Antiphospholipid antibodies (APLs) are important for the diagnosis of antiphospholipid syndrome (APS),especially for predicting the risk of thrombosis and pathological pregnancy.However,the heterogeneity of antiphospholipid antibodies,lacking of standardization and significant interlaboratory variation binder the clinical application of APLs and better understanding of APS diagnosis and treatment.Therefore,it is urgent to establish a standardize system for antiphospholipid antibodies test and to improve the performance of the test and perform well-designed clinical evaluation.

Objective To explore the clinical diagnosis and treatment of pediatric bridging bronchus deformity and brid-ging bronchus with pulmonary artery sling. Methods The clinical data of the 21 cases of diagnosed bronchial bridge deformity and bronchial bridge with pulmonary artery sling, the imaging findings of all the echocardiography, MSCT chest scan, enhanced CT and reconstructive image were retrospectively analyzed. Results In 21 cases, 10 were diagnosed as bronchial bridge only, among which three cases had other types of congenital heart disease;11 cases were diagnosed of pulmonary artery sling with pulmonary artery sling, among which 8 cases had other types of congenital heart disease;their average age of the 8 cases were all younger than 2 years old, except one case;most of them had the symptoms of recurrent respiratory tract infections and parox-ysmal dyspnea. According to Wells, bronchial bridge was divided into type I and typeⅡ;15 cases were type I, 6 cases were typeⅡ, 10 patients with bronchial bridge only were all type I, 5 cases of typeⅡwere associated with pulmonary artery sling. All of the 6 cases were diagnosed as typeⅡassociated with pulmonary artery sling. Conclusions Infants and young children with clini-cal recurrent respiratory tract infections should be considered the possibility of bronchus bridge deformity, and should be paid more attention to the possibility of pulmonary artery sling. MSCT plain chest scan, enhanced CT and airway reconstructive im-age are the important ways to diagnose the disease.

According to the consensus criteria of antiphospholipid syndrome (APS),the diagnosis of APS requires the persistent presence of antiphospholipid antibodies (aPLs),indicating the critical role of aPLs in the diagnosis of APS.During the last decade,great efforts have been made to improve the laboratory detection and standardization of aPLs testing.Unfortunately,the heterogeneous nature of aPLs,lacking of standardization in aPLs test,and significant inter-laboratory variation have hampered the clinical application of aPLs test.In this commentary,the clinical application and standardization of aPLs test are focused on,and how to establish the standardization system in aPLs test in order to improve the performance of aPLs test in clinical practice are discussed.

Objective To investigate the effects of Xuebijing injection on T-lymphocyte subgroups and clinical efficacy in treatment of patients with severe pneumonia.Methods 60 patients with severe pneumonia were selected into the study.The patients were randomly divided into Xuebijing group (n =30) and control group (n =30).Patients in the control group were given routine therapy.The Xuebijing group received the treatment of routine therapy combined with Xuebijing injection.The changes of T lymphocyte subgroups and clinical efficacy were compared between the two groups.Results The levels of CD3,CD4,CD4/CD8 after treatment in Xuebijing group and control group were significantly higher than those of before treatment (t =4.95,4.89,4.96,3.13,3.11,3.09,all P ＜ 0.05),those in the Xuebijing group were significantly higher than control group (t =3.89,3.56,3.78,all P ＜ 0.05).The total effective rate in the Xuebijing group was 93.3％,which was significantly higher than 76.6％ in the control group (x2 =4.55,P ＜ 0.05).Conclusion Xuebijing injection combined with routine western medicine is quite effective in treatment severe pneumonia.Xuebijing can improve the immune function of patients.

How to reduce immune response is an unprecedented challenge for rAAV gene medicine. Recent studies suggested that lowering dosage of the vector used could reduce immune response caused by rAAV gene medicine. Nevertheless, it would also decrease the transgene expression, leading to failure of gene treatment. It is therefore important to take appropriate steps to maintain high gene expression level and pharmacodynamic, while the dosage of rAAV used is reduced. Here, steps to enhancing gene therapy, such as optimization of the administration, reconstruction of the viral vector and selection of the promoter, are discussed in order to achieve maximum outcome.

Objective To evaluate the effect of sequential intrahepatic arterial FAM for the treatment of metastatic gastric cancer to the liver. Methods 14 patients with multiple hepatic metastases from gastric cancer were treated with sequential intrahepatic arterial FAM using the hepatic artery infusion port. Results Of 14 patients, CR, PR, NC and PD were observed in 1, 7, 4 and 2 cases respectively. The overall median survival was 15 months. The survival rate at 1, 2 and 3 years was 80.0%; 57.1% and 14.3% respectively. No severe complication was observed. Conclusions Sequential intrahepatic artery FAM is effective to increase the survival rate in patients with hepatic metastases from gastric cancer.

Objective To evaluate the efficacy of FAP combined intrahepatic artery with intravenous infusion chemotherapy in the treatment hepatic metastatic carcinoma. Methods 23 patients with metastatic hepatic carcinoma were diagnosed with CT or MRI. EPI 40mg/m 2, CDDP 60mg/m 2 were given intrahepcic arterial by means of one shot infusion and 5-FU 500mg/m2 (d1, d8) intravenously respectively. All patients were reexamined by with CT or MRI after 2～4 weeks. Results The total response rates was 74%. The survival rates at 1 year, 2 year and 3 year were 88 8%?7 9%;66 9%?12 3% and 24 6%?23 4% respectively. The median survival time was 25 months. Conclusions FAP was a traditional regimen,combined intrahepatic arterial and intravenous chemotherapy can improve response rate and prolong median survival to metastatic liver cancer .

Objective To explore the value of center vein catheter thoracostomy in the chemotherapy of malignant pleural effusion. Methods Carboplatin and ?-2b Interferon were infused into pleural cavity by implanted center vein catheter in the group observation (n=17). After repeated thoracocentesis, the same drugs were introduced into pleural cavity in the group control (n=29). At the end of the 1st, 3rd and 6th month after drug administration, follow-up was carried out to assess the response rates. Results At the end of the 1st, 3rd and 6th month after intrapleural therapies, the number of intrapleural therapies in the group observation was (2.2?1.9) times and in the group control (5.3?1.3)times, with statistically significant difference between the two groups (t=5.924, P=0.00). Numbers of complete remission (CR) in the group observation was 10 of 16, 11 of 16 and 10 of 15, respectively and in the group control 9 of 29, 11 of 29 and 5 of 19, respectively, producing significant difference (P=0.043, 0.050, 0.020, respectively). Overall response rates in the group observation were 87.5%, 87.5% and 80.0%, respectively, while in control were 62.5%, 68.7% and 66.7%, respectively, without significant difference (P=0.356, 0.114, 0.178, respectively). Compared with the control, long-term follow-up (six months) showed higher response rates in the group observation: 10 of 15 patients remained CR at 6th month after therapies. No significant difference was seen in respect to adverse effects(?2=2.491,P=0.114). Conclusions Intrapleural chemotherapy by center vein catheter may increase CR and decrease application times of Carboplatin and ?-2b Interferon in the treatment of malignant pleural effusion, with fewer side effects.

Objective To study the clinical,image and pathological features of cerebral gliomatosis.Methods 2 cases with cerebral gliomatosis underwent routine MRI scan, contrast enhance MRI scan and pathologic examination of the lesions. Their clinical manifestations were observed during the past 2 years.Results Main clinic features of the 2 patients were headache, dizziness, nausea, vomit, diplopia, hemiplegia, hemianesthesia and ataxia. Cranial MRI scan showed long T 2 signals in the bitemporal lobes, biparietal lobes, corpus collosum, thalamus, caudate nucleus and putamen. Brain stem and cerebellum were also involved in 1 patient. The borders of the lesions were unclear and no mass-effect phenomenons were found. Contrast enhancement occurred only in 1 patient after Gd-DTPA injection. The biopsies in the 2 patients showed diffuse infiltrative growth of most astroglioma cells. The shape of nucleus was round or ellipse and the staining of nucleus was comparatively deep. Cleavage of nucleus was seldom. The 2 patients died in 4 to 6 months after the onset of the disease.Conclusions MRI scan and pathologic examination are essential diagnostic methods for cerebral gliomatosis. The prognosis of cerebral gliomatosis is poor.

Objective To investigate chromosomal gains and losses in association with human papillomavirus status in the vulvar squamous cell carcinomas(VSCC). Methods We analyzed 21 VSCC with comparative genomic hybridization (CGH) and polymerase chain reaction.Results Each case had different degree of variances, including gains and losses of partial or whole chromosome. On average, each case had 4.9(102/21) abnormal regions; losses were more than gains, being respectively 2.6(54/21) and 2.3(48/21). Main variations were gains on chromosomes 3q(43%,9/21),8q(38%,8/21),12q(33%, 7/21 )and 9p(19%,4/21),and losses of 4p(52%,11/21),3p(43%,9/21)and 9p(10%,2/21).Gains of 3q(73%) and 12q(64%) were significantly more common in human papillomavirus (HPV)-positive VSCC compared to HPV-negative VSCC(10%,0;P