Objective:To isolate and establish long term T cell clones derived from bone marrow(BM) of a patient with severe aplastic anemia(sAA).Methods:CD34 + cells and CD3 +T cells were enriched from BM aspirates,respectively by positive and negative immunomagnetic sorting protocol.BM of exicised rib of a non hematological patient was used as control. Irradiated CD34 + cells together with T cells were subject to one way autologous mixed lymphocyte culture(AMLC).Viable T cells surviving from AMLC were limit diluted and single cell was plated into microtitier wells along with feeder cells.Then all wells were screened for the growing cell wells and they were transferred into new wells to be expanded and maintained.Each clones obtained were primarily assessed CD4/CD8 phenotype and their homogeneity by immunocytochemical analysis.Results:The purity of sorted CD34 + and T cells was more than 90%. On AMLC,a total of 4?10 3 cells were viable with sAA,but 65 cells viable with control.Upon single cell seeding it 11 growing cell wells were found for sAA,and no one growing cells for control.The actual plating rate(2.1%) was within Poisson theoretic value range (

Objective To investigate the miss rate of adenoma with colonoscopy and assess the features and risk factors for missed diagnosis.Methods Patients with colorectal adenoma received a second colonoscopy within 120 days after adenoma was detected and removed on the initial colonoscopy.The findings of two colonoscopies were reviewed and analyzed.The features of adenoma (including size, location, shape, number and pathology) , clinical characteristics of patients (including age, sex, reasons of colonoscopy, history of diverticular disease, history of abdominal or pelvic surgery and colonoscopy with sedation) and endoscopists were recorded.Miss rate and features of different types of missed adenoma were analyzed.We also assessed the effects of adenoma features, patients' characteristics and endoscopists on missed diagnosis of adenoma.Results Adenoma missed diagnosis was found in 271 patients out of 809 recruited subjects (33% ).A total of 425 adenomas were missed out of 2134 (20% ) adenomas detected by repeated colonoscopy.A large diameter was associated with a decrease in the miss rate for adenoma (P < 0.01).Conversely , sessile or flat shape (P < 0.01) , locations at sigmoid, hepatic flexure, cecum and ascending colonic ( P < 0.05) were significantly associated with a higher miss rate of adenoma, as was the number of adenomas (P <0.01).A higher adenoma missed diagnosis rate was observed in beginner colonoscopists, as compared with experienced ones (P < 0.01).Conclusion A marked miss rate of adenoma exists on colonoscopy, which is significantly associated with the size, shape, location and number of adenomas and endoscopists.

Objective To compare the positioning accuracy between personalized polyurethane foam with wing boards and negative pressure vacuum bag in radiotherapy for lung cancer using kilovoltage cone beam computed tomography(CBCT). Methods Thirty-nine patients with lung cancer who received chest radiotherapy in our hospital from 2015 to 2016 were enrolled as subjects. In those patients, 20 were immobilized by negative pressure vacuum bags(VB group)and the others by personalized polyurethane foam with wing boards(PF group).CBCT images were acquired weekly and registered with planning CT images. Setup errors in the left-right, superior-inferior, and anterior-posterior directions, three-dimensional(3D) displacement vector,and setup time were recorded. The margin of the planning target volume(PTV)was calculated using the Van Herk formula(2.5∑+0.7σ). Between-group comparison was made by paired t test. Results The PF group had a significant smaller setup error in the y-direction than the VB group (2.54±1.79 vs.3.19±2.14 mm,P=0.03),while there were no significant differences in setup errors in the x-or z-direction between the two groups(1.80± 1.48 vs. 1.90± 1.41 mm, P=0.46;2.14± 1.75 vs. 2.25± 1.75 mm,P=0.35). There were no significant differences in rotational setup errors in the Rx-,Ry-,or Rz-direction between the two groups(1.15°±0.76°vs. 1.15°±0.85°, P=0.50;0.71°±0.60°vs. 0.72°±0.43°, P=0.45;0.62°±0.54° vs. 0.46°±0.30°,P=0.06). The PTV margins in the x?,y?,and z?directions were expanded by 5.56, 8.57, and 7.02 mm, respectively, in the PF group, and by 5.62, 9.27, and 7.23 mm,respectively,in the VB group. The proportion of patients with 3D displacement vectors larger than 5 mm was 40% in the PF group and 45% in the VB group.Conclusions For patients undergoing radiotherapy for lung cancer,personalized polyurethane foam with wing boards can,to a certain extent,reduce the setup error in the superior-inferior direction and PTV margin expansion.[Key words] Lung neoplasms/radiotherapy; Polyurethane foam; Vacuum bag; Setup errors;Margin

Objective To evaluate the efficacy of different treatment options for cholecysto-choledocholithiasis (CCL),and try to find the ideal treatment.Methods From January 2006 to January 2016,a total of 3 107 patients with CCL from the Affiliated Hospital of Inner Mongolia Medical University were enrolled.Among them,1 283 patients were in open cholecystectomy (OC) and open common bile duct exploration (OCBDE) group,964 patients were in laparoscopic cholecystectomy (LC) and laparoscopic common bile duct exploration (LCBDE) group,and 860 patients were in endoscopic retrograde cholangiopancreatography (ERCP) + LC group.The clinical data of the three groups were analysed.One-way analysis of variance and chi-square test were performed for statistical analysis.Results From 2006 to 2010,the percentage of patients treated with OC + OCBDE,LC + LCBDE,and ERCP + LC were 56.05％ (829/1 479),25.15％ (372/1 479) and 18.80％ (278/1 479),respectively;from 2011 to 2016,the percentage of patients received the above three treatments were 27.89％ (454/1 628),36.36％ (592/1 628) and 35.75％ (582/1 628),respectively.The difference in the proportion of the same treatment at different times was statistically significant (x2 =4.775,4.168 and 0.669,all P ＜ 0.05).The success rate of surgery in the OC + OCBDE group was 100.00％ (1 370/1 370);while the success rate of surgery in the LC + LCBDE group was 94.26％ (920/976),and 56 patients converted to OC + OCBDE;the success rate of surgery in the ERCP + LC group was 95.00％ (817/860),and 31 patients converted to OC + OCBDE,and 12 patients to LC + LCBDE.The intraoperative complication in OC + OCBDE,LC + LCBDE and ERCP + LC were 2.85％ (39/1 370),3.48％ (32/920) and 1.22％ (10/817),respectively.The incidence rates of postoperative complication were 4.89％ (67/1 370),5.34％ (50/920) and 5.51％ (45/817),respectively.The incidence rates of intraoperative complication of the ERCP + LC group was lower than that of OC + OCBDE group and LC + LCBDE group,and the differences were statistically significant (x2 =6.203 and 3.001;both P ＜ 0.05).However there was no significant difference in incidence rate of postoperative complications among the three groups (all P ＞ 0.05).The hospital stay of the OC + OCBDE group,the LC + LCBDE group and the ERCP + LC group were (6.7 ± 1.3) days,(5.6 ± 1.2) days and (10.9 ± 1.6) days,respectively,and the differences were statistically significant (F =90.010,P ＜ 0.01).The hospitalization expenses of OC + OCBDE group,LC + LCBDE group and ERCP+LC group were (13 720±1 910) yuan,(18 150±1 490) yuan and (25 830 ± 2 430) yuan,respectively,and the differences were statistically significant (F =302.991,P ＜ 0.01).Conclusion The first choice of patients with CCL is endoscopic minimally invasive treatment and open surgery can be used as a remedial method for endoscopic treatment.