Mechanisms of tumor immunosuppressive microenvironment formation in esophageal cancer

As a highly invasive malignancy,esophageal cancer(EC)is a global health issue,and was the eighth most prevalent cancer and the sixth leading cause of cancerrelated death worldwide in 2020.Due to its highly immunogenic nature,emerging immunotherapy approaches,such as immune checkpoint blockade,have demonstrated promising efficacy in treating EC;however,certain limitations and challenges still exist.In addition,tumors may exhibit primary or acquired resistance to immunotherapy in the tumor immune microenvironment(TIME);thus,understanding the TIME is urgent and crucial,especially given the importance of an immunosuppressive microenvironment in tumor progression.The aim of this review was to better elucidate the mechanisms of the suppressive TIME,including cell infiltration,immune cell subsets,cytokines and signaling pathways in the tumor microenvironment of EC patients,as well as the downregulated expression of major histocompatibility complex molecules in tumor cells,to obtain a better understanding of the differences in EC patient responses to immunotherapeutic strategies and accurately predict the efficacy of immunotherapies.Therefore,personalized treatments could be developed to maximize the advantages of immunotherapy.

Bone graft incorporation failure with inappropriate limb load transfer can lead to aseptic acetabular loosening of metal-on-metal prosthesis: A case report

BACKGROUND Aseptic acetabular loosening can result from various factors that can be categorized into groups:patient-related,surgeon-related and implant-related.We present a case of a 63-year-old patient who at first underwent a total hip arthro-plasty(THA)using a metal-on-metal bearing due to hip arthrosis.Follow-up visits revealed no complications after the procedure.Two years after the THA,acetabular component loosening occurred due to subsequent trauma of the opposite hip,necessitating a revision THA using a ceramic-on-ceramic bearing.CASE SUMMARY We aim to illustrate a rare case where the primary reason for undergoing THA revision was not only incomplete bone graft incorporation but also improper limb load distribution.Following the revision arthroplasty,a 9-year follow-up visit revealed improvements in all evaluation measures on questionnaire compared to the state before surgery:Harris Hip Score(before surgery:15;after surgery:95),Western Ontario and McMaster Universities Arthritis Index(before surgery:96;after surgery:0),and Visual Analogue Scale(before surgery:10;after surgery:1).CONCLUSION Opposite-hip trauma caused a weight transfer to the limb after a THA procedure.This process led to a stress shielding effect,resulting in acetabular component loosening.

Risk Factors for Wound Infection Following Caesarean Section: A Case Control Study from Sir Salimullah Medical College &Mitford Hospital in Dhaka, Bangladesh

Background: Post caesarean section (CS) wound infection or surgical site infection is a leading cause of prolonged hospital stay or readmission. An understanding of its risk factors is important. Methods: A case control study was conducted in the Department of Obstetrics and Gynecology of Sir Salimullah Medical College & Mitford Hospital, in Dhaka, Bangladesh from January to June 2014 to evaluate the risk factors of postoperative surgical site infection following CS. One hundred patients were studied. Results: Fifty patients of post CS wound infection (surgical site infection: SSI) were selected as cases. Body mass index > 25 (kg/m2), anemia (p = 0.001), prolonged rupture of membrane (p = 0.005), prolonged operation time (p = 0.019), and junior surgeons performing the operation (p = 0.011) were the risk factors for CS-SSI. Conclusions: Pre- and postoperative care and surgical training of junior doctors should be directed to these risk factors.

28例风湿性多肌痛和颞动脉炎随诊分析

目的评价28例风湿性多肌痛(PMR)和颞动脉炎(TA)患者治疗过程,分析影响激素治疗时间和复发的因素。方法回顾性分析1992年至2001年本院诊治的28例PMR和TA患者,其中22例患单纯性PMR,3例PMR合并TA,3例单纯性TA,全部患者均应用糖皮质激素。其中13例加用免疫抑制剂。平均治疗时间25.5±24.0个月。按患者对激素有无抵抗及治疗后有无复发分组,对临床资料分析比较并分析影响PMR和TA治疗及预后的因素。结果激素抵抗组治疗前血沉和外周血白细胞水平较无抵抗组明显升高(P<0.01);复发组激素减量速度较无复发组快(P<0.05)。结论治疗前血沉快和外周血白细胞高者易发生激素抵抗。激素减量过快易复发。对激素治疗抵抗和复发者,或PMR合并TA者应加用免疫抑制剂治疗。

面肩肱型肌营养不良症染色体4q35和10q26的易位

目的了解面肩肱型肌营养不良症(facioscapulohumeralmusculardystrophy,FSHD)患者及中国正常人群中染色体4q35和10q26易位的分布状况。方法采用BglⅡ-BlnⅠ剂量检测方法,对70名FSHD患者、55名FSHD患者的亲属及52名正常人的染色体4q35和10q26易位的分布状况进行研究。结果(1)正常人群中4q35和10q26之间总的易位率为19.23%,其中4q35至10q26的易位率为9.62%,10q26至4q35的易位率为9.62%。(2)FSHD患者中4q35和10q26之间总的易位率为18.57%,其中4q35至10q26的易位率为12.86%,10q26至4q35的易位率为5.71%。结论在中国正常人群与FSHD患者中,染色体4q35和10q26之间较频繁地发生易位,两组之间的易位率差异没有显著性。

Management of liver diseases:Current perspectives

There is increasing incidence and prevalence of acute and chronic liver diseases(CLDs)all over the world which influence the quality of life and can give rise to life threatening complications.The burden of advanced liver disease due to hepatitis B has been controlled by antivirals but its eradication is difficult soon.Highly effective directly acting antiviral therapy has reduced the burden of hepatitis C but is partially offset by increasing IV drug abuse.Non-alcoholic fatty liver disease pandemic is on and there is recent alarming increase in alcohol related liver disease,both of which have no drug cure apart from control of the risk factors.Genetic factors have been identified in progression of all forms of CLD.Due to better management of complications of CLD,the life span of patients have increased spiking the number of hepatocellular carcinoma(HCC)and patients needing liver transplantation(LT).The present severe acute respiratory syndrome coronavirus pandemic has affected the outcome CLD including LT in addition to causing acute hepatitis.Better diagnostics and therapeutics are available for liver fibrosis,portal hypertension,HCC and post LT management and many drugs are under trial.The present review summarises the current scenario of the epidemiology and the advances in diagnosis and treatment of liver diseases including their complications like portal hypertension,HCC and LT.

Effect of liniment levamisole on cellular immune functions of patients with chronic hepatitis B

AIM: To explore the effects of liniment levamisole on cellular immune functions of patients with chronic hepatitis B. METHODS: The levels of T lymphocyte subsets and mlL-2R in peripheral blood mononuclear cells (PBMCs) were measured by biotin-streptavidin (BSA) technique in patients with chronic hepatitis B before and after the treatment with liniment levamisole. RESULTS: After one course of treatment with liniment levamisole, the levels of CD3+, CD4+, and the ratio of CD4+/CD8+ increased as compared to those before the treatment but the level of CD8+ decreased. The total expression level of mIL-2R in PBMCs increased before and after the treatment with liniment levamisole. CONCLUSION: Liniment levamisole may reinforce cellular immune functions of patients with chronic hepatitis B.

BLOODLETTING AT WEIZHONG POINT(UB 40)FOR TREATMENT OF ACUTE LUMBAR SPRAIN

The authors adopted bloodletting atWeizhong(UB 40)for the treatment ofacute lumbar sprain with good results.Incomparison with groups of massage andphysiotherapy,the present method was su-perior,as reported in the following:

H pylori seropositivity and cytokine gene polymorphisms

AIM: To investigate whether the pro- and anti-inflammatory cytokine gene polymorphisms, IL1B-511C/T, IL1B-31C/T, IL6-634C/G, TNF-1031T/C, TNF-857C/T, and IL10-1082A/G, interact with smoking and drinking habits to influence infection with H pylori.METHODS: The subjects were 410 Japanese transit company employees. C-reactive protein and conventional cardiovascular risk factors were evaluated. Serum anti-H pylori antibodies were measured. The genotypes of IL1B-511C/T, IL1B-31C/T, IL6-634C/G, TNF-1031T/C, TNF-857C/T, and IL10-1082A/G polymorphisms were determined by allelic discrimination using fluorogenic probes and a 5′nuclease assay.RESULTS: In gender- and age-adjusted logistic analyses, the subjects with TNF-857T/T had a significantly lower odds ratio (OR) for H pylori seropositivity (reference -857C/C; OR = 0.15, 95% CI: 0.03-0.59, P = 0.007). After stratification according to smoking and drinking status, among never-smokers, the subjects with IL1B-511C/T had a significantly lower OR (reference -511C/C; OR = 0.30, 95% CI: 0.10-0.90, P = 0.032). Among drinkers in the 1-5 times/wk category, the subjects with IL1B-511T/T had a significantly lower OR (reference C/C; OR = 0.38, 95% CI: 0.16-0.95, P = 0.039), and the subjects with IL1B-31C/T and T/T had a significantly higher OR (reference C/C; C/T: OR = 2.59, 95% CI, P = 0.042: 1.04-6.47; C/C: OR = 3.17, 95% CI: 1.23-8.14, P = 0.017). Among current smokers, the subjects withIL6-634C/G had a significantly higher OR (reference C/C; OR = 2.28, 95% CI: 1.13-4.58, P = 0.021). However, the interactions terms between the aforementioned genotypes and lifestyles were not statistically significant.CONCLUSION: Contrary to previous findings, the results herein suggest that the TNF-857T/T genotype may be protective against chronic infection with H pylori. Drinking and smoking habits may influence the effect of cytokine gene polymorphisms. Further studies are required to clarify the effects of the pro- and anti-inflammatory cytokine polymorphisms and gene-environmental interactions on H pylori infection.

Clinical Application of Blood-letting Therapy

Blood-letting therapy is extensively used in acupuncture clinic. In recent years, the author has applied blood-letting therapy to treat various kinds of diseases, with satisfactory therapeutic results reported in the following.

Experimental studies of relationship between phospholipid level and Yangxueqingnao particles in transient cerebral ischemia attack

AIM:To investigate the effect of transie nt ischemia attack(TIA)on phospho-lipid level and the effect of traditi onal Chinese herb -Yangxueqingnao p ar-ticles.METHODS:To establish the animal model of TIA i n mice by injecting Peroxide through caudal vein,and th en feed the mice with Yangxueqingnao particles in different dose.After e voking 4times of TIA and cut off the head the other day,then measure the level of lysophosphatidic acid(LPA),general phospholipid in blood plasma and bra in tissue.RESULTS:Score of the group without treatment was 1.0±0.8,while that of group administered with Yangxueqingnao particles(2g /kg)was 0.5±0.4(P<0.05)LPA level of TIA mice were 6.1±0.4and 2.1±1.3and increased significantly com-pared with that of the control.This c hanges can be reversed by treatment as can be seen the result 4.9±1.6.general phospholipid level of TIA mice in brain tissue decreased significantly com pared with that of the control as the r esult:(2.3±1.1)and(6.6±2.8)μmol /g,respectively.After treatme nt,general phopholipid level can reach(4.3±2.0)μmol /g.CONCLUSION:LPAand general phospholipid levels in bloo d plasma and brain tissue are abnorma l in experimental TIA mice,but can be rev ersed by Yangxueqingnao particles a nd it can be used in treatment.

Effect of comprehensiye rehabilitation treatment on patients with migraine

BACKGROUND: Migraine is a common disease in department of neurology, but it is often overlooked because doctors think patients will recover after some time even without treatment. Although patients feel headache, they don' t get to the degree looking for treatment. So therapeutic effects appeared slowly with high recurrence rate.OBJECTIVE: To observe effect of comprehensive rehabilitation on migraine.UNIT: Department of Rehabilitation, Zhengzhou Railway Central

Impact of ultrasound and optical biometry on refractive outcomes of cataract surgery after penetrating keratoplasty in keratoconus

AIM: To analyse the impact of ultrasound and optical intraocular lens(IOL) calculation methods on refractive outcomes of cataract phacoemulsification performed after penetrating keratoplasty(PK) in keratoconus. METHODS: Phacoemulsification cataract surgery was performed on 42 eyes of 34 patients with keratoconus who had previously undergone PK. The IOL power was determined by using both standard and corneal topography-derived keratometry using the SRK/T formula. We used two independent methods-ultrasound biometry(UB) and interferometry [optical biometry(OB)] for IOL calculation. The analysed data from medical records included demographics, medical history, best corrected visual acuity(BCVA) on Snellen charts, technique of IOL calculation and calculation formula and its impact on final refractive result.RESULTS: BCVA ranged from 0.01 to 0.4(mean 0.09±0.19) before surgery and ranged from 0.2 to 0.7(mean 0.38±0.14) at 1 mo and from 0.2 to 1.0(mean 0.56±0.16)(P<0.05) at 3 mo, postoperatively. The refractive aim differed significantly from the refractive outcome in both the UB and OB groups(P<0.05). There was no statistically significant difference in the accuracy of the two biometry methods.CONCLUSION: The refractive aim in keratoconus eyes post-PK is not achieved with either ultrasound or OB.

Effects of the Lifting Manipulation of Scalp Acupuncture for Raising Myodynamia of the Affected Limbs in Hemiplegic Patients Due to Cerebral Thrombosis

Objective: To provide a new therapy with definite quality controllable therapeutic effects for functional restoration of the affected limbs in hemiplegic patients due to cerebral thrombosis. Method: 180 patients with hemiplegia due to cerebral thrombosis were randomly divided into 2 groups: the treatment group (treated with scalp acupuncture by using the lifting manipulation) and the control group (treated with scalp acupuncture by using the twirling manipulation). Evaluations were given for the two groups based on the improvement of myodynamia and comprehensive functions after the treatment. Results: Both groups showed increased myodynamia, but with different cured and much relieved rates (86.67% in the treatment group and 5% in the control group, P＜0.01). Conclusion: Scalp acupuncture with the lifting manipulation can dramatically increase myodynamia of the affected limbs in hemiplegic patients due to cerebral thrombosis.

Measurement of Blood Loss during Adenotonsillectomy in Children and Factors Affecting It

This prospective study was done at the Southern Railway Headquarters Hospital, Ayanavaram, Chennai to measure the intraoperative blood loss during adenotonsillectomy and to assess the factors affecting it. Since blood volume in children is low, even a small loss will result in dreaded complications, so blood loss measurement in paediatric surgery is important. Adenotonsillectomy is the most common surgery performed in the field of otolaryngology, so blood loss measurement is essential in this surgery. In the study, 50 children who underwent adenotonsillectomy, by conventional dissection and snare method for tonsillectomy and curette method for adenoidectomy, were evaluated for operative blood loss. This study was conducted over a 1 year period, from June 2013 to June 2014. Both gravimetric method and blood volume studies were used to measure the operative blood loss. The estimated blood loss by gravimetric method was 94.35 ml, whereas the actual blood loss by blood volume studies was 90.57 ml and the average blood loss was 92.46 ml. The youngest child who was operated was 4 years old and the oldest child was 15 years old. The minimum blood loss was 40.30 ml and the maximum was 278.46 ml. In our series, operative blood loss was dependent on fibrosis of tonsil and the grade of the tonsil. There was no significant correlation between age and sex of the patient and the surgical skills.

CLINICAL EXPERIENCE IN ACUPUNCTURE TREATMENT OF FACIAL PARALYSIS

Facial paralysis refers to peripheral facial paralysis characterized by deviation of the mouth and eye, which may occur at any time of a year, especially in winter and spring. The incidence is higher in the young and middleaged people, more frequently affecting the males than females. Modem medical

Associations of gut microbiota with dyslipidemia based on sex differences in subjects from Northwestern China

BACKGROUND The gut microbiota(GM)has been proven to play a role in the regulation of host lipid metabolism,which provides a new theory about the pathogenesis of dyslipidemia.However,the associations of GM with dyslipidemia based on sex differences remain unclear and warrant elucidation.AIM To investigate the associations of GM features with serum lipid profiles based on sex differences in a Chinese population.METHODS This study ultimately recruited 142 participants(73 females and 69 males)at Honghui Hospital,Xi’an Jiaotong University.The anthropometric and blood metabolic parameters of all participants were measured.According to their serum lipid levels,female and male participants were classified into a high triglyceride(H_TG)group,a high total cholesterol(H_CHO)group,a low high-density lipoprotein cholesterol(L_HDL-C)group,and a control(CON)group with normal serum lipid levels.Fresh fecal samples were collected for 16S rRNA gene sequencing.UPARSE software,QIIME software,the RDP classifier and the FAPROTAX database were used for sequencing analyses.RESULTS The GM composition at the phylum level included Firmicutes and Bacteroidetes as the core GM.Different GM features were identified between females and males,and the associations between GM and serum lipid profiles were different in females and males.The GM features in different dyslipidemia subgroups changed in both female patients and male patients.Proteobacteria,Lactobacillaceae,Lactobacillus and Lactobacillus_salivarius were enriched in H_CHO females compared with CON females,while Coriobacteriia were enriched in L_HDL-C females.In the comparison among the three dyslipidemia subgroups in females,Lactobacillus_salivarius were enriched in H_CHO females,and Prevotellaceae were enriched in L_HDL-C females.Compared with CON or H_TG males,Prevotellaceae,unidentified_Ruminococcaceae,Roseburia and Roseburia_inulinivorans were decreased in L_HDL-C males(P value<0.05),and linear discriminant analysis effect size analysis indicated an enrichment of the above GM taxa in H_TG males compared with other male subgroups.Additionally,Roseburia_inulinivorans abundance was positively correlated with serum TG and total cholesterol levels,and Roseburia were positively correlated with serum TG level.Furthermore,Proteobacteria(0.724,95%CI:0.567-0.849),Lactobacillaceae(0.703,95%CI:0.544-0.832),Lactobacillus(0.705,95%CI:0.547-0.834)and Lactobacillus_salivarius(0.706,95%CI:0.548-0.835)could distinguish H_CHO females from CON females,while Coriobacteriia(0.710,95%CI:0.547-0.841),Coriobacteriales(0.710,95%CI:0.547-0.841),Prevotellaceae(0.697,95%CI:0.534-0.830),Roseburia(0.697,95%CI:0.534-0.830)and Roseburia_inulinivorans(0.684,95%CI:0.520-0.820)could discriminate H_TG males from CON males.Based on the predictions of GM metabolic capabilities with the FAPROTAX database,a total of 51 functional assignments were obtained in females,while 38 were obtained in males.This functional prediction suggested that cellulolysis increased in L_HDL-C females compared with CON females,but decreased in L_HDL-C males compared with CON males.CONCLUSION This study indicates associations of GM with serum lipid profiles,supporting the notion that GM dysbiosis may participate in the pathogenesis of dyslipidemia,and sex differences should be considered.

神经突触可塑性(英文)

脑、神经元、神经突触都具有可塑性。脑发育过程中其可塑性最强,成年脑仍具有可塑性。对神经可塑性的研究,大致可分类为发育可塑性、活动依赖性可塑性、损伤后可塑性以及移植后可塑性。本文概要地介绍了对神经可塑性的理解,发育可塑性的研究视点,以及活动依赖性突触可塑性的研究进展。