Objective To discuss the correlation of P-glycoprotein(P-gp) and lymphocyte subgroup(CD4+,CD8+) in patients with immune thrombocytopenia.Methods A total of 20 patients with immune thrombocytopenia were selected from August 2015 to September 2016 in the Eighth Hospital Affiliated to Sun Yat-sen University.According to the platelet count,all patients were divided into mild group and severe group,20 cases of health persons were selected at the same period as the healthy group,flow cytometry technique was used to detect the plasma lymphocyte subsets(CD4+,CD8+) and P-gp level of all the objects.Pearson correlation analysis was used to analyze the relationship between plasma P-gp and plasma CD4+,CD8+,CD4+ / CD8+ level,analyzed all the objects plasma platelet count,P-gp and CD4+,CD8+,CD4+ / CD8+ levels.Results Plasma CD4+,CD8+,CD4+ / CD8+ and P-gp level of severe group were significant higher than those of mild group(t=3.587,2.957,2.315,2.646,P<0.05),plasma CD4+,CD8+,CD4+ / CD8+ and P-gp level of mild group patients were significant higher than those of healthy group(t=5.479,2.921,4.536,7.750,P<0.05).Pearson correlation analysis results showed that the plasma levels of P-gp and plasma CD4+,CD8+,CD4+ / CD8+ levels were positively correlated(r=0.683,0.617,0.548,P<0.05).Conclusion Plasma CD4+,CD8+,CD4+/CD8+and P-gp level is associated with immune thrombocytopenia patients condition,plasma levels of P-gp closely links with abnormal immune function in patients with hyperthyroidism,prompting detection the level of change could help doctors to assess patients medication curative effect.

Objective To evaluate surgical therapies in patients with popliteal aneurysms (PA).Method The clinical data of 25 PA patients admitted from January 1988 to January 2012 were retrospectively analyzed.There were 21 men and 4 women,the mean age was (56 ± 16)years.There were 27 PA in these 25 patients,with bilateral PA in 2 cases.The main symptoms were pulsatile mass in the popliteal fossa,limb pain,acute or chronic distal limb ischemia and limb edema.Result In this series 23out of 25 PA cases recieved operations,17 of them were treated with aneurysmectomy and saphenous vein interposition or bypass grafting,4 of them were treated with aneurysmectomy and prosthetic grafts interposition,1 was treated with aneurism ligation and 1 underwent end-to-end anastomosis after aneurysm resection.There was no perioperative mortality.One patient recieved amputation for distal anastomotic thrombosis and severe limb ischemia.The mean follow-up time is (6.5 ± 0.5) years.After 4 years,a right subclavian artery aneurysm was found in a bilateral PA case and treated surgically.Conclusions Early elective surgical treatment is recommended for patients with PA because PA may go rupture or induce dital limb ischemia and these patients may have good outcome after surgical treatment.Long-term follow-up is warranted to detect the new aneurysm formation.

The pediatric reference intervals in clinical laboratory play an important role in diagnosis of illness,therapeutic monitoring,prediction of prognosis and health evaluation.Compared with establishing reference interval for adults,there are more challenges to establish pediatric reference intervals.Therefore,the procedure and key technologies of direct method and indirect method are stated based on the characteristics of children population and pediatric,by which to define,transfer and validate pediatric reference intervals.This study will provide systematically methodological ideas for clinical laboratories to establish pediatric reference intervals.

Objective To evaluate the clinical value and effect of biofeedback training therapy for functional constipation in elderly patients.Methods A total of 78 elderly patients with functional constipation were treated at the People's Hospital of Pudong New Area,and were divided randomly into two groups.The control group (n =39) received routine treatment plus oral polyethylene glycol,while the experimental group (n=39) received biofeedback training treatment in addition to what was offered to the control group.After treatment,constipation symptom scores,anorectal dynamic parameters and clinical effects were compared between the two groups.Results The scores on excrement characteristics,defecation difficulty,and time and frequency of defecation were better in the experimental group than those in the control group (t=5.670,4.740,4.170,5.530;P=0.016,0.034,0.039,0.022,respectively).The overall effectiveness rate was 94.9 ％ (37/39) in the experimental group,which was higher than that (71.8 ％,2 8/3 9) in the control group (x2 =4.493,P=0.030).Meanwhile,the levels of 3 SC and 10 SC in the two groups were higher than those before treatment,but the level of 10SR was lower than that before treatment (all P＜0.05).Moreover,improvement in 3SC,10SC and 10SR were more significant in the experiment group than in the control group (all P＜ 0.05).Conclusions Biofeedback training therapy is safe and effective for elderly patients with constipation to relieve constipation symptoms,enhance control of defecation and promote defecation.

Objective To investigate the phenotypic and functional properties of in vitro-induced He-lios+regulatory T cells(Helios+iTreg) and to analyze the differences between Helios+iTreg and Helios+thymic-derived natural Treg (Helios+nTreg). Methods CD4+CD25- effector T cells (CD4+CD25- Teff) that were separated from healthy subjects were cultured with anti-CD3 and anti-CD28 antibodies and stimulated with IL-2 and TGF-β to induce the generation of Helios+iTreg. Flow cytometry and real-time PCR were respectively used to analyze the differences in phenotype and CpG methylation in Treg-specific demethylated region (TSDR) be-tween Helios+iTreg and Helios+nTreg derived from the same donor. Results CD45RA was highly expressed on Helios+iTreg, but not on Helios+nTreg. Additionally, Helios+iTreg expressed significantly higher levels of CD127,ICOS and PD-1,but lower levels of CXCR3,CCR4 and CD25 than Helios+nTreg did. IFN-γ and IL-2 that expressed by Helios+iTreg were more than those by Helios+nTreg. It was also found that the level of CpG methylation in TSDR was much higher in Helios+iTreg than in Helios+nTreg. Conclusion Both nTreg and iTreg expressed Helios,but the phenotypic and functional properties of the two Treg subsets were different. It was suggested that Helios+iTreg and Helios+nTreg might play different roles in the immune system.

Objective To evaluate the clinical efficacy oftemozolomide (TMZ) and whole brain radiotherapy (WBRT) in the treatment of leptomeningeal metastases (LM) from non-small cell lung cancer (NSCLC).Methods The clinical data were retrospectively analyzed of the 19 patients with LM from NSCLC who had been treated from October 2007 to June 2016 at Guangdong Sanjiu Brain Hospital.Of them,10 were treated by a combination of TMZ+WBRT,and 9 by other therapies.The survival rate was determined by the Kaplan-Meier method and analyzed using the log-rank test.Results After treatment for 2 weeks,the illness was alleviated in 8,stable in 2 and progressive in 0 of the 10 patients receiving TMZ+WBRT,yielding a remission rate of 80％;the illness was alleviated in 5,stable in 3 and progressive in one of the 9 patients receiving other therapies,yielding a remission rate of 55.6％.The median overall survival was 8 months,the survival rate was 56.3％ at 6 months and 33.8％ at one year for those receiving TMZ+WBRT;the median overall survival was 7 months,the survival rate was 55.6％ at 6 months and 14.8％ at one year for those receiving other therapies.Conclusion Temozolomide and whole brain radiotherapy may prolong the survival time and improve the prognosis of patients with LM from NSCLC.

Objective:To investigate the clinical significance and the diagnostic value of detecting kidney injury biomarkers in urine and serum of children with Henoch-Sch?nlein purpura nephritis (HSPN).Methods:A total of 216 children with untreated HSPN, who were admitted in Beijing Children′s Hospital of Capital Medical University from January 2018 to December 2019, were recruited in this retrospective study. Two hundred and sixteen healthy children were selected as the healthy control group. We determined the levels of six biomarkers of kidney injury, including transferrin (TRF), immunoglobulin (IgG), microalbumin (mAlb), alpha-1 microglobulin (α1-MG), N-acetyl-β-D-glucosaminidase (NAG) in urine and cystatin C (CysC) in serum. The data from the two groups were analyzed, the diagnostic value of each biomarker was evaluated and a logistic regression model for the diagnosis of HSPN was established. In addition, 60 children with HSPN, who were admitted to our hospital from November 2021 to February 2022 and 60 healthy children, who underwent healthy check up in the same period were included to validate the diagnostic performance of the established logistic model. Receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of each biomarker.Results:The urine levels of TRF, IgG, mAlb, α1-MG and NAG and the serum level of CysC were significantly higher in the HSPN group than those in healthy control group (all P<0.05). The area under the ROC curve (AUC) of TRF, IgG, mAlb, α1-MG, NAG and the serum levels of CysC was 0.749, 0.719, 0.810, 0.648, 0.828 and 0.790 (all P<0.05). Logistics regression analysis showed that IgG, mAlb and TRF were the three diagnostic determinants of HSPN ( OR=1.083, 1.105, 1.704,all P<0.001), and the AUC was 0.916 of the established logistic model based on these three biomarkers. The sensitivity was 87.4% and the specificity reached 96.2%. The logistic model was validated by independent cohorts, and the AUC was 0.973, the sensitivity was 95.0% and the specificity was 98.3%. Conclusions:The levels of urine TRF, IgG, mAlb, α1-MG, NAG and serum CysC were higher in children with HSPN. The established logistic regression model based on three biomarkers including IgG, mAlb and TRF in this study has satisfactory clinical value in diagnosing HSPN in children.