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Objective:To investigate the changes of CD8 + CD28 - regulatory T cells (Treg) and its role in the pathogenesis of Kawasaki disease (KD). Methods:A total of 48 children with KD were enrolled in the present study from June 2019 to December 2021. Blood samples were collected from them during acute phage of KD and after intravenous immunoglobulin (IVIG) treatment. Another 32 age-matched healthy children were recruited as control group. The proportions of CD8 + CD28 -Treg cells and the expression of programmed cell death protein 1 (PD-1), factor associated suicide ligand (FasL), inducible T-cell co-stimulator ligand (ICOSL), CD80 and CD86 protein were evaluated by flow cytometry. The expression of Helios, perforin, granzyme B, immunoglobulin-like transcript 3 (ILT3) and ILT4 at the transcription level was measured by real-time PCR. Concentrations of IL-10 and TGF-β in the culture supernatants of CD8 + CD28 -Treg cells stimulated with activated CD4 + T cells were measured by ELISA. Results:⑴ The proportions of CD8 + CD28 -Treg cells and the expression of Helios in patients with acute KD were higher than those in the control group ( P<0.05), and reduced remarkably after IVIG therapy ( P<0.05). The two afore-mentioned indexes were lower in patients combined with coronary artery lesion (CAL) than in those without coronary artery lesion (NCAL) ( P<0.05). ⑵ Compared with the control group, the patients with acute KD showed increased expression of FasL, PD-1, ICOSL and perforin in CD8 + CD28 -Treg cells ( P<0.05). The concentrations of IL-10 and TGF-β1 in the culture supernatants of CD8 + CD28 -Treg cells from patients with acute KD were lower than those in the control group after stimulation with activated CD4 + T cells ( P<0.05), which restored to some extent after IVIG treatment ( P<0.05). All of the six above-mentioned indexes in the CAL group were found to be lower than those in the NCAL group ( P<0.05). There were slight differences in granzyme B expression between different groups ( P>0.05). (3) In comparison with the healthy controls, the patients with acute KD showed overexpressed co-stimulatory molecules such as CD80 and CD86 on CD14 + cells ( P<0.05) and up-regulated expression of inhibitory molecules ILT3 and ILT4 ( P<0.05), which were restored remarkably after IVIG treatment ( P<0.05). Furthermore, the expression of CD80 and CD86 at protein level increased in the CAL group than in the NCAL group ( P<0.05), while the expression of ILT3 and ILT4 at transcriptional level decreased in the CAL group ( P<0.05). Conclusions:Relative insufficiency and impaired function of CD8 + CD28 -Treg cells might be one of the important factors resulting in immune dysfunction and vascular damage in KD patients.
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Objective To evaluate the clinical value of CT in the diagnosis of early peripheral lung cancer , and to analyze the CT features of early peripheral lung cancer .Methods From November 2016 to November 2017 , 120 patients with suspected early peripheral lung cancer in Yongkang Long Chuan Family Hospital were selected in the study All patients underwent chest X -ray examination and CT examination ,and the pathological diagnosis results of puncture biopsy were taken as reference .The sensitivity,specificity and accuracy of X -ray CT in the diagnosis of early peripheral lung cancer were calculated , and the detection of lung lesions and extrapulmonary lesions between X-ray and CT was compared .Kappa consistency test was used to analyze the consistency between X -ray CT diagnosis of early peripheral lung cancer and pathological diagnosis of puncture biopsy .The X -ray signs of early peripheral lung cancer were observed and the CT findings of early peripheral lung cancer were analyzed .Results The diagnostic sensitivity,specificity and accuracy of CT for early peripheral lung cancer were 97.70％,96.97％, 97.50％,respectively,which of X -ray were 89.66％,81.82％ and 87.50％,respectively,the differences were statistically significant(χ2 =4.755,3.995,8.649,all P<0.05).By Kappa consistency test,the consistent Kappa values between the diagnostic results of X-ray and CT in early peripheral lung cancer and the pathological diagnosis of puncture biopsy were 0.514,0.748,respectively,which were moderate,good for lung lesions.The detective rates of intrapulmonary lesions and extrapulmonary lesions of CT were 94.03％and 96.43％,respectively,which were higher than those of X-ray(82.09％,78.57％,χ2 =4.542,4.082,all P<0.05).The X-ray signs of early peripheral lung cancer were mainly vacuole sign,lobulation,spiculation,pleural indentation,empty sign,visible low density,small transparent area,while the CT findings were lobulation ,spiculation,vascular convergence sign ,cavitation sign,pleural indentation ,visible spherical or oval nodules .Conclusion In the clinical diagnosis of early peripheral lung cancer , CT examination has significant diagnostic value .