Protracted bacterial bronchitis (PBB) is one of the most common causes of chronic wet cough in children.Pediatricians have paid more attention to the PBB.Three most commonly identified bacteria are non-typeable Haemophilus influenzae,Streptococcus pneumoniae and Moraxella Mora bacteria.The occurrence of PBB is associated with bacterial biofilm formation in the airway,tracheobronchomalacia,systemic immune function disorder,and environmental pollution.The clinical presentations of PBB are wet cough and wheezing.Pulmonary signs are moist rale and(or) wheezeing.International guidelines recommend the treatment of Amoxicillin and C1 avulanate,the courses are at least two weeks.Domestic scholars have also used traditional Chinese medicine or western medicine therapy for the treatment of PBB.

Objective NKT cells are very important as a kind of non-specific immune cells. Much attention in antitumor significance has been received in the study of its effect on malignant diseases. The aim of this study was to detect the expression of NKT cells and its CD+8 NKT subsets in peripheral blood of esophageal patients and normal person, and to analyze the changes in the expression of NKG2D and NKG2A receptorsand its clinical pathological factors. Methods By flow cytometric analysis, 53 patients with esophageal carcinoma and 39 normal controls were analysed for peripheral blood of NKT cells and CD+8 NKT subsets, and the expression of NKT cells NKG2A and expression of NKG2D receptor. The clinical pathological factors were collected for the comparative analysis. Results Compared with the normal control group, the expression of NKT cells in peripheral blood of esophageal patients increased [(4.32±0.73) %, (5.97±1.29) %] (t =3.562, P <0.01), and the expression level of its surface receptor NKG2D reduced [(17.56±5.92) %, (15.12±1.56) %] (t =3.892, P <0.05), but the express levels of NKG2A [(4.02±1.41) %, (5.99±4.59) %] in creased (r = 4.015, P <0.05), those expression change with the development of the esophageal cancer. Conclusion The increased expression of NKT cells and CD+8 NKT subsets in the peripheral blood of patients with esophageal carcinoma refletcs that the immune feedback of patients' antineoplastic effect is strengthened. The decresed expression of the active receptor NKG2D and the increased expression of the inhibitory receptor NKG2A on NKT cells might be one of mechanisms leading to the reduction of NKT cell activity and immune escape of patients with esophageal carcinoma. The changes of surface receptors of NKT cells may be associated with the development of the esophageal cancer.

A 56-year-old female patient of Han nationality presented with generalized erythema and vesicles for 6 days,as well as high fever for 2 days.Twenty days prior to hospitalization,the patient received surgical treatment combined with oral methazolamide and glucocorticoids for glaucoma.The patient had a history of allergy to sulfanilamides.On admission,the patient presented with generalized erythema,vesicles and occasional erosions with bilateral eyelid and oral involvement.Nikolsky's sign was positive.Wheezing sound was heard over the right lung.Genetic testing showed that HLA-B5901 allele was positive.The patient was diagnosed with methazolamide-induced toxic epidermal necrolysis (TEN) complicated by pneumonia,and managed with immunoglobulin (25 g/day,5 days),glucocorticoids (the largest dose equivalent to methylprednisolone 160 mg/day),fresh plasma,antibiotics,as well as other supporting and symptomatic treatments.The condition was controlled after 2 weeks,and the patient was cured and discharged from hospital after 25 days.The fact that the patient carried HLA-B5901 allele suggests that HLA-B5901 is strongly correlated with methazolamide-induced TEN or Stevens-Johnson syndrome in Chinese descendants or Han population,besides in Japanese and Korean descendants.

Objective To explore the expression, as well as the proportion of subsets of the natural killer (NK) T cells in peripheral blood of patients with esophageal carcinoma before and after surgery, and provide ideas and experimental basis for immune treatment through tests. Methods Using CD3, CD56, CD4 and CD8 antibody to study the NKT cells and its subsets. Peripheral NKT cell subsets in 59 patients with esophageal carcinoma were analysed by flow cytometer. Results With the ratio of CD+3 CD+56 CD+8/CD+3 CD+56 CD+4 gradually increased, the proportion of phase Ⅲ- Ⅳ patients with esophageal carcinoma is gradually decreased between the groups. One-way ANOVA analysis showed that there were differences between the groups (P ＜0.05). The ratio of CD+3 CD+56 CD+8/CD+3 CD+56 CD+4 was in Non-linear related to CD+3 CD+56 CD+4NKT cells; CD+3 CD+56 CD+8; NKT cells were positively correlated with CD-3 CD+56 NK cells and negatively correlated with CD+3 T cells.Conclusion The ratio of CD+3 CD+56 CD+8/CD+3 CD+56 CD+4 may relate to tumor burden, and is helpful to determine the extent of disease in patients with esophageal carcinoma and prognosis.

Objective To discuss the management and selection of donor and recipient veins in the transfer of vascularied autogeneous submandibular gland (SMG).Methods The SMGs of 48 patients with severe keratoconjunctivitis were transfered to the temporal region by microsurgery from June,2002 to June,2013.The secreted saliva was used as the substitute of tear.Donor and accepting-site vessels,vessels crisis and managements,survival of grafts were retrospectively analysed.Results Transplantation succeeded in 45 patients and failed in 3.For donor veins,39 were facial veins,12 were venae comitantes of facial artery,1 was vein near the duct.For revipient veins,41 were superficial temporary veins,6 were deep temporary veins and 5 were veins in the upper neck.For revipient artery,except superficial temporary artery,deep temporary artery was also a good selection.After surgery,2/5 venous crisis cases were rescued by reanastomosising veins.TC99m examination suggested that the 49 TSMGs were survived,and the ducts were unobstructed.Follow up lasted for 6 months to 10 years,the symptoms of photophobia and anemophobia were alleviated,the symptoms of corneal xerosis disappeared.Good clinical efficacy was obtained after transplantion.Conclusion During SMGs transplantion,facial veins,venae comitantes of facial artery or vein near the duct can be used for donor vein.For recipient veins,except the superficial temporary veins as major,deep temporary veins or veins in the upper neck is also a secection.Correct selection and microsurgical management of donor and revipient veins are keys to successful SMGs transplantion.

Objective To study the significance of discrimination of scarce cardiac masses by echocardiography. Methods Twenty-nine patients with cardiac masses selected randomly were examined by transthoracic echocardiography and transesophageal echocardiography to observe their shape, internal echo, margins, membrane and blood flow. Results Twenty-three patients in twenty-nine cases were confirmed by surgery and pathology including eight benign masses and fifteen malignant masses, but the other six patients with metastasis carcinoma had no pathologic results. Eighteen patients got correct diagnosis, nine patients weren′t diagnosed in character and two patients were made a wrong diagnosis. Conclusions Echocardiography is the only noninvasive method which can provide reliable evidences for clinic before surgery to discriminate scarce cardiac masses.

Objective To investigate the influence of electroacupuncture on the expression of neuropeptides in fibroeartilage callus tissue after femoral fracture. Methods Forty male Wistar rats were randomly divided into a fracture group and an electroacupuncture group. Femoral fracture models were established in both groups, and the rats in the electroacupuncture group were given electroacupuncture. Rats were sacrificed on the 4th, 7th, 14th and 28th days after surgery. The calluses were stained immunohistochemically to detect the expression of calcitonin gene-related peptide (CGRP) and substance P (SP). Results CGRP and SP levels increased rapidly after eleetroacu-puncture, with neuropeptides expressed strongly in callus cell tissue. The optical density (OD) in the electroacu-puncture group was significantly higher than that in the fracture group ( P≤0. 05 ). Conclusion Electroaeupune-ture can significantly increase the expression of neuropeptides in rats after femoral fracture. Electroaeupuneture can promote fracture healing through regulating neuropeptides.

Objective To analyze the diagnosis and therapy of pemphigus and pemphigoid.Methods Clinical data were retrospectively analysed for 648 patients with pemphigus or pemphigoid admitted in Huashan Hospital,Fudan University from 2003 to 2007.Results The mean age of onset of pemphigus was younger than that of pemphigoid(47.0±16.9 years vs 65.1±13.9 years.P＜0.001).Of 175 patients with pemphigus confirmed by direct immunoflorescence(DIF),100%were positive for IgG,and 92.0%for C3,while out of 223 patients with pemphigoid,51.12%were positive for IgG,99.1%for C3.For pemphigus,the consistency reached 68.8%among clinical diagnosis.pathological diagnosis and immunological(DIF)diagnosis,80.7%between pathological and immunological diagnosis.In the case of pemphigoid,the consistency was 62.8%among clinical,pathological and immunological diagnosis,and 78.1%between pathological and immunological diagnosis.Corticosteroids were primary treatment strategy for both pemphigus and pemphigoid.and prednisone of 0.5-1.5 mg per kilogram bodyweight per day could control the condition of most patients.Conclusions DIF could be used as an important diagnostic means for patients with pemphigus or pemphigoid which can not be confirmed by clinical manifestation or pathology.In primary hospitals,IgG and C3 are recommended for DIF testing when pemphigus is suspected,and C3 is recommended for suspected pemphigoid.

OBJECTIVETo explore the myeloid-derived suppressor cell (MDSC) expression in the peripheral blood and lesions of 4NQO-induced tongue carcinoma in mouse.

METHODSThe established 4NQO mouse model was used to analyze the distribution of MDSC and T cell subsets in the peripheral blood by flow cytometry. The relations of MDSC with T cell subsets and CD4⁺/CD8⁺ changes were evaluated. The distribution of MDSC in the lesions of tongues was analyzed by immu- nohistochemistry, and the expression of arginase 1 (ARG-1) in tongue tissues was detected by real-time polymerase chain reaction.

RESULTSDuring tumor progression, a significant increase was observed in the frequency of MDSC in the peripheral blood of 4NQO treated mice (P < 0.01). The frequency of MDSC was positively correlated with systemic CD3⁺CD8+T cells but negatively correlated with the CD4⁺/CD8⁺ ratio. Squamous cell carcinomas were extensively infiltrated with MDSC, whereas dysplastic area and normal tongue mucosa had only sparse MDSC infiltration. The majority of MDSCs were located in the stroma, particularly along the tumor invasive front. Moreover, 4NQO-treated mice showed significantly higher ARG-1 mRNA levels in the tumor site (P<0.01).

CONCLUSIONMDSC may contribute to oral tumor progression and represents a potential target for immunotherapy of oral cancer.

4-Nitroquinoline-1-oxide ; Animals ; Arginase ; Cell Count ; Flow Cytometry ; Mice ; Models, Animal ; Myeloid-Derived Suppressor Cells ; immunology ; Real-Time Polymerase Chain Reaction ; T-Lymphocyte Subsets ; immunology ; Tongue Neoplasms ; immunology

BACKGROUND:There is lack of effective diagnostic methods for early knee osteoarthritis. Proteomics refers to the large-scale experimental analysis of proteomes from the overal level of intracel ular protein compositioon, expression and modification, based on which, we can understand protein-protein interaction and relationship, thereby revealing protein functions and cel activity patterns. OBJECTIVE:To apply the isobaric tags for relative and absolute quantitation (iTRAQ) to identify proteins differential y in serums of osteoarthritis Kel gren-Lawrence classification at each stage, and to find out potential molecular markers at each stage of osteoarthritis. METHODS:Sixty patients with knee osteoarthritis were enrol ed, and according to Kel gren-Lawrence (K-L) grading, they were subdivided into K-L 0, II and IV groups. There were 10 males and 10 females randomly selected in each group. Proteins differential y regulated in serums were identified by the stable isotopes 116, 117, 118 of the iTRAQ labeled, reversed-phase column separation, mass spectrometry and Swissport database search, after the serums were subjected to high abundance proteins depletion. Final y, we analyzed the proteins identified by using bioinformatics software. RESULTS AND CONCLUSION:Total y 169 proteins were identified through iTRAQ peptides experiments of different sample tags, Q-star mass spectrum identification and MASCOT library search. 153 proteins were identified as K-L 0 to K-L IV, 153 proteins were identified as K-L 0 to K-L II, and 145 proteins were identified as K-L II to K-L IV. iTRAQ technology may help to identify novel serum markers for early diagnosis of knee osteoarthritis, indicating iTRAQ technology for proteomics serum biomarkers of osteoarthritis study has good application prospect.