Objective To describe our follow-up results of interventional management in 20 patients with subclavian artery stenosis. Methods This study involved in 20 symptomatic patients with an average age of 63.4 years,a mean stenose severity of 86.2% and a mean systolic arterial pressure difference of 116 mm?Hg between both upper limbs. Percutaneous transluminal angioplasty (PTA) in the first 8 patients and stenting in the last 12 patients were performed via a right femoral or radial artery. Results Both PTA and stenting were successfully archived in all patients with normalization of radial pulses and a mean systolic arterial pressure difference of 24 mm?Hg between both upper limbs. No major complications occurred. In the follow-up for an average of 18.5 months,19 patients were free of adverse events except one with symptom recurrence. Conclusion As effective,simple and safe procedures,PTA and stenting can be used as a first-line treatment modality for the symptomatic patients with subclavian artery stenosis.

Objective To explore the feasibility of applying small private online course (SPOC) in the course of Microcomputer Principle and Interface Technology to solve its problems in complicated knowledge points,abstract contents and difficulty in understanding.Methods The characteristics of the undergraduate students in the military medical university and SPOC mode were analyzed,and then the design and implementation of a SPOC-based Microcomputer Principle and Interface Technology course were explored in the military medical university.Results By applying the SPOC into the teaching of Microcomputer Principle and Interface Technology course,the student could find out the forgotten or leaked knowledge and reiterate them to reinforce the memory of those knowledge points,which promoted their self-regulation of learning.Besides,teaching the students with real cases not only increased the learner's enthusiasm but also strengthened the military medical background.The offline group discussion facilitated the students in understanding and application of knowledge.Conclusion Applying SPOC mode into PMIT teaching no doubt improves the effect and quality of teaching and learning.

Objective To determine the three-dimensional (3D) texture features extracted from intensity and high-order derivative maps that could reflect textural differences between bladder tumors and wall tissues,in order to achieve bladder cancer and wall tissue identification.Methods A total of 62 cancerous and 62 wall volumes of interest (VOI) were extracted from T2-weighted MRI datasets of 62 patients with pathologically confirmed bladder cancer.To reflect heterogeneous distribution of tumor tissues,3D high-order derivative maps (the gradient and curvature maps) were calculated from each VOI.Then 3D Haralick features based on intensity and high-order derivative maps and Tamura features based on intensity maps were extracted from each VOI.Statistical analysis was proposed to first select the features with significant differences and then obtain a more predictive and compact feature subset to verify its differentiation performance.Results From each VOI,a total of 58 texture features were derived.Among them,37 features showed significant inter-class differences (P≤ 0.01).Conclusion The results suggest that 3D texture features deriving from intensity and high-order derivative maps can reflect heterogeneous distribution of cancerous tissues.

Objective To establish a discriminant method based on clinical and laboratory data and common examinations for early predicting the severity of pediatric infection. Methods Consecutive hospitalized patients diag-nosed as septic shock were included who were admitted between June 2014 and May 2015 retrospectively. Gender (male - female ratio:1. 25∶ 1. 00)and age(1 month to 6 years old)were matched in all of 18 patients with septic shock,and 27 patients diagnosed as systemic inflammatory response syndrome(SIRS),sepsis and severe sepsis on ad-mission were included respectively in order of sequential admission number during the same period. Additional 36 gen-der - and age - matched children with common infection(non - SIRS)were enrolled as controls. The clinical and labo-ratory examination data of all the included patients were collected and then the pediatric critical illness scores(PCIS) were made according to the worst condition within 24 hours of hospitalization. The parameters correlated with the severi-ty of infection were evaluated by rank correlation and Logistic regression analysis. The discriminant models were estab-lished based on κth - nearest - neighbor analysis and evaluated with clinical diagnosis by interrater agreement test. Results Except for platelet count,the other indexes including PCIS,neutrophil count,C - reactive protein,procalcito-nin(PCT),international normalized ratio of prothrombin time,activated partial thromboplastin time,thrombin time,fi-brinogen,fibrin/ fibrinogen degradation product(FDP)and D - dimer(D - D)all had differences among groups with varying infection severity(all P ﹤ 0. 001). The Spearman's coefficient ρ of PCIS,PCT,D - D and FDP correlated to in-fection severity were - 0. 837,0. 680,0. 679 and 0. 648,respectively(all P ﹤ 0. 001). Multivariate cumulative odds Lo-gistic regression analysis showed PCIS,D - D and PCT were related to infection severity(all P ﹤ 0. 05). The total error rate of discriminant models based on 3 - index combination(Mahalanobis transformation,k = 2)was 0. 091 that was lower than any models based on 2 - index combination or single - index. Using the discriminant model based on three -index combination,the infection severity of 26 patients admitted during June 2015 were predicted with a high interrater a-greement(weighted Kappa coefficient:0. 670,P ﹤ 0. 001)compared to clinical diagnosis. Conclusion The discriminant model based on combination of PCIS,D - D and PCT could assist predicting the severity of pediatric infection earlier.

BACKGROUND:Methylprednisolone has been used for the treatment of acute spinal cord injury but there is a dispute about the efficacy and safety of methylprednisolon. OBJECTIVE:To evaluate the efficacy and safety of methylprednisolon based on system review. METHODS:PubMed database, EMBASE database, Cochrane Library, ISI Web of knowledge, CBM database, VIP database, CNKI database and Wanfang database were searched from their start year up to December 2014 for relevant randomized clinical trials on the treatment of acute spinal cord injury with methylprednisolon. RESULTS AND CONCLUSION:Twelve randomized clinical trials with 642 acute spinal cord injury patients were included. The results of the Meta analysis showed: methylprednisolone+conventional therapy was better to improve American Spinal Injury Association (ASIA) motor function score, ASIA touch sensation score, ASIA pinprick sensation score and the overal Frankel score than the conventional therapy alone (control group) with statistical significance (P < 0.05). In the aspect of safety, the methylprednisolone group had higher death ratio, digestive tract reaction ratio and urinary infection ratio than the control group but with no statistical significance. The gastrointestinal bleeding ratio and lung infection ratio was significantly higher in the methylprednisolone group than the control group (P < 0.05). We conclude that methylprednisolone has protective effect on acute spinal cord injury, but the main side effects are gastrointestinal bleeding and lung infection. There is a need for high-quality randomized controled trials to prove the efficiency and safety of methylprednisolone.

Objective: To investigate the effect of leukemia inhibitory factor (LIF) on the of proliferation and differentiation of ectomesenchymal cells of mandibular process in Balb/c fetal mice . Methods: Ectomesenchymal cells from the E12.5 mice mandibular process were cultured in DMEM/F12 with 10 6u/L LIF (experimental group) or without LIF (control). The proliferation effect was detected by MTT assay, Brdu test and flow cytometry. Immunohistochemistry were used to identify the differentiation state. Results: By day 7 the A value of the experimental group was 0.38?0.03,that of the control 0.30?0.02 (P

?Objective :To construct human skin with full thickness in vitro using tissue engineering techniques. Metheods: Epithelial cells and fibroblasts were isolated from the back skin of legally aborted human foetus. Fibroblasts were seeded into bovine type I collagen gel and cultured for 3 days. Epithelial cells were seeded on the surface of collagen gel and cultured for another 2 days, then the equivalent skin was exposed to air liquid interface to generate a protective cornified layer. 5 days later, equivalent skin was excised and observed under light microscope and transmission electron microscope. Results: Epithelium and dermis were observed in the equivalent skin,similar to those in normal human skin. Epithelium was made up of stratum basale, stratum spinosum, stratum granulosum and stratum corneum. The cells of different layers were connected with intercellular bridge. Horny pearl were also found in epithelium. Basement member was observed between epithelium and dermis. Epithelial spikes bristles of different length were existed in partial dermis. The results of TEM observation showed that desmosome existed between cells of different layer in epithelium. Conclusion: Human skin with full thickness can be tissue engineered with foetus back skin as the sources of epithelial cells and fibroblasts, and bovine I type collagen as carrier.

Objective: To investigate the clinicopathological features, morphological characteristics, immunophenotypes of littoral cell angioma (LCA) in spleen, and to provide new evidence for making diagnosis and avoiding misdiagnosis.Methods: Clinicopathological data, histological characteristics of 13 cases of LCA were retrospectively studied and immunohistochemical staining was imposed on the paraffi-nembedded specimens, and 5 cases of cavernous hemangioma, 4 cases of normal littoral cells of spleens were used as control groups, simultaneously.Results: All the 13 LCA patients included 7 males and 6 females, aged from 39 to 70 years with an average of 54.2 years and a median age of 55 years.Among these tumor patients, 6 cases were accompanied by malignances, benign tumors or inflammation states at abdominal cavities, and 7 cases were accidentally discovered by physical examinations.Grossly, spleens contained solitary or multiple gray red nodules ,which ranged from 0.5 to 6.2 cm in diameter.Histologically, tumors were composed by anastomosing vascular spaces which were lining by plump, rounded to cuboidal littoral cells that extended into vascular lumens.Usually, papillary frameworks that were covered by these cells were also seen extending into the lumens in some areas.Other types of histiocytoid cells were identified in lumens and the sizes were larger than the littoral cells.Both types of cells absented cytologic atypia.Immunohistochemical study demonstrated that the littoral cells in all cases were positive for vascular endothelial and histiocyte markers, such as CD21, CD31, CD68, polyclone FⅧRAg and ERG, while these cells were negative for CD8, CD34, and WT-1.These findings manifested that immunophenotype of littoral cell in LCA distinctive from that in controls.Conclusion: LCA is a benign lesion, which frequently occurs in the elderly.Its etiology remains confusion, however, immune dysregulation may associate with it because of the concomitance with other tumor or inflammation in some cases.The littoral cells in LCA show a hybrid endothelial-histiocytic phenotype on immunohistochemistry, therefore these cells may have features that intermediate between those of endotheliocytes and histiocytes.Emphasizing the histological findings and immunophenotypes is significant for diagnosis and differential diagnosis.

Objective To investigate the regulation of B-lymphocyte stimulator(BLyS) levels in response to IFN-γand IL-6. Methods Flow cytometry, quantitative polymerase chain reaction, ELISA and Western blot were applied to examine the expression level of BLyS in response to IFN-γ and IL-6 . Results IFN-γand IL-6 induced BLyS expression in KM3 cells. After treated with BAY11-7082, an IkB-α phospho- rylation inhibitor, the up regulation of BI,yS induced by IFN-γ was completely inhibited. Inhibiting the nu-clear faetor-kB (NF-kB) and mitogen activated protein kinase(MAPK) activation in KM3 cells reduced BLyS protein and gene expression. Conclusion MAPK and NF-kB pathways are involved in the regulation of BLyS expression, which suggests that MAPK and NF-kB might be used for the treatment of multiple mye- loma.

Objective This paper is to validate a speech intelligibility test in Chinese mandarin for the evaluation of speakers with cleft palate, and to determine the intelligibility deficit patterns based on minimal pairs. Methods Thirty cleft palate patients with dysarthria were included as speakers for the test. Then the speech intelligibility of each speaker was rated and the error proportions of each minimal pair were analyzed by SPSS 16.0. The stepwise multiple regression analysis was employed to determine which minimal pairs were the best predictors of reduced speech intelligibility. Results The intelligibility scores were obtained form the thirty speakers ranged from 37% to 92.4%. The error proportion of the minimal pairs was ranged from 0. 13 to 0. 80. The three most problematic pairs, from the most to least severe were dental versus retroflex pair (0.80), retroflex versus palatal pair(0.68), and aspirated versus un-aspirated affricative pair(0.66). The speech intelligibility from cleft palate patients could be predicted at 71.5% accuracy using two pairs, aspirated versus un-aspirated affricative pair, dentals versus palatal pair. Conclusion The speech intelligibility test for Chinese Mandarin speakers with cleft palate can be used as an effective evaluation method, both qualitatively and quantificationally.