Regulatory T cells (Treg cells) have a critical role in the maintenance of immune homeostasis. However, tumor infiltrating Treg (TITR) contributes to weaken anti-tumor specific immune response through enhancing immunosuppressive effect in tumor microenvironment (TME), leading to tumor escape from immune surveillance. Recently, Treg cells-based immunotherapy has achieved good anti-tumor effects with the appearance of immune checkpoint inhibitors, chemokines and their receptors antagonists, specific Treg cells selective target genes knockout and novel drugs. This paper reviews the biological characteristics of TITR and discusses the prospect and application of Treg cells-based immunotherapy.

Objective:to study cognitive impairment of patients with Alzheimer disease (AD). Method:62 patients with AD and 159 normal elderly were tested with MMSE. Result:The patients group had lower scores in all subtests except that of naming. Level of education had positive correlation with the total score, subscores of attention and calculation, understanding, and describe graph. Conclusion:MMSE can be used in clinical assessment of cognitive function of patients with AD.

The improvement of diagnostics teaching system,including the establishment of curriculum system and evaluation system,is the base of promoting clinical- medicine teaching.Our study showed that the theoretical knowledge and clinical skill of medical students could be improved by constructing clinical diagnostics curriculum system and improving organization management and assessment system,which could pave the way for the transition from medical students to clinicians.

Objective To investigate the feasibility, efficacy, safety and economy of secondary splenic pedicle trisection method in removing schistosoma cirrhosis caused the splenic function. Methods Thirty patients receiving spleen secondary structure amputation between July 2014 and September 2016 were analyzed. Results Laparoscopic splenectomy with secondary splenic pedicle transaction was successfully performed in 28 patients, whereas two Endo-GIAs were used in 2 patients. The average of operation time was (80 ± 20) min, and operative blood loss was (320 ± 10) ml. The drainage of the splenic fossa was removed (3- 4) days after operation.Postoperative hospital stay was (10.8 ± 1.2) days after operaions. No massive hemorrhage, pancreatic leakage, secondary infection, serious complications such as abscess under diaphragm and recent complication such as infection of incision occurred postoperatively. Platelet of all patients recovered in 4 days postoperatively, and patients with platelet>400 × 109/L was given oral aspirin enteric-coated metformin hydrochloride. All patients were followed up for 6 months postoperatively, and no intestinal obstruction, portal vein thrombosis and other long-term complications occurred in all patients. Conclusions The amputation of secondary structures of the spleen in laparoscopic splenectomy to remove schistosoma cirrhosis caused the splenic function is safe. It could shorten the length of hospital stay and reduce the medical cost. It is a valuable method for clinical promotion.

The effect of interventional therapy combined with multifactorial intervention on critical limb ischemia in patients with diabetes mellitus was investigated. The patency rate and limb salvage rate were followed up. Interventional therapy is effective in treating diabetic foot with critical limb ischemia. Multifactorial intervention was helpful for reducing amputation.

OBJECTIVE To investigate the clinical pathological characteristics of differentiated thyroid carcinoma (DTC) in children and adolescents. METHODS The clinical data of 30 children and adolescents with DTC were retrospectively reviewed. Meanwhile the clinical pathological characteristics of DTC were analyzed according to patients' age and gender. RESULTS Papillary thyroid carcinoma (PTC) was found in 27 cases and follicular thyroid carcinoma (FTC) in 3 cases. The average diameter of tumors was (2.56±1.1) cm. In the group of children, the incidence of lymph node metastasis was 92.3% (12/13), pulmonary metastasis was 46.2% (6/13), and those in the group of adolescents was 88.2% (15/17) and 35.3% (6/17) respectively. Children group tended to present with more vascular invasion, thyroid capsule invasion, and invasion out of thyroid, and a higher rate of cervical lymph node metastasis (P=0.025, 0.007, 0.025, 0.033). CONCLUSION Thyroid carcinoma in childhood and adolescent has a stronger invasive feature. It is easy to local invasion, lymph node and distance metastasis.

OBJECTIVE: To introduction the clinical application and surgical technique of the modified rhinotomy for treatment of skull base neoplasms. METHOD: The diagnosis and surgical outcome of 20 patients with skull base neoplasms were reviewed retrospectively. RESULT: All the cases were involvement with nasal cavity, ethmoidal sinus, sphenoidal sinus and medial wall of orbit. Two cases were involvement with pterygopalatine fossa, infratemporal fossa and intra calvarium separately. All cases were treated by modified rhinotomy. Among that 2 patient were with juvenal angiofibroma treated by combined with maxillary transposition and pterional and zygomatic approach, and 2 cases were with craniofacial approach. No complications were found relating to surgery. 6 patients was recurrent during follow-up among 6 to 60 months. CONCLUSION The modified rhinotomy is a effective and safe surgical approach to treat skull base neoplasms located in nasal cavity, ethmoidal sinus and sphenoidal sinus. Tumor involved with pterygopalatine fossa, inferotemporal fossa and intracranial extension, other surgical approach should be used at the same time.
Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Neurosurgical Procedures ; methods ; Nose ; surgery ; Retrospective Studies ; Skull Base ; surgery ; Skull Base Neoplasms ; surgery ; Young Adult

OBJECTIVE: To investigate the diagnosis and treatment of fibrous dysplasia (FD) involving the skull base. METHOD: The clinical data of 15 patients with fibrous dysplasia involving the skull base was retrospective analysis. RESULT: All patients were underwent CT examinations. FD involved orbital roof in 15 patients, ethmoidal bone in 15 patients, middle and lower nasal turbinate in 8 patients, frontal bone in 8 patients, sphenoidal bone in 6 patients, and maxillary bone in a patient. Although the optic canal was affected in 4 patients, only one patient had impaired vision. All the patients were treated by craniofacial approach. One patient with impaired vision was performed decompression of optic canal and had improved in vision. The titanium mesh was use for construction of skull base defect. There were not complications, such as infection, cerebral hemorrhage, etc. CONCLUSION It should be underwent surgical treatment for fibrous dysplasia involving skull base which resulted in clinical manifestations. Whether prophylactic decompression of optic canal is performed or notr depends on the patients clinical and radiological information.
Adolescent ; Adult ; Female ; Fibrous Dysplasia of Bone ; pathology ; surgery ; Frontal Bone ; pathology ; Humans ; Male ; Maxilla ; pathology ; Orbit ; surgery ; Retrospective Studies ; Skull Base ; pathology ; Sphenoid Bone ; pathology ; Young Adult

OBJECTIVE:To observe the efficacy and safety of Sanjiao fuzheng mixture combined with concurrent chemoradiotherapy of paclitaxel and nedaplatin in the treatment of local advanced non-small cell lung cancer (NSCLC). METHODS:A total of 68 patients with local advanced NSCLC selected from our hospital during Jan. 2015 to Jan. 2017 were divided into control group and observation group according to random number table,with 34 cases in each group. Control group was given Paclitaxel injection 135 mg/m2 intravenously,d1+Nedaplatin for injection 75 mg/m2 intravenously,d3,21 d as a treatment course,for 2 courses;routine fractionated intensity modulated radiation therapy,2 Gy each time,5 times a week,60-70 Gy in total;given 2 cycles of primary chemotherapy continuously after radiotherapy. Observation group was additionally given Sanjiao fuzheng mixture 250 mL/d,divided into 3 times,till the end of treatment,on the basis of control group. Clinical efficacies were observed in 2 groups. The levels of nutritional indexes (BMI,PAB,ALB,Hb) and tumor markers (SCC-Ag,CEA,TK1, CYFRA21-10) before and after treatment were observed. The occurrence of ADR were recorded. RESULTS:There was no statistical significance in the total effective rate between 2 groups (observation group 82.35％ vs. control group 73.53％)(P>0.05). After treatment,the levels of BMI,PAB,ALB and Hb in 2 groups were significantly lower than before treatment,but the observation group was significantly higher than the control group. The levels of SCC-Ag,CEA,TK1 and CYFRA21-1 in 2 groups were significantly lower than before treatment,and the observation group was significantly lower than the control group,with statistical significance (P<0.05). The incidence of Ⅲ-Ⅳ degree aleucocytosis,Ⅰ-Ⅱ degree hemoglobin reduction and thrombocytopenia in observation group were significantly lower than control group, with statistical significance (P<0.05). CONCLUSIONS:The efficacy of Sanjiao fuzheng mixture combined with concurrent chemoradiotherapy of paclitaxel and nedaplatin is similar to that of concurrent chemoradiotherapy of paclitaxel and nedaplatin for localadvanced NSCLC,which can improve nutritional status significantly,and reduce the incidence of ADR.

Objective To investigate the CT and MRI findings of different types of small round cell tumor(SRCT)in the nasal cavity and sinuses.Methods A retrospective analysis was conducted on the imaging data and clinical data of 35 SRCT patients confirmed by pathology.Thirty-one SRCT patients underwent CT examination,and 19 SRCT patients underwent MRI examination.Results There were 20 cases of tumors that invaded the nasal cavity and 19 cases involved the sinuses,including 11 cases of the maxillary sinus,7 cases of the ethmoid sinus,2 cases of the sphenoid sinus,and 1 case of the frontal sinus.CT findings of SRCT were all soft tissue masses.Lymphoma was relatively homogeneous with mild bone destruction,and usually involved nasal vestibular skin.Rhabdomyosarcoma(embryonic type)happened at an early age and easily caused bone destruction and metastasis.Melanoma generally occurred in the nasal septum and nasal cavity,which was prone to bleeding.Small cell neuroendocrine carcinoma was heterogeneous,with moderate to significant enhancement,bone absorption and destruction were often noticed.The MRI manifestations of SRCT were equal or long signal on T1WI,high signal on T2WI,and significant diffusion limitation on diffusion weighted imaging(DWI)and apparent diffusion coefficient(ADC)except for melanoma.On contrast-enhanced images,lymphoma showed mild to moderate enhancement,rhabdomyosarcoma showed typical"grape sign",and small cell neuroendocrine carcinoma showed"sieve"and"map-like"obvious enhancement.Typical melanoma showed a high signal on T1WI and a low signal on T2WI and usually caused bleeding.The MRI findings were related to the presence of melanoma and hemorrhage within the lesion.Conclusion SRCT of the nasal cavity and sinuses have a high degree of malignancy and poor prognosis,CT and MRI have many similar manifestations.Combining clinical data,bone destruction,MRI enhancement,and DWI sequence can effectively distinguish different types of SRCT,as well as squamous cell carcinoma of the nasal cavity and sinuses and adenoid cystic carcinoma.