Epigenomic imbalance drives abnormal transcriptional processes,promoting the onset and progression of cancer.Although defective gene regulation generally affects carcinogenesis and tumor suppression networks,tumor immunogenicity and immune cells involved in antitumor responses may also be affected by epigenomic changes,which may have significant implications for the development and application of epigenetic therapy,cancer immunotherapy,and their combinations.Herein,we focus on the impact of epigenetic regulation on tumor immune cell function and the role of key abnormal epigenetic processes,DNA methylation,histone post-translational modification,and chromatin structure in tumor immunogenicity,and introduce these epigenetic research methods.We emphasize the value of small-molecule inhibitors of epigenetic modulators in enhancing antitumor immune responses and discuss the challenges of developing treatment plans that combine epigenetic therapy and immuno-therapy through the complex interaction between cancer epigenetics and cancer immunology.

Objective:To investigate the value of the venous-to-arterial CO 2 gap (Δ CO 2 gap) before and after the fluid challenge (FC) in determining the fluid responsivenessin septic shock patients. Methods:A total of 104 septic shock patients admitted to the Medical Intensive Care Unit (MICU) of Peking Union Medical College Hospital were included in the retrospective study. All patients were monitored by Swan Ganz floating catheter during the FC. Hemodynamics and blood gas indices were collected before FC (T0) and immediately (T1), 10 min (T2), 30 min (T3) and 60 min (T4) after FC. Responders were defined as patients with a > 10% increase in cardiac output (CO) after FC. Spearman correlation analysis was used to evaluate the correlation between CO 2 gap and CO. The value of ΔCO2 gap were calculated by the area under the receiver operating characteristic (AUROC) curve in the whole population. Results:Among 104 patients, the effective rates of FC at T1, T2, T3 and T4 were 59% (61/104), 72% (75/104), 73% (76/104), and 77% (80/104), respectively. CO of patients in the reactive group was lower than that in the non-reactive group at T2 [6.0 (4.7, 7.5) vs. 7.2 (6.4, 8.5) L/min, P=0.019], and there was no significant difference in CO 2 gap between the two groups before FC. Spearman correlation analysis showed that CO 2 gap was negatively correlated with CO, and the correlations between CO 2 content gap and CO was -0.34, and -0.33 of CO 2 pressure gap and CO, respectively (both P <0.05). ROC curve analysis showed that the ΔCO 2 gap at T1 could weakly judge the reactivity at T2, T3 and T4, but could not judge the reactivity at T1. The AUROC at T2 was 0.669 of ΔCO 2 content gap and 0.684 of ΔCO 2 pressure gap (both P <0.05). Conclusions:The evaluate time judging the effect of FC should be appropriately extended. The change value of CO 2 gap before and immediately after volume expansion in septic shock patients can judge the fluid responsiveness within 10 min after FC.

Objective: To investigate the genetic characteristics of human norovirus (NoV) among infants under 5 years of age with diarrhea in Chaoyang District, Beijing from 2011 to 2017. Methods: NoV-positive stool samples were collected from 2011 to 2017 in this region. The partial RdRp and VP1 genes were amplified and sequenced. Multi-sequence alignment was performed and phylogenetic tree was constructed using Mega software. Results: A total of 151 samples were sequenced and analyzed. The ratio of male and female was 2.28∶1 with mean age of 1.72 years. Fourteen NoV subtypes were detected, including GII.Pe/GII.4 (47.68%), GII.P12/GII.3 (20.53%), GII.P4/GII.4 (17.22%), GII.P16/GII.2 (3.31%), GII.P12/GII.12 (1.99%), GII.P17/GII.17 (1.99%), GII.P16/GII.13 (1.32%), GII.P7/GII.7 (1.32%), GII.P7/GII.6 (1.32%), GII.P2/GII.2 (0.66%), GII.P21/GII.21 (0.66%), GII.Pg/GII.12 (0.66%), GI.Pa/GI.3 (0.66%) and GI.P6/GI.6 (0.66%). Conclusions NoV genetic diversity was found among infants under 5 with diarrhea in Chaoyang district, Beijing. The subtypes from surveillance and those from epidemics occurred in chronological order. The surveillance should be strengthened for early detection of new subtype for monitoring the epidemic and vaccine design.

Objective To explore the value of prenatal MRI signs in diagnosis of placenta accreta.Methods MRI data of 163 pregnant women with suspected placenta accreta were retrospectively reviewed.According to the results of cesarean section,they were divided into placenta accreta group (n =136) or without placenta accreta group (n =27).The differencesof MRI signs between the two groups were compared.Taking cesarean section results as the gold standard,the sensitivity,specificity,positive and negative predictive value of MRI signs were calculated,respectively.Results Uterine bulging,abnormal vessels and hypointense T2WI bands at junction of placental and myometrium,as well as uterine recess had statistical differences between the two groups (all P＜0.05).No statistical difference of placental heterogeneity,focal interruptions in myometrial wall,uterine penetration and parametrium implantation nor protrusion of placenta into cervix was found between the two groups (all P＞0.05).The MRI signs of uterine penetration and parametrium implantation,uterine recess,protrusion of placenta into cervix yielded a specificity and positive predictive value of 100％,respectively.Conclusion Prenatal MRI has high efficacy in the diagnosis of placenta accrete.Placenta accrete should be highly suspected especially in the presence of uterine penetration and parametrium implantation,uterine recess and protrusion of placenta into the cervix.

Objective To compare the diagnostic value of MR examination with fast imaging employing steady state acquisition (FIESTA) and single shot fast spin echo (SSFSE) sequences for normal fetal thymuses.Methods Totally 366 normal fetuses were examined using MRI with FIESTA and SSFSE sequences,and the anatomy and MR manifestations of thymuses were observed.Kappa analysis and x2 test were performed.The transverse area (TA) and transverse diameter (TD) were measured on the "three vessel" level,while the superoinferior diameter (SID) was measured on the sagittal level.The mean value of these parameters at different gestational were calculated,and the regression equations of each parameter and gestational age were fitted.Results Two doctors had good agreements with the images of FIESTA and SSFSE sequences (Kappa=0.745,0.802,both P＜0.01).The clear rate of FIESTA and SSFSE sequences was 86.34％ (632/732) and 37.70％ (276/732) respectively,and the differences were significant (x2 =367.520,P＜0.001).The thymic size increased with the gestational age,and the regression equations and correlation coefficients were:TA =-5.80 + 0.35 ×gestational (r=0.820,P＜0.01),TD=-14.59+1.63×gestational (r=0.817,P＜0.01),and SID=-9.63+1.44×gestational (r=0.778,P＜0.01).Conclusion The subtle structure and contour of fetal thymus showed with FIESTA sequence are clearer than those of SSFSE sequence.MRI can clearly show fetal thymus after 22 weeks of pregnancy.

Objective To investigate the current distribution of hepatitis C virus (HCV) genotype in Southern China and to understand the HCV transmission and to infer its transmitting trend.Methods The HCV gene subtypes of 3 524 specimens from Southern China were detected and analyzed by polyonerase chain reaction (PCR)-fluorescence probe method or sequencing.The regular nested PCR and sequencing were used for the phylogenetic tree analysis when the fluorescence PCR inefficiently identifying virus isolates.Results Among 3 524 specimens,there were 2 922 cases from Guangdong,78 cases from Fujian,152 cases from Hainan and 372 cases from Guangxi.Genotype 1b comprised the majority (1 808/ 3 524,51.3％),followed by genotype 6a (925/3 524,26.2％),2a (298/3 524,8.46％),3a (246/ 3 524,6.98％),3b (200/3 524,5.68％) and 1a (27/3 524,0.77％).In addition,1 case wasgenotype 6e,1 case was genotype 6q,1 case was genotype 6r,3 case were genotype 6w,2 case were genotype 6xa,2 case were genotype 6n,and 1 case was genotype 6 with unclassified subtype.The genotype 1b accounted for the majority in most areas of 21 cities and counties in Guangdong Province,followed by genotype 6a.But in some areas,the major genotype was genotype 6a,followed by 1b.Genotype 4,genotype 5 and genotype 7 were not found in this study.Conclusions In the past two years,genotype 1b and 6a are still the epidemic genotypes in Guangdong,Guangxi and Hainan provinces.However,genotype 6a has replaced 1b as the dominant one in some areas in Guangdong Province.The distributions of HCV genotypes do not change significantly in Guangxi and Fujian provinces.

Objective To investigate smoking status,knowledge of smoking hazards,attitude of tobacco control and skill of assisting smoking cessation of the staff in a teaching hospital in Chongqing and to provide references for the further construction of‘smoking-free hospital’. Methods General investi-gation was taken on the staff in a teaching hospital in Chongqing with a self-designed questionnaire. Main contents of questionnaire include:social demographic information,smoking status,awareness of tobacco hazard,willingness and methods of tobacco control,etc. All the data were inputted with software Epidata 3.1 and were analyzed with SPSS 13.0. Results The total smoking rate was 9.65%,with 30.49%for male, 2.75%for female and 12.50%for clinician. The age distribution of smoking staff was described as follow-ing:91.97% being under 50 year-old and more than 50.00% being 20-35 year-old. 52.43% of the surveyed did not know Framework Convention of Tobacco Control of WHO . Relatively ,most of the surveyed only knew well the relationship between respiratory diseases and tobacco use and the relation-ship between fetal abnormalities and tobacco use. 84.99%of the surveyed agreed with outdoor-smoking policy;83.56%of the surveyed claimed that they had discouraged smoking behaviors in public at various extents,14.20%of the surveyed agreed that assisting the public in smoking cessation was one of the aims of constructing‘smoking-free hospital’;70.00%clinicians claimed routinely inquiring and noting smok-ing status of patients, which was better than nurses and medical technicians;almost 30.00%clinic staff did not know quitting smoking drugs at all,approximately 70.00%clinic staff claimed a lack of confidence in smoking control and approximately 70.00% clinicians and nurses did not recommend pro-fessional methods of smoking cessation in practice. Conclusions Smoking staff in the teaching hospital are almost younger people,which is an alarm of the urgent need for tobacco control education. Most staff reach a consensus on keeping smoking-free environment in hospital,but they do not sufficiently acknowledge their social responsibility for tobacco control,and also there is a distance before they can serve as a smok-ing cessation assistant. Tobacco control must be incorporated in long-term mechanism of hospital con-struction. There are three steps in the construction of smoking-free hospital:①creating a smoking-free en-vironment in hospital;②encouraging patients to quit smoking and providing professional service of smoking cessation;③making a positive effort on social tobacco control and advocating smoking cessation in public.

OBJECTIVE: To investigate the correlation between serum specific immunoglobin E(sIgE) and skin prick test(SPT) and their differences of the positive rate. METHOD: One hundred and nine patients with allergic rhinitis were detected the serum slgE. The patients had positive symptoms and signs, positive SPT results with at least one allergen. RESULT: Specific IgE and SPT results of Dp,Df and Artemisia showed a positive correlation (r = 0.520, 0.4413, 0.764, P < 0.01). sIgE positive rates were 55.0%, 54.1% and 17.4% for Dp, Df and Artemisia respectively, whereas SPT positive rates were 68.8%,79.8% and 27.5% respectively. The difference between the positive rates of the sIgE and SPT was significant (chi2 = 27.93,18. 20,60. 60, are P< 0.01). CONCLUSION There was a good correlation between specific IgE and SPT. SPT is more sensitive than sIgE, but SPT can not substitute for slgE,vice versa.
Adolescent ; Adult ; Aged ; Allergens ; analysis ; Animals ; Artemisia ; Child ; Dermatophagoides farinae ; Female ; Humans ; Immunoglobulin E ; blood ; Male ; Middle Aged ; Rhinitis, Allergic ; Rhinitis, Allergic, Perennial ; blood ; diagnosis ; etiology ; Sensitivity and Specificity ; Skin Tests ; Young Adult