Objective To evaluate the protective effects elicited by ClpP fusion protein in animal protection tests. Methods Pneumococcal antigens were purified from recombinant Escherichia coli express-ing CIpP cloned gene. 6- to 8-week-old female BALB/c mice were immunized intraperitoneally with either ClpP or PBS plus alum. Every mouse received three doses of 20 μg antigen or PBS in 100 mg of alum adju-vant at 14 d intervals. Sera were collected from mice and analyzed by ELISA 1 week after the third immuni-zation, Intraperitoneal-challenge experiments with 12 different serotypes of Streptococcus pneumoniae were carried out 2 weeks after the third immunization, and we compared their median survival times and survival rates respectively by Mann Whitney U test and Fisher exact test. Results ELISA analysis demonstrated high titer specific antibody responses to ClpP. The median survival times for mice immunized with ClpP pro-tein antigens in adjuvant were significantly longer than those for mice that received the adjuvants alone. Con-clusion A highly expressed recombinant ClpP protein has been successfully obtained and proved to exert the protection against invasive pneumococcal infection without relation of serotype, suggesting ClpP can be a promising candidate vaccine.

Objective This research is aimed to investigate the efficacy and toxicity of icotinib for lung adenocarcinoma pa-tients with poor performance status and unknown EGFR gene status .Methods A total of 27 lung adenocarcinom patients with poor Eastern Cooperative Oncology Group-Performance status(ECOG-PS) and unknown EGFR gene status referred to Chongqing Canc-er Institute from August 2012 to August 2014 were analyzed .Icotinib (125 mg) was orally administered three times per day .Asess the efficacy and adverse reaction ,calculate survival rates .Results Among the 27 patients ,the objective response rate(ORR) and disease control rates(DCR) were 29 .6% and 81 .5% ,respectively .The median progression free survival time was 6 .0 months .A to-tal of 70 .4% of patients had an significant improvment in ECOG-PS scores ,following icotinib treatment (Z= - 2 .157 ,P= 0 .031) . Fatigue ,anorexia and diarrhea were the most frequent adverse reaction ,which defined as grade 1 to 2 rashes .Conclusion Lung ade-nocarcinoma patients with poor performance status and unknown EGFR gene status may benefit from icotinib therapy ,and patients were tolerated well .

Objective To analyze the reasons of invalid detections occurred in using three kinds of nucleic acid detection systems in our laboratory since 2016.Methods Analyze the numbers and types of invalid detections,for Roche Cobas S201 system from January to December 2016,Procleix Tigris system from January to September 2016,and Procleix Panther system from September 2016 to March 2017,respectively.Results The invalidation rates of Cobas s201,Tigris,and Panther systems were 0.90％ (402/44 838),4.01％ (2 960/73 835),and 1.34％ (1 093/81 741),respectively,and there were statistically significant differences between the three detection systems (P＜0.05).Except for the differences between Roche Cobas s201 and Panther 1404,there were statistically significant differences between instruments (P＜0.05).Failure of instruments,invalid detection of reagent calibrators,fault operation and sample quality are the causes of invalid detection.Conelusion The main reason of invalidation is instrument failure and reagent calibrator failmre.Invalid detections of nucleic acid screening is related on different detection systems.

Objective To investigate the clinical features and magnetic resonance imaging (MRI)findings of patients with Hirayama disease simply presenting proximal upper extremity muscular atrophy.Methods Three patients with Hirayama disease simply presenting proximal upper extremity muscular atrophy received cervical spine MRI on neutral and flexion position. The relationship between MRI findings and their clinical symptoms were analyzed. The outcomes were compared with those of 43 patients who were diagnosed as Hirayama disease with muscular atrophy at the hand and forearm. Results 1) Clinical features:three patients were young men. The disease was characterized by unilateral weakness and atrophy of the proximal upper limbs, such as pectoralis major muscle, deltoid muscle, and biceps brachii muscle. Electromyogram (EMG) showed bilateral upper extremities neurogenic damage. 2) Cervical spine MRI findings:cervical spine kyphosis without spinal cord compression was found on neutral position. On flexion position,anterior shifting of C3-C5 cervical cord and the posterior wall of dural sac were found; C4-C5 cervical cord was compressed by vertebral body or intervertebral disc or dural sac. Engorged posterior internal vertebral venous plexus were observed in epidural space. In the 43 patients who were diagnosed Hirayama disease with muscular atrophy at the hand and forearm, similar MRI findings were found, while cervical cords compression were at C6-C7 level. Conclusion Hirayama disease could present as proximal upper extremity muscular atrophy and weakness, such as pectoralis major muscle, deltoid muscle, and biceps brachii muscle.Neglecting of this will result in diagnostic errors or missed diagnosis. Flexion position MRI is an important base of early diagnosis of Hirayama disease.

BACKGROUNDSome studies have supposed that glutathione S-transferases (GSTs) may be involved in detoxification of carcinogens, especially from tobacco smoke. Therefore, polymorphism of GSTs has been considered as potential protectors of individual cancer risk. The objective of this study is to investigate the relationship between genetic polymorphism of GSTT1 and inherent susceptibility to lung cancer in Han population in Sichuan, China.

METHODSA case-control study was carried out to compare the distribution frequency of GSTT1 gene polymorphism between lung cancer (n=150) and control healthy individuals (n=152) with polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method and to analyze the relationship between the GSTT1 gene polymorphism and smoking and the inherent susceptibility of lung cancer.

RESULTS(1) The distribution frequency of GSTT1(-) genotype was 54.7% (82/150) in lung cancer and 38.2% (58/152) in control group respectively (OR=1.681, 95%CI=1.009- 2.803 , P=0.046); (2) GSTT1(-) genotype remarkably increased the risk of squamous cell carcinoma (OR=2.969, 95%CI= 1.511 -5.834, P=0.002) and adenocarcinoma (OR=2.095, 95%CI=1.060-4.140, P= 0.033 ); (3) In smokers, GSTT1(-) genotype significantly increased the risk for lung cancer (OR=4.051, 95%CI=1.959-8.380 , P=0.000); (4) In people with GSTT1(-) genotype, smoking markedly increased the risk for lung cancer (OR=53.885, 95%CI=11.789-246.302, P=0.000); (5) In heavy smokers (≥20 packyears), GSTT1(-) genotype could remarkably increase the risk of lung cancer (OR=4.296, 95%CI=1.649-11.190, P=0.003).

CONCLUSIONS(1) People with GSTT1(-) genotype have significantly increased risk for lung cancer in Han population in Sichuan, China, especially for squamous cell carcinoma. (2) GSTT1(-) genotype interacts synergistically with smoking on lung cancer risk. The more the cigarettes smoke, the higher the risk of lung cancer increases in those people who are smokers with GSTT1(-) genotype.

BACKGROUNDGenetic polymorphism in metabolic enzymes, which are involved in metabolism of environmental carcinogens, have been thought to be related to susceptibility of lung cancer. The aim of this study is to investigate the cytochrome P450 2D6(CYP2D6) genetic polymorphism distribution in Han population in Sichuan, China, and to evaluate the relationship between CYP2D6 genetic polymorphism and lung cancer susceptibility.

METHODSPCR-RFLP was used to identify CYP2D6ch genotypes among 150 patients with primary lung cancer and 152 healthy controls, in Han population in Sichuan, China, and case-control study was used to analyze the relationship between genetic polymorphism and lung cancer susceptibility.

RESULTS(1) The distribution frequency of CYP2D6ch C and T allele were 39.5% and 60.5% in control group and 46.3% and 53.7% in lung cancer group, respectively. There was no significant difference between the two groups (P=0.089). (2)The distribution frequency of C/C, C/T and T/T genotypes were 18.4%, 42.1% and 39.5% in control group, and 22.7%, 47.3% and 30.0% in lung cancer group, respectively. No significant difference was found between the two groups (P=0.215). (3) The individuals who carried with Non-T/T genotypes had a 2.084-fold increased risk with squamous cell carcinoma (95%CI 1.024-4.244, P=0.043) than those who carried with T/T genotype. (4) The lighter smokers ( < 30 pack-years) who carried with Non-T/T genotypes had a 2.92-fold increased risk with lung cancer (95%CI 1.087-7.828, P=0.033) than those who carried with T/T genotype.

CONCLUSIONSCYP2D6ch Non-T/T genotypes are factors associated mail:zhouqh@mail.sc.cninfo.net) with increased risk of squamous cell carcinoma and also increase risk of lung cancer among lighter smokers.

BACKGROUNDLung cancer is the leading cause of malignant tumor death among Chinese population. It has been known that the development of lung cancer may be associated with genetic po-lymorphism of some lung cancer related genes. The aim of this study is to evaluate the relationship between genetic polymorphism of metabolizing enzymes and susceptibility of lung cancer in Chinese population.

METHODSPolymorphism of CYP2E1 RsaI/PstI and GSTM1 was detected in 99 patients with lung cancer and 66 patients with benign pulmonary disease by PCR-RFLP and PCR. The association between genetic polymorphism and susceptibility of lung cancer was analyzed.

RESULTSNo significant difference in three RsaI/PstI genotype distribution of CYP2E1 was found between lung cancer group and control group (Chi-Square=1.374, P=0.241). (2) The frequency of GSTM1-null genotype in lung cancer group was significantly higher than that in control group (57.6% vs 40.9%, Chi-Square=4.401, P=0.036). (3) The individuals who carried with GSTM1-null genotype had a 1.96 fold increased risk of lung cancer (OR=1.96, 95%CI=1.042-3.689, P=0.037) than those who carried with GSTM1-present genotype. (4) When data were stratified by smoking status, the smokers who carried with c1/c1 genotype had a significantly higher risk of lung cancer (OR=3.525, 95%CI=1.168- 10.638, P=0.025) than those never-smokers who carried with at least one c2 allel. (5) When combination of polymorphism of CYP2E1 RsaI/PstI genotype and GSTM1 genotype was analyzed, compared with individuals who had concurrent present of GSTM1 and at least one c2 allel genotype, the risk of lung cancer for combination of GSTM1 null and c1/c1 genotype was increased significantly (OR=3.449, 95%CI=1.001- 11.886, P=0.050). Considering smoking status, compared with never-smokers who had concurrent present of GSTM1 and at least one c2 allel genotype, the risk of lung cancer for combination of GSTM1 null and c1/c1 genotype was remarkably increased (OR=11.553, 95%CI=1.068-124.944, P=0.044), as well as that for combination of GSTM1 null and at least one c2 allel genotype (OR=13.374, 95%CI=1.258-142.166, P= 0.032).

CONCLUSIONS(1)GSTM1 null genotype is an important factor associated with increased risk of lung cancer. (2) The combination of c1/c1 and GSTM1-null genotype can remarkably increase risk of lung cancer both in smokers and non-smokers.

BACKGROUNDTo investigate the diagnosis and treatment of pulmonary sclerosing hemangioma (PSH).

METHODSThe clinical features, radiographic manifestations and treatment of 21 patients with PSH were reviewed.

RESULTSNone of the 21 patients was diagnosed as PSH preoperatively. There were 18 females and 3 males, and the average age was 48.0 years in this group. Twelve patients were symptom free. The plain chest roentgenograms showed a well defined, homogeneous, round or oval nodulous shadow in most cases. All patients received operation. There was no postoperative morbidity and mortality. Postoperative follow-up showed a good prognosis.

CONCLUSIONSPreoperative diagnosis of PSH is quite difficult. PSH should be suspected in middle to old aged female patients who show a well defined, homogeneous, round or oval shadow in plain chest roentgenograms. PSH has a good prognosis if it is treated surgically.

Objective:To investigate the reproducibility of whole-heart and volume-targeted balanced steady-state free precession (bSSFP) non-contrast MR coronary angiography (CMRA) for displaying coronary trunks.Methods:From February and September 2021, the whole-heart and volume-targeted CMRA examinations of 58 volunteers were prospectively and consecutively acquired in The First Affiliated Hospital of Fujian Medical University. Each volunteer underwent CMRA twice within a week. The subjective score, vessel-to-myocardium ratio (VMR), vessel-to-fat ratio (VFR), signal-noise ratio (SNR), and coronary corresponding coordinate was analyzed and extracted. Inter-observer, intra-observer and inter-scan consistency were evaluated by intraclass correlation coefficient (ICC), Bland-Altman analysis, Hausdorff Distance (HD), and Dice Similarity Coefficient (DSC).Results:The inter-observer and intra-observer consistencies of subjective scores, VMR, and VFR of the whole-heart and volume-targeted coronary artery images were excellent (ICC>0.76, P<0.001). The inter-scan VFR consistencies of RCA, LM, and LCX of whole-heart coronary scans were moderate (ICC=0.235, 0.264, 0.380, all P<0.05), while the consistencies of the remaining variables were good, (all ICCs>0.49, P<0.001). Bland-Altman method showed that most VMR, VFR, and SNR of two CMRA imaging were within the 95% limits of agreement. Whole-heart CMRA inter-and intra-observer mean HD was 1.79 (1.35, 3.25), 1.68 (1.09, 4.10), mean DSC was 0.96±0.04, 0.97±0.03. Volume-targeted CMRA inter-and intra-observer mean HD were 1.74 (1.63, 3.11), 1.74 (1.63, 1.98), and the mean DSC was 0.91±0.10, 0.95±0.05. The subjective score of raw images of the total artery trunk of volume-targeted CMRA [3.86 (3.68,4.00) vs. 3.80 (3.58,3.96) ], VMR [1.45 (1.27,1.58) vs. 1.22 (1.13,1.41) ], and VFR [7.36 (6.44,8.60) vs. 5.97 (4.97,6.64) ] were better than those of whole-heart CMRA (all P<0.05). The overall subjective score of whole-heart CMRA coronary trunk curved projection reformation was better than volume-targeted CMRA [3.75 (3.57, 3.88) vs. 3.63 (3.44, 3.71)] ( P<0.001). Conclusions:Whole-heart and volume-targeted bSSFP non-contrast CMRA represent good reproducibility and image quality in the main coronary artery of healthy volunteers. Both of the two methods have their advantages and complement each other.

Objective:To analyze the characteristic of prenatal serological screening in fetus with X-linked ichthyosis (XLI), and to explore the relationship between unconjugated estriol (uE 3) levels and XLI. Methods:A total of 56 fetuses with Xp22.31 microdeletion indicated by prenatal diagnosis and 70 fetuses diagnosed with trisomy 21 and 26 fetuses with trisomy 18 in Henan Provincial People's Hospital and Affiliated Hospital of Weifang Medical College from September 2016 to June 2021 were collected. The multiples of median (MoM) values of uE 3, alpha-fetoprotein (AFP), and human chorionic gonadotropin (hCG) during the second trimester of pregnancy were retrospectively analyzed. Prenatal diagnosis was made by amniotic fluid karyotype analysis and genome copy number variant analysis, parent genetic verification and pathogenicity analysis were performed, and maternal and infant outcomes were followed up. Results:Of 56 pregnant women with fetal Xp22.31 microdeletion, 43 underwent serological screening during the second trimester of pregnancy, of which 42 were abnormal (39 male fetuses and 3 female fetuses). The median uE 3 MoM value of 39 male fetuses [0.06 (0.00-0.21)] was lower than the normal value and significantly lower than that of fetuses with trisomy 21 [0.71 (0.26-1.27)] and fetuses with trisomy 18 [0.36 (0.15-0.84)], the difference was statistically significant ( Z=99.96, P<0.001). While the MoM values of AFP and hCG were all within the normal range. Among the 56 fetuses carrying Xp22.31 microdeletion, 45 were male fetuses and 11 were female fetuses, and the deletion fragments all involved STS gene. Eighty-nine percent (50/56) were inherited from mother (49 cases) or father (1 case), and 11% (6/56) were de novo mutations. Follow-up showed 48 live births (38 males and 10 females) and 8 chose to terminate pregnancy (7 males and 1 female). Among the 38 male newborns, 37 presented with scaly skin changes from 1 to 3 months of age, and one had no clinical manifestations until 4 months after birth. Ten female newborns had no obvious clinical manifestations. Conclusions:The decrease levels of uE 3 MoM on maternal serological screening is closely related to the higher risk of XLI in male fetuses. For pregnant women with low uE 3 in serological screening or with family history of ichthyosis, in addition to chromosomal karyotype analysis, joint detection of genomic copy number variant analysis should be recommended.