[Immunomicroecology: concept and applications].

Microorganism exerts a profound impact on the development and function of human immunity. Vice versa, immunity also affects the constitution and function of human microbiota. Hence, a new concept, immunomicroecology, has been put forward as an inevitable consequence of the development in the fields of microecology and immunology. Here, we describe the reciprocities between immunological system and microecological system, and elaborate the concept, developing course, and prospects of immunomicroecology.

[Short-term outcome of sacral neuromodulation on refractory interstitial cystitis/pelvic pain syndrome].

Objective: To summarize the initial experiences of applying sacral neuromodulation (SNM) for refractory interstitial cystitis/pelvic pain syndrome (IC/PPS). Methods: From January 2013 to August 2016, 26 patients with refractory IC/PPS (including 5 males and 21 females) treated with SNM were recruited in Beijing Chaoyang Hospital and Hebei Yanda Hospital in this retrospective study. The data before operation, after implantation of stage Ⅰ tined lead, and during short-term follow-up after implantation of stage Ⅱ implanted pulse generator (IPG) were compared in order to observe the improvement of relevant symptoms, and to summarize the effectiveness and safety of SNM for IC/PPS. Results: All the 26 patients received stage Ⅰ tined lead implantation under local anesthesia, of whom 7 patients finally had the tined lead removed under local anesthesia because of poor testing effects. And 19 patients chose embedding of IPG at the end of stageⅠ, with the conversion rate from stage Ⅰto stage Ⅱ being 73.1%. The mean follow-up time after stage Ⅱ was 12.1 months. The data at the end of follow-up compared with those before treatment were: voiding frequency in 24 hours 24.3±9.6 vs 13.5±5.7, nocturia 4.6±2.2 vs 2.7±1.5, average voiding amount (109.4 ±45.3)vs(172.6±61.6) ml, O'leary-sant scale score 26.0±3.1 vs 17.0±3.8, quality of life (QOL) score 5.7±0.4 vs 3.3±1.3, sex rating 5.4±1.4 vs 2.9±1.6, and Numeric Pain Intensity Scale 8.4±1.7 vs 3.9±1.2 (all P<0.05). During the follow-up period for the 19 patients, 11 showed symptoms relieve without recurrence, 5 patients had slightly symptoms recurrence and 3 patients had severe recurrence of pelvic pain and frequent urination. About 42.1%(8/19) patients received reprogramming, the average reprogramming rate being 1.73/person. And 84.2% (16/19) patients had symptoms improvement greater than 50% after stage Ⅱ IPG implantation. Conclusions: SNM is an effective, safe and minimally invasive procedure for refractory IC/PPS. IC/PPS is a good indication for SNM with a high conversion rate from stage Ⅰ to stage Ⅱ. Patients should be followed up regularly after operation, and reprogramming should be arranged according to the degree of symptom improvement.

Radiobiological effects of photon radiosurgery on choroid plexus cells in vitro.

The standard surgical treatment of hydrocephalus by cerebrospinal fluid (CSF) shunt is accompanied by numerous complications. The search for alternative treatment methods includes resection, coagulation and irradiation of part of the plexus choroideus. The reduction of CSF secretion after choroid plexus (CP) irradiation has been investigated only on the experimental level. The new Photon Radiosurgery System (PRS) now also provides clinically the opportunity to induce selective radionecrosis on the CP with high efficiency and safety. In order to achieve a basic understanding of the reaction of CP cells after PRS irradiation, we investigated the cell death after different irradiation doses using TB dye-exclusion and MTT assay on sheep choroid plexus (SCP) cells. We observed a dose-dependent decrease in cell survival with increasing doses of irradiation (9, 18, 27 and 36 Gy). Lower irradiation doses (9, 18 Gy) induced an initial decrease of cell survival. Cells were able to recover from day 6 on and achieved a similar cell viability compared to non-irradiated cells on day 12. In contrast, higher doses (27 and 36 Gy) of irradiation induced a constant decrease of the cell survival over 12 days. These results clearly demonstrate that PRS irradiation is able to induce radionecrosis of CP cells which are responsible for the secretion of CSF. Interstitial photon radiosurgery can provide the opportunity to deliver the irradiation dose locally to CP with minimal exposure of surrounding tissue. Our basic data support further studies investigating this concept in animal models and clinically.