Cytokeratins can maintain the morphous and function of normal cells. Clinically, cytokera-tins are used to diagnose several tumors as tumor markers. Recently, numerous studies indicate that the abnor-mal expression, mutation in the site of phosphorylation and hyperphosphorylation have relationship with the mechnism of tumorigenesis. Reseach of the relationship is important for the diagnosis, therapy and prognosis of tumor.

Adult ; Chromosome Aberrations ; drug effects ; Ethylene Oxide ; poisoning ; Humans ; Lymphocytes ; drug effects ; pathology ; Male ; Micronuclei, Chromosome-Defective ; drug effects

Objective To evaluate the therapeutic effect of narrow band-ultraviolet B (NB-UVB) alone or in combination with interferon-alpha-2b (INF-alpha-2b) for mycosis fungoides (MF),and to assess the correlation between the therapeutic effect and peripheral blood regulatory T (Treg)/T helper type 17 (Th 17) cells.Methods Thirty-three patients with stage ⅠA to ⅡA MF were randomly divided into two groups:NB-UVB group (n =15) receiving NB-UVB radiation alone,combined group (n =18) treated with NB-UVB radiation and intramuscular injection of INF-alpha-2b.Ten healthy volunteers were selected as the control group.Peripheral blood samples were collected before and 9 months after the start of treatment.Flow cytometry was performed to determine the percentages of Treg cells and Th17 cells.Statistical analysis was carried out by using t test,one-way analysis of variance,and Fisher's exact test.Results The average treatment duration was 9 months among these patients.Therapeutic outcomes were significantly better in the combined group than in the NB-UVB group (P =0.023).Among the 15 patients in the NB-UVB group,6 achieved complete remission,3 partial remission,6 showed no response;of the 18 patients in the combined group,12 experienced complete remission,5 partial remission,and 1 showed no response.Before the treatment,the percentages of both Treg and Th17 cells in peripheral blood were significantly higher in the NB-UVB group and combined group than in the control group (both P ＜ 0.05),but similar between the NB-UVB group and combined group (both P ＞ 0.05).After the treatment,the percentages of both Treg and Th17 cells in the NB-UVB group and combined group significantly decreased compared with those before the treatment,but were still higher than those in the control group (both P ＜ 0.05).Additionally,the degree of decrease in the percentages of Treg and Th17 cells was significantly greater in the combined group than in the NB-UVB group (both P＜ 0.05).The seven patients with no response also showed a significant decrease in the percentage of Treg cells (P ＜ 0.05),but no obvious changes in that of Th 17 cells (P ＞ 0.05) after the treatment.Conclusions The therapeutic effect of NB-UVB radiation combined with intramuscular INF-alpha-2b is superior to that of NB-UVB radiation alone for MF,which may be associated with the degree of decrease in peripheral blood Treg and Th 17 cells.

Objective:To investigate the expression and clinical significance of effector T cell (Teff), regulatory T cell (Treg) and their cytokines in patients with vitiligo.Methods:84 patients with vitiligo (38 cases in stable stage, 46 cases in advanced stage) who were admitted to the Dermatology Department of the Dezhou People's Hospital between June 2018 and June 2019 and 30 healthy people (control group) were enrolled in the study. The levels of Teff subsets and Treg cells in peripheral blood were detected by flow cytometry. The levels of Teff subsets and Treg cells-associated cytokines were detected by enzyme-linked immunosorbent assay (ELISA). The relationship between Teff subsets and Treg cells levels in peripheral blood, relationship between Teff subgroups, Treg cells-associated cytokines and course of vitiligo, skin lesion area were analyzed.Results:The levels of T helper cell (Th)17 and Th22 in peripheral blood of vitiligo group were significantly higher than those of control group, while levels of Treg cells were significantly lower than control group ( P<0.05). Compared with the stable vitiligo group, the levels of Th17 and Th22 in peripheral blood were higher and levels of Treg cells were lower in the advanced vitiligo group ( P<0.05). Treg cell level was negatively correlated with Th17 cell level ( r=-0.303, P=0.001), and negatively correlated with Th22 cell level ( r=-0.200, P=0.033). The levels of serum interleukin (IL)-17 and IL-22 in vitiligo group were significantly higher than those in control group, while the level of transforming growth factor-β (TGF-β) was significantly lower than that in control group ( P<0.05). Compared with the stable vitiligo group, levels of serum IL-17 and IL-22 were higher and level of TGF-β was lower in the advanced vitiligo group ( P<0.05). Correlation analysis showed that levels of IL-17 and IL-22 were positively correlated with skin lesion area ( r=0.361, 0.288, P<0.05), and level of TGF-β was negatively correlated with skin lesion area ( r=-0.312, P<0.05). Conclusions:Teff/Treg cells are unbalanced in patients with vitiligo, showing obvious shift to Teff subsets. The progression of vitiligo may be related to Teff subsets and Treg cells-associated cytokines.

BACKGROUND:YY1 is mainly expressed in the undifferentiated epidermic cells in mouse basal lamina, and the expression level is gradual y down-regulated as the differentiation towards suprabasal lamina. The differential expression indicates that, YY1 is one of the regulators in the process of epidermic cells differentiation.
OBJECTIVE:To observe the effects of YY1 over-expression on the differentiation of HaCaT cells infected with lentivirus.
METHODS:Lentivirus-YY1 was transferred into the HaCaT cells by using Lipofectamine 2000. After selection of the puromycin, monoclonal celllines were established, and the control group were lentivirus-infected HaCaT cells and uninfected HaCaT cells. The expression of YY1 was detected by using western blot analysis. cells in Lentivirus-YY1-HaCaT group and HaCaT-YY1 group were further divided into two subgroups according to the calcium concentration in culture medium, cells were either cultured in low-calcium medium (0.12 mmol/L) for 48 hours, or cultured in low-calcium medium (0.12 mmol/L) for 24 hours and in high-calcium medium (0.35 mmol/L) for additional 24 hours. Keratin K1, K10, K14, and involucrin, filaggrin and loricrin after over-expression of YY1 were detected with western blot analysis.
RESULTS AND CONCLUSION:The HaCaT cells were successful y infected with lentivirus-YY1, and we obtained over-expression of YY1 protein in monoclonal celllines under high-calcium concentrations, the over-expressed YY1 could decrease the expression of K1, involucrin and loricrin, thereby preventing the process of epidermal keratinocytes and maintaining the cells in an undifferentiated state. Lentivirus can efficiently infect human immortalized epidermal cellHaCaT, and YY1 may the important factor of inhibiting the differentiation of basal epidermal cells and maintaining the undifferentiated proliferation status.

Objective To investigate the application value of spatio-temporal image correlation (STIC) combined with tomographic ultrasound imaging(TUI) in the prenatal diagnosis of conotruncal defects(CTD).Methods Two-dimensional(2D) fetal echocardiography to screen and TUI-STIC volumes from 1508 cases of fetuses of high risk with congenital heart disease.Postnatal work-up and pathological results were available for all fetuses with CTD.Results Thirty nine cases with CTD were found by TUI-STIC while thirty five cases were found by 2D echocardiography,but TUI-STIC had new findings and corrected the diagnosis in 9 cases as compared with 2D echocardiography.The sensitivity,specificity,positivity predictive value,negative predictive value and accuracy of TUI-STIC in evaluating CTD were 97.5 ％,100％,100 ％,99.9 ％ and 99 ％.The Kappa value of consistency test between 2DE and TUI-SIC was 0.244(P ＜ 0.01),McNemar test showed that the difference was statistically significant (P ＜ 0.01).Conclusions TUI-STIC allows a complete sequential analysis of fetal conotruncal defects and supplying additional information over 2D fetal echocardiography,it could improve the prenatal diagnosis rate.TUI-STIC is helpful in diagnosis of prenatal conotruncal defects.

Objective To investigate the changes of T helper type 17 (Thl7) cells and regulatory T (Treg) cells in different stages of mycosis fungoides.Methods Flow cytometry was performed to determine the percentage of Treg and Th17 cells in peripheral blood from 28 patients with mycosis fungoides (MF),13 patients with large plaque parapsoriasis (PP),17 patients with lichen planus (LP) and 10 healthy human controls,and immunohistochemistry to detect the expressions of forkhead box protein 3 (FOXP3) and interleukin (IL)-17 in tissue specimens from 40 patients with MF,13 with PP,17 with LP and 10 healthy human controls.Statistical analysis was carried out by one-way analysis of variance and Pearson correlation analysis.Results As far as the percentage of Treg cells in peripheral blood was concerned,MF,PP and LP patients were significantly higher than the healthy controls (8.09％ ± 1.68％,6.53％ ± 1.67％ and 2.84 ％ ± 1.16％ vs.1.01％ ± 0.35,all P＜ 0.05),PP patients were higher than LP patients and healthy controls (both P ＜ 0.05),and LP patients were higher than healthy controls (P ＜ 0.05).The percentage of Th17 cells in peripheral blood was significantly increased in MF patients compared with PP patients,LP patients and healthy controls (3.22％ ± 0.82％ vs.2.46％ ± 0.79％,1.38％ ± 0.47％ and 0.59％ ± 0.30％,all P ＜ 0.05).Elevated expression rate of FOXP3 was observed in MF,PP and LP lesions as compared with normal skin (14.94％ ± 4.46％,11.95％ ± 4.72％,6.32％ ± 2.81％ vs.3.43％ ± 1.79％,all P ＜ 0.05),and in MF and PP lesions compared with LP lesions (both P ＜ 0.05),but no significant difference was observed between MF and PP lesions (P ＞ 0.05).There was a significant increase in the expression rate of IL-17 in MF lesions compared with PP lesions,LP lesions and normal skin (15.89％ ± 4.27％ vs.12.02％ ± 3.34％,4.84％ ± 1.93％ and 2.62％ ± 0.89％,all P ＜ 0.05).The Th17/Treg ratio in peripheral blood was significantly lower in MF and PP patients than in LP patients and healthy controls (0.41 ± 0.11 and 0.39 ± 0.12 vs.0.50 ± 0.06 and 0.57 ± 0.19,all P ＜ 0.05).A positive correlation was observed between the proportion of Thl7 cells and Treg cells (r =0.423,P ＜ 0.05) in patients with early-stage MF,but not in those with tumor-stage MF.The proportion of Th17 cells decreased,but that of Treg cells continuously increased in patients with tumor-stage MF.However,no significant difference was noted in the proportion of Thl7 cells or Treg cells among patients with different stages of MF.Conclusion The imbalance between Treg and Th17 cells may be involved in the occurrence and development of MF.

Objective To compare the treatment response of plasma exchange and immunoadsorption for children suffering from severe systemic lupus erythematosus (SLE),and then find the more advantageous treatment method.Methods Between March 2007 and March 2013,27 children with severe SLE were collected from the Department of Pediatric Nephrology and Rheumatology of Shengjing Hospital of China Medical University.Part of them about 11 children accepted plasma exchange treatment (plasma exchang group) and the others accepted immunoadsorption(immunoadsorption group).The clinical features,ANA,IgG,serum ions,the cost of treatment and the hospitalization time were reviewed,and the comparative analysis were performed in two groups.Results There were comparabilities between plasma exchange group and immunoadsorption group in age,gender,couse of disease and systemic lupus erythematosus disease activity index(SLEDAI) score before treatment.(1)In plasma exchang group,11 children were conducted 26 times treatment.The SLEDAI score significantly decreased after plasma exchange (19.00 ± 3.77 vs 5.34 ± 4.35,P ＜0.05),and the ANA and IgG significantly decreased as well[2 439.58 ± 1 430.56 vs 303.54 ± 169.32; (8.35 ± 5.67) g/L vs (4.04 ± 2.23) g/L,P ＜ 0.05].(2) There were 16 children in immunoadsorption group,they accepted immunoadsorption treatment about 44 times.The SLEDAI score after immunoadsorption significantly decreased (18.25 ± 4.62 vs 4.25 ± 2.23,P ＜ 0.05),and the ANA and IgG significantly decreased as well [2 560.39 ± 1 563.78 vs 289.62 ± 137.62 ; (9.98 ± 6.03) g/L vs (3.23 ± 1.37) g/L,P ＜0.05].(3) There were no statistical differences in the value of SLEDAI score,ANA and IgG after the treatment between two groups.(4) The concentrations of serum potassium,sodium and chlorine and calcium in the children treated by plasma exchange or immunoadsorption were consistent with the original.(5) The hospitalization expense in plasma exchange group was distinctly higher than that of immunoadsorption group (P ＜ 0.05).(6) There was no significant difference in the length of hospitalization between two groups [(33.6 ± 8.60) d vs (31.9 ± 14.6) d,P ＞ 0.05].Conclusion The treatment both plasma exchange and immunoadsorption were effective methods for the children with severe SLE.However,the cost of plasma exchange was much higher and had a great influence on the concentration of antihypertensive drugs.

Objective To evaluated the role of postoperative radiotherapy (PR) after surgery in patients with uterine sarcoma,and analyzed the prognostic factors.Methods A total of 182 patients with uterine sarcoma were included between June 1994 and October 2014.Radiotherapy dose were 30-50 Gy/10-25 fractions/5 fractions/week.The LRFFS and OS were calculated with Kaplan-Meier method,and difference was analyzed with log-rank method.Cox regression analyses were used to determine prognosticators.Results There were 114 patients which survived more than 5-years in this whole group,including PR 24 cases and no PR 90 cases.The 5-year LRRFS and OS were 62.1％ and 56.2％,respectively.The 5-year LRRFS were 78.0％ and 55.3％ on PR and no PR (P=0.013);with OS 64.1％ and 51.7％ on PR and no PR (P=0.070).A multivariate analysis showed that pathological types,histological grade and clinical stage were associated with LRRFS and OS (P=0.032,0.008,0.000 and 0.046,0.000,0.000).PR was significant influencing factor for OS (P=0.013).Conclusions Uterine sarcoma patients treated with PR after surgery had an improved LRRFS compared to those treated with surgery,especially those with leiomyosarcoma.The role of PR personalized radiation for uterine sarcoma still needs to be further discussed.

Objective To identify uropathogens responsible for urinary tract infection in children less than 5 years of age and determine the antibiograms.Methods The data of 523 children(2 months to 5 years old) admitted at the Shengjing Hospital of China Medical University from January 2008 to December 2013 were studied retrospectively.Results Out of 523 children suffering from urinary tract infection,54 (10.3％) were complicated urinary tract infection,including 24 vesicoureteral reflux,8 ureter-pelvic junction stenosis,5 hydronephrosis,4 double kidneys,2 renal dysplasia,2 bladder diverticula,2 bladder ear,2 neurogenic bladder,1 urethral vaginal fistula,1 congenital megaureter,1 horseshoe kidney,and 1 Ureteral cyst and stone.A total of 487 cases underwent urine culture,207 (42.5 ％) had positive bacterial growth,the gramnegative bacteria accounted for 94.69％,gram-positive bacteria 5.31％.E coli was the most common uropathogens in gram-negative bacteria (79.23 ％),the second was Klebsiella (5.31％),the third was Proteus mirabilis(2.90％).Gram-positive bacteria was almost Enterococcus (4.35％).Twenty one strains were extended-spectrum beta-lactamase enzyme positive(ESBLs +),and they were sensitive to imipenem,amikacin and piperacillin/tazobactam.Conclusion The clinical features were atypical in children with urinary tract infection,we should investigate the underlying causes such as urinary anomalies or stones.E coli was still the most common uropathogens in children with urinary tract infection,the empirical therapy should according to the patient's conditions while awaiting the culture and sensitivity results.