Objective To compare the beneficial efficiency of chemotherapy combined with radiotherapy or radiotherapy alone,for locally advanced nasopharyngeal carcinoma.Methods A systematic review of randomized controlled trials(RCT) on this subject was performed.Mortality rate(MR),event-free survival(EFS),loco-regional control rate(LRR) and distant metastasis rate(DMR) were analyzed.Meta-analysis was carried out to compare the efficiency of adding chemotherapy to radiotherapy or radiotherapy alone.Results Totally 16 trials involving 3 768 patients were included.Our results showed that:① Patients receiving concomitant chemotherapy had better 2-,3-and 5-year MR,EFS,LRR and DMR compared with those receiving radiotherapy alone;② Neoadjuvant chemotherapy improved LRR and DMR in patients with nasopharyngeal carcinoma when compared with radiotherapy alone;③ There was no significant difference between adjuvant chemotherapy and radiotherapy alone in MR,EFS,LRR and DMR.Conclusion Adding chemotherapy to radiotherapy improves survival rate and EFS of patients with nasopharyngeal carcinoma,reduces LRR and DMR of these patients when compared with radiotherapy alone.We believe that adding chemotherapy to radiotherapy is a very effective therapy for patients with locally advanced nasopharyngeal carcinoma.

Objective To isolate and identify the lung cancestem like cellfrom the cell line NCI-H1650 .MethodThe NCI-H1650 cellwere continuously cultured in serum-free medium with human insulin ,recombinanepidermal grow th facto(EGF) ,recombinanbasifibroblasgrowth facto(bFGF) and bovine serum albumin(BSA) ,and paclitaxel waadopted to induce the stem cell.Flow cytometry and immunofluorescenstaining were used to analyze the expression levelof lung cancestem cell markeCD133 and CD326 .The expressionof stem cell related markeOct4 ,Nanog and Sox-2 were detected by RT-Pcand West-ern blo.ResultThe NCI-H1650 cellcontinuously cultured by serum-free medium and induced by combining paclitaxel induction showed the spherical suspension growth .Compared with NCI-H1650 cellcultured by serum ,CD133 and CD326 had significantly high expression and the expression levelof Oct4 ,Nanog and Sox-2 were significantly increased (P＜0 .05) .Conclusion Adopting the serum-free culture in vitro combined with paclitaxel foinducing NCI-H1650 cellcan effectively isolate the stem cellamong them.

Objective To explore the expression of T cell immunoglobulin and mucin-3(TIM-3)in peripheral blood mononu-clear cells from patients with primary Sj¨ogren’s syndrome(pSS)and its clinical significance.Methods Enrolled 33 pSS pa-tients from Shanghai Changzheng Hospital and Changhai Hospital in October 2012 and July 2013.The relative expression of TIM-3 in the peripheral blood mononuclear cells(PBMC)in 33 patients and 33 healthy individuals was detected by RT-PCR. The association between TIM-3 mRNA level and clinical characteristics were analyzed,for example,serum RF,CRP and anti-SSA/SSB antibody.1 2 of the pSS patients were followed up and their TIM-3 mRNA level was determined after glucocorti-coid treatment for 2 months.Results The expression of TIM-3 in PBMCs from patients with pSS was increased significantly than that in healthy individuals (0.55±0.12 vs 0.13±0.10,t=15.44,P<0.000 1),but its expression between anti-SSA/anti-SSB positive and negative patients were not statistical difference (0.45±0.21 vs 0.54±0.31;0.46±0.15 vs 0.51± 0.24).The TIM-3 mRNA expression in pSS patients was positively correlated with serum RF and CRP (R=0.558 5,R=0.414 7,P>0.05),but was not associated the anti-SSA/SSB antibody (P=0.298 2).TIM-3 mRNA level was decreased in the patients who were treated with glucocorticoids for 2 months (0.62±0.10 vs 0.38±0.13,t=5.07,P<0.05).Conclusion TIM-3 may play a role in the pathogenesis of pSS and it may be regarded as a biomarker to pSS.

Objective To explore TRAIL expression in patients with primary immune thrombocytopenia (ITP)and its role in the pathogenesis.Methods Peripheral Blood Mononuclear Cells (PBMCs)from twenty-eight patients with ITP and thirty healthy controls were obtained.TRAIL expression was determined using Real-time Quantitative Polymerase Chain Reaction (RT-PCR).Serum TNF-α,IFN-γ,IL-4 and IL-10 were detected using ELISA.Associations between TRAIL expression and clinical parameters were assessed.Results Compared to healthy controls,TRAIL expression was significantly increased in PBMC from patients with ITP (2.80±0.43 vs 1.00±0.24,t=19.72,P<0.001).Compared to the healthy controls,ex-pression of IFN-γand TNF-αfrom ITP patients were increased (52.43±11.04 pg/ml vs 23.26±8.15 pg/ml;69.14± 10.89 pg/ml vs 36.14±13.17 pg/ml,t=10.36~11.50,P<0.001)and expression of IL-10 were decreased (11.18±6.13 pg/ml vs 33.28±9.85 pg/ml,t=10.17,P<0.001)and there was no significant difference in IL-4 expression (35.75± 12.52 pg/ml vs 40.16±14.26 pg/ml,t=1.25,P>0.05).Furthermore,TRAIL expression was positively correlated with serum IFN-γ,TNF-αlevel (r=0.432,0.541,P<0.05),and negatively correlated with IL-10 and PLT (r=-0.424,-0.553,P<0.05).Conclusion Rur results suggest that TRAIL may be involved in the pathogenesis of ITP.

Objective To evaluate the diagnostic performance of osteopontin (OPN)for ovarian cancer.Methods Wanfang, CQVIP and CNKI were retrieved to identify eligible studies on diagnostic value of OPN for ovarian cancer that published be-fore May,2014.The quality of the studies was evaluated by QUADAS tools.The diagnostic sensitivity,specificity,negative and positive likelihood ratios and diagnostic odds ratio (DOR)were pooled by random-effects models.The overall diagnostic performance was estimated by summary receiver operating characteristic (SROC)curves approaches.Results Six studies met the included criteria.The summary estimates for OPN in the diagnosis of ovarian cancer in the studies included were as follows:sensitivity 0.83 [(95% confidence interval(CI):0.78~0.87)],specificity 0.91 (95% CI,0.88~0.94),positive likelihood ratio 9.00 (95% CI,5.91~13.71),negative likelihood ratio 0.19 (95% CI,0.15~0.25),and DOR 47.58 (95%CI,27.93~81.05).The area under curve (AUC)for OPN was 0.87 with Q value of 0.80.Conclusion OPN has high diag-nostic value for ovarian cancer.

Objective To investigate the role of Th9 cells in primary biliary cirrhosis and its clinical significance.Methods The percentages of Th9 cells in patients with PBC (n=38)and healthy controls (n=38)were measured by flow cytometry. Patients clinical data were collected and Mayo risk scores were calculated.Determined the levels of IL-9,PU-1 and TGF-βmRNA expressions and the protein levels of IL-9 in plasma.Further analyzed the correlation between Th9 cells and clinical parameters.Results Compared to healthy controls,Th9 cells percentage was higher in PBC patients and increased with dis-ease stages (t=27.29;P<0.01).IL-9,PU-1 and TGF-βmRNA expressions were increased compared with healthy controls (t=14.69,23.92,10.48;all P<0.01)and the protein level of IL-9 was also up-regulated (t=11.66;P<0.01).The clinical parameters (ALP,AST,ALT,GGT and TBIL)were higher than healthy controls (t=10.94,12.95,10.56,14.92,27.70;all P<0.01).Moreover,the percentage of Th9 cells were positively correlated to Mayo risk,ALT,AST,GGT and TBIL (P<0.05).Conclusion Th9 cells may be involved in the pathogenesis of PBC and related to the disease stage,which provides new clues for future immunotherapy.

Objective To investigate a new therapeutic pathway for primary biliary cirrhosis (PBC) by immune tolerance reestablishment in a PBC mouse model. Methods Spleenic cells from naive mice were incubated with M2 in the presence of ECDI and the ceils were injected into caudal vein of the mice which would be used for development of PBC model. Spleenic cells incubated with bovine serum albumin (BSA) were injected as controls. 16 weeks later, anti-mitoehondrial antibody (AMA) , alkaline phosphatase(AKP) and portal inflammation were assayed for evaluating the prevention effect. Results AMA positive rate in tolerance group was lower than that in BSA and PBC groups ( P = 0. 007, P = 0. 003 ). The difference between BSA and PBC was not significantly. Serum AKP levels in tolerance, BSA and PBC group were (80.5 ±9.8) U/L, (93.8 ±15.7) U/L and (92.5 ±17.7) U/L, separately. The level in tolerance group was lower than that in BSA and PBC groups (P =0.0095, P =0.029). The rates of portal areas with cell infiltration were 42. 67% ± 12. 30% , 57. 07% ± 11. 35% and 51. 53% ± 9. 96% , separately. The number of infiltrated portal tracts in tolerance group was less than that in PBC group (P = 0.039) and BSA group (P = 0. 0024). Conclusion PBC was prevented to some extent by reestablishing immune tolerance to M2 autoantigen. This provides clues for finding a better treatment proposal.

Objective To explore the clinical significance of neutrophils/lymphocyte(NLR)and platelet/lymphocyte ratioof (PLR)peripheral blood in patients with primary biliary cirrhosis.Methods Retrospectively analyzed 62 patients with PBC and three subgroup patients according to Child-pugh,who were hospitalized in Shanghai Changhai Hospital and Shanghai Changzheng Hospital from January 2010 to July 2015.Enrolled 59 healthy controls.Baseline data and laboratory indicators were extracted,and the correlation between PLR and NLR and disease activity were analyzed.The changes of NLR in 3 pa-tients with PBC were analyzed.3 patients were followed up and their NLRs were recorded before and after therapy.Results Compared with healthy controls,NLR was significantly increased in PBC patients (P<0.05),and not PLR (P>0.05). NLR was positively correlated with TBIL and Mayo risk (R=0.35,0.30,P<0.05),and not ALT,AST or ALP (P>0.05).After therapy,NLRs were significantly reduced in three PBC patients (P<0.05).Conclusion NLR may be a useful biomarker for assessing clinical therapy in PBC patients.

Objective To investigate the clinical significance of neutrophils/lymphocyte ratio (NLR)and platelet/lymphocyte ratio (PLR)of peripheral blood in patients with myasthenia gravis (MG).Methods 54 patients with MG treating from Jan-uary 2013 to December 2013 in Changhai hospital and 57 healthy adults who received check-up were enrolled the study as MG group and control group.WBC count,NLR and PLR were compared between two groups and among different clinical classifications in MG patients.The area under the receiver operating characteristic (ROC)curve was performed to evaluate these indicators’diagnostic value for MG.Results The WBC count,NLR and PLR in MG group were (6.85±0.37)×109/L,2.48±0.19 and 118.79±6.38 respectively,which were significantly higher than (5.87±0.12)×109/L,1.59±0.06 and 102.01±3.45 in control group (P <0.05).The area under the ROC curve of WBC count,NLR and PLR were 0.559,0.717 and 0.581 respectively.PLR of MG patients with type Ⅲ or Ⅳ was significantly higher than that of patients with typeⅠ,Ⅱ(P <0.05).Conclusion NLR and PLR of MG patients increased significantly.The diagnostic value of NLR is higher,and PLR may be associated with the severity of disease.

Objective: To investigate the effect of intravenous immunoglobulin in highly sensitized patients awaiting organ transplantation. Methods: IVIG was used to reduce donor specific anti HLA alloantibodies in vitro and in vivo . Fifteen patients received IVIG′s suppressive experiment in vitro by random panel lymphocytotoxicity test. The serum of patients were divided into 2 groups: one was diluted with equal volume of IVIG and the other was diluted with PBS solution, and then reacted with lymphocytes from healthy donors randomly. Of them 5 patients received the treatment by IVIG. Four patients were administrated with 0.5 g/kg. Period of treatment was 4 weeks. One patient received 8 weeks infusion in same dose, 2 patients resulted in PRA drop to 10% had received kidney and pancreas kidney transplantation. Results: The percentage of RPLT in experimental group was lower than that in control group. After large dose of infusion of IVIG, the patients showed a reduction in absolute PRA of 2% 51% (mean decrease: 23%). Two patients had undergone subsequent transplantation and no serious rejection occurred. Conclusion: Treatment with IVIG is a valuable tool for the transplantation of immunized patients. The effect of IVIG is dose dependent and can be achieved in 3 weeks.