The T help cell 1(Th1) and Th2 cell classification have provided the framework for understanding CD4+ T cell biology and the interplay between innate and adaptive immunity for almost two decades. Recent studies have defined a previously unknown subset of the CD4+ T cell effectors, the Th17 lineage. The uncover on the differentiation of IL-17-producing effector T cells from naive T cell precursors provides insights into mechanisms by which signals from cells of the innate immune system guide alternative pathways of Th1, Th2 or Th17 development. Th17 lineage has an important role in autoimmune and inflammatory diseases. This promises to change our understanding on the immune regulation, immune pathogenesis and host defense. The identification, differentiation and immune function of the new subsets of Th cells, Th17 cells will be reviewed.

Radiotherapy plays an important role in the treatment of lung cancer .Radiation-induced lung injury is a major complication in the process of radiotherapy .It is of great significance for the treatment and prog-nosis of the diseases to predict the early stage of radiation -induced lung injury in the clinical treatment .TGF-β1(transforming growthfactor-β1) can induce some inflammatory cells including lymphocytes ,neutrophils,mon-ocytes ect,contributing to the formation of fibrosis .Plasma TGF-β1 shows different levels followed different sta-ges of radiation-induced lung injury .This article reviews the value of cytokine TGF -β1 in predicting the radia-tion-induced lung injury over various aspects such as singlely used ,combined with radiation physics and other cytokines,and genomics.

Objective To investigate the insulin and glucagon levels in the patients with different islet cell antibody (ICA) subtypes and to explore the pathogenesis of latent autoimmune diabetes of adult (LADA). Methods Subjects were classified by immunohistology and 29 ICA-peripheral-positive DM patients, 28 ICA-diffused-positive DM patients and 17 controls (ICA-negative) were included. Serum glucose, insulin and plasma glucagon were measured at 0, 30, 60, 120 min after standard meal. Results (1) As compared with controls, glucagon in ICA positive groups were higher (both P

Objective To assess the risk factors of pulmonary infection in patients with cerebral hemorrhage,and then to provide references for policy-making.Methods Relative literature of crosssectional or case-control studies about risk factors of pulmonary infection in patients with cerebral hemorrhage was searched by computer in data bases such as CNKI,VIP,CBM,WanFang Data and PubMed from January of 1994 to October 2014.Resluts A total of 22 studies (2 case-control studies and 20 crosssectional studies) were brought into the study.The risk factors' OR and its 95％CI was 2.64(2.10-3.33) for over 60 years of age,2.05(1.56-2.69) for smoking history,3.07(2.24-4.19)for those who have diabetes,3.36 (2.40-4.70) for those who have chronic pulmonary diseases,1.54 (1.16-2.05) for those who have heart diseases,2.38 (1.83-3.08) for those who have a history of stroke,5.07 (3.15-8.16) for disorder of consciousness,2.78(2.36-3.27) for amount of bleeding over 30ml,2.85(2.22-3.66) for deviated from midline,2.58 (1.60-4.17) for breaking into ventricle,2.05(1.67-2.51) for high level of fasting blood sugar respectively,and so on.Conclusions Prophylactic measures can be carried out according to the risk factors of pulmonary infection in patients with cerebral hemorrhage,and then to reduce the incidence rate of pulmonary infection.

Objective　To investigate the expression level and clinical significance of LncRNA RP11-147L13.8 in peripheral blood of patients with acute cerebral infarction.Methods　Fifty patients with acute cerebral infarction (case group) and 50 patients without cerebral infarction (control group) hospitalized in our department were randomly selected,and the expression level of LncRNA RP11-147L13.8 in peripheral blood was detected by real-time fluorescence quantitative PCR in case group and control group,and the correlation between LncRNA RP11-147L13.8 and cerebral infarction was investigated.Results　〖JP2〗The expression level of LncRNA RP11-147L13.8 in peripheral blood of patients with cerebral infarction was significantly higher than that of control group (P<0.05).The expression level of LncRNA RP11-147L13.8 in peripheral blood was positively correlated with the occurrence of acute cerebral infarction,and LncRNA RP11-147L13.8 was an independent risk factor for the occurrence of acute cerebral infarction.LncRNA RP11-147L13.8 in the diagnosis of acute cerebral infarction had an area under the curve of 0.750,a critical value of 0.40,a sensitivity of 0.66 and a specificity of 0.74.Conclusion　LncRNA RP11-147L13.8 is differentially expressed in cerebral infarction,which is expected to become a potential biomarker for the diagnosis of acute cerebral infarction and provide new ideas for clinical diagnosis and treatment.

Objective To sum up the clinical experience of operative management of tibia plateau fracture in senile patients. Methods 35 cases of senile tibia plateau fracture were treated with different ways of internal fixation, including screw, cannulated compression screw, L shaped plate, and T shaped plate. Results All the 35 cases were followed up and the time ranged from 6 months to 2 years. X ray films showed that the anatomical reduction was reached and the fractures healed in 33 cases. The final results were rated according to Merchant criteria: excellent in 22 cases, good in 9 cases, fair in 2 cases and poor in 2 cases. The excellent and good rates were 85.7%. Conclusions Operation on senile patients with tibia plateau fracture should be performed early so as to reconstruct the articular surface. Rigid fixation and bone transplantation are impartment means to avoid plateau collapse, and early functional exercise can reduce postoperative complications.

Objective To study the effects and mechanism of focal mild hypothennia on brain inflarnmation response during the early stage of tranrntic brain injury(TBI)in rats.Method Traumatic brain injury wag produced in anesthetized rats by using free-falling impact model.Sixty-three male Sprague Dawley rats were randomly divided into three groups:TBI group,focal hypothermia group,and sham group.each group with 7 SD rats.Then all groups Wag further subdivided into three subgroups according to different intervals after TBI.Myeloperoxiduse (MPO)activity assay,immunohistochemical staining for the detennination of intercellular adhesion molecule-1(ICAM-1)expression and the number of ICAM-1 positive blood vessels were counted up in the traumatic brain tissues.All data were analyzed by SNK-q test Using SPSS 10.0 sofeware program.Results The number of ICAM1 positive blood vessels was significantly fewer in the rats of focal hypothermia group than those in the rats of TBI group at different intervals after TBI(P<0.01).Similarly,the MPO activity was significantly lower in the rats of focal hypothermia group than that in the rats of TBI group(P<0.01).Conclusions Focal mild hypothermia could significantly decrease neutrophil infdtration and ICAM-1 expression in the traumatized areas.It might be one of the mechanisms of focal mild hypothermis for TBI.

Objective To investigate the safety and feasibility of laparoscopic removal of exogenous caesarean scar pregnancy (CSP).Methods From January 2009 to May 2011,71 patients with CSP treated in Shengjing Hospital of China Medical University were studied retrospectively.Thirty-nine patients were treated with hysteroscopic excision of CSP,while 32 patients were treated with laparoscopic surgery.The following clinical parameters were compared,including intraoperative blood loss,quantity of postoperative uterine drainage,postoperative hospital days,the time for the mass absorption and the return of β-hCG to normal were studied.Results Two cases in the hysteroscopic group were transformed to abdominal surgery because of introperative bloody loss,the 37 cases underwent hysteroscopic surgery successfully with the ultrasound supervision and guidance.Laparoscopic surgery were successfully completed in all 32 cases.In hysteroscopic group,the operation time,the time for the return of serum β-hCG to normal,postoperative uterine drainage volume and the postoperative hospital stay were (44 ± 18) minutes,(27 ±5) days,(38 ± 12) ml,(3.8 ±0.7) days.While,in laparoscopic group,they were (100 ±21) minutes,(17 ±4) days,(19 ± 6) ml,(3.5 ± 0.6) days,respectively,the differences reached statistically significant (all P ＜ 0.05).But the amount of intraoperative bleeding were was (113 ± 63) ml in hysteroscopic group and (109 ±59) ml in laparoscopic group,the difference was not statistically significant (P ＞0.05).The duration of absorption of mass were (88 ± 17) days in hysteroscopic group.In laparoscopic group,the mass were completely removed.Conclusions Laparoscopic exicion of CSP could be suitable in treatment of exogenous CSP which offers advantages including prompt recovery,blood loss and hospital stays.This management could repair the uterine scars,reduce the reoccurring risk and conservate the fertility potential.

Objective To investigate the safety and feasibility of uterine arterial embolization (UAE) combined with hystersocpic excisionl of exogenous cesarean scar pregnancy (CSP). Methods Totally 67 patients with exogenous CSP treated with selective UAE combined with hysterscopic surgery in Shengjing Hospital of China Medical University were analyzed retrospectively; 35 patients in Group A (thickness of the cesarean scar>3 mm), while 32 patients in Group B (thickness of the cesarean scar≤3 mm). The following clinical parameters including operative time, intraoperative blood loss, quantity of postoperative uterine drainage, postoperative hospital days, the time for the mass absorption and the return ofβ-hCG to normal were compared. Results All hysterscopic procedures were successfully completed in Group A, and only one case underwent a second hysteroscopic excision due to the 1-month postoperative ultrasound examination indicating a mass located in the cesarean scar and a slow decline of β-hCG. Three cases of Group B were transformed to laparoscopic or laparotomy operation and 7 cases underwent a second surgery. The volume of introperative blood loss was (97±41) ml in Group A and (161±92) ml in Group B, the difference was statistically significant (P<0.01). But the operative time, quantity of postoperative uterine drainage, postoperative hospital days, the time for the retrun ofβ-hCG to normal and the mass absorption in Group A were (36±9) minutes, (38±13) ml, (3.5±0.5) days, (26±5) days, (82±17) days, in Group B were (37± 9) minutes, (42 ± 16) ml, (4.0 ± 0.7) days, (28 ± 8) days, (88 ± 15) days, respectively, the differences were not statistically significant (all P>0.05). Conclusions For exogenous CSP, when the thickness of cesarean scar is ≤3 mm, whether or not undertaking UAE, it should be seen as contraindication of hysterscopic surgery. UAE combined with hysterscopic surgery for the treatment of exogeous CSP with the cesarean scar thickness>3 mm is safe and feasible according to patients condition and should be performed by experienced hysteroscopist.

The electroencephalography (EEG) has a wide range of content, complex graphics and abstract theory. Meanwhile, there are differences in professional level, learning ability and subjective initia-tive among refresher doctors. In order to improve the quality of teaching, and to better serve the refresher doctors, the following strategies have been applied in the teaching process. We not only make the training target according to the actual condition of every refresher doctors, but also make them take a correct atti-tude towards study and follow the teaching arrangement. Besides, we not only orient at the operational skills training, including electrode installation, EEG evoked test, Point-of-Care test to eliminate the interference, but also promote the refresher doctors to seek the law of the diagram in the actual interpretation process with longitudinal development view and horizontal comparison perspective. Furthermore, we not only stan-dardize their report, but also broaden their view.