ObjectiveTo study the alteration mechanism of T follicular helper (Tfh) cells in patients with Kawasaki disease (KD).MethodsTwenty children with KD and the same number of agematched healthy subjects were studied.The proportion of CD4+CXCRS+ICOS+ T in peripheral blood was analyzed by flow cytometry.Real-time PCR was performed to detect the level of Tfh transcriptional factor( Bcl6) and its inhibitor( Blimp-1 ).The plasma concentration of IL-4 and IL-21 were determined by ELISA.ResultsThe proportion of CD4+CXCR5+ICOS+ T in patients with KD was significantly higher than healthy controls [ (2.6±0.6) ％ vs ( 1.8±0.7 ) ％,P＜0.05 ].Transcription levels of Bcl-6 were significantly elevated in patients with KD( P＜0.05),its inhibitor Blimp-1 were found to be down-regulated during acute phase of KD compared with healthy controls (P ＜ 0.05 ).The significant increase of IL-4 and IL-21 plasma concentrations were detected in patients with KD(P＜0.05),in comparison with healthy controls.ConclusionThe over activity of Tfh might be correlated with immune dysregulation in Kawasaki disease.Dysregulation of Bcl-6/Blimp-1,altered microenvironment of IL-4 and IL-21 might be correlated with the abnormal activity of Tfh cells.

Objective To investigate the clinicopathologic characteristics and prognostic factors of primary clear cell carcinoma of the liver(PCCCL). Methods A total of 214 PCCCL patients treated by curative resection from January 1996 to March 2006 were retrospectively analyzed. Results The 1-,3-,and 5-year overall survival (OS) rates for PCCCL patients were significantly better than those of non-clear cell hepatocellular carcinoma ( NHCC ) patients ( 90.2％,70.6％,and 55.9％ vs 82.8％,62.7％ and 47.7％,P =0.001 ).Tumor size was significantly smaller in PCCCL group than in NHCC group ( x2 =4.37,P =0.04 ).Tumors of PCCCL group had a lower incidence of vascular invasion ( x2 =9.42,P =0.002) and a better differentiation than those of NHCC group ( x2 =4.30,P =0.04).Serum a-fetoprotein (AFP) level,tumor size,liver cirrhosis,and vascular invasion were independent risk factors impacting OS and disease-free survival (DFS) of PCCCL. Conclusions PCCCL is an uncommon subtype of HCC and has different clinicopathologic characteristics from NHCC. Complete surgical resection is the optimal treatment for PCCCL and its prognosis is much better than that of NHCC.

OBJECTIVETo determine the value of elective neck dissection in patients with clinically stage I (cT1N0M0) squamous cell carcinoma of the tongue.

METHODSThis was a retrospective study of patients with surgical treatment between November 1984 and November 1999. A total of 130 patients were included in the study, all of whom received operation of the primary site, meanwhile, 99 of whom underwent elective neck dissection simultaneously including level I -III or level I -IV neck dissection in 20 patients and level I - V neck dissection in 79 patients. Results Among all these patients, the rate of occult metastasis to the neck were 12. 0%. Local failure rate in patients with only local treatment, level I II, II, III/IV neck dissection and level I - V neck dissection were 25. 8%, 15. 0% and 7. 6% respectively. There were significant difference in regional failure between patients with only local treatment and patients with elective neck dissection (P < 0.05). Also, no significant differences were noted in the survival rate between patients with only local treatment, elective neck dissection (level I -III or level I -IV) and level I -V neck dissection (P > 0.05).

CONCLUSIONSElective neck dissection significantly reduced regional control failure but was not able to reduce distant metastasis or increase the overall survival. A prospective randomized study is worthwhile to further evaluate the benefit of elective neck dissection in the treatment of clinically stage I squamous cell carcinoma of the tongue.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; pathology ; surgery ; Elective Surgical Procedures ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neck Dissection ; Neoplasm Staging ; Retrospective Studies ; Tongue Neoplasms ; pathology ; surgery ; Treatment Outcome ; Young Adult