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T-cell exhaustion is characterized by the stepwise and progressive loss of T cell functions under conditions of antigen-persistence, which occurs following chronic infections and tumor outgrowth. Exhausted T cells present functional defects, express multiple inhibitory receptors and show reprogrammed transcriptional regulation. As T cell exhaustion is correlated to its dysfunction to control infections and tumors, exploring new strategies to target exhausted T cell may reverse this dysfunctional state and reinvigorate immune response. This study takes CD8+ T cell as an example, which acts as an important subset involved in exhaustion state, discuss current understanding of the properties of exhausted T cell and the mechanisms that promote and maintain this state, and reveal new therapeutic targets for chronic infection and cancer.
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Objective To investigate the safety of thyroid gland resection and primary resection in the treatment of thyroid nodule and its influence to thyroid function.Methods 86 patients with thyroid nodules were selected as the research subjects.The patients were randomly divided into two groups.43 cases in the observation group implemented the thyroid gland resection treatment.43 cases in the control group received thyroid gland subtotal resection.The curative effect,safety,thyroid function and other indicators were compared between the two groups.Results The operation time and hospitalization time in the observation group after operation[(105.65 ± 12.54)min;(6.35 ± 2.01)d]were shorter than those in the control group[(149.41 ± 13.68)min;(9.62 ± 2.45)d].The amount of bleeding during operation in the control group [(134.51 ± 9.64) mL] was significantly higher than the observation group [(84.62 ± 6.35) mL],there was significant difference between the two groups (P ＜ 0.05).The total effective rate of the observation group was 95.55％,which was significantly higher than 72.09％ in the control group,the difference was statistically significant (P ＜ 0.05).Before operation,the between the two groups had no significant difference (P ＞ 0.05).After surgical treatment,serum FT3 and serum FT4 levels in two groups were decreased,but those in the observation group[(11.62 ± 3.02),(51.24 ± 7.25)pmol/L] were significantly lower than the control group [(14.14 ± 5.11) pmoL/L;(60.52 ± 6.35) pmol/L],there were obvious differences (P ＜ 0.05).The incidence rate of complications such as throat edema,hemorrhage,postoperative hoarseness in the observation group was 9.30％,which in the control group was 23.26％,the difference was statistically significant (P ＜ 0.05).Conclusion The thyroid gland resection therapy for thyroid nodules has high safety and significant curative effect,it can quickly improve the thyroid function,reduce relapse rate,has higher application value in benign and malignant tumors indistinguishable after surgery.It can reduce the length of stay in hospital,is conducive to the recovery of patients,it is worthy of clinical promotion.
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BACKGROUND: Lentivirus-mediated RNA interference technology has been widely used in the study of gene function because of its specificity, high inhibition efficiency and persistent effects. Virus packaging, transfection, as well as small hairpin RNA (shRNA)-coding sequence could affect the inhibition efficiency. Therefore, impact factors of RNA interference for human Bax inhibitor 1 (BI-1) was studied in this experiment.OBJECTIVE: To find the valid small interference RNA (siRNA) targeting human BI-1 gene by Lentivirus.DESIGN, TIME AND SETTING: Single sample observation was completed in Department of Medical Genetics, Basic Medical College, Peking University Health Science Center from September 2007 to December 2008.MATERIALS: 293T cell and SH-SY5Y cells were preserved in this laboratory; 4 shRNAs were designed through a use of online design tool by Ambion (www.ambion.com). METHODS: Several recombinant plasmids which expressed shRNAs targeting different regions of the BI-1 gene and labeled enhanced green fluorescent protein as a fusion gene were constructed. Four types of shRNA-expressing virions were obtained by cotransfection of shRNA-expressing plasmid and package protein-expressing plasmids into 293T cells. Green fluorescent protein expression was determined using flow cytometry to search the optimal package conditions. Real-time PCR and beta actin mRNA was used as an internal control, four types of recombinant viral supernatant and control viral supernatant were added on the SH-SY5Y cells, knock-down efficacies of the endogenous BI-1 gene were determined, and the RNA interference effective sequences were optimized. MAIN OUTCOME MEASURES: Intracellular green fluorescent protein expression rate of the cells infected with different packaging virus. RESULTS: The optimal infective packaging virus could be obtained when the ratio of plasmids pLentiLox3.7, REV, VSVG and RRE was 2:1:1:1 and the supernatants were collected 48 hours after transfection. Replacement of culture media 24 hours after transfection could increase the infection efficacy of the virions. shRNA targeting-2-17nt (start coding region) of BI-1 gene was most valid interference efficiency and could decrease the gene expression to 40%. CONCLUSION: Influencing factors of Lentivirus-mediated RNA interference technology virus packages were investigated in this study, which could be a foundation for constructing stable BI-1 knocked down neuronal cell model and for studying the abnormal expression of BI-1 related to the neuron apoptosis disease.
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Objective To report the surgical treatment results of cardiac and esophageal cancer of remnant stomach.Methods From 1980 to 2005,11 patients with cardiac and esophageal cancer of remnant stomach were treated surgically.Results Primary cardiac and esophageal carcinoma of remnant stomach developed in male patients more than females.Of 11 patients,7 underwent subtotal gastrectomy with Billroth Ⅱ reconstruction at first time.The mean interval between two operations was 13 years.Clinical symptoms frequently included abdominal distension,pain and hemorrhage.Thirty patients received radical resection.Conclusion Cancer in remnant stomach should be suspected in patients undergoing subtotal gastrectomy 5 years and over have clinical symptoms of upper gastrointestinal tract.Early diagnosis and early curative resection should be done.For esophageal cancer of remnant stomachmcolon reconstruction after the resection of esophageal cancer is recommmended.
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Objective To study the clinical features,diagnosis and management of nose and nasal sinusen fungus.Methods Different manner of surgical procedure was taken according to the areas and degree of pathological changes.The patients with noninvasive fungus were treated with radical maxillary sinusotomy(cald-well-Luc operation) or endoscopic sinus surgery.The patients with invasive form were undergone by the sinusotomy of enlarging areas,and combined with a postoperatively antifungal therapy.Results Twenty-six patients were involved in noninvasive fungus,and 25 cases in them were cured in single surgery through different manner.Nine patients were in invasive one,and 7 in them were also cured by single surgery in dfferent manner.One patient with invasivi fungus died 5 months postoperatively for extensive area and noneffective treatment although four surgical excisions were done.Conclusion CT scan is very important in their diagnosis,and the histopathology leads to identification of the fungus.Surgical removal is a radical kind of treatment.It is essential to exercise and open entirely the involved sinus cavity whatever type,and to enlarge areas for the extensive invasive fungus.
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Objective To research the way ro deal with the acute laryngeal damage.Methods Data of 23 cases with acute laryngeal damage were analyzed.Results Among 23 cases,there were 6 cases who received non-surgical treatment and their phonation were normal except one case who had mild hoarseness.Among 17 cases who had been performed operation,13 cases had normal phonation after operation.4 cases still had roughness of voice.There were 15 cases with normal respiration but two cases with larynostenosis and difficulty in decannulation.And these two cases were decannulated respectively after 2 months and 3 years after operation.15 cases made of 80% in all were cured and decannulated within 1 month.Conclusion Acute laryngeal damage patients should be diagnosed and treated as early as possible according to the damage degree so as to recover the laryngeal and tracheals function and prevent the sequelae and increase the cure rate.