ObjectiveTo investigate whether the cellular immune function of athymia nude mice can be reestablished and whether the recipients' specific immune tolerance can be induced by the combined xenotransplantation of embryonic thymus and metanephros anlagen from rats to athymia nude mice.Methods Male and female rats were mated overnight.The presence of vaginal plaques was marked as the embryonic day 0(E0).The whole embryos from Lewis rats on embryonic day 15(E15) were taken for the present experiment.The Lewis E15 metanephros and thymus anlagen were taken out from the embryos and immediately preserved in normal saline at 4℃,and then were implanted into the omentum and renal capsule of nude mice.10 weeks post-implantation,the peritoneotomy was carried out on some recipients,metanephros and thymus transplants were removed for histopathological examination.The concentrations of urea nitrogen and creatinine in cyst fluid from the metanephros transplants were measured.The survival time of the recipients was observed after nephrectomy.The blood of the recipients was obtained to detect the re-establishment of T lymphocyte with flow cytometry(FCM).The lymphocyte suspension extracted from recipients were mixed respectively with the spleen cells suspension of Lewis rats,BN rats or C57BL/6 mice to perform mixed lymphocyte reaction(MLR) test.The skins of Lewis rats,BN rats,C57BL/6 and nude mice were transplanted in the chest-back of the recipients to observe the reject reaction.Results10 weeks post-implantation,both E15 metanephros and thymus transplants were enlarged,and showed well-developed structure under optical microscope and electronic microscope.Metanephros displayed partial excreting function.The concentrations of urea nitrogen and creatinine in cyst fluid from the metanephros transplants were close to the concentrations in the bladder urine.The combined transplant recipients survived longer than the others after nephrectomy(P ＜0.05).The re-establishment of T lymphocyte from the blood of recipients was certified by FCM.MLR indicated that the lymphocyte of the combined transplant recipients had normal reaction to the spleen cells of the BN rats and C57BL/6 mice,but had under-reaction to the donor Lewis's( P＜0.01 ).Survival time of the skin from donor Lewis is longer than that of the BN rats' and the C 5 7 BL/6 mice' s ( P ＜ 0.01 ).Conclusion E15 Lewis metanephros and thymus anlagen heterografted into the athymia nude mice will grow and function well.The nude mice with combined transplantation of E15 Lewis thymus and metanephros anlagen can reestablish immunologic function and may induce tolerance to the metanephros and skin graft from donor Lewis

Objective To investigate the effect of Fukeqianjin tablets combined with progesterone on serum immunoglobulin,serum IL-2 and soluble receptor levels in patients with functional uterine bleeding,and to explore the optimal regimen for patients with functional uterine bleeding.Methods A total of 98 patients with functional uterine bleeding diagnosed in our hospital from June,2015 to June,2016 were randomLy divided into observation group and control group(n=49).The patients in the control group were treated with oral progesterone and the observation group.The control group was treated on the basis of the combination of gynecological Qianjin Tablet,compared the two groups of patients before and after treatment of menstrual conditions,serum IgM,IgA,serum IL-2 and soluble receptor levels.Results In the first month,the second month and the third month after treatment,the menstrual volume in the observation group were(103.5±21.5)mL,(93.5±14.7)mL,(81.4± 12.2)(7.68±0.92)d,(6.81±0.87)d and(6.14±0.78)d respectively in the observation group were significantly shorter than those in the control group(P<0.05).After treatment,the menstrual period The serum levels of IgA and IgM were(3.6±0.8),(2.6±0.8),(1.8±0.3)and(2.9±0.5),(2.2±0.3),(1.1±0.2)in the first month,the second month and the third month respectively,Significantly lower than the control group,the difference was statistically significant; the first month after treatment,the first two months,the first three months,observation group of patients with serum IL-2 and soluble receptor levels significantly Lower than the control group.Conclusion Fukeqianjin tablets combined with progesterone can improve the immune function of patients with functional uterine bleeding,reduce the level of inflammation and soluble receptor levels,compared with single progesterone treatment better,the program better.

Objective: To explore the application of extensive pterional approach combined with cutting of the zygomatic arch for the resection of large sphenoid ridge meningioma. Methods: Thirty-three patients with large sphenoid ridge meningioma underwent operation using the extensive pterional approach combined with cutting of the zygomatic arch. Twenty patients with large sphenoid ridge meningioma received operation with the traditional pterional approach as the control. The resection rate, operative time, intraoperative blood loss, and postoperative complications were compared between the groups. Results: Two groups of patients underwent craniotomy under microscope. The Simpon grade I resection and grade Ⅱ resection rate was 93.9％ in the cutting of the zygomatic arch approach group and 60.0％ in the control group (P<0.01). The operative time was (325.2±121.3) min in the cutting of the zygomatic arch approach group, which was significantly shorter than that in the control group with (406.4±182.9) min (P<0.05). The intraoperative blood loss was (502.5±101.8) mL and (697.7±115.4) mL in the two groups (P<0.05). In addition, postoperative complication rate was 15.2％ and 45.0％ in the cutting the zygomatic arch approach group and the control group, respectively (P<0.05). No death was reported in both groups. Conclusion: Extensive pterional approach combined with cutting of the zygomatic arch can fully expose the anatomical structures of the skull base and the sellar region to eliminate the influence of temporal muscle in the exposure of the surgical area. The operative field is exposed to reduce the stretch injury to only the frontotemporal brain tissue, which might be helpful for the complete resection of large sphenoid ridge meningioma, and is more conducive to neurovascular anatomy and relevant functional protection.

Objective To explore the relationship between cellular rejection and the development of allo-or xenografted primordia from different gestational ages .Methods Whole rat metanephroi from embryonic day E14～ E19 were transplanted into omenta of outbred (SD → SD ,6 groups ,n≥10 each ;E15-E17SDCsA ,3 groups ,n=15 each) ,syngeneic (Lewis→Lewis ,5 groups ,n=8 each) ,allogeneic (Lewis→BN ,E15BN n= 6 each E15BNCsA n= 10 each ,E16BNCsA n= 10 each) rats and xenogeneic (Lewis→C57groups ,E15C57 n=10 each ,E15C57CsA ,n=8 each ;Lewis→Balb/c nude mice ,3 groups ,n=10 each) recipients .Histopathology ,Banff's grading and electron microscopy (EM ) were utilized for assessing the graft development .Similarly ,biochemical indicators and creatinine clearances were measured .Results At 4 weeks post-transplantation , in SD → SD groups ,E14-E17SD metanephroi developed with Banff ' s rejections . E14/E15SD was significantly lighter than E16/E17SD ( P< 0 .01 );E18/E19SD barely developed . After cyclosporine A (CsA , 8 mg·kg -1·d-1 )dosing ,Banff's rejection of E15-E17SDCsA group lessened significantly .In Lewis→BN ,E15BN metanephroi were completely rejected .After dosing CsA (12 mg·kg -1·d-1 ) ,E15BNCsA and E16BNCsA Banff ' s rejections became alleviated . Upon a discontinuation of CsA , both metanephroi were rejected . In Lewis → Lewis , E15 ～ E17Lewis metanephroi developed well . No significant difference existed in Banff's classification (P>0 .05) .E14Lewis and E18Lewis rats had significantly poorly differentiated metanephroi than those in E16 Lewis group .In Lewis→C57BL/6 , E15 metanephroi were rejected at Day 14 post-transplantation (n= 10) and no improvement was evident after CsA dosing (15 mg·kg -1·d-1 ,n=8) .In Lewis→Balb/c nude mice ,all E15～E17Balb/c metanephroi developed well .Both light microscopy and EM examination showed normal nephrons and collecting ducts and wet weight ,creatinine or urea nitrogen of effusion showed no significant difference (P>0 .05) .E15Lewis and E16Lewis had significantly different values of wet weight and creatinine clearances from those of E15SDCsA and E16SDCsA .E15SDCsA had the greatest wet weight and the lowest creatinine clearance rate (P< 0 .01) .Conclusions After controlling rejection during allo-and xenotransplantations ,E15 ,E16 and E17 rat metanephros have similar development characteristics . And cellular immunogenic factors still remain the major barriers to their developments .

Objective To investigate the distribution characteristics of nasal cavity and maxillary sinus microbiota in aged patients with chronic maxillary sinusitis.Methods A total of 15 aged patients with chronic unilateral maxillary sinusitis who received surgical treatment between January 2017 to June 2018 in Beijing Hospital were enrolled and analyzed retrospectively.Their lavage samples from nasal cavity(N)and maxillary sinus(M)were collected and the samples were labeled according to the location(N and M groups,n=15 each).The high-throughput sequencing was used for sequencing all bacterial 16S rRNA genes in the samples.The composition of nasal cavity and maxillary sinus microbial communities was obtained,and the distribution features of nasal cavity and maxillary sinus microbiota were analyzed.Results A total of 8 bacterial phyla and 34 bacterial genera were found in nasal cavity and maxillary sinus microbiota.The most widely distributed phyla in nasal and sinus groups were Bacteroidetes,Fusobacteria,Frimicutes,Spirochaetes and Proteobacteria.The abundance of Bacteroidetes was higher in group M(60.0 ％,51 762/86 301)than in group N(42.9 ％,37 999/88 576)with statistically significant difference(P ＜0.05).The most widely distributed bacteria genera were Prevotella,Fusobacterium,Alloprevotella,Treponema,Parvimonas,Streptococcus,Filifactor,Phocaeicola,Campylobacter,Prevotella-7 and Lentimicrobiaceae.The abundance of Prevotella was higher in group M(47.7％,41 252/86 414)than in group N(33.5％,29 680/88 598) with statistically significant difference(P ＜ 0.05).Conclusions In the aged patients with chronic maxillary sinusitis,the distribution of bacteria in the nasal cavity and maxillary sinus is partly consistent.The abundance of the anaerobes distribution is higher in maxillary sinus than in nasal cavity in aged patients with chronic maxillary sinusitis.

Objective     To explore the causes of conversion to thoracotomy in patients with minimally invasive esophagectomy (MIE) in a surgical team, and to obtain a deeper understanding of the timing of conversion in MIE. Methods     The clinical data of patients who underwent MIE between September 9, 2011 and February 12, 2022 by a single surgical team in the Department of Thoracic Surgery of the Fourth Hospital of Hebei Medical University were retrospectively analyzed. The main influencing factors and perioperative mortality of patients who converted to thoracotomy in this group were analyzed. Results     In the cohort of 791 consecutive patients with MIE, there were 520 males and 271 females, including 29 patients of multiple esophageal cancer, 156 patients of upper thoracic cancer, 524 patients of middle thoracic cancer, and 82 patients of lower thoracic cancer. And 46 patients were converted to thoracotomy for different causes. The main causes for thoracotomy were advanced stage tumor (26 patients), anesthesia-related factors (5 patients), extensive thoracic adhesions (6 patients), and accidental injury of important structures (8 patients). There was a statistical difference in the distribution of tumor locations between patients who converted to thoracotomy and the MIE patients (P<0.05). The proportion of multiple and upper thoracic cancer in patients who converted to thoracotomy was higher than that in the MIE patients, while the proportion of lower thoracic cancer was lower than that in the MIE patients. The perioperative mortality of the thoracotomy patients was not significantly different from that of the MIE patients (P=1.000). Conclusion     In MIE, advanced-stage tumor, anesthesia-related factors,extensive thoracic adhesions, and accidental injury of important structures are the main causes of conversion to thoracotomy. The rate varies at different tumor locations. Intraoperative conversion to thoracotomy does not affect the perioperative mortality of MIE.