The clinical significance of Th17 cells in patients with myelodysplastic syndrome and iron overload / 中华内科杂志

Objective To study the significance of Th17 cells in patients with myelodysplastic syndrome (MDS) and iron overload.Methods A total of 77 patients with MDS admitted to Guangzhou First People's Hospital were enrolled from January 2017 to December 2018,who were divided into iron overload group (37 cases) with serum ferritin (SF) over 1000 μg/L and non-ferrous overload group(40 cases).CD4+T cells in peripheral blood (PB) and bone marrow (BM) were sorted by flow cytometry.The ratio of Th17 cells and cells with abnormal karyotype were compared.IL-17 and IL-6 protein and RNA expression were detected by ELISA and quantitative real-time PCR(qRT-PCR).Results The proportions of Th17 cells in PB and BM in iron overload group were significantly higher than those in non-iron overload group [(41.06± 0.96)％ vs.(26.80± 1.21)％;(47.39± 1.60)％ vs.(34.29± 1.03)％;P＜0.01].The Th17 positive cells with abnormal karyotype in iron overload group were more than those in non-iron overload group[(4.96±0.53)％ vs.(3.67±0.12)％ in PB;(10.06±1.67)％ vs.(4.36±0.43)％ in BM;P＜0.01].Similarly,the protein levels as well as mRNA expression of IL-6 and IL-17 in patients with iron overload were significantly higher than those in non-iron overload group (P＜0.01 both in PB and BM).Conclusions As hematopoietic regulators secreted by Th17 cells,the expression of IL-6 and IL-17 in MDS patients with iron overload are elevated.This may predict the influence of these factors to the differentiation of Th 17 cells.

Comparison of endoscopic balloon dilatation and endoscopic stricterotomy in the treatment of postopera-tive anastomotic stenosis of colorectal cancer / 实用医学杂志

Objective Comparing the efficacy of endoscopic balloon dilatation and endoscopic stricteroto-my for postoperative anastomotic stenosis of colorectal cancer. Methods Retrospectively analyzed the clinical data of patients with postoperative anastomotic stenosis of colorectal cancer that underwent anastomotic dilatation from 2013 to 2016,and analyzed the anastomotic stenosis before and after treatment,and compared the efficacy of the two groups of dilatation methods. Results There was no statistically significant difference between the two groups in baseline characteristics. Balloon dilatation was effective in 3 cases(23.1%),ineffective in 10 cases(76.9%). 7 cases(63.6%)were effective in the stricterotomy group,4 cases(36.4%)were ineffective,the difference was statistically significant(P=0.045).Two groups of patients were not bleeding after surgery,infection and perfora-tion and other complications. Conclusion Endoscopic stricterotomy of postoperative anastomotic stenosis of colorectal cancer is more effective than conventional endoscopic balloon dilatation

Pediatric colonoscopy in South China: a single-center experience from 229 cases / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the safety, feasibility, clinical value, indication, and distribution of diagnostic diseases in different age groups of colonoscopy in pediatric patients.</p><p><b>METHODS</b>A retrospective analysis was performed on the data of pediatric patients receiving colonoscopy from April 2013 to June 2016 at The Sixth Affiliated Hospital of Sun Yat-sen University. Pediatric patients were divided into 0-6 years group (n=57) and 7-14 years group (n=172). Indication for colonoscopy, detective events and diagnostic diseases distribution were compared between two groups.</p><p><b>RESULTS</b>A total of 229 pediatric patients (male 157 and female 72) were divided into 0-6 years group (57/229, 24.9%) and 7-14 years group(172/229, 75.1%). The main Indications for colonoscopy included abdominal pain (81/229, 35.4%), hematochezia (64/229, 27.9%), crissum abscess or fistula (40/229, 17.5%). Hematochezia was the most common complaint in 0-6 years group (40/57, 70.2%), while abdominal pain in 7-14 years group (74/172, 43.0%). Completion rate between 0-6 years group and 7-14 years group was not significantly different (87.72% vs. 85.47%, χ=0.181, P=0.671). Only one pediatric patient (1/229, 0.4%) developed transient oxygen desaturation and recovered quickly after oxygen supply and aspiration of sputum. No serious complications such as bleeding, perforation or death occurred. Including 45 pediatric patients in 0-6 years group and 102 pediatric patients in 7-14 years group, a total of 147 pediatric patients (147/229, 64.2%) were found to have colorectal lesions. Inflammatory bowel disease (57/147, 38.8%), colonic polyps (40/147, 27.2%) and other intestinal inflammation (39/147, 26.5%) were the main findings. The most frequent diagnosis in 0-6 years group was colonic polyps (28/57, 49.1%), among them, 25 pediatric patients (25/28, 89.3%) were with the complaint of hematochezia. The most frequent diagnosis in 7-14 years group was Inflammatory bowel disease (54/172, 31.4%), among them, 29 pediatric patients (29/54, 53.7%) were with the complaint of abdominal pain.</p><p><b>CONCLUSIONS</b>Pediatric colonoscopy is safe and effective. Hematochezia and abdominal pain are the most common complaints in 0-6 years group and 7-14 years group respectively. Colonic polyps and inflammatory bowel disease are the most frequent diagnosis in 0-6 years group and 7-14 years group respectively.</p>

Rituximab impacts Th17 cells and related cytokines in patients with diffuse large B-cell lymphoma in vitro / 白血病·淋巴瘤

Objective To explore the impact of rituximab on Th17 cells and related cytokines in patients with diffuse large B-cell lymphoma (DLBCL) in vitro and its significance.Methods 20 cases of DLBCL untreated patients and 20 healthy subjects were enrolled in the name of DLBCL group and health control group, respectively.4 peripheral blood samples were collected from every case to separate peripheral blood mononuclear cells (PBMCs), which were assigned to 4 subgroups according to different culture conditions: blank subgroup(subgroup A), rituximab subgroup (subgroup B), rituximab and serum subgroup (subgroup C) and polarization subgroup (subgroup D) (added IL-6 and TGF-β).After cultured in vitro, the percentage of Th17 cells in each subgroup was tested by flow cytometry, and the cytokine IL-17 in the abovementioned culture fluid was measured by enzyme-linked immunosorbent assay (ELISA).Results In health control group, the percentage of Th17 cells and the level of IL-17 in subgroup D [(17.12 ± 4.90) ％ and (45.735±10.012) pg/ml] were significantly higher than those in subgroup A, B, C (P ＜ 0.05), and there was no difference in each other subgroup A, B, C (P ＞ 0.05).The percentage of Th17 cells and the level of IL-17 in the DLBCL subgroup A were significantly lower than those in health control subgroup A [(0.69±0.24) ％ and (6.012±1.312) pg/ml vs (2.43±0.61) ％ and (8.217±1.681) pg/ml (P ＜ 0.05)].In DLBCL group, after cultured with rituximab, the percentages of Th17 cells in subgroup B, C, D were (2.34±0.48) ％, (2.31±0.53) ％ and (16.92±4.81) ％, and the levels of IL-17 were (7.944±1.538) pg/ml, (7.957±1.533) pg/ml and (44.417±9.881) pg/ml, respectively, which were all significantly higher than those in subgroup A.Besides, the percentage of Th17 cells and the level of IL-17 in DLBCL subgroup D were significantly higher than those in subgroup B, C (P ＜ 0.05), while there was no difference between subgroup B and subgroup C.Conclusion Experiments in vitro confirmed that the percentage of Th17 cells in PBMCs of DLBCL patients was lower than that in healthy persons, and rituximab could elevate the percentage of Th17 cells in PBMCs of DLBCL patients.

The content difference of T lymphocyte subsets and natural killer cell in diffuse large B-cell lymphoma in different clinical stages and the analysis of their clinical significance / 中国医师进修杂志

Objective To explore the content of peripheral blood T lymphocyte subsets and natural killer (NK) cells in diffuse large B-cell lymphoma (DLBCL) in different clinical stages and analyze their clinical significance.Methods Sixty-two DLBCL patients were divided into 3 groups according to clinical stages:stage Ⅱ group (21 cases),stage Ⅲ group (21 cases ),stage Ⅳ group (20 cases).Thirty healthy examiners were selected as control group.Two ml peripheral blood was taken from every person.Peripheral blood T lymphocyte subsets(CD3+,CD4+,CD8+) and NK cell count were detected by flow cytometry(FCM) and CD4+/CD8+ was calculated.Results CD3+ in stage Ⅱ and Ⅲ groups[(854.6 ± 276.9 ) × 106/L,(823.3 ± 211.5)× 106/L] were lower than those in control group[(1268.8 ±684.0) × 106/L] and stage Ⅳ group [(1332.7 ±571.2) × 106/L](P ＜ 0.05).CD4+ in stage Ⅱ,Ⅲ,Ⅳ groups [(433.5 ± 240.7) × 106/L,(423.8 ± 234.8) ×106/L,(423.0 ± 143.8 ) × 106/L] were lower than those in control group [(751.3 ± 367.4) × 106/L] (P ＜0.05).CD8+ and CD4+/CD8+ in stageⅣ group [(861.2 ±634.1) × 106/L,0.5 ±0.3] were significantly higher than those in control group [(455.9 ± 334.6) × 106/L,2.1 ± 1.3],stage Ⅱ group [(390.6 ± 54.1 ) × 106/L,1.0 ±0.8] and stageⅢ group [(377.4 ±493) × 106/L,0.9 + 0.6](P＜0.05).NK cell in stage Ⅳgroup was obviously lower than that in control group[(210.3 ± 122.0) × 106/L vs.(353.3 ± 284.7) × 106/L,P＜ 0.05].And the higher clinical stage was,the lower NK cell was.Conclusions With the clinical stage increasing,the immunity depression and disorder of DLBCL patients become more and more serious,the more tumor burden is,the worse NK cell activity is.

Relationship between the international prognosis indexes and the cell-mediated immunity condition in DLBCL patients / 白血病·淋巴瘤

ObjectiveTo explore the relationship between the international prognosis indexes(IPT) and the cell-mediated immunity condition in DLBCL patients. Methods52 DLBCL patients were divided into 4 groups and the FCM was used to examine the T lymphocyte subsets,including CD3+、CD4+、CD8+、NK cells.T lymphocyte subsets absolute value and CD4+/CD8+ ratio were examined. Correlation with IPI were compared among groups.ResultsCD3+ cells in high risk group [(1570.9±370.5)/μl]were higher than other IPI groups;CD4+ cells in DLBCL groups were all lower than normal group(751.3±367.4)/μl]; CD8+ cells in high risk group [(1055.9±523.8)/μl] were higher than other groups; CD4+/CD8+ ratio in middle-high risk group and high risk group (1.0±0.2、0.7±1.0)were lower than other IPI groups and normal group;NK cells in middle-high risk group and high risk group were lower than the normal group[(199.5±68.4)/μl、(171.9±126.9)/μl];Age,clinical stage,body state had correlated with the CD3+ 、CD8+ cells and CD4+/CD8+ ratio of the DLBCL patients' peripheralblood T lymphosyte subsets. ConclusionsThe immunity condition in DLBCL patients has correlated with IPI; With increasing IPI value,the immunity depression and disorder become more serious,NK cells function become worse,and the prognosis is bad too.

Changes of Th17 cells and related cytokines in diffuse large B-cell lymphoma patients before and after treated with rituximab / 白血病·淋巴瘤

Objective To understand the changes of Th17 cells and related cytokines in diffuse large B-cell lymphoma (DLBCL) patients treated with rituximab and its significances.Methods Patients were assigned to 4 groups,there were 20 cases in the control group,31 cases in the initial treatment group,31 cases in CHOP group and 25 cases in RCHOP group.The percentage of Th17 cells in the peripheral blood of each group was tested by flow cytometry,the related cytokines IL-17,IL-21,IL-23,TGF-β in the peripheral blood were measured by enzyme-linked immunosorbent assay.Results The percentage of Th17 cells and the levels of IL-17,IL-21,IL-23 in the initial treatment group [(0.67±0.21) ％,(5.929±1.342) pg/ml,(130.632±17.945)pg/ml,(51.681±9.808) pg/ml] and the CHOP-CR group [(1.07±0.37) ％,(6.526±0.538) pg/ml,(132.119±7.700)pg/ml,(50.245±7.668) pg/ml] were both significantly lower than those in the control group[(2.53±0.63) ％,(8.435±2.031) pg/ml,(149.265±12.316) pg/ml,(55.303±7.778) pg/ml] (P ＜ 0.05).The level of TGF-β in the initial treatment group [(370.615±98.444) pg/ml] was significantly higher than that in the control group [(311.895±73.365) pg/ml] (P ＜ 0.05).The percentage of Th17 cells and the levels of IL-17,IL-21,IL-23 in the RCHOP-CR group [(2.38±0.59) ％,(7.724±0.780) pg/ml,(148.412±7.355) pg/ml,(55.668±7.532) pg/ml] were significantly higher than those in the initial treatment group [(0.67±0.21) ％,(5.929±1.342) pg/ml,(130.632±17.945) pg/ml,(51.681±9.808) pg/ml] and the CHOP-CR group [(1.07±0.37) ％,(6.526±0.538) pg/ml,(132.119±7.700) pg/ml,(50.245±7.668) pg/ml] (P ＜ 0.05).The level of TGF-β in the RCHOP-CR group[(283.904±59.223) pg/ml] was significantly lower than that in the CHOP-CR group [(341.481±95.597) pg/ml] (P ＜ 0.05).Conclusion Th17 cells might be negatively correlated with the DLBCL development,the reduced IL-23 and elevated TGF-β might suppress the differentiation of Th17 cells.Rituximab could elevate the percentage of Th17 cells in DLBCL patients,and it is related with the effect of chemotherapy.