Objective To report a case of pulmonary alveolar microlithiasis ( PAM) in Peking Union Medical Col-lege Hospital and to summarize the clinical features and genetic characters .Methods The clinical features , ima-ging results , pathology findings and SLC34 A2 gene mutation was analyzed and reported .Results The patient was a 35 years old male, presenting with cough and sputum for 10 years and worsen with short of breath for 3 weeks. Computed tomography of lung and pathology findings support the diagnose of pulmonary alveolar microlithiasis .And a heterozygous mutation c .A910 T in exon 8 of SLE34 A2 gene was discovered through genetic testing .Conclusions Since to the treatment is non-specific in this rare disease , it's significantly important to recognize this disease through early non-specific clinical features but typical imaging findings .And the finding that c .A910 T is more common in Asia population may provide us a potential target for screening and possible genetic engineering therapy .

Objective To improve the recognition of intravaseular lymphoma.Methods One case of intravaseular T-cell lymphoma was reported and the related literatures were reviewed.Results Intravaseulal T-cell lymphoma presenting with fever,rash and haemophagocytie syndrome is rare.Although the patient was given chemical therapy,he was died of liver failure and gastrointestinal bleeding.Conclusion Intravascular T-cell lymphoma is rare,often diagnosed after autopsy and shows a rapidly aggressive course.

Objective To investigate the lipoteichoic acid(LTA) induced apoptosis and the expression of inflammatory cytokines in human alveolar macrophage (AM) and the anti-apoptotic and anti-inflamatory effect of moxifloxacin (MXF).Methods Obtained human AM from bronchoalveolar lavage and used MTT assay to observe the effects of LTA and MXF on cell activity,optical microscope to investigate the change of the cell morphology,flow cytometry to assess cell apoptosis,RT-PCR to detect the mRNA levels of TLR2,IL-1 β,IL-8 and TNF-α,ELISA for the production of IL-8 to exam RT-PCR.Results LTA showed cytotoxicity on AM in a dose-dependent manner ( P＜0.05 ) ; MXF inhibited the effect of LTA without cytotoxicicy ( P＜0.05 ).LTA promoted apoptosis ( P＜0.05 ) and the mRNA expressions of TRL2,IL-1 β,IL-8 and TNF-α significantly in AM (P＜0.05),the peaks and peak time ofthe above factors were (3.56±0.03) at 12 h,(46.63±7.06) at 6 h,(28.07±1.24) at 12 h and (2.34 ±0.50) at 3 h respectively and increased the release of IL-8 protein level at 24 h (P＜0.05).MXF inhibited the cell apoptosis and the above mRNA expression at 12h ( P＜0.05 ),and inhibited the IL-8 protein level at 24 h( P＜0.05 ).Conclusion LTA showed cytotoxicity on AM,induced AM apoptosis and increased the expression of TLR2,IL-I β,IL-8 and TNF-α of AM ; MXF could protect AM through inhibiting of the above effects and may play a key role beside bactericidal effect in gram-positive bacteria pneumonia.

ACKGROUND:Autism is a kind of neurobiological disease.The increase of plasma concentration of 5 hydroxytryptamine(5 HT) is considered to be one of study results,which is the most definite and has the best repetition,for the biological investigation of autism. Whether the season of birth and maternal mood during pregnancy are correlated with the occurrence of autism? OBJECTIVE:To compare the differences of the plasma concentration of 5 HT,season of birth and the maternal mood during pregnancy between autistic and normal children,and probe into the cause of increased 5 HT in autism. DESIGN:An observational comparative study taking autistic and normal children as the subjects. SETTINGS:A clinical psychological department of a university hospital;Mental Health Institute of the Xiangya Second Hospital;A rehabilitation center for dumb children of city grade. PARTICIPANTS:Children in the autistic group(n=54),who were in accordance with the diagnostic criteria of autism in Diagnostic and Statistical Manual of Mental Disorders Fourth Edition(DSM IV) and had the total score of social adaptive ability scale(SAAS) over 40, were selected from the Outpatient Clinic for Children of the Mental Health Institute,Xiangya Second Hospital of Central South University and the training class of autism of Shenzhen Special Education School;Children in the normal control group,who had no obvious somatic and neurological diseases,and developing delay detected by physical,neurological and mental status examinations, rough detection of developing level,were selected from the primary school and kindergarten in Changsha and Shenzhen cities. INTERVENTIONS:The plasma level of 5 HT was examined, season of birth and maternal mood during pregnancy were investigated in autistic and normal children.The children with autism were accessed with SAAS. MAIN OUTCOME MEASURES:The plasma level of 5 HT,the season of birth and the maternal mood during pregnancy in both groups. RESULTS:The score of SAAS in children with autism was 67.65± 1.67.The plasma level of 5 HT was(0.78± 0.32) μ mol/L in the autistic group,which was significantly higher than that in the normal control group [(0.62± 0.16) μ mol/L](t=3.17,P=0.002). There were 17 children with autism had increased 5 HT.Compare with normal children,most children with autism were born in winter and spring,and their mother had obvious mood problems during pregnancy. CONCLUSION:The 5 HT level is higher in children with autism than in normal children.Most children with autism were born in winter and spring,and their mother had obvious emotional problems during pregnancy.There are phase of high functioning of 5 HT in mother in key period of fetus cerebra development that may be one of the causes of hyperserotonemia in autism,and that is possibly one of the etiologies of autism.

AIM:To investigate the specific anti-tumor effects of mature dendritic cells ( DCs) transfected with amplified mucin 1 ( MUC1) mRNA in vitro.METHODS:DCs separated and purified from the peripheral blood mononu-clear cells were induced in vitro and then identified by flow cytometry .pcDNA3.1(+)-MUC1 plasmid was constructed and was able to transcribe MUC1 mRNA in vitro.The MUC1 mRNA was transfected into DCs by electroporation .MUC1-trans-fected DCs were used to induce T cells to be cytotoxic T-lymphocytes .Quantitative real-time PCR was performed to assess MUC1 mRNA expression in transfected DCs .The proliferation of T cells was examined by MTT assay .The proportion of CD8 +cells in the T cells was determined by flow cytometry and the specific cytotoxicity was measured by LDH assay .The secretion of IFN-γwas detected by ELISA .RESULTS: The marker gene expression in the DCs transfected with MUC 1 mRNA was significantly increased compared with control group , peaking at 24 h.The transfection group showed the higher capacity to stimulate the proliferation of T cells compared with control group when the ratio of DCs to T cells was 1∶10.The proportion of CD8 +cells in transfection group was higher than that in control group .The lethal effect of special cytotoxic T-lymphocytes on target cells in transfection group was stronger than that in control group .The level of IFN-γin the cell su-pernatant of transfection group was higher than that in control group .CONCLUSION:DCs plus MUC1 mRNA by electri-cal transfection induces specific anti-tumor effects , which provides an experiment evidence of using MUC 1 as a target for immunotherapeutic strategy against non-small cell lung cancer .

Objective:To study the clinical effect of splenic arninopeptide combined with pulmicort on the bronchial asthma in children and its effect on the CD4+,CD8+ and serum IgE concentrations.Methods:88 cases of patients with acute exacerbation of bronchial asthma in our hospital from June 2015 to October 2016 were selected and randomly divided into the control group and the observation group,44 cases in each group.All the children were treated with cough and phlegm.In addition,the control group was given inhalation of Pulmicort suspension,the observation group of children was treated by spleen ammonia peptide oral freeze-dried powder on the basis of control group.The clinical efficacy,disappearance time of clinical symptoms,changes of lung function,hospitalization time and levels of CD4+,CD8+,CD4+/CD8+,Serum IgE concentration before and after treatment were compared between two groups.Results:The total effective rate of treatment group was significantly higher than that of the control group (P＜0.01).After treatment,the disappearance time of cough,chest wheezing,wheezing and hospitalization time of observation group were significantly shorter than those of the control group (P＜0.01),the FVC,FEV1 and FEV1/FVC,CD4+,CD4+/CD8+ levels after treatment were significantly higher than those in the control group (P＜0.01),and the serum IgE concentration was lower than that of the control group(P＜0.01).There was no significant difference in the incidence of adverse reactions and CD8+ between the two groups(P＞0.05).Conclusion:Splenic aminopeptide combined with Pulmicort could enhance the clinical efficacy of children with bronchial asthma,which could quickly improve the clinical symptoms and immune function with high safety.

The chronic disease management of rheumatoid arthritis has been popularized and applied in China. This article will review the application and research progress of different chronic disease management models, including chronic care mode, chronic disease self-management, transitional care mode, community-based chronic disease management, and "internet + chronic disease management" in rheumatoid arthritis patients in China, and compare the advantages and disadvantages of different intervention models, in order to provide a theoretical basis for exploring the chronic management of rheumatoid arthritis under different regional medical resources.

Objective The aim of this study was to analyze the predictive value of an immune scoring model based on im-mune cell infiltration for the efficacy and prognosis of immunotherapy in early gastric cancer.Methods The gene expression data and related clinical parameters of 167 early gastric cancer patients were downloaded from the Cancer Genome Atlas(TCGA)as the training set.The clinical information of 92 early gastric cancer patients who first visited our hospital from January 2017 to January 2020 was collected as a validation set.The infiltration of 22 immune cells in tumor tissues was calculated by the Cibersort software.The key pre-dictive factors for early gastric cancer patients were further screened and determined by lasso analysis and multivariate Cox regression analysis.The eligible immune cells were used to construct the prognostic risk scoring model and verify it.Based on the risk model,a nomograph model was established to predict the probability of death and treatment failure in early gastric cancer patients,and evaluate the differentiation,accuracy,and reliability of the model.Results There was no statistically significant difference in the general infor-mation of patients between the training set and the validation set(P＞0.05).Compared with normal tissues,the content of CD8+T cells,activated memory CD4+T cells,M0 macrophages,M1 macrophages,resting dendritic cells,and activated dendritic cells in early gastric cancer tumor tissues decreased.The contents of regulatory T cells(Treg cells)and eosinophils increased,and the difference was statistically significant(P＜0.05).The LASSO analysis further screened five types of infiltrating immune cells,including activated memory CD4+T cells,M1 macrophages,Treg cells,activated dendritic cells and eosinophils.The survival curve results showed that the immune scoring model could effectively distinguish the survival time of patients.The total score of the prognostic nomogram model was 274,corresponding to risk of death of 72%.The total score of the treatment effect nomograph model was 307,corresponding to a 75%risk of ineffective treatment.The model validation results showed that the nomograph model has high discrimination,accuracy and reli-ability.Conclusion The immune scoring model based on immune cell infiltration has a certain predictive value for the efficacy and prognosis of immunotherapy in patients with early gastric cancer.

OBJECTIVETo determine the level of neurohormonal operative stress response-reactive protein (CRP) and rest energy expenditure (REE) after laparoscopic cholecystectomy (LC) and open cholecystectomy (OC).

METHODSTwenty-six consecutive patients with noncomplicated gallstones were randomized for LC (n = 14) and OC (n = 12). Plasma concentrations of somatotropin, insulin, cortisol and CRP were measured. The levels of REE were also measured.

RESULTSOn the third postoperative day, the insulin levels were lower than those before operation (P < 0.05). On the first postoperative day, the levels of somatotropin and cortisol were higher in OC than in LC. After operation, the parameters of somatotropin, CRP and cortisol increased compared to the preoperative period in all patients (P < 0.05). On the all-postoperative day, the CRP levels were higher in OC than in LC (P < 0.05). After operation, the REE level increased in OC and LC (P < 0.05). On the all-postoperative day, the REE levels were higher in OC than in LC (P < 0.05).

CONCLUSIONSLC results in less prominent stress response and smaller metabolic interference compared to open surgery. These benefit the restoration of stress hormones, nitrogen balance, and energy metabolism. However, LC can also induce acidemia and pulmonary hypoperfusion because of pneumoperitoneum during surgery.

Acid-Base Equilibrium ; Adrenocorticotropic Hormone ; blood ; Adult ; C-Reactive Protein ; metabolism ; Cholecystectomy ; adverse effects ; Cholecystectomy, Laparoscopic ; adverse effects ; Energy Metabolism ; Female ; Gallstones ; surgery ; Growth Hormone ; blood ; Humans ; Insulin ; blood ; Male ; Middle Aged ; Postoperative Complications ; Postoperative Period ; Stress, Physiological ; etiology ; physiopathology ; Time Factors

Objective To investigate the effects of graphic health education pathway in patients with osteoporosis after postmenopausal.Methods Totals of 120 cases of perimenopausal patients with osteoporosis were divided into the observation group (n=60) and the control group (n=60) from January 2011 to December 2013.The control group patients were given the routine sexual health education.The observation group was taught with graphic health education for three months.The Osteoporosis Health Belief Scale ( OHBS ) , the Visual Analogue Scale (VAS), Oswestry Disability Index (ODI) and bone mineral density of the two groups were observed and compared before and after the health education.Results In the observation group, the total score of KAP and the score of heath belief, the knowledge of osteoporosis, the prevention healthcare were (139.62 ±32.12), (65.32 ±12.48), (43.69 ±5.78) and (32.12 ±4.56), respectively, which were significantly higher than (105.63 ±28.69), (51.21 ±11.45), (31.25 ±4.96) and (22.62 ±5.12) in the control group after the intervention (t =3.456, 4.362, 5.126, 5.623, respectively;P <0.05).In the observation group, the score of ODI and VAS were ( 23.25 ±5.12 ) and ( 3.86 ±0.75 ) , which were significantly higher than (36.12 ±6.78) and (5.29 ±0.92) in the control group after the intervention (t=4.985, 5.122, respectively;P<0.05).The bone mineral density of lumbar L1 to L4, femoral neck and hip trochanter area and Wards area of the observation group were significantly higher than the control group ( t=4.252, 4.825, 4.312, 4.985, respectively;P<0.05).Conclusions The graphic health education pathway can effectively improve the KAP of osteoporosis patients and the bone mineral density.It can relieve the pain and dysfunction, so as to promote the rehabilitation of patients.