Chromosome 22qll deletion syndrome(22q11DS) is a common chromosomal microdeletion syndrome. Its clinical manifestation is complex, comprising congenital heart disease, dysmorphic facial, immunodeficiency, endocrine dysfunction and so on. The syndrome has a population prevalence of approximately 1/2500-1/4000. There have been many recent advances in understanding of the clinical manifestation, behavior and psychiatric problems and the mechanisms leading to the specific phenotypic features in chromosome 22q11 deletion syndrome. Asymmetric recombination of homologous low copy repetitives in the deletion region causes the deletion of 22q11. TBX1 is the dominant gene contributing to the phenotype.

The immune microenvironment of hepatocellular carcinoma (HCC) is mainly composed of tumor-associated macrophages, myeloid-derived suppressor cells and other cellular components, as well as extracellular components, such as cytokines, growth factors and extracellular matrix, etc. In China, most liver cancer patients are complicated with chronic hepatitis B and cirrhosis. Immune microenvironment promotes the incidence and progression of HCC, immune escape and treatment resistance, and exerts immunosuppressive effect. In recent years, significant progress has been made in immunotherapy for systemic treatment of HCC, such as immune checkpoint inhibitors (ICIs). However, in the KEYNOTE-240 and CheckMate 459 trials, anti-PD-1 therapy with nivolumab or pembrolizumab as a single drug failed to reach the expected overall survival endpoint. At present, it is urgent to deepen the understanding of immune microenvironment of HCC and explore novel therapies to improve clinical efficacy of ICIs. Currently, the combination of ICIs with other therapies (such as tyrosine kinase inhibitors, monoclonal antibodies or local therapy) has been proven to improve the efficiency of single ICIs. In this article, research progress in immune microenvironment, immunotherapy and immune combined with targeted therapy for HCC was reviewed.

Objective To assess the clinical effectiveness and safety of gatifloxacin gel to bacterial conjunctivitis. Methods Double-blind and random selection were designed for the study,with levofloxacin gel as the control medicine.Thirty-six eyes of the experimental group and 36 of the control group were eligible for evaluation.Each eye received the gel one drop a time and three times per day.The gels were applied to the conjunctiva sac for 7 d. Results The clinic effectiveness of experimental group and control group were 88.89% and 91.67%,which indicated no significant difference.Microbial eradication rates were 90.48% and 93.75%,no significant difference either.Safety composite scores were similar between groups. Conclusion Gatifloxacin ophthalmic gel is safe and effective for treatment of bacterial conjunctivitis,and contains certain clinical value.

Adult ; Bloodletting ; Combined Modality Therapy ; Female ; Herpes Zoster ; therapy ; Humans ; Male ; Manipulation, Chiropractic ; Middle Aged ; Young Adult

Angioplasty, Balloon, Coronary ; Drug Delivery Systems ; Humans ; Stents

Animals ; Brain ; drug effects ; pathology ; physiology ; Child ; Child Development ; drug effects ; Female ; Fetus ; drug effects ; Humans ; Hypothalamo-Hypophyseal System ; physiology ; Metals ; toxicity ; Pituitary-Adrenal System ; physiology ; Pregnancy ; Stress, Psychological ; complications

Adenocarcinoma ; metabolism ; pathology ; Aged ; Carcinoid Tumor ; metabolism ; pathology ; Chromogranin A ; metabolism ; Humans ; Immunohistochemistry ; Male ; Neoplasms, Multiple Primary ; metabolism ; pathology ; Phosphopyruvate Hydratase ; metabolism ; Rectal Neoplasms ; metabolism ; pathology ; S100 Proteins ; metabolism

Objective To assess the effect of lung protective ventilation on outcome of children with acute respiratory distress syndrome(ARDS).Methods Between January 1999 and December 2007,43 children with ARDS were enrolled from PICU of Shanghai Children's Medical Center and assigned to the protective-ventilation group(group A) or the conventional-ventilation group(group B).The patients in group A (from January 2004 to December 2007)received lower tidal volume(6～7 ml/kg) and high levels of positive end-expiratory pressure(PEEP),and optimal oxygenation was achieved by adjusting FiO2 and PEEP.The patients in group B(from January 1999 to December 2003) received relatively higher tidal volume(8～12 mL/kg) with lower PEEP(2～6 cm H2O),and optimal oxygenation was achieved by adjusting FiO2.Tidal volume,PEEP,arterial blood gas,mortality and the number of ventilator-free days were compared between the two groups.Results Since protective ventilation was adopted after 2004,tidal volume was significantly lower in group A[(7.09±1.66)ml/kg]as compared with that in group B[(9.82±2.31) ml/kg](P=0.001).PEEP was significantly higher in group A[(7.15±2.08) cm H2O]as compared with that of group B[(5.40 + 1.84) cm H2O](P=0.021).The mortality was 30.3% in group A and 60.0% in group B.The number of ventilator-free days were(10.88±8.84) d in group A and(8.40±10.86) d in group B.Although mortality was lower and number of ventilator-free days was greater in group A,no significant differences were found between the two groups(P＞0.05).Conclusion Lung protective ventilation may improve the outcome for pediatric patients with ARDS,however,larger trials are required before a definite conclusion can be reached.

BACKGROUND:Daclizumab can be special y combined with the inerleukin-2 receptor on the surface of activated T cells in human body, and this method can reflect the close of interleukin-2 receptor thus inferring the effect of induction therapy. At present, the daclizumab has been widely used in renal transplantation, but there is no consensus on its clinical application in liver transplantation. OBJECTIVE:To investigate the expression of serum CD25+T cells and soluble interleukin-2 receptor in the patients receiving daclizumab for liver transplantation during perioperative period. METHODS:A total of 58 patients received orthotopic liver transplant for the first time were included and then the patients were randomly divided into two groups:control group (n=28) and treatment group (n=30). The patients in the two groups were treated with tacrolimus, mycophenolate mofetil and corticosteroids triple immunosuppressive regimen. The patients in the treatment group received immune induction therapy with daclizumab, and the patients in the control group did not receive daclizumab. RESULTS AND CONCLUSION:Flow cytometry and enzyme-linked immunosorbent assay showed the expression levels of CD25+T cells in the treatment group were significantly lower than those in the control group at different time points after liver transplantation (P<0.01);and the expression levels of soluble interleukin-2 receptor in the treatment group were lower than those in the control group during transplantation and at the first day after transplantation (P<0.05, P<0.01). At 6 months after transplantation, the incidence of acute rejection was decreased in the treatment group (P<0.01). The results indicate that daclizumab can effectively suppress the expression level of CD25+T cells, as wel as the expression level of soluble interleukin-2 receptor in the peripheral blood in the early stage of liver transplantation, thus effectively reducing the rate of acute rejection.

ObjectiveTo explore the clinical value on the detection of urinary podocyte marker protein podocalyxin(PCX) in children with nephritic syndrome(NS) and Schonlein-Henoch purpura nephritis(HSPN).MethodsUrinary samples voided in the morning were obtained from 14 healthy children and 75 children with NS or HSPN or Schonlein-Henoch purpura(HSP),including 21 children with NS in the acute phrase,14 children with NS in the catabasis,16 children with HSPN in the acute phrase,14 children with HSPN in the catabasis,10 children with common HSP,and 14 healthy children for control group.And urinary PCX content of the first morning urine was quantified by enzyme-linked immunosorbent assay(ELISA).SPSS 13.0 software was used to analyze the data.Results1.The levels of PCX content were significantly higher in the urine from children with any case of NS and HSPN compared with those in the control group(P≤0.009),but there was no obvious difference between common HSP children and children in the control group(P=0.754).2.The level of urinary PCX content in acute phrase of NS was(0.593?0.271) ?g/L,in the catabasis of NS was(0.162?0.093) ?g/L,there were significant difference(P=0).The level of urinary PCX content in acute phrase of HSPN was(1.822?1.342) ?g/L,in the catabasis of HSPN it was(0.236?0.141) ?g/L,which was significantly different(P=0.004).The level of urinary PCX content in common HSP was(0.089?0.061) ?g/L,there were significant difference in any case of HSPN(Pa