In recent years,considerable progress has been made in the treatment of hematologic malig-nancies.However,most patients will eventually relapse and suffer from severe side effects caused by chemotherapy or radiation.Thus,as a well tolerated,safe,effective and innovative therapy,adoptive cellular immunotherapy e-merges at this very moment.This therapy can kill tumors or control recurrence by reinfusing the in vitro amplifi-cated or treated immune effective cells into the patients.It has been actively used in the treatment of various he-matological malignancies and achieved significant effects,which brings hope for more and more patients with re-lapsed or refractory hematological diseases.

Objective:To discuss the effect of cochlear implant and hearing aid to voice quality.Method:Four groups of randomly selected 73 subjects were compared. The groups comprised: cochlear implant children, children using hearing aids, normal hearing children and deaf children with no hearing instrumention. The latter two groups were control groups. Each subject was required to phonate // about 3 s using 'voice assessment' to record the sound, and following voice acoustice variables were analysed: F0,SDF0,Jitter,Shimmer,NNE,HNR,SNR.Result:Voice F0 of children with cochlear implant was significantly lower that the other three groups(P<0.05);there were no significant difference between hearing aid group, normal hearing gourp, and deaf children group with no intervention(P>0.05);SDF0 of cochlear implant group and hearing aids group were significantly larger than the normal hearing group and deaf children group with no intervention(P<0.05),and the interaction of two factors(hearing and sex ) was close to the critical level of significance(P>0.05),which means that cochlear implant and hearing aid could have affected the SDF0 of female children more than those of male children. There were no significant difference among all the four groups about voice quality variables: Jitter,Shimmer,NNE,HNR,SNR.Conclusion:Cochlear implant and hearing aid mainly change the voice F0 and/or SDF0, and have no effect on the voice quality variables.

Objective To determine the relationship between Methylenetetrahydrofolate reductase (MTHFR)(C677T, A1298C and G1793A)polymorphisms and stillbirth.Methods 33 unexplained stillbirth and 582 normal livebirth were col-lected for case-control study from August 2014 to August 2016.The genotyping of C677T,A1298C and G1793A polymor-phisms of the MTHFR gene was tested by using restriction fragment length polymorphism polymerase chain reaction.The relationship between MTHFR polymorphisms and stillbirth susceltibility was analyzed by logistic regression.Results There was no significant difference in the genetype frequencies of A1298C and G1793A of MTHFR polymorphisms between case and control.But there was significant difference in the genetype frequencies of C677T between case and control (CT:P=0.02,χ2=3.67;TT:P=0.02,χ2=3.65).Heterozygous CT and homozygous TT would be high risk factors of stillbirth. C677T was found in one (14.3%)of the cases with early stillbirth and in three (11.5%)of the cases with late stillbirth, having no significant difference.Twin pregnancy and MTHFR C677T increased the risk 8-fold (P<0.001,χ2=13.28)and 3.4(P=0.02,χ2=3.65)for stillbirth,respectively.Conclusion MTHFR C677T polymorphism is high risk factors associ-ated with the susceptibility of stillbirth.MTHFR C677T may be used as a prognostic marker of pregnancy cases predisposed to preterm delivery.

Objective To discuss the cause and treatment strategy for open laryngotracheal trauma.Methods The clinical data of 38 cases with open laryngotracheal trauma admitted from 1998 to 2012 were collected and analyzed.Of them,one patient died in emergency department despite energetic resuscitation,37 were hospitalized and given advanced treatment after life support measures in emergency department.They were treated with tracheotomy before or during operation.Of them,32 patients were regularly followed up for imaging studies.Result Except 1 patient died of exsanguination from carotid artery rupture,the other 37 survived after successful treatment.Twenty patients were treated with debridement and suture of the wounds and laryngoplasty (20/37,54.1％),8 patients were operated with laryngoplasty plus intraluminal stents implanted (8/37,21.6％) ; the rest 9 patients (9/37,24.3％) were separately given placement of nickel-titanium shape memory alloy stent (n =2),laryngofissure with rubber gloves throat models implanted and laryngoplasty (n =3),linear silicone tube implanted and laryngoplasty with trans-cervical approach (n =1) and tracheoesophageal fistula neoplasty with laryngoplasty and laryngofissure (n =3).The operated patients were followed-up for 0.5 to 3 years after discharge.Of them,35 patients (35/37,94.6％) had successful decannulation,breathing smoothly and swallowing normally,23 patients (23/37,62.2％) had almost normal pronunciation,12 patients (12/37,32.4％) had different degrees in hoarseness of voice,and 2 patients (2/37,5.4％) were referred to other hospital because of failure in extubation with severe stenosis of laryngotrachea.Conclusions When the patients with open laryngotracheal trauma were treated,the essential strategy was to prevent shock,hemorrhage,and asphyxia.In the case of patent respiratory tract and stable vital signs,laryngotracheal reconstruction should be carried out as soon as possible to prevent complications,thereby obtaining good therapeutic effect.

Objective To investigate the association of risks related to maternal factors with the subsequent development of necrotizing enterocolitis (NEC) in very preterm infants and to determine whether the placental inflammatory lesions were also related to the NEC.Methods This retrospective cohort study examined newborns born at ＜ 32 weeks (n =180) between July 2006 and July 2015 and their mothers at our hospital,recorded the maternal age,body mass index (BMI),multiparity situation,and the usage of prenatal steroids or antibiotics.Medical records of eligible newborns and their mothers were reviewed.Maternal blood white blood cell and differential counts were measured at admission and the placentas were examined histologically after delivery.The primary outcome measure was NEC Bell Stage Ⅱ a.Bivariate analyses and multivariate logistic regression were used for the statistical analyses.Results NEC was diagnosed in 14 of 180 very preterm infants (7.8％),including 11 Stage Ⅱ and 3 Stage Ⅲ infants,and the overall mortality rate of these infants was 7.1％ (n =1).Multivariate regression analysis identified maternal neutrophil-to-lymphocyte ratio (OR =1.07,P =0.002),muhiparity (OR =3.39,P =0.013),and birth weight (OR =0.06,P =0.01) were significantly associated with an increased risk of NEC development.Neonatal neutrophil-to-lymphocyte ratio (NLR) as measured within 24 hours of birth (P =0.65) was not associated with NEC development.Clinical chorioamnionitis (P≥0.99) and histological chorioamnionitis (P =0.46) and funisitis (P =0.21) could not be used as significant predictors of NEC.Conslusions The development of NEC in very preterm infants is associated with the maternal NLR,parity,and birth weight,not with clinical and histological chorioamnionitis and funisitis.

Objective To investigate the effects of different volumes of ropivacaine with the same solubility in supraclavicular brachial plexus block(SCBPB) under ultrasound guidance on ipsilateral diaphragmaticparalysis.Methods Seventy two patients (32 males,40 females, aged 18-65 years, of ASA Ⅰ or Ⅱ, scheduled for the right upper limb fracture internal fixation removal were randomized into group A (0.375% ropivacaine 20 ml) and group B (0.375% ropivacaine 30 ml), 36 cases in each group.The onset and duration of sensory and motor block were observed as well as complication.Diaphragmatic excursion were evaluated by M type ultrasound before and 30 min after drug injection under eupnea and forced respiration through observing diaphragmatic excursion to study diaphragmatic paralysis.Results The onset time of sensory block and maintaining time of sensory block or motor block had no significant difference between the two groups.Compared with group A,the onset time of motor block in group B was significantly shorter (P<0.05).Twelve cases (33.3%) in group A and 22 cases (61.1%) in group B respectively showed complete or partial hemidiaphragmatic paralysis 30 min after drug injection.Compared with group A, the rate of diaphragmatic paralysis in group B was significantly higher (P<0.05).Conclusion Supraclavicular brachial plexus block under ultrasound guidance with 0.375% ropivacaine 20 ml or 30 ml both can provide excellent anesthetic effect.0.375% ropivacaine 20 ml is less likely to lead to diaphragmatic paralysis.

Objective To investigate the clinical effect of ropivacaine hydrochloride at 0.25%, 0.375% and 0.5% concentration for lower limb nerve block anesthesia.Methods75 cases of lower extremity nerve block anesthesia from Ningbo Zhenhai District Hospital of traditional Chinese Medicine from September 2014 to February 2015 were enrolled in the course of the study, they were divided into three groups: group 0.25%, the equivalent number of 0.375% and 0.5% groups, and three groups of patients were made with a concentration of 0.25%, 0.375%, 0.5% ropivacaine hydrochloride for lower extremity nerve block anesthesia;the clinical data of three groups were analyzed retrospectively, observation of three groups of patients with lower limb nerve block effect.ResultsThe results showed that 0.25% groups of patients in the motor block time was (36.8±5.9) minutes, motor block in patients with a total of 7 cases, with nerve block in patients with a total of 11 cases.0.375% groups of patients in the motor block time was (23.1±4.3) minutes, motor block in patients with a total of 14 cases, with nerve block in patients with a total of 18 cases.0.5% groups of patients in the motor block time was (20.6±5.7) minutes, motor block in patients with a total of 16 cases, with nerve block in patients with a total of 18 cases.Available block time of 0.375% groups of more than 0.5% groups, less than 0.25% groups;0.375% motor block group was 56.0%, higher than the 0.25% group, lower than the 0.5% group;the 0.375% group and 0.5% group of nerve block ratio is same, higher than the 0.25% group, the difference was statistically significant (P<0.05).ConclusionThe effect of anesthesia using concentration of 0.375% ropivacaine hydrochloride is relatively good, can reduce the dosage of anesthetic drugs, but also ensure the anesthetic effect, meet the clinical requirement, this method will be applied to.

Objective: To observe the effect on Tangzu Heji on diabetic foot rat with blood stasis syndrome and to investigate the mechanism in it. Methods: Combination of streptozocin injection and reduction of ambient temperature was used to duplicate diabetic foot rat with blood stasis syndrome. 60 Male SD rats were randomly divided into 6 groups as normal control group, the low temperature control group, diabetic foot group (model group), three groups of Tangzu Heji treatment with high, medium and low dose respectively. In the first three groups the rats were given normal saline, and in the latter three treatment groups the model rats were given Tangzu Heji as 60gkg, 30g/kg, 15g/kg weight, respectively. After two weeks of treatment, the changes of the weight, water intake, blood glucose, blood rheology, acral gangrene symptoms, Choroid blood vessels of the sublingual and ear, serum vascular endothelial growth factor changes were observed. Results: After two weeks of treatment with Tangzu Heji, compared with the model group, a marked increase in body weight, decrease of water intake were happened to the rats in treatment groups. Erythrocyte aggregation index in the low-dose treatment group decreased significantly (P

Aim To investigate the synergistic effects and possible molecular mechanism of hepatitis B virus (HBV) and alcohol on liver injury in HBV transgenic mice(HBV-Tg mice).Methods 20 HBV-Tg mice and 20 wild-type mice were randomly divided into 4 groups:alcohol-fed Tg mice and alcohol-fed Wt mice, and they were given intragastric administration with alcohol. Control Tg mice and control Wt mice received intragastric administration with saline.All groups were rasied for 10 weeks.The levels of ALT and AST in serum, the degree of inflammation, the degree of fibrosis, the mRNA expression of TGF-β_1, Smad3, Smad7, CTGF and the protein expression of TGF-β_1, CTGF, α-SMA in liver tissue were detected.Results The serumlevel of ALT and AST, the mRNA expression of TGF-β_1, Smad3, Smad7, CTGF and the protein expression of TGF-β_1, CTGF, α-SMA in liver all increased markedly in alcohol-fed Tg mice. Alcohol consumption induced hepatocyte steatosis and hepatic inflammation in alcohol-fed Tg mice, but the change of liver fibrosis was not remarkable.Conclusion HBV and alcohol have synergistic effects on early liver injury, possibly by enhancing the expression of TGF-β_1, Smad3, CTGF, α-SMA and inducing unbalanced expression of Smads.

Objective To establish a new multiplex-PCR assay to improve the detection rate of mutations in the DMD gene in Chinese patients. Methods A retrospective review of DMD deletion spectrum of 355 DMD patients with deletions all over the gene was performed. All deletions were confirmed by " one-step approach" diagnostic procedure and MLPA analysis. The exons with high frequency of mutations were identified to constitute the amplification system and the PCR conditions were optimized. Results Two new multiplex-PCR assays were established. Assay one was used to detect 10 exons including exon 5, 8, 17, 44, 45, 47, 49, 50, 51 and 52 of DMD gene, in two PCR sets. The theoretical detection rate would be 92% (326/355). Assay two was used to detect 5 exons including exon 12, 19, 35, 43 and 54, which could be used to screen additional 5% (17/355) deletion cases. The method was validated in other 22 DMD patients. Multiplex-PCR results were completely identical to the MLPA results in all 22 DMD patients. Conclusions The two multiplex-PCR assays were established based on the analysis of 355 Chinese DMD patients with gene deletions. It is believed that the new approach would be more applicable for deletion detection on the Chinese DMD patients since the DMD cases involved were from the whole country.