Objective　To make clear the expression,role and receptor polymorphism of γ/δ T cells in peripheral blood in systemic lupus erythematosus (SLE).Methods　Total γ/δ T cells,Vγ1 and Vγ9/Vδ2 subsets in peripheral blood of 12 normal controls,12 active and 12 stable SLE patients was examined by using cytometry assay.Then,peripheral blood mononuclear cells (PBMC) were stimulated with γ/δ specific antigen.TCR γ/δ receptor expression and Vδ2 chain CDR3 (complementary determination region) length display analysis were investigated further in these patients using SSCP method.Results　The number of γ/δ T cells were remarkably decreased in active SLE patients,and the γ/δ T cells did not show proliferation after antigen stimulation in SLE.Vδ2 was expressed in all of the SLE patients.CDR3 of Vδ2 genes was polyclonally displayed.Conclusion　This result adds more weight to the protective role of γ/δ T cells in SLE.It is postulated that γ/δ T cells might have deficient function and act as suppressor T cells.But it appears that there are no specific antigens that stimulate γ/δ T cells to proliferate leading to the occurrence of SLE.

Objective To make clear the expression,role and receptor polymorphism of ?/? T cells in peripheral blood in systemic lupus erythematosus (SLE).Methods Total ?/? T cells,V?1 and V?9/V?2 subsets in peripheral blood of 12 normal controls,12 active and 12 stable SLE patients was examined by using cytometry assay.Then,peripheral blood mononuclear cells (PBMC) were stimulated with ?/? specific antigen.TCR ?/? receptor expression and V?2 chain CDR3 (complementary determination region) length display analysis were investigated further in these patients using SSCP method.Results The number of ?/? T cells were remarkably decreased in active SLE patients,and the ?/? T cells did not show proliferation after antigen stimulation in SLE.V?2 was expressed in all of the SLE patients.CDR3 of V?2 genes was polyclonally displayed.Conclusion This result adds more weight to the protective role of ?/? T cells in SLE.It is postulated that ?/? T cells might have deficient function and act as suppressor T cells.But it appears that there are no specific antigens that stimulate ?/? T cells to proliferate leading to the occurrence of SLE.

Objective To study the values of neck dissection for thyroid carcinoma who received nonstandard operation and help to choose good re-operation methods. Methods Retrospective investigation was carried out in 38 cases of neck dissection for thyroid carcinoma patients who received nonstandard operation during 1997 to 2005, and 32 cases were treated with neck dissection. Results Pathological results confirmed there were 73.68 % with residual tumor, positive rate of thyroid was 47.38 %, and that cervical lymph node was 57.89 %. Conclusion The residual rate of cervical lymph nodes of reoperated patients with thyroid carcinoma was relatively higher, so neck dissection for thyroid carcinoma who received nonstandard operation was necessary.

Objective To compare the treatment outcome of underwent surgery plus radiotherapy and radiotherapy/chemoradiotherapy plus salvage surgery for stage Ⅲ/Ⅳ laryngeal carcinoma,to investigate an optimized treatment for the patients of stage Ⅲ/Ⅳ laryngeal carcinoma.Methods Clinical data from 103 patients with stage Ⅲ (39 cases) or stage Ⅳ (64 cases) laryngeal carcinoma were retrospectively analyzed.The patients were divided into surgery plus radiotherapy group (S±R,46 cases) and radiotherapy/chemoradiotherapy plus salvage surgery group (R±S,57 cases).Overall survival,relapse free survival,and laryngeal preservation rate were used to compare the treatment outcome between two groups.Multivariate regression models were used to analyze the independent factors for survival and laryngeal preservation rate.Results Survival rate was higher in S±R group than in R±S group [2 year overall survival/relapse free survival 74.7 ％ (34/46) / 72.4 ％ (33/46) vs 46.4 ％ (26/57) / 40.9 ％ (23/57),P ＜ 0.05].Laryngeal preservation rate was higher in R±S group than in S±R group [93.0 ％ (15/46) vs 32.6 ％ (53/57),P ＜ 0.05].Multivariate analysis demonstrated that treatment modality and T stage were independent factors for long-term survival,while treatment modality was the only an independent factor for laryngeal preservation rate.Conclusions Surgery plus radiotherapy result in better survival and lower laryngeal preservation rate than radiotherapy/chemoradiotherapy plus salvage surgery in treatment of stage Ⅲ/Ⅳ laryngeal carcinoma.Surgery plus radiotherapy should be the first choice for treatment of locally advanced laryngeal carcinoma.Improvement of the quality of life could be achieved by laryngeal preservation surgery and phonation reconstruction procedures.

Objective:To study the use of left renal vein as a graft vessel in reconstruction after portal vein/superior mesenteric vein (PV-SMV) resection in pancreaticoduodenectomy.Methods:A retrospective study was conducted on 5 of these patients who underwent surgery from July 2008 to December 2017 at Chinese PLA General Hospital. The operative, complication and follow-up data were analysed.Results:There were 4 males and 1 female, with an average age of 57 (33-72) years. The mean operative time was 6.8 (5.4-9.1) h and the mean tumor size was 3.8 (2.8-4.8) cm. The average length of the PV-SMV defect left after resection was 3.8 (3.2-4.6) cm. The average length of the left renal vein used was 3.4 (3.0-4.1) cm. The operations were carried out in 3 patients with pancreatic cancer and in 2 patients with colon cancer pancreatic metastasis. The average postoperative hospital stay was 12 (10-25) days. Perioperative complications included 1 patient each with ascites, diarrhea and delayed gastric emptying. The creatinine levels ranged from 70-98 μmol/L preoperatively, with a transient creatinine rise to 80-156 μmol/L after operation and became 62-107 μmol/L upon discharge from hospital. The follow-up time was 4.3-17.8 months. Two patients died of recurrence/metastasis at 14.2 and 17.8 months after surgery.Conclusions:The left renal vein has the appropriate diameter and rich collateral branches. It has a sufficient length and it is conveniently located in the surgical field. This study showed that there was a minimal effect on renal function after its excision, and it can be used as a graft vessel for reconstruction in pancreaticoduodenectomy after PV-SMV resection.

Objective To indentify Streptobacillus moniliformis isolated from the knee joint pus by 16S rRNA gene sequencing and biochemical reactions and explore the clinical value of the method. Methods The bacterial 16S rRNA gene sequence-based identification, bacterial morphology, VITEK 2 automate systems, API 20NE strips, API 20E strips and API 50CH were performed to identify the rare bacteria. Results The bacteria grew slow on blood agar and chocolate agar and were inhibited on Maconkey agar. The bacterial colony on blood agar tookes the form of 1~2 mmomelette, which was translucent and moist with circular protrusion and smooth edges. They were Gram-staining negative and in catenation, its thalli 1~3μm, round, oval or fusiform. Vitek 2 GN-13, API 20NE and API 20E were unable to reach the identification of the bacteria. 16S rRNA gene sequencing showed the bacteria were similar to streptobacillus moniliformis by 100%. Conclusion The rare bacteria isolated from left knee joint are streptobacillus moniliformis. 16S rRNA gene sequences combined with the biochemical reactions is accurate in the identification of these bacteria.

[ABSTRACT]OBJECTIVEThis study was designed to compare the quality of life between patients who
underwent a tongue reconstruction with radial forearm flap (RFF) and infrahyoid myocutaneous flap (IHMCF) after hemiglossectomy for their tongue cancers, and to figure out an optimal reconstructive method for the defects resulted from hemiglossectomy.METHODSA non-randomized case-control study was performed on 24 patients with tongue squamous cell carcinoma who underwent a standard hemiglossectomy combined with perfectly tongue reconstruction from June 2005 to June 2012. All of the cases were without tongue base invasion. Of the 24 cases, 19 had T2 disease, 5 had T3 disease, and they were divided into RFF group (n=10) and IHMCF group (n=14). The quality of life were evaluated one year after operation using EORTC-QLQ30 and FACT-H&N35 and compared between the two groups.RESULTSThe scores were comparable between the two group with regard to all domains of EORTC-QLQ30,with all P values>0.05.The scores of swallowing(P=0.005), speech (P=0.008), teeth (P=0.014), and cough (P=0.009) domains were significantly higher in IHMCF group than in RFF group, with P value of 0.005, 0.008, 0.014 and 0.009 respectively, while the other domains of FACT-H&N35 were comparable between the two groups, with allP values>0.05.CONCLUSIONOverall quality of life was similar in the two groups. Oral function domains were better in IHMCF group than in RFF group. When guarantee of flap survival is available, IHMCF could be used as a good alternative flap to RFF in tongue reconstruction after hemiglossectomy.

Objective To report the clinical results and the advantages/disadvantages of anterolateral thigh flap (ALT) and forearm flap (FAF) in reconstruction of head and neck defect after cancer ablation. Methods 20 FAFs and 12 ALTs were performed to repair the head and neck tumor ablation defects. Of the 20 FAFs, 7 were used for repair of the through and through buccal defects, 4 for circumferential bypopharyngeal defects, 2 for plate defects, 1 for parotid area skin defect, 4 for floor of the mouth defects, and 2 for defect, of the base of the tongue, while of the 12 ALTs, 3 were used for repair of the defects of the base of the tongue, 4 for plate defects, and 5 for the floor of the mouth and/or lower gum defects. Survival of the flaps, function of the recipient site, and impact to the donor site were compared between these two groups to analyze the advantages/disadvantsges and key technique details of these two flaps. Results 19 FAFs totally survived. Vascular crisis occurred in 2 cases of FAF, of which 1 flap survived after conservative treatment, while the other 1 developed partial necrosis. All the 12 ALTs survived, without vascular crisis. 2 of the 14 planed ALTs were abandoned and replaced by FAFs, of which 1 because of absence of the perforating branch and the other 1 because of injury of the perforating branch. Secondary defects of the ALTs could be closed primarily, while secondary defects of the FAFs should be closed with skin grafts. Conlusion Both ALT and FAF can be performed with high survival rate. Each has its own advantages. Selection of the donor site deponds on situation of the defect and purpose of the reconstruction.

ObjectivesTo identified the strain 1012 from the National Center of Clinical Laboratory of China for microbe inter-laboratory quality assessment in 2010, and study the taxonomic status of strain 1012 and related species in the genus Actinomyces. Methods The bacterial traditional morphological characteristics, commercial API systems, and 16S rRNA gene sequence analysis were applied to identify the problematic culture of strain 1012. The phylogenetic tree based on the remote information of the prokaryotes systems was constructed to study the taxonomic status and evolutionary relationship of the genus Actinomyces and related species in the family Actinomycetaceae. Results Strain 1012 was determined as a kind of facuhative anaerobic,non-spot-forming,Gram-positive coryneformbacteria,which was identifiedto Actinomyces turicensis for the phenotypic biochemical characteristics of more than 60 items, The comparative study of 16S rRNA gene showed the strain 1012 with 99. 8％ similarities to Actinomyces turicensis, but only 90. 6％ to the type species of Actinomyces bovis in the genus Actinomyces. However, the comparative study of 16S rRNA gene showed the strain 1012 with only 90. 6％ homology to the type species of Actinomyces bovis in the genus Actinomyces. Further phylogenetic analysis showed that nine independent clusters were grouped in the family Actinomycetaceae, of which four clusters were separately represented the genera Varibaculum,Mobiluncus, Actinobaculum and Arcanobacterium, while other five clusters all were designated to the genus Actinomyces. The study showed strain 1012 was located in genus Ⅲ of Actinomyces, yet with a relatively long genetic distance to Actinomyces bovis. ConclusionThe genus Actinomyces may be reclassified as one genus Actinomyces sensu stricto and several new genera for the genotypic characteristics.

Objectives Use ITS gene sequence analysis to identify 15 strains of dematiaceous fungi , to learn the types of pathogenic strains and clinical treatment. Methods By observing the colony morphology and microscope morphological of the dematiaceous fungi isolated from superficial mycoses , and identified by ITS gene sequence analysis. Results 15 strains were identified by morphological observation as dematiaceous fungi.The amplified bands were identified by Tanon-3500 gel imaging system between 500 ~ 700 bp. Blast sequencing results show that 2 strains Alternaria alternate , 2 strains Cladosporium sphaerospermum. 2 strains Exophiala dermatitis, 1 strains Cladosporium cladosporioides, Curvularia lunata, Talaromyces rugulosus, Phaeobotryon cupressi, Cladosporium tenuissimum, Fonseceea pedrosoi, Exophiala werneckii, Exophiala oligosperma and Fonsecaea monophora. Conclusion ITS gene sequence analysis can identify dematiaceous fungi effectively , avoided undetected and misdiagnose cause by the lack of clinical experience.