Objective: Combined with the metrological verification in order to strengthen the quality control of medical ultrasonic diagnostic instrument, to ensure the image quality of instruments and medical safety. Methods: Measure output sound intensity, patient leakage current, metrological verification parameters detection depth, resolution, geometric position error value, cystic focal diameter error, blind area and so on. Results: Through analyzing the data of metrological verification results, and in combination with the practical situation of hospital ultrasonic diagnostic instrument calibration, approved metrological verification instrument performance detection technology as the basis. Conclusion: The combination of metrological verification, strengthen training, maintenance, etc, to ensure the operation and safety of instruments, to achieve good quality control in the device.

Objective To assess the impact of antithymocyte globulin (ATG) on the incidence of graft-vs-host disease (GVHD) in hematopoietic stem cell transplantation from unrelated donors.Methods A total of 92 patients with hematological malignancies including leukemia,myelodysplastic syndrome (MDS) and lymphoma who underwent hematopoietic stem cell transplantation from unrelated donors from January 1999 to December 2011 were included in this retrospective analysis.Patients were classified into ATG group (n =66)and non-ATG group (n =26) according to the GVHD prophylaxis regimen.The incidence of acute GVHD (aGVHD) and chronic GVHD (cGVHD),risk factors of aGVHD and cGVHD and impact of ATG on the overall survival (OS),treatment related mortality (TRM) and relapse rate were analyzed.Results Grade Ⅱ-Ⅳ aGVHD (26.7 ％ vs 44.0 ％,P=0.12) or grade Ⅲ-Ⅳ aGVHD (13.3 ％ vs 8.0 ％,P =0.74) were not significantly different between ATG and non-ATG group.However,the incidence of cGVHD in the ATG group was significantly lower (34.0 ％ vs 72.2 ％,P =0.005) than non-ATG group.The incidence of extensive cGVHD was also significantly reduced (10.0 ％ vs 44.4 ％,P =0.005) compared to non-ATG group.In multivariate analysis,the use of ATG prophylaxis significantly decreased the cGVHD (RR =0.22,95 ％CI 0.081-0.599,P =0.003) while one allele mismatch of human leukocyte antigen (HLA) was associated with increased risk of cGVHD (RR =3.25,95 ％ CI 1.39-7.61,P =0.007).As to the extensive cGVHD,the use of ATG was the only independent factor (RR =0.05,95 ％ CI 0.009-0.240,P ＜ 0.001).With a median follow-up of 12 months (1-84 months),ATG prophylaxis had no impact on OS rate (60.4 ％ vs 43.1％,P =0.41),TRM rate (19.8 ％ vs 34.3 ％,P =0.43) and relapse rate (40.6 ％ vs 33.6 ％,P=0.54).Conclusion In hematopoietic stem cell transplantation from unrelated donors,ATG prophylaxis total dose of 6 mg/kg may significantly decrease the incidence of cGVHD and extensive cGVHD without increase of TRMand relapse rate and impairment of OS.

Purpose To evaluate the CT features and pathological manifestations of the solid components of mixture ground-glass opacity (GGO) in adenocarcinoma in situ (AIS), minimally invasive adenocarcinom (MIA) and invasive adenocarcinoma (IAC), to analyze the qualitative diagnosis value of solid components of mixture GGO in the diagnosis of AIS, MIA and IAC, to provide reference for the selection of clinical treatment.Materials and Methods Eighteen patients with AIS, 53 patients with MIA and 28 patients with IAC (the maximum diameter smaller than 2 cm) proved by surgery and pathology with CT features appearing as mixture GGO were retrospectively analyzed, CT features of the solid components in three groups were analyzed and compared with pathology.Results The solid components in AIS mainly appeared as punctiform or polygon, with extensive distribution, solid nodules were usually single (17 cases, 94.44%), located in the middle of the lesion (14 cases, 77.78%), with clear binderies (16 cases, 88.89%) and the same density with vessels in the same axis (13 cases, 72.22%); the majority of solid components in MIA appeared as circular or elliptical (33 cases, 62.26%), less than or equal to 5 mm (48 cases, 90.57%), with eccentric or multi-point distribution (45 cases, 84.90%), the boundaries were less sharp (40 cases, 75.47%), with slightly lower density than that of the vasculars in the same level (34 cases, 64.15%); the solid components in IAC mainly appeared as irregular lesions (21 cases, 75.00%), lager than 5 mm (24 cases, 85.71%), with eccentric growth (20 cases, 71.43%) and less sharp boundary (15 cases, 53.57%), the integration of multiple nodules could also be observed. There were statistically significant differences in the CT features of solid components within the lesions among the three groups (P<0.01).Conclusion It is possible to predict the pathological typing and the prognosis of pulmonary mixture GGO in a certain extent according to the different CT features of the solid components in it, and to guide clinical treatment principles.

Objective To assess the impact of a composite index which combines the prognosis of specific hematologic malignancies and the disease remission state pre-transplant on the efficacy of allogeneic hematopoietic stem cell transplantation.Methods A total of 148 patients who underwent allogeneic hematopoietic stem cell transplantation from Jan,2007 to Feb,2012 in the Blood and Marrow Transplantation Center of Ruijin Hospital were included in this retrospective analysis.According to the composite score,patients were classified into low-risk group (n =17),medium-risk group (n =100) and high-risk group (n =31).The overall survival (OS),event free survival (EFS),treatment related mortality (TRM) and relapse rate (RR) were analyzed.Results Significant difference had been found on OS (76.5 ％ vs 66.0 ％ vs 41.9 ％,P =0.002),EFS (70.6 ％ vs 57.0 ％ vs 32.3 ％,P =0.001) and RR (41.9 ％ vs 27.0 ％ vs 5.9 ％,P ＜ 0.001) among the three groups.However,there was no impact on treatment related mortality (23.5 ％,17.0 ％,29.0 ％,P =0.190).Multivariate analysis suggested that the composite index affecting the OS,EFS and RR of allogeneic hematopoietic stem cell transplantation (P =0.005,P =0.001,P ＜ 0.001),but not the TRM (P =0.666).To some extent,it was an independent prognosis index on RR.Conclusion The composite index is closely related to the efficacy of allogeneic hematopoietic stem cell transplantation.

Objective To identify the prevalence of anti-transcriptional intermediary factor (TIF)1-γ antibody in Chinese patients with idiopathic inflammatory myositis and to define its role in the assessment of early diagnosis of cancer associated myositis (CAM) in a large cohort.Methods Sera from 96 Chinese patients with dermatomyositis(DM),50 patients with polymyositis (PM),33 patients with systemic lupus erythem-atosus (SLE),54 patients with rheumatoid arthritis (RA),8 patients with systemic sclerosis (SSc),and 40 healthy controls were examined by immunoprecipitation assays followed by Western blotting.The distribution of these antibodies in each group was assessed and the association between this autoantibody and CAM in a large cohort was further revealed.T test,Mann-Wittney U test,Chi-square test and Fisher exact test were used for statistical analysis.Results Sera from 17 of 96 DM patients (18％),including 1 with juvenile dermatomyositis (JDM) (17％),2 with clinical amyopathic dermatomyositis (CADM) (25％),and 9 with CAM (64％) were found to have anti-TIF1-γ antibody by immunoprecipitation assays followed by Western blotting.Only 1 patient with PM (2％) was observed with anti-TIF1-γ autoantibody,and no patients with other connective tissue disease patients as well as healthy controls were positive for this autoantibody.The risk of -developing CAM in anti-TIF1γ-positive patients was significantly increased compared to the anti-TIF1-γnegative group,with an OR of 17.74 (95％CI,5.68-55.40).In DM,the negative and positive predictive value of anti-TIF1-γ autoantibody for the diagnosis of CAM was 90.8％ and 56.3％,respectively.Anti-TIF1γ-positive DM patients were significantly older than anti-TIF1-γ-negative DM patients (63±11 vs 48 ±14,P＜0.01).Notably,three of the anti-TIF1γ-positive patients had ILD,one patient was classified as having CAM and the other two were DM patients without cancer,but anti-TIF1γ-positive patients still had a significantly lower incidence of interstitial lung disease (19％ vs 54％,P＜0.05).In contrast to anti-TIF1-γγ-negative DM patients,anti-TIF1-γ antibody-positive patients were more frequently (81％ vs 50％,P＜0.01).There was no significant difference between these groups in terms of other clinical and laboratory parameters.Conclusion Anti-TIF1-γ antibodies may act as a useful diagnostic serological marker for early diagnosis of CAM in Chinese patients.For patients with DM,anti-TIF1-γ antibodies should be assessed at the time of disease diagnosis.This antibody may have impo-rtant significance in the early diagnosis of tumor and improving prognosis.

Objective To determine the sera levels of anti-nuclear matrix protein (NXP)-2 autoantibodies and their clinical associations in patients with idiopathic inflammatory myopathies (IIM).Methods Sera from 198 Chinese patients with IIM including 15 juvenile dermatomyositis (JDM),133 dermatomyositis (DM) and 50 polymyositis (PM),other connective tissue diseases (CTDs) including 70 systemic lupus erythematosus,60 rheumatoid arthritis,15 systemic sclerosis,46 primary Sj(o)gren syndrome,10 mixed connective tissue disease and 60 healthy controls were measured by enzyme linked immunosorbent assay.The anti-NXP-2 antibodies were detected.The positive sera were further examined by immunoprecipitation assays.Statistical analyses were performed using student's t test or Mann-Wittney U test and x2 test.Results The positive rate of sera anti-NXP-2 autoantibodies in patients with IIM was 5.1％ (10/198),20.0％ (3/15) in patients with JDM,3.7％ (5/133) in patients with dermatomyositis,and 4.0％(2/50) in patients with polym-yositis.There was statistical significant difference in anti-NXP-2-positive rates between JDM,DM and PM (P＜0.05).However,the autoantibody did not present in patients with other CTDs as well as healthy controls.The anti-NXP-2-positive patients had significantly younger age [(33±20) vs (45±17) years old (t=-2.09,P＜0.05)] and higher incidence of calcinosis [30.0％(3/10) vs 2.6％(15/188)] compared with the anti-NXP-2-negativepatients (x2=0.7,P＜0.01).There were no statistical difference between the two groups in gender,disease duration,arthritis,rash,dysphagia,myasthenia,conccurrence with interstitial lung disease and cancer.In follow-up assessment,among the three JDM patients with anti-NXP-2 autoantibodies,one of them who died 10 months later had increased serum level of anti-NXP-2 autoantibody,extensive subcutaneous calcinosis,severe myasthenia and rapid progress.Conclusion This is the first report of the serum levels of anti-NXP-2 antibodies in Chinese patients with IIM and other CTDs.We find that anti-NXP-2 antibodies only exist in patients with IIM and are associated with early and calcinosis.

Objective To evaluate the risk factors of developing post-engraftment hemorrhagic cystitis (HC) in patients receiving allogeneic stem cell transplantation (allo-HSCT).Methods Retrospective data was collected from 92 patients with acute leukemia (acute myeloid leukemia 41 and acute lymphoblastic leukemia 51) who underwent allo-HSCT from 2000 to 2010,and the association of pre-transplantation parameters with the incidence of post-engraftment HC was analyzed.Results Forty-three patients had HLA-matched donors and 49 had unrelated donors.Of these patients,25 developed HC at a median of 35 days (day +20 to +65) after allo-HSCT.In the univariate analysis,unrelated donor,gender mismatch (female donor to male recipient),conditioning containing busulfan,graft-versus-host disease (GVHD),prophylaxis with cyclosporine (CSA) + methotrexate (MTX) + mycophenolate mofetil (MMF),use of anti-thymoglobulin (ATG) and development of GVHD were associated with increased incidence of HC.In the multivariate study,gender mismatch (P =0.001),use of ATG (P ＜ 0.001),and GVHD (P =0.007) remain as independent factors for the increased risk of HC.More importantly,with these 3 factors,it is able to classify patients into 4 groups with risk of postengraftment HC at (7.7±4.6) ％,(22.9±7.1) ％,(48.2±10.5) ％,and 100.0 ％,respectively.Conclusion This retrospective study identified the gender mismatch,use of ATG in the preparation regimen,and aGVHD as important risk factors to predict the development of post-engraftment HC.Based on these risk factors,it is possible to classify patients into different risk groups for post-engraftment HC.Prospective study with a large cohort of patients is warranted to confirm the findings.Future clinical trial for HC prevention and treatment must be carried out on the intermediate and high-risk patients.

Purpose To explore the independent predictors of malignant solitary pulmonary nodule (SPN) manifesting as ground-glass nodule (GGN),and to establish a prediction model.Materials and Methods The clinical data and CT images of 362 patients (group A) with pathological-confirmed SPN appearing as GGN in Shanghai Chest Hospital Shanghai Jiaotong University from January 2014 to December 2015 were retrospectively analyzed.The independent predictors of malignant SPN were identified,and the clinical prediction model was established.Another 119 SPN patients in Affiliated Zhoushan Hospital of Wenzhou Medical University were selected as group B to verify the diagnostic efficiency of the prediction model.Results Using multivariate Logistic regression analysis,clear border (OR=6.274,P＜0.01),smooth edge (OR=0.391,P＜0.01),lobulation (OR=3.387,P＜0.01),pleural retraction sign (OR=2.430,P＜0.01),and vocule sign (OR=3.076,P＜0.01)were identified as independent predictors of malignant SPN.The area of the model under the ROC curve was 0.859 with 95％ CI (0.804-0.903).The diagnostic accuracy rate,sensitivity,specificity,positive predictive value and negative predictive value were 85.92％,91.03％,81.97％,92.03％ and 73.53％,respectively.Conclusion In this study,the independent predictors of malignant SPN appearing as GGN were identified,and the prediction model was established.The model can accurately identify SPN and provide effective help for early diagnosis of SPN.

Objective To profile the differentially expressed genes in the muscle of polymyositis (PM) patients.Methods A mRNA microarray analysis was performed to profile mRNAs from 5 treatment-naive PM patients and 5 healthy controls.Gene Ontology and KEGG pathway analyses were applied to delineate the functional roles of the differentially expressed mRNAs.Quantitative real-time PCR analysis was conducted to validate the microarray data.The Student's t-test was used to analyze the statistical significance of the microarray results,and Benjamini-Hochberg FDR was used for multiple-test correction.Results Microarray analysis revealed that a total of 1 905 mRNAs (787 up-regulated and 1 118 down-regulated) were significantly differentially expressed in PM patients compared with the healthy controls (fold change＞2,P＜0.05).Six mRNAs were selected to analyze by quantitative RT-PCR to validate their expression levels and the results were consistent with that of the microarray analysis,and thus provide reliable validation for the microarray results.Gene ontology and KEGG pathway analysis for the differentially expressed mRNAs revealed that these genes were mainly involved in the biological process of infection and cytotoxic effect.In addition,there were some common signaling pathways that shared by PM and other autoimmune diseases.Conclusion There are differences in gene expressions between PM patients and healthy controls.The muscle damage in PM patients may be due to multi gene involvement and multi gene regulation.