Objective To explore the prognostic value of peripheral blood absolute lymphocyte count (ALC) for patients with peripheral T-cell lymphoma,not otherwise specified (PTCL-NOS).Methods The clinical data of 69 patients with PTCL-NOS treated in Tianjin Union Medical Center from January 2008 to January 2016 were analyzed retrospectively.The relationship between different levels of ALC and clinical characteristics,therapeutic efficacy and prognosis was analyzed.Results Among 69 patients,23 cases (33.3％) had low ALC (＜1.0×109/L),and 46 cases (66.7％) had high ALC (≥ 1.0×109/L).Compared with the high ALC group,the low ALC group showed the higher International Prognostic Index (IPI) and PTCL-NOS Prognostic Index (PIT) scores,advanced clinical stage and higher lactate dehydrogenase level (all P ＜ 0.05).The total efficacy rate in the low ALC group was lower than that in the high ALC group [56.5％ (13/23) vs.67.4％ (31/46)],but the difference was not statistically significant (x2 =0.784,P =0.376).The 3-year survival rate in the low ALC group was significantly lower than that in the high ALC group,and the difference was statistically significant (40.5％ vs.68.6％,x2 =7.846,P =0.010).Univariate analysis showed that the US Eastern Cooperative Oncology Group performance status score ≥ 2,IPI score ≥2,Ann Arbor stage Ⅲ-Ⅳ and ALC＜1.0×109/L were the poor prognostic factors (all P ＜ 0.05),while Cox multivariate analysis showed that the Ann Arbor stage Ⅲ-Ⅳ and ALC＜1.0×109/L were the independent risk factors for prognosis of patients with PTCL-NOS (P =0.008,P =0.029).Conclusion The decrease of peripheral blood ALC in patients with PTCL-NOS at the initial diagnosis suggests a poor prognosis,and ALC can be used as a new indicator for prognosis evaluation of PTCL-NOS patients.

Objective We aimed to evaluate the efficacy and safety of fecal microbiota transplantation (FMT) for the treatment of ulcerative colitis (UC) in this Meta-analysis.Methods Literature related to FMT for the treatment of UC from PubMed,Embase,Cochrane databases,CNKI,VIP and Wanfang Data were searched and screened with update study in May 2018.Two independent investigators extracted information according to inclusion and exclusion criteria.The Meta-analysis was conducted by Stata 12.0 software.Results A total of 4 randomized controlled trials (RCTs) and 19 non-randomized controlled trials (non-RCTs) including 536 participants met the inclusion criteria.Meta-analysis of RCTs showed that FMT significantly increased the clinical remission rate (OR=2.47,95％CI 1.40-4.33,P=0.02) and clinical response rate (OR=1.86,95％CI 1.15-3.02,P=-0.01) in UC patients without increasing the incidence of severe adverse effects (OR=1.40,95％CI 0.51-3.79,P=-0.51).The results from 19 non-RCTs showed that clinical remission rate in UC patients with FMT treatment was 20％(95％CI 13％-28％) and the clinical response rate was 50％(95％CI 36％-65％).All adverse events were graded as mild and self-resolving.No FMT-related severe adverse effects were reported.Conclusions Our analysis suggests that FMT is a safe and effective method for the treatment of UC.Considering several limitations of this Meta-analysis and previous clinical trials,further large-scale multicenter RCTs are still required to further verify the conclusion.

Objective:To investigate the effects of simulated microgravity on the phenotype of extensively drug-resistant Acinetobacter baumannii extracted from sputum specimens of elderly patients with hospital-acquired pneumonia. Methods:A strain of A. baumannii grown in simulated microgravity was constructed by a three-dimensional rotary cell culture system, and a strain of A. baumannii grown in normal gravity was prepared as a control group.The growth rates of the two strains were detected by the Bioscreen system, colony numbers were measured by the plate colony-counting method, oxidative stress was analyzed by observing the survival rate in phosphate buffer saline(PBS) with 5 mmol/L H 2O 2, biofilm formation ability was determined by crystal violet staining, and antibiotic susceptibility was measured by the K-B method. Results:Compared with the normal gravity strain, the simulated microgravity strain was associated with a significantly slower growth rate, especially after 10 h( P<0.05), a decreased number of bacterial colonies[(2.33±0.61)×10 13CFU/L vs.(4.87±0.63)×10 13CFU/L, t=4.865, P=0.040], lower survival rates in PBS solution with H 2O 2[(51.43±0.97)% vs.(56.53±2.54)%, t=4.715, P=0.042], reduced biofilm formation ability( A570), [(0.449±0.014) vs.(0.506±0.024), t=8.692, P=0.013], and an increased inhibition zone diameter of amikacin[(15.17±0.21) mm vs.(13.77±0.15) mm, t=6.725, P=0.021]. Conclusions:Simulated microgravity changes the growth rate, biofilm formation ability, oxidative stress and antibiotic susceptibility of extensively drug-resistant A. baumannii, potentially providing a new treatment strategy for extensively drug-resistant A. baumannii-associated hospital-acquired pneumonia in the elderly.

Objective:To analyze the anatomical morphology of the zygomatic arch for reduction malarplasty.Methods:Computed tomography (CT) data were obtained from the electronic records of 45 patients in the Tianjin Stomatological Hospital from January 2018 to February 2020. Among them, there were 30 patients with normal protrusion of zygoma (group A) and 15 patients with prominent protrusion of zygoma (group B). The data were imported into modeling and analysis software (Mimics). Left and right three-dimensional (3D) zygoma models were created through standard procedures. In the 3D models, a vertical cut of the zygomatic arch was done, and anatomical morphological characteristics of the zygomatic arch were obtained through bone data measurement and morphological observation. Mean values with 95% confidence intervals ( CI) were calculated for the positional data. Independent sample T-test was conducted on the positional data and anatomical morphology data of the zygomatic arch in the two groups. P< 0.05 was considered as statistically significant. Results:In group B, the anterior edge of the stabilization area was located in front of the articular tubercle point (15.12 mm, 17.16 mm). The posterior edge of the stabilization area was located in front of the articular tubercle point (7.11 mm, 8.24 mm). The posterior edge of the enlarged area was located in front of the articular tubercle point (3.17 mm, 3.94 mm). There were significant differences between group A and group B in the posterior edge of the stabilization area ( t= 2.41, P= 0.018), the posterior edge of the enlarged area ( t=2.58, P= 0.012), and the width of the unilateral face ( P<0.01). Conclusions:There exists a stabilization area of bone morphology and enlargement area in zygomatic arch. The anatomical morphology of the zygomatic arch is different in width of the unilateral face and location of the enlarged area between populations with normal protrusion and prominent protrusion of the zygoma.

Objective To investigate the relationship between sleep duration and the risk of stroke in Asian populations.Methods Using duration of sleep,stroke and cerebrovascular event as search terms,we searched the China National Knowledge Internet (CNKI),Wanfang,Chinese BioMedical Literature(CBM),Vip Citation Databases(VIP),PubMed,EMBASE and Science Citation Index databases from the time of database construction to April 1,2018.Observational studies including cross-sectional studies,case-control studies and cohort studies that aimed to investigate the relationship between sleep duration and the risk of stroke in Asian populations were collected.Two investigators independently screened the literature,extracted data and assessed the quality of included studies.All analyses were performed by using the Stata 12.0 software.Results A total of 18 studies,including 658 778 participants,were included in this meta-analysis.Pooled results showed that short sleep duration was not associated with increased risk of stroke(OR =1.08,95 ％CI:0.96-1.22,Z =1.27,P =0.205),but long sleep duration was associated with increased risk of stroke(OR =1.61,95 ％CI:1.42-1.83,Z =7.49,P ＜ 0.001).Subgroup analysis showed that short sleep duration was correlated with a high risk of stroke only in the Singaporean population while it was not the case in other Asian populations,and long sleep duration was correlated with a high risk of stroke in many studies except in pooled results of case-control studies and pooled research results concerning the Korean population.Conclusions Long but not short sleep duration is a risk factor for the incidence of stoke in Asian populations.

Objective To evaluate the effect of electroacupuncture (EA) on mitochondrial fusionfission during endotoxin-induced acute lung injury (ALI) in rabbits.Methods Sixty clean-grade New Zealand white rabbits,aged 2 months,weighing 1.5-2.0 kg,were divided into 4 groups (n=15 each) using a random number table:control group (group C),ALI group,EA at non-acupoint plus ALI group (group SEAM+ALI) and EA at acupoint plus ALI group (group EAM+ALI).Endotoxin-induced ALI was induced by injecting lipopolysaccharide 5 mg/kg (in 2 ml of 0.9％ normal saline) via the auricular vein in ALI,SEAM+ALI and EAM+ALI groups.At 4,3,2 and 1 days and 30 min before lipopolysaccharide injection,bilateral Zusanli (ST36) and Feishu (BL13) acupoints were stimulated with an electric stimulator for 30 min in group EAM+ALI,and EA was performed for 30 min at the points 1 cm lateral to the acupoints of Zusanli and Feishu in group SEAM+ALI.The animals were sacrificed at 6 h after lipopolysaccharide injection and the lungs were removed for microscopic examination of the pathological changes (with a light microscope) and mitochondrial ultrastructure (with an electron microscope) and for determination of ROS and ATP contents and expression of Mfn1,Mfn2,optic atrophy 1 (OPA1) and dynamin-related protein 1 (Drp1) protein and mRNA in lung tissues (by real-time polymerase chain reaction or Western blot).Results Compared with group C,ATP content was significantly decreased,ROS content was increased,the expression of Mfn1,Mfn2 and OPA1 protein and mRNA was down-regulated,and the expression of Drp1 protein and mRNA was up-regulated in ALI,SEAM +ALI and EAM +ALI groups (P＜ 0.05).Compared with group ALI,ATP content was significantly increased,the expression of Mfn1,Mfn2 and OPA1 protein and mRNA was up-regulated,and the expression of Drp1 protein and mRNA was down-regulated in SEAM+ ALI and EAM+ALI groups,and ROS content was decreased in group EAM+ALI (P＜0.05).Compared with group SEAM+ALI,ATP content was significantly increased,ROS content was decreased,the expression of Mfn1,Mfn2 and OPA1 protein and mRNA was up-regulated,and the expression of Drp1 protein and mRNA was down-regulated in group EAM+ALI (P＜0.05).Conclusion The mechanism by which EA mitigates endotoxin-induced ALI may be related to promoting mitochondrial fusion and inhibiting mitochondrial fission in rabbits.

Cyclic Cushing's syndrome is a special manifestation of Cushing's syndrome, of which the serum cortisol is only periodically increased. The causes include Cushing' s disease, ectopic adrenocorticotropic hormone ( ACTH)-producing syndrome, and primary adrenal disease. It is difficult to diagnose because the cycle length varies from hours to years and the clinical signs may show spontaneous remissions and recurrent attacks. The detection methods include either measurement of serum cortisol, 24 h urinary free cortisol, early-morning urinary cortisol/creatinine, salivary cortisol or hair cortisol. No matter which method to be used, repeated and continuous measurement is essential. Here, we present a female patient who was diagnosed as cyclic Cushing's syndrome due to a pituitary ACTH adenoma. The clinical features, detection methods, diagnosis, and treatment strategies of cyclic Cushing' s syndrome are also reviewed in this article.

Nephron sparing surgery ( NSS ) has become the standard treatment of small renal cancer . NSS have the similar curative effect compared with radical nephrectomy and preserve the kidney fuction. However, positive surgical margins after NSS is increasing and has attracted more and more attention. We will discuss positive surgical margins related factors and how to reduce the positive surgical margins in this review.

The application of immunotherapy in advanced gastric cancer has become a research hotspot. At the same time, the combination of immunotherapy and neoadjuvant therapy is expected to further achieve tumor downstage, pathological remission, increase the proportion of R0 resection, which enhance the overall therapeutic effect of locally advanced gastric cancer (LAGC). Whether neoadjuvant immunotherapy affects perioperative complications, adverse events, tumor pathological responses, and long-term survival in LAGC is still in the initial stage of clinical exploration, which depends on large-scale prospective phase III clinical studies to demonstrate its clinical value. Meanwhile, the application of new innovative drugs and comprehensive perioperative treatment, screening high-specific biomarkers for therapeutic prediction, and weighing the selection of neoadjuvant cycle and interval of treatment-operation time are helpful to optimize and standardize the rational application of neoadjuvant immunotherapy, and ultimately bring benefits to patients.

Objective:To evaluate the value of preoperative serum miRNA-146a-5p expression in predicting postoperative delirium (POD) in the pediatric patients undergoing living donor liver transplantation.Methods:Eighty pediatric patients with congenital biliary atresia, aged 5-12 months, with body mass index of 4-10 kg, of American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ, undergoing elective living donor liver transplantation in our hospital, were selected. Venous blood samples were collected at 1 day before surgery, and serum miRNA-146a-5p expression was detected by quantitative real-time polymerase chain reaction. The children′s cognitive function was evaluated using the Mini-Mental State Examination and the Modified Montreal Cognitive Assessment at 1 day before operation and at 1, 3 and 7 days after operation. The pediatric patients were divided into POD group and non-POD group according to whether POD occurred within 7 days after surgery. Multiple logistic regression analysis was used to evaluate the relationship between serum miRNA-146a-5p expression and POD, Pearson′s correlation analysis was used to analyze the correlation between miRNA-146a-5p and POD, and the receiver operating characteristic curves were used to evaluate the accuracy of serum miRNA-146a-5p concentrations in predicting the occurrence of POD.Results:There were 30 cases in POD group and 50 cases in non-POD group, and the incidence of POD was 38%. The results of multiple logistic regression analysis showed that down-regulated serum miR-146a-5p expression was an independent risk factor for POD in pediatric patients undergoing living donor liver transplantation ( P<0.05). The incidence of POD was negatively correlated with serum miRNA-146a-5p expression ( r=-0.658, P<0.001). The area under the receiver operating characteristic curve of serum miRNA-146a-5p expression in predicting POD was 0.870 in pediatric patients undergoing living donor liver transplantation, with a sensitivity of 0.825 and a specificity of 0.875. Conclusions:Preoperative serum miRNA-146a-5p expression has a certain predictive value for POD in the pediatric patients undergoing living donor liver transplantation.