Objective To investigate the expression of regulatory T cells in the peripheral blood of rheumatoid arthritis patients and to explore the possibility of using CD127 instead of FOXP3 in the study of regulatory T cells. Methods Thirty-two patients with active rheumatoid arthritis (RA) [ including 20 patients who hadn't been treated with disease modifying antirheumatic drugs (DMARDs) and 12 patients whose disease were poorly improved after DMARDs therapy], 25 patients with primary Sjogren's syndrome (pSS) and 24 healthy controls were selected. The percentages of CD4+CD25high, CD4+CD25+CD127low/'- and CD4+CD25+ FOXP3+T cells were analyzed by 3-color flow cytometry. Meanwhile, the levels of CRP, ESR, immunoglobulin and complement were measured. Results Percentages of CD4+CD25+CD127low/-T cells and CD4+CD25+FOXP3+ T cells in RA patients were significantly lower than those of healthy controls (P<0.01 for each category of T cells),but the percentage of CD4+CD25high T cells didn't show significant changes (P>0.05). The expression of CD4+CD25+CD127ow/- and CD4+CD25+FOXP3+T cells showed no difference between RA and pSS patients (P> 0.05 for each). Differences of the three group cells between untreated RA patients and poorly-improved RA patients were not significant (P>0.05 for each case). CD4+CD25+CD127low/-T cells were positively associated with CD4+CD25+FOXP3+T cells (r=0.698, P=0.001), but the two groups had no correlation with the levels of CRP, ESR and anti-CCP antibody and RF (P>0.05 for each case). Conclusion The percentage of CD4+CD25+CD127low/-T cells is decreased in the peripheral blood of active RA patients and positively correlates with CD4+CD25+FOXP3+T cells.It suggests that CD127 may be an ahemative marker of FOXP3 in the study of Treg cells.

Objective To study the role of peripheral blood T regulatory cells (Treg) markers, as well as different Treg cells in the pathogenesis of systemic lupus erythematosus (SLE) and explore the correla-tion betweenCD127 and Foxp3. The immunosuppressive effect of CD4~+CD25~+CD127~(low/-) T cell is explored. Methods ①Four-color direct fluorescence-labeled and multi-parameter flow cytometry were used to detect peripheral blood CD4~+CD25~+ T cells and other Treg cells accounted for the proportion of CD4~+ T cells in 40 SLE patients (19 cases with active disease 21 cases in remission) and 15 healthy controls. Meanwhile, its correlations with anti-dsDNA antibodies among 7 groups were analyzed.②Flow cytometry sorting combined with cell culture were applied to detect and analyze the proliferation inhibition effect of CD4~+CD25~+CD127~(low/-)regulatory T cells to CD4~+CD25~-effector T cell.Two independent samples t test,ANOVA for repeated measures,Pearson's correlation and Spearman's correlation were used for statistical analysis.Results ①The cell ratio of the 7 groups of SLE patients was(6.1±1.7)%,(3.1±1.3)%,(2.1±1.0)%,(1.6±0.3)%(0.97±O.28)%,(0.69±0.23)%and(O.71±0.35)%respectively.In the SLE group,the proportion of the first 6 groups was lower than the control group (P<0.05).For CD4~+CD127~(low/-)Foxp3~+,there wag no difference in the two groups(P>O.05).②CD4~+CD25~+Foxp3~+,CD4~+CD25~(high)Foxp3~+ T cells and IgA ratio Was positivelv correlated.While CD4~+CD25~(high)CD127~(low/-) T cells and anti-SSB antibodies was positively correlated in SLE patients.③The seven group of cells,in addition to CD4~+CDl27~(low/-)Foxp3~+ T cell ratio were lower in early-onset SLE patients than those in patients at remission(P<0.05).④The cell propor-tion of the first 6 groups was lower than that of post steroid treatment(P<0.05).⑤Foxp3 expression of CD4~+CD25~+T ceils and CD4~+CD25~(high) T cells was positively correlated with low expression of CDl27 in the early onset group,remission group and the control group.⑥The CD4~+CD25~- effect T cells could be suppressed by their own CD4~+CD25~+CDl27~(low/-) regulatonry T cells in vitro,and the inhibition of SLE patients was significantly lower than controls.Conclusion The immunological abnormality of SLE may be associated with the qnatity and functional defects of immune regulatory T cells.CDl27 may be a possible alternative to Foxp3 regulatory T cell-specific surface markers.

The therapeutic effect is not ideal for patients with colorectal cancer that has already metastasized.In recent years,it has been found that extracellular vesicles play an important role in various aspects of cancer cells,and their impact on the invasion and metastasis process of colorectal cancer has gradually been revealed.This review reviews and analyzes the role of extracellular vesicles in the invasion and metastasis of colorectal cancer,and briefly introduces the role of some extracellular vesicles in the treatment of colorectal cancer.

To explore the basics of integrated curriculums and the reform plan of integrated organ-system based curriculum of clinical subjects, this paper takes the integrated musculoskeletal system based curriculum in the third semester for undergraduates majoring in clinical medicine as an example, elaborates on the following five aspects: the organ system-centered curriculum system, the integration of teaching content, curriculum implementation plans, curriculum advantages, major issues and measures for improvement. This paper puts forward some urgent problems such as writing teaching materials, changing teachers' traditional teaching concepts, arranging the course reasonably, achieving learning outcomes, and deepening the integration of knowledge in various subjects. It is also provides suggestions for building a coherent and complete teaching model and knowledge system of the integrated organ-system based curriculum, helping students better understand the organic relationships between various disciplines, and promoting the curriculum reform. The reform of the integrated organ-system based curriculum has achieved initial results.