Objective:To investigate and analyze the effect of ubiquitin-editing protein A20 on monocytes activity in patients with ventilator-associated pneumonia (VAP).Methods:Twenty-four VAP patients (VAP group) and twelve healthy controls (control group) were included from the First Affiliated Hospital of Zhengzhou University between February 2019 and September 2019. Peripheral blood mononuclear cells (PBMCs) and bronchial alveolar lavage fluid (BALF) (both infection site and non-infection site) were collected from VAP patients, while PBMCs were collected from healthy controls. A20 level in CD14 + monocytes were measured. CD14 + monocytes and CD4 + T cells were purified from VAP patients. CD14 + monocytes were transfected by A20 siRNA. Transfected CD14 + monocytes were directly/indirectly co-cultured with autologous CD4 + T cells. The secretion of interferon-γ (IFN-γ) and interleukin-17 (IL-17) by CD4 + T cells was investigated. Transfected CD14 + monocytes were directly/indirectly co-cultured with NCI-H889 cells. Cytotoxicity, and cytokines/granzyme B level, and tumor necrosis factor-related apoptosis inducing ligand (TRAIL)/Fas ligand (FasL) level was assessed. Student t test or SNK-q test was used for comparison. Results:VAP group had elevated percentage of circulating CD14 +A20 + cells than control group [(66.14±19.62)% vs. (52.52±13.71)%, P<0.05], and also had increased A20 mean fluorescence intensity (MFI) than control group [(268.0±72.56) vs. (197.4±60.01), P<0.05]. The percentage of CD14 +A20 + cells in BALF from infection site was higher than from non-infection site in VAP group [(66.14±19.62)% vs. (52.52±13.71)%, P<0.05], while A20 MFI in infection site was also up-regulated compared with non-infection site [(268.0±72.56) vs. (197.4±60.01), P<0.05]. In direct contact co-culture, A20 siRNA transfected CD14 + monocytes, which were purified from peripheral blood and BALF of VAP patients, induced elevated percentage of IFN-γ and IL-17 secreting CD4 + T cells than un-transfection or control siRNA transfection ( P<0.05). However, there were no significant differences of CD4 +IFN-γ + or CD4 +IL-17 + percentages among un-transfection, control siRNA transfection, and A20 siRNA transfection ( P>0.05). A20 siRNA transfected CD14 + monocytes, which were purified from peripheral blood and BALF of VAP patients, induced increased target cell death in both direct and indirect contact co-culture than un-transfection or control siRNA transfection ( P<0.05). Tumor necrosis factor-α, IL-6, granzyme B level and TRAIL MFI was also up-regulated ( P<0.05). There was no remarkable difference of target cell death between direct and indirect contact co-culture ( P>0.05). Conclusions:A20 was increasingly expressed in monocytes of VAP patients, and might dampen the activity of monocytes.

目的 研究黄芪多糖(APS)对支气管哮喘模型小鼠气道上皮中胸腺间质淋巴细胞生成素(thymic stromal lymphopoietin,TSLP)和树突状细胞(dendritic cell,DCs)表达的影响.方法 饲养雌性BALB/c小鼠30只,随机将其分为对照组、哮喘模型组和黄芪多糖组,各组采取相应的干预措施.通过支气管哮喘激发试验、肺组织病理学和酶联免疫吸附试验(ELISA)评价哮喘模型造模是否成功;肺组织中TSLP mRNA的相对表达水平采用实时荧光定量PCR(qRT-PCR)检测;蛋白免疫印迹实验(Western blot)检测肺组织中TSLP蛋白的表达;流式细胞术检测支气管肺泡灌洗液(bronchoalveolar lavage fluid,BALF)中DCs表面CD40、CD80和CD86的表达水平.结果 哮喘模型组小鼠气道反应性增高和肺组织HE染色结果均为哮喘的典型表现且哮喘模型组BALF中IL-13、IL-5和IL-4的表达水平显著高于黄芪多糖组和对照组(P＜0.001);黄芪多糖组和对照组小鼠肺组织中TSLP mRNA的表达水平与哮喘模型组相比较低(P＜0.001),TSLP mRNA的表达水平在黄芪多糖组与对照组之间差异无统计学意义(P＞0.05);黄芪多糖组与对照组小鼠肺组织中TSLP蛋白的表达与哮喘模型组相比较弱;黄芪多糖组与对照组BALF中DCs表面CD54、CD80、CD86的表达明显低于哮喘模型组(P＜0.001),黄芪多糖组与对照组之间差异无统计学意义(P＞0.05).结论 黄芪多糖可明显抑制哮喘模型小鼠气道上皮细胞TSLP水平和DCs表面CD54、CD80、CD86的表达,并减轻气道炎症反应.

Objective To discuss the clinical manifestation,pathological features and prognostic factors of pulmonary mucoepidermoid carcinoma (PMEC).Methods The clinical data of 31 cases of PMEC admitted to the First Affiliated Hospital of Zhengzhou University from May 2012 to May 2017 was retrospectively analyzed,its prognostic factors were also analyzed.Results There were 31 patients in this study,including 17 males and 14 females,age is (52.16 ± 17.15) years (range from 5 to 78 years).The pulmonary shadow was most common in the left upper lobe.15 cases were diagnosed by lung biopsy,14 cases were diagnosed by bronchoscopy,and two cases were confirmed by operation.One case was diagnosed as PMEC combined adenosquamous carcinoma in the 31 cases.There were 15 patients identified as high-grade PMEC and 16 patients identified aslowgrade PMEC.11 cases were underwent surgery treatment,20 cases were non-operatived treatment.The follow-up time was 5 ～ 72 months.The overall 1-,3-,5-year survival rates were 87.1％,45.2％,6.5 ％ respectively.The median survival time was 26 months.Conclusions PMEC is a rare malignant tumor of the lung,lacking specific clinical characterization,which mainly characterized as respiratory tract irritation and obstruction symptoms.PMEC can be diagnosed mainly depends on biopsy,bronchoscopy or histopathology,supplemented by immunohistochemical analysis.Surgery is the main treatment method,chemotherapy and molecular targeting therapy are also needed.The prognosis of PMEC relates topathological types,TNM stage and surgery treatment.

目的 探讨肺黏液表皮样癌的临床特征、影像学表现、预后及治疗.方法 回顾性分析郑州大学第一附属医院收治的1例肺黏液表皮样癌患者的临床资料,并进行相关文献复习.结果 该患者给予新辅助化疗3个周期后行胸腔镜下手术治疗,持续随访4个月疾病无复发.结论 肺黏液表皮样癌是一种罕见的肺部恶性肿瘤,其临床表现缺乏特异性,预后受多种因素的影响,治疗以手术为主,辅以化疗及靶向治疗.

Objective To investigate the changes in CD4+CD25+CD127 dim/- regulatory T cells ( Tregs) and interleukin ( IL)-35 in peripheral blood and bronchoalveolar lavage fluid ( BALF) samples from patients with ventilator-associated pneumonia ( VAP) . Methods A total of 23 patients with VAP and 11 normal controls ( NCs) were enrolled in this study. Peripheral blood mononuclear cells, serum and BALF samples were isolated and collected. Levels of IL-35 were measured by enzyme linked-immunosorbent assay. Percentages of CD4+CD25+CD127dim/-Tregs were measured by flow cytometry. CD4+CD25+CD127dim/-Tregs in BALF samples were isolated and purified, which were then stimulated with recombinant human IL-35 and co-cultured with autologous CD4+CD25-T cells. Cells and supernatants were harvested for analysis of cell proliferation and cytokine secretion. Results No significant difference in peripheral Tregs and serum IL-35 was found between patients with VAP and NCs. The percentages of Tregs and the levels of IL-35 in BALF samples collected from infectious sites were remarkably higher than those collected from non-infectious sites in patients with VAP. Moreover, there was a positive correlation between Tregs and IL-35 in BALF ( r=0. 441, P=0. 035). Tregs and IL-35 in BALF samples as well as Treg-secreted IL-35 were significantly re-duced in patients who had good response to therapy. However, no significant change in these parameters was observed in patients who had poor response to therapy. Besides, suppression of cell proliferation and IL-10 secretion that were related to Tregs were inhibited in patients whose condition was improved as compared with those in patients who had no response to therapy. Stimulation with recombinant human IL-35 enhanced the immunosuppressive function of purified Tregs that were separated from BALF of treatment-na?ve patients with VAP, which was mainly marked by suppressed cell proliferation, increased secretion of inhibitory cytokines (IL-35 and IL-10), and decreased secretion of proinflammatory cytokines (IFN-γ and TNF-α). However, IL-35 had little effect on the activities of Tregs that were separated from patients with VAP who responded to therapy. Conclusion Both IL-35 and Tregs are increased in BALF of patients with VAP and IL-35 en-hances the immunosuppressive function of Tregs, which indicates that IL-35-mediated modulation of Tregs might take part in the pathogenesis of VAP.

OBJECTIVE: To explore the expressions of STAT3 and MMP-9 in colorectal carcinoma tissues and its correlation with angiogenesis.METHODS:The expressions of STAT3,MMP-9 and CD-105 was studied by immunohistochemical staining in 60 colorectal carcinoma and 20 normal mucosa.RESULTS:The positive rates of STAT3 and MMP-9 in colorectal were 61.7% and 73.3% in colorectal carcinoma respectively,Whereas normal mucosa had weak reactivity,which were 30.0% and 35.0%(P0.05).The microvessel density(MVD) of colorectal carcinoma tissues was 36.02±9.74,which was significantly higher than that of the normal group(11.25±7.35,t=11.97,P0.01).The value of MVD was apparently higher in tumor tissue with both positive STAT3 and MMP-9 than in that with one or both negative group(P0.01).The expression of STAT3,MMP-9 and CD105 were all closely associated with histological differentiation,T-stage,lymph node invasion and hepatic metastasis(P0.05).Well,it had no correlation with sex,age and tumor size(P0.05).CONCLUSIONS:The high expression of STAT3,MMP-9 and MVD are significant concerned with the invasion and metastasis of colorectal carcinoma.Combined detecting of STAT3,MMP-9 and MVD may play an important role in judging the invasion,metastasis and the prognosis of colorectal carcinoma.

Objective To observe the effect of comprehensive therapy on the patients with gastric carcinoma.Methods The prognostic factors of gastric carcinoma were analyzed based on clinical data of 220 cases with gastric carcinoma who underwent surgical treatment.The rates of curative resection,recurrence,and mortality were analyzed between the different stages which were parted by the method of TNM.Results The stage I gastric carcinomas were all radical resected and found no recurrence or died case;the rates of curative resection,recurrence,and mortality of the stage Ⅱ patients were 100.0%,18.8% and 12.5% respectively;the rates of curative resection,recurrence,and mortality of the new adjuvant chemotherpy(NAC)group and the common chemocherapy(CC) group were(73.8% vs 61.2%,P<0.05),(38.5% vs 46.3%,P<0.05),and(32.3% vs 34.3%,P>0.05) respectively.Conclusion A suitable small resection operation for early gastric carcinoma is efficient and its prognoses are very good.NAC for the advanced gastric carcinoma is effective,which can improve the rate of curative resection and reduce the postoperative recurrence.Surgery-based comprehensive therapy used individually will improve the therapeutic effect of gastric carcinoma.

Objective To explore the expressions of signal transducers and activators of transcription 3(STAT3) and epidermal growth factor receptor(EGFR) in gastric carcinoma tissues and their correlation.Methods Immunohistochemical method for STAT3 and EGFR were performed for 60 cases of gastric carcinoma tissues,20 cases of normal gastric tissues.Results In gastric carcinoma,the expressions of STAT3 and EGFR were significantly higher than those of normal gastric tissues(P<0.05);and they were significantly correlated with the pathological grades,the depths of invasion,the lymph node metastases and the clinical stages(P<0.05).The expressions of STAT3 were positively correlated with EGFR(r=0.636,P<0.05).Conclusion STAT3 and EGFR can play an important role in the genesis and development of gastric carcinoma,and they give us a new direction to the diagnosis and therapy of gastric carcinoma.