Objective To pay more attention to the adverse drug reactions caused by tigecycline. Methods Four cases in our hospital which happened acute or subacute liver failure after the uses of tigecycline were analyzed, including age, basic disease, drug combination,the time when liver function failure happen ,dosage of tigecycline and the course of treatment. Results The aged of four patients was 49-77 years old, the average age (67.5±12.79)years; the time when liver failure happened from 6 d to 20 d, the average(11.75±6.24) d; the course of treatment was 9 d to 23 d, the average(9.75±6.63) d; the total dose of tigecycline was 900 mg to 3650 mg, the average (1812.5±1243.23) mg.The four patients have many basic diseases, combined with many drugs, all of them have mechanical ventilation. Conclusion More attention should be paid to adverse events caused by tigecycline.

Purpose: To investigate the pathogenesis and clinical treatment of pulmonary inflammatory pseudotumor (PIP). Methods:To analyze the pathogenic characteristics and X-ray findings of 18 cases of PIP. Results:The rate of incidence in PIP is increasing in recent years .70 percent of the patients have infection of the respiratory system and is related to the abuse of large doses of antibiotics, there is little specificity in X-ray or CT so it is easy to confuse with malignant tumor of the lung .In pathologic sections of PIP, no malignant changes were seen, and only inflammatory cells, lymphocytes and plasm cells could be seen by light microscope. Conclusions:The antibiotic must be used properly in infection of the respiratory system and surgical treatment can be done in some asses to exclude tumor of the lung in diagnosis.

Objective To determine the best extraction process of ginkgo leaves with the total transfer rate of total flavonol glycosides and terpene lactones as the index.Methods The effects of ethanol concentration, solid-liquid ratio and extraction time on extraction process were investigated by orthogonal design method, and the contents of total flavonol glycosides and terpene lactones were detected by HPLC to calculate transfer rate.Results The optimum extraction conditions were as follows:85% ethanol refluxing and extracting for three times;the first time extracting with five-fold amount of solvent (V/W) for 3 hours;the last two times with three-fold solvent (V/W) for 2 hours.Conclusion This extraction process has the advantages of simplicity of operator, reason, energy conservation, high efficiency, and is suitable for industrial production.

Objective To evaluate the effect of various methods of fecal exfoliated cell testing for screening of colorectal cancer.Methods The stool samples from 814 patients who underwent colonoscopy were collected for fecal exfoliated cell testing using diarrhea feces,twice naturally evacuated feces,magnetic separation or naturally evacuated combined with diarrhea feces.The fecal exfoliated cells were isolated and examined cytologically.The DNA quantitative analysis and gene detection were carried out.Fecal occult blood test was simultaneously performed in twice naturally evacuated feces and naturally evacuated combined with diarrhea feces.Results The sensitivity and specificity of exfoliated cells testing for colorectal Cancer was 66.27%(112 of 169 cases of colorectal cancer)and 99.56%(225 of 226 normal subjects),respectively.There was no correlation of positive rate with differentiations of colorectal cells or Duke's stages(P＞0.05).The nuclear DNA quantitative analysis showed that the sensitivity for detecting cancer was 76.09%for twice naturally evacuated feces and 68.29%for naturally evacuated combined with diarrhea feces,which was superior than diarrhea feces(26.31%)and magnetic separation (43.24%).The positive rate of genes detected in carcinoma tissues concordant with fecal exfoliated cells testing were 83.33%(25/30)for p53,9/10 for APC and 9/10 for K-ras.The sensitivity of cytology was higher than gene detection.The sensitivity of cancer detection was higher in combining exfoliated cells test with fecal occult blood test(93.10%)than exfoliated cells test(73.56%)or fecal occult blood test (80.46%)alone(P＜0.05).Conclusions Fecal exfoliated cells test is an effective method for screening of colorectal cancer.It is the best option for detecting cancer by twice tests of fecal exfoliated cells with liquid-based thin-layer cytological test,and combined with fecal occult blood test.

Objective:To investigate the influence of all-trans-retinoic acid (ATRA) on the proliferation and invasion of osteosarcoma 143B cells and its possible regulatory mechanism.Methods:Different concentrations of ATRA were used to treat human osteosarcoma 143B cells, and the optimal concentration and treatment time those affected cell proliferation were selected. The MTS method, Transwell migration and invasion experiments were used to detect the changes in the proliferation, migration and invasion of 143B cells after ATRA treatment. The real-time quantitative polymerase chain reaction (qRT-PCR) and Western blot were used to detect the expression changes of miRNA-34a (miR-34a), E2F1 and Eag1 in osteosarcoma 143B cells after ATRA treatment. Then miR-34a was interfered and E2F1 was overexpressed, and the abilities of cell proliferation, invasion and migration abilities as well as the expression changes of miR-34a, E2F1 and Eag1 in 143B cells were detected.Results:The proliferation inhibition of 143B cells was most obvious when 143B cells were treated with 10 μmol/L ATRA for 72 h. The cell migration and invasion numbers when 143B cells were treated with 10 μmol/L ATRA for 72 h were lower than those in the negative control group [(73±3) cells vs. (182±5) cells, t = 21.46, P<0.01; (94±3) cells vs. (203±7) cells, t = 13.70, P<0.01]. 10 μmol/L ATRA could promote the expression of miR-34a in 143B cells and inhibit the expressions of Eag1 and E2F1 (all P<0.01). Compared with ATRA group, the ability of cell proliferation in ATRA+miR-34a interference group was restored after 72 h of treatment [cell survival rate (41.0±2.2)% vs. (25.0±3.6)%, t = 108.68, P<0.01]. Compared with ATRA group, the abilities of cell migration and invasion in ATRA+miR-34a interference group were restored [(122±14) cells vs. (64±10) cells, t = 21.06, P<0.01; (103±10) cells vs. (59±8) cells, t = 24.27, P<0.01), and the mRNA and protein expressions of Eag1 and E2F1 in cells were promoted (both P<0.01). Compared with ATRA group, the ability of cell proliferation in ATRA+E2F1 overexpression group was restored [cell survival rate (40.0±3.4)% vs. (24.0±3.1)%, t = 108.74, P<0.01]; the abilities of cell migration and invasion in ATRA+E2F1 overexpression group were restored [(78±12) cells vs. (29±8) cells, t = 13.52, P<0.01; (75±12) cells vs. (49±10) cells, t = 6.28, P<0.01], and the mRNA and protein expressions of Eag1 and E2F1 in cells were promoted (both P<0.01). Conclusion:ATRA inhibits the proliferation and invasion of osteosarcoma cells via regulating miR-34a-E2F1-Eag1 signaling pathway, and it may become one of the effective treatment drugs for osteosarcoma.

Objective To analyze changes in the percentages of circulating follicular helper T (Tfh) cells and Tfh subsets in patients with systemic lupus erythematosus (SLE) for better understanding their relationships with SLE , and to investigate effects of steroids on circulating Tfh cells .Methods Pe-ripheral blood mononuclear cells (PBMCs) from 27 patients with SLE (including 10 inactive patients and 17 active patients ) and 21 sex-and age-matched healthy donors were analyzed by flow cytometry to detect the percentage of CD4+CD45RA-CXCR5+Tfh-like cells.Disease activity and the concentration of anti-double-stranded DNA ( anti-dsDNA) antibody were evaluated by SLEDAI score ( SLE disease activity index ) and ELISA, respectively.PBMCs from healthy donors were treated with or without prednisone to evaluate its effects on circulating Tfh cells .Twelve patients with SLE were treated with high-dose steriods ( 200-500 mg/d, 2-3 d) and the percentages of circulating Tfh cells and Tfh subsets in them were analyzed before and after treatment .Results No significant difference in the percentage of circulating Tfh cells was ob-served between patients with SLE and healthy donors (P>0.05), but the percentage of Tfh17 cells in pa-tients with SLE was significantly higher than that in healthy donors (P<0.05).Compared with patients with inactive SLE and healthy donors , patients with active SLE had a lower percentage of Tfh 1 cells (P<0.05).Moreover, the percentage of Tfh1 cells was negatively correlated with SLEDAI score (r=-0.44, P<0.05). The percentage of Tfh2 cells in anti-dsDNA antibody-positive group was significantly higher than that in anti-dsDNA antibody-negative group (P<0.05).In vitro treatment of PBMCs from healthy donors with predni-sone could significantly down-regulate the percentage of circulating Tfh (P<0.01), Tfh1 (P<0.05) and Tfh2 cells (P<0.01), and up-regulate the percentage of Tfh17 cells (P<0.01).In vivo treatment of pa-tients with SLE with steriods could significantly down-regulate the percentage of circulating Tfh (P<0.01), Tfh1 (P<0.05) and Tfh2 cells (P<0.01) and up-regulate the percentage of Tfh17 cells (P<0.01).Con-clusion Abnormal distribution of Tfh subsets is correlated with SLE disease activity and anti -dsDNA anti-body .Steroids in the treatment of SLE could affect the percentage of circulating Tfh cells and the distribution of Tfh subsets .

Objective:To evaluate the performance of an artificial intelligent (AI)-based automated digital cell morphology analyzer (hereinafter referred as AI morphology analyzer) in detecting peripheral white blood cells (WBCs).Methods:A multi-center study. 1. A total of 3010 venous blood samples were collected from 11 tertiary hospitals nationwide, and 14 types of WBCs were analyzed with the AI morphology analyzers. The pre-classification results were compared with the post-classification results reviewed by senior morphological experts in evaluate the accuracy, sensitivity, specificity, and agreement of the AI morphology analyzers on the WBC pre-classification. 2. 400 blood samples (no less than 50% of the samples with abnormal WBCs after pre-classification and manual review) were selected from 3 010 samples, and the morphologists conducted manual microscopic examinations to differentiate different types of WBCs. The correlation between the post-classification and the manual microscopic examination results was analyzed. 3. Blood samples of patients diagnosed with lymphoma, acute lymphoblastic leukemia, acute myeloid leukemia, myelodysplastic syndrome, or myeloproliferative neoplasms were selected from the 3 010 blood samples. The performance of the AI morphology analyzers in these five hematological malignancies was evaluated by comparing the pre-classification and post-classification results. Cohen′s kappa test was used to analyze the consistency of WBC pre-classification and expert audit results, and Passing-Bablock regression analysis was used for comparison test, and accuracy, sensitivity, specificity, and agreement were calculated according to the formula.Results:1. AI morphology analyzers can pre-classify 14 types of WBCs and nucleated red blood cells. Compared with the post-classification results reviewed by senior morphological experts, the pre-classification accuracy of total WBCs reached 97.97%, of which the pre-classification accuracies of normal WBCs and abnormal WBCs were more than 96% and 87%, respectively. 2. The post-classification results reviewed by senior morphological experts correlated well with the manual differential results for all types of WBCs and nucleated red blood cells (neutrophils, lymphocytes, monocytes, eosinophils, basophils, immature granulocytes, blast cells, nucleated erythrocytes and malignant cells r>0.90 respectively, reactive lymphocytes r=0.85). With reference, the positive smear of abnormal cell types defined by The International Consensus Group for Hematology, the AI morphology analyzer has the similar screening ability for abnormal WBC samples as the manual microscopic examination. 3. For the blood samples with malignant hematologic diseases, the AI morphology analyzers showed accuracies higher than 84% on blast cells pre-classification, and the sensitivities were higher than 94%. In acute myeloid leukemia, the sensitivity of abnormal promyelocytes pre-classification exceeded 95%. Conclusion:The AI morphology analyzer showed high pre-classification accuracies and sensitivities on all types of leukocytes in peripheral blood when comparing with the post-classification results reviewed by experts. The post-classification results also showed a good correlation with the manual differential results. The AI morphology analyzer provides an efficient adjunctive white blood cell detection method for screening malignant hematological diseases.