Objective To investigate the changes of T cells and dendritic cells (DCs) and their related factors in children with immune thrombocytopenia (ITP) before and after therapy,and to analyze their clinical significance.Methods T-cells and DCs subsets were determined by flow cytometry both in 64 children with ITP (ITP group) before and after therapy and the control group.The serum levels of interleukin (IL)-4,interferon-γ (IFN-γ),transforming growth factor beta 1 (TGF-β1),and IL-27 were detected by enzyme linked immunosorbent assay (ELISA).Results Treatments of glucocorticoid or IVIg were effective in 41 cases of 64 ITP children.Compared to the control group,helper T cells (Th),Th/suppressor T cells (Ts),T regulatory cells (Treg),plasmacytoid DC (pDC),pDC/myeloid DC (mDC),and TGF-β1 in ITP patient group before treatment were significantly lower,while IFN-γ and IFN-γ/IL-4 were significantly higher (P ＜0.05).In ITP group,Th,Th/Ts,Treg,pDC,pDC/mDC,TGF-β1,and IL-27 were significantly increased,while IFN-γ and IFN-γ/IL-4 were decreased in children with ITP after therapy and achieved response (P ＜ 0.05).However,there was no significant difference between before and after therapy in ITP children without treatment response (P ＞ 0.05).Conclusions T cells and DCs subsets disorder and abnormal cytokine levels are observed in children with ITP,which can be corrected by immunosuppressive therapy,indicating that Th1 overactivity and the decrease of Treg and pDC both in quantity and function may be related to the pathogenesis of ITP in children.

Objective:To investigate the anti-leukemia effect of icaritin on 697 cells of children relapsed acute lymphoblastic leukemia in vitro, and to analyze its possible mechanism. Methods:697 cells were cultured in vitro and divided into control group and icariin groups (5, 10, 20 μmol/L). After treated with icaritin, the cell proliferation was detected with cell counting kit-8 (CCK-8) method, and apoptosis was measured with Hoechst 33258 staining and Flow Cytometry Assay. Expression of Bcl-2, Cyt-C, Bax and Caspase3 proteins in 697 cell were detected by Western blot. Results:After treatment with various concentrations (5-20 μmol/L) of icaritin for different time-points (24, 48, 72 h), the growth inhibition rate exhibited a dose and time-dependent manner ( r=0.76, r=0.89); the apoptotic rate exhibited significant increase for 48 h ( P<0.05). Bcl-2 protein decreased significantly ( P<0.05), while Bax, Cyt-C and Caspase3 cleavage protein increased significantly in icaritin treated group for 48 h compared with control group ( P<0.05). Conclusions:Icaritin shows the effects of anti-leukemia by inducing apoptosis and inhibiting proliferation of 697 cell. Icaritin maybe induce apoptosis of 697 cell by down-regulation of Bcl-2 expression and up-regulation of the Bax, Cyt-C and cleaved Caspase 3 expression.

Objective:To investigate the changes of regulatory B cells (Bregs) and lymphocyte subsets in children with primary immune thrombocytopenia (ITP), and to analyze their relationship with ITP duration and remission time.Methods:Proportion of different immune cell subsets were detected in the peripheral blood of 88 ITP children before treatmen, 84 ITP children after treatmen and 45 normal controls by flow cytometry. The treatments included glucocorticoids, intravenous IgG as first-line treatment. The changes of lymphocyte subsets in ITP children with different remission time after treatment were compared.Results:The Th, natural killer (NK), Breg cell counts and Th/Tc ratio in all children with ITP were significantly lower than those in the control group ( P<0.05), while the Tc and CD19 + B cells were significantly higher than those in the control group ( P<0.05). The Breg cell count in the persistent and chronic ITP groups was significantly lower than that in the newly diagnosed ITP ( P<0.05). A total of 84 children with ITP were relieved after treatment: 58 cases (69.1%) achieved long-term remission, and 26 cases (30.9%) had short-term remission. The Breg and lymphocyte subsets in the short-term remission ITP group after treatment were not significantly different from those before treatment, but there were still significant differences from the control group ( P<0.05); The Breg and lymphocyte subpopulations in the long-term remission ITP group after treatment were not significantly different from those in the control group, but compared with those before treatment, other cell subpopulations except Tc were significantly increased ( P<0.05); The NK cells and Breg cells in the long-term remission ITP group were significantly higher than those in the short-term remission ITP group ( P<0.05). Conclusions:The Bregs in peripheral blood of long-duration ITP children significantly decrease. After treatment, the Bregs in ITP children with long-term remission increase significantly, indicating that the restoration of the immune mechanism of Bregs may be related to the long-term remission of children with ITP.

The thyroid function test is universally used for the evaluation of thyroid function. However, there are factors other than endocrine diseases, such as special physiological conditions, interference in laboratory measurement, or disorders in other systems that should be taken into consideration. When encountering thyroid function test results that are not in line with clinical manifestation, a comprehensive evaluation is essential for a correct and timely diagnosis. We presented a case of a significant rise in serum total triiodothyronine(TT 3) secondary to multiple myeloma. Through case studies and literature review, we intended to provide clinicians with experience for better interpretation of abnormal thyroid function test results.

Objective:To investigate the expression levels of serum KLK5, IL-17 and IL-18 in patients with rosacea and their clinical significance.Methods:A prospective study included 65 patients with rosacea from the Department of Dermatology, Sichuan Provincial People＇s Hospital, from May to October 2022. There were 8 males and 57 females with an average age of (30.9±9.8) years, including 47 cases of erythematotelangiectatic type and 18 cases of papulopustular type. Twenty healthy individuals from the same hospital＇s physical examination during the same period were included as control group, consisting of 3 males and 17 females with an average age of (33.8±10.0) years. Enzyme-linked immunosorbent assay (ELISA) was used to detect the expression levels of serum KLK5, IL-17, and IL-18. Investigator＇s global assessment (IGA) score was used to assess the severity of papules and pustules, and clinical erythema assessment (CEA) score was used to assess the severity of persistent erythema. The expression levels of serum KLK5, IL-17, and IL-18 were compared between the two groups, and the correlation between the severity of the disease and the expression levels of KLK5, IL-17, and IL-18 was analyzed. Additionally, the expression levels of KLK5, IL-17, and IL-18 in different subtypes of rosacea were compared.Results:The expression levels of serum KLK5, IL-17, and IL-18 in the rosacea group were (3134.01±448.82), (154.78±37.64), (236.24±38.81) pg/ml, respectively, all of which were higher than those in the healthy control group (2421.54±340.07), (95.36±24.94), (181.61±23.88) pg/ml, with statistically significant differences (all P<0.05). The levels of serum KLK5, IL-17, and IL-18 in patients with rosacea were positively correlated with IGA scores ( r=0.534, 0.767, 0.417) and CEA scores ( r=0.852, 0.459, 0.309) (all P<0.05). There were no statistically significant differences in the expression levels of serum KLK5, IL-17, and IL-18 between the erythematotelangiectatic and papulopustular subtypes of rosacea (all P>0.05). Conclusions:The expression levels of serum KLK5, IL-17 and IL-18 in patients with rosacea are higher than those in the healthy control group and are positively correlated with the severity of rosacea.