ObjectiveTo find out the inhibitory effects of CD4 - CD8 - DNT cells on growth of which depresses the pancreatic cancer in vitro and in vivo.Methods The inhibitory effects of DNT cells on the growth of Panc- 1 were studied in vitro by MTT method.Eighteen BALB/c mice were divided into 3 groups randomly.Human pancreatic cancer xenografts were established in 2 groups randomly.The last group was injected the cell suspension which comprises DNT and Panc- 1 cells ( Panc- 1∶ DNT =1∶ 5 ).When the diameter of tumor was about 5 mm,the first 2 group mice were further divided into 2 groups randomly.One was control,treated with distilled water.The other was treated with celebrex (4 mg/d).The size of the tumors was calculated every 2 weeks and tumor growth curve was depicted.At the end of the treatments,the mice were sacrific and the tumors were harvested.The tumor inhibition rate was calculated.Results( 1 ) MTT study showed that DNT cells produced a dose- dependent inhibition of Panc- 1 proliferation in vitro.(2) The growth of transplanted pancreatic cancer was down-regulated by treatment of DNT cells.ConclusionDNT cells can inhibit the growth of pancreatic cancer in vitro and in vivo.

ObjectiveTo summarize the clinical features and surgical outcomes in solid pseudopapillary tumor of pancreas.MethodsA retrospective clinical analysis was made on 18 cases of solid pseudopapillary tumor of pancreas confirmed by pathological diagnosis from Jan.2000 to Feb.2011.ResultsThe median age of these cases was 27.8 years,ranging from 15 to 46 years.Fifteen cases were female and 3 cases were male.The size of the tumor ranged from 4.0 cm to 15.0 cm,with an average size of 7.1 cm.Eleven of 18 tumors(61.1％ ) had a well-defined capsule,and 5 tumors (27.8％ ) extended beyond the pancreas.Nine of the 18 tumors (50.0％) had a cystic component,and calcification was observed in 3 tumors ( 16.7％ ).The frequency of microscopic venous invasion,lymphatic invasion,and nerve invasion was 16％ (3 of 18),0 and 0 respectively.No lymph node involvement or liver metastasis was observed.Distal pancreatectomy plus splenectomy was done in 5 patients,spleen- preserving distal pancreatectomy in 3,medial pancreatectomy in 1,subtotal stomach- preserving pancreatoduodenectomy in 1,enucleation in 9.Fifteen patients were still alive without recurrent disease or metastasis after a median follow-up of 48 months.Conclusions These results demonstrated that solid pseudopapillary tumor of pancreas occurs mainly in young women,patients with solid pseudopapillary tumor of the pancreas had a favorable outcome after surgical treatment,including enucleation.

Pancreatic cancer is a commonly malignant gastrointestinal tumor with an significantly increasing incidence.Those patients without nonspecific symptoms at early stage had mostly lost the opportunity of surgical therapy when pancreatic cancer was detected at advanced stage,and its prognosis is poor.Therefore,it is rather important to improve the early diagnosis of pancreatic cancer.In recent years,proteomics is developing rapidly.Proteomics technologies have been widely used in clinical research.Using proteomics technology screening pancreatic cancer tumor markers becomes the research focus,thus we try to find a kind of or a group of pancreatic tumor markers,so as to improve the diagnosis of pancreatic cancer.

ObjectiveA comparative proteomic method was used to analyse serum proteins between pancreatic cancer patients and control group,and to find a new protential specific marker.MethodsComparative analysis on the pancreatic peripheral blood protein profiling from 40 pancreatic cancer patients,10 chronic pancreatitis patients,10 benign tumor patients and 40 cancer-free controls was carried out by 2D differential gel electrophoresis,and differentially expressed proteins were identified by matrix-assisted laser desorption/ionization time of flight mass spectrometry.ResultsTwo differentially expressed proteins:transthyretin and apolipoprotein E were identified.Those proteins were highly expressed in pancreatic carcinoma group compared with normal control group,chronic pancreatitis group and benign tumor group.Conclusion2D differential gel electrophoresis and matrix-assisted laser desorption/ionization time of flight mass spectrometry technology in screening specific serum biomarkers of pancreatic cancer has a well repeatability and stability.The identified protein transthyretin in this study may be as specific serum biomarkers of pancreatic carcinoma.

Objective: To analyze the clinical characteristics and diagnosis of multisystemic smooth muscle dysfunction syndrome(MSMDS). Method: Clinical data of a case diagnosed as MSMDS and hospitalized in our hospital in July 2016 was retrospectively analyzed. Literature search was performed at databases of PubMed, Wanfang, China National Knowledge Infrastructure and VIP with the key words "multisystemic smooth muscle dysfunction syndrome" "ACTA2" . The literature retrieval was confined from January 1980 to November 2016.The characteristics of MSMDS were summarized through review of literature. Result: A girl aged 1.6 years had recurrent cough and wheeze for more than 1 year, complicated with congenital fixed dilated pupils, patent ductus arteriosus, pulmonary hypertension, chronic lung disease, and cerebrovascular abnormalities. We had done gene analysis for the patient and found ACTA2 c. 536C>T(p.R179H) heterozygous mutations, but her parents were normal. Totally 11 reports were retrieved from foreign language literature and no report from Chinese literature could be found; the retrieved articles reported a total of 25 cases of multiple system smooth muscle dysfunction syndrome. The minimum age was 11 months, 17 cases were female, 8 were male. The clinical common characteristic is congenital fixed dilated pupils, patent ductus arteriosus, cerebrovascular disease, pulmonary hypertension, chronic lung disease, and so on. Conclusion Genetic testing for ACTA2 gene mutations should be considered in infants presenting with congenital fixed dilated pupils and patent ductus arteriosus.

Objective: To compare the characteristics of Mycoplasma pneumoniae necrotizing pneumonia (MPNP) and bacterial necrotizing pneumonia (BNP), and explore the biomarkers for differentiation of MPNP from BNP. Methods: A retrospective, observational study of 52 necrotizing pneumonia (NP) cases who were hospitalized in our hospital from January 2008 to December 2017 was conducted. According to the pathogen causing NP, patients were divided into two groups, BNP and MPNP, and the clinical manifestations, laboratory data, imaging findings, hospital course and prognosis between these groups were analyzed. Results: This study enrolled 19 boys and 33 girls, and the median ages of patients were 4.4 (0.1-13.8) years old. Of the totally of 52 NP patients, 19 were in the BNP group (9 boys and 10 girls), 33 were in the MPNP group (10 boys and 23 girls). The mean age of MPNP patients was much older than that of BNP patients (5.2 (2.3-13.2) years vs. 1.8 (0.1-13.8) years, Z=-0.128, P<0.01). The number of patients with tachypnea and pleural effusion septation were significantly higher in BNP patients than those in MPNP patients (15 cases vs. 4 cases, χ²=23.222, P<0.01; 14 cases vs. 1 case, χ²=29.326, P<0.01), which more needed to oxygentherapy (18 cases vs. 12 cases, χ²=16.833, P<0.01) and undergo chest drainage (9 cases vs. 4 cases, χ²=5.829, P=0.022); while the number of patients required bronchoalveolar lavage was higher in MPNP patients than that in BNP patients (5 cases vs. 32 cases, χ²=29.326, P<0.01). The values of white blood cell (WBC) (23.2 (5.2-67.1)×10⁹/L vs. 9.7 (6.3-18.7)×10⁹/L, Z=-4.855, P<0.01), procalcitonin (PCT) (3.69 (0.23-90.15) mg/L vs. 0.28 (0.02-1.44) mg/L, Z=-3.207, P=0.001), C reactive protein (CRP) (160 (94-220) mg/L vs. 90 (5-134) mg/L, Z=-4.337, P<0.01), interleukin (IL)-10 (11.7 (4.2-401.5) ng/L vs. 4.8 (2.0-23.4) ng/L, Z=-2.278, P=0.023), pleural fluid cell count (5 200 (120-50 000)×10⁶/L vs. 790 (68-6 920)×10⁶/L, Z=-3.125, P=0.002), pleural fluid lactic dehydrogenase (LDH) (3 990 (589-29 382) U/L vs. 2 211 (673-3 993) U/L, Z=-2.488, P=0.013) in BNP group were significantly higher than those in MPNP group; while the values of pleural fluid glucose(0.43 (0.03-18.00) mmol/L vs. 5.95 (4.27-7.87) mmol/L, Z=-2.795, P=0.005), serum tumor necrosis factor (TNF)-α (2.3 (1.0-2.8) ng/L vs. 2.6 (1.3-109.2) ng/L, Z=-2.113, P=0.035) and interferon (IFN)-γ (4.8 (2.6-7.7) ng/L vs. 11.9 (2.9-154.6) ng/L, Z=-2.455, P=0.014) were lower in BNP group than those in MPNP group. Meanwhile, the mean time from the onset of symptoms to the discovery of necrotic lesions was longer in MPNP group than that in BNP group ((20.6±6.4) days vs. (14.6±6.2) days, t=3.029, P=0.004). After treatments, all patients were discharged without death, WBC and PCT recovered more quickly in MPNP group than those in BNP group (12 (0-24) days vs. 0 (0-23) days, Z=-4.484, P<0.01; 10 (5-15) days vs. 0 (0-23) days, Z=-3.244, P=0.001). As to prognosis, 34 cases were followed up, and the results showed that patients recovered without surgical intervention, and chest lesions were resolved within 3.0 (1.0-8.0) months, and the time to necrosis disappearance was similar in the BNP group and MPNP greup (3.0 (1.0-8.0) months vs. 3.0 (1.0-8.0) months, Z=-0.128, P=0.001). In receiver operator characteristic curve analysis, the cut-off values for the age, WBC, CRP, PCT, pleural fluid cell count and pleural fluid glucose were set at 2.4 years of age, 17.2×10⁹/L, 157 mg/L, 1.505 mg/L, 2 630×10⁶/L and 3.73 mmol/L, respectively. Conclusions NP is found to be severe and prolonged, yet, reversible through proper therapy, such as rational antibiotics application. The age, WBC, CRP, PCT, pleural fluid cell count and pleural fluid glucose could be used as biomarkers to differentiate MPNP from BNP in children.

Objective To compare the characteristics of Mycoplasma pneumoniae necrotizing pneumonia (MPNP) and bacterial necrotizing pneumonia (BNP), and explore the biomarkers for differentiation of MPNP from BNP. Methods A retrospective, observational study of 52 necrotizing pneumonia (NP) cases who were hospitalized in our hospital from January 2008 to December 2017 was conducted. According to the pathogen causing NP, patients were divided into two groups, BNP and MPNP, and the clinical manifestations, laboratory data, imaging findings, hospital course and prognosis between these groups were analyzed. Results This study enrolled 19 boys and 33 girls, and the median ages of patients were 4.4 (0.1-13.8) years old. Of the totally of 52 NP patients, 19 were in the BNP group (9 boys and 10 girls), 33 were in the MPNP group (10 boys and 23 girls). The mean age of MPNP patients was much older than that of BNP patients (5.2 (2.3-13.2) years vs. 1.8 (0.1-13.8) years, Z=-0.128, P<0.01). The number of patients with tachypnea and pleural effusion septation were significantly higher in BNP patients than those in MPNP patients (15 cases vs. 4 cases, χ2=23.222, P<0.01; 14 cases vs. 1 case, χ2=29.326, P<0.01), which more needed to oxygentherapy (18 cases vs. 12 cases, χ2=16.833, P<0.01) and undergo chest drainage (9 cases vs. 4 cases, χ2=5.829, P=0.022); while the number of patients required bronchoalveolar lavage was higher in MPNP patients than that in BNP patients (5 cases vs. 32 cases, χ2=29.326, P<0.01). The values of white blood cell (WBC) (23.2 (5.2-67.1)×109/L vs. 9.7 (6.3-18.7)×109/L, Z=-4.855, P<0.01), procalcitonin (PCT) (3.69 (0.23-90.15) mg/L vs. 0.28 (0.02-1.44) mg/L, Z=-3.207, P=0.001), C reactive protein (CRP) (160 (94-220) mg/L vs. 90 (5-134) mg/L, Z=-4.337, P<0.01), interleukin (IL)‐10 (11.7 (4.2-401.5) ng/L vs. 4.8 (2.0-23.4) ng/L, Z=-2.278, P=0.023), pleural fluid cell count (5 200 (120-50 000)× 106/L vs. 790 (68-6 920)×106/L, Z=-3.125, P=0.002), pleural fluid lactic dehydrogenase (LDH) (3 990 (589-29 382) U/L vs. 2 211 (673-3 993) U/L, Z=-2.488, P=0.013) in BNP group were significantly higher than those in MPNP group; while the values of pleural fluid glucose(0.43 (0.03-18.00) mmol/L vs. 5.95 (4.27-7.87) mmol/L, Z=-2.795, P=0.005), serum tumor necrosis factor (TNF)‐α (2.3 (1.0-2.8) ng/L vs. 2.6 (1.3-109.2) ng/L, Z=-2.113, P=0.035) and interferon (IFN)‐γ (4.8 (2.6-7.7) ng/L vs. 11.9 (2.9-154.6) ng/L, Z=-2.455, P=0.014) were lower in BNP group than those in MPNP group. Meanwhile, the mean time from the onset of symptoms to the discovery of necrotic lesions was longer in MPNP group than that in BNP group ((20.6 ± 6.4) days vs. (14.6 ± 6.2) days, t=3.029, P=0.004). After treatments, all patients were discharged without death, WBC and PCT recovered more quickly in MPNP group than those in BNP group (12 (0-24) days vs. 0 (0-23) days, Z=-4.484, P<0.01; 10 (5-15) days vs. 0 (0-23) days, Z=-3.244, P=0.001). As to prognosis, 34 cases were followed up, and the results showed that patients recovered without surgical intervention, and chest lesions were resolved within 3.0 (1.0-8.0) months, and the time to necrosis disappearance was similar in the BNP group and MPNP greup (3.0 (1.0-8.0) months vs. 3.0 (1.0-8.0) months, Z=-0.128, P=0.001). In receiver operator characteristic curve analysis, the cut‐off values for the age, WBC, CRP, PCT, pleural fluid cell count and pleural fluid glucose were set at 2.4 years of age, 17.2× 109/L, 157 mg/L, 1.505 mg/L, 2 630×106/L and 3.73 mmol/L, respectively. Conclusions NP is found to be severe and prolonged, yet, reversible through proper therapy, such as rational antibiotics application. The age, WBC, CRP, PCT, pleural fluid cell count and pleural fluid glucose could be used as biomarkers to differentiate MPNP from BNP in children.

Objective To understand the management status of emergency and life support medical equipment in town-ship health centers in Huazhou City,providing a reference for improving emergency service levels in grassroots medical institu-tions.Methods A convenience sampling method was used to conduct a questionnaire survey of physicians,nurses,medical technicians,public health personnel,and administrative and logistical staff in 24 township health centers in Huazhou City.The survey focused on seven aspects:procurement and configuration,upgrades,operational use,maintenance,emergency handling,management systems,and quality assessment and monitoring.Results Training on emergency and life support equipment was generally adequate in Huazhou City(65.2％).Health centers in northern and central Huazhou performed better than those in the urban and southern areas regarding equipment training,emergency handling procedures for equipment failures,regular emergency drills,meeting clinical treatment needs,management system completeness,routine maintenance and inspections,and regular quality assessments.Factor analysis revealed significant issues with equipment aging and quality in urban township health cen-ters,while northern township health centers urgently needed life-sustaining and therapeutic equipment.Conclusion There are regional disparities in the management levels of emergency and life support medical equipment in township health centers in Hua-zhou City.It is recommended to enhance the overall quality of personnel in township health centers,optimize"effective training"for staff,and improve annual management plans to further elevate grassroots emergency service capabilities.

Human metapneumovirus(hMPV)is a common cause of acute lower respiratory infection(ALRI)in children, especially in children aged 2~5 years.The study and mastery of the epidemiological characteristics and transformation patterns of various subtypes of hMPV can lead to a deeper understanding of the distribution areas, epidemiological years and clinical relevance of various subtypes of hMPV.It is important to carry out systematic and comprehensive genotyping and epidemiological study of hMPV to reveal the distribution characteristics and epidemic trend of hMPV.In this review, the research progress in the epidemiology of hMPV is reviewed, which provides ideas for the surveillance, prevention and clinical treatment of hMPV infection, and provides reference for the development of hMPV vaccine and disease prevention and control.

Objective:To explore potential predictors of refractory Mycoplasma pneumoniae pneumonia (RMPP) in early stage. Methods:The prospective multicenter study was conducted in Zhejiang, China from May 1 st, 2019 to January 31 st, 2020. A total of 1 428 patients with fever >48 hours to <120 hours were studied. Their clinical data and oral pharyngeal swab samples were collected; Mycoplasma pneumoniae DNA in pharyngeal swab specimens was detected. Patients with positive Mycoplasma pneumoniae DNA results underwent a series of tests, including chest X-ray, complete blood count, C-reactive protein, lactate dehydrogenase (LDH), and procalcitonin. According to the occurrence of RMPP, the patients were divided into two groups, RMPP group and general Mycoplasma pneumoniae pneumonia (GMPP) group. Measurement data between the 2 groups were compared using Mann-Whitney U test. Logistic regression analyses were used to examine the associations between clinical data and RMPP. Receiver operating characteristic (ROC) curves were used to analyse the power of the markers for predicting RMPP. Results:A total of 1 428 patients finished the study, with 801 boys and 627 girls, aged 4.3 (2.7, 6.3) years. Mycoplasma pneumoniae DNA was positive in 534 cases (37.4%), of whom 446 cases (83.5%) were diagnosed with Mycoplasma pneumoniae pneumonia, including 251 boys and 195 girls, aged 5.2 (3.3, 6.9) years. Macrolides-resistant variation was positive in 410 cases (91.9%). Fifty-five cases were with RMPP, 391 cases with GMPP. The peak body temperature before the first visit and LDH levels in RMPP patients were higher than that in GMPP patients (39.6 (39.1, 40.0) vs. 39.2 (38.9, 39.7) ℃, 333 (279, 392) vs. 311 (259, 359) U/L, both P<0.05). Logistic regression showed the prediction probability π=exp (-29.7+0.667×Peak body temperature (℃)+0.004×LDH (U/L))/(1+exp (-29.7+0.667×Peak body temperature (℃)+0.004 × LDH (U/L))), the cut-off value to predict RMPP was 0.12, with a consensus of probability forecast of 0.89, sensitivity of 0.89, and specificity of 0.67; and the area under ROC curve was 0.682 (95% CI 0.593-0.771, P<0.01). Conclusion:In MPP patients with fever over 48 to <120 hours, a prediction probability π of RMPP can be calculated based on the peak body temperature and LDH level before the first visit, which can facilitate early identification of RMPP.