The technique of chimeric antigen receptor-engineered T cells (CAR-T) is combined single chain antibody and T-cell activation modification and has specific and durable killing effect on tumors.It had achieved stunning results on clinical trials of B lymphocytic leukemias,B lymphomas and solid tumors.Meanwhile it also had potential risk on the off target effects,cytokine release syndrome,graft versus host disease and so on.This paper briefly reviews the principal of CAR-T cellular mechanism,advantages and clinical applications.

Epidermal growth factor receptor (EGFR), an important target for tumor targeted therapy, is overexpressed / mutated in the majority of tumors. Immune cells modified by chimeric antigen receptor , including T cells, NK cells and so on, is a new technology in recent years, which has showed an unique advantage in the treatment of malignant tumors. In this paper, the research progress of T cells and NK cells modified with chimeric antigen targeting for EGFR and its mutants will be reviewed.

Objective To investigate the acoustic characteristics of snoring sound in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and with simple snoring. Methods 22 patients with OSAHS and 15 with simple snoring were included in this study. Natural overnight snoring was digitally recorded and portable sleep mo-nitoring was performed simultaneously. 10 snores, which were the 1st snores after 10 cycles of obstructive apnea, from each patient in OSAHS group, and 10 snores from each patient in simple snoring group were analyzed in the time and frequency domains. Results The sound waves of snoring in the two groups exhibited different patterns both in the time and frequency domains. The snoring spectrum of patients with simple snoring showed distinct fun-damental- harmonic structures which were not clear in patients with OSAHS. The central frequency of the patients with OSAHS was higher, and 800 Hz power ratio was lower than those of the patients with simple snoring. In the OSAHS group, the central frequency of the patients with moderate-to-severe OSAHS was higher, and 800 Hz power ratio was lower than those of the patients with mild OSAHS. The differences of the two parameters were of statistical significance. Conclusion The snoring sounds in patients with OSAHS and with simple snoring have dif-ferent characteristics in time and frequency domains, indicating that it is feasible to research the OSAHS by way of snore monitoring and analyzing technique.

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Objective To establish a stem cell life-cycle management information system to realize collection,storage,inquiry,processing and statistical analysis of the stem cell and to provide information for the research on stem cell translation medicine.Methods The functional modules of the system were determined based on the analyses on the requirements of stem cell bank management and its operational flow.The system design was explored from the aspects of technical framework,safety control and fuzzy query.Results The system was gifted with a technical architecture and anallocation scheme based on Spring MVC mode,which proved its efficiency by the trial.Conclusion Stem cell resource library can be used as an important supplement to the clinical sample life-group database,providing data and technical basis support for large-scale clinical samples to transform,integrate,manage and share large data resources.

Objective To investigate whether TG2 plays an important role in the osteoblast differentiation and mineralization.Methods TG2 mRNA of SaOS-2 cells was knocked down using a lentivirus stably expressing short-hairpin ( sh) RNA targeting TG2.Then the cells were cultured in osteo-inductive medium for 14 d to measure mineralization and for 7 d to measure the levels of osteoblastic differentiation markers including ALP activity and mRNA of collagen I, osteocalcin ( OCN) and BMP-2.The wild-type SaOS-2 cells and scrambled shRNA-transducted SaOS-2 cells served as the controls. Results The controls displayed an increasing trend of the level of ALP activity and mRNA of collagen I, osteocalcin and BMP-2,and notable mineralization at 14 d.When TG2 was knocked down, ALP activity, mRNA of collagen I, osteocalcin and BMP-2 at 7d,and mineralization at 14 d were all significantly lower in comparison with the corresponding values in the controls.Conclusion TG2 is involved in the differentiation and mineralization of osteoblasts in vitro.

ObjectiveTo evaluate the treatment efifcacy of the treatment promotion of standardized management for chil-dren with asthma.MethodsMedical records of 150 children with asthma were reviewed and divided into management group or control group according to whether standardized management was accepted. Comprehensive asthma education for asthma pa-tients and their parents including asthma associated basic knowledge education, health education as well as follow-ups at deifned intervals was conducted in 78 cases. In the meantime, standardized asthma therapies were performed. Control group involved 72 cases who did not receive asthma education managements and only accepted regular clinical therapies. After 1-year observational follow-up, , clinical efifcacy of children with asthma, changes of knowledge-attitude-practice of parents, and compliance of med-ication were compared between the two groups.ResultsAfter promotion of standardized managements treatment, asthma con-trol rates in the management group were signiifcantly higher than that of the control group(χ2=54.68,P<0.01); In addition, the rate of asthma attacks, emergency visits as well as hospitalizations were obviously reduced in the management group than control group (both withP<0.01). Knowledge associated with asthma, therapy and management executions as well as knowledge-atti-tude-practice of parents also demonstrated apparent elevations in the management group (P<0.01); At the same time, management group has illustrated superior medication compliance over the control group (χ2=66.27,P<0.01).ConclusionPromotion of standardized treatment management among children with asthma can help to achieve effective control by raising levels of knowl-edge-attitude-practice of the parents as well as the patient’s compliance to the treatment.

Objective To evaluate the intraoperative advantage and short-term outcomes of three-dimensional laparoscopic surgery for rectal cancer.Methods The clinical data of patients who underwent radical resection for rectal cancer at Department of Colorectal Surgery,China-Japan Union Hospital of Jilin University from November 2013 to February 2014 were retrospectively analyzed.There were 20 patients undergoing three-dimensional laparoscopic surgery and 26 patients undergoing two-dimensional laparoscopic surgery.The following parameters were compared between the two groups:intraoperative factors,oncologic outcomes,and short-term surgical outcomes.Data were analyzed by SPSS 17.0 software packet,using t and x2 inspection.Results All the operations were perfomed successfully without conversion.Compared with the two-dimensional laparoscopic surgery group,the three-dimensional laparoscopic surgery group had shorter operative time [(97.2 ± 19.3) vs.(114.1 ± 22.6) min,t =2.680,P =0.010],less intraoperative blood loss [(13.5 ± 6.7) vs.(20.1 ± 12.7) ml,t =2.288,P =0.028],less stapler docking times [(1.4 ± 0.6) vs.(2.3 ± 0.8) number of times,t =4.962,P =0.000],earlier removal of urethral catheter [(2.2± 0.6) vs.(2.7 ± 0.8) d,t =2.401,P =0.021].There were no significant differences in the postoperative ventilation time,postoperative hospital stay,number of lymph node dissection (all P ＞ 0.05).Conclusions Three-dimensional laparoscopic compared with two-dimensional laparoscopic radical resection for rectal cancer has many advantages,such as shorter operative time,less intraopretive blood loss,high accuracy operation and earlier postoperative urine voiding.

Objective To study the distribution of Candida infection and drug tolerance in intensive care unit(ICU). Methods A retrospective study was conducted. The critical patients admitted from January 2011 to December 2013 in ICU of the First Hospital of Jiaxing in Zhejiang Province were enrolled,and their clinical data with positive Candida culture and drug susceptibility results in specimens of sputum,urine,blood,ascites,bile, etc were collected. In the study of these 3 years in ICU,the situation of Candida infection,the distribution of positive specimen,the condition of distribution of different strains of Candida,and the Candida tolerance to antifungal drugs were analyzed. Results From 2011 to 2013,2 412 times of patients(including one patient had admitted into ICU for more than one time)were admitted into ICU in which 407 cases were of Candida infection(16.9%),and the rate of Candida infection was rising gradually in the 3 years〔2011 to 2013 Candida positive rates were 13.4%(77/573), 16.1%(146/907),19.7%(184/932)〕,the difference being statistically significant(P<0.01). In the 407 strains of Candida,166 strains(40.8%)were isolated from sputum,157(38.6%)from urine,53 strains(13.0%)ascites, 13 strains(3.1%)blood,11 strains(2.7%)bile,7 strains(1.7%)from other specimens. The strain distribution of Candida was mainly as follows:Candida albicans(174 strains),Candida glabrata(131 strains),Candida tropicalis (83 strains),Candida parapailosis(5 strains),Candida krusei(12 strains),and 2 strains of rare Candida portugal and Lipolztica. From 2011 to 2013,the highest tolerance of Candida albicans,Candida glabrata,Candida tropicalis to fluconazole,itraconazole,Fushita Yasu and other antifungal drugs was in 2013,and the lowest was in 2012,the rates of tolerance of the above 3 strains of Candida to amphotericin B being 0,to itraconazole being the highest(10.9%, 27.8%,9.6%,respectively),to Fushita Yasu the secondary(6.6%,11.0%,0,respectively)and to fluconazole the last(4.7%,7.4%,1.9%,respectively),and the rates of tolerance of Candida parapsilosis,Candida krusei,Candida Portugal,Candida lipolztica to amphotericin B,fluconazole,itraconazole,Fushita Yasu were all 0. Conclusion In ICU,the Candida infection is mainly in the respiratory tract and urinary tract,its rate of infection has a tendency of rising,and the rate of Candida tolerance to itraconazole is the highest.

Objective To investigate the effects of electroacupuncture (EA) on the implementation of blind nasojejunal (NJ) tube placement and enteral nutrition (EN) in neurosurgical severe coma patients in intensive care unit (ICU).Methods Seventy-nine neurosurgical severe coma patients admitted to ICU were randomly divided into conventional group (blind NJ tube placement,n =40) and EA group (NJ placement and EA,n =39).EA was performed after NJ tube placement at bilateral acupoints Zusanli (ST36) and Hegu (L14) points using EA treatment instrument.The impelling distance of NJ tube were measured and the success rate of NJ tube placement were calculated.The postoperative complications were observed.Results The difference of NJ tube impelling distances at the 24th,48th,and 72th hours after surgery in EA group were significant longer than that in conventional group (P ＜ 0.05).The success rates of NJ tube placement at the 24th and 72nd hours after surgery in EA group were significantly better than that in conventional group (P ＜ 0.05).Their EN calories qualifiedness rate in 72 hours also increased significantly compared with conventional group and the proportion of patients assisted with parenteral nutrition decreased (P ＜0.05).The postoperative complications including alimentary tract hemorrhage,vomiting,and abdominal distension decreased remarkably in EA group compared with conventional group (P ＜ 0.05).Conclusions EA stimulation at acupoints could promote the gastrointestinal peristalsis of neurosurgical severe coma patients and elevate the success rate of blind NJ tube placement,so it is beneficial for the implementation of early enteral nutrition (EEN).