AIM:To discuss the changes of IL-17, IL-21 in glucocorticoid therapy of active thyroid associated ophthalmopathy (TAO) and analyze the relation with results.METHODS:The 67 patients (134 eyes) of TAO in our hospital, were divided into activity group(32 patients 64 eyes) and atypical activity group(35 patients 70 eyes) according clinical activity score (CAS) grading standard, and 30 cases of healthy as control group at the same time.The activity group were treated by glucocorticoid therapy treatment, and proceed the CAS scores before and after treatment, measured the degree of exophthalmus and width of palpebral fissure.At the same time, compared the expression level of IL-17 and IL-21 in all groups, and analyzed the correlation between the IL-17 and IL-21 and CAS score.RESULTS:Compared with control group, expressions of IL-17 and IL-21 in TAO patients were significantly higher (P<0.05).The expressions of IL-17 and IL-21 in active period TAO patients were higher than atypical activity (P<0.05).After glucocorticoid treatment, the expressions of IL-17 in active period TAO patients decreased significantly(P<0.05), and it was significantly positive correlation with CAS score (before treatment:r=0.8847,P=0.042;after treatment:r=0.8886,P=0.0439) the expression of IL-21 in active period TAO patients was significantly positive correlation with CAS score (before treatment:r=0.8893, P=0.0435;after treatment:r=0.8876,P=0.045).CONCLUSION:IL-17 and IL-21 is closely related to the TAO disease activity, and glucocorticoids impact treatment by reducing IL-17 and IL-21 in activity TAO, IL-17 and IL-21 can be used as one of indexes of predicted curative effect and condition in patients with TAO.

Objective To detect the changes in DNA loads of human papillomavirus (HPV) type 6/11 in lesions of patients with condyloma accuminatum (CA) before and after 5-aminolevulinic acid photodynamic therapy (ALA-PDT).Methods After removal of warts by electrocautery,HPV6/11-positive patients with CA were divided into two groups:treatment group (32 cases) receiving two sessions of ALA-PDT with intervals of 7-10 days,and control group (29 cases) remaining untreated.Exfoliated cells were collected from the lesional sites of these patients before and 3 months after the first session of ALA-PDT,and fluorescence-based quantitative PCR was conducted to estimate the DNA loads of HPV 6/11 in these cells.Results Three months after the first session of ALA-PDT,89.7％ (26/29) of the patients in the treatment group and 68.4％ (13/19) in the control group became HPV DNA negative,with significant differences between the treatment group and control group in the DNA loads of HPV ((1.70 ± 7.86) × 105 vs.(1.27 ± 2.21) × 106 copies/ml,P ＜ 0.05).Conclusion ALA-PDT can reduce HPV DNA loads in lesions of CA in patients.

Objective To evaluate the value of revised Geneva score, Daniel ECG score and age-adjusted D-dimer for predicting pulmonary embolism(PE).Methods A total of 91 cases suspected as pulmonary embolism were collected, and 52 cases were diagnosed as pulmonary embolism by computed tomographic pulmonary angiography(CTPA) results.Receiver operating characteristic(ROC) curves and diagnostic test evaluation indexes were used to evaluate the probability of PE predicted by the revised Geneva score,Daniel ECG score, age-adjusted D-dimer and combination of these two clinical scores and age-adjusted D-dimer.Results The confirmed PE was 21.4% with a low probability(revised Geneva score 0~3 points),55.4% in intermediate probability(4~10 points),85.7% in high probability(score≥11 points).The prevalence of PE was 33.3% with a low clinical probability (Daniel ECG score<2 points)and 70.7% with a high clinical probability(Daniel ECG score≥2 points).The sensitivity and specificity of age-adjusted D-dimer in predicting pulmonary embolism were 92.3%,69.2%.The area under curve of the ROC curve(AUC)in the revised Geneva score and Daniel ECG score has no significant difference(Z=0.979).The negative predictive value of the revised Geneva score, Daniel ECG score combined with D-dimer in pulmonary embolism were 100.0% and 87.5%.Conclusion All of revised Geneva score, Daniel ECG score and age-adjusted D-dimer have certain predictive value on pulmonary embolism , and the revised Geneva score combined with age-adjusted D-dimer can be more safely exclude pulmonary embolism.

China ; Foundations ; Integrative Medicine ; Natural Science Disciplines

Humans ; Integrative Medicine ; Medicine ; Medicine, Chinese Traditional

Myeloid-derived suppressor cells (MDSCs) and regulatory T cells (Tregs) are important inhibitory immune cells.Research finds that MDSCs and Tregs increase in a large number under the conditions of inflammation,infection and tumor and they are able to suppress the immunity system and promote tumorigenesis and metastasis through multiple mechanisms.Finding the causes resulting in the increase of MDSCs and Tregs in tumor microenvironment and the eliminating methods have become new focuses in the field of antitumor immunotherapy.

Objetives: To evaluate the microtensile bond strengths o f four dentin adhesives (Single Bond, Bond-1, Prime&Bond NT and One-Step) i n vivo.Methods: Before extraction the superficial occlu sal dentin of 19 molars (because of severe periodontitis) in 17 volunteers was exposed by diamond bur of a high-speed hand-piece copious air-water spray under local anesthesia, the crown was bonded with one of the above adhesives a ccording to the manufacturers' instructions. The teeth were then extracted and kept in normal saline for 24 h under 37 ℃,sectioned to obtain two or three bar -shaped specimens, which were then shaped to an hour-glass form. The specimens were stressed until rupture of the bond. The mean bond strength of the adhesive s was measured and compared using student test. Rusults: M ean microtensile bond strength (MPa) of Single Bond,Bond-1,One-Step and Prime & Bond NT to the tooth surface was 26.18?3.67,30.08?3.15,29.91?3.51,29.70?3 .03 respectively (P

Twenty six uncontrolled patients with Graves′ disease were treated with thyroid artery embolism. Twenty two cases were followed for 24 60 months. The long term effect was observed after thyroid artery embolism. The results showed that the long term cure rate is 81.4% (18/22).

Objective: To compare the clinical value of video-mediastinoscopy (VM) and standard mediastinoscopy(SM) in diagnosis of thoracic diseases. Methods: The clinical data of 100 patients with mediastinoscopy were studied retrospectively. Of them, 54 patients underwent VM, and 46 patients underwent SM. The operative parameters including operating time, complications and post-operative hospital stay, the diagnosis accuracy of undifferentiated mediastinal diseases and the accuracy of perioperative staging of lung cancer were compared. Results: The average operating time in VM group was (53.9?17.2) mins, which was less than that in SM group (69.4?24.7)mins (t=2.05,P

Objective To evaluate the role of mediastinoscopy with biopsy on right trachea-bronchial lymph node (R4) in the diagnosis and pathologic staging of lung cancer. Methods From November 1999 to May 2004, sixty-six patients with lung cancer (47 right and 19 left) received mediastinoscopic biopsy on R4 lymph node. 17 patients were preoperative diagnosed and 49 suspected have lung cancer. The approach included cervical mediastinoscopy in 62 cases, parasternal mediastinoscopy in 1 and cervical combined with parasternal mediastinoscopy in 3. Results In total 66 patients, R4 lymph node positive was found in 49 cases, including 38 patients with right lung cancer and 11 with left lung cancer. The metastasis rate in small cell lung cancer, adenocarcinoma and squamous cell carcinoma were 100%, 82.2% and 52%, respectively. For 49 preoperatively suspected lung cancer patients, malignant tumor was confirmed by mediastinoscopy with biopsy in 40 and open thoracic surgery in 9. All the operations were successful and the patients recovered smoothly without severe postoperative complications. Conclusion R4 lymph node is one of the most common and important site for the tumor metastasis in lung cancer. Mediastinoscopy with biopsy on R4 lymph node has incomparable advantages in diagnosis and staging lung cancer over other examinations and biopsy on other sites of lymph nodes.