The intestinal mucosa is the biggest lymph organ in human body, which consists of the first line of defensive system with the respiratory mucosa and urinary mucosa. The intestinal mucosa is responsible to defend bacteria, viruses, dietary pathogens, non-steroid anti-inflammatory drug and so on. If the intestinal mucosal immune system is destroyed, the human will suffer many diseases such as infectious diseases,autoimmune diseases. Therefore, it plays an important part in physical health. T helper type 17 (Th17) cells different from Th1 cells and Th2 cells are a distinct lineage of T cells. The discovery of Th17 cells has ruined the constitutional pattern of Th1/Th2. Th17 cells, which are important parts of intestinal mucosal immune system,play critical roles in intestinal autoimmune diseases, tissue inflammation and the infection of various pathogenic bacteria. This paper will review the differentiation of Th17 cell and its function in intestinal mucosal barrier,intestinal autoimmune diseases and intestinal infectious diseases.

Objective:To observe the clinical curative effect of narrow-band UVB-LED (308nm) combined with tacrolimus, narrow-band UVA-LED (365nm) combined with 8-Methoxypsoralen irradiation in the treatment of vitiligo.Methods: Sixty-four cases of vitiligo patients were chosen and randomly divided into control group and observation group, each group with 32 cases. The control group received 308nm narrow-band UVB-LED irradiation combined with tacrolimus,the observation group received 365nm narrow-band UVA-LED irradiation combined with 8-Methoxypsoralen, the time of appreance of the first pigment island in patients were compared between the two groups,the clinical curative effect of both groups were observed when treated with 10 times and 20 times.Results: The average irradiation times when first pigment island appreance in the observation group and the control group were 5.59 and 6.24 respectively, the difference was not statistically significant (t=1.772,P>0.05). The efficiency rate of the control group was 37.50% after 20 times treatment, and in the observation group was 40.63%, the difference was not statistically significant (x2=0.000,P>0.05).Conclusion: 308nm narrow band UVB-LED combined with tacrolimus and 365nm narrow-band UVA- LED combined with 8- Methoxypsoralen irradiation in the treatment of vitiligo have significant treatment effects, how to improve the treatment effect still need further study.

Nephroblastoma is the most common pediatric renal tumor.The research progress of gene mutations in Wilms tumor children is reviewed in this paper.The WT1 gene,CTNNB1 gene and WTX gene plays a role in onset of Wilms tumor,and the MYCN gene,P53 gene and SIX1 gene may be associated with the prognosis.

Objective To summarize the experience in nursing 2 patients with anti-glomerular basement membrane disease.Method The nursing measures such as close observation of disease condition,careful nursing of medication,nursing during the treatment of double filtrated plasmapheresis and mental care to the patients and their family members.Results After treatment,the concentration of anti-GBM antibody was declined and the level of serum creatinine was also decreased.The renal function got rccovered to a certain extent.Conclusion Such nursing points as close observation of renal and pulmonary pathgenesis,timely and accurate administration of medicine according to doctor's orders and active observation and prevention of complication from double filtrated plasmapheresis are key.

Snake venoms are complex mixtures containing many different biologically active applications in the field of cancer research. In this paper, not only unpurified fraction, but also highly purified snake venoms are discussed,such as rhodostomin, acutobin, agkistrodon halys antithrombotic enzyme, batroxobin. The review mainly introduced the inhibitory effects of snake venoms on tumer metastasis.

Before irreversible neuronal damage occurs, quickly and securely recanalize vessels and restore blood flow to save the ischemic penumbra tissue are the main therapeutic target for acute ischemic stroke (AIS). Currently, the method for recanalization in early AIS is intravenous thrombolysis, how ever, the effect of intravenous thrombolysis is often not satisfactory because of the reasons, such as its short treatment time w indow , low vascular recanalization rate, and high incidence of bleeding complications. In recent years, w ith the research and development of mechanical thrombectomy device and the development of interventional technology, the therapeutic time w indow of AIS has been significantly prolonged, the vascular recanalization rate has increased significantly, the clinical outcome has improved significantly, and the treatment of mechanical thrombectomy has show n good application prospects.

Breast conserving surgery has become the first choice for the treatment of early breast cancer.However,the safety margin is still one of the important issues for surgeons in the implementation of breast conserving surgery.Because variety of clinical factors have some effects on the safety margin,at present,no consensus on safe margin of breast conserving surgery is reached,and the controversy still goes on.

Objective To evaluate the application effect of bedside evaluation of deglutition function and predictive nursing intervention on patients with dysphagia in neurology department. Methods 320 Patients with dysphagia were divided into the observation group and control group with 160 cases in each group. The observation group was given admission nursing evaluation and bedside evaluation of deglutition function while the control group only received admission nursing evaluation. The incidence of complications in each group were assessed. Results The incidence of complications such as aspiration, pulmonary infection, asphyxia and metabolic disturbance in the observation group was lower than that of the control group(P＜0.01).Conclusion The bedside evaluation of deglutition function could accurately evaluate the degree of swallowing disorder and supply theoretical evidence for predictive nursing intervention by in structing clinical application of selective measures for patients with dysphagia. This could guarantee safe food intake and reductive incidence of complications of patients. So we advocated that bedside evaluation of deglutition function should be a routine admission nursing evaluation in neurology department.

Random clustering was conducted among a total of 1068 residents aged 18 years or older at a certain Shanghai community.And they completed a questionnaire survey.Logistic data processing and model building were performed.The respondents were willing to go to a community health center for the following reasons:close proximity (88.4％),excellent service attitudes (40.4％) and low drug prices (37.8％).No statistically significant differences existed in terms of first choices of community health service,occupation,monthly income and-walking distance (P ＞ 0.05).However,statistically significant differences existed in education level,age and chronic diseases (P ＜ 0.05).

Objective To investigate the correlation between CD40-1C/T gene polymorphism and serum soluble CD40L (sCD40L) expression in cerebral infarction.Methods According to the inclusion and exclusion criteria,select the acute large artery atherosclerosis in patients with cerebral infarction as the case group,select the same period without a history of stroke examination subjects as the control group.Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technology was used to detect CD40 gene polymorphism and sequencing,double-antibody sandwich enzyme-linked immunosorbent assay (ELISA) was used to detect the expression levels of serum sCD40L.Results A total of 209 patients with large artery atherosclerotic cerebral infarction (case group) and 87 subjects without history of stroke (control group) were included.The CC genotype (31.6％) and C allele frequency (53.8％) of the case group were significantly higher than that of the control group (17.2％,39.1％) (x2 =6.94,10.69,P ＜0.01).Case group serum sCD40L expression level was significantly higher than those in the control group [(3.97 ± 1.20) vs (2.69 ±0.88)] (t =10.19,P ＜0.001).Case group serum sCD40L expression level was different among CC,CT,and TT genotypes (F =19.22,P ＜0.001),serum sCD40L level (4.55± 1.16) of CC genotype in patients was significantly higher than that of CT (3.93 ± 1.17) and TT genotypes (3.27 ± 0.90),serum sCD40L level (3.93 ± 1.17) of CT genotype in patients was significantly higher than the TT genotype (3.27 ±0.90).The serum sCD40L expression level of the control group in the CC,CT,TT has no statistically significant differences among various genotypes [(2.91 ±0.79),(2.67 ±0.89),(2.61 ±0.91),F =0.619,P =0.541).Conclusions CD40-1C/T gene polymorphism is associated with serum sCD40L expression level in cerebral infarction,serum sCD40L level of the CC genotype was significantly higher.