Objective:To investigate the immune response characteristics of helper T cells Th1, Th2, Th17 and their related cytokines in acute, chronic and recovery phases after Brucella infection. Methods:Using prospective study, a total of 130 patients with brucellosis in the First Affiliated Hospital of Medical College of Shihezi University from January 2017 to December 2018 were selected as the research subjects, including acute phase group (49 cases), chronic phase group (44 cases), recovery phase group (37 cases), and 30 cases of healthy physical examination during the same period were included in the control group. The peripheral blood samples of all subjects were collected, and flow cytometry was used to detect Th1, Th2 and Th17 cells in the peripheral blood; the cytometry bead array (CBA) was used to detect the serum cytokines interferon-γ (IFN-γ), interleukin (IL)-4 and IL-17A expression levels.Results:In the control, acute phase, chronic phase and recovery phase groups, the differences of the expression ratios of Th1 [(1.03 ± 0.85)%, (5.46 ± 3.54)%, (4.48 ± 2.26)%, (2.29 ± 2.25)%], Th2 [(4.72 ± 2.36)%, (7.00 ± 3.14)%, (13.99 ± 9.14)%, (5.89 ± 4.69)%], and Th17 cells [(2.09 ± 0.48)%, (3.04 ± 2.17)%, (3.61 ± 2.67)%, (2.74 ± 2.58)%] were statistically significant ( F = 20.95, 21.15, 2.90, P < 0.05). Compared with the control group, the expressions ratio of Th1, Th2, Th17 cells in acute and chronic phase groups and Th1 cells in recovery phase group were significantly higher ( P < 0.05); compared with the recovery phase group, the expressions ratio of Th1, Th2 and Th17 cells in acute and chronic phase groups were significantly higher, but the expression ratio of Th2 cells in acute phase group was lower than that in chronic phase group ( P < 0.05). The expression levels of IFN-γ, IL-4, and IL-17A in serum of control group, acute phase, chronic phase and recovery phase groups were significantly different ( F = 7.79, 15.85, 7.55, P < 0.05); compared with the control group, the expression levels of IFN-γ, IL-4, IL-17A in acute and chronic phase groups and IFN-γ, IL-4 in recovery phase group were significantly higher ( P < 0.05); compared with the recovery phase group, the expression levels of IFN-γ, IL-4, IL-17A in acute phase group and IFN-γ, IL-17A in chronic phase group were significantly higher ( P < 0.05). The expression ratio of Th1 cells in recovery phase patients who finished treatment for less than 12 months was significantly higher than that of recovery phase patients who finished treatment for ≥12 months ( t = 2.26, P < 0.05). Conclusions:After patients are infected with Brucella, Th1 cell immunity is dominant in acute phase, Th2 cell immunity is dominant in chronic phase, and there is no significant difference in the response of Th17 cell immunity between acute and chronic phases. The immune function of patients in the recovery phase may still be abnormal when the treatment time is less than 12 months. Some clinically cured patients in the recovery phase still have a relatively high proportion of Th1 cells, suggesting that the patient's immune function has not fully recovered.

Objective To evaluate the clinical effect and complications of total hip replacement (THR) in novel femoral neck fracture,old femoral neck fracture, aseptic necrosis of femoral head and coxa degenerative osteoarthropathy. To provide instructions to surgical indications and treatment effects analysis.Methods One hundrde and four patients were divided into 4 groups by disease type: novel femoral neck fracture group (n = 32 ), old femoral neck fracture group (n = 22) ,aseptic necrosis of femoral head group (n =34) and coxa degenerative osteoarthropathy group (n = 16). These patients were followed-up for 12 - 144 months after THR, their Harris standard score and complications data, before and after operation, were analyzed retrospectively. Results After operation, the Harris standard scores were 92. 6 ± 5.8,90. 1 ± 5. 2,86. 3 ± 4. 6,81.9 ±4. 1 in novel femoral neck fracture,old femoral neck fracture,aseptic necrosis of femoral head and coxa degenerative osteoarthropathy groups respectively, which were significantly higher than the scores before operation (25.6±1.8,36.7±2.6,52.9±4.3,42. 1 ±3.8,Ps ＜0.05). Conclusion THR has good effects in the four types of diseases. Short length of stay and high healing rate are marked characteristics of THR. More attention shoud be paid to the complications of THR.

Objective To investigate the accuracy of volumetric measurements (Dotian formula and platform-like volume calculation formula [PLVCA]) in pituitary adenomas and their practicabilities.Methods Forty-five large and giant pituitary adenomas patients,admitted to our hospital from May 2013 to May 2014,were collected.According to the imaging finds of pituitary adenomas,the patients were divided into regular type group and irregular type group;the volume of these tumors were calculated by PLVCA method,Dotian formula and virtual reality (VR) reconstruction method,respectively.The results of VR method were used as the standards to investigate the accuracy of Dotian formula and PLVCA method on pituitary adenomas.Results In 45 pituitary adenomas,17 (37.78％) were regular;the result of tumor volume using VR method was (6.54±11.27) cm3,that using PLVCA method was (5.50±9.40) cm3 and that using Dotian formula was (4.32±9.00) cm3;significant differences were noted between the results of VR method and PLVCA method and the results of VR method and Dotian formula (P＜0.05);there was no significant difference between the results of PLVCA method and Dotian formula (P＞0.05).Another 28 (62.22％) were irregular;the result of volume using VR method was (11.65±16.60) cm3,that using PLVCA method was (11.50±16.18) cm3,there was no significant difference between the two results (P＞0.05);that using Dorian formula was (10.04±19.45) cm3,and there was significant difference between the VR method and Dotan formula (P＜0.05),which was also found between PLVCA method and Tada formula (P＜0.05).Conclusion PLVCA method has a higher accuracy in volume measurement of pituitary adenomas than Dotian formula,especially in irregular adenomas.

Objective To analyze the correlative factors of hypopituitarism in patients with intracranial non-sellar tumors.Methods Eighty-three patients with intracranial non-sellar tumors,admitted to our hospital from May 2014 to April 2015,were included in our study;their clinical data were retrospectively analyzed.The status of pituitary function was assessed according to the level of preoperative serum hormone.Univariate and multivariate Logistic regression analyses were employed to analyze the correlations of preoperative hypopituitarism with age,gender,hypertension,epilepsy history,course of disease,mass effect of tumor,tumor location,intracranial pressure (ICP),and composition of cerebrospinal fluid.Results Before surgery,30 showed hypopituitarism,accounting for 36.14％:23 had deficiency in one pituitary axe and 7 had multi-axial deficiency.Univariate analysis showed that high ICP (ICP＞200 mmH2O),acute or sub-acute course (≤ 3 months) and presence of mass effect by non-sellar brain tumor were the risk factors of hypopituitarism (P＜0.05).Multivariate Logistic regression analysis revealed that intracranial mass effect in patients with non-sellar brain tumor was an independent risk factor (OR=3.197,95％CI=1.085-9.423,P=0.035).Conclusion Hypopituitarism has high morbidity in patients with non-sellar brain tumor;intracranial mass effect is an independent risk factor for hypopituitarism.

Anatomical right superior segmentectomy has always been a difficult surgical procedure in laparoscopic liver resection. How to accurately judge the interface between liver segments, so as to achieve a true sense of anatomic resection based on portal territory is a new requirement in the era of precision liver surgery. The portal vein puncture and indocyanine green (ICG) fluorescence positive staining technique can effectively solve this problem, which has a series of advantages and certain technical requirements in anatomical right superior segmentectomy. ICG fluorescence staining can intuitively define the three-dimensional range of the liver segment, which is a more accurate navigation mode that helps liver surgeons identify the range of the right superior liver segment, thus conducting surgery more safely and normatively. The authors consult relevant studies and combined with clinical practice to explore the application value of laparoscopic ultrosound guided puncture and positive staining technique in anatomical right superior segmentectomy.

With the development of modern medical standards,autoimmune diseases and their associ-ated successive osteoporosis have received increasing attention in recent years.Patients with autoimmune diseases,due to the characteristics of the disease and the prolonged use of glucocorticoid hormone thera-py,may affect the bone formation and bone absorption of the patient,followed by severe successive osteo-porosis,thereby increasing the risk of osteoporotic vertebral fractures.Vertebral compression fractures of the spine are common fracture types in patients with osteoporotic fractures.Osteoporosis is a common complication after glucocorticoid therapy in patients with autoimmune diseases.Percutaneous vertebro-plasty(PVP)and percutaneous kyphoplasty(PKP)are minimally invasive operation and are commonly used surgical methods for the treatment of osteoporotic vertebral compression fractures.However,due to the operation of spinal puncture during the operation,there are serious surgical risks such as bone cement leakage,spinal epidural hemorrhage,subdural hemorrhage,and subarachnoid hemorrhage in both PVP and PKP.As a result,it is necessary to evaluate the patient's body before surgery carefully,especially in the case of blood coagulation.This article reports a case of autoimmune disease patient admitted to Peking University People's Hospital due to lumbar 4 vertebral compression fracture combined with Sj?gren's syn-drome.The patient's preoperative examination showed that the activated partial thromboplastin time(APTT)was significantly prolonged.After completing the APTT extended screening experiment and lu-pus anticoagulant factor testing,the multi-disciplinary team(MDT)of Peking University People's Hospi-tal jointly discussed the conclusion that the patient's test results were caused by an abnormal self-immuni-ty anti-copulant lupus(LAC).Based on the results of the laboratory examination,the patient was con-sidered to be diagnosed with combined antiphospholipid syndrome(APS).For such patients,compared with the patient's tendency to bleed,we should pay more attention to the risk of high blood clotting in the lower limbs of the patient,pulmonary clots and so on.With timely anti-coagulation treatment,the patient safely passed the peripheral period and was successfully discharged from the hospital.Therefore,for pa-tients with autoimmune diseases with prolonged APTT in the perioperative period,doctors need to careful-ly identify the actual cause and carry out targeted treatment in order to minimize the risk of surgical and perioperative complications and bring satisfactory treatment results to the patients.

Objective To investigate the early clinical and imaging features,treatment strategies of subarachnoid hemorrhage secondary to cerebral venous sinus thrombosis.Methods The clinical data of 3 patients with subarachnoid hemorrhage secondary to cerebral venous sinus thrombosis,admitted to our hospital from October 2013 to March 2015,were retrospectively analyzed.One patient underwent anticoagulant therapy singly,and two underwent anticoagulation and thrombolytic therapy.Results One patient was admitted to hospital in gestation period,two patients had unknown etiology.All patients complained of headache;among them,two presented with epilepsy.Two patients with early diagnosis and treatment of anticoagnlation and thrombolysis had favorable prognosis,one patient with secondary intracranial hemorrhage had good outcome after active treatment.Conclusions For those patients with onset of non-aortogenic subarachnoid hemorrhage,we must keep an eye out for underlying cerebral venous sinus thrombosis.Anticoagulant and thrombolytic therapy are the first-line treatment.It is suggested that the appropriate dosage at the appropriate time to prevent cerebral hemorrhage from occurring is necessary.