Objective To reveal the important role of aberrant splicing in cancer and to identify differential expressing isoforms and differential alternative splicing events between acute myeloid leukemia ( AML) and chronic myeloid leukemia (CML).Methods Based on whole transcriptome sequencing of CML (K562) and AML(THP1 and HL-60) cells,TopHat, MATS and Cufflinks were used to identify alternative splicing events and alternative splicing isoforms and analyze differenti -al expression of isoforms and genes .Results A total of 130 genes were identified to be highly expressed in CML and 80 genes in AML cells .Also, 337 differential expressed isoforms and 35 specific alternative splicing events between AML and CML cells were identified.Conclusion There are significant differences in alternative splicing isoforms and events between AML and CML cells.Leukemia-associated alternative splicing events can be used as potential tumor markers or drug targets.

Objective:To investigate the effects of ginkgo biloba tablets plus relevant mechanism on HPA axis in patients with steroid-dependent asthma.Methods:80 patients with steroid-dependent asthma were divided into control group and experimental group at random,40 cases in every group.The control group were treated with pulmicort respules(1 mg/d) ,patients in the experiment group were given ginkgo biloba tablets in addition to routine treatment(120 mg/d).The therapeutic courses were both 12 weeks.The effective rate of reducing hormone,lung function,the plasma concentrations of ACTH and COR and the levels of PBMC GCR were deter mined before and after treatment.Results:The effective rate of reducing hormone was 89.47%in experimental group,which was 66.67%in control group.There were significant difference at the tows groups(P<0.01).There were no significant difference at lung function,the plasma concentrations of ACTH and COR and the levels of PBMC GCR at pre-treatment( P>0.05).After treatment,the lung function, the levels of plasma concentrations of COR and the levels of PBMC GCR were increased significantly than control group( P<0.01,P<0.05),the levels of plasma concentrations of ACTH was decreased significantly than control group(P<0.01).There was a significant positive correlation between the value of FEV1/FVC and the plasma concentrations of COR,the levels of PBMC GCR( r=0.724,0.632, P<0.01).There was a significant negaitive correlation between the value of FEV1/FVC and the plasma concentrations of ACTH( r=-0.668,P<0.01).Conclusion:Ginkgo biloba tablets combined with routine treatment therapy can increase the effective rate of reducing hormone in patients with steroid-dependent asthma,which can improve the lung function maybe by regulate the HPA axis and upgrade the levels of GCR.

Objective:To investigate the effect of O-6-methylguananine-DNA methyltransferase (MGMT) gene promoter methylation status on the treatment and prognosis of elderly patients newly-diagnosed with glioblastoma (GBM).Methods:Clinical data of 65 newly-diagnosed GBM patients admitted to Tianjin Huanhu Hospital from January 2012 to December 2018 were retrospectively analyzed. All patients received intensity-modulated radiotherapy after surgery and 49 patients received temozolomide (TMZ) monotherapy. All patients were divided into the MGMT(+ ) group and MGMT(-) group according to the methylation status of MGMT promoter. Kaplan- Meier method and log-rank test were used for univariate survival analysis, and Cox regression model was used for multivariate prognostic analysis. Results:The median overall survival (OS) for all patients was 18.0 months. The median OS was 27.0 months and 15.3 months in the MGMT(+ ) group and MGMT(-) group, respectively. Univariate analysis revealed that tumor number, MGMT promoter methylation, postoperative concurrent chemoradiotherapy were significantly related to clinical prognosis ( P=0.029, P=0.001 and P<0.001). In multivariate analysis, tumor number and postoperative concurrent chemoradiotherapy were identified as significant prognostic factors for OS ( P=0.037, P=0.004). In the MGMT(+ ) group, the median OS was 27.0 months for patients receiving concurrent chemoradiotherapy and 12.0 months for radiotherapy alone ( P=0.040). In the MGMT(-) group, the median OS was 17.0 months for concurrent chemoradiotherapy patients and 10.0 months for radiotherapy alone ( P=0.122). Conclusions:MGMT promoter methylation status is significantly associated with longer OS in elderly GBM patients. Conventional fractional radiotherapy combined with concurrent and sequential TMZ chemotherapy probably yields better survival benefits.

Aim To investigate the influence of gly-cyrrhizic acid( GA) on cell proliferation and cell cycle and secretion of extracellular matrix ( ECM) , the level of fibronection ( FN) , type Ⅳ collagen ( C-Ⅳ) in the rats′ glomerular mesangial cells ( HBZY-1 ) cultured with advanced glycation endproducts ( AGEs ) . Meth-ods HBZY-1 were incubated in culture medium con-taining AGEs in the presence of GA and treated for 48 h. At the same time, the normal and control groups were established. Methylthiazoletetrazolium ( MTT) as-say was used to measure cell proliferation;cell cycle a-nalysis was performed using a flow cytometry; FN and C-Ⅳwere analyzed by enzyme-linked immunosorbent assay ( ELISA ) . Results Cell counts increased markedly in AGEs group. Cell cycle analysis showed that cell percentage of S phase increased, G1 reduced and PI increased from 35. 01% ± 4. 21% to 44. 93%± 0. 25% ( P <0. 05 ) . FN and C-Ⅳ secretion in-creased ( P <0. 05 ) . Whereas GA was added, cell counts decreased, and the percentage of S phase also decreased and G1 increased, PI decreased from 44. 93% ± 0. 25% to 42. 16% ± 1. 04% ( P<0. 05 ) . In addition, the secretion of FN and C-Ⅳ decreased ( P<0. 05 ) . Conclusion GA could prevent AGEs-induced HBZY-1 . GA may protect HBZY-1 from in-hibiting the abnormal cell proliferation, changing the cell cycle. GA can reduce the synthesis of FN and C-Ⅳ.

OBJECTIVE:To strengthen application management of antibiotics in outpatients,promote rational use of antibiot-ics,and to provide reference for scientific management and decision-making in the hospital. METHODS:The proportion of outpa-tients receiving antibiotics in total outpatients was analyzed statistically during Jan. 2008-Jun. 2016. Utilization rate data of antibiot-ics in outpatients during 2008-2015 were used to establish Autoregressive integrated moving average model(ARIMA),and the data of the first half of 2016 was used to validate established model;the utilization rate trend of antibiotics in outpatients in the second half of 2016 was predicted. SPSS 20.0 statistical software was adopted for statistical analysis. RESULTS:Established ARIMA(2,1, 0)(2,1,0)12 model has higher fitting degree. There was a small difference between measured value and fitted value of utilization rate of antibiotics in outpatients in 2016. Average absolute error was 0.72%,and average relative error was 4.20%,within 95%confidence interval of fitted value. Dynamic trend of model predicted value was basically consistent with measured value. CONCLU-SIONS:ARIMA model simulates utilization rate trend of antibiotics in outpatients well,can be used for short-term prediction and dynamic analysis of utilization rate trend of antibiotics. However,for long-term prediction,various factors should be considered.

Objective:To investigate of AIDET communication model in caring for type 2 diabetes mellitus of hospitalized patients.Methods:A total of 113 patients with type 2 diabetes mellitus treated in our department from January 2018 to November 2019 were enrolled, and divided into the control group(receiving a conventional communication mode)and the observation group(receiving an AIDET communication mode)according to a time order in the selecting of the research patients.The changes of self-care behavior and glucose metabolism index were evaluated and analyzed between the two groups.Results:On admission, the fasting blood glucose, 2-h postprandial blood glucose and glycosylated hemoglobin were(9.1±1.7)mmol/L, (13.8±2.9)mmol/L and(8.4±3.5)% in the observation group, and(9.4±2.1)mmol/L, (14.1±3.2)mmol/L and(8.1±2.9)% in the control group, respectively, with no statistically significances( P>0.05). At discharge, the observation group versus the control group showed a statistically significantly improved levels in FPG of(5.9±1.5)mmol/L vs.(7.8±1.9)mmol/L, in 2h-PBG of(10.1±3.7)mmol/L vs.(12.8±3.9)mmol/L and in glycosylated hemoglobin of(6.3±1.2)% vs.(7.5±0.9)%, respectively( P<0.05). The scores of management of poor blood glucose, foot care, blood glucose monitoring, medication compliance, regular exercise and diet control were higher in the observation group than in the control group at discharge( P<0.05). Conclusions:The application of AIDET communication mode can effectively enhance the self-care behavior of patients and help improve the glucose metabolism in hospitalized patients with type 2 diabetes mellitus.It has very positive effects on controlling the development of type 2 diabetes mellitus and improving the quality of life.

Objective To evaluate the effects of exercise therapy for patients with difficult weaning using mechanical ventilation.Methods A total of 63 patients with difficult weaning using mechanical ventilation were randomly divided into the experimental group(33 cases) and the control group(30 cases).The patients in the control group received routine respiratory care,however,the patients in the experimental group received gradual and individualized exercise therapy according to patients' condition and physical strength.The items such as the tidal volume,respiratory rate,PaO2/FiO2 were compared between two groups.Results Compared with the control group,the tidal volume,respiratory rate,PaO2/FiO2 and the score of APACHE Ⅱ were better in the experimental group on the 21th and 28th day after mechanical ventilation,the heart rate was better in the experimental group on the 28th day after mechanical ventilation.In addition,the duration of mechanical ventilation and ICU hospitalization was shorter in the experimental group.But the rate of complications showed no significant difference.Conclusions Exercise therapy has a positive effect on patients with difficult weaning using mechanical ventilation.

Objective:In this study, the feasibility of this method was evaluated in children with large distance femoral lengthening cases, and the acute correction and staging surgeries were compared at healing speed. At the same time the key points of surgical techniques would be summarized, so as to clarify the application value of this technology in children patients.Methods:Since July 7 of 2014 to January 16 of 2018, a total of 10 cases of Lengthening Over Retrograde Nail (LORN) surgery have been formulated and carried out, including 9 males and 1 females.The average age of the operation was 13.10±2.18 y. In all cases, the osteotomy point was located in the metaphysis of the distal femur, and the records from the first meeting to the end of follow-up included gender, date of birth, reason of discrepancy and treatment history, age at surgery, lengthing distance, the length of duration with frame, healing time, ROM of the knee joint, complications, et al. To compare the healing time of acute correction and staging surgery. Statistical analysis was made by SPSS 22.0 software, and then reasonable treatment strategies were proposed.Results:The average lengthing distance of 7.07±1.01 cm. The median time of the duration with frame was 8.5 (4,16) months, and the median follow-up time was 39 (34, 54) months. All cases obtained good clinical and imaging healing (1.70±1.10 month/cm vs. 1.16±0.54 month/cm), and all regained to normal walking function (136.67°±20.82° vs. 125.71°±26.37°), without the occurrence of fracture after therapy. There were no statistically significant differences in the speed of healing, range of joint motion or complication rate between acute correction and staging treatment. Conclusion:It is feasible for femoral lengthening surgery assisted by retrograde intramedullary nail in the treatment of femoral shortening deformityin children. The correction of mild angular deformity and lengthening surgery can be performed simultaneously. The osteotomy site was proposed at distal metaphysealof the femur for better quality of osteogenesis and shorter duration for fixator. It is safe to osteotomy and lengthening in the area of enchondroma.

Objective To elucidate cerebral cortical response to esophageal acid exposure in normal individuals by functional magnetic resonance imaging (fMRI) and the characteristics of activity. Methods Fifteen volunteers were received intraesophageal perfusion with either 0.9% of sodium chloride or acid (0.1 mmol/L HC1) solutions. The modified block-design model of fMRI scanning was performed simultaneously. All of 32 minutes were needed for resting (A, 8 minutes), 0.9% of sodium chloride perfusion (B,8 minutes), acid perfusion (C,8 minutes) and 0.9% of sodium chloride perfusion again (D,8 minutes). Each chunk was consisted of 160 scans and every scan contained 3 seconds. Six hundred and forty scans were collected in all. The clinical response to esophageal acid exposure was observed and the changes in the cerebral regions was statistically analyzed. Results After perfusion of 0.9% of sodium chloride or acid, 10 out of 15 volunteers had chemosensitive complaints, such as pain in pars laryngen pharyngis, heartburn and chest complaint. The initial active domains involved deutocerebrum, anterior part of callosal gyrus, left side of insula, two sides of amygdale and subiculum hippocampi, two outers of forehead cortex. The provoked regions of acid perfusion (C-A) and 0.9% of sodium chloride perfusion again (D-A) were as same as that of the activated domains by initial perfusion of 0.9% sodium chloride (B-A). The intensity and amplitude of most provoked regions increased gradually(D-A> B-A, P< 0.01). Conclusions The two different stimulations of saline and acid provoke similar cerebral regions that may act in the regulation of esophageal sensitivity. There are the evidences of the central mechanism of esophageal visceral hypersensitivity by acid perfusion.

Objective To investigate the effectiveness of Lactobacillus paracasei N1115 combined with fructooligosaccharides (FOS) in the treatment of nonalcoholic fatty liver disease(NAFLD) in a mouse model and to analyze the possible mechanism.Methods Fifty male C57BL/6 mice were randomly divided into five groups and respectively given normal diet (ND group), high-fat diet (HFD group), HFD containing Lactobacillus paracasei N1115 (HFD+L) (2.2×109 CFU/ml), HFD containing FOS (HFD+FOS) (4 g/kg per day) and HFD containing Lactobacillus paracasei N1115 and FOS for 16 consecutive weeks.Levels of triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), lipopolysaccharide (LPS) and diamine oxidase (DAO) in serum samples from each group were measured.Expression of tight-junction proteins (Claudin-1 and Occludin), p38 and phosphorylated p38 (p-p38) in intestinal tissues were analyzed.Results Compared with the HFD group, the HFD+FOS+L group showed decreased levels of TC, TG, LDL, LPS and DAO in serum samples, but increased serum HDL level (P<0.05).Moreover, combined treatment with Lactobacillus paracasei N1115 and FOS alleviated liver lipid deposition, significantly increased the expression of Claudin-1 and Occludin in intestine and inhibited the phosphorylation of p38 (P<0.05).Conclusion Lactobacillus paracasei N1115 combined with FOS may increase the expression of Claudin-1 and Occludin through inhibiting the phosphorylation of intestinal p38, which is conducive to maintaining the intestinal mucosal barrier integrity and alleviating NAFLD.