Objective To explore the role of Schistosoma japonicum egg antigens in host immune response. Methods Female BALB/c mice aged 6-8 weeks were divided into two groups. The mice in the experiment group were administrated with 10 000 eggs of S.japonicum orally and injected with 200 ?g SEA via tail vein,once for a week. The mice in the control group were infected with PBS. The number of CD4+CD25+T cells was detected in a murine model treated by S. japonicum egg antigens,and the regulatory properties of CD4+CD25+ T cells were assessed while CD4+CD25+ T cells were cocultured with CD4+CD25-T cells. For the detection of murine TGF-? and IL-10,a DuoSet ELISA development kit was used. IL-4,IL-10 and IFN-? were detected by using flow cytometry. Results The number of CD4+CD25+T cells and the level of IL-10 increased in mice treated with S. japonicum egg antigens. CD4+CD25+T cells dramatically enhanced IL-10 production and decreased IFN-? production compared with the CD4+CD25-population. CD4+CD25+T cells suppressed the proliferation of CD4+T cells. Conclusion S. japonicum egg antigens downregulate the host immune response by inducing the production of CD4+CD25+ T cells and IL-10.

Objective To investigate the clinical efficacy and safety of double filtration plasmapheresis (DFPP) pretreatment combined with CD25 monoclonal antibody inducible therapy for sensitized recipients of cadaver kidney transplantation.Method The clinical data of 45 sensitized recipients who received the pretreatment with DFPP and CD25 monoclonal antibody from November 2011 to January 2012 were retrospectively analyzed.Panel reactive antibody (PRA) was examined by using ELISA.Before the DFPP combined with CD25 monoclonal antibody,the PRA was (56.5 ± 19.9) ％ (＞ 20％),and after the pretreatment,the PRA level was decreased to (18.9 ± 19.1)％.HLA mismatch of recipients and donators was (2.1 ± 0.7),and the lymphocytotoxic crossmatch tests before operation were negative.The incidence of patient/kidney survival,transplantation rejection and pulmonary infection were observed.All the patients were followed up for 12 months.Result During the follow-up period,no patient died,and transplanted kidney dysfunction occurred in 2/45 recipients.Twelve months after months,the survival rate was 100％ and transplanted kidney survival rate was 95.6％ (43/45).One (2.2％) of 45 recipients had hyperacute rejection during the operation,and was given plasmapheresis after the resection of the transplanted kidney.Twelve (26.7％) of 45 recipients had acute rejection:11 recipients completely recovered after methylprednisolone and ATG therapy,and 1 recipient given plasmapheresis for kidney dysfunction.Four (8.9％) had the pulmonary infection after operation,and all of them recovered after antiinflammation treatment.Conclusion DFPP pretreatment before kidney transplantation combined with CD25 monoclonal antibody inducible therapy is safe and effective,specially for sensitized recipients.

To determine whether the targeting inhibition of Kupffer cellsfunction mediated by gadolinium chloride (GdCl_3) could interfere with the CD4~+CD25~+ regulatory T cells of mice at the granuloma stage of schistsomiasis, female C57BL/6 mice of 6-8 weeks old were divided randomly into 3 groups, i.e. control group. group infected with cercariae of Schistsoma japonicum and group of infection plus GdCl3,. GdCl3 in a dosage of 15 mg/kg was introduced into mice through penile vein twice per week. The number of CD4~+CD25~+ T cells was determined using flow cytometry and the number of cells with Fox p3 was detected by using immunohistochemical methods. For detection of cytokines, such as IL-4, IL-5, IL-10, TGF-β1, ,IFN-γ in mouse sera, a DuoSer ELISA development kit was used, It was found that the number of CD4~+CD25~+ T cells and level of IL-10 in Schistosomiasis granuloma stage were decreased in the S.japonicum cercariae infected mice injected with GdCl_3 in comparison with the infection group. The percentages of CD4~+CD25~+ T cells of infection group and infection plus GdCl_3 group were 13.8%, 9.3% and 6.4% respectively, while the levels of IL-10 of these 3 groups of rats were 41.4 pg/mL, 22.6 pg/mL and 11.5% respectively. In addition, treatment with GdCl_3 could down-regulate the expression of Fox p3 and reduce the inflammatory reactions in Schistosomiasis granuloma. It is evident that the targeting inhibition of Kupffer cellsfunction mediated by GdCI_3 interfere with the production of the regulatory T cells and reduce the inflammatory responses in Schistsomiasis granuloma.

ObjectiveTo explore the appropriate teaching methods for medical international students.MethodsTotally 84 students in grade 2005 and 63 students in grade 2006 took part in clinical skills training in 2010 and 2011.The traditional method was employed in grade 2005 and interactive teaching and imagery training was applied in grade 2006 combined with the traditional methods.ResultsThe scores of clinical skill tests ( posterior thorax puncture test,abdomen puncture test,bone puncture,catheterization test) were significantly higher in grade 2006 than in grade 2005 with statistical differences,P ＜ 0.01.The clinical skill test scores were not statistically different between grade 2005 and 2006 before training,P ＞ 0.05,but the scores were statistically different between grade 2005and 2006 after training,P ＜ 0.05.Conclusion Using polynary teaching methods synthetically is helpful to improve the clinical skill training effect for medical international students.

Objective To explore the effect of targeting Kupffer ceHs on CD4~+ CD25~+T cells in schistosome gramtloma.Methods A total of 30 six-to eight-week-old C57BL/6 female mice were divided into three groups equally,namely a control group,an infection group with S.japonicum cercariae(10 cercariae per mouse) and an infection group injected with GdCl_3 through the penile vein(15 mg/kg)twice perweek.After8 weeks of theinfection,the number of CD4~+ CD25~+T cells was detected by using flow cytometry and the number of Foxp3 was detected by using immunohistochemistry.For the detection of murine IL-4,IL-5,IL-10,TGF-β1 and IFN-γ,a DuoSet ELISA development kit was used.Results The number of CD4~+ CD25~+T ceils and the level of IL-10 decreased significantly in the infection group injected with GdCl_3 compared with the infection group.GdCl_3 treatment decreased Foxp3 production and the level of ALT,and reduced the inflammatory response in schistosome Granuloma.Conclusion Kupffer ceils Can regulate the response of CD4~+ CD25~+T cells in schistosome granuloma.

Objective To study the efficacy and complications of reconstruction of failed urethro-plasty for hypospadias with pedicle flap , bladder mucosa , buccal mucosa , and biological patch . Methods 23 patients were enrolled from Jul .2005 to Dec.2011.8 patients, with good local skin condition , were performed with pedicle flap urethroplasty .The other 15 patients, with bad local skin condition or with long segment urethral stricture , were performed with free grafts , including 6 bladder mucosa , 7 buccal muco-sal and 2 biological patch. Results Of the 23 cases, 7 cases were cured by one phase operation .There were 16 (16/25) cases had complications.3 (3/16) cases were failed because of serious infection (2 pedi-cle flap, 1 bladder mucosa ) .The failed cases were implemented with urethroplasty 6 months later by the buccal mucosa installments operation .4 (4/16) cases had solitary urethral fistula (1 pedicle flap, 2 bladder mucosa, and 1 buccal mucosal), who were successfully treated with simple fistula repair 3 to 6 months later. 9 ( 9/16) cases had urethral stricture ( 2 pedicle flap , 3 bladder mucosa , 3 buccal mucosal , and 1 biologi-cal patch graft ) , who were treated with urethral sound and got good result .We had reconstructed the urethra using mucosa graft onlay urethroplasty .All of the 23 patients were followed up with an average of 14.5 ( 6-24) months.23 cases were satisfied with the stretched penis , urination and no need to expand the urethra more than 6 months.3 cases were not satisfied with penile appearance .After communication, these patients did not require a further penis orthopedic surgery . Conclusions Pedicle flap, bladder mucosa , buccal mucosa and biological patch can be used in urethral repair and construction of failed urethroplasty for hypos -padias.Urethral sound dilation plays an important role in hypospadias repair .

ObjectiveTo review the effect of response interruption and redirection intervention on vocal stereotypy in children with autism spectrum disorder (ASD). MethodsLiteratures on response interruption and redirection intervention for vocal stereotypy in children with ASD were retrieved from databases of EBSCO, PubMed, Web of Science, CNKI, and Wanfang data. The information of the literatures was extracted to conduct a scoping review. ResultsA total of 16 English literatures were included. All researches employed a single-subject time series study design. A total of 41 children with ASD were involved. Significant differences were found in levels of basic verbal functioning of children with ASD. Vocal stereotypy was characterized by both verbal and nonverbal forms. Most of the reviewed researches used experimental functional assessment to analyze the function of vocal stereotypy. In most cases, the function of vocal stereotypy was automatic reinforcement. Iwata et al.'s paradigm was dominantly adopted in performing experimental functional assessment across researches. Other related paradigms developed based on Iwata et al.'s paradigm to make operating process more concise were also used for experimental functional assessment in reviewed researches. Response disruption and redirection was often conducted in individualized setting, with a few researches conducted in special education classes. The time and frequency of interventions varied widely across subjects due to the levels of impairment in vocal stereotypy and other behaviors. According to a comparison of the effects of traditional response interruption and redirection and its morphing procedures, it was found that changing the content of the redirection task, reducing the number of redirection tasks, and varying the duration of execution did not impact the improvement of vocal stereotypy. Based on the comparisons of response interruption and redirection with matched stimuli, response cost, verbal manipulation training, and medication, it was found that both response interruption and redirection and other methods (except for medication) could reduce vocal stereotypy and promote the emergence of appropriate behaviors in children with ASD. Combining response interruption and redirection with other techniques, such as stimulus matching and response costs, yielded more favorable improvement of vocal stereotypy in children with ASD. ConclusionASD children with vocal stereotypy show different levels of functional language, and vocal stereotypy is generally characterized by both verbal and nonverbal formats. The function of vocal stereotypy is mostly automatic reinforcement. Response interruption and redirection as a behavioral intervention is mostly conducted in individualized setting, and the time and frequency of interventions depend on the levels of vocal stereotypy and other behaviors problems. Changing the content and number of redirection instructions does not significantly influence the improvement of vocal stereotypy in children with ASD. Other intervention methods such as matching stimulus and response cost are able to reduce vocal stereotypy in children with ASD, but response interruption and redirection used in conjunction with these methods show more favorable improvements. Response interruption and redirection interventions can not only reduce vocal stereotypy in children with ASD, but also increase appropriate vocalizations, task engagement and command obedience.

Objective:To analyze the clinical features of tuberculous peritonitis (TBP).Methods:The clinical data of 252 TBP patients admitted to three hospitals in Wuhu area from January 2014 to June 2020 were retrospectively analyzed, and the clinical characteristics of TBP patients of different genders and ages were compared. SPSS 26.0 software was used to analyze the data.Results:Among 252 TBP patients, 130 were males (51.6%) and 122 were females (48.4%). History of abdominal surgery, abdominal masses, reproductive disorders, genital tuberculosis, and delay in diagnosis were more common in female patients (all P<0.01); while fever, cough/sputum expectoration, intestinal tuberculosis and active tuberculosis were more common in male patients (all P<0.01). The proportion of adenosine deaminase in ascites (ADA) ≥35 U/L, strong positive tuberculin test or T-cell spot test in middle-aged and elderly patients was lower than that in young patients ( P<0.01), but there was no significant difference between different genders. Compared with young patients, middle-aged and elderly patients had a low complete response rate, a high proportion of irregular medications, a high incidence of gastrointestinal reactions, liver damage and overall adverse reactions (all P<0.05). Conclusion:Female patients with TBP have fewer symptoms of systemic tuberculosis and high rate of delay in diagnosis, and are prone to complicated with reproductive tuberculosis. In middle-aged and elderly patients with TBP, the sensitivity of ADA and tuberculosis tests is decreased, and the anti-tuberculosis therapy is less effective. The study indicates that the clinical diagnosis and treatment of TBP should be optimized based on the gender and age of patients.

Objective To compare the clinical outcomes of low-dose rabbit antithymocyte globulin (rATG ) vs basiliximab as induction therapy in recipients of ABO-incompatible kidney transplantation (ABOi-KT) .Methods Retrospective analysis was conducted for e the clinical data of 40 ABOi-KT recipients between March 2017 and March 2019 .17 recipients of them received induction therapy with basiliximab (basiliximab group) while another 23 recipients received low-dose rATG (rATG group ,rATG 25 mg/d × 3 d) .During a median follow-up period of 282 days , the data of serum creatinine and eGFR at 1 week and 1 month ,graft survival rate and complication rate of two groups were compared .Results No significant difference existed in age ,gender ,dialytic modality/ duration , blood groups of recipients , HLA mis-match , blood group antibody titers , dose of rituximab ,blood groups of donors or donor age ( P > 0 .05 ) . The times of double filtration plasmapheresis in Basiliximab group were more (P< 0 .05) .No significant difference existed in serum creatinine and eGFR at 1 week or 1 month ( P > 0 .05 ) . No significant difference existed in graft survival rate . No significant difference existed in rate of acute rejection ,parvovirus B19 infection , urinary tract infection or hematoma .Conclusions Low-dose of rATG is as effective as basiliximab for ABOi-KT recipients .And rATG does not increase the rate of infection .

Objective To investigate the application of percutaneous transluminal balloon dilatation (PTA) in catheter replacement within patients with catheter-related central vein disease (CVD). Methods Thirteen cases of CVD patients from Jan 2015 to Mar 2018 admitted into the First Affiliated Hospital of Zhejiang University were retrospectively analyzed. All of them underwent digital subtraction angiography (DSA) to clarify problem origin. Suitable balloons were chosen to dilate the original catheters or the occlusive veins, and then the original catheters were replaced. PTA was used to help catheter replacement and all patients were followed up for 6 months. Results Four of the 13 patients were found stuck when replacing catheters. All of them successfully had catheters removed with PTA (Hong's techniques). All patients had successfully catheter replacement with blood flow volume>250 ml/min. Among 4 patients with edema, 3 patients showed better within 6 months. Only 3 patients needed warfarin to keep blood flow volume>250 ml/min within 6 months. Conclusions PTA shows advantages of lesser trauma, better tolerance and higher success rate in patients with catheter-related CVD. It can also relieve symptoms resulting from occlusive central vein.