CD8+ T cells play an essential role in defending against viruses,intracellular bacteria,protozoal infections and clearance of tumors since almost all the nucleated cells express MHCⅠ molecule.Following antigen recognition,CD8+ T cells are activated and differentiated to different subsets of effector or memory cells,which could clear the pathogen and form long-term protection.Phenotypic markers,functional properties and anatomical locations are different among these CD8+ T cell subsets.They also show variation in surviving time,proliferation and effector functions when re-challenged with the pathogen or tumor.Multiple signaling pathways and transcriptional factors are involved in CD8+ T cells activation and differentiation,and will be discussed in this review.We will also briefly summary the clinical applications of T cells against tumor or pathogens.

Tumor markers for early diagnosis of cancer is an important auxiliary mean,which for early tumor detection,monitoring and for judging curative effect of treatment regimens play important role.Clinical method for early diagnosis on ovarian cancer is the detection of serum CA125,however,its precision and specificity for early diagnosis are not enough.It has been found that in the development period of the patients with ovarian cancer,SMRP and CA125 is co-expression.This article reviews the value of serum mesothelin on diagnosis of epithelial ovarian cancer to provide reference on early diagnosis and treatment.

Dopa-responsive dystonia(DRD) is a clinical syndrome characterized by childhood dystonia and dramatic and sustained response to low-dose levodopa.The deficiency of any link in dopamine synthesis pathway can lead to DRD that is caused by TH gene mutation and is autosomal recessive, which results in the reduction of tyrosine hydroxylase(TH) synthesis and extensive deficiency of dopamine and catecholamine.However, DRD presents atypical clinical manifestations.Mild patients mainly present with dystonia.Some of them might progressively develop into spastic paraplegia and some may have parkinsonian features.Most of them display good response to levodopa.Severe patients present with progressively complex infantile encephalopathy, and badly response to levodopa and remnant intellectual development problems.Most of them manifest with declining homovanillic acid(HVA) in cerebrospinal fluid.However, due to the noncharacteristic clinical course and nonspecific laboratory tests of TH DRD, gene detection still is the only reliable criterion of diagnosis so far.Low-dose levodopa is effective to most mild patients and can improve symptoms to severe patients to some extent.

Objective To study the diagnostic value of spiral CT pulmonary angiography(SCTPA) for pulmonary embolism(PE).Methods SCTPA scans were performed in 25 patients with PE,the contrast-enhanced SCT scans of the pulmonary arteries were performed,MPR,MIP and SSD were performed simultaneously.Results The 29 SCTPA scans were performed in 25 patients, including the central type in 23 cases(92%) and the peripheral type in 2 cases(8%).The rates of the main,the sinistral and dextral,the middle lobular,the lobular and the lingular pulmonary artery displayed were 100%,the rates of the segmental pulmonary artery displayed were 97.77% and the rates of the subsegmental pulmonary artery displayed were 68.00%.The lobular and segmental pulmonary artery were mainly embolized,the rates of PE were between 46.58% and 75.00%.Conclusion SCTPA has great value in earlier and clear and definite diagnosis of PE.

Objective To investigate the natural head position and cervical posture in the patients with different vertical facial patterns with skeletal class Ⅰ relationship,and to clarify the relationships between vertical facial patterns and natural head position, cervical posture in the patients with skeletal class Ⅰ relationship. Methods 94 patients aged 8- 15 years old with skeletal class Ⅰ relationship were selected as the subjects.The subjects were classified into high angle group,average angle group,and low angle group according to their mandibular plane angles.The cephalometric radiographs in natural head position were taken,and the variables representing craniofacial morphology,head position,and craniocervical posture were measured.The intergroup differences in variables were compared.Results The inclinations of mandible to the true vertical and cervical column (ML/VER,ML/OPT,ML/CVT)were smallest in high angle group,and they were largest in low angle group (P <0.01);other variables representing head posture and craniocervical posture (NSL/VER,FH/VER,NSL/OPT,NL/OPT,NSL/CVT,FH/CVT)were largest in high angle group,and they were smallest in low angle group (P <0.05).The inclinations of ramus to cervical column (RL/OPT,RL/CVT)were largest in high angle group and they were smallest in low angle group (P <0.01).There were no significant differences in the inclinations of cervical column and cervical lordosis (OPT/HOR,CVT/HOR,OPT/CVT)among three groups (P >0.05). Conclusion The significant differences exist in natural head position and cervical posture among the patients with skeletal class Ⅰ relationship with different vertical facial patterns (high angle,average angle,low angle);the subjects with high angle show extended head position and cervical posture,while the subjects with low angle exhibit the opposite tendency.

Objective To elucidate the relationship between mandibular lateral displacement and mandible asymmetry by observing the morphological changes of condylar head and mandible during mandibular lateral displacement in growing rats.Methods Forty-eight male Wistar rats at the age of four weeks were divided at random into experimental and control groups,with 24 rats in each group.A super-hard resin plate was cemented to upper incisors to displace rat mandibles 2 mm to the left during closure(Ipsilateral side).A metal crown was fitted to lower incisors.The rats were killed 2,4,8 or 12 weeks after appliance attachment.The mandible was dissected out and halved.The length and width of condylar head were measured with a caliper.Radiographic films of the mandibles were exposed,and selected measurements were made.Results The length of condylar cartilage on the ipsilateral side was significantly larger than contralateral side in experimental group(P

The adoption of the system of multi-technical appraisals of malpractice means that the appraisals made each time, which constitute the key basis and evidence for the health administrative departments and the judicial organs to deal with medical disputes, are of legal validity as proof. By analyzing the causes of the differences in the appraisals of certain cases, the authors argue that a correct understanding of the definition of malpractice is the key to a correct determination of it; an appropriate application of the principle of allocating the burden of proof is the key link in the technical appraisal of malpractice; perfection of Regulations on Handling Malpractice, Standards for the Classification of Malpractices, and Temporary Provisions on the Technical Appraisal of Malpractice is the basis of correct and impartial appraisals; and a good grasp of the gist of rules and regulations and appraisal according to law is the guarantee for a correct determination of the nature of malpractices.

Objective To explore the efficacy and safety of sequential telbivudine ( LDT) therapy following interferon-α( IFN-α) in hepatitis B e antigen (HBeAg) positive chronic hepatitis B patients.Methods 94 chronic hepatitis B patients in our hospital hepatitis clinic archives from August 2008 to September 2013 were divided into two groups, 45 patients treated with LDT following IFN-αdue to unsatisfactory response to peginterferon-α-2a (peg-IFN-α-2a)treatment in the sequential group and 49 patients treated with LDT initially in the controlled group.In the sequential group, 22 patients failed to respond to IFN-αtreatment, 4 patients obtained IFN-resistance, 6 patients developed severe side effects, 1 patients had pre-C mutation and 12 patients switched to LDT due to economic factors or fertility requirement.The biochemical response and virological response, virological breakthrough and serological response were observed.Chi-square test was adapted for data analysis.Results After 32.35 months of LDT therapy, 88.9%(40/45) patients had with HBV-DNA <100 IU/mL in the experiment group compared with 44.9%(22/49) patients in the control group (P<0.05).The rates of HBeAg loss and HBeAg seroconversion in the experiment group were 53.3%(24/45) and 51.1%(23/45) respectively, which were significantly higher than that of the control group, 24.5%(12/49) and 24.5% (12/49) (P<0.05).6.7% (3/45) patients developed virological breakthrough in the sequential group compared with 34.7%(17/49) in the control group (P<0.05).Above results suggested the synergistic antiviral activity between peg-IFN-α-2a and LDT.Conclusion Sequential LDT therapy following peg-IFN-α-2a is better efficacy and safety compared with treating patients with LDT alone initially.

Objective:To analyze some clinical factors influencing the treatment outcomes by Peer assessment rating(PAR).Meth-ods:80 cases underwent othordontic therapy were included.The clinical data and treatment effects were analyzed by PAR,the behav-ioral and psychological evaluation of the subjects was collected and analyzed by statistics.Results:Improvement and great improvement were achieved in 42.5% and 56.3% of the patients.There was no significant difference in different groups of gender,bone-facial con-tour classification and tooth extraction,but there was a significant difference in different groups of Angle classification in terms of pre-treatment PAR and reduction of PAR.There was a linear regression between pre-treatment PAR and reduction of PAR and percentage reduction of PAR,respectively.PAR showed more decrease in the patients of Angle class III classification,than in those with Class II and Class I.Conclusion:PAR is less influenced by gender,bone-facial contour,classification and tooth extraction.PAR evaluation shows that the more severe initial Angle malocclusion the patients have,the more significant improvement they may finally obtain.

Maxillary transverse growth is inhibited by congenital cleft, early surgical scar strain, and oppression of lipmuscles in patients with cleft lip and palate. Clinical manifestations have shown severely constricted maxilla, insufficientmaxillary width, mismatch of upper and lower dental arches, and crossbite. Alveolar bone graft and arch expansion can effectively correct the deficiency in maxillary width. This paper discusses the timing and success rate of alveolar bone graft, as wellas the relationship between alveolar bone graft and arch expansion. Secondary alveolar bone graft is optimally performed beforepermanent canine eruption, especially when the teeth have formed between half and three quarters of their roots. Rapid maxillaryexpansion prior to alveolar bone graft is beneficial because this process increases the gap of the cleft, expands bone graft, andreduces the difficulty. However, the stability of this process remains controversial. Small-scale studies have reported that rapidmaxillary expansion after alveolar bone graft can open the midpalatal suture without bone graft loss. Slow maxillary expansioncan provide continuous light forces to reconstruct the bone. However, these studies are coordinated with fixed orthodontictreatment. Further research is necessary to determine the effects of maxillary expansion on long-term stability of teeth.
Alveolar Bone Grafting ; Bone Transplantation ; Cleft Lip ; Cleft Palate ; Dental Arch ; Humans ; Malocclusion ; Maxilla ; Palatal Expansion Technique ; Time Factors ; Tooth Eruption