0.05).Conclusion Low iron stores contribute to ADHD.SF level must be evaluated and retrieved in subjects with ADHD,particularly in the subgroup of ADHD-I.

Objective To observe whether peripheral blood mononuclear cells (PBMCs) from patients with active systemic lupus erythematosus (SLE) can induce the adhesion of T lymphocytes to endothelial cells. Methods Sera and PBMCs were obtained from patients with active SLE and normal human controls. PBMCs were cultivated and culture supematants were harvested. Human umbilical vein endothelial cells (HUVECs) were cultured in vitro with or without the presence of the sera or culture super-natants of PBMCs. Some cells were pretreated with the antibody to IL-17 before the treatment with the sera or supematants. After another 48-hour culture, RT-PCR and real-time PCR were used to detect the mRNA expressions of adhesion molecules, including intercellular adhesion moleeule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) and E-cadherin in HUVECs, wound healing assay to estimate the motility of HUVECs. Additionally, T lymphocytes were added to HUVECs 48 hours after stimulation with the sera or supematants, the adhering of T lymphocytes to HUVECs was observed by microscopy. Results After stimulation with supematants of PBMCs from patients with active SLE, the mRNA expressions of ICAM-1, VCAM-1 and E-cadherin were significantly increased in HUVEC, while the increase could be inhibited by the antibody to IL-17. The elevation of adhesion molecule expression subsequently promoted the motility of HUVEC, mediated the adhesion of T lymphocytes to HUVEC, and the antibody to IL-17 could suppress the adhesion of T lymphocytes and motility of HUVEC. Conclusion The culture supematants of PBMCs from patients with active SLE can induce the expression of vascular cell adherin molecules and promote the adherin of T lymphocytes, which may in turn mediate the development of lupus vasculitis.

Objective To evaluate the regulatory effect of hydroxychloroquine on in vitro differentiation of regulatory T cells(Treg). Methods Fifteen milliliters of peripheral blood were obtained from a healthy human subject followed by isolation of monouclear cells and sorting of naive T cells. Then, the naive T cells were classified into two groups:control group cultured with the presence of tumor growth factor(TGF)?βand interleukin(IL)?2, experimental group cultured with the presence of 20μmol/L hydroxychloroquine and inducing factors. The number and percentage of CD4+Foxp3+Treg cells were determined by flow cytometry at days 0, 6, and 12. Results The number of Treg cells at days 0, 6, and 12 were(2 ± 0.4)× 104,(13.2 ± 5.2)× 104, and(143.5 ± 35.9)× 104 respectively in the control group, (2 ± 0.5)× 104,(2.4 ± 0.4)× 104, and(5.6 ± 3.5)× 104 respectively in the experimental group. There was a significant difference in the number of CD4+Foxp3+ Treg cells between the two groups at days 6 and 12 (t = 3.78 and 6.16, respectively, both P < 0.05). At day 12, the percentage of CD4 +Foxp3 + Treg cells was 79.7% ± 18.1% in the experimental group, compared to 16%± 13%in the control group(t=11.77, P<0.01). Conclusion Hydroxychloro?quine could inhibit the differentiation and proliferation of CD4+Foxp3+Treg cells in vitro.

Objective To evaluate the value of double stapling technique with curved cutter stapler in colorectal anastomosis,especially in low colorectal anastomosis. Methods The clinical data of 168 cases of rectal carcinomas treated with double stapling technique with curved cutter stapler were retrospectively reviewed.The intraoperative condition,postoperative complications and findings during follow up were analysed. Results During the operations,the processes of closure and anastomosis of all the patients were satisfactory,and no operative death occurred.After the operations,4 cases(2.4%) had anastomotic leakage,3 cases(1.8%) had anastomotic bleeding,and 2 cases(1.2%) had rectovaginal fistula.All the complications were cured.There was no anastomotic stricture. Conclusion Double stapling technique with curved cutter stapler may help to accomplish low colorectal anastomosis which is a difficult task for handed suture.

Humans ; Language Development Disorders ; complications ; Presbycusis ; complications

Objective To evaluate the relationship of peripheral blood Th17 and regulatory T (Treg) cells with disease activity in patients with systemic sclerosis (SSc).Methods This study recruited 21 patients with active SSc,24 patients with inactive SSc and 24 normal human controls with informed consent.Peripheral blood samples were obtained from these subjects.Flow cytometry was used to detect the percentages of Th17 and Treg cells in peripheral blood CD4+ cells,a fluorescence-based quantitative PCR to determine the levels of interleukin (IL)-17A,retinoid-related orphan receptor gamma t (RoRγt),forkhead box P3 (FoxP3) mRNA in peripheral blood mononuclear cells (PMBCs),and enzyme linked immunosorbent assay to measure the serum level of IL-17.Results Increased percentage of Th17 cells in peripheral blood CD4+ cells was observed in patients with active SSc compared with those with inactive SSc and normal human controls (2.34％ ± 1.19％vs.0.68％ ± 0.39％ and 0.57％ ± 0.49％,respectively,both P ＜ 0.05).No statistical difference was noted in the percentage of Treg cells in CD4+ cells or the mRNA expression levels of FoxP3 between the patients with active SSc,inactive SSc and normal human controls (all P ＞ 0.05).There was a significant increase in the mRNA expression of IL-17A,RoRγt in PBMCs and serum levels of IL-17 in patients with active SSc compared with patients with inactive SSc and normal human controls ( 11.73 ± 0.80 vs.9.77 ± 1.30 and 10.79 ± 0.74,respectively,both P ＜ 0.05; 18.48 ± 1.09 vs.15.89 ± 1.48 and 17.77 ± 1.64,respectively,both P ＜ 0.05; 53.60± 9.90 pg/ml vs.15.18 ± 3.24 pg/ml and 15.53 ± 4.12 pg/ml,respectively,both P ＜ 0.05).The percentage of Th17 cells in CD4+ cells and serum IL-17 levels were both positively correlated with disease activity in patients with active SSc (r =0.675,0.644,respectively,both P ＜ 0.05).Conclusions Th17 cells are highly proliferative in patients with active SSc,which may be closely correlated with the activity of SSc.

ObjectiveTo observe clinical features and identify causative genes of reticulate pigmented anomaly of the flexures in a pedigree.Methods A survey was conducted in a pedigree with reticulate pigmented anomaly of the flexures.Clinical manifestations were recorded in details for each patient in this pedigree.Tissue specimen was obtained from the proband for histopathological examination and ultrastructural observation.Mutation scanning was carried out by PCR and direct sequencing in 3 patients in the family.ResultsAll the patients in this pedigree presented with reticular pigmentation of the flexures and idiopathic guttate hypomelanosis on the abdomen and back.Histopathological and ultrastructural study revealed epidermal hyperpigmentation with an increase in melanin content in epidermal keratinocytes but no changes in the number of melanocytes.No mutation was found in the KRT5 gene in this family.ConclusionsThis is the first case report of reticulate pigmented anomaly of the flexures associated with idiopathic guttate hypomelanosis.No mutation is identified in the KRT5 gene of patients with reticulate pigmented anomaly of the flexures in this family,indicating the existence of other causative genes.

Objective To evaluate the application value of T cell infected with Mybacterium tuberculosis assay in diagnosis of smear and culture negative pulmonary tuberculosis .Methods In total ,145 patients with smear and culture negative pulmonary tu‐berculosis and 45 patients with non‐tuberculosis lung disease were enrolled in the study .All patients received T cell infected with Mybacterium tuberculosis test and sensitivity ,specificity ,positive predicted value ,negative predicted value of testing for the diagno‐sis of smear and culture‐negative TB patients were calculated .Results The sensitivity of specificity T cell infected with Mybacteri‐um tuberculosis assay in diagnosis of smear and culture negative pulmonary tuberculosis was 85 .5% ,the specificity was 84 .4% , positive predicted value was 94 .7% ,negative predicted value was 64 .4% .No statistical significance in age‐dependent groups(P>0 .05) .Conclusion T cell infected with Mybacterium tuberculosis assay has high positive predicted value in diagnosis of smear and culture negative pulmonary tuberculosis and is suitable for clinical auxiliary diagnosis .

Adenocarcinoma ; diagnosis ; genetics ; Carcinoma, Non-Small-Cell Lung ; diagnosis ; genetics ; Carcinoma, Squamous Cell ; diagnosis ; genetics ; Cyclin-Dependent Kinase Inhibitor p16 ; blood ; metabolism ; DNA Methylation ; Genes, p16 ; Humans ; Lung Neoplasms ; diagnosis ; genetics ; Tumor Suppressor Proteins ; blood ; metabolism

Objective To evaluate the safety and efficacy of the endoscopic resection of large nonampullary duodenal adenomas.Methods Twenty cases with large nonampullary duodenal adenomas(≥ 1.0 cm) were referred for EMR.After submucosal injection of the mixture of glycerin fructose solution and methylene blue,either en bloc or piecemeal snare polypectomy was performed.All resected specimens were retrieved for pathologic study.Follow-up gastroscopy was performed in patients after EMR.Results Among 20 lesions,six were found located in the 1st part(30％),13 were in the 2nd part(65％),and one in the 3rd part(5％)of the duodenum.The mean diameter of the lesions was 1.9 ± 1.1 cm.Endoscopic ultrasonography (EUS) was performed in 12 patients,and all lesions were originated from the mucosa.EMR was performed successfully in 20 patients.The en bloc resection rate was 75％ (15/20),and the mean time for EMR was 33.8 ± 16.7 min.The perioperative complication rate was 20％ (4/20).Bleeding occurred within 24 hours after EMR in 4 cases.There were no perforations.The complete resection rate was 100％.Of these 20 adenomas,14 adenomas were tubulous and 6 was tubulovillous.During the follow-up period (2-39 months),1 patient showed recurrence within 6 months after EMR.Conclusion Endoscopic resection of large nonampullary duodenal adenomas is safe and effective treatment.