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Currently, research and practice on roadway floor heave mainly explore the deformation mechanism and control technology of roadway floor. The mechanical analysis of floor before and after roof cutting and pressure relief in gob-side entry retaining is not comprehensive. In order to solve the above problem, mechanical models of the surrounding rock and floor of the roadway before and after roof cutting are constructed based on the features of coal partition failure. The effects of solid coal, roadway support, and goaf on the floor are analyzed. The analytical solutions for the floor heave of the roadway before and after roof cutting are obtained. The conclusion is drawn that the elastic-plastic zone of the coal wall beside the roadway, the support structure of the roadway, and the load on the floor of the subsidence zone jointly affect the magnitude of the roadway floor heave. Numerical simulation is used to verify the features of rock mass failure, stress distribution, and changes in floor heave in gob-side entry retaining before and after roof cutting and pressure relief. The results show that roof cutting and pressure relief technology can effectively reduce the damage area on the solid coal side and top of the roadway, and maintain the stability of the roadway rock mass structure. The maximum stress of the roadway floor, the resistance of the roadway side support, and the amount of roadway floor heave all decrease, with an average decrease of 25.78%, 56.14%, and 54.07%, respectively. The on-site application results show that the amount of floor heave of thick hard top in gob-side entry retaining is reduced from 709.345 1 mm to 320.965 8 mm. The roof cutting and pressure relief technology can optimize the stress structure of the surrounding rock of the roadway, suppress the floor heave of the roadway, and effectively improve the floor damage.

Objective To investigate the changes of retinal nerve fiber layer (RNFL) thickness and superficial vascular density in patients with Parkinson's disease (PD), and analyze the correlation between the changes and disease severity. Methods Total 43 patients (76 eyes) with PD admitted to the Affiliated Hospital of North Sichuan Medical College from June 2021 to March 2022, and 45 patients (90 eyes) with normal neurological and visual functions from their family members were recruited as the control group. Optical coherence tomography angiography (OCTA) was used to measure RNFL thickness, retinal blood vessel length density and perfusion density, and the area and circumference of foveal avascular zone (FAZ). Disease severity was evaluated by modified Hoehn - Yahr staging, and motor function was evaluated by Unified Parkinson's Disease Rating Scale Ⅲ (UPDRS Ⅲ) in PD group. Pearson and partial correlation analyses were used to investigate the correlation between retinal parameters and PD severity. Results Comparison of OCTA related parameters between the 2 groups: RNFL thickness (t = - 6.424, P = 0.000), central length density (t = - 3.629, P = 0.000), inner ring length density (Z = - 2.846, P = 0.004) and central perfusion density (Z = - 2.703, P = 0.007) in the PD group were lower than those in the control group. Correlation analysis showed that RNFL thickness was negatively correlated with UPDRSⅢ score (r = - 0.625, P = 0.000). Conclusions RNFL thickness may be a potential indicator for early diagnosis and evaluation of the severity of PD.

It is one of the main ideas of developing ATF cladding materials to improve the accident resistance of zirconium alloy by coating. In the existing research on the protection mechanism of the coating on zirconium alloy substrate, the main focus is on the oxidation resistance of the coating. It is often concluded that all kinds of coating can effectively improve the accident resistance of zirconium alloy. But in fact, the embrittlement of zirconium alloy cladding under accident conditions depends not only on the degree of oxidation, but also on the change of hydrogen content in zirconium alloy. The increase of hydrogen content will greatly reduce the plasticity of zirconium alloy under accident conditions. In this study, the high-temperature steam oxidation quenching experiment at 1 200 ℃ was carried out on the AlCrNbSiTi high entropy alloy coating zirconium alloy prepared by multi-arc ion plating process. The plasticity of zirconium alloy coated with high entropy alloy after oxidation was evaluated by ring compression. The embrittlement mechanism of zirconium alloy was investigated by weighing, metallography, scanning electron microscope, electron probe X-ray microanalysis and inert gas pulse melting infrared absorption method. After oxidation for 335 seconds, no oxide layer is observed on the coating side, which indicates that the coating can effectively prevent the oxidation of zirconium matrix under this oxidation condition. The result of testing the hydrogen content of the matrix is about 100 ppm (under the same conditions, the Zirlo alloy is about 10 ppm), and the result of testing the offset strain of the matrix is more than 20%, which indicates that the coating can not prevent the hydrogen content in the zirconium alloy matrix from increasing under this oxidation condition, but plays a reverse role. However, 100 ppm hydrogen is not enough to reduce the plasticity of high matrix, and oxidation still plays a major role. After oxidation for 500 seconds, no oxide layer is observed on the coating side, which indicates that the coating can still effectively prevent the oxidation of zirconium matrix under this oxidation condition. The result of testing the hydrogen content of the matrix is about 240 ppm (under the same conditions, the Zirlo alloy is about 10 ppm), and the result of testing the offset strain of the matrix is more than 5%. This indicates that the increase of hydrogen content caused by the coating is the main reason for the loss of plasticity of the zirconium alloy matrix. The results show that high entropy alloy coating can effectively prevent the oxidation of zirconium matrix, and the loss of plasticity of zirconium matrix may be due to the synergistic effect of hydrogen embrittlement and oxidation embrittlement.

Bacterial quorum sensing (QS) is a process in which bacteria conduct chemical communication through the production, release, accumulation and induction of signaling molecules called autoinducers (AI). Aeromonas is a common spoilage bacterium in aquatic products, and also a conditional pathogenic bacterium in animals and humans. In recent years, studies have reported that the pathogenicity and spoilage behavior of Aeromonas may be related to QS, suggesting that it can be prevented and controlled by inhibiting the QS. Aeromonas has three QS systems including AI-1 system with N-acyl homoserine lactones (AHLs) as signaling molecules, AI-2 system with 4,5-dihydroxy 2,3-pentanedione (DPD) derivatives as signaling molecules and AI-3 system regulated by QseBC. This paper introduces these three QS systems and their regulation mechanisms in detail. Furthermore, this paper focuses on recent progress in research on plant-derived, microbe- and animal-derived and chemically synthesized QS inhibitors (QSI) of Aeromonas. The potential application of QSI to the prevention of aquatic product spoilage and aquatic diseases caused by Aeromonas is discussed in order to provide a reference for the application of Aeromonas QSI in aquatic product safety.

Objective: In order to evaluate the difference of characteristic flavor intensity between different times of cyclic stewed beef. Methods: The volatile flavor compounds in circulating stewed beef were determined by solid phase microextraction-gas chromatography-mass spectrometry （SPME-GC-MS）, and the key flavors with important contribution were screened out according to the relative odor activity value. The flavor substances contributed by circulating stewed beef were analyzed by principal component analysis, the flavor intensity evaluation model of cyclic stewed beef was established, and the comprehensive evaluation of cyclic stewed beef was carried out combined with sensory evaluation. Results: The seven key flavourings were n-hexanal, undecanal, nonanal, n-hexanol, 3-methylpentane, cineole and anethole. The results showed that the contribution rates of the first to third principal components obtained by principal component analysis were 52.40%, 25.64% and 12.95% respectively, and the cumulative contribution rate was 90.98%, which could represent the main information of volatile flavor substances in cyclic stewed beef. The correlation coefficient between the characteristic flavor intensity of the model and the sensory score was 0.90（P＜0.05）. Conclusion: The model can be applied to the flavor evaluation of cyclic stewed beef.

Objective To explore the clinical effect of gait motor imagination therapy on improving motor function of stroke patients with hemiplegia. Methods A total of 120 stroke patients admitted to University of Chinese Academy of Sciences Shenzhen Hospital (Guang Ming) from January 2018 to January 2021 were selected and divided into intervention group and control group by random number table method. The control group was treated with conventional rehabilitation nursing therapy, and the intervention group was treated with conventional rehabilitation nursing combined with gait motor imagination therapy. After excluding the number of shedding cases, 59 cases were found in the intervention group and 56 cases in the control group. Fugl-Meyer scale and QLQ-C30 scale were used to evaluate motor function and quality of life in 2 groups, and the correlation between them was analyzed. Serum levels of BDNF and S100B were determined by ELISA. Results With the extension of intervention time, the improvement effect of Fugl-Meyer score, QLQ-C30 scale score, BDNF and S100B content in 2 groups was better (P< 0. 05). At 5 and 10 weeks after intervention, Fugl-Meyer score and the contents of BDNF and S100B in QLQ-C30 scale score in the intervention group were better than those in the control group (P< 0. 05). There was a significant positive correlation between motor function and quality of life (P< 0. 05). Conclusion Gait motor imaging therapy can effectively improve the patients' motor function, neurobiochemical indexes and quality of life, and the improvement of motor function is helpful to promote the improvement of patients' quality of life. (目的 探讨步态运动想象疗法改善脑卒中偏瘫患者运动功能的临床效果。方法 选取2018年1月—2021年1月中国科学院大学深圳医院(光明)收治的120例脑卒中患者, 采用随机数字表法将患者分为对照组和干预组。对照组采用常规康复护理疗法。干预组在对照组的基础上, 增加步态运动想象疗法。剔除脱落例数后, 干预组为59例, 对照组为56例。用Fugl-Meyer量表和QLQ-C30量表评定2组患者运动功能和生活质量, 分析两者的相关性。用ELISA法测定患者脑源性神经营养因子(BDNF)和S100B蛋白含量。结果 随着干预时间的延长, 两组患者的Fugl-Meyer得分、QLQ-C30量表得分、BDNF和S100B含量的改善效果越好(P＜0. 05); 在干预5周、10周时, 干预组Fugl-Meyer得分、QLQ-C30量表得分BDNF和S100B含量均优于对照组(P＜0. 05)。患者运动功能与生活质量呈显著正相关(P＜0. 05)。结论 步态运动想象疗法能有效改善患者运动功能、神经生化指标和生活质量, 且运动功能的改善有助于促进患者生活质量的提升。)

Objective To investigate the effect of family member participation nursing on depression of patients with dysphagia. Methods A total of 72 patients with dysphagia were selected and divided into control group and intervention group, with 36 cases in each group. The control group was given routine rehabilitation nursing, and the intervention group was given family member participation nursing on the basis of the control group. The nursing ability of family members, depression degree score and quality of life score of the two groups were observed on the first day of hospitalization and one month after intervention. Results After intervention, the Family Caregiver Task Inventory(FCTI) score of family members in intervention group was better than that in control group (P＜0. 01). The Hamilton Depression Scale(HAMD) in the intervention group was lower than that of control group(P＜0. 05), and the Swallow Quality-of-Life Questionnaire (SWAL-QoL)score in the intervention group was higher than that of control group (P＜0. 05). Conclusion Family participation nursing can improve the care ability of family members of patients with dysphagia, improve the depression state and improve the quality of life of patients. (目的 探讨家属参与型护理对吞咽障碍患者抑郁状态的影响。方法 选取2019年8月—2021年8月中国科学院大学深圳医院(光明)收治的吞咽障碍患者72例, 分为对照组和干预组, 各36例。对照组给予常规康复护理, 干预组在对照组基础上增加家属参与型护理。对比观察住院第1天及干预1个月后2组患者家属的照顾能力、患者抑郁程度评分和生活质量评分情况。结果 干预后, 干预组患者家属照护能力量表(FCTI)评分低于对照组, 差异有统计学意义(P＜0. 01)。干预组患者汉密尔顿抑郁量表(HAMD)评分低于对照组, 吞咽障碍生活质量量表(SWAL-QOL)评分高于对照组, 差异有统计学意义(P＜0. 01)。结论 家属参与型护理能提高吞咽障碍患者家属照顾能力和改善抑郁状态, 提升患者生活质量。)

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In order to solve the design problem of variable ratio tooth profile of gear for the recirculating ball variable ratio steering,a digital design method is put forward,the Boolean reduction operation macro program is established based on variable ratio movement rule and the envelope surface generation machining processes of variable ratio tooth profile of gear is simulated in CATIA software,and the three dimensional model of variable ratio gear is generated. The tooth surface is repaired and the virtual assembly of variable ratio gear is completed,then the kinematics simulation analysis of variable- ratio rack and pinion meshing pair is carried out by using ADAMS software,the curve of simulation is analyzed and compared with the curve of designing,the effectiveness of the method is validated.

Objectives: The present study used single-cell RNA sequencing (scRNA-seq) to characterize the cellular composition of ovarian carcinosarcoma (OCS) and identify its molecular characteristics., Methods: scRNA-seq was performed in resected primary OCS for an in-depth analysis of tumor cells and the tumor microenvironment. Immunohistochemistry staining was used for validation. The scRNA-seq data of OCS were compared with those of high-grade serous ovarian carcinoma (HGSOC) tumors and other OCS tumors., Results: Both malignant epithelial and malignant mesenchymal cells were observed in the OCS patient of this study. We identified four epithelial cell subclusters with different biological roles. Among them, epithelial subcluster 4 presented high levels of breast cancer type 1 susceptibility protein homolog ( BRCA1 ) and DNA topoisomerase 2-α ( TOP2A ) expression and was related to drug resistance and cell cycle. We analyzed the interaction between epithelial and mesenchymal cells and found that fibroblast growth factor (FGF) and pleiotrophin (PTN) signalings were the main pathways contributing to communication between these cells. Moreover, we compared the malignant epithelial and mesenchymal cells of this OCS tumor with our previous published HGSOC scRNA-seq data and OCS data. All the epithelial subclusters in the OCS tumor could be found in the HGSOC samples. Notably, the mesenchymal subcluster C14 exhibited specific expression patterns in the OCS tumor, characterized by elevated expression of cytochrome P450 family 24 subfamily A member 1 ( CYP24A1 ), collagen type XXIII α1 chain ( COL23A1 ), cholecystokinin ( CCK ), bone morphogenetic protein 7 ( BMP7 ), PTN , Wnt inhibitory factor 1 ( WIF1 ), and insulin-like growth factor 2 ( IGF2 ). Moreover, this subcluster showed distinct characteristics when compared with both another previously published OCS tumor and normal ovarian tissue., Conclusions: This study provides the single-cell transcriptomics signature of human OCS, which constitutes a new resource for elucidating OCS diversity.

Objective: To investigate the safety and efficacy of the TRIANGLE operation after neoadjuvant chemotherapy in locally advanced pancreatic cancer(LAPC). Methods: This study is a retrospective case series analysis. Between January 2020 and December 2022, a total of 103 patients were diagnosed as LAPC who underwent neoadjuvant chemotherapy at the Pancreas Center, the First Affiliated Hospital of Nanjing Medical University. Among them, 26 patients (25.2%) underwent the TRIANGLE operation. There were 15 males and 11 females,with a age of (59±7) years (range: 49 to 74 years). The pre-treatment serum CA19-9( M (IQR)) was 248.8(391.6)U/ml (range: 0 to 1 428 U/ml),and the serum carcinoembryonic antigen was 4.1(3.8)μg/L(range: 1.4 to 13.4 μg/L). The neoadjuvant chemotherapy regimens included: mFOLFIRINOX regimen in 6 cases(23.1%), GnP regimen in 14 cases(53.8%), and mFOLFIRINOX+GnP regimen in 6 cases(23.1%). The follow-up duration extended until June 2023 or until the occurrence of the patient's death or loss to follow-up. The Kaplan-Meier method was employed to estimate the 1-year and 3-year overall survival rates. Results: After neoadjuvant chemotherapy,CA19-9 levels decreased by 92.3(40.1)%(range:2.1% to 97.7%). Evaluation of the response to treatment revealed 13 cases(50.0%) of stable disease,11 cases(42.3%) of partial response,and 2 cases(7.7%) of complete response. The surgical operation consisted of 12 cases(46.2%) of pancreaticoduodenectomy,12 cases(46.2%) of distal pancreatectomy,and 2 cases(7.7%) of total pancreatectomy. Margin determination was based on the "standardised pathology protocol" and the "1 mm" principle. No R2 and R1(direct) resections were observed,while the R0 resection rate was 61.5%(16/26), and the R1(1 mm) resection rate was 38.5%(10/26).The R1(1 mm) resection rates for the anterior margin,posterior margin,transected margin,portal vein groove margin,and uncinate margin were 23.1%(6/26),19.2%(5/26),12.5%(3/24),2/14, and 1/12, respectively. The overall postoperative complication rate was 57.8%(15/26),with major complications including grade B/C pancreatic fistula 25.0%(6/24,excluding 2 cases of total pancreatectomy),delayed gastric emptying in 23.1%(6/26),wound complications 11.5%(3/26),postoperative hemorrhage 7.7%(2/26), chylous fistula 7.7%(2/26) and bile fistula 3.8%(1/26). No reoperation was performed during the perioperative period(<90 days). One patient died on the 32 nd day postoperatively due to a ruptured pseudoaneurysm. A total of 25 patients were followed up,with a follow-up time of 21(24)months(range: 8 to 42 months). During the follow-up period,8 cases(32.0%) died due to tumor recurrence and metastasis,while 17 patients(68.0%) remained alive,including 11 cases of disease-free survival,5 cases of distant metastasis,and 1 case of local recurrence. The overall survival rates at 1- and 3-year after the initiation of neoadjuvant chemotherapy were 95.8% and 58.9%, respectively. The overall survival rates at 1- and 3-year after surgery were 77.7% and 57.8%, respectively. Conclusion: Performing pancreatoduodenectomy according to the Heidelberg triangle protocol in LAPC patients after neoadjuvant chemotherapy might increase the R0 resection rate without increasing perioperative mortality or the incidence of major postoperative complications.

Objective: To investigate the clinical efficacy of distal pancreatectomy with celiac axis resection(DP-CAR). Methods: A total of 89 consecutive patients (50 males and 39 females) who were diagnosed with pancreatic body cancer and underwent DP-CAR in Pancreas Center,First Affiliated Hospital of Nanjing Medical University between September 2013 and June 2022 were retrospectively reviewed. There were 50 males and 39 females,with age( M (IQR)) of 63(12) years(range:43 to 81 years). Perioperative parameters,pathology results and follow-up data of these patients were analyzed, χ 2 or Fisher's test for categorical data while the Wilcoxon test for quantitative data. Survival results were estimated by the Kaplan-Meier survival method. Results: Among 89 cases,cases combined with portal vein-superior mesenteric vein or organ resection accounted for 22.5% (20/89) and 42.7% (38/89),respectively. The operative time,blood loss and postoperative hospital stay were 270 (110) minutes,300 (300) ml and 13 (10) days,respectively. The overall morbidity rate was 67.4% (60/89) while the major morbidity was 11.2% (10/89). The increase rate in transient liver enzymes was 42.7% (38/89),3.4% (3/89) for liver failure,53.9% (48/89) for clinically relevant postoperative pancreatic fistula,1.1% (1/89) for bile leak,3.4% (3/89) for chylous leak of grade B and C,11.2% (10/89) for abdominal infection,9.0% (8/89) for postoperative hemorrhage of grade B and C,4.5% (4/89) for delayed gastric emptying,6.7% (6/89) for deep vein thrombosis,3.4% (3/89) for reoperation,4.5% (4/89)for hospital mortality,7.9% (7/89) for 90-day mortality. The pathological type was pancreatic cancer for all 89 cases and pancreatic ductal adenocarcinoma made up 92.1% (82/89). The tumor size was 4.8(2.0) cm, ranging from 1.5 to 12.0 cm. The number of lymph nodes harvested was 14 (13)(range:2 to 33),with a positive lymph node rate of 13.0% (24.0%). The resection R0 rate was 30.0% (24/80) and the R1 (<1 mm) rate was 58.8% (47/80). The median overall survival time was 21.3 months (95% CI : 15.6 to 24.3) and the median disease-free survival time was 19.1 months (95% CI : 11.7 to 25.1). The overall survival at 1-year and 2-year were 69.60% and 39.52%. The median survival time of 58 patients with adjuvant chemotherapy was 24.3 months (95% CI : 17.8 to 32.3) while that of 13 patients without any kind of adjuvant therapy was 8.4 months (95% CI : 7.3 to 22.3). Seven patients accepted neoadjuvant chemotherapy and there was no significant morbidity among them,with a resection rate of R0 of 5/7. Conclusion: DP-CAR is safe and feasible for selective cases,which could be more valuable in improving long-term survival when combined with (neo) adjuvant therapy.

Background: The SMARCA4 mutation has been shown to account for at least 10% of non-small cell lung cancer (NSCLC). In the present, conventional radiotherapy and targeted therapy are difficult to improve outcomes due to the highly aggressive and refractory nature of SMARCA4-deficient NSCLC (SMARCA4-DNSCLC) and the absence of sensitive site mutations for targeted drug therapy, and chemotherapy combined with or without immunotherapy is the main treatment. Effective SMARCA4-DNSCLC therapeutic options, however, are still debatable. Our study aimed to investigate the efficacy and prognosis of programmed cell death 1 (PD-1) immune checkpoint inhibitors (ICIs) in combination with chemotherapy and chemotherapy in patients with stage III-IV SMARCA4-DNSCLC., Methods: 46 patients with stage III-IV SMARCA4-DNSCLC were divided into two groups based on their treatment regimen: the chemotherapy group and the PD-1 ICIs plus chemotherapy group, and their clinical data were retrospectively analyzed. Efficacy assessment and survival analysis were performed in both groups, and the influencing factors for prognosis were explored for patients with SMARCA4-DNSCLC., Results: Male smokers are more likely to develop SMARCA4-DNSCLC. There was no significant difference in the objective response rate (76.5% vs 69.0%, P=0.836) between chemotherapy and the PD-1 ICIs plus chemotherapy or the disease control rate (100.0% vs 89.7%, P=0.286). The one-year overall survival rate in the group with PD-1 ICIs plus chemotherapy was 62.7%, and that of the chemotherapy group was 46.0%. The difference in median progression-free survival (PFS) between the PD-1 ICIs plus chemotherapy group and the chemotherapy group was statistically significant (9.3 mon vs 6.1 mon, P=0.048). The results of Cox regression analysis showed that treatment regimen and smoking history were independent influencing factors of PFS in patients with stage III-IV SMARCA4-DNSCLC, and family history was an individual influencing factor of overall survival in patients with stage III-IV SMARCA4-DNSCLC., Conclusions: Treatment regimen may be a prognostic factor for patients with SMARCA4-DNSCLC, and patients with PD-1 ICIs plus chemotherapy may have a better prognosis.

Objective: To compare and analyze the clinical efficacy of pancreaticoduodenectomy for distal bile duct cancer and pancreatic head cancer. Methods: Clinical data of 1 005 patients who underwent pancreaticoduodenectomy and postoperative pathological examination confirmed the diagnosis of distal bile duct cancer and pancreatic head cancer at the Pancreas Center of the First Affiliated Hospital of Nanjing Medical University from January 2016 to December 2020 were analyzed retrospectively. There were 112 cases in the distal bile duct cancer group, 71 males and 41 females,with age ( M (IQR)) of 65(15) years(range: 40 to 87 years); 893 cases in the pancreatic head cancer group, 534 males and 359 females,with age of 64(13)years(range: 16 to 91 years). The differences between clinicopathological characteristics and postoperative overall survival of the two groups were analyzed by χ 2 test, Fisher's exact probability method, rank sum test or log-rank test, respectively. The difference in postoperative overall survival between the two groups was compared using Kaplan-Meier method after propensity score matching (1∶1). Results: Compared with the pancreatic head cancer group,the distal bile duct cancer group had shorter operative time (240.0(134.0) minutes vs. 261.0(97.0) minutes, Z =2.712, P =0.007),less proportion of combined venous resection (4.5% (5/112) vs. 19.4% (173/893), χ²=15.177, P <0.01),smaller tumor diameter (2.0(1.0) cm vs. 3.0(1.5) cm, Z =10.567, P <0.01),higher well/moderate differentiation ratio (51.4% (56/112) vs. 38.0% (337/893), χ²=7.328, P =0.007),fewer positive lymph nodes (0(1) vs . 1(3), Z =5.824, P <0.01),and higher R0 resection rate (77.7% (87/112) vs. 38.3%(342/893), χ²=64.399, P <0.01),but with a higher incidence of overall postoperative complications (50.0% (56/112) vs. 36.3% (324/892), χ²=7.913, P =0.005),postoperative pancreatic fistula (28.6% (32/112) vs. 13.9% (124/893), χ²=16.318, P <0.01),and postoperative abdominal infection (21.4% (24/112) vs. 8.6% (77/892), χ²=18.001, P <0.01). After propensity score matching, there was no statistical difference in postoperative overall survival time between patients in the distal bile duct cancer group and the pancreatic head cancer group (50.6 months vs. 35.1 months, Z =1.640, P =0.201),and multifactorial analysis showed that tumor site was not an independent risk factor affecting the prognosis of patients in both groups after matching ( HR =0.73,95% CI :0.43 to 1.23, P =0.238). Conclusions: Patients with distal bile duct cancer are more likely to benefit from early diagnosis and surgical treatment than patients with pancreatic head cancer,but with a relative higher postoperative complication rates. The different tumor origin site is not an independent risk factor for prognosis of patients with distal bile duct cancer and pancreatic head cancer after propensity score matching.

Abstract: Objective To explore the value of degree of cranial suture closure in forensic adult age estimation by thin-layer CT scan and establish an adult age estimation model of the Han nationality. Methods Thin-layer CT scan samples of the heads of 220 healthy Sichuan Han adults （110 males, 110 females） aged 20 to 70 were collected, of which 20 samples （10 males, 10 females） were randomly selected as test samples. The sagittal suture, coronal suture （both left and right） and lambdoid suture （both left and right） were respectively and equally divided into 2 segments, and every segment was equally divided into 10 layers and the corresponding multiplanar reformation （MPR） images were selected. The closure of cranial sutures on MPR images was classified into the grades 1-7. The correlations between cranial sutures and age were analyzed to build regression equation for age estimation. Results The degree of closure of sagittal suture, coronal suture （both left and right） and lambdoid suture （both left and right） was positively correlated with age. The coefficient of determination （ R 2 ） of regression equation was 0.419 in males, 0.589 in females, and 0.522 in all samples. The results of the verification test showed that the mean absolute error （MAE） was 6.39 years in males, 6.16 years in females, and 6.29 years in all samples. Conclusion There was a higher accuracy in adult age estimation by thin-layer CT scan of cranial sutures. The age of Han nationality adults can be estimated by the degree of cranial sutures closure., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Forensic Medicine.)

Objective: To explore susceptibility genes for autism spectrum disorders (ASD)., Methods: Whole-exome sequencing was carried out for 60 family trios affected with sporadic ASD. Genetic variants discovered in over 10% of the patients were selected for genotype-phenotype correlation and pathway enrichment analysis using Phenolyzer software and metascape database. Combining gene-phenotypic scores, pathway-related genes associated with neural and neurite triggering were screened for the candidates., Results: A total of 170 common variants were found to be associated with the ASD phenotype. Among these, there was only one high-confidence gene [SHANK2(0.8146)] and four medium-confidence genes [ERBB2(0.1322), LAMC3(0.1117), PPFIA4(0.1059), DISC1(0.1002)]. Twenty-pathways and four biological processes were found to be statistically significant by pathway enrichment analysis, which included neuron projection morphogenesis (GO: 0048812), regulation of neuroblast proliferation (GO: 1902692), modulation of excitatory postsynaptic potential (GO: 0098815), and dendrite morphogenesis (GO: 0048813). Twenty-one genes were found to be closely associated with neurological and neurite triggering, among which only SHANK2, ERBB2, and DISC1 had above-medium confidence correlation scores with the ASD phenotypes., Conclusion: Abnormal neuron projection morphogenesis (GO: 0048812) may be closely related to the occurrence of ASD. SHANK2, ERBB2, and DISC1 are susceptibility genes for ASD.

Objective: To investigate the therapeutic effects of first phase renal puncture and drainage guided by B ultrasound and second phase percutaneous nephrolithotomy(PCNL) in the treatment of urinary calculi complicated with pyonephrosis. Methods: From January 2014 to April 2018, 28 patients with upper ureteral segment and kidney calculi complicated with pyonephrosis were collected. All patients received the pyonephrosis puncture under B ultrasound. After the inflammation was controlled and the clinical situation improved, the second phase was treated by PCNL. During the operation, routine in dwelling ureteral stent drainage and renal fistula wereperformed. The outcomes of the operation were observed. Results: A total of 28 cases were successfully punctured, the obstruction was relieved and the inflammation was controlled. Additionally, the second phase of PCNL surgery was successful, and there were no significant stone residues after PCNL. There were no complications such as severe systemic inflammatory response syndrome and severe hemorrhage. After 3 to 12 months of follow-up, renal function was restored to varying degrees, and there were no renal failure patients who needednephrectomy. Conclusions: Early diagnosis of urinary calculi complicated with pyonephrosis is the key to successful treatment. Active and effective B ultrasound-guided renal puncture and drainage, drainage of pus, and removal of urinary obstruction can improve the safety of the second phase of PCNL, and thus it attaches great importance to the treatment of pyonephrosis.

Objective: To evaluate the clinical characteristics and survival outcomes of patients with de novo grade 3 or transformed follicular lymphoma (FL). Methods: Fifty-two patients treated at Peking University Cancer Hospital between January 2009 and September 2017 were assessed, including 28 patients with FL 3A grade, 13 patients with FL 3B grade, 11 patients with transformed FL. Baseline characteristics, survival and prognostic factors were analyzed. Results: ① Twenty-six male and 26 female patients were enrolled, including 28 patients with FL 3A grade, 13 patients with FL 3B grade, 11 patients with transformed FL. ②The 3-year progression-free survival (PFS) and overall survival (OS) for the entire cohort were 56.0% and 80.6%, respectively. Patients with international prognostic index (IPI) score 0-1 demonstrated significantly better 3-year PFS (80.3% vs 20.1%; t =18.902, P <0.001) and OS (95.7% vs 57.0%; t =10.406, P <0.001) than patients with IPI score 2-3. Three-year PFS (94.1% vs 37.2% vs 25.2%; P =0.002) and OS (100.0% vs 76.0% vs 59.8%; P =0.020) were also significantly different among patients with FLIPI 1 score 0-1, 2, ≥3. FLIPI 2 score was also identified as a prognostic factor for 3-year PFS (68.4%, 0, 0; P =0.001) and OS(87.5%, 76.2%, 0; P =0.003). ③Multivariate analysis indicated a significant association of PFS ( HR =3.536, P =0.015) and OS ( HR =15.713, P =0.015) with IPI. FLIPI 2 was associated with OS (score 0-1, HR =0.078, P =0.007; score 2, HR =0.080, P =0.022). Conclusion: De novo grade 3 or transformed FL might be a group of curable disease with current treatment strategies. IPI is still a prognostic tool in this scenario.

Objective: To evaluate the prognostic value of (18)F-fluorodeoxyglucose positron emission tomography (PET)/computed tomography (CT) in patients with diffuse large B cell lymphoma (DLBCL) undergoing autologous hematopoietic stem cell transplantation (auto-HSCT). Methods: Forty-eight patients with DLBCL treated at Peking University Cancer Hospital between November 2010 and December 2014 were assessed. All patients underwent PET/CT scanning prior to or after auto-HSCT. Correlation analysis was done based upon patients characteristics, PET/CT scan results and survival. Results: ①Among 48 patients, 27 was male, 21 female, median age was 43 (17-59) years old. ② Patients with negative pre-auto-HSCT PET/CT assessment demonstrated significantly better 3-year progression free survival (PFS) (87.1% vs 53.3%, χ (2)=7.02, P =0.019) and overall survival (OS) (90.3% vs 60.0%, χ (2)=6.51, P =0.022) than patients with positive pre-auto-HSCT PET/CT assessment. Three-year PFS (94.1% vs 30.0%, χ (2)=22.75, P =0.001) and OS (97.1% vs 40.0%, χ (2)=21.09, P =0.002) were also significantly different between patients with negative and positive post-auto-HSCT PET/CT assessment. ③ Multivariate analysis indicated a significant association of PFS ( HR =13.176, P =0.005) and OS ( HR =20.221, P =0.007) with post-auto-HSCT PET/CT assessment. Number of prior treatment regimens was associated with PFS ( HR =10.039, P =0.040). ④ Harrell's C index revealed that the value of combined use of number of prior treatment regimens and post-auto-HSCT PET/CT assessment was superior to either one used alone in PFS (Harrell's C values were 0.976, 0.869 and 0.927 in combined use, number of prior treatment regimens and post-auto-HSCT PET/CT assessment, respectively), and the combined use of ECOG performance status and post-auto-HSCT PET/CT assessment significantly increased the Harrell's C index in OS (Harrell's C values were 0.973, 0.711 and 0.919 in combined use, ECOG performance status and post-auto-HSCT PET/CT assessment, respectively). Conclusions: Post-auto-HSCT PET/CT assessment is the main predictor of outcomes in DLBCL patients receiving auto-HSCT. Combined use of post-auto-HSCT PET/CT assessment and number of prior treatment regimens and ECOG performance status is a better prognostic tool in patients with DLBCL undergoing transplantation.

Objective: To explore the clinical effect of a novel artery first and uncinate process first approach for laparoscopic pancreaticoduodenectomy(LPD), emphasizing the left lateral and posterior dissection of uncinate process (UP) via Treitz ligament approach. Methods: From April to November 2016, 18 patients received LPD with a novel approach in Pancreas Center of the First Affiliated Hospital with Nanjing Medical University. All patients were diagnosed as pancreatic head or peri-ampulla tumor, without major vessel invasion nor distant metastasis. For resection, routine caudal view was used in the first step, to dissect the anterior medial border between uncinate process and superior mesenteric vein(SMV). Lymphatic tissues were completely dissected form anterior surface of hepatoduodenal ligament. In the second step, left lateral view with camera from left para-umbilical trocar was used, Treitz ligament was incised, SMA root was exposed. After anticlockwise rotation and retraction of mesentery, the anatomic relationship between SMA trunk, inferior pancreaticoduodenal artery(IPDA), jejunal branch of SMV, and distal part of UP, could be perfectly exposed from left lateral view. SMA was dissected from its root until the position above the uncinate process and duodenum, IPDA was transected, distal part of UP was freed from SMA. In the third step, right lateral view and caudal view were alternatively used; proximal UP mesentery was completely dissected out from SMA root, CA root and posterior surface of hepatoduodenal ligament. Pancreaticoduodenectomy was completed in the forth step after transection of pancreatic neck and common hepatic duct. Results: The SMA root and distal UP were successfully dissected out via Treitz ligament approach in all 18 patients, among them, distal UP was completely excised in 8 patients from left view. Postoperative pathology showed R0 resection rate in 69%. Postoperative complication included intra-abdominal hemorrhage in 1 patient, pancreatic fistula in 7 patients(6 cases with grade A and 1 case with grade B), delayed gastric emptying in 4 patients (2 cases with grade A, 2 cases with grade B). Average postoperative hospital stay was (15.5±6.8)days. Conclusion: The novel artery first and uncinate process first approach through Treitz ligament could help surgeons to completely dissect the full length of meso-pancreas along celiac axis-SMA axis in LPD.

Objective: To investigate the clinical features, diagnosis, treatment and prognosis of primary intestinal lymphoma (PIL) . Methods: The characteristics, diagnosis, treatment methods, and follow-up outcomes of 99 PIL patients, diagnosed in Peking university cancer hospital between Nov.1,1995 and Nov. 30, 2013. Results: There were 65 males and 34 females with a median age of 50 years. The majority of clinical manifestation were non-specific gastrointestinal symptoms, 67.68% of cases presented abdominal pain, 26.26% with acute abdomen. The most common primary sites of ileum and ileocecus were identified in 21 cases, respectively. The positive rate of endoscopic was only 24.24%, and 69 cases were diagnosed by operation. 71 patients (71.72%) were stageⅠ-Ⅱand 28 patients (28.28%) were stage Ⅳ. Hodgkin's lymphoma was not found in all patients. Of the 99 cases, 77 were B-cell origin (77.78%) and 22 were T-cell origin. 55 cases (55.56%) were diagnosed with diffuse large B cell lymphoma (DLBCL) . 60 cases presented IPI score 0-1 point. The median overall survival (OS) was 100.0 months, and 5 year overall survival (5y-OS) was 53.5%. By multiple-factors analysis, T-cell origin lymphoma was significantly correlated with poor prognosis ( P <0.05) . There was no difference of the median OS between the patients with operation and chemotherapy alone (79.0 vs 123.0 months, P =0.616) . Conclusion: PIL is commonly seen in males. Abdominal pain is the most common clinical manifestations and the most primary sites are ileum and ileocecus. The diagnosis value of the endoscopic is limited. DLBCL is the most common pathologic type of PIL. T-cell origin lymphoma is an independent prognostic factor for PIL. Surgery is still commonly used in the diagnosis and treatment of PIL, and the operation do not increase the risk of death of patients with PIL.

Objective: To analyze the change of cigarette consumption price, and understand the cigarette affordability in China. Methods: A total of 16 800 households were selected through multi-stage stratified cluster sampling. Then IPAQ was used to randomly select one family member to conduct the survey. Questionnaire from Global Tobacco Surveillance System with added country-specific questions was used. Results: Up to 50 % of current smokers would buy 20 cigarettes with price of 9.9 yuan (RMB) or less, and 25 % of current smokers would not buy 20 cigarettes with price exceed 5.5 yuan (RMB). Only 10 % would buy 20 cigarettes with price over 19.9 yuan (RMB). The calculated median monthly expenditure for cigarettes was 181.4 yuan (RMB). From 2010 to 2015, the proportion of annual expenditure for cigarettes in disposable income per capita declined from 10.5 % to 8.8 % in urban area and from 21.1 % to 17.3 % in rural area. Conclusion: During 2010-2015, the purchasing power of Chinese smokers increased in both urban area and rural area due to the decrease of cigarette consumption price.

The automatic classification of epileptic electroencephalogram(EEG)is significant in the diagnosis and therapy of epilepsy.A classification algorithm for epileptic EEG based on wavelet multiscale analysis and extreme learning machine(ELM)is proposed in this paper.Firstly,wavelet multiscale analysis is applied to the original EEG to extract its sub-bands.Then,two nonlinear methods,i.e.Hurst exponent(Hurst)and sample entropy(SamEn)are used to the feature extraction of EEG and its sub-bands.Finally,ELM algorithm is employed in epileptic EEG classification with the nonlinear features.The proposed method in this paper achieved 99.5% classification accuracy for the discrimination between epileptic ictal and interictal EEG.The result implies that this method has good prospects in the diagnosis and therapy of epilepsy.

Objective: To investigate the efficacy and survival of the DICE regimen (cisplatin, ifosfamide, etoposide, dexamethasone) for relapsed and refractory NHL. Methods: Clinical data of 97 relapsed and refractory NHL patients treated with DICE regimen in Peking University Cancer Hospital between Sep 1. 2008 and Dec 31. 2013 were retrospectively analyzed, and then we evaluate the efficacy and safety of DICE regimen. Results: ① There were 64 males and 33 females with a median age of 49 years. The most common pathological type was DLBCL (73.20%). There were 35 B-NHL patients used rituximab combined with DICE. Finally, a total of 26 patients underwent autologous stem cell transplantation (auto-HSCT) after the salvage chemotherapy. ② The overall response rate (ORR) was 47.42%, the complete response (CR) rate was 22.68%. The ORR of the relapsed/progressive group was higher than the refractory group [67.57% (25/37) vs 35.00% (21/60), χ 2 = 9.736, P =0.002]. ③The median follow-up of these 97 patients was 15.0 months (1.5-80.0 months). The expected median progression-free survival (PFS) and overall survival (OS) was 12.0 (95% CI 5.0-19.0) months, 26.0 (95% CI 6.0-45.9) months. ④There was no difference between the auto-HSCT group and no auto-HSCT group in the median OS [41.0 (95% CI 8.9-73.1) vs 22.0 (95% CI 8.5-35.5) months, P =0.361]. The patients who achieved CR and PR after DICE regimen had longer OS than those patients who in stable or progressive disease (56.0 vs 18.5 months, P <0.001). Patients who used DICE combined with rituximab had longer OS than patients who only used DICE regimen (51.5 vs 28.5 months, P =0.041). The multiple-factor analysis showed that the efficacy of DICE was an independent prognostic factor of OS [ HR =4.24 (95% CI 2.12-8.50), P <0.001 ]. ⑤ The major adverse events included neutropenia (84.54% ) , thrombocytopenia (41.24% ), anemia (68.04%), and nausea/vomiting (65.98%), 14 patients (14.43%) had liver function abnormality, 1 patient had acute renal function injury during the treatment period. There was no chemotherapy-related death occurred. Conclusion: The DICE regimen is effective in refractory and relapsed NHL, and DICE is safe and well-tolerated. The high response rate of DICE regimen may correlate with good prognosis. For the B-NHL patients who used DICE combined with rituximab had longer OS than those patients who used DICE regimen only.

People aged 18 years could be punished lightly or diminished criminal responsibility, even be spared the death sentence, which has important meaning in Chinese judicatory adjudication. The epiphysis of long bones from human limbs and the secondary sexual characteristics almost have developed completely before 18 years old. Clavicle epiphysis is one of the articular metaphysis which has a late epiphyseal closure. The recent studies in exploring the rule of clavicle epiphyseal by multi-imaging technology shows that the development of clavicle epiphysis has some value in age estimation of 18 years old. CT, especially thin-section CT, is widely used at present. However, thin-section CT scanning has great net radiation, which is not ethically acceptable if it is not for diagnosis and treatment. MRI is nonradioactive tomographic imaging and easy to evaluate, which is one of the future research directions in forensic age estimation using the medial clavicle. This paper summarizes the progress on the rule of clavicle epiphyseal closure, and analyzes and summarizes the feasibility of rule of clavicle epiphyseal closure applies on age estimation., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Forensic Medicine.)

Objective: To understand the situation on exposure to second-hand smoke among Chinese adults aged 15 and above and their support to policy on banning smoking in public places in 2015., Methods: A cross-sectional survey was conducted based on the protocol on Global Adult Tobacco Survey. Stratified multi-stage cluster sampling was used to select 16 800 households in China. Data were collected through household survey, using the electronic devices. One eligible respondent was selected by random sampling in each household. Standardized questionnaire was used from Global Tobacco Surveillance System. Data were weighted and analyzed by SAS 9.3 and SUDAAN 10.0.1 complex survey data analysis program., Results: 93.1% (60 128×10(3)/64 575×10(3)), 76.3% (455 473×10(3)/596 782×10(3)), 57.1% (621 793×10(3)/1 089 582×10(3)), 54.3% (218 792×10(3)/402 732×10(3)), 38.1% (61 208×10(3)/160 574×10(3)), 26.9% (119 783×10(3)/444 679×10(3)), 23.8%(17 598×10(3)/73 993×10(3)), 17.2% (41 099×10(3)/239 022×10(3)) and 16.4% (102 153×10(3)/623 015×10(3)) of the respondents reported that smoking did exsit in the following places as: inside of bars or night clubs, in the restaurants, households homes, working places, government buildings, health care facilities, universities, primary and high schools (both indoor and outdoor areas), and on public transportation, respectively. Compared with those data in 2010, the proportions of exposure to indoor areas of restaurants, government buildings, health care facilities, primary and high schools (both indoor and outdoor areas), public transportation, and homes all significantly decreased after standardization of data. RESULTS also showed that most respondents were supportive to the policy on banning smoking in public and working places. However, the proportions of exposure to indoor areas of restaurants were still high but almost 70% of the respondents thought smoking should not be allowed in indoor areas of restaurants., Conclusion: From 2010 to 2015, proportions of exposure to indoor areas of public places, working places, public transportation and homes were obviously declining in China. The Chinese public seemed supportive to the policy on banning smoking in public places.

Objective: To compare the prognostic value of different models in patients with early-stage diffuse large B-cell lymphoma (DLBCL)., Methods: Early-stage DLBCL patients diagnosed from January 2000 to December 2012 were analyzed retrospectively. All patients received with at least 2 cycles of immunochemotherapy R-CHOP regimen (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) with or without radiotherapy. The prognostic value of international prognostic index (IPI) , revised IPI (R-IPI) and enhanced IPI (NCCN-IPI) was compared., Results: Ninety-seven cases of early-stage DLBCL were included in the study. The median age was 58 years (15-88 years) with a median follow-up of 34.7 months (range 7.3-77.4 months). The expected 5-year overall survival (OS) for entire group was 82%. There was no patient in the high risk group according to IPI or NCCN-IPI. According to IPI, the 5-year OS in the low, low intermediate, high intermediate risk groups were 95%, 38% and 60%, respectively. According to R-IPI, the 5-year OS in the very good, good, and poor risk groups were 93%, 75% and 60%, respectively. According to NCCN-IPI, the 5-year OS in the low, low intermediate, high intermediate risk groups were 92%, 85% and 29%, respectively., Conclusion: NCCN-IPI would be of an ideal prognostic model for early-stage DLBCL patients.

Objective: To establish regression model between craniofacial lines and body height by measuring craniofacial lines in Southwest Han males using CT and to accumulate data for the study of forensic anthropology., Methods: Head CT data of 273 Han males in Southwest were collected and 7 craniofacial lines were determined. Multiplanar reconstruction and volume rendering were performed by image post-processing software and the selected lines were measured. The relationship between each measuring indicator and body height was analyzed using SPSS 21.0 software. The regression equation of body height estimation was established and 50 samples were selected again and put into the mathematics models to verify its accuracy., Results: The linear regression equations of 7 lines were established (P < 0.05). The correlation coefficients of the unary linear regression equations were 0.190-0.439 and the standard errors of the estimate (SEE) were 4.597-5.023 cm. The correlation coefficients of the multiple linear regression equation were 0.494-0.524 and the SEE were 4.418-4.458 cm. The return tests showed that the highest ± 1SEE accuracy of the multiple regression equation: y = 83.959+3.589 x6+2.573 x2, were 30%; and the highest ± 2SEE accuracy of the multiple regression equation: y = 72.646+3.316 x6+1.586 x2+1.553 x4+2.211 x3, were 92%., Conclusion: There is significant linear correlation between 7 selected lines and the stature in this study, and the plural linear regression equation established could be applied for estimating the stature of Southwest Han males.

Until now, more than seventeen parvovirus have been reported which can infect mammals and poultries. The infected cells appeared different properties of apoptosis and death, present a typical cytopathic effect. NS1 is a major nonstructural protein of parvovirus, with a conservative structure and function, which plays an important role in the viral life cycle. In addition to the influence on viral replication, the NS1 also participates in apoptosis induced by viruses. Parvovirus induced apoptosis which is mainly mediated by mitochondrial pathway, this review summarized the latest research progresses of parvovirus induced apoptosis.

Objective: To establish the linear regression equation between body height and combined length of manubrium and mesostenum of sternum measured by CT volume rendering technique (CT-VRT) in southwest Han population., Methods: One hundred and sixty subjects, including 80 males and 80 females were selected from southwest Han population for routine CT-VRT (reconstruction thickness 1 mm) examination. The lengths of both manubrium and mesosternum were recorded, and the combined length of manubrium and mesosternum was equal to the algebraic sum of them. The sex-specific linear regression equations between the combined length of manubrium and mesosternum and the real body height of each subject were deduced., Results: The sex-specific simple linear regression equations between the combined length of manubrium and mesostenum (x3) and body height (y) were established (male: y = 135.000+2.118 x3 and female: y = 120.790+2.808 x3). Both equations showed statistical significance (P < 0.05) with a 100% predictive accuracy., Conclusion: CT-VRT is an effective method for measurement of the index of sternum. The combined length of manubrium and mesosternum from CT-VRT can be used for body height estimation in southwest Han population.

Objective: To analyze clinical features and outcomes of non-upper aerodigestive tract NK/T-cell lymphoma (NUAT-NKTCL)., Methods: Clinical data of 44 patients with NUAT-NKTCL diagnosed at Peking University Cancer Hospital between 1999 and 2013 were retrospectively analyzed., Results: Of the 44 patients, there were 31 males and 13 females with a median age of 39 years (range, 15 to 82 years). 27 patients (61.4%) were stage III/IV, 28(63.6%) with B symptoms, 12(27.3%) ECOG ≥ 2, 18 (40.9%) IPI score ≥ 3, and 48.8% patients had elevated serum lactate dehydrogenase. The common primary sites were skin (21/44, 47.2%) and intestinal tract (11/44, 25.0%). All the 44 patients received systemic chemotherapy. After a median follow-up of 13.5 months (range, 0.3-121.0 months), 32 patients died, and the median overall survival (OS) was 16 months with 1-year OS rate as 54.1%. CR rate of the 26 patients received CHOP or CHOPE regimens as the first line chemotherapy was 19.2% (5/26). Then L-asparaginase (L-ASP)- based regimens were used for salvage treatment, with CR rate of 47.7% and the median OS of 13 months. CR rate of the other 18 patients received L-ASP-based regimens in the firstline therapy was 55.6% (10/18) with the median OS of 16 months. Using L-ASP in firstline treatment obviously improved CR rate (P=0.015), but did not affect OS (P=0.774)., Conclusion: Although L-ASP improved the efficacy of NUAT-NKTCL, but the prognosis remained dismal. Thus, more effective treatment strategies are required for NUAT-NKTCL.

Objective: To evaluate the value of flow cytometry (FCM) in the diagnosis of bone marrow involvement in patients with non-Hodgkin's lymphoma (NHL)., Methods: The cytomorphology, biopsy and FCM tests were performed concurrently on bone marrow samples from 206 patients who were consecutively diagnosed as NHL from March 2013 to August 2013 at Peking University Cancer Hospital. The results were analyzed and compared., Results: Totally bone marrow involvement occurred in 25.7% (53/206) patients. The detection positivity of bone marrow involvement by cytomorphology, biopsy and flow cytometry were 6/14, 6/14 and 9/14 respectively in 14 T-cell lymphoblastic lymphoma and T-cell acute lymphoblastic leukemia (T-LBL/ALL) patients; 9.2% (14/152) , 19.1% (29/152) and 23.7% (36/152) respectively in 152 mature B-cell NHL patients; 0 (0/40) , 15.0% (6/40) and 2.5% (1/40) in 40 cases of mature T/NK-cell NHL. The overall rate of concordance of biopsy and flow cytometry was 88.3%., Conclusions: FCM has a high sensitivity in detecting bone marrow involvement in NHL patients, especially those with T-LBL/ALL and B-cell NHL. And a combination of morphology, biopsy and FCM may improve the sensitivity and accuracy in the detection of bone marrow involvement in NHL patients.

Objective: To study the infection status of Helicobacter pylori (H. pylori) and sensitivity to commonly used antibiotics in Taizhou district,Zhejiang province., Methods: 39 099 cases aged between 5 and 95 years old (mean as 48.42 years) were involved during January 2010 to December, 2013 for this study. Sex ratio was 1 : 0.95. Yearly distribution of the number of cases were 5 031, 6 709, 11 902 and 15 457 in 2010, 2011, 2012 and 2013, respectively. Gastric mucosal specimens were collected and H. pylori strains were isolated and cultured in the same platform in Zhiyuan Medical Inspection Institute of Hangzhou. Resistance tests of all the H. pylori isolates were performed to 6 commonly used antibiotics:metronidazole, clarithromycin, amoxicillin, gentamicin, levofloxacin and furazolidone with the agar dilution method. The antibiotic resistance rates of H. pylori strains isolated during year 2010-2013 and the changing trends were analyzed., Results: Resistance rates to levofloxacin and clarithromycin kept at higher level and the highest was in 2011 and then decreased in both 2012 and 2013 (P < 0.01). The resistance rates to both levofloxacin and clarithromycin reached the highest in 2011 (P < 0.01), and decreased thereafter, with no significant change in 2013 to 2012 (P > 0.05)., Conclusion: Antibiotic resistance rate against metronidazole for HP isolate was highest. Resistance rate against amoxicillin and furazolidone, gentamicin was low. Clinical treatment should choose amoxicillin and furazolidone, gentamicin. The resistance rates to levofloxacin and clarithromycin had been seen at a significantly downward trend since 2011. However, the combined resistance rates to levofloxacin and clarithromycin did not seem to reduce since 2012.

Objective: To determine the predictive value of interim and end-of-treatment ¹⁸F-FDG PET-CT after first-line treatment in patients with Hodgkin lymphoma (HL)., Methods: The clinical data of 50 newly diagnosed HL patients were retrospectively analyzed. Baseline, interim and end-of-treatment PET-CT were performed, and then imaging results were analyzed for the survival of patients via software SPSS 13.0., Results: Fifty patients received first-line treatment with ABVD (doxorubicin + bleomycin + vincristine + dacarbazine) or BEACOPP (bleomycin + etoposide + doxorubicin + cyclophosphamide + vincristine + procarbazine+ prednisone) regimen. Interim PET-CT of 35 patients were performed after 2-4 cycles of treatment, 46 patients received PET-CT scans at the end of treatment. After a median follow-up of 29.4 months (12.2-52.4 months), the 3-year progression-free survival (PFS) rates were 100% and 70% for the interim PET-CT negative (n=25) and positive (n=10) patients, respectively (P=0.004). The 3-year PFS rates were 100% and 60% for the post-treatment PET-CT negative (n=36) and positive (n=10) patients, respectively (P<0.01)., Conclusion: Interim and end-of-treatment PET-CT were correlated with 3-year PFS rates for HL patients. They may play an important role in predicting the outcome of HL. The relationship with OS can not be determined because of the short follow-up time.

The precondition of accurate gastric cancer surgery is precise assessment of lymph node metastasis. To date, no imaging modality achieves both high sensitivity and high specificity in detecting lymph node metastasis in gastric cancer. Intraoperative sentinel node tracing and biopsy are the most popular method to identify the localization of tumor cell, but is limited to early gastric cancer. Nano-composite materials, designed for tumor imaging and tracing, show us a newly emerging domain for tumor detection in gastric cancer. The function of these nano-composite materials to detect lymph node metastasis in gastric cancer relies on the effective backflow of lymph system. However, the lymph vessels can be obstructed by tumor cells in advanced gastric cancer, which may restrain the application of these nanoparticles. Therefore, more methods to detect lymph node metastasis in gastric cancer should be explored. This review summarizes the characteristic of the targeted nanosphere. Based on the reported studies, a novel idea is conceived that targeted multifunctional nanosphere may be a potential method to achieve precise assessment of lymph node metastasis in gastric cancer.

In this paper, a series of low-molecular-weight PEG-PCL-PEG triblock copolymers were successfully synthesized by ring-opening polymerization method, and were characterized using 1H-NMR and FTIR. The aqueous solution displayed specific thermosensitive gel-sol transition when the concentration was above corresponding critical gel concentration (CGC). The gel-sol phase diagram was recorded using test tube-inverting method, which was depended on the hydrophilic/hydrophobic balance in macromolecular structure, as well as heating history. As a result, the gel-sol transition temperature range could be altered, which might be very useful for its application as injectable drug delivery system.

Comet assay provided a object method for DNA damage caused by physical and chemical factors. A new system of SCGE image analysis, which combines microphotodensitometry and microphotography with image analysis have been developed. Compared with the international popular, it has well at speed, convenience, exchange face of Chinese and English and print. We used it to directly determine the A. flavus' DNA damages for citral. The results show that test time was shorted 2/3 and accuracy was improved. It is probable that cell structural parameter, cell molecule and membrane could be test long, successive, movably and instantly. So the new system has a wide application.

The purpose of the research is to provide a new standard for matching of HLA three-dimensional structure, and summarize the major permissible mismatch and immunogenic mismatch antigens. The molecular modeling method was used to create HLA molecular structures by Swiss Model Server, and the comparison of the differences among the alleles was done by SPDV software with the function of iterative magic fit. The results were recorded by relative mean square deviation (RMSD, nm). The differences among alleles were scattered below 0.06 nm for HLA-A and -B molecules, and below 0.03 nm for HLA-DRB1 molecules. On the basis of the statistical analysis, when RMSD is greater than 0.04 nm for -A and -B molecules and 0.02 nm for -DRB1 molecules, the difference is meaningful and can be related with graft versus host disease. When RMSD is lower than 0.02 nm for -A and -B molecules and 0.01 nm for -DRB1 molecules, the difference is decided unmeaningful. From the data, the permissible mismatch and immunogenic mismatch alleles within HLA-A, HLA-B and HLA-DRB1 molecules were summarized. Three-dimensional structure matching is a new area in the transplantation field, much research should be done in the future.

Aim: To study the correlation between the differences of three-dimensional structures among different HLA loci and their functions, and to investigate the potential usage of HLA conformational differences in predicting the occurrence of graft-versus-host disease (GVHD)., Methods: Total RNA were extracted from human peripheral blood, and reverse-transcription PCR (RT-PCR) were used to amplify the whole gene sequences of HLA-DR loci, and the PCR products were linked to vector and transformed to E.coli, and then sequencing. HLA-DR second exon amino acid sequences were inputted to computer, through internet to SWISS-MODELLING molecular modelling server to model their three-dimensional structure., Results: The whole HLA-DR loci sequences were successfully reversibly transcript from 2 normal unrelated donors. The sequencing results were completely identical to the published sequences of HLA-DRalpha * 0101, DRbeta1 * 04051 and DRbeta1 * 07011. The modelling results of the later two indicated that there were significant differences between their structures., Conclusion: The sequencing analysis of the whole HLA loci could clearly designate HLA allelic types, and three-dimensional structure modelling could directly identify the differences among them. Therefore, this study provide experimental foundation to the study of HLA structure and function, and uo the study of predicting GVHD after HLA incompletely matched hematopoietic stem cell transplantation (HSCT).

The decoction of Tribulus terresteis could significantly inhibit the gluconeogenesis and influence glycometabolism on normal mice. The decoction could also reduce the level of triglyceride and the content of cholesterol in the plasma.

Objective: To make a comprehensive and systematic study on the constructive expression of IL-6 mRNA and IL-6 autosecretion in human leukemic cells and discuss the effect of IL-6 autosecretion on the specific binding of IL-6-PE40 fusion protein to targeted leukemic cells., Methods: Semi-quantitative RT-PCR, sequencing and ELISA were used to detect the constructive expression of IL-6 mRNA and autosecretion level of IL-6 protein in human leukemic cell lines, such as U937, HL60, KG1, TF1, K562, HuT28, CEM and Raji., Results: The relative expression level of IL-6 mRNA in myelocytic, monocytic and erythrocytic leukemic cell lines including HL60, U937, KG1 and TF1 and lymphoblastic leukemic cell lines such as CEM, HuT28 and Raji is very weak, ranging from 0.03 to 0.07. However, K562, an chronic myelocytic leukemic cell line, had the highest level 1.25 among the 8 leukemic cell lines and the level was also higher than that of the positive control U266 multiple myeloma cell line. Based on ELISA assay of IL-6, there were remarkable differences between the 8 leukemic cell lines, their secretion of IL-6 could be divided into 3 levels, i.e. high, moderate and low secretion type., Conclusion: These observations imply that the intrinsic expression and secretion of IL-6 differ obviously among different leukemic cell lines. Autocrine IL-6 may prevent IL-6-PE40 fusion protein from specific binding to targeted leukemic cells and consequently affect its specific killing toxicity.

Objective: To study the influence of prophylactic cranial irradiation (PCI) on survival and brain metastases in patients with limited small-cell lung cancer (SCLC)., Methods: Fiftyone patients with limited SCLC under complete remission after chemoradiotherapy were randomly divided into prophylactic cranial irradiation (PCI) group (n = 26) and control group (n = 25). Patients in PCI group received irradiation at a dose of 25.2-30.6 Gy. Survival rates were analyzed and compared by life table and Long-Rank, incidence of cranial metastases by chi 2 test., Results: The clinical features of patients such as age, sex, effect of treatment before PCI were similar between the two groups. The incidence of cranial metastases was 3.8% in PCI group in contrast to 28% in the control group (P < 0.05). The 1, 2, 3-year survival rate was 84.6%, 73.1%, 42.3% respectively in PCI group and 72%, 40%, 32% respectively in the control group. The differences between the two groups of petients were statistically insignificant. No serious sequela was observed in patients receiving PCI., Conclusion: PCI decreases the incidence of cranial metastases for patients with limited SCLC following complete response to chemoradiotherapy, but it does not improve survival.

Olfactory neuroblastoma is a rare malignant tumor arising from the nasal cavity. From 1982 to 1987 fourteen cases had been treated in this hospital. The average age was 34 years with a range from 15 to 65 years, male to female ratio was 1:1. At the time of diagnosis, 3 tumors were of kadish stage A-involvement of the nasal cavity only, 5 of stage B-involvement of the nasal cavity and one or more paranasal sinuses, and six of stage C-extension beyond the nasal cavity, including the orbit, base of skull or intracranial cavity, or metastasis to cervical nodes or distant sites. All were treated with radiation therapy and 7 also by surgery. The three and five-year survival rates were 50% and 30% respectively. Seven patients died, six because of distant metastases within one year. It shows that the disease is aggressive from the beginning, and tends to metastasize early. A treatment regimen for prophylactic cervical node irradiation combining chemotherapy is proposed.