Comparison of the predictive performance of Logistic regression, BP neural network and support vector machine model for the risk of acute exacerbation of readmission in elderly patients with chronic obstructive pulmonary disease within 30 days / 中华危重病急救医学

Objective:To compare the effectiveness of Logistic regression, BP neural network and support vector machine models in the prediction of 30-day risk of readmission in elderly patients with an exacerbation of chronic obstructive pulmonary disease (COPD) and to provide a scientific basis for the screening and prevention of high-risk patients with readmission.Methods:The COPD patient survey questionnaire was made, including the general data questionnaire, modified Medical Research Council dyspnea scale (mMRC), activities of daily living (ADL), the geriatric depression scale, the mini nutritional assessment-short form (MNA-SF) and COPD assessment test (CAT). Elderly COPD patients were selected from the department of respiratory medicine of 13 general hospitals in Ningxia from April 2019 to August 2020 by convenience sampling method, and they were followed up 30 days after discharge. To explore the risk factors of patient readmission, Logistic regression model, BP neural network model and support vector machine models were constructed based on the risk factors. According to the ratio of the training set to the testing set of 7∶3, the model was divided into the training set sample and the testing set sample. The prediction efficiency of the model was compared by the precision rate, recall rate and accuracy rate, F1 index and the area under the receiver operator characteristic curve (AUC).Results:A total of 1 120 patients were investigated, including 879 non-readmission patients and 241 readmission patients. Univariate regression analysis showed that there were statistically significant differences in age, education level, smoking status, proportion of diabetes and coronary heart disease, hospitalization times of acute exacerbation of COPD in the past 1 year, seasonal factors and long-term home oxygen therapy, regular medication, proportion of rehabilitation exercise, course of disease, ADL, depression status, mMRC, nutritional status between non-readmission patients and readmission patients. Binary Logistic regression analysis showed that education level, smoking status, coronary heart disease, hospitalization times of acute exacerbation of COPD in the past 1 year, seasonal factors, whether long-term home oxygen therapy, whether regular medication, nutritional status were the risk factors for 30-day acute exacerbation of readmission in elderly patients with COPD. The training set showed that the accuracy rate of Logistic regression model, BP neural network model and support vector machine models were 70.95%, 76.51% and 84.78%, respectively. The recall rates were 79.55%, 86.36% and 88.64%, respectively. The accuracy rates were 87.81%, 90.81% and 93.82%, respectively. F1 indexes were 0.75, 0.81 and 0.87, respectively. The AUC were 0.850, 0.893 and 0.921, respectively. The testing set showed that the precision rate of Logistic regression model, BP neural network model and support vector machine model were 78.38%, 80.65% and 88.57%, respectively. The recall rates were 70.73%, 60.98% and 75.61%, respectively. The accuracy rates were 85.82%, 84.40% and 90.07%, respectively. F1 indexes were 0.74, 0.69 and 0.82, respectively. The AUC were 0.814, 0.775 and 0.858, respectively.Conclusion:Comparing with Logistic regression and BP neural network, support vector machine model has better prediction effect, and can effectively predict the risk of acute exacerbation of readmission in elderly patients with COPD within 30 days.

Paeoniflorin-6'-O-benzene sulfonate ameliorates progression of adjuvant-induced arthritis by inhibiting interaction between Ahr and GRK2 of fibroblast-like synoviocytes / 中国药理学与毒理学杂志

OBJECTIVE Aryl hydrocarbon receptor (Ahr) is thought to be a crucial factor that regulates immune responses, which may be involved in the pathogenesis of autoimmune inflammation including rheumatoid arthritis (RA). The results of our group in recent years have shown that CP-25, a novel ester derivative of paeoniflorin, has a good effect on improving RA animal models. However, whether the anti-arthritis effect of CP-25 is related to Ahr remains unclear. METHODS CP-25 treatment ameliorated adjuvant-induced arthritis (AA), a mouse model of RA, by inhibiting Ahr-related activities in fibroblasts like synoviocytes (FLS). AA rats were treated with CP-25 or paroxetine from day 17 to 33 after immunization. RESULTS CP-25 alleviated arthritis symptoms and the pathological changes, decreased the expression of Ahr in the synovium and FLS of AA rats. Besides, treatment with CP-25 reduced the proliferation and migration of MH7A caused by Ahr activation. In addition, we also demonstrated that CP-25 down-regulated the co-expres?sion and co-localization of Ahr and G protein-coupled receptor kinase 2 (GRK2) in MH7A. CONCLUSION The data pre?sented here demonstrated that CP-25 suppressed FLS dysfunction in rats with AA, which were associated with reduced Ahr activation and the interaction between Ahr and GRK2.

Research Progress on Molecular Mechanism of Lipid-lowering and Anti-inflammatory Effect of Zexietang / 中国实验方剂学杂志

Zexietang is a Chinese herbal compound prescription with a long history， which consists of Rhizoma alismatis and Atractylodes macrocephala. Zexietang comes from "Synopsis of Golden Chamber"， as "there is a drink under the heart， and its people are bitter and dizzy". Zexietang has the effect of removing water from drinking water and invigorating spleen for diuresis. Modern pharmacological studies have shown that its lipid-lowering and anti-inflammatory effects are very significant. It can be used to treat hyperlipidemia， anti-atherosclerosis and non-alcoholic fatty liver disease. With the continuous development of molecular biology， the research on the pharmacological effects of Zexietang， extracts and their monomers has deepened to the molecular level gradually， and the relevant mechanism of action has also been continuously elucidated. In terms of lipid-lowering effect of Zexietang， the levels of cytokines or receptors such as 3-hydroxy-3-methyl glutaryl coenzyme A reductase （HMGCR）， cholesterol 7α-hydroxylase （CYP7A1）， and liver X receptors （LXR） are affected. It is widely involved in adenosine 5'-monophosphate-activated protein kinase （AMPK） and peroxisome proliferators-activated receptors （PPAR） pathways， while Zexietang's anti-inflammatory effect mainly affects inflammatory factors such as interleukins （IL） and tumor necrosis factors （TNF）， and simultaneously nuclear factor κB （NF-κB）， toll-like receptors （TLR） and other cytokines or receptor-related pathways. In order to promote the further research and clinical application of Zexietang and contribute to the development of modernization of traditional Chinese medicine， the studies of the past 15 years on molecular mechanism of the lipid-lowering and anti-inflammatory effect of Zexietang， Alisma and Atractylodes extract as well as their monomer components were reviewed.

Comparative analysis of the accuracy of visual qualitative assessment and semi-quantitative analysis in 18F-florbetaben β-amyloid imaging / 中华核医学与分子影像杂志

Objective:To compare the accuracy of visual qualitative assessment and semi-quantitative analysis for 18F-florbetaben ( 18F-FBB) β-amyloid (Aβ) imaging in the diagnosis of Alzheimer′s disease (AD) and to explore their clinical application value. Methods:From January 2019 to October 2019, 17 patients (8 males, 9 females, age (74.1±8.5) years) with mild/moderate-stage clinically probable AD and 17 cognitive normal control (NC; 9 males, 8 females, age (64.5±6.3) years) were prospectively enrolled in this study. All patients underwent dynamic 18F-FBB PET/CT brain imaging in the Chinese PLA General Hospital. Visual qualitative assessment and semi-quantitative analysis methods were used to analyze PET brain imaging results. The difference of standardized uptake value ratio (SUVR) between the two methods was analyzed by using independent sample t test. The consistency of the two methods and clinical results was analyzed by Kappa test. The cut-off value of SUVR for the diagnosis of AD was determined by receiver operating characteristic (ROC) curve. Results:The sensitivity, specificity and accuracy of visual qualitative assessment to diagnose AD were 14/17, 16/17 and 88.2% (30/34). The global SUVR of NC and AD group were 1.09±0.85 and 1.75±0.25 ( t=-10.263, P<0.001), and the composite SUVR were 1.16±0.57 and 1.89±0.15 ( t=-10.789, P<0.001), respectively. The cut-off value of SUVR for the diagnosis of AD was 1.47, with the sensitivity of 15/17, the specificity of 16/17 and the accuracy of 91.2%(31/34). The visual qualitative assessment and semi-quantitative analysis had good consistency with clinical diagnosis results with Kappa value of 0.765 and 0.824 respectively (both P<0.001). Conclusion:The visual qualitative assessment and semi-quantitative analysis methods used in 18F-FBB Aβ imaging to diagnose AD patients show high accuracy and can provide effective value for clinical diagnosis, but the visual qualitative assessment method is concise and easy to grasp, which is worth further promotion and use in clinical.

Forensic Analysis of 43 Medical Disputes Caused by Death after Cardiac Surgery / 法医学杂志

Objective To explore the causes and characteristics of medical disputes caused by death after cardiac surgery and to analyze the pathological changes after cardiac surgery and the key points of forensic anatomy, thus to provide pathological evidence for clinical diagnosis and treatment of cardiac surgery and judicial appraisal as well as reference for the prevention of medical disputes in such cases. Methods Forensic pathological cases of medical disputes caused by death after cardiac surgery which were accepted by the Center for Medicolegal Expertise of Sun Yat-Sen University from 2013 to 2018 were analyzed retrospectively from aspects such as causes of death, pathological diagnosis, surgery condition, medical misconduct, and so on. Results The causes of death after cardiac surgery of 43 patients were abnormal operation, low cardiac output syndrome, postoperative infection, postoperative thrombosis, and other diseases. Among the 43 cases, there were 18 cases without medical fault while 25 cases had medical fault. Conclusion The medical disputes caused by death after cardiac surgery are closely related to the operative technique and postoperative complications. The causes of medical faults include defects in diagnosis and treatment technique, as well as unfulfillment of duty of care.

Research progress on the abnormal metabolism of macrophages in rheumatoid arthritis pathogenesis / 药学学报

Macrophages play an important role in the pathogenesis of rheumatoid arthritis (RA). Previously, studies have shown that changes in the metabolism of glucose, choline, amino acids and lipids in macrophages of patients with RA can lead to the accumulation of metabolic intermediates which can act as inflammatory signaling molecules to aggravate the inflammation and cause complications. Therefore, a full understanding of the metabolic process of macrophages in RA patients will lay the foundation for macrophage-targeted therapy of RA. In this review, not only the role of macrophage abnormal metabolism in the pathogenesis of RA but also the research progress on macrophage-targeted drugs in RA treatment will be discussed.

Analysis and health risk assessment, including recommendation of limits for heavy metals and harmful elements in Chinese patent medicines / 药学学报

Heavy metals and other harmful elements in traditional Chinese medicines inflict serious damage on public health. Therefore, risk assessment of Chinese raw materials has gained increasing attention. To date, few reports have been published on the health risk assessment of heavy metals and harmful elements in Chinese patent medicines. To gain a comprehensive understanding of heavy metals and other harmful elements in Chinese patent medicines and to establish proper limits, residual Pb, Cd, As, Hg, Cu and Cr in 15 054 samples of 295 drugs was analyzed with regard to distribution and variation between elements and dosage forms. In addition, in accord with procedures including hazard identification, hazard characterization, exposure assessment and risk characterization, basic procedures and specific parameters for risk assessment of heavy metals and harmful elements in Chinese patent medicines were clarified based on the health risk assessment of 14 787 samples and 276 drugs. A method and equation for establishing residual limits is proposed. The results show that content and target hazard quotients (THQs) of the investigated elements in all samples showed a skewed distribution approaching 0. Content of Pb, As, Cu, Hg, Cd or Cr in the samples exceeded 100 mg·kg-1 and the content of Pb, As, or Cu in individual samples exceeded 1 000 mg·kg-1. THQs of 586 samples and four drugs were above 1. We believe that the health risk of Hg, Pb and As in Chinese patent medicines with dosage forms of pill, capsule, tablet and powder, especially those in raw powder preparations, warrant concern.

Association between family factors with dietary behaviors of left-behind children in rural China / 中国学校卫生

Objective@#To find out the association between family factors and left-behind children’s dietary behaviors in rural China.@*Methods@#This cross-sectional study was implemented in four counties of medium economic level were selected in Guizhou and Anhui province and four primary schools were chosen in each county and in total 16 schools were involved. Three classes from grades 5 and 6 each were selected randomly from included primary schools; all students in these classes, as well as their caregivers, were invited to participate. Self-designed questionnaire was adopted to collect intake frequencies of vegetable, fruit, meat, egg, milk, drink and fast food. Scores were calculated to evaluate these behaviors frequencies and multi-linear regression was used to explore the association between family factors and behavioral scores.@*Results@#The proportion of fruit, eggs and milk intake more than 4 times once a week in left-behind children were 44.9%, 35.1%, and 28.5%, while they were 57.2%, 38.5%, and 38.1% in non-left-behind children. It was found that statistical significant differences existed between scores of dietary behaviors of leftbehind children’s and non-left-behind children(t=-5.83, P<0.01). The results of multi-linear regression demonstrated that family cohesion (β=0.07, P=0.05) and caregivers’ behaviors (β=0.49, P<0.01) were protective factors for left-behind children’s behaviors, while taking care by single left-behind fathers was a risk factor(β=-1.21, P=0.03).@*Conclusion@#Primary caregivers play a critical role in offering guidance to children to help them develop health behaviors.

Application of Two-parameter Scoring System Based on CD105 and CD117 in MDS Diagnosis / 中国实验血液学杂志

OBJECTIVE@#To study the value of flow cytometric scoring system in the diagnosis of myelodysplastic syndromes (MDS).@*METHODS@#The phenotypes of erythroid and immature cells were analyzed retrospectively in 130 MDS patients, 19 healthy controls and 89 pathological controls, all of them were well clinically immunophenotyped. The 4-parameter scoring system reported in the literature was studied, including myeloblast-related cluster size, B-progenitor-related cluster size, lymphocyte to myeloblast CD45 ratio, and granulocyte to lymphocyte side scatter ratio. The two flow cytomatric parameters of the erythroid scoring system were analyzed, including CD36 coefficient of variation (CV) and CD71CV. According to our previous study, the percentage of CD117CD105 myeloid progenitor cells and the proportion of CD105 cells in CD117 cells were selected to establish a two-parameter scoring system, and compared with the four-parameter scoring system and the erythroid scoring system.@*RESULTS@#The sensitivity of the four-parameter scoring system and the erythroid scoring system for the diagnosis of low-risk MDS was 43.5% and 63.0%, and the specificity was 87.0% and 63.9%, respectively. After combining the two scoring systems, the sensitivity to diagnose low-risk MDS was 73.9% and the specificity was 62.0%. The sensitivity of the two-parameter scoring system for the diagnosis of low-risk MDS was 76.1% with a specificity of 81.5%. Combined with the four-parameter scoring system, the sensitivity was increased to 78.3%, but the specificity was reduced to 71.3%. After combining with the erythroid scoring system, the sensitivity reached 87.0%, but the specificity was reduced to 54.6%.@*CONCLUSION@#Using the two-parameter scoring system alone can achieve great sensitivity and specificity in the diagnosis of low risk MDS.

Progress in research of Trp-IDO1,2/TDO2-Kyn metabolic pathway in the pathogenesis of rheumatoid arthritis / 药学学报

Rheumatoid arthritis (RA) is an autoimmune disease characterized by excessive activation of autoreactive T cells and B cells, abundant production of autoantibodies and multiple joint involvement. Under the influence of heredity and environment, the disorder of innate immunity and adaptive immunity is the fundamental cause of the disease. In recent years, with rapid development of immunometabolism, milestone has been made in regulating the differentiation and function of immune cells through different energy metabolism pathways and related molecules. Many studies have shown that Trp-IDO1,2/TDO2-Kyn metabolic pathway mediates the pathogenesis and development of autoimmune diseases such as RA. This review summarizes the role of tryptophan (Trp), kynurenine (Kyn) and other metabolites in this metabolic pathway, as well as the role of rate-limiting enzymes indoleamine 2,3-dioxygenase 1 (IDO1), indoleamine 2,3-dioxygenase 2 (IDO2) and tryptophan-2,3-dioxygenase 2 (TDO2) in mediating RA inflammatory immune response and synovitis inflammation. This provides an important basis for elucidating the new pathological mechanism of RA and discovering new drug targets.

Characteristic and prognostic significance of leukemia stem cells associated antigens expressions in t (8;21) acute myeloid leukemia / 中华血液学杂志

Objective@#To investigate the characteristic and prognostic significance of leukemia stem cells associated antigens expressions including CD34, CD38, CD123, CD96 and TIM-3 in t (8;21) AML.@*Methods@#Bone marrow samples of 47 t (8;21) AML patients were collected at diagnosis from October 2015 to April 2018 in Peking University Peoples’ Hospital, then flow cytometry method was performed to detect the expression frequencies of CD34, CD38, CD123, CD96 and TIM-3 to analyze the relationship between leukemia stem cells associated antigens expressions and relapse.@*Results@#Of 47 t (8;21) AML patients tested, the median percentages of CD34+CD38-, CD34+ CD38-CD123+, CD34+CD38- CD96+ and CD34+ CD38- TIM-3+ cells among nucleated cells were 2.37%, 0.24%, 0.27% and 0.06%, respectively. All the frequencies of CD34+CD38-, CD34+CD38-CD123+, CD34+CD38-CD96+ and CD34+ CD38-TIM-3+ cells had no impact on the achievement of CR after the first course of induction. All higher frequencies of CD34+CD38-, CD34+CD38-CD123+, CD34+CD38-CD96+ cells were related to higher 2-year CIR rate. Whereas, the frequency of CD34+ CD38- TIM-3+ cells had no impact on CIR rate. Both high frequency of CD34+ CD38- cells and the high level of minimal residual diseases (patients with <3-log reduction in the RUNX1-RUNX1T1 transcript level after the second consolidation therapy) were independent poor prognostic factors of CIR[P=0.025, HR=6.9 (95%CI 1.3-37.4) ; P=0.031, HR=11.1 (95%CI 1.2-99.2) ].@*Conclusion@#Different leukemia stem cells associated antigens had distinct prognostic significance in t (8;21) AML. High frequencies of CD34+ CD38-, CD34+ CD38- CD123+ and CD34+CD38-CD96+ cells at diagnosis predicted relapse in patients with t (8;21) AML.

Study on the mechanism of intense pulsed light therapy for evaporative dry eye disease / 国际眼科杂志(Guoji Yanke Zazhi)

@#Dry eye disease(DED)is closely related to inflammatory diseases of the skin near the eyelids, such as ocular rosacea, <i>etc</i>. At present, intense pulsed light(IPL)is one of the main treatments for rosacea. Recent studies have found that patients with meibomian gland dysfunction(MGD)have alleviated the symptoms and signs of dry eyes during IPL treatment, but its specific mechanism is not clear. The purpose of this paper is to review the possible mechanisms of IPL treatment of dry eye and to discuss its rationality.

Diagnosis and treatment of autoimmune pancreatitis and the value of surgery / 中国实用外科杂志

OBJECTIVE: To summarize the experience of diagnosis and treatment of autoimmune pancreatitis(AIP)and to investigate the value of surgery in the management of AIP.METHODS: The clinical data of 17 patients with AIP who were admitted to Fujian Medical University Union Hospital between January 2013 and June 2017 were analyzed retrospectively. Observed indexes included clinical manifestations,blood test results,imaging findings,diagnosis and treatment and follow-up status. RESULTS:(1)Clinical manifestations:of the 17 patients,7 demonstrated obstructive jaundice,8 had upper abdominal pain,1 had recurrent diarrhea and 1 was found a pancreatic tumor by health checkup. Extrapancreatic organ involvement was detected in 11 of the 17 patients.(2)Blood test results:13 patients underwent serum IgG4 detection and increased expression of IgG4 was found in 13 patients.Increased expression of serum CA199 was detected in 4 patients. Elevated level of serum amylase was found in 3 patients.(3)Imaging findings:all the 17 patients underwent enhanced computed tomography(CT)scan of pancreas.Diffused enlargement of pancreas was observed in 12 patients and localized pancreatic enlargement was observed in 5 patients.(4)Diagnosis and treatment:All of the 17 patients were diagnosed as type 1 AIP. Three of the 17 patients underwent operation due to suspicion of pancreatic cancer and were diagnosed as AIP based on postoperative pathological examinations, including 2 pancreaticoduodenctomy and 1 distal pancreatectomy with splenectomy.Fourteen patients received initial steroid treatment. After steroid treatment,11 patients achieved remission, 1 underwent distal pancreatectomy with splenectomy due to continuous elevation of serum CA199,1 underwent pancreaticoduodenctomy because of a continuous enlarged pancreatic pseudocyst in the head of pancreas with obstructive jaundice,and 1 underwent cystjejunostomy due to a pancreatic pseudocyst in the body of pancreas with abdominal pain.(5)Follow-up status:All of the 17 patients were followed up for an average time of 29 months(range,12-66 months). Three patients who initially underwent pancreatectomy achieved remission after operation and no recurrence was observed. Of the 14 patients who received initial steroid treatment,11 got remission and the other three patients received maintenance steroid treatment for 3 months after operation and no recurrence was observed. CONCLUSION: The diagnosis of AIP should be based on the clinical manifestations,blood test results,imaging findings and pathological examinations. Steroid is the most critical therapy for AIP,but surgery is still important for the management of AIP,especially for localized AIP which is difficultly distinguished from pancreatic cancer and AIP with pancreatic pseudocyst which is refractory to steroid treatment.

Rheological properties of compound carrageenan / 药学学报

The rheological properties of six compound gels that consists of kappa carrageenan (KC) and another excipient such as konjac gum were explored through comparison of their viscosity measured by the rotation method. The gel fluid type was dependent on the rheological curve fitted by the power-law equation. The effect of concentration on the viscosity of different compound gels was investigated by establishing the linear equation between their viscosity and concentration, the slope of which was used to determine the relation between viscosity and concentration of different compound gels. The viscous flow activation energy (Eη) was calculated by the Arrhenius equation, which was able to investigate the effect of temperature on their viscosity. The interaction between monomer and compound gels was also studied by measuring their viscosity. The results showed that six compound gels were pseudoplastic fluid. Among all compound gels, the KC-xanthan gum (KC-XG) solution exhibited the most obvious shear thinning, the strongest pseudoplasticity, while the smallest Eη, resulting in the best thermal stability of viscosity. Furthermore, the concentration of KC-sodium hyaluronate (KC-HA-Na) solution affected its viscosity significantly. The viscosity of six compound gels was greater than the summation of the two kinds of monomer gels, which suggests that there is a synergistic-viscosity interaction between KC and another excipient.

GABA Receptor Activity Suppresses the Transition from Inter-ictal to Ictal Epileptiform Discharges in Juvenile Mouse Hippocampus / 神经科学通报·英文版

Exploring the transition from inter-ictal to ictal epileptiform discharges (IDs) and how GABA receptor-mediated action affects the onset of IDs will enrich our understanding of epileptogenesis and epilepsy treatment. We used Mg-free artificial cerebrospinal fluid (ACSF) to induce epileptiform discharges in juvenile mouse hippocampal slices and used a micro-electrode array to record the discharges. After the slices were exposed to Mg-free ACSF for 10 min-20 min, synchronous recurrent seizure-like events were recorded across the slices, and each event evolved from inter-ictal epileptiform discharges (IIDs) to pre-ictal epileptiform discharges (PIDs), and then to IDs. During the transition from IIDs to PIDs, the duration of discharges increased and the inter-discharge interval decreased. After adding 3 μmol/L of the GABA receptor agonist muscimol, PIDs and IDs disappeared, and IIDs remained. Further, the application of 10 μmol/L muscimol abolished all the epileptiform discharges. When the GABA receptor antagonist bicuculline was applied at 10 μmol/L, IIDs and PIDs disappeared, and IDs remained at decreased intervals. These results indicated that there are dynamic changes in the hippocampal network preceding the onset of IDs, and GABA receptor activity suppresses the transition from IIDs to IDs in juvenile mouse hippocampus.

Visually Isoattenuating Pancreatic Acinar Cell Carcinoma:Report of One Case / 中国医学科学院学报

Acinar cell carcinoma of pancreas(ACCP)is a rare pancreatic exocrine tumor that accounts for about 1% of pancreatic tumors. The typical imaging manifestations of ACCP are as follows:(1)the tumor is large in volume,partially or completely exophytic;(2)complete or incomplete capsule is visible with thin linear enhancement;(3)CT density and MRI signal:plain CT images reveals that the tumors have similar or slightly hypodense densities relative to the adjacent normal pancreas,the solid part of ACCP has low to intermediate signal intensity on T1WI and intermediate to high signal intensity on T2WI compared with the surrounding normal pancreas;(4)pattern of enhancement:tumors exhibit heterogeneous enhancement and it is less than that in the surrounding normal pancreas;(5)fissure-like,swirling necrosis that may be a characteristic change of tumor;(6)pancreatic and biliary duct dilatation is rare;(7)adjacent organs and blood vessels around the pancreas may be invaded;(8)distant metastasis of liver and other parts may be observed;(9)PET-CT shows high FDG uptake. An ACCP patient with atypical imaging manifestations was treated in Peking Union Medical College Hospital from November 2015 to August 2017. The lesion manifested iso-enhancement and many imaging examinations failed to find the tumor. The patient ultimately underwent surgery and diagnosed as ACCP by pathology.

Application of Sigma Management in Quality Control of Blood Cell for Occupational Health Examination / 现代检验医学杂志

Objective To evaluate the performance of the main indicators in the blood analysis of an occupational health exam ination agency by Sigma verification of performance chart and guide quality improvement.Methods Collected blood testing laboratory internal quality control (IQC) data in October 2016 and 2016 second national external quality assessment (EQA) results of the blood analysis laboratory in the agency.Regarded the accumulated coefficient of variability as the estimation value of imprecision.Used the percentage difference in EQA results as the estimation value of bias (％) of the laboratory.The total allowable error in health industry standard WS/T406-2012 was adopted as the quality specification (％).Sigma verification of performance chart of the main eight projects in the blood analysis were drawn with professional software.Results The sigma value of WBC reached σ≥6 level,as the first-class performance,and the sigma values of HGB in the 4≤σ ＜5 level,test performance was good.The sigma value of Hct,HCV and MCHC all were in the 3≤σ＜4 level,as the critical level,and the sigma values of RBC,platelet and MCH in the 2≤σ＜3 level,as poor performance.Conclusion Sigma verifica tion of performance chart could reflect the level of the laboratory testing performance on different test items of blood count,promote the quality improvement.

Allogeneic demineralized cancellous bone for cartilage tissue engineering / 西安交通大学学报(医学版)

Objective Chondrocytes were seeded on allogeneic demineralized cancellous bone (DCB ) constructing tissue-engineered cartilage to evaluate the feasibility of DCB as scaffolds for tissue engineering cartilage.Methods Allogeneic DCB was prepared by successive defatting and decalcification and then observed under scanning electronic microscope.One-month old rabbit articular chondrocytes were isolated and proliferated by monolayer culture.Passage 1 chondrocytes were seeded on DCB to construct tissue-engineered cartilage in vitro for 6 weeks.Specimens were taken after 7,14,21,28,35 and 42 days'culture and evaluated by hematoxylin and eosin (HE),toluidine blue (TB),and immunohistochemistry for collagen type Ⅰ and Ⅱ.Results Prepared DCB showed three-dimensional porous structure of 100 - 500 μm with good plasticity and certain mechanical strength. Chondrocytes grew well on and inside the DCB,and were located in lacunae and expressed matrix proteoglycan and type collagen Ⅱ,which formed cartiageous tissues on DCB up to 42 days'culture.Conclusion DCB combined with allogeneic chondrocytes successfully constructed tissue-engineered cartilage in vitro ,which is an ideal scaffold for tissue engineering cartilage.

Allogeneic demineralized cancellous bone for cartilage tissue engineering / 西安交通大学学报(医学版)

Objective Chondrocytes were seeded on allogeneic demineralized cancellous bone (DCB ) constructing tissue-engineered cartilage to evaluate the feasibility of DCB as scaffolds for tissue engineering cartilage.Methods Allogeneic DCB was prepared by successive defatting and decalcification and then observed under scanning electronic microscope.One-month old rabbit articular chondrocytes were isolated and proliferated by monolayer culture.Passage 1 chondrocytes were seeded on DCB to construct tissue-engineered cartilage in vitro for 6 weeks.Specimens were taken after 7,14,21,28,35 and 42 days'culture and evaluated by hematoxylin and eosin (HE),toluidine blue (TB),and immunohistochemistry for collagen type Ⅰ and Ⅱ.Results Prepared DCB showed three-dimensional porous structure of 100 - 500 μm with good plasticity and certain mechanical strength. Chondrocytes grew well on and inside the DCB,and were located in lacunae and expressed matrix proteoglycan and type collagen Ⅱ,which formed cartiageous tissues on DCB up to 42 days'culture.Conclusion DCB combined with allogeneic chondrocytes successfully constructed tissue-engineered cartilage in vitro ,which is an ideal scaffold for tissue engineering cartilage.

Comparison and analysis of minimal residual disease in multiple myeloma patients detected by 4-color and 8-color fluorescence antibody panels / 中华血液学杂志

Objective@#To explore and compare 4-color and 8-color fluorescence antibody panels for detecting minimal residual disease of multiple myeloma patients after therapy.@*Methods@#One 8-color antibody panel was built including CD38 and CD138 for the identification of plasma cells (PCs) , membrane antigen CD45, CD19, CD56 and CD117, cytoplasmic Kappa (cκ) and Lambda (cλ) light chain antigen. Six tubes of 4-color panels were built, among them, membrane antigen CD45/CD19, CD56/CD117, CD19/CD56 and light chains were analyzed combined by CD38/CD138 for PCs gate in the tubes M1-3 and tube C-κ/λ, respectively; CD19 or CD45 and cκ/cλ light chains were detected in the tube MC1-CD38 for CD38/SSC identified PCs gate and tube MC2-CD138 for CD138/SSC identified PCs gate separately. Twenty normal volunteer bone marrows and seventy-three specimens from multiple myeloma patients after complete remission were measured and analyzed.@*Results@#MRD positive samples were discriminated in 82.19% of the specimen evaluated through either abnormal plasma cells (aPCs) or clonal plasma cells (cPCs) by 8-color antibody panel. Among of them, consistency was 89.04%. The median percentage of cPCs was 0.105%. The lowest sensitivity of experiment was 0.004%. Percentage of PCs identified by CD38/ SSC gate was higher than that by CD38/CD138 (P<0.001) and CD138/SSC gate (P=0.001) apparently. The lowest MRD positive rate was found in tube C (65.75%) , which lower than 8-color panel obviously (P=0.024) . The percentages of aPCs measured by tube M2-56/117 were significantly lower than other tubes (P=0.014) . MRD positive rate determined by cPCs was higher than that by aPCs both in the tube MC1-CD38 and tube MC2-CD138, whose concordance rate were 68.49% and 79.45%, respectively. Compared with 8-color panel, tube MC2-CD138 the best choice among six tubes of 4-color panels, which has the best sensitivity, accuracy and negative predicted value, higher positive predicted value and specificity. Tube M1-45/19 was the second choice.@*Conclusions@#CD38/CD138 are the best markers for gating PCs. Membrane antigen and cκ/cλ detected simultaneously is a better method for MM MRD detection and 8-color antibody panel is an ideal approach. Two tubes of 4-color antibody combination, M1-45/19 and MC2-CD138 are recommended in the 4-color panels.