Carcinoma tipo-linfoepitelioma pulmonar con expresión de virus de Epstein-Barr y PD-L1 / Pulmonary lymphoepithelioma-like carcinoma with ex pression of Epstein-Barr virus and PD-L1

Resumen El carcinoma tipo-linfoepitelioma pulmonar es una variante rara de carcinoma de células no pequeñas de pulmón, representa aproximadamente 0.7% de todos los casos. Está usualmente asociado con la infección por el virus de Epstein-Barr y es más prevalente en el Sureste de Asia; sin embargo, es extremadamente raro en Améri ca Latina. Informamos el caso de un hombre de 65 años de edad con un carcinoma tipo-linfoepitelioma pulmo nar, que se presentó con tos, disnea y pérdida de peso. La TAC de tórax mostró nódulo mal definido localizado en el pulmón derecho. Se realizó biopsia transtorácica de la lesión, y el estudio microscópico reveló células gran des poligonales dispuestas en mantos, infiltrados por abundantes linfocitos y células plasmáticas, alrededor del intersticio. Las células neoplásicas fueron positivas para citoqueratina 5/6 y p63, y negativas para Napsina A y el factor de transcripción tiroideo 1 (TTF-1). La expre sión de PD-L1 fue positivo (aproximadamente 100%) por inmunohistoquímica; así como el núcleo de las células neoplásicas mediante hibridación in situ para el RNA codificado por el virus de Epstein-Barr (EBER-ISH). El paciente recibió seis ciclos de un esquema combinado de quimioterapia basado en platino (gencitabina/cisplatino) más durvalumab. Presentó progresión de la enfermedad y finalmente murió 9 meses después del diagnóstico.

Abstract Pulmonary lymphoepithelioma-like carcinoma is a rare type of non-small cell lung cancer, it accounts for approximately 0.7% of all cases. It is usually associated with Epstein-Barr virus infection and is more prevalent in Southeast Asia; however, it is extremely rare in Latin America. We present a 65-year-old man with a primary pulmonary lymphoepithelioma-like carcinoma, who presented with cough, dyspnoea and weight loss. Com puter tomographic scan of the thorax showed a nodule localized in the right lung. A transthoracic biopsy of the lung lesion was made and the microscopic obser vation revealed large polygonal cells that proliferated in a nest pattern with infiltration by lymphocytes and plasma cells around the interstitium. The tumour cells were positive for citokeratin 5/6 and p63, and negative for Napsin A and thyroid transcription factor 1 (TTF-1). PD-L1 expression was positive (approximately 100%) in the immunohistochemical study, and the nuclei of the tumour cells were positive for EBV-encoded small RNA in-situ hybridization (EBER-ISH). The patient underwent six cycles of platinum-based combination (gencitabine/ carboplatin) chemotherapy plus durvalumab. He pre sented progression of the disease and finally he died 9 months after diagnosis.

Human Telomeric i-motif: Its Structure‚ Recognition and Physiological Activity / 中国生物化学与分子生物学报

The human telomeric i-motif (htel-iM) is a unique higher-order DNA structure formed by the cytosine-rich (C) sequences at the end of human telomeres. Studies have shown that htel-iM plays a significant role in the transcriptional regulation of telomeric repeat-containing RNA (TERRA) ‚ maintenance of telomere function and inhibition of telomerase activity. Thus‚ it is closely related to the development and progression of many cancers and is a promising new target for cancer treatment therapy. Compared to other nucleic acid higher-order structures such as G-quadruplexes‚ the stability of htel-iM is much weaker and affected by many factors like buffer pH‚ ionic conditions and molecular crowding environments. Therefore the existence of the iM structures in near neutral physiological conditions has been uncertain for a long time. Recently‚ using in-vitro screened small molecule ligands to selectively recognize and stabilize htel-iM provides a new strategy for the exploration of the biological relevance of htel-iM. Thus it has become a research hotspot to take telomere as a cancer treatment target. However‚ so far the reported small molecule ligands selectively targeting the htel-iM are far from sufficient compared with those targeting other higher-order nucleic acid structures. In this review‚ the discovery and the characteristic of the iM structures are briefly described‚ with an emphasis on the in-vitro affecting factors of the htel-iM structure‚ the reported htel-iM ligands and its biological relevance and regulation mechanisms‚ which will be helpful in further exploration of the htel-iM structure and ligand screening in near physiological conditions‚ and understanding the mechanism and developing novel therapeutic strategies for cancer treatment targeting the htel-iM structures.

Psychometric Properties of the Spanish-language Version of the Interpersonal Mindfulness in Parenting (IM-P) Scale among Mothers of Preschool Children in Chile / Propiedades psicométricas de la versión en español de la Escala de Atención Plena (Mindfulness) Interpersonal en la Parentalidad en madres de preescolares en Chile

Abstract The Interpersonal Mindfulness in Parenting (IM-P) scale is one of the first measures that specifically assesses mindful parenting, a specific application of mindfulness, that has been defined as paying attention to your child and parenting in a particular way, intentionally, in the present moment, and non-judgmentally. Psychometric properties of a Spanish-language version of the IM-P scale were examined in a sample of 111 mothers of preschool-age children living in Santiago, Chile. The original IM-P model with five factors and 31 items showed indicators of goodness of fit within acceptable ranges, however two items presented extremely low factor loadings that suggest a lack of fit to the model. Also, there was a high correlation between two factors which were theoretical and conceptually very related: Compassion for the self and child and Non-judgmental Acceptance of the self and child. Therefore, it was considered appropriate to test a new four-factor model in which these two factors were merged into one, and items loading low in the previous model were eliminated. This new model showed a slightly better fit than the five-factor model. The resultant four-factor version and its subscales showed good internal consistencies. Construct validity of the IM-P scale was investigated by calculating correlations with general mindfulness (Five Facet Mindfulness Questionnaire, FFMQ). As expected, a significant positive correlation was found between the two measures (r=0.73, p<0.01), and among almost all subscales. In general, the results present sound psychometric properties of the Spanish translation of the IM-P in Chilean mothers of preschool children.

Resumen Las propiedades psicométricas de la versión en español de la escala de Atención Plena (Mindfulness) Interpersonal en la Parentalidad (IM-P) fueron examinadas en una muestra de 111 madres de niños y niñas de edad preescolar en Santiago de Chile. La estructura de cinco factores de la escala IM-P original no fue completamente respaldada mediante análisis factorial confirmatorio. Por lo tanto, se testeó una estructura de cuatro factores. Dos de los factores encontrados fueron coherentes con aquellos originalmente hipotetizados. Los otros consistieron en una re-agrupación de items de las subescalas Consciencia Emocional de si misma y del hijo(a), Aceptación sin juicio de si misma y del hijo(a) y Compasión hacia si misma y hacia su hijo(a), en dos factores: uno que da cuenta de compasión y no-juicio de la madre hacia si misma y, el otro que da cuenta de la compasión, no-juicio y consciencia emocional de la madre hacia su hijio. La versión resultante de cuatro factores y sus sub-escalas presentaron buena consistencia interna. Se analizó la validez de constructo mediante cálculo de correlaciones con mindfulness general (Cuestionario de cinco dimensiones de Mindfulness, FFMQ). Como se esperaba, se encontró una correlación positiva significativa entre las dos medidas (r=0.71, p<0.01), y entre la mayor parte de las subescalas. En general, los resultados dan cuenta de buenas propiedades psicométricas de la versión en español de la escala IM-P en madres de niños y niñas preescolares en Chile.

Signaling pathways involved in inhibition of macrophage phagocytosis by TcpC of uropathogenic Escherichia coli / 中华微生物学和免疫学杂志

Objective:To investigate the signaling pathway of inhibiting macrophage phagocytosis of TIR domain-containing protein encoded by Escherichia coli (TcpC) N-terminal ubiquitin ligase active fragments of uropathogenic Escherichia coli. Methods:Bioinformatics software was used to analyze the amino acid sequences and the function of TcpC N-terminal ubiquitin ligase active fragments as well as the functional sites. PCR was performed to amplify tcpc-330, tcpc-450 and tcpc-510 genes and a prokaryotic expression system was constructed to express the target proteins. The recombinant proteins rTcpC-N110, rTcpC-N150 and rTcpC-N170 were purified by Ni-NTA affinity chromatography. LPS in the recombinant proteins was removed by Detoxi-gel chromatography. The expression of MyD88 at protein and mRNA levels in macrophages incubated with rTcpC-N110, rTcpC-N150, rTcpC-N170 or rTcpC-TIR was detected by Western blot and qRT-PCR. The activation of NF-κB signal pathway and the levels of proinflammatory factors in macrophages incubated with the above TcpC protein fragments were measured by Western blot and ELISA, respectively. Results:Cys12, Trp104 and Trp106 in the N-terminal fragment of TcpC were crucial amino acids in maintaining its ubiquitin ligase activity. The target recombinant proteins rTcpC-N110, rTcpC-N150 and rTcpC-N170 were successfully expressed and purified. After Detoxi-gel chromatography, rTcpC-N110, rTcpC-N150 and rTcpC-N170 extracts were undetectable for LPS. TcpC ubiquitin ligase fragments inhibited the expression of MyD88 at protein level, but not affect its expression at mRNA level in macrophages. LPS-induced phosphorylation of NF-κB signaling pathway-related proteins p50 and p65 was significantly inhibited in macrophages treated with TcpC ubiquitin ligase fragments. Moreover, LPS-induced production of pro-inflammatory factors was also significantly inhibited.Conclusions:The recombinant proteins rTcpC-N110, rTcpC-N150 and rTcpC-N170 could inhibit the expression of MyD88 at protein level and suppress the activation of NF-κB signaling pathway, suggesting that they were closely related to the inhibition of innate immune activity of macrophages.

O Impacto do Programa "Ainda Estou a Aprender" na Fluência Leitora dos Alunos com Dificuldades / The Impact of the Program "I'm Still Learning" on Reading Fluency of Students with Difficulties / El Impacto del Programa "Todavía estoy aprendiendo" en la Fluidez Lectora de Estudiantes con Dificultades

As estratégias de intervenção no âmbito das dificuldades na aprendizagem da leitura constituem o foco deste trabalho. No panorama nacional, a escassez desses recursos educativos, associada ao fraco investimento na sua validação empírica, orientaram o nosso interesse para a análise desta temática. O recente programa Ainda Estou a Aprender (AEA) é uma ferramenta que tem como objetivo avaliar e intervir na aprendizagem da leitura, mas não se conhecem estudos que atestem a sua eficácia. Neste contexto, desenvolvemos um estudo com 44 alunos do 2º ano de escolaridade com dificuldades na aprendizagem da leitura, que distribuímos aleatoriamente por dois grupos, experimental e controle, no sentido de medir o impacto do programa AEA na fluência leitora. Ao grupo experimental foi aplicado o AEA, individualmente ou em pequeno grupo, em 18 sessões de 30 minutos durante seis semanas. O grupo de controle não seguiu o programa. O desempenho dos dois grupos foi monitorizado em três momentos (pré-teste, pós-teste e follow-up). Os resultados demonstram que os alunos do grupo experimental registaram um desempenho manifestamente superior na fluência (h2= .30), assumindo-se como uma prova da eficácia da intervenção. (AU)

Intervention strategies in the context of difficulties in learning to read are the focus of this work. In the national panorama, the scarcity of these educational resources, associated with the low investment in their empirical validation, guided our interest in analyzing this theme. The recent program "I'm Still Learning" is a tool that aims to assess and intervene in learning to read, but there are no known studies attesting to its effectiveness. In this context, we developed a study with 44 2nd grade students with difficulties in learning to read, which we randomly distributed into two groups, experimental and control, as to measure the impact of the program on reading fluency. The "I'm Still Learning" was applied to the experimental group, individually or in a small group, in 18 sessions of 30 minutes during six weeks. The control group did not follow the program. The performance of both groups was monitored at three times (pre-test, post-test and follow-up). The results demonstrate that the students in the experimental group registered a manifestly superior performance in fluency (h2 = .30), assuming this as a proof of the effectiveness of the intervention. (AU)

Las estrategias de intervención en el contexto de las dificultades para aprender a leer son el foco de este trabajo. En el panorama nacional, la escasez de estos recursos educativos, asociada a la baja inversión en su validación empírica, orientó nuestro interés por analizar este tema. El reciente programa "Todavía estoy aprendiendo" es una herramienta que tiene como objetivo evaluar e intervenir en el aprendizaje de la lectura, pero no se conocen estudios que atesten su eficacia. En este contexto, desarrollamos un estudio con 44 alumnos de segundo año con dificultades para aprender a leer, que distribuimos aleatoriamente en dos grupos, experimental y control, para medir el impacto del programa en la fluidez lectora. El "Todavía estoy aprendiendo" se aplicó al grupo experimental, individualmente o en grupo reducido, en 18 sesiones de 30 minutos, durante seis semanas. El grupo de control no siguió el programa. El desempeño de ambos grupos se controló en tres momentos (preprueba, posprueba y seguimiento). Los resultados demuestran que los estudiantes del grupo experimental registraron un desempeño manifiestamente superior en fluidez (h2 = .30), asumiendo esto como prueba de la efectividad de la intervención. (AU)

Genotypes of Epstein-Barr virus (EBV1/EBV2) in individuals with infectious mononucleosis in the metropolitan area of Belém, Brazil, between 2005 and 2016

Abstract Two types of Epstein Barr virus (EBV1/EBV2) have been shown to infect humans. Although their genomes are similar, the regions containing the EBNA genes differ. This study aimed to characterize the EBV genotypes of infectious mononucleosis (IM) cases in the metropolitan region of Belém, Brazil, from 2005 to 2016. A total of 8295 suspected cases with symptoms/signs of IM were investigated by infectious disease physicians at Evandro Chagas Institute, Health Care Service, from January 2005 to December 2016. Out of the total, 1645 (19.8%) samples had positive results for EBV by enzyme immunoassay and 251 (15.3%) were submitted to polymerase chain reaction (PCR) technique, using the EBNA3C region, in order to determine the type of EBV. Biochemical testing involving aspartate aminotransferase, alanine aminotransferase and gamma-glutamyl transferase were also performed. EBV type was identified by PCR in 30.3% (76/251) of individuals; of those, 71.1% (54/76) were classified as EBV1, 17.1% (13/76) as EBV2, and 11.8% (9/76) as EBV1+EBV2. The main symptoms/signs observed with EBV1 infection were cervical lymphadenopathy (64.8%, 35/54), fever (63%, 34/54), headache (20.4%, 11/54), arthralgia (20.4%, 11/54), and exanthema (18.5%, 10/54). EBV2 infection was detected in all but two age groups, with an average age of 24 years. The most common signs/symptoms of EBV2 were fever (76.9%, 10/13), average duration of 18 days, and lymphadenopathy (69.2%, 9/13). In contrast, EBV1+EBV2 coinfections were more frequent in those aged five years or less (20.0%, 2/10). The symptoms of EBV1+EBV2 coinfection included fever (66.7%, 6/9), and cervical lymphadenopathy and headache (33.3%, 3/9) each. The mean values of hepatic enzymes according to type of EBV was significantly different (p<0.05) in those EBV1 infected over 14 years of age. Thus, this pioneering study, using molecular methods, identified the EBV genotypes in 30.3% of the samples, with circulation of EBV1, EBV2, and EBV1+EBV2 co-infection in cases of infectious mononucleosis in the northern region of Brazil.

A study to assess and develop injection administration skill in medical undergraduates of GMC, Bhopal

Background: Injections are one of the vital route of drug administration in emergency medical practice. WHO has estimated that out of 12 billion injections administered worldwide annually 50% are unsafe and 75% are unnecessary. Despite of humungous efforts medical students still lack the confidence in injecting drugs due to stress for post graduation selection. The objectives of the study were to assess the knowledge of students regarding administration of I.M. and I.V. injections; to make students confident and skilful about administration of I.M. and I.V. injections and to assess the proportion of students who can skilfully administer I.V. and I.M. before and after this intervention.Methods: This was a Quasi experimental study carried out on 150 students of junior final medical students of GMC Bhopal for a period of three months.Results: Out of effective 136 students, 93.4% had ever seen I.M./ I.V. administration. 29.4% have administered I.M. and 16.9% I.V. injection ever. A significant increase in knowledge regarding I.M. and I.V. administration technique is observed following interventional training of the participants. Significant gain in self confidence among the students was perceived.Conclusions: There was a convincing increase in skillful knowledge and self-confidence for parenteral injection technique among medical undergraduates.

Metabolic Reprogramming by the Excessive AMPK Activation Exacerbates Antigen-Specific Memory CD8⁺ T Cell Differentiation after Acute Lymphocytic Choriomeningitis Virus Infection

During virus infection, T cells must be adapted to activation and lineage differentiation states via metabolic reprogramming. Whereas effector CD8⁺ T cells preferentially use glycolysis for their rapid proliferation, memory CD8⁺ T cells utilize oxidative phosphorylation for their homeostatic maintenance. Particularly, enhanced AMP-activated protein kinase (AMPK) activity promotes the memory T cell response through different pathways. However, the level of AMPK activation required for optimal memory T cell differentiation remains unclear. A new metformin derivative, IM156, formerly known as HL156A, has been reported to ameliorate various types of fibrosis and inhibit in vitro and in vivo tumors by inducing AMPK activation more potently than metformin. Here, we evaluated the in vivo effects of IM156 on antigen-specific CD8⁺ T cells during their effector and memory differentiation after acute lymphocytic choriomeningitis virus infection. Unexpectedly, our results showed that in vivo treatment of IM156 exacerbated the memory differentiation of virus-specific CD8⁺ T cells, resulting in an increase in short-lived effector cells but decrease in memory precursor effector cells. Thus, IM156 treatment impaired the function of virus-specific memory CD8⁺ T cells, indicating that excessive AMPK activation weakens memory T cell differentiation, thereby suppressing recall immune responses. This study suggests that metabolic reprogramming of antigen-specific CD8⁺ T cells by regulating the AMPK pathway should be carefully performed and managed to improve the efficacy of T cell vaccine.

Review of detection methods for neutrophil extracellular traps (NETs) / 中国药理学通报

Neutrophil extracellular trap nets (NETs) are complex networks of proteins and DNA. Many studies have shown that NETs are important participants in the pathophysiological processes of various immune inflammatory diseases, thrombosis, cancer and so on. The dynamic changes of NETs at each stage can predict the course of the disease to a certain extent. This article systematically reviews the current detection methods for ef-fectively quantifying NETs in order to provide the latest theoretical reference for the early detection of chronic inflammation and targeted therapy of cancer.

Effects of laparotomy on cognitive function in rats with traumatic brain injury and the realationship with calcium overload / 中华行为医学与脑科学杂志

Objective To evaluate the effect of laparotomy on cognitive function in rats with trau-matic brain injury and the relationship with calcium overload. Methods One hundred and fifty healthy male Wistar rats,aged 2~3 months,weighing 190~220 g,were assigned into 5 group ( n=30 each) using a ran-dom number table:blank group(group B),surgery group of blank rats(group BS),surgery group of sham rats (group SS),traumatic brain injury rats group( group T),surgery group of traumatic brain injury rats(group TS). TBI model was made in rats of group T and TS by Feeney method. Rats in group SS were only treated with cranial bone window without crainocerebral impact. Both group B and BS were normal rats. Then the rats in group BS,SS and TS group underwent laparotomy under sevoflurane anesthesia (the operation time was a-bout 3 hours) and the rats in group B and T inhaled pure oxygen for 3 hours after 20 days. One day before surgery,3 and 7 d after surgery,10 rats in each group were randomly selected for Morris water maze test. The hippocampus tissue of 10 rats were taken after the water maze test. The apoptosis rate and calcium concen-tration of hippocampal neurons were measured by flow cytometry,and the expression level of cleaved caspase-3 in hippocampal tissues was determined by Western blot. Results One day before surgery,compared with group B(the escape latency(9. 8±0. 8)s,the number of crossing platform (5. 8±0. 8),the apoptosis rate of hippocampal neurons ( 2. 5 ± 0. 9)%, calcium ion concentration ( 2. 3 ± 0. 2),the expression of cleaved caspase-3 (0. 22±0. 07) ),the escape latency of group T and group TS were prolonged (group T:(25. 5± 0. 7)s,P<0. 05;group TS:(25. 1±1. 1) s,P<0. 05),the number of crossing platform decreased (group T:(2. 7±0. 8),P<0. 05;group TS:(2. 8±0. 6),P<0. 05),the apoptosis rate of hippocampal neurons increased (group T:(5. 3±0. 6)%,P<0. 05;group TS:(5. 2±1. 0)%,P<0. 05),calcium ion concentration increased (group T:(3. 7±0. 4),P<0. 05;group TS:(3. 6±0. 5),P<0. 05) and the expression of cleaved caspase-3 increased (group T:(0. 45±0. 07),P<0. 05;group TS:(0. 44±0. 05),P<0. 05),the differences were statis-tically significant. Compared with the group SS,the escape latency ( 3 d after surgery:group SS:( 23. 8 ± 1. 3)s,group TS:(56. 4±2. 5)s,P<0. 05;7 d after surgery:group SS:(16. 6±1. 8)s,group TS:(38. 1±2. 1) s,P<0. 05)of the rats in group TS were prolonged,the number of crossing platform decreased (3 d after sur-gery:group SS:(2. 9±0. 6) ,group TS:(1. 1±1. 1) ,P<0. 05;7 d after surgery:group SS:( 4. 2± 1. 2) , group TS:(1. 7±1. 3),P<0. 05),the apoptosis rate of hippocampal neurons ( 3 d after surgery:group SS:(4. 8±0. 6)%,group TS:(14. 4± 0. 6)%,P<0. 05;7 d after surgery:group SS:(3. 8± 1. 1)%,group TS:(9. 6±1. 3)%,P<0. 05),calcium ion concentration ( 3 d after surgery:group SS:(3. 1± 0. 3),group TS:(6. 4±0. 5),P<0. 05;7 d after surgery:group SS:( 2. 6± 0. 3),group TS:( 4. 8± 0. 4),P<0. 05) ,the ex-pression of cleaved caspase-3 (3 d after surgery:group SS:( 0. 42± 0. 03),group TS:( 0. 88 ± 0. 08),P<0. 05;7 d after surgery:group SS:(0. 33±0. 05),group TS:(0. 63±0. 06),P<0. 05) in the hippocampus in-creased after surgery (P<0. 05). Compared with the T group,the escape latency (3 d after surgery:group T:( 18. 6±2. 0)s,group TS:(56. 4±2. 5)s,P<0. 05;7 d after surgery:group T:(13. 8±2. 6)s,group TS:(38. 1 ±2. 1)s,P<0. 05) of the rats in group TS were prolonged,the number of crossing platform (3 d after surger-y:group T:(3. 4±0. 5),group TS:(1. 1±1. 1),P<0. 05;7 d after surgery:group T:(4. 3±1. 2),group TS:(1. 7±1. 3),P<0. 05) decreased,the apoptosis rate of hippocampal neurons (3 d after surgery:group T:(4. 4±0. 7)%,group TS:( 14. 4 ± 0. 6)%,P<0. 05;7 d after surgery:( 3. 3 ± 1. 3)%,group TS:( 9. 6 ± 1. 3)%,P<0. 05),calcium ion concentration (3 d after surgery:group T:( 3. 4 ± 0. 4),group TS:( 6. 4 ± 0. 5),P<0. 05;7 d after surgery:group T:(3. 0±0. 3),group TS:(4. 8±0. 4),P<0. 05),the expression of cleaved caspase-3 (3 d after surgery:group T:(0. 40±0. 04),group TS:( 0. 88±0. 08),P<0. 05;7 d after surgery:(0. 35±0. 02),group TS:(0. 63±0. 06),P<0. 05) in the hippocampus increased after surgery(P<0. 05). Conclusion Laparotomy can aggravate the cognitive impairment of rats with traumatic brain injury and cause postoperative cognitive impairment,which may be related to the increased degree of calcium over-load and the increased rate of hippocampal neuron apoptosis.

Diagnóstico em psicanálise: da estrutura ao discurso / Diagnosis in psychoanalysis: from structure to discourse / Diagnostic en psychanalyse: de la structure au discours / Diagnóstico en psicoanálisis: de la estructura al discurso

O presente artigo propõe uma investigação acerca da questão do diagnóstico diferencial no contexto da prática de orientação psicanalítica. Trata-se de uma pesquisa traçada diante de uma constatação clínica que se refere à operacionalidade do diagnóstico estrutural, um apontamento de uma perspectiva na qual a orientação do manejo clínico perpassa não pelo rigor classificatório preestabelecido, mas factualmente pela questão do sujeito em sua relação com o Outro, sua posição de discurso.

This paper proposes an investigation regarding the issue of the differential diagnosis in the context of the psychoanalytic practice. It consists of a research based on a clinical observation that refers to the operability of the structural diagnoses. It points out to a perspective in which the direction of the clinical management is not pervaded by the pre-established classificatory rigor, but by the issue of the subject in his relation with the Other, his discursive position.

Cet article propose une investigation sur la problématique du diagnostic différentiel dans la pratique clinique orientée par la psychanalyse. Il s'agit d'une recherche élaborée à partir de la constatation observée dans la clinique, qui se réfère à l'opérationnalité du diagnostic phénoménologique ou structurel, d'une perspective dans laquelle l'orientation du maniement clinique ne se soumet pas à des rigueurs classificatoires préétablies, mais, effectivement, elle passe par la question du sujet dans sa relation à l'Autre, sa position dans le discours.

El presente artículo propone una investigación sobre la cuestión del diagnóstico diferencial en el contexto de la práctica de orientación psicoanalítica. Se trata de una investigación trazada frente a una constatación clínica que se refiere a la operatividad del diagnóstico estructural, una observación de una perspectiva en la cual la orientación del manejo clínico no está impregnada por el rigor clasificatorio preestablecido, sino por la cuestión del sujeto en su relación con el Otro, su posición de discurso.

Dieser Artikel beschreibt eine Forschungsarbeit zum Thema der Differentialdiagnose im Kontext der Praxis der psychoanalytischen Beratung. Es handelt sich um eine auf einer klinischen Bewertung beruhende Forschungsarbeit, welche die Durchführbarkeit der strukturellen Diagnose untersucht, ein Hinweis auf eine Perspektive, in der die klinische Praxis nicht auf eine vorgegebene klassifikatorische Strenge, sondern faktisch auf die Frage nach dem Subjekt in seiner Beziehung zum Anderen, seiner Position im Diskurs, beruht.

Glycyrrhiza uralensis Fisch L. crude polysaccharides enhance mouse immunity and immune responses induced by HPV-DNA vaccine / 中华微生物学和免疫学杂志

Objective To investigate the effects of Glycyrrhiza uralensis Fisch L. crude polysac-charides (GUCP) as an adjuvant on the immunity of mice and the immune responses induced by human pap-illoma virus ( HPV)-DNA vaccine. Methods ICR mice were injected with different concentrations of GUCP by different ways to detect the influences of GUCP on body weight, organ indexes and the numbers of immune cells in spleen. C57BL/ 6 mice were co-immunized with HPV-DNA vaccine and GUCP to detect the adjuvant efficacy on antigen-specific cellular and humoral immune responses. Results GUCP in all injected groups had no side effect on mouse body weight and liver, heart, lung and kidney indexes, but intraperitone-al injection of GUCP significantly increased spleen and thymus indexes and the numbers of B cells, CD4+ T cells, macrophages and dendritic cells in spleen. Subcutaneous injection of GUCP significantly increased the numbers of B cells and macrophages in spleen and intragastric administration significantly increased the num-bers of CD4+ and CD8+ T cells in spleen. Furthermore, GUCP as an adjuvant enhanced the antigen-specific CD4+ and CD8+ T cell responses and the levels of IgG, IgG1 and IgG2a induced by HPV-DNA vaccine at a certain degree. Conclusion GUCP enhanced the immunity of mice and the antigen-specific cellular and hu-moral immune responses induced by HPV-DNA vaccine. These results suggested that GUCP might be used as an adjuvant for DNA vaccine.

Expression and clinical pathological significance of the five types heavy chain of Ig protein in mucosa-associated lymphoid tissue lymphoma / 临床与实验病理学杂志

Purpose To investigate the expression of the heavy chain of Ig protein, and observed it's value on differential diagnosis and significance on clinical pathological. Methods50 cases of non-Hodgkin's lymphoma (NHL) were collected as experimental group, including 30 cases of MALToma, 10 cases of follicular lymphoma (FL), and 10 cases of plasmacytoma(PC), 10 cases of reactive lymphoid hyperplasia (RLH) were collected as control group. The expression of IgM, IgA, IgD, IgG and IgE were detected by immunohistochemistry in the two groups. Results The lower positive rates of IgM, IgA were observed in the experimental group, MALToma, PC, and the lower positive rates of IgG, IgA were observed in FL (P＜ 0.05 ). The positive rate and expression intensity of IgM showed a rising trend (P＜ 0.05), and the positive rate of IgG show a downward trend (P＞0.05) in FL, MALToma, PC. There were three patterns of the heavy chain expression in the two groups: a single type expression, all negative expression, and a various type expression. The positive rates of a single type/ all negative heavy chain expression were 86.7％, 60％, 80％, 0 respectively in MALToma, FL, PC and RLH, the differences were statistically significant (P＜ 0.05 ). The positive rate of IgG was related to the type of tumor cells in MALToma(P＜ 0.05 ). Conclusion The expressions of IgM and IgG show a contrast trend in FL, MALToma, PC, and support that the most of MALToma and PC which come from postgerminal center experience class switch recombination, and frequently express a single IgG. A single type/all negative heavy chain expression is a frequent event in the MALToma, and it's helpful to the differential diagnosis of MALToma and RLH.

Influence study of oxycodone hydrochloride injection pretreatment on postoperative analgesic and immune function after fracture / 临床外科杂志

Objective To observe the effects of oxycodone hydrochloride injection pretreatment on postoperative analgesic and immune function after fracture.Methods 120 patients scheduled to re-ceive orthopedic surgery under general anesthesia were randomly divided into oxycodone hydrochloride in-jection group(groupⅠ)and saline control group(groupⅡ)and 60 cases in each group.GroupⅠreceived pretreatment of 0.1 mg/kg oxycodone hydrochloride injection at 15 min before the end of surgery while groupⅡ received the same volume saline;all accepted postoperative intravenous analgesia postoperative-ly.Monitor visual analogue scores(VAS)at 2,6,12,24,48 h after operation in two groups,postoperative analgesia pressing times in 48 h and the incidence of adverse reactions;record NK cells,CD4 +T lympho-cytes cells,CD8+ T lymphocytes and CD4 +/CD8+ levels at 30min before anesthesia,postoperative 30 min,24 h,48 h.Results Compared with group Ⅱ,VAS scores of group Ⅰ at 2,6 h after operation were lower[(3.3 ± 0.6)vs(4.5 ± 0.7),(2.8 ± 0.5)vs(3.5 ± 0.6)],and 48 h postoperative analgesia press-ing times was less[(6.7 ± 2.2)vs(12.4 ± 2.5)](P<0.05).Compared with groupⅡ,NK cells,CD4 +T cells and CD4 +/CD8 +levels of group Ⅰ at 24 h,48 h after operation were higher[(10.2 ± 1.2)vs (9.1 ± 1.3),(9.6 ± 1.4)vs(8.4 ± 1.3);(40.5 ± 3.1)vs(37.4 ± 2.6),(39.6 ± 3.3)vs(34.3 ± 3.6);(1.6 ± 0.3)vs(1.3 ± 0.2),(1.5 ± 0.3)vs(1.2 ± 0.3)],and CD8+ T lymphocyte cell level was lower[(25.9 ± 2.2)vs(28.9 ± 2.1);(26.7 ± 2.3)vs(29.2 ± 2.5)](P<0.05);and in intra-group comparison,NK cells,CD4 +T cells and CD4 +/CD8 +levels of group Ⅰ,Ⅱ at 24 h,48 h after operation were higher,and CD8 +T lymphocyte cell level was lower(P <0.05). The adverse effects of the two groups had no significant difference(P>0.05).Conclusion Oxycodone hydrochloride injection precon-ditioning on postoperative analgesic after fracture has better effect,it can reduce the degree of postoperative pain and the degree of immune function decreased after the surgery,but it do not increase the adverse re-action,so clinical should be safe and worthy of promotion.

Application of Activities of Daily Living Scale in Mild Psychiatric Impairment As-sessment / 法医学杂志

Objective To explore the application of activities of daily living(ADL)scale in mild psy-chiatric impairment assessment under the guideline of Classification of Human Body Disability Caused by Injury. Methods A total of 124 subjects with organic mental disorders and mild psychiatric impair-ments(levels 7 to 10), and 106 healthy controls were included in. All participants were assessed by the ADL scale, physical self-maintenance scale(PSMS)and instrumental activities of daily living(IADL) scale. The difference between the scores of control group and study group, and the relationship of im-pairment level and the scores were compared, and the threshold value was determined according to the ROC curve. Results The total scores of ADL, IADL and PSMS were significantly different between the control group and the study group(P<0.05). The scores of ADL,IADL,PSMS were significantly different among the impairment levels(P<0.05), which showed a relativity with impairment level. The scores of ADL corresponding to levels 10, 9, 8 and 7 were 14-17, 18-23, 24-29 and 30-34, respectively, which showed a good correlation between the conclusion according to the scale and the expert's opinion(k=0.914, P<0.05). Conclusion The score of ADL was significantly related to mild psychiatric impairment, and the higher ADL score represents the more severe disability, which can be used as a reference index for preliminarily judging the level of mild psychiatric impairment.

Study on glycosaminoglycan from Apostichopus Japonius on cellular immuno-regulation function of peripheral blood cells from pulmonary tuberculosis patients in vitro / 中国医师杂志

Objective To investigate the effects of glycosaminoglycans (HGAG) on the immune function of peripheral blood cells from patients with pulmonary tuberculosis.Methods Peripheral blood monouclear cells (PBMC) were isolated from peripheral blood of 40 healthy people (healthy group) and 30 tuberculosis patients (tuberculosis group) and cocultured with HGAG in vitro for 24 hours.Flow cytometry was used to detect the expression of CD45RA and CD45RO,as well as the expression of CD1a and CD83.Results The results showed that the expression of CD45RA and CD45RO in the tuberculosis group was the most significant (P ＜ 0.05) at the concentration of 50 μg/m coculturing with HGAG.The expression of CD45RA and CD45RO were most obvious in the healthy group at the concentration of 10 μg/ml and 50 μg/ml respectively (P ＜0.001).The difference of CD45RA between the two groups was no significant (P ＞0.05),while the difference of CD45RO was statistically significant (P ＜ 0.01) before co-culturing.The expression of CD45RA and CD45RO at 10 μg/ml and 50 μg/ml after co-culturing with HGAG were statistically significant (P ＜ 0.05).There was no statistical difference in CD1a and CD83 in healthy group before and after co-culturing (P ＞ 0.05),while there was statistically difference (P ＜ 0.05) before and after culturing in tuberculosis group.Before co-culturing,there was no significant difference in the expression of CD1a between the healthy group and the tuberculosis group (P ＞ 0.05),but CD83 expression was statistically different (P ＜ 0.001).After co-culturing,there were no significant differences in CD1a and CD83 expression between healthy and healthy groups (P ＞ 0.05).Conclusions HGAG can down-regulate the expression of CD45RA and up-regulate the expression of CD45RO in a certain concentration range,and promote the maturation of dendritic cells (DC) in tuberculosis patients and regulate the cellular immunity of patients with pulmonary tuberculosis in vitro.

Effect of Yupingfeng granule on Th17/Treg balance in children with milk protein allergy / 中国医师杂志

Objective To observe Thl7 cells,Treg cells and their related factors in peripheral blood of children with milk protein allergy and explore the influence of Yupingfeng granule on Th17 / Treg imbalance and its clinical effect.Methods 40 children with milk protein allergy were divided into two groups randomly:the conventional treatment group (n =20),Yupingfeng granule group (n =20).The conventional treatment group received conventional treatment for 2 months.On the basis of routine treatment,Yupingfeng granule group was additionally treated with Yuping feng granule.The serum Th17,Treg cell counts,interleukin (IL)-17 and transforming growth factor-β1 (TGF-β1) levels were detected,and the eczema area and severity index (EASI) score of rash in children was recorded.Results The levels of Th17 cells and IL-17 in allergy children were obviously increased compared with those of the normal children,while the Treg cells,and the TGF-β1 level were lower than those of the normal children (P ＜ 0.05).After treatment,the Thl7 cells,the IL-17 levels and ESAI scores of the conventional treatment group and the Yupingfeng granule group were lowered,while the Treg cells and the TGF-β1 levels were increased (P ＜ 0.05).Compared with the conventional treatment group,these indexes increased and decreased more significantly in the Yupingfeng granule group (P ＜ 0.05).Conclusions Milk allergy children have obvious imbalance of Thl7/Treg;the Yupingfeng granule can adjust this imbalance and alleviate the allergic symptoms of milk protein.

Losartan inhibited atherosclerosis in experimental renal failure by regulating Treg/Th17 cells immune balance / 中国医师杂志

Objective To explore the effects and mechanisms of losartan on atheroscleorsis and T cell (Treg/Th17) immune balance of CKD apolipoprotein E knockout (ApoE-/-) mice.Methods The model of CKD was induced by a 5/6 nephrectomy (SNx) in male ApoE-/-mice.ApoE-/-mice were randomly allocated into 3 subgroups:the control group,SNx group and losartan group.The fifth week after building model the mice in losartan group were taken losartan at a dose of 30 mg/(kg · d) by intragastric administration for 12 weeks.While the other mice were treated with the same volume of 0.5％ sodium carboxymethylcellulose.Sixteen weeks after nephrectomy,the serum levels of urea and creatinine were determined.Haematoxylin Eosin (HE) staining were used to observe the general morphology changes of atherosclerotic plaque.Flow cytometry was performed to detect the proportion of T cells (Treg/Th17) in spleen.Enzyme linked immunosorbent assay (ELISA) was performed to detect the level of cytokines in serum such as interleukin (IL)-17,IL-6,transforming growth factor-β1 (TGF-β1) and IL-10.Results Sixteen weeks after nephrectomy,the result of serum creatinine and urea nitrogen showed the CKD animal model established successfully.Losartan could improved the renal function of CKD mice.The size of aortic root plaques in control group,SNx group,and losartan group are (16.35 ± 3.72) × 104 μm2,(28.64 ± 5.86) × 104 μm2 and (22.76 ± 3.97) × 104 μ m2 respectively,indicating that losartan treatment significantly decreased the size of aortic root plaques of the CKD mice (P ＜ 0.05).The proportion of Treg cells in the spleen of control group,SNx group,and losartan group are (4.34 ± 0.93) ％,(1.78 ± 0.56) ％,and (2.68 ± 0.58)％ respectively,indicating that losartan treatment significantly increased the proportion of Treg cells of CKD mice (P ＜ 0.01).The proportion of Th17 cells in the spleen of control group,SNx group,and losartan group are (0.11 ± 0.06) ％,(0.67 ± 0.12) ％,(0.37 ± 0.08) ％ respectively,indicating that losartan treatment significantly decreased the proportion of Th17 cells of CKD mice (P ＜ 0.01).Compared with control mice,the level of cytokines TGF-β1 and IL-10 in the serum of the SNx group mice significantly decreased (P ＜0.01),and the level of cytokines IL-17 and IL-6 in the serum of the SNx group mice significantly increased (P ＜0.01),indicating that such effects could be significantly regulated by losartan (P ＜ 0.05).Conclusions Losartan inhibited the differentiation of Th17 cell subsets,promoted the differentiation of Treg,and alleviated atherosclerosis in CKD ApoE-/-mice by modulating the immune imbalance of the Treg/Th17 cell.

The research of inflammatory cytokines and T cell activation in peripheral blood of opportunistic infections and death in HIV / 中国医师杂志

Objective The plasma levels of interleukin 6 (IL-6),high sensitive C reactive protein (hs-CRP) and the level of T cell activation were detected in the peripheral blood inflammatory factors of acquired immunodeficiency syndrome (AIDS) patients,and the relationship with opportunistic infection and prognosis was analyzed.Methods 79 human immunodeficiency virus (HIV)-positive/aids cases from May 2014 to January 2015 in first hospital of Changsha were enrolled in the study.They were divided into three groups:HIV-infected without opportunistic infections group (n =20),HIV-infected with infections group (n =43,including HIV-infected with tuberculosis group,HIV-infected with merge fungus group.HIV combined hepatitis C),death group (n =16).Serum IL-6 and the concentration of hs-CRP were detected by enzyme-linked immunosorbent assay (ELISA).Flow cytometry was used to test the CD3 + CD4 + cell count,the percentage of CD4 + CD38 + cell and CD8 + CD38 + cell in peripheral blood mononuclear cell (PBMC).Compare the differences among the three groups.Results The results showed that:the concentration of hsCRP and IL-6 in peripheral blood of HIV death group was significantly higher than that in other three groups (P ＜ 0.05).The concentration of hs-CRP and IL-6 in the peripheral blood of the HIV-infected with tuberculosis group and HIV-infected with merge fungus group were significantly higher than that in the HIV-infected without opportunistic infections group (P ＜ 0.05),and the hs-CRP in the peripheral blood of the HIV combined with the hepatitis C group was higher than that in the HIV-infected without opportunistic infections group (P ＜ 0.05).The number of CD3,CD4T lymph nodes in the death group and the combined opportunistic infection group was significantly lower than that in the HIV-infected without opportunistic infections group (P ＜ 0.05).The HIV-RNA expression in peripheral blood of the death group and the combined opportunistic infection group was significantly lower than that in the HIV-infected without opportunistic infections group (P ＜ 0.05).The expression of CD8+CD38+ on PBMC in the HIV-infected without opportunistic infections group was significantly lower than that in the death group,the tuberculosis group,the fungus group and the hepatitis C group (P ＜ 0.05).The expression of CD4+ CD38 + on PBMC in the HIV-infected without opportunistic infections group was higher than that in the death group (P ＜ 0,05).Conclusions The concentration of inflammatory cytokines (IL-6,hs-CRP) and the expression level of T cell surface CD8 + CD38 + related to immune activation were associated with opportunistic infection and prognosis of AIDS.

Correlation between CD8 + T cells' balance and prognosis for patients with diffuse axonal injury / 中国医师杂志

Objective To study the correlation between CD8 + T cells' balance and prognosis for patients with diffuse axonal injury(DAI).Methods To collect the 41 patients with DAI as observation group,with 33 cases light craniocerebral injury (LCI) patients and 35 healthy volunteers as control group.We detect the peripheral blood CD8 + CD28 + T cells and CD8 + CD28-T cell percentage,and calculate the ratio of both.The subjects working curve method (ROC) of.the above CD8 + T cells and its ratio were used to predict the prognosis of patients with DAI efficiency evaluation.Results (1) Compared with control group,CD8 + CD28 + T cells in patients with DAI and LCI increased significantly,and DAI was significantly higher than that of LCI group (P ＜ 0.05).Compared with control group,CD8 + CD28-T cells in patients with DAI were decreased,but no statistical difference was found between LCI and the control group,but DAI group was significantly lower than the LCI group (P ＜ 0.05).(2) CD8 + CD28-T cells and CD8 + CD28 +/CD8 + CD28-ratio were correlated with DAI diagnosis (P =0.003,0.000).When the percentage of CD8 + CD28-T cells =2.95％,the sensitivity of the diagnosis of DAI was 87.49％,86.21％;When the ratio of CD8 + CD28 +/CD8 + CD28-=7.39,the sensitivity was 92.63％,90.71％.(3) a total of 7 cases of patients died within 1 week after injury,CD8 + CD28 + T cells and CD8 + CD28 +/CD8 + CD28-ratio were significantly negative correlated with survival time (r =-0.739,-0.834,P =0.021,0.002),and CD8 + CD28-T cells were significantly positive correlated with survival time (r =0.782,P =0.006).Conclu sions Decreasing CD8 + CD28-T cells and higher CD8 + CD28 +/CD8 + CD28-ratio in patients with DAI immunological characteristics,especially the ratio (balance) is closely corrected with the diagnosis and prognosis of DAI.