LV),right ventricular volume (RV)and total vol-ume (TV)(P<0.05).Angle of bilateral anterior horn and temporal horn but not posterior horn of the lateral ventricle in patients with AD were significantly higher than that in normal elderly (P<0.05).The volume of the left,right and total cerebral ventricle, the angle of the anterior horn of the left and right lateral ventricle and the angle of the temporal horn of the left and right lateral ven-tricle were negatively correlated with MMSE (P<0.05).Conclusion Patients with AD exhibites significantly greater volume and an-gle of the lateral ventricular than normal elderly people.These related data measured can predict brain parenchymal atrophy of pa-tients with AD more conveniently and accurately.

Radiation safety has been a focus of attention in the past few years. This review summarizes the researches related to the effective dose (ED) of PET/CT in recent years, including the ranges and influential factors of ED. In order to provide guidance in clinical practice, the common methods for estimating ED of PET/CT are also introduced.

Objective:To clarify the evidences of hippocampal injury after radiotherapy avoiding hippocampus and explore its relationships with cognition.Methods:A prospective design was adopted in this study.A total of 183 patients with nasopharyngeal carcinoma treated by intensity modulated radiation therapy (IMRT group) and 30 matched healthy control (HC group)were collected in the Affiliated Hospital of Jiangsu University and Southeast University Affiliated Zhongda Hospital from January 2017 to December 2019. All subjects were assessed by Montreal Cognitive Assessment (MoCA-B) at baseline and 6 months after radiotherapy, then the patients with nasopharyngeal carcinoma were divided into cognitive impairment group and non-cognitive impairment group. Subjects were scanned with Siemens 3.0 T MR, and T 1WI was used as analysis sequence.The individual standardized hippocampus ROIs were extracted based on Montreal Neurological Institute(MNI) brain template.All texture features were calculated using the Radiomics developed by C++and Delphi, and the intra group correlation coefficients (ICC), average direction, machine learning (random forest) and autocorrelation matrix were used for reducing the features dimension. One-way ANOVA and generalized linear models were used to compare the differences among different groups. Pearson correlations analyses were used to evaluate the relationships between important texture features and clinical data. Logistic regressions were used to calculate the abilities of texture features to predict cognitive impairment. Results:After 9 patients who lost follow-up were excluded, a total of 164 patients with nasopharyngeal carcinoma were included as IMRT group.Texture features of ROIs were extracted and dimensionally reduced successfully. Five differences features (Variance, Entropy, GlevNonU, RLNonUni and Contrast)were found among HC group, cognitive impairment group and non-cognitive impairment group, and the last three further showed significant differences within IMRT group (GlevNonU, P=0.011;RLNonUni, P<0.001;Contrast, P<0.001). Hippocampal doses were positively correlated with Variance ( r=0.448, P<0.05), and negatively correlated with Entropy ( r=-0.461, P<0.05). There was a positive correlation between MoCA-B scores with GlevNonU, RLNonUniand Contrast ( r=0.503, P<0.05; r=0.587, P<0.05; r=0.531, P<0.05). GlevNonU and Contrast were independent predictors of cognitive impairment in hippocampal avoidance of radiotherapy (OR=0.731, 95%CI 0.610-0.857; OR=0.651, 95%CI 0.496-0.853). Conclusion:Results of texture analysis could be used as micro imaging evidences of hippocampal injury in radiotherapy avoiding hippocampus, and could also effectively predict the occurrences of cognitive impairment.

Objective To investigate the variation of serum fibroblast growth factor-22 (FGF-22) of first episode depressive patients before and after treatment,and its relations with serotonin (5-HT) and interleukin-1[β (IL-1β) levels and Hamilton's depression scale (HAMD) scores to provide assistance for further study of pathogenesis of depression.Methods Ninety patients with first episode depression accepted treatment in our hospital from June 2015 to June 2016 and 90 healthy controls were enrolled.The serum FGF-22 level was detected and Hamilton's depression scale (HAMD) was performed before and after drug treatment.The relations of FGF-22 level with 5-hydroxytryptamine (5-HT) and interleukin (IL)-1[β levels were analyzed.Results (1) Before treatment,the first episode depressive patients had significantly lower scrum FGF-22 level ([180.44±17.02] ng/mL) and statistically higher HAMD scores (17.84±5.92) as compared with the healthy controls ([200.74±16.63] ng/mL,1.88±2.67,P＜0.05).(2) The serum FGF-22 level after treatment ([195.74+19.57] ng/mL) was significantly higher than that before treatment,and the HAMD scores after treatment (7.64±4.09) were significantly lower than those before treatment (P＜0.05).(3) In the patient group,serum FGF-22 level and HAMD scores were negatively correlated (r=-0.644,P=0.000);serum FGF-22 level had positive correlation with 5-HT level (r=0.718,P=0.000),and negative correlation with IL-1β level (r=-0.763,P=0.000).Conclusion The serum FGF-22 level is abnormal in first episode depressive patients,and it could be a good indicator of peripheral blood in response to depression,which plays an important role in the pathogenesis of depression.

Objective To evaluate the effect of minimally invasive therapy for treating intraventricular hemorrhage.Methods The minimally invasive therapy with unilateral or bilateral drainage were received according to quantity and shape of intraventricular hemorrhage.Results It was operated 22 cases with unilateral drainage and 28 cases with bilateral drainage in the 50 cases intraventricular hemorrhage.Death was 3 cases and mortality rate was 6% in the minimally invasive therapy.ADL1 15 cases(30%),ADL2 18 CRSeS(36%),ADL3 8 cases(16%),ADLA4 cases(8%),ADL5 2 cases(4%)in leave hospital.Conclusion Minimal invasive therapy of intraventrieular hemorrhage has great superiority,such as it can operate simple,trauma mild,decrease complications and enhance curative effect.It can generalize in the basic hospital.