Natural killer T(NKT) cells are a heterogeneous group T cells that share properties of both natural killer cells and T cells,play an important role in tumor immunity.Related researches have confirmed that actived NKT cells can inhabit tumor progress,but activated NKT cells commonly become anergic for some unknown reasons after a short time.This article reviews researches on the possible mechanisms and solutions to NKT cells anergy.

Objective To investigate and analyze the status quo of the patients of extended stay at 11 clinical hospitals of a general university in Beijing, and explore the countermeasures and solutions.Methods Contact with the medical affairs departments of these hospitals to collect information about such patients of extended stay.Results A total of 43 cases of patients were identified as extended stay at these hospitals, accounting for 0.00% to 0.93% of total beds.Their stay ranged from 1 month to 15 years, including 17 cases with medical disputes (39.5%), and 26 cases without (60.5%).Conclusions The phenomenon of extended stay at hospitals deserve enough attention and appropriate actions accordingly.

Objective To observe the effects of bolus volume on pharyngeal and upper esophageal sphincter pressures and durations in healthy volunteers by using high-resolution manometry (HRM).Methods Twentyfour health subjects were recruited and asked to swallow three volumes of bolus (3 ml,5 ml and 10 ml) in the neutral head position.Pressure and duration measurements were acquired by utilizing a high-resolution solid-state manometer,with an emphasis on the hypopharynx and upper esophageal sphincter (UES).Variables including UES residual pressure,UES relaxation duration,maximum hypopharygeal pressure and hypopharyngeal pressure duration were analyzed across bolus volumes and consistencies by using three-way repeated measures analysis of variance (ANOVA) to investigate influence of bolus volume.Results UES residual pressure [-1.71 mmHg(3 ml thick liquid)vs.-4.68 mmHg(10 ml thick liquid)],UES relaxation duration[590.45 ms(3 ml thick liquid) vs.702.49 ms (10 ml thick liquid)],maximum hypopharygeal pressure [169.91 mmHg (3 ml thick liquid) vs.204.42 mmHg (10 ml thick liquid)] and hypopharyngeal pressure duration(P ＜0.05) varied significantly across bolus volumes when swallowing water or thick liquid.The UES relaxation duration,UES residual pressure and maximum hypopharyngeal pressure had a direct positive relationship with bolus volume.There was significant differences with regard to UES relaxation duration [685.75 ms(3 ml paste)vs.772.27 ms (10 ml paste)] but not to UES residual pressure (P ＞ 0.05) and maximum hypopharyngeal pressure (P ＞ 0.05) across bolus volume when swallowing paste.Conclusions Difference in hypopharyngeal pressure and duration,UES residual pressure and duration were detected across varying bolus volumes.Consideration of these variables is paramount in understanding normal and pathological swallowing.

BACKGROUND:Massive blood loss was caused by an over-reactive fibrinolytic system, as a sequence of tourniquet usage and surgery trauma in total knee arthroplasty. As an antifibrinolytic drug, tranexamic acid has been proven to decrease not only the obvious and total blood loss, but also the ratio of alograft blood transfusion in total knee arthroplasty. Nevertheless, the effect of tranexamic acid on hidden blood loss in total knee arthroplasty had not been clarified yet. OBJECTIVE: To observe the effect of intravenous infusion of tranexamic acid on hidden blood loss in primary total knee arthroplasty. METHODS:Clinical data of 54 patients who received primary unilateral total knee arthroplasty in the Third Hospital, Peking University from June to December 2013 were retrospectively analyzed. They were divided into two groups according to the use of tranexamic acid. 22 patients in the tranexamic acid group were given 2 g tranexamic acid by intravenous infusion during surgery. 32 patients in the control group were given an equal volume of physiological saline. Patients in both groups were oraly given anticoagulant rivaroxaban after replacement. Hemoglobin level and blood hematocrit were recorded before and after surgery for 5 consecutive days. The total amount of blood loss and hidden blood loss were calculated by using Cross equation. The difference in the amount of blood loss was compared between the two groups. Lower extremity venous ultrasound examination was conducted at 1 week after replacement to determine deep venous thrombosis in the lower limb. RESULTS AND CONCLUSION:No significant difference in general data and perioperative conditions was detected between the two groups (P > 0.05). Postoperative drainage, dominant blood loss, total blood volume, the amount of autologous blood transfusion and the amount of alogeneic blood transfusion were significantly less in the tranexamic acid group than in the control group (P < 0.05). According to Gross formula, the difference of hidden blood loss was statisticaly significant between the tranexamic acid group (302.9±189.9) mL and the control group (596.8±271.4) mL (P < 0.05). Deep vein thrombosis appeared in one case between the two groups after replacement. Results indicate that intravenous infusion of tranexamic acid dramaticaly decreased the hidden blood loss in unilateral total knee arthroplasty, reduced alogeneic blood transfusion, and simultaneously did not increase the incidence of deep vein thrombosis in the lower limb.

Objective To evaluate the effect of the modified balloon dilatation intervention on the pharyngeal constriction function of the brainstem stroke survivors with dysphagia using videofluoroscopy-based digital analysis.Methods Thirty brainstem stroke survivors with pharyngeal dysphagia were recruited and randomly divided into a treatment group and a control group,with 15 in each.The treatment group was treated with the modified balloon dilatation in addition to the routine treatment of 30min,respectively,once a daily,3 days a week,whiled a control group was treated with routine treatment of 30min twice a day,3 days a week.Before and after the treatment,the rate and duration of pharyngeal constriction were measured in both groups.Results After the treatment,the rate of pharyngeal constriction in the treatment group was (0.20 ± 0.030),(0.14 ± 0.05) and (0.15 ± 0.04) when swallowing thin liquid,thick liquid and pasty food,significantly better than before the treatment.The duration of the pharyngeal constriction was (990.34 ±96.14),(1010.47 ± 133.64) and (1180.10 ± 121.27) ms,respectively,also significantly better than before the treatment.In the control group,significant differences were also observed in the rate and duration of pharyngeal constriction before and after the treatment.Conclusions Digital analysis based on videofluoroscopy can be used to quantify swallowing function effectively,and the rate and duration of pharyngeal constriction can be used to evaluate the pharyngeal function before and after treatment.

Objective To explore the effect of theta-burst stimulation (TBS) of the motor cortex on the suprahyoid muscles and the mechanism through which the bilateral motor cortex regulates the suprahyoid muscles.Methods Continuous TBS (cTBS) was applied to the left motor cortex followed by intermittent TBS (iTBS) applied to the right motor cortex of 24 healthy subjects.The motor-evoked potentials (MEPs) of the suprahyoid muscles on both sides were recorded before the stimulation and after 15 and 30 minutes.The MEP amplitudes of the left and right suprahyoid muscles were analyzed using repeated measures analysis of variance.Results Before stimulation, the average MEP amplitudes of the left and right suprahyoid muscles were (375.29 ± 176.09) μV and (368.17 ± 149.02) μV respectively, significantly lower than the values after the stimulation.Conclusion iTBS can distinctly enhance the excitability of the right motor cortex controlling the suprahyoid muscles and reverse the inhibition caused by cTBS applied to the left motor cortex.Clarifying the effect of TBS on the excitability of the bilateral motor cortex is important for the rehabilitation of dysphagic stroke survivors.

OBJECTIVETo study the application of VSD in the treatment of severe necrotizing fasciitis in extremities of patients.

METHODSEight patients, suffering from severe necrotizing fasciitis, who had been traditionally treated with iodophor-soaked gauze for 21 to 365 days in other hospitals, were transferred to our institute because of the nonhealing wounds and systemic toxic symptoms induced by infection, from January 2011 to August 2013. After admission, surgical debridement was performed timely, and the necrotic tissue was collected during the operation for pathological observation after HE staining. After the operation, VSD was started with negative pressure ranging from -100 to -80 kPa, and the furacilin solution (0.2 g/L) and oxygen (2 L/min) were continuously infused into the wound during the treatment. Surgical debridement was performed repeatedly according to the wound condition followed by change of VSD dressings to continue VSD treatment. The wounds were closed by suturing or with autologous skin grafts after being covered by fresh granulation tissue. The times of surgical debridement, times of change of VSD materials, wound healing status, and length of stay in our institute were recorded. All patients were followed up for a long time. Results HE staining showed that there were diffuse necrotic adipose and fibrous connective tissues in the necrotic tissue, and the normal tissue structure disappeared accompanied by significant infiltration of inflammatory cells. The number of surgical debridement was 2 to 10 (3.9 +/- 2.8) times. The number of VSD materials change was 2 to 10 (4.0 +/- 2.9) times. Wounds were closed by suturing and healed in two patients; wounds in the other six patients were partially sutured, their residual wounds were healed by autologous skin grafting. The length of stay in our institute was 20 to 49 (33 +/- 10) days. All patients were discharged after recovery. Patients were followed up for 2 to 24 months, and their wounds were found to be in good condition without ulceration or recurrence.

CONCLUSIONSVSD can effectively remove the necrotic tissues and exudates from the fascial spaces and promote proliferation of granulation tissue. Therefore it serves as an effective approach to the treatment of severe necrotizing fasciitis in extremities.

Debridement ; Drainage ; Extremities ; surgery ; Fasciitis, Necrotizing ; surgery ; Granulation Tissue ; Humans ; Negative-Pressure Wound Therapy ; Oxygen ; Pressure ; Skin ; Skin Transplantation ; Ulcer ; Vacuum

Craniofacial Abnormalities ; genetics ; Humans ; Mutation ; Tooth Abnormalities ; genetics

Objective To design a new cancer vaccine by using alpha-galactosylceramide (α-Galcer,α-GC) loaded tumor cells in combination with TLR 9 ligand and to evaluate its therapeutic effects on colon canc-er in mice.Methods MC38 cells were transfected with lentivirus (GFP-CD1d) to prepare CD1d-MC38 cells. The expression of CD1d molecules in CD1d-MC38 cells was detected by fluorescence microscopy , RT-PCR and flow cytometry.The sorted CD1d-MC38 cells were loaded with α-Galcer to prepare CD1d-MC38/α-GC complex. Flow cytometry was performed to evaluate the efficiency of combination .A mouse model of colon cancer was es-tablished to investigate the therapeutic effects of α-Galcer loaded tumor cells in combination with TLR 9 ligand ( CD1d-MC38/α-GC+CpG1826) on colon cancer in mice by analyzing tumor growth and mice survival time .Im-munohistochemical staining was used to detect CD 4+T and CD8+T infiltrating lymphocytes in tumor tissues .Re-sults The MC38 cancer cells that expressed CD 1d and GFP were successfully constructed , among which 98.10%±2.53%were positive for CD1d.Moreover, the CD1d-MC38 cells could combine with α-Galcer effec-tively in a dose and time dependent manner .Compared with PBS treated group ,α-GC treated group and TLR9 ligand treated group , the experimental vaccine strategy was sufficient to inhibit the growth of established tumors and prolong survival of tumor-bearing mice (P<0.01).Immunohistochemistry analysis revealed that levels of CD4+T cells and CD8+T cells in experiment group were significantly higher than those in groups treated with PBS,α-GC and TLR9 ligand (P<0.01).Conclusion CD1d-MC38/α-GC in combination with CpG1826 could efficiently inhibit the growth of established tumors and prolong survival of tumor-bearing mice .Immunohisto-chemistry analysis revealed that CD 4+T cells and CD8+T cells played important roles in anti-tumor immunity.

BACKGROUND: At present, the researches on steroid-induced avascular necrosis of the femoral head are mostly concentrated on the treatment of formed necrosis. And there are fewer reports on how to prevent the ostoenecrosis of the femoral head in the course of steroid therapy.OBJECTIVE: To observe the effect of preventive medication on femoral head structure and blood flow in steroid-induced osteonecrosis.DESIGN: Randomized controlled experiment.SETTING: Department of Pharmacology, Department of Anatomy, Medical College of Shaoguan University; Department of Nuclear Medicine, Guangdong Province Yuebei People's Hospital.MATERIALS: Thirty adult New Zealand rabbits of either sex, whose body mass was (2.5±0.5) kg.METHODS: The experiment was carried out in the Central Laboratory,Medical College of Shaoguan University, the Department of Electron Microscope, the Northern Campus of Guangzhou, Sun Yat-sen University, and the Department of Nuclear Medicine, Guangdong Province Yuebei People's Hospital from April to July 2005. ①Thirty rabbits were divided randomly into 3 groups with 10 rabbits in each group: control group with intramuscular injection of 1 mL/kg normal saline twice a week and meanwhile, intragastric administration of normal saline(10 mL/d), steroid group with intramuscular injection of dexamethasone sodium phosphate(1 mL/kg) twice a week and meanwhile, intragastric administration of normal saline(10 mL/d),treatment group with intramuscular injection of dexamethasone sodium phosphate(1 mL/kg) twice a week and meanwhile, intragastric administration ofXuesaitong(25 mg/kg), Zhibituo(350 mg/kg) and alendronate(5 mg/kg)daily for 8 weeks. ②After 1 week of drug withdrawal, the blood flow of femoral head was measured in all the rabbits with radioactive microsphere technique, and the histological changes were observed under light microscope and electron microscope.MAIN OUTCOME MEASURES: ①Blood flow of the femoral head in each group.②Histological and morphological changes, and ultrastructure of the femoral head cartilage in each group.RESULTS: ①The blood flow in the treatment group was more than that in the steroid group[(0.261±0.042), (0.197±0.053) mL/(min·g), q=6.10,P ＜ 0.01]. Compared with the control group[(0.243±0.039) mL/(min ·g)],the difference was not significant. ②The number of empty bone lacunae in the treatment group was fewer significantly than that in the steroid group [(15.22±5.49), (24.78±7.87) pieces, q=6.35, P ＜ 0.01]. However, there was no difference between the treatment group and control gruop [(10.38±3.78)pieces].③In the treatment group, the bone cells were normal, the endoplasmic reticula were abundant and the cellular nuclei were of normal shape.In the steroid group, the bone cells contracted in volume, the pyknosis occurred, the chromatin gathered to the edge and the bone lacuna enlarged.CONCLUSION: While using steroid hormone for long, using Xuesaitong,Zhibituo and alendronate may elevate the blood flow of femoral head, improve the tissue structure of bone and prevent or lighten steroid-induced necrosis of femoral head.