Regulatory T cells play an important role in regulating immune responses.Recently,a novel immune Treg cell with phenotype TCRαβ + CD3 + CD4-CD8-NK1.1-was known as the Double-negative T cells (DNT).DNT cells are able to suppress CD4 + and CD8 + T cells,B cells as well as NK cells and dendritic cells(DCs) and play an important role in regulating immune responses in models of autoimmunity,infection,inflammatory disease,transplantation and tumor immunity.Now DNT cells have already become a hot point in the research of the immunotherapy.This article mainly introduces the possible sources of DNT cells and the mechanisms of their functions.

AIM and METHOD: In terms of difference value between bleeding blood volume that caused hemorrhagic shouk (HS) and residual blood volume at 2 h after HS, showed that HS at 5.3 kPa level was compen- satory and at 4.0 kPa level was decompensatory. Comparing some blood changes between HS two levels and their changes while pretreated with captopril (Capt. ) to reduce the release of angiotensin Ⅱ (Ang-Ⅱ), so as to inveshgate the significance of Ang - Ⅱ during HS. RESULTS: The residual blood volume in 4.0 kPa HS + Capt. group are again from near "zero" value in simple 4.0 kPa HS group. In both two HS level groups found blood dilution and was not influenced by pretreating with Capt.; contents of K+ and aldosterone increased, but Na+ had no changes, in Capt. + HS group, the former two contents reduced and Na+ had no changes comparing with each HS group. In two HS groups, the bind lactate, lactic dehydrogenase (LDH), blood urea nitrogen (BUN) increased and had more increment in 4.0 kPa HS group. All these changes could be prevented by pretreating with Capt. The blood glucose in 5.3 kPa HS group increased markedly and Capt. had no influence on it, but decreased extremely in 4.0 kPa HS group and Capt. could make it re - increased. CONCLUSIONS: Artery blood pressure (ABP) at 5 .3 kPa level was compensatory HS and ABP at 4 .0 kPa level was decompensatory HS, some changes on decompensatory HS were more serious and severe than compensatory HS, Capt. has protective effects on some changes during HS and could prolong the survival time of decompensatory HS, all that indicated the increment of Aug - Ⅱ is an important pathogenetic factor during HS.

Child, Preschool ; Epilepsy, Rolandic ; diagnosis ; drug therapy ; physiopathology ; Humans ; Male ; Prognosis ; Steroids ; therapeutic use ; Treatment Outcome

OBJECTIVEWilson's disease (WD) is an autosomal recessive disorder characterized by excessive accumulation of copper in the liver and later in the brain and other organs. Penicillamine acts as a reductive chelator. Zinc salts induce the synthesis of metallothionein in cells. Thus these two drugs are theoretically synergistic for the treatment of the disease. However, the two drugs may also have some unfavorable interactions. In this study, the effect of the therapy with combined penicillamine and zinc salts was evaluated based on the follow-up observations of 21 patients with Wilson's disease.

METHODSUsing the combined therapy of penicillamine [10-30 mg/(kg.d)] and zinc (22.5 mg, 3 times per day), follow-up study by hospitalization or communication with telephone or mail.

RESULTSBefore treatment, all the 21 patients were suffered from chronic liver disorder. Among them, 13 patients (62%) showed to be reactive to the treatment for their liver disorder, 5 patients (24%) died, and 3 patients (14%) dropped off our follow-up study. Among the 5 patients who died, 3 died within 40 days after treatment, one had taken penicillamine only 8 mg/(kg.d), and one died after discontinuation of the treatment by the parents. Of the 12 patients having neurological involvement, neurological symptoms disappeared or markedly improved in 11 patients after treatment. One patient dropped off the follow-up study. The patient with renal tubular acidosis responded well to the treatment. Urine routine analysis was followed up in 6 of the 7 patients with hematuria. Hematuria disappeared in one, became less severe in 1, and remained unchanged in 4 patients. Hypersensitivity to penicillamine was found in one patient. WBC and platelet were found decreased further in 3 patients after the medications.

CONCLUSIONSThe combined therapy with penicillamine and zinc salts was effective in treatment of patients with Wilson's disease.

Adolescent ; Antidotes ; administration & dosage ; adverse effects ; therapeutic use ; Child ; Drug Therapy, Combination ; Female ; Follow-Up Studies ; Hepatolenticular Degeneration ; drug therapy ; Humans ; Male ; Penicillamine ; administration & dosage ; adverse effects ; therapeutic use ; Treatment Outcome ; Zinc ; administration & dosage ; adverse effects ; therapeutic use

Objective To investigate the long-term outcome of children with recurrent wheeze and to determine the effectiveness of inhaled hormone therapy. Methods One thousand and thirty-five children with recurrent wheezing were followed up for more than 4 years and the data were retrospectively evaluated. Results Of 1035 cases, 751 (72.56%) patients outgrew their wheeze during the follow-up period, whereas the other 284 (27.44%) patients had recurrence wheeze during the last two years. The age of wheezing onset was<3 years in 542 (52.37%) cases, from 3 to 7 years in 386 (37.29%) cases, and from 7 to 12 years in 107 (10.34%) cases. There was significant difference in clinical control rate among groups with different wheezing ages onset (χ2=45.27, P<0.001). Children with wheezing age onset from 7 to 12 years had the lowest clinical control rate. Among 1035 wheeze children, 343 (79.95%) children in 429 cases who received inhaled hormone therapy for more than one year outgrew their wheeze. Whereas 408 (67.35%) in 606 cases who did not receive inhaled hormone therapy outgrew their wheeze. There was significant difference of clinical control rate between inhaled group and non-inhaled group (P<0.01). Con-clusions The age of wheezing onset is<7 years in 89.66%of children with recurrent wheeze. Most of them can be clinicalycon-trolled. The long term inhaled hoemone therapy for children with recurrent wheeze can reduce the risk of developing adulthood asthma.

Objective To determine the expression of brain-derived neurotrophic factor (BDNF) in pancreatic ductal adenocarcinoma and its clinical significance.Methods SP immunohistochemical staining method was used to detect the expression of BDNF in 46 cases of pancreatic ductal adenocarcinoma,38 cases of benign pancreatic diseases and 20 cases of normal pancreatic tissue.Real time PCR and Western blot was used to detect the protein and mRNA expression levels.The relationship between BDNF expression and clinicopathological parameters of pancreatic cancer was determined.Results The positive expression rate of BDNF was 52.2％ (24/46) in pancreatic ductal adenocarcinoma pancreatic ductal adenocarcinoma,7.8％ (3/38) in benign pancreatic diseases,and none of the normal pancreatic tissue was BDNF positive.The BDNF protein expression levels in pancreatic ductal adenocarcinoma,benign pancreatic diseases and normal pancreatic tissue were 0.38± 0.01,0.56± 0.01,0.97± 0.01,respectively,and the BDNF mRNA expression levels were 0.85 ± 0.14,1.67 ± 0.21,3.45 ± 0.67,respectively,and the expression levels in pancreatic ductal adenocarcinoma and benign pancreatic diseases were significantly higher than that in normal pancreatic tissue,while the expression level in pancreatic ductal adenocarcinoma was significantly higher than that in benign pancreatic diseases (P ＜0.05).Positive BDNF expression was correlated with nerve infiltration and lymph node metastasis of pancreatic ductal adenocarcinoma,but it was not related to age,sex,tumor size,location and differentiated degree (P ＞ 0.05).Conclusions BDNF is involved in the development and growth of pancreatic cancer,and it may be related with patient's prognosis.

Objective A comparative proteomic method was utilized to analyze serum proteins among pancreatic cancer patients,pancreatic benign tumor group,chronic pancreatitis group and normal control group to discover a new potential specific early diagnostic marker.Methods Comparative analysis on the pancreatic peripheral blood protein profiling from 40 pancreatic cancer patients,10 benign tumor patients,10 chronic pancreatitis patients and 40 cancer-free controls from May 2009 to April 2011 was carried out by 2D differential gel electrophoresis (2D-DIGE) and differentially expressed proteins were identified by matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS).Results Three differentially expressed proteins,Hemopexin (Hpx),Ficolin 3 (FCN3) and Serum amyloid P-component (SAP) was identified.Those proteins were higher expression in pancreatic cancer group compared with benign tumor group,chronic pancreatitis group and normal control group.Each point in pancreatic cancer expression were 1.57,1.99,1.63 times than normal control expression,respectively (P ＜0.05).Conclusions In this study,the identified proteins,Hpx,FCN3 and SAP may be as potential specific early diagnostic markers of pancreatic carcinoma.2D-DIGE and MALDI-TOF-MS technology in screening specific serum tumor markers of pancreatic cancer has a well repeatability and stability.

Objective To assess the efficacy and safety of ketogenic diet(KD) on refractory epilepsy in children.Methods KD treatment was designed to observe the effects for 12 weeks.Totally 22 children with 16 boys and 6 girls were enrolled in the study.The epileptic syndromes included infantile spasms(13 cases),Lennox-Gastaut syndrome(4 cases),Dravet syndrome(2 cases),and the unclassified(3 cases).The KD was prepared according to the modified Johns Hopkins regimen.Urinary ketones were measured every day to ensure that ketosis state and parents′ diaries were kept to find out when it started to work and the change of seizure frequency.Effects of KD was evaluated by Engel standard.Blood chemistry was done at baseline,4 weeks and 12 weeks to analyze the effects of KD on metabolism.Side effects were monitored and treated.Results All cases completed the KD regimen for at least 2 weeks,19 cases for at least 4 weeks,and 10 cases for at least 12 weeks.Sixteen out of 22 children experienced the seizure reduction within 3 weeks(1-15 d),especially in the first week,and seizure free appeared within 5 weeks(1-32 d) in 8 cases.Overall,the diet achieved the seizure-free in 36.4%(8/22 cases) and an over 90% of seizure frequency reduction in 22.7%(5/22 cases).The efficacy of KD seemed not correlated with the sex,age,etiopathogenisis,and syndromes and so on.Blood chemistry suggested a normal range of glucose level at 4 weeks,though higher than that at the baseline.The blood triglyceride and total cholesterol level at 12 weeks increased strikingly,even beyond the normal range compared with the baseline.The side effects mainly including transient gastrointestinal symptoms and metabolic disturbances were mostly tolerable.Conclusions KD is probably a feasible therapy on refractory epilepsy in children,with quick and high efficacy and few side effects.

Objective To explore the initial clinical and imaging characteristics of basal ganglia germinoma in children.Methods Four patients with basal ganglia germinoma were reported.Their clinical features,laboratory findings,radiological manifestations,treatment and outcome were analyzed.They recieved radiation therapy and chemotherapy after diagnosis.All patients were clinically diagnosed,according to the results of low-dose cranial irradiation.The outcomes were followed up for 2 years.Results All patients were male and school-aged(9-13 years) children.The course of the disease ranged from 5 to 13 months.All patients were presented with slowly progressive hemiparesis,and 2 cases of them were presented with cognitive decline and psychosis.Seizure occurred in 2 patients.The serum ?-human chorionic gonadotropin(?-hcG) level was significantly increased in 2 patients(30.16 IU/L and 77.85 IU/L,respectively),and mildly elevated in 1 patient(4.29 IU/L),while serum ?-hcG level in another case was within normal control range.MRI demonstrated mildly high intensity in the left or right basal ganglia on T1-weighted and T2-weighted images without remarkable occupying lesion.Ipsilateral hemiatrophy of the hemisphere and midbrain was also noted.Inhomogeneous Gd-DTPA enhancement was observed.All patients had been treated with radiation therapy and chemotherapy.During 2 years follow up,significant improvement was observed in all patients after therapy,imaging lesions disappeared and the elevated ?-hcG level of those elevated before therapy returned to normal.Conclusions Early diagnosis and treatment for basal ganglia germinoma are critically important to improve the prognosis.In young male patients with progressive hamiparesis,basal ganglia germinoma should be considered for differentiation,if abnormal high intensity signals in basal ganglia on T1-weighted and T2-weighted image with ipsilateral hemiatrophy of the hemisphere are demonstrated on MRI,even without occupying effect.

Objective To describe a novel surgical technique for male long-segment urethral stric- ture after pelvic trauma using the intact and pedieled pendulous urethra to replace the bulbar and membra- nous urethra,and then reconstructing anterior urethra.Methods Three patients with long-segment post- traumatic bulbar and membranous urethral strictures with short left pendulous urethras who had undergone several failed previous surgeries were treated with staged pendulous-prostatic anastomotic urethroplasty fol- lowed by reconstruction of the anterior urethra.This procedure was divided into 3 stages.The first-stage sur- gery was mobilization of anterior urethra down to the coronary sulcus and then re-routing the prostatic urethra followed by pendulous-prostatic anastomotic urethroplasty with transposition of penis to perineum.The sec- ond-stage surgery was transecting the anterior urethra at the site of coronary sulcus 6 months later when it was re-vaseularized,then straightening the penis and performing urethroperineostomy.The third-stage surgery was reconstruction of anterior urethra 6 months later.Results Case 1 reported satisfactory voiding postopera- tively.Retrograde urethrography showed that the urethra was patent with no post-voiding residual urine (PVR),and bilateral vesicoureteral reflux almost disappeared.The Qmax was 18.8ml/s,and 18ml/s after the third stage surgery and at 2-year follow-up.Case 2 also had satisfactory voiding.A 22F urethral catheter could smoothly pass through the urethra,and Qmax was 19.5 ml/s with no PVR at 2-year follow-up.Case 3 underwent the first stage surgery through perineal and pubic routes.The urethrorectal and urethroperineal fis- tulas were excised and repaired simultaneously.After operation the fistulas healed,but the stenostomia resul- ting from wound infection needed further treatment.Conclusions This procedure is effective for men with complex long-segment post-traumatic bulbar and membranous urethral strictures,especially for those undergo- ing failed previous surgical treatment.