Epstein-Barr virus (EBV) is generally susceptible in human beings and multi-organ systems can be involved in EBV infection, such as blood, respiratory, urinary, digestive and nervous systems. EBV infection also plays an important role in the pathogenesis of related tumors, autoimmune diseases and other diseases, posing a great threat to human health. As a DNA virus, EBV can be sensed by DNA recognition receptors to trigger a series of downstream immune responses. A DNA-sensing pathway consists of DNA sensors, adaptor molecules and downstream effector signals. Double-stranded DNA sensors mainly include absent in melanoma 2-like receptors (ALRs) and cyclic GMP-AMP synthase (cGAS). Adaptors were mainly stimulator of interferon genes (STING) and apoptosis-associated speck-like protein containing a caspase recruitment domain (ASC). Downstream immune responses mainly involve typeⅠIFN, inflammasomes and proinflammatory cytokines. As a double-stranded DNA virus of the Herpesviridae family, EBV triggers complex innate and adaptive immune responses in the host, especially the sensing pathways mediated by a variety of DNA recognition receptors, which play a key role in host immune defense and pathogen immune evasion. This review made the DNA sensor as the clue to comprehensively summarize the progress in the activation, regulatory mechanism and clinical relevance of DNA-sensing pathways in EBV infection in recent years, aiming to achieve a better understanding of the host innate immune responses during EBV infection and provide an immunological basis for the prevention and treatment of EBV infection-related diseases.

Objective: To investigate the clinical significance of antegrade lower limb venography in varicose veins of lower limbs. Methods: The data of 230 cases of varicose veins of lower limb in Department of Vascular Surgery, Xiangyang Central Hospital from June 2018 to August 2019 were examined by antegrade lower limb venography. All patients were divided into simple varicose veins group (group A, 67 cases) and secondary varicose veins group (group B, 63 cases) according to the patency of deep veins. The data of sex, limb side, swelling and ulcer were analyzed respectively. Results: There was no significant difference in the results of sex between the two groups (57.5% vs 63.5%, P>0.05). The incidence of left side in group A was lower than that in group B (59.3% vs 76.2%, P<0.05). And the incidence of swelling of lower extremities and ulcer in boot area in group A was lower than that in group B (31.1% vs 49.2%, P<0.05; 18.6% vs 31.7%, P<0.05 respectively). Conclusions Combined with swelling of lower extremities, ulcer in boot area or the varicose veins in left side had a higher incidence of secondary varicose veins. Anterograde venography of lower extremities can accurately distinguish the classification of varicose veins of lower extremities and improve the diagnostic coincidence rate, which has significant clinical significance.

Objective     To analyze the safety and effectiveness of ultrasound-guided thoracoscopic atrial septal defect (ASD) closure. Methods     We prospectively collected the clinical data of 12 patients with ASD treated by ultrasound-guided thoracoscopic ASD closure in Fuwai Hospital from January to September 2017. The characteristics of the patients' ASD and operation, operation safety and effectiveness, postoperative complications and follow-up results were analyzed. Results     Among the 12 patients, 10 were successfully treated with ultrasound-guided thoracoscopic ASD closure. Two patients switched to ASD repair under thoracoscopy-assisted cardiopulmonary bypass. The size of the ASD was 17-40 (27.22±8.97) mm and the size of the occluder was 36 (30-42) mm. The average postoperative length of hospital stay was 6 days. There were no complications such as arrhythmia, bleeding and pericardial effusion after operation. The average follow-up was 6 (3-10) months after the operation. During the follow-up, no Ⅲ-degree conduction block, occluder dislocation, residual shunt or cardiac pericardial effusion was found. Conclusion     Ultrasound-guided thoracoscopic ASD closure is a minimally invasive, safe and effective treatment. This technique provides a new minimally invasive surgical option for patients with large defect diameter and poor edge condition.

Objective To analyze the midterm outcome of patients with congenital aortic stenosis undergoing percutaneous balloon aortic valvuloplasty (PBAV) by single echocardiographic guidance. Methods The clinical data of 12 patients with congenital aortic stenosis who underwent PBAV by single echocardiographic guidance at Fuwai Hospital from January 2016 to November 2017 were retrospectively analyzed. There were 7 males and 5 females with an average age of 18.27±15.30 years. The preoperative peak pressure gradient was 61.8–110.0 (80.30±24.50) mm Hg, and 50% of patients had aortic regurgitation. Results All patients successfully underwent PBAV. Aortic annulus diameter was 18.65±3.17 mm and balloon diameter was 17.62±3.77 mm, with balloon diameter to annulus diameter ratio of 0.92±0.07. The peak transaortic gradient was 16-51 (36.72±12.33) mm Hg immediately after procedure, which was significantly different from the preoperation (P=0.000). During the follow-up period, the peak transaortic gradient was 21-58 (37.06±13.52) mm Hg, and there was no significant difference between the follow-up and immediate postoperation (P=0.310). Immediately after procedure and during follow-up, 58% of patients had aortic regurgitation, which was not statistically different from the preoperation (P=0.682). Conclusion Systematic use of Doppler echocardiographic guidance for PBAV is feasible, and that it is associated with a high success rate and a very low complication rate.

Objective    To investigate how to establish stable mice cervical heart transplantation model. Methods    Totally, 40 male C57 mice with the age of 6-8 weeks and weight of 19-24 g were randomly divided into recipients and donors (n=20 in each group). Mice cervical heart transplantation model was established by connecting the ascending aorta of donors to the right cervical common artery of recipients through end to side anastmosis and the pulmonary artery of donors to the right external jugular vein of recipients through end to end anastmosis. Results    More than 95% recipients survived after surgery. Cold ischemia time was 15±5 min, warm ischemia time 23±6 min, and the whole operation took about 55±15 min. The recipients survived more than 30 d with functional heart grafts. Histologically, there was no difference between the heart graft one month after the transplantion and the normal heart. Conclusion    Cervical heart transplantation of mice model is reliable and feasible, which is easy to monitor the survival condition of heart graft by visual examination and palpation, which will benefit the basic research in transplantation field.

Objective To summarize the effect of supra-arch branches bypass combined with endovascular aortic repair for aortic diseases.Methods From January 2012 to August 2015,120 cases of thoracic aortic diseases (aortic dissection 103,aortic aneurysm 16,penetrating aortic ulcer 1) received hybrid operation in Guangdong Cardiovascular Institute.Vascular bypass was established among the brachiocephalic arteries,followed by endovascular repair through femoral artery either one-stage or two-stage.Patients were followed up for 3-24 months.Results Technical success was achieved among all the patients.Five patients died after the operation(one patient had retrograde aortic dissection,2 patients had pericardial tamponade,one patient had apnea,and one patient had respiratory and cardiac arrest.The death rate is 4.1％),4 patients had stroke,among them,symptoms were relieved in three patients,one patient was not cured.Total 92 patients were followed-up and had no symptoms of up-limb ischemia or dizziness.CT scan showed bypass graft and endovascular stent patency.6 patients had endoleak (type Ⅰ b 2 cases,type Ⅱ 3 cases,and type Ⅲ 1 case),distal aortic dissection occurred in one patient,three patients had mild contrast agent leakage around the distal endovascular stent,type A aortic dissection occurred in one patient,there were no late stage death.Conclusion Supraarch branches bypass combined with endovascular aortic repair for treating aortic disease is minimally invasive,safe,and can reduce the incidence of postoperative complications.

ObjectiveTo investigate the establishment of stable mice orthotopic left lung transplant model MethodsForty male Balb/c mice randomly served as recipients and donors.Each couple had the similar weight. Three-cuff technique was used to establish mice orthotopic lung transplant model.The micro CT of chest and the artery blood analysis were detected at first month after transplantation.ResultsThe achievement ratio was 95％.More than 90％ of the recipients survived after surgery.Cold ischemia time was (35.6±5.9) min,warm ischemia time was (25.3±7.2) min,donor lung back up time was (21.0±5.6) min,and the whole surgery time was (85±15)min.The long-term survival time achieved more than 30 days with functional lung graft.Micro CT showed clear left lung graft field one month after surgery,and left bronchus cuff was still open.The PaO2 of the artery blood was ( 106.9±5.8 ) mmHg before clipping right lung hlium,and after clipping that was (105.0±8.7) mmHg with the difference being not significant between them (P＞0.05).Histologically,the lung graft appeared very similar to the right lung one month after surgery.The pulmonary alveoli were aerated well.ConclusionBased on our experience of the orthotopic lung transplantation model in mice,through practicing,we independently and successfully established orthotopic lung transplantation model in mice.Compared to the method established by the other country,our method is easier to perform and more stable.This will benefit the basic research related to lung transplantation.

Objective To study the clinical pathological features, treatment and prognosis of umbilical metastases of colorectal carcinoma. Methods From January 2000 to September 2010, 10 umbilical metastases of colorectal carcinoma cases were admitted. The clinical features were reviewed. Results Four radical resection of colon cancer and resection of the umbilical plexus metastases cases with chemotherapeutic intraperitoneal perfusion lived 9,11,14 and 18 months respectively, 1 ileum-transverse colon anastomosis case with chemotherapeutic intraperitoneal perfusion lived six months, 2 patients with systemic widely transfer and umbilical transfer with pure venous chemotherapy lived 3, 3.5 months respectively, 3 colon intra-operative cases with venous chemotherapy lived 5 ,5. 5 and 7 months respectively. Conclusion Surgical resection of the primary focal and periumbilical metastases can prolong survival time with adjunctive therapy.

Objective To investigate the clinical and laboratory features of acute promyelocytic leukemia (APL).Methotis 513 APL patients in the last two decades were retrospectively analyzed in this research.We investigated the clinical features including age,sex,abnormality of peripheral hemogram before treatment.therapeutic effect and follow-up and laboratory data such as morphology,immunology,cytogenetics and molecular biology(MICM).Results The median age of the APL patients was 33 years old and the ratio of male and female was 1.21:1.Before treatment,the median level of WBC was 4.3×109/L and the deteetion rate of abnormal promyelocyte on blood film was 85.8%;with immunophenotypie detection,the expression levels of CD117、CD34、HLA-DR、CD7、CD14 and CD19 in APL were found to be lower and the expression 1evels of CD2、CD33 and MPO higher than those in other subtypes of acute myelocytie leukemia(AML)(beth P<0.01).Specific abnormal chromosome t(15;17)was detected in 91.7%of the patients,of whom 75.9%had standard translocation of t(15;17),being the most common one and 15.8% of the patients had t(15;17)with additional abnormal chromosome.There was only 7.5%of the patients with nolnlal karyotype.However,the presence of both simple translocation and complex translocation was seldom seen.With molecular biological detection.PML/RARα fusion gene positive rate was 99.6%.In a relativelv long clinical follow-up,we found that the complete remission(CR)rate in APL patients was 84.7%.incidence of DIC was 13.4%and five-year survival rate was 30.7%.111e median count of WBC in CR group was lower than that non-remission group(P<0.01).There were no significant differences on expressions of CD34 and CD2 and changes of cytogenetics between the two groups(P>0.05).Conclusions Comprehensive evaluation of MICM could be of important significance in the diagnosis and prognosis iudgrnent for APL patients.The CR rate in these patients with high WBC eount was considerable low.

In order to provide us new clues to induce some endogenous protective molecular mechanisms, the changes in gene expression profile induced by ischemia-reperfusion in pulmonary tissues of rats were investigated and the dynamic mechanism of pulmonary ischemia-reperfusion in- jury was elucidated. Thirty male Wistar rats were randomly divided into 6 groups: 5 ische-mia-reperfusion (I/R) groups (I/R 0-h, I/R 1-h, I/R 3-h, I/R 6-h, I/R 24-h) and control group (n=5 ineach). An in situ ischemia-reperfusion lung injury rat model was established by occluded hilus of lung. The RatRef-12 Expression Beadchip (22 226 gene probes per array) was used to analyze the pattern of gene expression in all groups. The results showed that 648, 340, 711, 1279 and 641 genes were differentially expressed in I/R 0-, 1-, 3-, 6- and 24-h groups respectively. The differentially ex- pressed genes were classified as following 7 functional categories: cytokine, adhesion molecule, growth factor and apoptosis-related factor, oxidation and antioxidation molecule, metabolic enzyme, ion channel and aquaporin, signal transduction molecule. It was suggested that gene chip technology was an effective and quick method for screening differentially expressed genes. Many differentially expressed genes with different functions interacted each other to result in pulmonary ische- mia-reperfusion injury.