Objective To investigate the therapeutic value of high-resolution microendoscopy for early esophageal cancer.Methods A total of 60 patients,who underwent esophageal endoscopy,were included in this study.The therapeutic value of high-resolution microendoscopy was investigated with reference to pathological results as golden standard.Results Diagnostic sensitivity,specificity,positive predictive value,negative predictive value and accuracy of microendoscopy for high grade dysplasia/early cancer were 81.22％,94.12％,81.82％,94.12％,91.11％,respectively.Diagnosis of severe dysplasia/carcinoma with high-resolution microendoscopy was highly consistent with that of pathology (K =0.760).Conclusion The high-resolution microendoscopy is of high diagnostic value for early esophagus cancer.

Objective To investigate the effect of isoflurane anesthesia on the expression of amyloid β protein (Aβ) in hippocampus in aged rats.Methods Sixty-one healthy male SD rats,aged 18-19 months,weighing 400-500 g,were randomly divided into 3 groups:isoflurane group (group Ⅰ,n =31),control group (groupⅡ,n =20),and blank group (group Ⅲ,n =10).Group Ⅰ inhaled 1.4％ isoflurane for 2 h,and cognitive function was assessed at 5 d before and 2 d after anesthesia by Morris water maze.Group Ⅱ received Morris water maze text only.Group Ⅲ received no treatment.Group Ⅰ was divided into 2 subgroups according to whether the cognitive impairment occurred:cognitive impairment group (P subgroup) and no cognitive impairment group (NP subgroup).The animals were sacrificed immediately after the test.The hippocampus was isolated for determination of the levels of Aβ40 and Aβ42,β-secretase (BACE),insulin degrading enzyme (IDE)and neprilysin (NEP).Results There was no significant difference in the results of Morris water maze test before anesthesia among the 3 groups.There was no significant difference in the swimming velocity between group Ⅰ and group Ⅱ.The time of staying at the original platform quadrant was significantly shorter in P subgroup than in NP subgroup and Ⅱ group,and there was no significant difference in the time of staying at the original platform quadrant between NP subgroup and Ⅱ group.There was no significant difference in the levels of Aβ40 and Aβ42,BACE,NEP and IDE among the 5 groups,and between P subgroup and NP subgroup.Conclusion Isoflurane anesthesia has no effect on the expression of Aβ in the hippocampus,indicating that isoflurane-induced cognitive impairment is not related to Aβ pathway in aged rats.

Objective To study the influence on allograft function of HLA antibody in patients who received pairs of allograft from the same donor.Methods In Beijing Friendship Hospital.HLA antibodies were tested from October,2008 to April 2009 in patients.Recently (October,2013-February,2014),renal functions(serum creatinine/urea nitrogen)were studied in 226 patients who received transplant from 113 donors.LATM10x5,One Lambdas used for Panel reactive antibody screen-ing.Results 41 pairs of renal for male,21 pairs of renal for female and 51 pairs of renal for both male and female.PRA posi-tive in 26 patients (only 4 pairs of renal for patients were positive),11 recipients (HLA II antibody positive in only 1 pair of renal for patients)and 36 recipients (only 5 patients produced antibody)in 226 patients,HLA antibody positive in 73 pa-tients,in which renal function lost or decreased in 64 patients.HLA antibody negative in 153 recipients,in which renal func-tion lost or decreased in 4 patients.There was significant difference between the two group (χ2=160.70,P<0.001).Con-clusion HLA antibody is a important factor influence renal function and long term survival.

Objective To investigate the influences of HLA mismatching on renal function in the kidney transplant patients re-ceiving pairs of allograft from the same donor.Methods 171 pairs of renal transplant patients receiving the kidneys from the same donors were investigated.They were admitted in our hospital before 2008.Their human leukocyte antigens (HLA)were typed with the commercial polymerase chain reaction (PCR)-sequence-specific primers (SSP)HLA typing kit (One Lambda,Inc.,USA;and GTI Diagnostics,USA).The serum creatinine (SCr)and blood urea nitrogen(BUN)were measured in the clinical laboratory of our hospital.Results Among 171 pairs of renal transplant patients,there were 162 recipients with HLA mismatch≤4,in which the re-nal function was remained stable in 107 recipients and lost or decreased in 55 patients.There were 180 recipients with HLA mis-match >4,in which the renal function was stayed normal in 84 recipients and lost or decreased in 96 patients.The difference in in-fluencing the renal function between the HLA mismatch≤4 and HLA mismatch>4 had statistical significance (χ2 =12.22,P <0.05).Conclusion Excellent HLA typing match has important significance for renal long term survival.

Objective:To investigate the long-term efficacy of oral appliance treating of obstructive sleep apnea and hypopnea syndrome (OSAHS) in different periods of treatment.Methods:A total of 55 patients were included in the study.Patients were all diagnosed with OSAHS by overnight polysomnography and all received oral appliance (OA) as the therapy.The OA positioned the mandible at 60％-70％ of the maximal mandible advancement position and created a 4-5 mm incisor separation.The patients were instructed to wear the appliance during sleep,6-8 hours per day,for 5-7 days per week.They were divided into four groups by the period of treatment,including less than 1 year group;1-2 years group;2-6 years group and 6-9 years group.The polysomnographic study was used to investigate the efficacy of the four groups.The outcome measures included the score on the apnea-hypopnea index (AHI),the longest apnea time and the lowest oxygen saturation (LSaO2) levels during an overnight sleep.Results:The AHI decreased significantly in all the four groups.The less than 1 year group decreased from 24.50 (14.65,54.05) to 7.40 (2.12,10.00) events/h (P ＜ 0.001);The 1-2 years group decreased from 19.50 (12.15,39.23) to 1.80 (0.70,6.58) events/h (P =0.001);The 2-6 years group decreased from 25.00 (11.41,42.60) to 4.50 (1.35,7.90) events/h (P =0.001);The 6-9 years group decreased from 26.2 (16.95,47.45) to 4.00 (1.90,26.70) events/h (P =0.043).The longest apnea decreased significantly in less than 1 year group,1-2 years group and 2-6 years group.The longest apnea decreased from 57.00 (37.70,61.50) to 25.00 (15.90,33.50)seconds (P＜0.001) in the less than 1 year group,from 41.00 (25.50,62.26) to 13.10 (0.00,22.10) seconds (P =0.001) in the 1-2 year group and from 42.50 (30.35,58.15) to 15.60 (0.00,28.10) seconds (P =0.003) in the 2-6 year group.The LSaO2 levels increased significantly in the less than 1 year group and 2-6 years group.The LSaO2 levels rose significantly in the less than 1 year group,from 74.18％ ±7.96％ to 84.06％ ±7.67％ (P =0.001),and in the 2-6 years group,from 76.71％ ± 10.98％ to 84.06％ ±4.64％ (P =0.006),The LSaO2 levels did not increase significantly in the 1-2 years and 6-9 years groups.Kruskal-Wallis test showed that there were no statistically significant differences in the AHI,longest apnea time and LSaO2 in 4 the groups.Conclusion:The oral appliance is an effective therapy for patients with OSAHS in the long-term treatment.However,it's recommended to make appointments with patients as a follow-up supervision whether there is any efficacy decrease.And the oral appliance should be replaced if necessary.

Objective To study the HLA match rate of 222 living-related donors for kidney transplantation, and to give suggestions for clinical selection of suitable donors and recipients. Methods We analyzed the HLA match rate of 222 kidney transplantations from living relative donors from April 2006 to December 2008. There were 168 male recipients and 54 female recipients. The ages of 222 recipients ranged from 10 to 58. There were 133 male donors and 89 female donors. The ages of 222 recipients ranged from 21 to 64.Results The HLA-A, B, DR, DR, antigens of 87 kidney transplantations from living parental donors were half-matched, of which 14 were higher than half-matched. The HLA-A, B, DR, DQ antigens of 7 kidney transplantations from living children donors were half-matched, including 2 cases higher than half-matched.Among 56 kidney transplantations from living sibling donors, 12 cases were totally mated, 34 cases were half-matched, and the rest were less than half-matched or mismatched. Among 72 kidney transplantations from other living relative donors, 20 cases were higher than half-matched and 5 cases were completely mismatched. More than 4 HLA antigens in 6 cases were matched, but not half-matched. Three HLA antigens or less were matched in 41 cases. Conclusion The HLA match rates from living parental, children, or sibling donors were higher than other relative donors.

Objective To elaborate the role of hepatic inherent macrophages and monocyte-derived macrophages in acute liver injury.Methods A model of acute liver injury in mice was induced via intraperitoneally injection of CCl 4 .Af-ter CCl4 injection, analysis of the expression of CD45, F4/80, Ly6C and CD11b on the hepatic macrophage surface was performed by flow cytometry at 24, 48 and 72 h before the hepatic inherent macrophages (CD45+F4/80hi) and monocyte-de-rived macrophages ( CD45+F4/80 lo ) were sorted at the same time .The relative expression of cytokines in the two popula-tions of macrophages was detected by qRT-PCR.Results Compared with control , the number of total F4/80 +cells in the liver was markedly increased after CCl 4 injection, especially at 72 h.The number of CD45+F4/80lo cells increased signifi-cantly after CCl4 injection 24 h.The mRNA levels of MCP-1, TNF-α, TGF-β1, matrix metalloproteinase(MMP)-12 and MMP-13 were elevated significantly both in F 4/80 hi and F4/80 lo macrophages .IL-12βand IL-6 mRNA levels increased significantly only in F4/80hi macrophages, while the level of MMP-9 mRNA increased markedly only in F4/80lo macropha-ges.When compared with F4/80lo macrophages, MCP-1 and MMP-12 mRNA levels were elevated significantly , while the level of TNF-αmRNA decreased significantly in F4/80hi macrophages.Conclusion In acute liver injury, hepatic inherent macrophages and monocyte-derived macrophages both express inflammatory cytokines , promoting inflammation response and leading to liver damage .The ability to recruit inflammatory monocytes into the liver is much stronger ,the expression of in-flammatory cytokines ( IL-12βand IL-6 ) and MMP-12 is higher , but the expression of inflammatory cytokines ( TNF-α) MMP-9 is lower in hepatic inherent macrophages than in monocyte-derived macrophages .

@@

Complement system is a central part of the innate immune response that has developed as a first defense against non-self cells.Complement activation has traditionally been considered part of the body's immunosurveillance against cancer.However,recent studies have demonstrated that activated components of the complement system can assist the escape of tumor cells from immunosurveillance,promote angiogenesis,activate mitogenic signaling pathways,sustain cellular proliferation and insensitivity to apoptosis,and participate in tumor cell invasion and migration.This review reviewed the progress of complement activation and tumor immune surveillance and immune evasion,in order to provide a new strategy for antitumor immunotherapy.

Objective:To analyze the results of surgical treatment in patients with obstructed total anomalous pulmonary venous connection.Methods:Inclusion criteria: Patients with obstructed total anomalous pulmonary venous connection, who underwent surgical treatment in our hospital between December 2012 to January 2018. Exclusion criteria: (1)With complicated malformations, such as single ventricle and visceral inversion; (2)The maximum flow velocity of pulmonary vein was less than 1.2 m/s; (3)Had not underwent surgery. 57 patients[33 males and 24 females, age: (3.2±1.7) months, weight: (5.0±0.9) kg] were enrolled. There were four anatomical subtypes: supracardiac type(n=30), cardiac type(n=16), infracardiac type(n=5), and mixed type(n=6). Patients were followed up after operation.Results:During the follow-up of(52±21) months, 8 cases(14.0%, 8/57) died postoperatively. Postoperative pulmonary vein stenosis was present in 7 patients(12.3%, 7/57). The mortality of patients with postoperative pulmonary vein stenosis(57.1%, 4/7) was significantly higher than that of patients without postoperative pulmonary vein stenosis(8.0%, 4/50).Conclusion:The results of surgical treatment in patients with obstructed total anomalous pulmonary venous connection were encouraging, however, recurrent pulmonary venous stenosis still should be taken care.