Myeloid-derived suppressor cells (MDSCs) are a heterogeneous population of immature myeloid cells at different stages of maturation.MDSCs mediate the suppression of the anti-tumor immunity,and play a crucial role in cancer tolerance through suppressing the activity of T cells and natural killer cells,inducing T-regs and involving the angiogenesis,and then contribute to the tumor development and metastasis.Promoting the differentiation of MDSCs,reducing its quantity and inhibiting its function by using various methods may contribute to the recovery of patients normal immune status,the tumor progression control,and improvement of the efficacy of other anti-neoplastic therapies.Therefore,possible novel therapeutic approaches targeted at MDSCs could be considered and developed rapidly now.

Objective To observe optic nerve axons degenerative disorder and microglial responses by establishing unilateral optic nerve crush model.Methods YFP mouse group with axonal markers and GFP mouse group with microglia markers were divided into surgery and control group,the optic nerve were dissected at 4 hours,1 day,3 days,5 days,10 days after optic nerve crush,and the neuronal degenerative disorder and microglial responses were observed by confocal laser scanning microscope.Rrsults Compared with control group,the optic nerve axons in YFP mouse group were fractured in injury region at postoperative 4 hours;The partial axon became beadlike change at postoperative 1 day;Most of the axons turned into the process of beadlike change at postoperative 3 days;The axons became to debris from beadlike at postoperative 5 days;The axons changed into many debris at postoperative 10 days.Compared with control group,the formation of glial scar and resting microglia in GFP mouse group began to emerge at postoperative 4 hours;The microglia gradually activated and began to cover the injury region at postoperative 1 day;The activated miacroglia basically covered the injury region at postoperative 3 days;The number of microglia roughly remained stable,although the axons continued to deteriorate at postoperative 5 days and 10 days.Conclusion The optic nerve occur irreversible degenerative disorder after being injured,meanwhile with the microglial increase and activation.This phenomenon suggests that microglia is closely associated with optic nerve degeneration.

Objective To optimize the best condition of semi-bionic extraction for Vernonia anthelmintica.Methods The best condition of the semi-bionic extraction for V.anthelmintica by uniform design was optimized with total HPLC integrate area of common peaks in fingerprints,total flavonoids and dried extract weight as the indexes.Results According to industry production condition,the best technical condition:pH values of 80% ethanol for the 1st,2nd,and 3rd decoctions were in order of 6.0,6.5,and 8.0,and the extraction time were 1,0.5,and 0.5 h,respectively.Conclusion It is better for V.anthelmintica extracted by semi-bionic extraction,and the parametrs are optimized by uniform design.

Objective To know how large platelets influnece the platelet count difference of the optical and impedance methods so as to provide the support for the reasonable application of optical method and effectively increasing the accuracy of platelet count.Methods 132 blood routine specimens with normal RBC parameters were anaylzed by both electrical impedance and optical methods with the Sysmex-XE5000 fully automativ hematology analyzer.The data were divided into the large platelet group and the normal platelet group according to the platlet-large cell ratio(P-LCR)results.The RBC and platelet parameters were compared be-tween the two groups with the unpaired t-test and the platelet count results detected by the optical and electrical impedance methods were compared within group with the paired t-test.Results The extremely significant differences of platelet parameters existed be-tween the two groups.The P-LCR,MPV,PDW and IPF % of the large platelet group were significantly higher than those of the normal platelet group,but the RBC parameters had no obvious difference.The significant difference of the platelet count also existed between the electrical impedance and optical methods in the large platelet group(P <0.05 ),the platelet count results detected by the electrical impedance method was on the low side,but the normal platelet group had no significant difference.Conclusion P-LCR increase is related with the increase of immature platelet.The electrical impadence method conducts the differentiation according to the granular size,which is easy to exclude the large platelel with larger volume and leads to reduce the platelet count results.There-fore,when P-LCR is increased,the optical method should be adopted in conducting the platelet count for avoiding the false reduce caused by the electrical impedance method.

Objective To observe the effect of elbow support on muscle activity and subjective feelings of comfort during typing.Methods Ten college students voluntarily participated in this experiment.They typed the same text using elbow supports of five different heights.The distance between their elbows and the desk was supported at 3 cm below,0 cm,and-3 cm and-6 cm above the desk.There was also an unsupported condition.Myoelectric readings were recorded from the right splenius,trapezius,biceps,extensor carpi radialis,flexor digitorum superficialis,flexor carpi radialis,and extensor digitorum muscles.Perceptions of comfort of the neck,shoulder,hand and forearm,and hand using the different supports were surveyed using a questionnaire.Results One way ANOVA shows that the height of the elbow significantly affects the activity of the trapezius,the extensor carpi radialis and the extensor digitorum muscles.Trapezius muscle activity was higher with 3 cm high elbow support than without support,and the value was smaller when using-6 cm elbow support.The activity of the carpi radialis longus extensor was least when using-6 cm and-3 cm elbow support,and greatest with 3 cm support.Extensor digitorum activity was least when using-3 cm high elbow support and again greatest with 3 cm support.The different elbow support heights had no significant relationship with comfort perceptions for any body part.Conclusion The height of elbow support can change the average myoelectric signals from muscles during typing,but there is no significant difference in the typist's perception of comfort.This could be due to a change of typing position and neuromuscular motion control mode in response to the height of elbow support.

ObjectiveTo study the efficacy and safety of heated humidified high flow nasal cannula ( HHHFNC) and nasal continuous positive airway pressure( NCPAP) ventilation for prevention of extubation failure in extremely low birth weight(ELBW)infants in our NICU.MethodsFrom Jan.2011 to Dec. 2014, 129 ELBW infants admitted to our hospital were randomly assigned into HHHFNC group and NCPAP group. The inclusion criteria were gestational age ( GA ) <34 w, birth weight ( BW )<1000 g, admission within 7 d after birth and transition to noninvasive respiratory support after a period of mechanical ventilation with an endotracheal tube. The primary outcome included:the incidence of extubation failure, nasal injury, air leak, abdominal distention and bronchopulmonary dysplasia ( BPD). Results Statistically significant difference sexisted between the two groups on oxygen the rapyduration, the time required reaching total enteral feedings and the incidences of nasal injury, air leak, abdominal & nbsp;distention and necrotizing enterocolitis ( P<0. 05). The incidence of extubation failure within 7 days was 25. 8℅ in HHHFNC group and 47. 6℅ in NCPAP group ( P <0. 05 ) . No differences between the 2 groups on total ventilation duration, non-invasive ventilation duration, re-intubation rate at 3d after extubation, BPD, retinopathy of prematurity ( ROP ) , intracerebral hemorrhage ( ICH ) , periventricular leukomalacia(PVL)and patent ductus arteriosus(PDA).Conclusions HHHFNC is an effective and safe method for prevention of extubation failure in ELBW infants.

Objective To evaluate the lung protection of remote limb ischemic preconditioning during one-lung ventilation (OLV) in the patients undergoing esophageal cancer resection.Methods Seventyone patients of both sexes,aged 30-64 yr,with body mass index of 15-28 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective esophageal cancer resection,were randomly divided into control group (group C,n =34) and remote limb ischemic preconditioning group (group RLIP,n =37) using a random number table.Patients in group RLIP received three cycles of 5-min ischemia/5-min reperfusion induced by a blood pressure cuff placed on one upper arm before OLV.Before OLV (T0),at 1 and 2 h of OLV (T1,2),at 20 min after re-expansion of the collapsed lung (T3),and at 2 h after operation (T4),blood samples were drawn from the radial artery for blood gas analysis,oxygenation index (PaO2/FiO2) and alveolar-arterial oxygen gradient (A-aDO2) were calculated.At T0,T2,T3 and T4,blood samples were collected from the radial artery for determination of plasma tumor necrosis factor-alpha (TNF-α),interleukin-6 (IL-6),and IL-10 concentrations.Results Compared with group C,PaO2/FiO2 was significantly increased,and A-aDO2was decreased at T1,2,the plasma TNF-α concentrations were decreased at T2-4 (P＜0.05),and no significant change was found in the plasma IL-6 and IL-10 concentrations and rate of abnormal pulmonary function at T1-4 in group RLIP (P＞O.05).Conclusion Although remote limb ischemic preconditioning can produce lung protection during OLV in the patients undergoing esophageal cancer resection,it provides no clinical significance.

Objective To compare the efficacy of insulin aspart and human soluble insulin on postprandial glucose control and blood glucose excursion in type 2 diabetic patients managed with insulin pump therapy. Methods All of 345 hospitalized type 2 diabetic patients were randomized divided into two groups. One group underwent insulin pump therapy with insulin aspart (aspart group, 173 cases),another group with human soluble insulin (humulin R group, 172 cases). Capillary glucose concentrations were measured at 9 time points,including preprandial,2 hours postprandial,bedtime (22:00),midnight(0:00) and 3:00 every day during the treatment. The change of blood glucose at each time point and the variation of postprandial blood glucose excursion was compared between the two groups. The frequency of hypoglycemia was also evaluated. Results After treatment, fasting blood glucose and post breakfast and post dinner blood glucose levels were decreased more significantly in the aspart group than those in the humulin R group. And a significantly smaller postprandial blood glucose excursion was shown in the aspart group compared with that in the humulin R group (P< 0.05). The time to achieve good glycemic control in the aspart group was (4.40 ± 2.16) d, significantly shorter than that in the humulin R group[(5.68 ± 2.29) d](P< 0.05). The incidence of hypoglycemia was significantly lower in the aspart group (P <0.05). Conclusion Insulin aspart results in better control of blood glucose and less glycemic variability compare with human soluble insulin in type 2 diabetic patients during delivery by continuous subcutaneous insulin infusion.

Objective To investigate the effects of early nasal intermittent positive pressure ventilation (NIPPV) compared with early continuous positive airway pressure (NCPAP) in low birth weight preterm infants with respiratory distress syndrome (RDS).Methods We performed a prospective,randomized controlled trial involving 364 low birth weight preterm infants with respiratory distress syndrome within 6 hours of birth.The infants were randomly assigned to NIPPV (n=188) or NCPAP (n=176) groups.Non invasive ventilation was initiated in the neonatal intensive care unit (NICU).The rate of mechanical intubation (within 3 days or 7 days),the use of pulmonary surfactant (PS),the rate of complications and mortality were compared between the two groups.Mann Whitney U,t and Chi-square tests were used for statistical analysis.Results The average time of invasive mechanical ventilation in NIPPV group were lower than that in NCPAP group[2.0 (1.0-4.0) d vs 7.0 (3.0-8.5) d,U=-3.457,P=0.001].The need for intubation and mechanical ventilation by day 3 and day 7 in the NIPPV group were less than those in the NCPAP group [day 3:4.8％ (9/188) vs 10.8％ (19/176),x2=4.621,P=0.032; day 7:9.0％ (17/188) vs 16.5％ (29/176),x2=4.551,P=0.033].In the NIPPV group,infants who got PS therapy was less than that in the NCPAP group [3.2％ (6/188) vs 8.5％ (15/176),x2=4.752,P=0.029].There was no significant difference in the fatality rate between the NIPPV and the NCPAP group [12.8％ (24/188) vs 10.8％ (19/176),P ＞ 0.05].There were no significant difference in the incidence of air leak,intracranial hemorrhage,periventricular leukomalacia,retinopathy of prematurity,necrotizing enterocolitis,patent ductus arteriosus,and bronchopulmonary dysplasia between the NIPPV group and the NCPAP group.Conclusion Among low birth weight prcterm infants with RDS,the early use of NIPPV reduces the need for PS,intubation and invasive ventilation compared with NCPAP.

Objective To explore the application range and preponderance of different therapeutic methods of traditional medicines in overseas countries with retrospective studies on bibliographies of overseas traditional medicines. Methods All bibliographies were articles written in August 1964 to September 2009 and came from MEDLINE data base through searching 17 inferior words of"replacement therapy" in MeSH subject headings. Results We got altogether 10103 articles in 1633 kinds of periodicals concerned with replacement therapy, and summed up to 9841 effective articles in the end. Conclusion More and more attentions have been paid to traditional medicine in overseas countries; Such kinds of articles were mostly published in American and British medical periodicals; articles with advanced technologies and high reliability have more chances to be adopted by medical periodicals; traditional Chinese medicine plays a leading role in the fields of traditional medicines in the whole world; replacement therapy were increasingly adopted to deal with disease protection and health care.