Immune system is the autologous defense system for people to resist disease. Immunotherapy stimulates the immune system to resist disease, including treatment with immunocyte and vaccine. In recent years, the prognosis and survival quality of tumour patients have been greatly improved through cell immunotherapy by immunoregulation and killing directly on tumor. Immunotherapy becomes the hotspot in research.The study of DN Treg cell on immunotherapy will be of vital significance.

Child ; Humans ; Pneumonia, Pneumococcal ; Streptococcus pneumoniae

Objective To analyze perioperative process, oncologic state and prognosis of patients with rectal carcinoma treated by lapascopic abdominoperineal resection. Methods 9 cases of rectal carcinoma treated by lapascopic abdominoperineal resection were reviewed retrospectively from December 1993 to February 1996. Results The median age was 50y(30y～67y), median follow-up time 80 months(40m～90m) and median operative time 6h (4 5h～7 5h). 9 cases were operated on by standard radical operation, including abdominal procedures under laparoscope in 8 cases and under the help of mini-incision in 1 case.Complications occurred in 4 cases, including subcutaneous emphysema and urine detention, iliac vein injury, deep vein thrombosis and part mucous necrosis, and perineal wound infection in 1 case respectively. The median number of lymph nodes in the specimen was 13(4～25). 6 patients survived and 3 ones died with the survival rate at 5-year being 77.8%. Conclusions Lapascopic abdominoperineal resection in the treatment of rectal carcinoma is feasible, and it can meet the tumor resection requirements of open radical operation.

To observe and evaluate the effects of manipulation on knee osteoarthritis (KOA) using T2-mapping and magnetic resonance imaging (MRI)-based volume measurements.

Objective To study the clinical application of the complete audiologic evaluation battery consisting of ABR,ASSR and behavioral audiometry in sound field for the identification of sensorineural losses in children.Methods In the study 48 children were divided as group PTA of the children assessed by pure tone audiometry and ABR and ASSR test,and group BA of the children unable to perform on behavioral evaluations.Results The analysis of the audiometric results of group PTA showed significant correlation between the ASSR thresholds and pure tone thresholds(P＜0.01) at various frequencies.The correlation coefficients were 0.75,0.76,0.76,and 0.83 at different frequencies.The ASSR-PTA linear regression was utilized.The comparison of the ABR and ASSR results of group BA indicated that 23 ears responded in ASSR but without responses in ABR.Those without ASSR responses also had no ABR There were 116 tests in total four frequencies for the 29 ears.83 responses were obtained from ASSR,89 responses from behavior audiometry and 96 from the use of the both tests.Conclusion The comprehensive audiologic evaluation battery could be used to test younger children with severe heating loss children as compared to the pure tone audiometry alone.More detailed data can be obtained thus from children to assist in rehabilitation in a more effective mariner.

SUMMARY Mercury intoxication is a rare cause of severe hypertension. A case of mercury intoxication presented with severe hypertension and erythromelalgia was reported. A 10-year-and-5-month-old girl presented with recurrent rash and painful hands for 2 months, with seizure attack and episodic loss of consciousness for one hand half months. The girl was found to have red painful hands, a blood pressure 170/120 mm Hg(1 mm Hg=0.133 kPa), tachycardia and hypokalemia (2.83-3.25 mmol/L, reference value 3.5-5.5 mmol/L). An extensive investigation ensued. Elevated renin-angiotensin and aldosterone were demonstrated in plasma. Cranial MRI T2 weighed images showed widespread white matter signal abnormalities, which particularly involved parietal, occipital and frontal lobes. With hypertension controlled, white matter signal abnormalities weakened. Other symptoms included insomnia, nausea and paroxysmal abdominal pain. The girl was found to have a raised concentration of mercury in urine (0.171 mg/L, reference value

Objective To investigate the relationship between corneal basal nerve change and type 2 diabetic retinopathy based on confocal laser microscopy.Methods Together 118 patients with type 2 diabetes (T2D) were collected in our hospital from February 2016 to February 2017,including 57 patients with diabetic retinopathy (DR group) and 61 patients without DR (NDR group).For comparison,60 healthy volunteers were selected as the control group.And all the subjects were examined by corneal confocal laser microscopy to analyze the relationship between the morphological parameters of the corneal nerve and clinical variables.Results Corneal nerve fiber density,corneal nerve branch density and corneal nerve branch length in DR group were (20.03 ±4.22) · mm-2,(22.01 ± 7.05) · mm-2 and (9.50 ± 1.76) mm ·mm-2,significantly less than those of the control group and NDR group (all P ＜ 0.05);and corneal nerve fiber curvature was (0.30 ± 0.03),significantly higher than that of the control group and NDR group (all P ＜ 0.05);In DR patients,phase Ⅲ patients had smaller the corneal nerve fiber density,corneal nerve branch density and corneal nerve branch length,but the larger corneal nerve fiber curvature than the phase Ⅰ and Ⅱ patients (all P ＜ 0.05);course of disease of DR group was (12.04 ± 2.48) years,which was significantly higher than that of NDR group (P ＜ 0.05),while fasting C peptide and fasting insulin were (1.41 ± 0.58) μg · L-1 and (20.05 ± 7.91) mU · L-1,respectively,significantly lower than those of NDR group (all P ＜ 0.05);The duration of T2D was negatively correlated with the corneal nerve branch density and corneal nerve branch length (r =-0.322,-0.317,all P ＜0.05);Fasting C peptide was positively correlated with the corneal nerve branch density (r =0.298,P ＜ 0.05),and negatively correlated with the corneal nerve curvature (r =-0.311,P ＜ 0.05).Conclusion Patients with T2D retinopathy have abnormal morphology of corneal nerve.And confocal laser scanning microscopy is conducive to the early detection of microvascular disease in T2D patients with a longer course of disease or a low level of fasting C peptide.

Background:Abnormal immune response is involved in the pathogenesis of Crohn’s disease( CD),and T lymphocytes are the main players in the immune response. Aims:To investigate the relationship between peripheral blood CD3 + ,CD4 + and CD8 + T cells and inflammation-related markers in patients with CD. Methods:Proportions of peripheral blood CD3 + ,CD4 + and CD8 + T cells were measured by flow cytometry in 26 CD patients( including 14 patients in active stage and 12 in remission stage )and 8 healthy volunteers(control group),and their correlation with inflammation-related markers(including white blood cell count,platelet count,ESR,CRP,albumin and hemoglobin) were analyzed. Results:Proportions of CD3 + ,CD4 + and CD8 + T cells were significantly increased in patients with active CD than those with remission CD and controls( P ﹤ 0. 05),however,no significant differences were found between remission CD patients and controls(P ﹥ 0. 05). ESR and CRP in active CD patients were significantly higher than those in controls(P ﹤ 0. 05),while albumin and hemoglobin levels were significantly decreased(P ﹤ 0. 05);albumin in remission CD patients was significantly lower than that in controls(P ﹤ 0. 05). No significant differences in white blood cell count and platelet count were found between active,remission CD patients and controls(P ﹥ 0. 05). Proportions of CD3 + , CD4 + and CD8 + T cells were positively correlated with CRP,and negatively correlated with hemoglobin( P ﹤ 0. 05);CD3 + and CD4 + T cells were positively correlated with ESR(P ﹤ 0. 05). However,CD3 + ,CD4 + and CD8 + T cells were not correlated with white blood cell count,platelet count and albumin level( P ﹥ 0. 05). Conclusions:Proportions of peripheral blood CD3 + ,CD4 + and CD8 + T cells are increased with the increase of disease activity in CD,and are positively correlated with CRP,and negatively correlated with hemoglobin.

Background:Capsule endoscopy has been demonstrated to be an effective diagnostic tool for small bowel diseases in a series of small sample researches. However,the results need to be verified by large sample studies. Aims:To investigate the diagnostic performance and safety of capsule endoscopy for small bowel diseases. Methods:Consecutive patients undergoing capsule endoscopy for suspected small bowel diseases from May 2008 to Apr. 2013 in Nanjing General Hospital of Nanjing Military Command of PLA were collected and analyzed retrospectively. Results:A total of 573 patients were enrolled,the overall success rate of the examination was 99. 13%(568 / 573)and the overall completion rate was 88. 38%(502 / 568). The mean time of capsule passing the pylorus was 43. 45 min,and that of passing the small bowel was 287. 21 min. The overall detection rate of small bowel lesions was 53. 52%(304 / 568)and the overall diagnostic rate was 51. 06%(290 / 568). Both the detection rate and diagnostic rate in patients with obscure gastrointestinal bleeding(OGIB) were significantly higher than those in patients with obscure abdominal pain and chronic diarrhea(64. 26% and 62. 46%vs. 41. 72% and 39. 07% ,and 32. 14% and 27. 38% ,P all < 0. 05). Small bowel lesions detected by capsule endoscopy included angiopathy(21. 38% ),ulceration(20. 72% ),neoplasms(14. 47% ),erosion(11. 84% ),and Crohn’s disease(11. 18%),etc. Capsule retention occurred in 2. 29%(13/568)of the patients,and one acute intestinal obstruction and 2 perforations were observed. Conclusions:Capsule endoscopy is a safe and effective diagnostic modality for small bowel diseases. OGIB is the most common indication for capsule endoscopy,and capsule endoscopy is also helpful for evaluation of established or suspected Crohn’s disease.

Endoscopic activity has been used as an endpoint in treatment of Crohn's disease (CD).Simplified Endoscopic Score for Crohn's Disease (SES-CD) is a simple and easy-to-use endoscopic scoring system for CD, however, studies evaluating the correlation between SES-CD and noninvasive inflammatory markers are scarce.Aims: To investigate the correlation between SES-CD and clinical and laboratory inflammatory markers for identifying a noninvasive surrogate marker for endoscopic activity of CD.Methods: Forty-two patients with CD were enrolled for detecting laboratory inflammatory markers including leukocyte and platelet count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), hemoglobin (Hb), albumin (Alb) and fecal calprotectin (FC);SES-CD and Crohn' disease activity index (CDAI) were assessed.Predictive performance of these markers for endoscopic activity of CD was analyzed by ROC curve, and the correlation of SES-CD with all these markers was evaluated.Results: The platelet count, CRP, ESR, FC and SES-CD were significantly higher in active CD than in inactive CD, while Hb and Alb were significantly lower in active CD (P all <0.05).In all the noninvasive markers, only CDAI and FC had an area under the curve (AUC) greater than 0.9 for predicting CD endoscopic activity.Taken 150 as the cut-off value of CDAI and 50 μg/g (the upper limit of normal, ULN) as the cut-off value of FC, the sensitivity of CDAI and FC were 58.8% and 100%, and the specificity were 100% and 60.0%, respectively.SES-CD had moderate correlation with CDAI, platelet count, CRP, ESR, Alb and FC, respectively (P all <0.05).Conclusions: SES-CD is correlated moderately with the clinical and laboratory inflammatory markers, however, when taken the ULN as cut-off value the conventional inflammatory markers such as CDAI, CRP and ESR are hard to predict sensitively and accurately the endoscopic activity of CD;while FC has fairly high accuracy and sensitivity and can be used as a noninvasive surrogate marker for evaluating endoscopic activity of CD.