Malignant tumor is typically characterized by fast proliferation and invasiveness. As such, tumor blood supply often fails to satisfy tumor growth requirements, resulting in a stressful cancer microenvironment with low oxygen level and insufficient nutri-ents. Cancer cells survive in such stressful environments by activating various signals (such as unfolded protein response), changing metabolic pathways, and undergoing autophagy. Hence, the cross-talk among these mechanisms should be determined to provide new insights into the interdynamics of cancer cells and their microenvironment. Furthermore, results would provide relevant information for the development of novel therapeutic strategies.

Objective In order to enhance the understanding of Churg- Strauss syndrome, the clinical manifestations and the pathological features of 15 patients were reviewed. Methods The clinical and patho- logical findings of 15 patients with Churg- Strauss syndrome admitted to Peking Union Medical College Hospi- tal were retrospectively analysed. Results In 15 cases, the initial clinical manifestations were poly- mononeu- ropathy, gastrointestinal disorders and skin lesions. Peripheral eosinophilia was significant in all cases. Biopsies were taken in all cases. The typical pathological features usually demonstrated in diffiferent stage of the dis- ease. Conclusions If a patient shows a clinical manifestation of fever, skin lesions, neuropathy, abdominal pain and diarrhea, as well as eosinophilia in peripheral blood, the diagnosis of Churg- Strauss syndrome should be considered. It is necessary to take biopsies from several sites at different time.

CD4 +CD25 +Foxp3 +regulatory T cells(Tregs)are essential for tumor immunosuppressive mi-croenvironment and secrete some inhibitory cytokines IL -10,IL-35,TGF-β1 and FGL2 which are key media-tors of Treg immunosuppressive function .Tregs have been shown to be important contributors to the tumor escape immunosurveillance and play a critical role in the induction of suppression to CD 4 +T,CD8 +T and NK cell,and suppression of specific anti -tumor immunity .Further research of the role of Tregs in tumor immunosuppressive microenvironment is important to understand malignant tumor pathogenetic and immunological therapeutics .In ad-dition,Tregs and inhibitory cytokines become more critical for clinical applications ,prognosis evaluation and ther-apies.

Objective To study changes of expression in Ephrin and its receptors in DRG neurons after peripheral nerve injury. Methods A rat model of unilateral crushed sciatic nerve was prepared, and changes in the expression pattern of Ephrin B1, Eph B1、Eph B2、Eph B3、EphA4 and RYK in DRG neurons in the rats crushed unilateral sciatic nerve were estimated by the number of positive staining cells in DRG, and the percentage of positive cells as well as the cell size.Results After peripheral nerve injury, the expression of Ephrin B1 significantly decreased, but there was no change in expression of Eph B1、Eph B2、Eph B3 or Eph A4, RYK expression was intensely induced in DRG neurons. Conclusion Ephrin B1 and RYK showed very significant expression changes in ERG neurons after peripheral nerve injury, and may be a component factor process of peripheral never regeneration.

Objective To study the expression pattern of RYK in the pathway of developmental corticospinal tract projection and provide hints for further study on RYK's function involved in this processes.Methods By In situ and immuno-fluorescence histochemistry,we examined the RYK expression pattern in the developmental murine motor cortex and the projection of corticospinal tract at various time points of E14.5、 E16、E18.5 and postnatal P3、 P5、P7.Results The motor cortex the RYK expression started at E18.5 stage and enhanced gradually at P0 stage.Moreover from P0 to P5 stage the RYK expression also appeared in the pathway of developmental corticospinal tract and decreased gradually after that.Conclusion RYK's expression is closely related to the corticospinal tract projection during its development stage.

Objective To explore the treatment effect and comfort of colostomy surgery with fecal water der-matitis around stoma after application of multilayer soft silicone dressings.Methods Approved by the Hospital Ethics Committee and the patients'informed consent,120 patients were divided into the hydrocolloid dressings group ( the control group) and multi-layer soft silicone dressing group (the treatment group),60 cases in each group.Before treatment,after treatment 24h and 36h,DET score,GCO score and the treatment effect were evaluated.Results After treated for 24h,the DET,GCO scores and treatment effects ( in the control group,cured in 3 cases,effective 45 cases, in the treatment group 5 patients were cured,effective in 46 cases) had no significant differences between the two groups (t=-2.624,P>0.05,t=-0.429,P>0.05,χ2 =0.519,P>0.05).After treated for 36h,the DET,GCO scores and treatment effects ( in the control group:cured in 29 cases,effective in 25 cases,in the treatment group:51 patients were cured,effective in 9 cases) had significant differences between the two groups ( t=-5.022,P<0.01,t=12.784,P<0.01,χ2 =6.316,P<0.05).Conclusion Colostomy fecal water dermatitis around stoma after application of multilayer soft silicone dressings can significantly improve the patients'comfort.

Objective To investigate effects of arthroscopic reconstruction of medial patellofemoral ligament (MPFL) using partial peroneus longus tendon autograft in treating recurrent patellar dislocation.Methods Forty-six patients (53 knees) with recurrent dislocation of patella received autologous partial peroneus longus tendon grafting for MPFL reconstruction after arthroscopic lateral retinaculum release from May 2009 to April 2010.Anatomic relation between femoral trochlea and patella,and motion path of patella were observed arthroscopically in adjustment of flexion and extension strength of grafted tendon in different angles.Successively,the tendon ends were fixed within bone tunnel of medial femoral condyle by using absorbable interface screws with synchronous superomedial displacement of tibial tuberosity.Stability of patellofemoral joint,dislocation recurrence,subjective symptoms of affected knees and general function recovery condition of affected limbs were studied.Results All patients were followed up for average 18 months (range,12-24 months),which showed the improvement of knee joint stability,without recurrence of patellar dislocation.Apprehensive test was negative.Axial X-ray films and CT of patella showed normal anatomical relation of patellofemoral joint.The Kujala patellar stability questionnaire scored (54.6 ±5.4) points before operation and (92.3 ±8.9) points after operation (t =55.41,P ＜ 0.01).All patients showed some improvement of motor ability after operation.CT examination showed that the congruence angle of patella and femoral trochlea was improved from preoperative (27.8 ± 8.1) ° to postoperative (2.3 ± 9.4) ° (t =20.87,P ＜ 0.01).Otherwise,ankle joint in the tendon donor site acted well,with normal function.Conclusion Arthroscopic lateral patellar retinaculum release and MPFL reconstruction using partialperoneus longus tendon autograft are effective in treatment of recurrent patellar dislocation in combination with superomedial displacement of tibial tuberosity,and avoid potential complications in tendon removal from around knee joint.

0.05). Conclusion The dot-immunogold filtration assay is rapid and simple for performing and reading in the detection of IgG against T.s with high sensitivity and specificity.

Objective To explore the effect and mechanism of superficial vein puncture for the first time in obese children auxiliary with venous enhancement.Methods From January 201 5 to July 201 5,1 20 children (3 -7 years old)with obesity were randomly divided into control group and observation group,60 cases in each group.The control group used conventional methods to select limbs superficial vein puncture,the observation group guided by visualizer to select limbs superficial vein puncture.Results The superficial vein puncture success rate of observation group was 96.67% for the first time,the puncture time was (78.95 ±6.68)s;Success rate of control group was 78.33%,the puncture time was (98.44 ±34.1 3)s,the differences between two groups were statistically significant (χ2 =1 0.385,t =21 .787,all P <0.05).Conclusion Obese children with venous visualizer superficial vein punc-ture success rate increased significantly,for the first time the puncture time shortened.

Objective To introduce an augmentation technique with 4-strand semitendinesus ten-don in treatment of partial anterior cruciate ligament (ACL) injury of under arthroscope and investigate the clinical outcome of the technique. Methods A total of 26 patients with posterolateral bundle rup-tures of ACL were treated arthroscopically with 4-strand semitendinosus tendon augmentation. The Inter-nationnal Knee Documentation Committee (IKDC) and Lysholm knee score scale were used for evaluation of knee function. The side-to-side difference in anterior knee laxity was examined by KT-1000 (25 de-grees flexion and 301b). Results There was no knee extension limitation, with knee flexion of 130°-150 °(average 142°). The patients were followed up for 12-18 months, which showed grade A in 25 pa-tients (96%) and grade B in one (4%) according to IKDC grade at final follow-up. The subjective IK-DC score was increased from preoperative (71.4±3.7) points to (95.8±3.4) points at final follow-up (t =9.836,P <0.01). The average side-to-side difference in maximal manual test with KT-1000 ar-thrometer at 25° flexion decreased from preoperative (5.1±1.2) mm to (2.1±1.3)mm at final follow-up (t = 10.48 ,P < 0.01). The Lysholm score of all patients was (76.7±3.2) preoperatively and (95. 7±2.4) at final follow-up (t =7.356,P<0.01). Conclusion Augmentation with 4-strand semiten-dinosus tendon under arthroscope can attain excellent clinical results and good anterior stability in treat-ment of partial tears of posterolateral bundle of ACL.