Circulating tumor cells (CTCs), as the seeds of tumor metastasis, manage to escape from immune clearance both in microen-vironment and in peripheral blood. CTCs can also facilitate formation of pre-existing environment, which is the crucial step in metasta-sis. Myeloid-derived suppressor cells (MDSC), as a group of immunosuppressive cells derived from bone marrow cells, may play a key role in this process. In this review, the progress in MDSC and its role in the formation, survival, and immune escape of CTCs were exten-sively discussed to explore a new target for tumor immunotherapy.

Objective To observe the therapeutic efficacy of endoscopic pancreaticobiliary duct drainage for acute necrotizing pancreatitis. Methods 41 cases of acute necrotizi ng pancreatitis were randomly divided into pancreaticobiliary duct drainage (21 causes) group and control group (20 cases).Results The procedure was successful in all 21 cases. The difference bet ween the two groups was statistically significant including hospital stay 〔(2 8?12) days vs. (37?19) days,P

Immunosenescence is a biological process featured by the structural and functional decline of immunity in ageing people,which favors the carcinogenesis by rendering the body's immune surveillance and tumor escape.Decreasing clearance of tumor cells by macrophages and natural killer cell reflects the immunosenescence of innate immune,also,the tumor antigen presentation ability of dendritic cell is decreased.While,the decline of the CD8 + T cells cytotoxic effect and the secretion of tumor growth factor accounts for the immunosenescence of adaptive immunity.Intervention of immunosenescence may produce the novelty ideas of prevention and treatment of cancer.

BACKGROUND: Perinatal hypoxic-ischemic encephalopathy(HIE) is the primary cause of neonatal brain injury, which retards the mental development in affected infants.OBJECTIVE: To investigate the influence of early intervention on mental and psychological development in infants with HIE, study the time-effect relation of the early intervention, and to find an optimal time for intervention.DESIGN: A time series of following-up and a non-randomized concurrent controlled investigation.SETTING: Xiangya Hospital and Xiangya School of Medicine Affiliated to Central South University.PARTICIPANTS: From February 1999 to May 2001, in the Pediatric Department of Xiangya Hospital Affiliated to the Central South University, the inpatient and outpatient infants with HIE were selected. There were 32 inpatients in the intervention group, 10 with moderate HIE and 22 with severe HIE. There were 36 outpatients in the control group, 10 with moderate HIE and 26 with severe HIE. Comparison was performed between these two groups.METHODS: BRS and the Infant and Child Mental Development Scales,made by The Institute of Psychology of The Chinese Academy of Science and The China National Children' s Center(CNCC), were adopted in the assessment between the two groups.MAIN OUTCOME MEASURES: Mental Development Index(MDI) and Psychomotor Development Index(PDI) scores of the two groups were compared.were significantly higher in the intervention group(90.50 ± 11.12/90. 34±12.49,94.06±14.96/92.03±13.07,90.78±7.46/91.38 ± 13.87)than those in the control group(62.28±7.44/62.67±6.06, 59.11following-up results showed that one patient in the intervention group had a MDI score at the critical threshold value, and two patients had PDI scores at the critical threshold value. For all the other patients in this group, the MDI/PDI scores of them were above the moderate range. In contrast, all the 36 infants in control group had developed mental deficiencies at that time.CONCLUSION: A quantifiable effect of the intervention can be observed in patients at 3 months of life. This indicates that an early intervention is essential for improving the mental development in infants with HIE.

Objective To explore the current situation of knowledge,beliefs and behavior of elderly patients with COPD during their community-based rehabilitation.Methods Phenomenological research method of qualitative research was used,14 elderly patients with COPD during their community-based rehabilitation period received in-depth interviews.Results There were three themes and corresponding subthemes sublimated from the patients:self-management knowledge and skills,self-management beliefs and attitudes and self-management behavior.Conclusions It is necessary to pay close attention to spreading disease related health information,especially for patients with low health literacy.During the process of COPD self-management projects,we should focus on negative beliefs and negative attitudes on their selfmanagement behavior choice,which is as important as strengthening the patients' self-efficacy.

Metastasis is the leading cause of death in patients with lung cancer .Circulating tumor cells (CTCs)play a key role in the process of distant metastasis .In recent years,research results have shown that CTCs may become a emerging marker and new target in the treatment of lung cancer .In this article,we elaborate the clinical significance of CTCs in lung cancer from the way of diagnosis and clinical staging ,metastasis and recur-rence,individual treatment and prognosis and so on ,so that we can provide a new direction for the treatment of lung cancer .

Objective To explore the negative emotion and self-management of elderly patients with COPD during their community-based rehabilitation.Methods Phenomenological research method of qualitative research was used,12 elderly patients with COPD during their community-based rehabilitation period received in-depth interviews.Results There were three themes sublimated from the patients negative emotions:aloneness and inferiority feeling,self-abasement and guilty feeling,sense of helplessness.Self-management of negative emotions also had three themes:gratitude mood,complying with the disease and distracting attention.Conclusions It is necessary to pay close attention to the negative emotions of elderly patients with COPD during their community-based rehabilitation; the community healthcare services should bear the responsibility of COPD patients' rehabilitation; we should explore practical intervention plan work on gratitude mood of elderly patients with COPD ; mobilize all social resources to do a good job on social support in elderly patients with COPD.

0.05). CONCLUSION BDP do not cause adrenal suppression on therapeutic doses of 400 microgram/day after 4 weeks of use.

AIM: To investigate the effect of peripheral administration of arginine vasopressin (AVP) on lipopolysaccharide (LPS)-induced fever and hyperalgesia in rats and its relationship with interleukine-1β (IL-1β) and prostaglandin E2 (PGE2).METHODS: The core temperature (Tc), brown adipose tissue (BAT) temperature and activity were measured by telemetry in adult male Sprague-Dawley rats at an ambient temperature of 23 ℃ during a 12 h light/12 h dark photoperiod (lights on at 06:00 and lights off at 18:00).The rats were intraperitoneally injected with LPS (50 μg/kg), AVP (10 μg/kg) or V1a vasopressin receptor antagonist (V1a antagonist, 30 μg/kg) at 10:00 or 11:30.Hyperalgesia was assessed by measuring the latency to withdraw a hindpaw from radiant heat (Hargreaves test).The concentrations of IL-1β and PGE2 in the serum were tested by ELISA.RESULTS: Intraperitoneal administration of LPS induced periods of biphasic fever accompanied by hyperalgesia.AVP reversed LPS-induced fever, and decreased the hyperalgesia and BAT thermogenesis.Peripheral administration of V1a antagonist enhanced the fever produced by LPS, but did not affect the hyperalgesia.AVP significantly attenuated LPS-induced IL-1β and PGE2 production.CONCLUSION: Peripheral administration of AVP reverses LPS-induced fever and decreases hyperalgesia by reduction of BAT thermogenesis and inhibition of IL-1β and PGE2.Endogenous AVP attenuates the fever induced by LPS, but does not affect the nociceptive thresholds.

Objective:To investigate the prognostic value of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and prognostic nutritional index (PNI) before radiation in pancreatic cancer patients underwent radiation therapy. Methods:Clinical data of 61 patients with pathologically confirmed pancreatic cancer were retrospectirely analyzed. Query index values for each patient were clinically tested through electronic medical records. Overall survival (OS) data were collected through electronic medical records or telephone follow-up. Survival curves were compared using Kaplan-Meier methodology and log-rank test. Cox regression methodolo-gy was used for univariate analysis. Results:Using log-rank test and univariate regression analysis, we found that patients with lower NLR, PLR, CA19-9, increased PNI, and lower TNM-staging lived longer than those with increased NLR, PLR, CA19-9, lower PNI, and high-er TNM-staging, and that the difference was statistically significant. Through multivariate analysis, we found that NLR (P=0.029, OR 2.344, 95%CI:1.090-5.041) and PNI (P=0.026, OR 0.477, 95%CI:0.248-0.917) were independent predictors of OS in patients with pan-creatic cancer. Conclusion:NLR, PLR, and PNI are simple, effective, and reliable indicators for evaluating the prognosis of pancreatic cancer.