Objective To explore the characteristics and regulations of CD28 and CTLA-4 expressions in the process of mice' T-cell inefficiency induced by staphylococcal enterotoxin A(SEA).Methods Twelve mice were averagely divided into three groups(4 each).The mice in group 1 received single injection of SEA,and the mice in group 2 and 3 received SEA injection twice and three times,respectively,with a 3 days interval.Mice were sacrificed at day 1,3,7 and 14 after the last injection,and then the splenic lymphocytes were isolated.The expressions of CD28 and CTLA-4 in cellular membrane and the intracellular expressions of CTLA-4 and IL-2 were detected with flow cytometry.Results In group 1,the CD28 expression in cellular membrane and the intracellular expression of IL-2 were significantly up-regulated,while the CTLA-4 expressions both in cellular membrane and intracellular expression were lower with no obvious changes.In group 2,the expressions of both CD28 and IL-2 were up-regulated slightly,the expressions of CTLA-4 increased significantly both in cellular membrane and intracellular expression,even more increase was the intracellular CTLA-4 expression.In group 3,the expressions of CD28 and CTAL-4 in cellular membrane and the intracellular CTLA-4 expression declined,and at day 7 the intracellular IL-2 expression was undetectable.Conclusions SEA may obviously promote the activation of naive T-cells when initially used to induce the splenic lymphocytes,while multiple stimulations(e.g.3 times) of SEA may lead T-cells to anergy.On the process of inefficiency,the declined IL-2 production may be closely related to the down-regulation of CD28 expression;the up-regulation of CTLA-4 expression may profit inducing inefficiency,but is not on the maintenance of inefficiency.

OBJECTIVE: To study the regulatory effect of IL-35 on the balance of Treg/Th17 cells in AR patients. METHOD: In this study, 30 cases were randomly selected from outpatients of otolaryngological department in the second hospital of Hebei Medical university who were diagnosed as AR. Another 20 healthy cases enrolled from physical examination branch of our hospital were control group. The expression level of IL-35 and IL-17 in peripheral blood were detected by using ELISA and defeced CD4+CD25+Foxp3+ T cell and CD4+IL-17+T cell expression level were identified via flow cytometry. RESULT: The expression level of IL-35 in AR group was obviously lower than that in control group, and the difference was a statistically significance (t = -8.145, P < 0.01). The expression level of IL-17 in AR group was obviously higher than that in control group, and the difference was a statistically significance (t = 14.969, P < 0.01). There was a remarkable negative correlation between the IL-35 and IL-17 expression in the serum of AR group (r = -0.773, P < 0.01). The percentage of CD4+CD25+Foxp3+ T cell in CD4+ T cell was significant lower in AR group than that in control group (t = -13.678, P < 0.01). The percentage of CD4+IL-17+ T cell in CD4+ T cell was much higher in AR group than that in control group (t = 5.632, P < 0.01). There was a remarkable negative correlation between the Treg and Th17 expression in the peripheral blood of AR group (r = -0.613, P < 0.01). There was a positive correlation between the expression of CD4+ CD25+Foxp3+ T cell and IL-35. There was a negative correlation between the IL-35 and Th17 in AR group (r = 0. -594, P < 0.01). CONCLUSION The lower expression of IL-35 was related to the incidence of AR, and it was an important cytokines for that. The lower expression of IL-35 may inhibit the proliferation of Treg cells, lead to hyper function of Th17 cells, increase secretion of s IL-17 and result in unbalance of Treg/Th17 cells; these may be the important mechanism of the occurrence of AR, thus regulation of IL-35 may become a new target for the immunological therapy of AR.
Case-Control Studies ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Humans ; Interleukin-17 ; blood ; Interleukins ; Rhinitis, Allergic ; immunology ; T-Lymphocytes, Regulatory ; immunology ; Th17 Cells ; immunology

Objective: To explore the influence of body mass index (BMI) on postoperative complications and survival in patients with esophageal squamous cell carcinoma (ESCC) using propensity score matched (PSM) methods. Methods: We retrospectively analyzed clinical data of 533 patients with ESCC who were admitted for thoracic surgery in Shandong Provincial Hospital, between January 2011 and December 2012. After conducting PSM methods to balance the covariates, the incidence of postoperative complications and sur-vival rate were compared between the two groups. The effects of BMI on postoperative complications and survival were analyzed with multivariate Logistic regression and Cox proportional hazard analyses, respectively. Survival analysis was performed using Kaplan-Mei-er curves and Log-rank test. Results: After adjusting the PSM and confounding variables, the two groups were well matched (146 pa-tients each) without significant differences in baseline characteristics. The incidence of wound infection and respiratory system compli-cations in the H-BMI group (BMI≥25 kg/m2) were significantly higher than those in the N-BMI group (18.5-25 kg/m2) (P<0.05). H-BMI was an independent risk factor for wound infection and respiratory system complications. In the present study, no significant differ-ence was observed in the 3-year overall survival between H-BMI and N-BMI patients (54.1% vs. 47.8%, P=0.212). Patients with H-BMI had significantly better 5-year overall survival than those with N-BMI (39% vs. 25%, P=0.016). The subgroup analysis showed that pa-tients with H-BMI had a better overall survival than those with N-BMI in stages Ⅰ-Ⅱ (47.3% vs. 29.0%, P=0.032). However, this difference was not significant when patients were stratified into stages Ⅲ and Ⅳ (24.5% vs. 16.7%, P=0.393). Conclusions: H-BMI appears not to decrease the overall survival of patients with ESCC. Therefore, ESCC in patients with H-BMI can receive surgical treatment safely, but proper intraoperative management and close postoperative monitoring should be performed.

Objective To evaluate the effectiveness of peer support interventions on exclusive breastfeeding among primiparous women. Methods Randomized controlled trials (RCTs) that reportedthe effectiveness of peer support interventions on exclusive breastfeeding among primiparous women were retrieved in several electronic databases. Data were analyzed using RevMan 5.3 software after quality assessment and data extraction. Results A total of 9 RCTs which included 1435 patients were incorporated in this meta-analysis. The meta-analysis revealed that peer support interventions could increase the rate of exclusive breastfeeding(OR=2.84, 95％CI2.22-3.64, P<0.01), increase duration of exclusive breastfeeding(WMD=43.66, 95％CI28.04-59.27, P<0.01). Subgroup analysis showed that peer support increased the rate of exclusive breastfeeding atone month(OR=1.84,95％CI1.24-2.73, P<0.01), three months(OR=2.28, 95％CI1.67-3.12, P<0.01)and six months(OR=3.42,95％CI2.46-4.76, P<0.01) of postpartum. Conclusions Peer support interventions could increase exclusive breastfeeding rate and duration of exclusive breastfeeding. It is worth being popularized.

The clinical data of a case of diabetic ketoacidosis with FOXP3 mutation identified by genetic test were collected and summarized. The follow-up results and clinical characteristics of 18 months after hematopoietic stem cell transplantation were analyzed. The male patient was 3 years and 5 months old. At the age of 5 months, the patient was diagnosed as diabetic ketoacidosis due to mental malaise and vomiting, followed by severe diarrhea, repeated eczema, and nephrotic syndrome, which was confirmed as IPEX syndrome due to FOXP3 gene mutation by genetic test. In August 2018, hematopoietic stem cell transplantation was carried out in the Hematology Department of our hospital. During 18 months of follow-up, the patients′ autoimmune status was ameliorated, no new autoimmune diseases appeared, the blood glucose control was significantly improved, and the insulin dosage was significantly reduced.

Objective: To analyze and summarize the clinical and molecular characteristics of the patients with multiple congenital anomalies- hypotonia-seizures syndrome 1 (MCAHS 1). Method: Clinical data and test results were collected from a patient who was diagnosed with confirmed genetic basis of MCAHS 1 in Shanghai Children′s Medical Center since December 2015. The patient and his parents were examined by the next generation sequencing (NGS) technology using peripheral blood genomic DNA, and the relevant mutations identified by NGS were verified with Sanger sequencing. Related literature was searched from PubMed and Embase databases (from their establishment to January 2017) by using "PIGN gene" as a keyword, the retrieved articles were further reviewed for the clinical manifestations, results and prognosis of PIGN related variants. Result: A nearly 4-month-old Chinese boy was presented with epilepsy, hypotonia, developmental delay, accompanied by nearly normal laboratory test results. The NGS analysis revealed a compound heterozygous variations in the PIGN gene, included a known splice site mutation (c.963G>A) which was inherited from his father, and a novel nonsense mutation (c.2773A>T, p.Lys925*) which was inherited from his mother. Nine associated articles were retrieved. Including our patient, a total of 22 cases were identified as the PIGN variants. The most common clinical manifestations were developmental delay, hypotonia, and epilepsy.Missense varients were most frequently found. Prognosis was poor. Eight cases died, while survived cased suffered from refractory epilepsy, profound mental retardation, muscle weakness, etc. Conclusion MCAHS1 is characterized by epilepsy, severe developmental delay, hypotonia, and may be accompanied by multiple malformations of other systems. Homozygous or compound heterozygous variants in PIGN gene are the cause of the disease.

OBJECTIVETo analyze clinical manifestations and genetic mutation in a child with severe short stature and other malformations.

METHODSThe child has undergone history taking and physical examination. Genome DNA was extracted from peripheral blood samples of the proband and her family members. Candidate genes were captured with Agilent SureSelect and sequenced on an Illumina platform. Suspected mutation was verified by Sanger sequencing.

RESULTSThe patient, a six-year-and-10-month old girl, presented with non-symmetrical short stature, dysmorphism, abnormalities of limbs and spine, amblyopia of left eye, and cataract of right eye, in addition with frequent respiratory infection and micturition. Laboratory testing suggested 25-hydroxy vitamin D deficiency (18.9 ng/mL). Spine X-ray showed multiple malformations with centrums. Her mother also featured short stature (138 cm). Her aunt had short stature (130 cm) and limb-length discrepancy. Her little brother was 2.5 years old, and his height was 81 cm (-3.4 SD). Exome sequencing revealed a heterozygous mutation c.184C to T (p.Arg62Trp) in the proband and her mother. The same mutation was not found in her father and brother.

CONCLUSIONThe patient was diagnosed with X-linked chondrodysplasia punctata 2. Mutation of the EBP gene probably underlied the disease in this family.