A 49-year-old male patient with primary hepatocellular carcinoma was treated with donafenib combined with tislelizumab. After 2 cycles of treatments, he developed persistent fever, poor appetite, fatigue, decreased white blood cells, hemoglobin, platelets, and fibrinogen, and significant increase of serum ferritin(91 501 μg/L) and splenomegaly. Hemophagocytic lymphohistiocytosis was diagnosed, which was consideredto be caused by tislelizumab. He received intravenous infusion of methylprednisolone 60 mg/d for 4 days, 40 mg/d for 7 days, 28 mg/d for 5 days, and at last, oral prednisone 35 mg/d was given, with dose reduction to discontinuation within 4-6 weeks. During the treatment, his laboratory tests results were improved. The patient did not use tislelizumab again and donafenib treatment was reused, and the above symptoms did not recur.

A 49-year-old male patient with primary hepatocellular carcinoma was treated with donafenib combined with tislelizumab. After 2 cycles of treatments, he developed persistent fever, poor appetite, fatigue, decreased white blood cells, hemoglobin, platelets, and fibrinogen, and significant increase of serum ferritin(91 501 μg/L) and splenomegaly. Hemophagocytic lymphohistiocytosis was diagnosed, which was consideredto be caused by tislelizumab. He received intravenous infusion of methylprednisolone 60 mg/d for 4 days, 40 mg/d for 7 days, 28 mg/d for 5 days, and at last, oral prednisone 35 mg/d was given, with dose reduction to discontinuation within 4-6 weeks. During the treatment, his laboratory tests results were improved. The patient did not use tislelizumab again and donafenib treatment was reused, and the above symptoms did not recur.

Objective To study the clinical effect of endotracheal stent implantation for treatment of congenital tracheal obstruction due to preoperative airway stenosis and postoperative dislocation difficulty .Methods 23 children with congenital heart disease complicated with severe tracheal stenosis were treated in our hospital from March 2015 to December 2017.The op-eration of congenital heart disease and airway stenting were performed .The preoperative diagnosis of the children was based on the bronchoscopy and CT airway reconstruction, and the patients were followed up for 1 to 24 months after the hospital was dis-charged.And every 1 to 3 month, the hospital was assessed by FFB.Results 20 children had good growth and development, and 21 of the 23 cases were removed by tracheal intubation to NCPAP within 1 weeks after the stent implantation , and they were transferred to the general ward within 2 weeks after the operation, and the hospital was discharged within 4 weeks after the oper-ation.1 children were discharged from hospital in 4 month after the operation ,because of severe lung infection.In 1 cases, the airway was blocked by recurrent granulation tissue and necrotic epithelium, the treatment was abandoned.22 cases of children were followed up by FFB.The stent was well epithelialization.13 out of 23 cases were successfully removed.Conclusion Tracheal intubation can not be performed in children with congenital heart disease due to airway stenosis before operation .After operation,with uncontrolled pulmonary infection and atelectasis, the children often failed to removing intubation.By FFB, the airway stent of implantation and removal are one of the effective treatment methods .However, there are still many complications and need to be strictly controlled .

BACKGROUND:Studies have found that liver cels can synthesize insulin after giving pancreatic and duodenal homeobox 1 (PDX1) gene. Anti-CD20 monoclonal antibody can inhibit the immune reaction of insulin-producing liver cels, but the mechanism is unclear. OBJECTIVE:To observe the influence of interleukin-10 gene on liver cels and liver PDX1 expression in nonobese diabetic mice after interfered by adenovirus vector-mediated murine interleukin-10 and anti-CD20 monoclonal antibody. METHOD:Forty nonobese diabetic female mice aged 3-5 weeks were randomly divided into anti-CD20, anti-CD20 + interleukin-10, interleukin, and control groups. Mice in each group were respectively injected with anti-CD20 monoclonal antibody, anti-CD20 monoclonal antibody + adenovirus vector-mediated murine interleukin-10, adenovirus vector-mediated murine interleukin-10 and normal saline on days 1, 8, 15 and 21via tail vein. RESULTS AND CONCLUSION:At 12 weeks, the blood glucose level of mice treated with anti-CD20 monoclonal antibody and/or interleukin-10 was significantly reduced compared with the control group, while the insulin, interleukin-10 and CD20 expression levels in the serum and liver were significantly increased, the liver PDX1 expression was also upregulated. Anti-CD20 monoclonal antibody with interleukin-10 had more obvious effects than the single use. No matter the combined intervention or single use, anti-CD20 monoclonal antibody and interleukin-10 show no impact on the inflammation of liver cels. Anti-CD20 monoclonal antibody and/or interleukin-10 increases PDX1 expression in nonobese diabetic mice.