Objective To evaluate the effects of Pidomorph on serum immune cell level and T cell subsets in children with bronchial asthma.Methods 140 pediatric patients with bronchial asthma from January 2014 to October 2016 in our hospital were randomly divided into experimental group and control group according to the order of admission,70 cases in each groups.The control group was treated with conventional glucocorticoid drugs,and the experimental group was treated with pidotimod.The total effective rate of clinical treatment,the rate of rapid breathing in the flow rate,forced expiratory peak value,forced breathing vital capacity were compared between two groups three weeks after treatment,and the serum levels of immune cells(IgA,IgG,IgM)and T cell subsets(CD3+,CD4+,CD8+)were compared before and after treatment.Results The total effective rate was 92.86％(65/70)in the experimental group and 72.86％(51/70)in the control group,the total effective rate in the experimental group was significantly higher than that in the control group(P<0.05); Forced breathing speed in the speed,forced expiratory peak value,forced breathing vital capacity in the experimental group were better than the control group(P<0.05); After treatment,the levels of serum immune cells(IgA,IgG,IgM)in the experimental group were significantly higher than those in the control group(P<0.05); After treatment,the levels of T cell subsets(CD3+,CD4+,CD8+)in the experimental group were significantly higher than those in the control group(P<0.05).Conclusion Pidotimod is effective and safe in the treatment of bronchial asthma in children,it can effectively regulate T cell subsets and improve the immune function of children with asthma.

Objective To investigate the epidemiological features of fractures caused by earthquake to elevate the quality of prevention and treatment and reduce the mortality and disability rate.Methods A retrospectire study was performed on the data of 1 262 patients with fractures caused by earthquake from May 12,2008 to Aug 31,2008.The following data was statistically analyzed:cause of injury,injured part,associated injuries and treatment.Resultsof the 1 262 cases,11 resulted in deaths;bruise and crush trauma was the major cause (93.98%)of casualties;fractures oflimbs were the main types(55.7%)of fracture;operation was the major treatment.Concluslon Correct treatment is important for fractures caused by earthquake to reduce mortality and disability rate.

Objective To summarize our experiences in the diagnosis and treatment of traumatic splenic rupture (TSR), in order to improve the diagnosis and treatment effect of TSR. Methods Retrospective (analysis) of the diagnosis and treatment of 184 patients with traumatic splenic rupture in recent 9 years was made. Results The preoperative correct diagnosis rate was 96.7% and was established on the history of (injury), clinical presentation, abdominal paracentesis, abdominal ultrasonography and CT. All the 34 of (patients) treated nonoperatively were cured. Of the 150 patients treated by operation, two died during operation and 148 patients were cured. Conclusions Combination of obtaining a detailed history of injury, physical examination, abdominal paracentesis, abdominal ultrasonography and CT can improve the accuracy rate of (preoperative) diagnosis.Under the ensurrance of the safety of the patients' life, preservation of the spleen should be performed if possible, especially for children. Both splenorrhaphy with or without ligation of splenic artery are simple, safe and effective methods to salvage the spleen.

Objective To prove that valve sparing aortic root reconstruction may have an impact on the outcome and longevity of the repair for patients with acute type A aortic dissection.Methods Clinical data of 98 consecutive AAAD patients undergoing the valve sparing aortic root reconstruction were analyzed.The postoperative follow-up and the clinical effect of the procedure were retrospectively analyzed.Results Pre-operative grade of aortic insufficiency was(2.3 ± 0.5), CPB-time was (217.8 ± 43.1)min, aortic cross clamp time was(142.7 ± 37.4)min and stay on ICU (11.1 ± 5.7) days, while hospitalisation was(14.3 ± 3.2) days.8 patients(8.2％) died peri-operatively.None of the early deaths were valve-related.Rethoracotomy rate was 3.1％.All patients followed up(19.3 ± 7.6) (6-68) months.Survival at 1 year was 90.8％.Freedom from valvular reoperation was 97.9％ at 3 years.At last investigation, mean grade of aortic insufficiency for AADA was 0.5 ± 0.3 (0-3).Conclusion Regardless of the underlying indication, the aortic valve preserving reimplantation technique can be performed with favourable functional results.

Cardiac surgery carried out on cardiopulmonary bypass(CPB) in a pregnant woman is associated with poor neonatal outcomes although maternal outcomes are similar to cardiac surgery in non-pregnant women.Most adverse maternal and fetal outcomes from cardiac surgery during pregnancy are attributed to effects of CPB.The CPB is associated with utero-placental hypoperfusion due to a number of factors,which may translate into low fetal cardiac output,hypoxia and even death.Better maternal and fetal outcomes may be achieved by early pre-operative optimization of maternal cardiovascular status,use of perioperative fetal monitoring,optimization of CPB,delivery of a viable fetus before the operation and scheduling cardiac surgery on an elective basis during the second trimester.

Objective To analyze the constituent ratio and clinical characteristics of spine trauma and spinal cord injury of the survivors in the Sichuan earthquake.Methods198 cases wounded in the Sichuan earthquake were divided into four groups according to age for collecting the type of fracture, nerve damage, spinal fractures combined injuries of data from multiple sites, analyzing their clinical characteristics.ResultsFracture types are most common compression fractures (49.3%), followed by the burst fractures (45.9%). 105 of them had spinal cord injury, ASIA grade: A grade: 20 cases, B Grade: 18 cases, C grade: 25 cases, D Grade: 42 cases. 41 cases had combined injury. T12, L1, and L2 vertebral fractures were common types.ConclusionCompression fractures and burst fractures as spinal injuries occurred commonly in Sichuan earthquake mainly in the 18～65 years old, and spinal cord injury accounted for 53.03% spinal injury.

Objective To examine the frequency and mode of distal spread of low and middle rectal cancer in the mesorectum and rectal wall. Methods Thirty-four specimens from low and middle rectal cancer were collected between August 2004 and December 2005 in Cancer Center of Sun Yat-sen University. Twenty-eight specimens of low and middle rectal cancer were collected between October 2006 and October 2007 in Shandong Provincial Hospital of Shandong University. All 62 specimens were studied using large slices stained with CK20. Logistic regression was used to analyze clinicopathologic factors related to distal spread of low and middle rectal cancer in the mesorectum and rectal wall. Results Two types of distal spread of the tumor were observed in rectal wall: submucosa invasion and muscularis propria invasion. Distal spread in rectal wall was observed in 16% (10/62) of the patients. The length of distal spread in rectal wall was found from O. 5 cm to 1.0 cm. Four types of distal spread of the tumor were observed in mesorectum: lymph node invasion, blood and lymphatic vessel invasion, perineural invasion, isolated neoplastic microfoci. Distal spread in mesorectum was observed in 24% (15/62) of the patients. The length of distal spread in mesorectum was found from 0. 5 cm to 4. 0 cm. Three more cases with microcapillary invasion in distal mesorectum was observed by immunohistochemical technique, which was difficult to identify by conventional HE staining. Univariate analysis showed that serum CEA , lymph node invasion, CMI and TNM stage were correlated with distal spread of low and middle rectal cancer in the mesorectum and rectal wall. TNM stage was shown to be independent impact factor by multivariate analysis( Wald = 9. 567, P =0. 002). Conclusion TNM stage is an independent impact factor for distal spread of low and middle rectal cancer in the mesorectum and rectal wall. Resection of 1.5 cm for distal rectal wall is necessary for a curative intention, but it must be emphasized that the clearance for distal mesorectum should be 5 cm at least.

Objective To assess the value of susceptibility-weighted imaging (SWI) in staging hepatic fibrosis (HF) in rabbits. Methods Sixty healthy rabbits were randomly divided into HF group (n=44), control group (n=16). Rabbits in the HF group and supplementary group were injected subcutaneously with 50%CCl4 oily solution to establish hepatic fibrosis model. On the basis of preliminary test, 8 rabbits in the HF group and 4 rabbits in the control group were selected randomly at the 4th, 5th, 6th, 10th week after CCL4 injection ,respectively , to undergo liver MR scan,including conventional axial T1WI, T2WI and axial SWI, DWI scan. All rabbits were sacrificed after MR scan and the tissue of liver were sampled for pathological test and hepatic fibrosis staging. Rabbits were classified into group F0, F1-2 and F3-4 based on pathological results. Liver signal intensity (SI), and liver-to-muscle SI ratio were measured on SWI images and ADC values were measured on DWI images correspondently. One-way ANOVA analysis was performed to compare difference in liver SI, liver-to-muscle SI ratio and ADC values among group F0 (no fibrosis), F1-2 (mild-moderate fibrosis) and F3-4 (severe fibrosis) . Spearman correlation analysis was performed to correlate pathological staging and liver SI, liver-to-muscle SI ratio and ADC values. Receiver operating characteristic (ROC) curve analysis was performed to compare the diagnostic performance of SWI and DWI for staging HF. Results Two and 5 rabbits in the HF group died at the 5th and the 6th week after CCL4 injection , respectively due to acute hepatic necrosis, hepatorrhexis and systemic failure. Seven rabbits in supplementary group were used as supplement. Of the 16 rabbits in the control group, 1 was excluded from the study due to liver fibrosis. Fifteen rabbits in group F0, sixteen rabbits in group F1-2 and sixteen rabbits in group F3-4 underwent MRI and were included into this study. Liver-to-muscle SI ratio in group F0, F1-2 and F3-4 were 0.973 ± 0.020, 0.880 ± 0.090 and 0.649 ± 0.140, respectively. Liver SI were 378 ± 45, 374 ± 19 and 317 ± 34. ADC values were (1.473 ± 0.320) × 10-3, (1.311 ± 0.310) × 10-3 and (0.942 ± 0.180) × 10-3mm2/s. There were statistically significant differences in liver SI, liver-to-muscle SI ratio and ADC values among group F0, F1-2 and F3-4 (F=46.571,15.803 and 15.317, P< 0.01). Liver-to-muscle SI ratio was highly negatively correlated with HF staging (r=-0.818,P<0.01), while liver SI and ADC values were moderately correlated with HF staging (r=-0.565,-0.630;P<0.01). Area under ROC curve (AUC) of liver-to-muscle SI ratio, liver SI and ADC value for differentiating hepatic fibrosis stage F0 and stage F1-4 were 0.916, 0.695 and 0.768, while the AUC for differentiating hepatic fibrosis stage F0-2 and stage F3-4 were 0.951, 0.904 and 0.900. Conclusion Liver-to-muscle SI ratio on SWI provide added diagnostic value and could be an useful parameter for staging hepatic fibrosis.

Objective To analyze the early outcomes of the Sun' s procedure,which is an approach integrating total arch replacement using a 4-branched graft with implantation of a special stented graft in the descending aorta,and observe the mortality,morbidity and mid-term clinical results of postoperative in patients with acute type A aortic dissection (AAAD).Methods Clinical data of 61 consecutive AAAD patients undergoing the Sun' s procedure were analyzed.There were 53 male and 8 female,aged (54 ± 12) years.61 patients had postoperative follow-up and the clinical effect of Sun' s procedure were retrospectively analyzed.Results Cardiopulmonary bypass time was (229 ± 46) min,aortic clamping time was (147 ± 37) min and unilateral selective cerebral perfusion time was (35 ± 9) min.Reoperation for excessive bleeding in 5 cases (8.2％),acute renal failure in 3(4.9％),tracheotomy patients for pulmonary infection in 3(4.9％),and spinal cord injury in 2 (3.3％),delayed thoracic incision healing in 1 (1.6％),and osteofascial compartment syndrome of the right lower limb in 1 (1.6％).The 30 day mortality is 8.2％,and the leading causes was low cardiac output syndrome in 2(3.3％),multi-organ failure in 1 (1.6％),pulmonary infection in 1 (1.6％) and ruptured of abdominal aortic dissection in 1 (1.6％).The average follow-up time is(5.1 ± 0.7) years.Postoperative 1 year survival rate was 91.8％,5 year survival rate was 83.6％.Conclusion The Sun' s procedure has generated a relatively lower mortality rate in 61 patients with AAAD.Postoperative survival rate is high,and the reoperation rate is low.

Objective To determine the antigen-specific CTL in PBMC induced by a fusional family-gene vaccine of the immunoglobulin heavy chain variable gene framework region combined with the sequence of cytokine CM-CSF in vitro with MHC pentamer. Methods Peripheral blood samples were collected from two healthy donors and two patients. One was follicular lymphoma and another was hair cell leukemia. PBMC were isolated by density gradient centrifugalization with Ficoll and then subsequently differentiated into immature DCs (imDCs) induced by recombinant human GM-CSF and recombinant human IL-4. Gene gun was used to deliver the plasmids of the gene vaccine or the control plasmids into the imDCs. RT-PCR and ELISA assay were used to detect IgHVl-GM-CSF mRNA and GM-CSF in order to validate the transfection of the vaccine. After adding the cytokine cocktail, the imDCs became mature DCs. Then the mature DCs were co-cultured with lymphocytes from the blood samples for the induction of the antigen-specific CTL. The cultured cells were classified into vaccine group and control group and harvested at different time points of 0 d,7d, 17 d and 24 d after transfection. The subset of CD3+CD8+ T cells was analyzed by FCM assay. Finally, the CTL levels were detected with fluorescently labeled MHC pentamer antibody targeting vaccine epitopes. Results With the induction of cytokines, the imDCs with typical morphology were generated in PBMC. After delivering, the efficient expressions of the vaccine in the imDCs were determined by RT-PCR. And ELISA results also confirmed that GM-CSF was produced at a level of (28 ±6) ng/106 cells of the imDCs loaded with the vaccine, which was significantly different from that of control group (10 ± 3) ng/106 cells (t = 5. 191, P <0.01). FCM assay result showed that the CD3+ CD8+ T cells increased in a stepwise pattern during the culture. For control group, the levels at 0 d,7d, 17d and 24 d were ( 34. 24 ± 2. 72 )% , (46.06 ± 3.08)%, ( 65. 34 ± 4. 26 )% and (73.86 ±4.85 )% , respectively. For vaccine group, the results were (32. 28 ± 2. 08 ) % , (45. 32 ± 3. 81)% , ( 63. 37 ± 4. 21)% and (75. 01 ±3. 20)%. The differences between each time point had statistical significance (F = 176. 966 ,P <0.01) ,but there was no statistical differences between vaccine group and control group ( F = 0.657,P>0.05). The MHC pentamer analysis showed that the DCs loaded with IgHV1-GM-CSF fusional vaccine could efficiently induce the antigen-specific CTL response and the CTL levels increased gradually with the culture time, with the highest level of 4. 36% in the lymphoma blood and 3. 89% in the hair cell leukemia blood. Conclusions MHC pentamer assay could efficiently determine the antigen-specific CTLs response induced by the gene vaccine of family IgHV frame region in vitro. It could be a useful method for monitoring of anti-tumor cell immunity and evaluating of diagnosis and prognosis of the tumors in clinical application.