Objective To investigate the significance of Th 17 cells, Treg cells and Th17/Treg cell-associated cytokines in the development of tuberculous pleurisy through detecting the expressions of Th 17 cells and Treg cells (CD4+CD25+Foxp3+) in CD4+T cells, analyzing concentrations of IL-17, IL-23, IL-6 and TGF-βin serum of patients with tuberculous pleurisy and healthy controls and measuring levels of IL -17, IL-23, IL-6 and TGF-βin hydrothorax of patients with tuberculous pleurisy .Methods Flow cytometry was used to detect expressions of Th 17 and Treg cells in peripheral blood of patients with tuberculous pleurisy and healthy controls.ELISA method was performed for quantitative detection of concentrations of IL -17, IL-23, IL-6 and TGF-βin serum and hydrothorax .Differences and correlations between the above measured data were analyzed by the statistical software SPSS 17.0.Results Compared with the healthy control group , the expressions of Th17 cells in peripheral blood of the patients were significantly increased (1.02%±0.20%vs.0.89%±0.13%, P=0.002<0.05), while the expressions of Treg cells were significantly decreased (4.64%±0.77%vs.5.10%±0.90%, P=0.000<0.05).Correspondingly, the ratio of Th17/Treg cells (0.25±0.07) in the patients were significantly higher than that in the healthy controls (0.17±0.05, P=0.000<0.05).Concentrations of IL-17, IL-23 and IL-6 in peripheral blood and in hydrothorax of the pa-tients were (17.49±3.94) ng/L, (90.42±23.06) ng/L, (4.54±1.02) ng/L and (26.13±5.98) ng/L, (122.26±31.71) ng/L, (5.31±0.74) ng/L respectively, which were remarkably higher than the levels of IL-17 (14.45±3.81) ng/L, IL-23 (77.55±20.26) ng/L and IL-6 (4.26±0.91) ng/L in control group. In tuberculous pleurisy group , concentrations of IL-17, IL-23 and IL-6 in hydrothorax were significantly higher than those in peripheral blood with P values of 0.000, 0.000 and 0.003.There was no difference be-tween IL-6 levels in peripheral blood from patients and IL-6 levels in peripheral blood from the healthy con-trols, P=0.274.In comparison with the control group , TGF-βlevels in peripheral blood and in hydrothorax of the patients were significantly decreased (3.95 ng/L±0.79 ng/L, 3.12 ng/L±0.77 ng/L vs.3.32 ng/L ±0.80 ng/L) .In tuberculous pleurisy patients , the expression of Th17 cells in peripheral blood was nega-tively correlated with Treg cells in peripheral blood (r=-0.684, P=0.000<0.05), but was positively relat-ed to the levels of IL-17, IL-23 and IL-6 (r=0.479, 0.441, 0.326, P=0.013, 0.015, 0.017).TGF-βlevel had significantly positive correlations with Treg cells in the peripheral blood of the patients (r=0.297, P=0.024), but no significant correlation with Th17 cells was found (r=0.091, P=0.659).Conclusion Th17/Treg cell-associated cytokines might regulate the expressions of Th 17 and Treg cells and inflammatory reaction.Changes of Th17 cells, Treg cells and related cytokines might be important immunopathological mechanisms for tuberculous pleurisy .

Objective To observe the expression of breast cancer resistance protein(BCRP) gene in breast cancer patients,and to explore its value in evaluating the therapeutic effect of chemotherapy for breast cancer.Methods Semi-quantitative reverse-transcription polymerase chain reaction(RT-PCR) was applied for the detection of mammary BCRP gene expression level in 60 female breast cancer patients who have received chemical therapeutic regimen of CEF(cyclophosphamide,epirubicin and 5-fluorouracil).The patients were divided into two groups according to the BCRP gene expression before CEF therapy.After treatment,the therapeutic effect in the two groups was observed and the BCRP gene expression level was also measured.Results In 17(17/60,28.3%) patients with positive BCRP gene expression,11 were relieved,with a relief rate of 64.7%,lower than 93.0% in patients with negative BCRP gene expression(P

Objective To evaluate the clinical value of elasticity imaging and area ratio by ultrasonography in differential diagnosis of benign and malignant thyroid nodules.Methods Gray-scale ultrasound and elasticity imaging was used to examine 88 patients with thyroid nodules.The elasticity classification and area ratio were retrospectively reviewed and compared with pathology.The elasticity grades 1 - 3 predicted benign,grades 4 - 5 predicted malignant.Results Eighty-eight patients with 116 thyroid nodules were detected,93 nodules were benign and 23 nodules were malignant.( 1 )An elasticity grades of 1 - 3 was observed in 82 (95.3％) of 86 benign nodules,while elasticity grades of 4 - 5 in 19 (63.3％) of 30 malignant nodules.The diagnosis sensitivity,specificity and accurate rate of the elasticity grades was 82.6％,88.2％,87.1％.(2) The mean of elasticity imaging and area ratio of 93 benign nodules (1.31 ± 0.13 ) was statistically lower than that in 23 malignant nodules ( 1.73 ± 0.13 ) (t =13.536,P =0.001 ).( 3 )According to ROC analysis,the cut-off point of elasticity imaging and area ratio was determined as 1.52.With elasticity imaging and area ratio ＜ 1.52,89 nodules [98.9％(89/90)] were confirmed as benign and 22 nodules [84.6％ (22/26)] were confirmed as malignant by pathology.The diagnosis sensitivity,specificity and accurate rate of elasticity imaging and area ratio was 95.7％,95.7％,95.7％.(4)The area under the ROC curve of elasticity imaging and area ratio ≥ 1.52 was 0.996,significantly higher than that of elasticity grades ≥ 4 (0.891).The diagnostic accurate rate of elasticity imaging and area ratio was significantly higher than that of elasticity grades(95.7％ vs.87.1％,x2 =5.472,P=0.019).Conclusions The elasticity imaging and area ratio by ultrasonography can be used in the differential diagnosis of thyroid lesions.It is a new diagnostic indicator for diagnosis of thyroid lesions.

Objective To explore the influence of icotinib in the apoptosis of the human salivary adenoid cystic carcinoma cells ACC-M, and to clarify the mechanism of icotinib for the treatment of salivary adenoid cystic carcinoma.Methods The ACC-M cells were randomly divided into control group,2,4,8μmo1·L-1 icotinib groups,p38-MAPK inhibitor SB203580 (20μmol· L-1 )group,SB203580 (20 μmol· L-1 )+4μmo1 · L-1 icotinib group;the cells were collected 4 h after treatment.The viability of ACC-M cells was measured by MTT assay.The apoptosis of ACC-M cells was assessed by caspase-3 activity kit. The expression of p-p38-MAPK protein was determined by Western blotting analysis.Results Compared with control group,the inhibitory rates of growth of the ACC-M cells in icotinib groups were significantly decreased (P<0.05 ), and the activities of caspase-3 were increased (P<0.05),and the expression levels of p-p38-MAPK were significantly increased (P<0.05).Compared with 4μmo1·L-1 icotinib group,the expression level of p-p38-MAPK in SB203580+icotinib group were decreased (P < 0.05 ), and the activity of caspase-3 was decreased dramatically (P < 0.05 ). Conclusion Icotinib may induce the apoptosis of ACC-M cells through the activation of p38-MAPK signaling pathway.

[ ABSTRACT] AIM:To investigate the effects of sulindac on oxidative stress in autism.METHODS:With an au-tistic model induced by prenatal exposure to valproic acid ( VPA) , we detected the expression of the signaling molecules of canonical Wnt pathway in the prefrontal cortex ( PFC) and hippocampus ( HC) of autistic rats treated with sulindac.The protein expression levels of glycogen synthase kinase 3β(GSK-3β), β-catenin and 4-hydroxynonenal (4-HNE) were ob-served by Western blotting.The mRNA expression of thioredoxin(Trx)1 and Trx2 was assessed by semi-quantitative RT-PCR.RESULTS:The protein level of GSK-3βand mRNA levels of Trx1 and Trx2 were lower, whereas the protein expres-sion levels ofβ-catenin and 4-HNE were higher in VPA group than those in control group.In contrast, the protein levels of GSK-3βwere significantly higher in the animals treated with both VPA and sulindac than those in VPA group, while the lev-els ofβ-catenin and 4-HNE were decreased.CONCLUSION:Sulindac attenuates oxidative stress in the pathogenesis of au-tism, suggesting the up-regulation of the Wnt/β-catenin signaling pathway disrupts oxidative homeostasis and further facili-tates susceptibility to autism.

Objective To explore the clinical value of related indicators of blood analysis in the differential diagnosis of acute and chronic leukemia .Methods From January 2015 to June 2017 ,15 patients with acute leukemia ( A group ) and 10 patients with chronic leukemia ( B group ) , and 20 healthy volunteers ( C group ) , 20 cases of nosocomial infection(D group) in Jiaocheng People's Hospital of Lyuliang were selected .The differences of WBC, RBC,PLT,HB in four groups were analyzed,and the differences of WBC,immature granulocyte percentage (IG％), immature granulocyte(IG),the percentage of naive cells ,immature cells count between A group and B group were further analyzed.Results The count of WBC from high to low was B group [(120.3 ±39.2) ×109/L],A group [(81.4 ±29.2) ×109/L],D group[(26.3 ±10.3) ×109/L],C group [(5.4 ±1.9) ×109/L],there was statistically significant difference among the four groups (P <0.05).The count of RBC in C group [(4.6 ± 1.3) ×109/L] ≈D group [(4.0 ±0.9) ×109/L] >B group [(1.4 ±0.7) ×109/L] >A group [(0.6 ± 0.1) ×109/L](P<0.05).The count of PLT in D group [(361.5 ±103.3) ×109/L] >C group [(264.3 ± 84.2) ×109/L] >B group [(12.3 ±6.5) ×109/L] ≈A group [(5.9 ±1.7) ×109/L](P<0.05).Through the analysis of bone marrow AML 11 cases,54.55％was M2,followed by M1,M3,M5.ALL in 4 cases,CML in 10 cases. The IG％,IG count,WBC,percentage of naive cells ,immature cells count in A group and B group were increased ,but in the different types of leukemia increased in amplitude had significant difference , AML was characterized by the increase of IG％and percentage of naive cells ,ALL was characterized by the significant increase of WBC ,CML was characterized by the significant increase of WBC ,IG％,IG count.Conclusion Blood analysis is of high value in the differential diagnosis of acute and chronic leukemia .It can provide a reliable basis for the initial diagnosis and classification of leukemia ,and can be used to guide clinical treatment .

Fragile X syndrome (FXS) is the most common monogenic disease that causes intellectual disability and autism spectrum disorder (ASD),causing moderate to severe mental retardation with unusual facial features and connective tissue abnormalities.Fragile X syndrome is caused by the mutation of FMR1 gene,resulting in the reduction or loss of its product,fragile X mental retardation protein (FMRP).The diagnosis is mainly based on the detection of FMR1 gene,and there is no effective treatment for fragile X syndrome.Therefore,it is very important to strengthen genetic counseling and prenatal diagnosis,and effectively reduce the incidence of fragile X syndrome.

Objective To observe the efficacy and side effects of anlotinib combined with paclitaxel and cisplatin as the first-line treatment of advanced esophageal squamous cell carcinoma (ESCC). Methods We retrospectively analyzed 50 cases of advanced esophageal squamous cell carcinoma diagnosed pathologically. Among them, 24 cases were treated with the combination of anlotinib and paclitaxel plus cisplatin (experimental group), and 26 cases were treated with paclitaxel plus cisplatin regimen (control group). The efficacy and adverse reactions were observed and followed up. Results The objective response rates of the experimental and control groups were 83.33% and 53.84% (P < 0.05), the disease control rates were 100% and 96.15% (P > 0.05), mPFS were 10.6 and 9.13 months (P < 0.05), and mOS were 13.4 and 11.8 months (P < 0.05). The common adverse events in the experimental group were hand-foot syndrome (12.5%), hypertension (12.5%), epistaxis (8.33%) and proteinuria (4.16%), all of which were grade Ⅰ-Ⅱ and controllable without affecting the continuity of chemotherapy. Conclusion The combination of anlotinib, paclitaxel and cisplatin as the first-line treatment of advanced esophageal squamous cell carcinoma can improve the curative effect and the adverse effects are endurable.

ObjectiveThis paper aims to analyze the current status of outcome indicators in randomized controlled trials （RCT） of traditional Chinese medicine （TCM） for treating chronic atrophic gastritis （CAG）， so as to provide references for constructing the core outcome set （COS） of TCM in the treatment of CAG. MethodChina National Knowledge Infrastructure （CNKI）， Wanfang， VIP， SinoMed， PubMed， Embase， and Cochrane Library databases were searched for RCTs of TCM in the treatment of CAG in the last five years. The risk of bias of included studies was evaluated， and the selection status of outcome indicators was statistically analyzed. ResultA total of 150 RCTs were included， with a sample size of 44-398 cases. 164 outcome indicators were reported， with an application frequency of 1 229 times. The outcome indicators were classified into seven indicator domains according to functional attributes， followed by physical and chemical examination （69.41%）， TCM syndrome （12.69%）， symptoms and signs （11.15%）， safety indicators （5.37%）， quality of life （0.65%）， long-term prognosis （0.65%）， and economic evaluation （0.08%）. According to the statistical analysis， there were problems in the selection of outcome indicators in RCTs of TCM for treating CAG， including various indicators， non-standard name reports， unclear primary and secondary indicators， random combination of subjective and objective indicators， neglected patient report outcome indicators， missing long-term prognosis and economic indicators， insufficient reporting of safety indicators， and inconsistent measurement tools and measurement time points. ConclusionIn the past five years， there have been many problems in the selection of outcome indicators in RCTs of TCM for treating CAG. It is necessary to actively promote the construction of the COS of TCM in the treatment of CAG and promote the high-quality development of clinical research of TCM.