Objective To study the value of time intensity curve of contrast enhanced ultrasound in the discrimination of benign and malignant soft tissue tumors. Methods Thirty-seven cases of soft tissue tumors were carried out contrast-enhanced ultrasound examination. The region of interest in the dynamic images were chosen to carry out Gamma-Variate curve fitting through Q-LAB software and made a quantitative analysis. Then they were compared with pathological diagnosis to analyze the ultrasound imaging performance of benign and malignant tumors and their characteristics of micro-irrigation. Results Thirty-seven cases of soft tissue tumors were pathologically diagnosed 21 cases of benign and malignant in 16 cases. The perfusion of benign tumors were mainly uniformity (19/21) or potentialization (2/21). The perfusion of malignant tumors were mainly uniformity (10/16) or nonuniformity (6/16). There were no significant differences in time to peak(TTP) and arrival time of contrast agent(AT) between benign and malignant tumors( P ＞0.05). The upslope rate(A) and the derived peak intensity(DPI) in benign group were significantly less than malignant group ( P ＜0.05). Conclusions Time-intensity curve analysis of contrast-enhanced ultrasound showed that benign and malignant soft tissue tumors were different in perfusion,and it will be of a certain value for the clinical differential diagnosis.

Objective To analyze the hot research spots of MOOC research of higher medical edu-cation in China. Methods We searched the database of China National Knowledge Infrastrucure (CNKI), VIP database of Chinese journal (VIP), Wanfang Database for published studies on MOOC research of higher medical education from 2005 to April 2015. The high frequency words were counted by an analysis program-Bibliographic Item Co-occurrence Matrix Builder (BICOMB). According to the ranking word frequency threshold formula by Donohue, we collected the high-frequency keywords. The corresponding co-word ma-trixes were constructed by Bibexcel, then the data was input into SPSS 19.0 software for hierarchical clus-tering analysis. Results Finally 2 459 articles were included. 11 177 keywords and 13 high frequency words (the number of the real selected was 24) were taken into account. The keywords “stanford” clus-tered with “education module”, “online education”, “online courses”, “distance education”, “learning pro-cess”, “self-regulated learning”, “information technology”, “classroom teaching”. The keywords “network course” clustered with “teaching design”. The keywords “online learning” clustered with itself. The key-words “challenge” clustered with “colleges and universities”. The keywords “flipped classroom” clustered with“micro-lecture”,“MOOC”,“higher education”, “library”, “teaching module”, “teaching reform”, “big data”,“open education”. The keywords“SPOC”clustered with itself. Conclusion The research of MOOC research of higher medical education in our country has formed the basic characteristics with six hot spots involving teaching design, the model of online learning, dispassion thinking, teaching reform, and develop-ment. And there are many potential areas.

Objective To evaluate a score system(Association of Coloproctology of Great Britain and Ireland ACPGBI)in prediction of postoperative mortality from colorectal cancer patients in a Chinese hospital. Methods We analyzed retrospectively 904 patients with histologically confirmed colorectal cancer who had colorectal surgery from 1992 to 2005.There were 525 colonic cancer patients and 379 rectal cancer patients.We divided patients into several groups according to operative urgency(elective or emergency);surgeons(colorectal specialists or other surgeons);cancer location(colon or rectal).According to ACPGBI score we got the prediction.This prediction was compared with the actual mortality;Chi-square test,receiver operator characteristic curve(ROC),Hosmer-Lemeshow goodness-of-fit test were used.Results Observed overall mortality within 30 days after surgery was 1.0%(9/904),and the predicted mortality was 8.3%(75/904).In all the subgroups the predicted momdity wag higher than observed mortality.We found that the actual mortality was higher in an individual subgroup in which the predicted mortality was higher. Conclusions For colorectal cancer patients undergoing a surgery the predicted mortality of ACPGBI score system was higher than the actual mortality in a Chinese hospital.

Objective To explore the clinical features of hemophagocytic syndrome in children and the signifi﹣cance of gene detection. Methods TWenty－tWo pediatric patients diagnosed as hemophagocytic syndrome since 2004 clinical and laboratory criteria Were enrolled in Children＇s Hospital Affiliated to Zhengzhou University from January 2014 to January 2016. The clinical data of patients Were analyzed,and the genes associated With hemophagocytic syn﹣drome Were detected. The clinical biochemical indicators Were compared betWeen mutation group and non －mutation group. Results TWenty－tWo cases of patients(3 months to 12 years)Were enrolled,including 10 males and 12 fe﹣males,and the proportion of children over 5 years old accounted for the highest proportion,accounting for 50%,and all of them had fever,liver,spleen and lymph node enlargement. The main test results Were as folloWs:peripheral blood cells decreased in 6 cases( 27. 27%),hemophagocytic phenomena presented in bone marroW smears in 12 cases (54. 55%),abnormal liver function in 18 cases(81. 82%),and loW serum albumin in 22 cases(100. 00%). High serum ferritin levels Were detected in 20 cases(90. 91%);the detection of natural killer(NK)cell activity shoWed nor﹣mal activity( active ＞ 15%) in 7 cases( 31. 82%),and decreased activity( activity ≤ 15%) in 15 cases (68. 18%). The genes associated With hemophagocytic syndrome Were detected in 22 cases of patients,and 12 of them Were associated With mutations related to hemophagocytic syndrome,accounting for 54. 55%. LYST,ITK and UNC13D gene Were common. There Was no statistical difference in Which ages of onset,symptoms of the nervous system,and labo﹣ratory data of leukocyte count,red blood cell count,hemoglobin,platelet count,NK cell activities,prognosis,hemophago﹣cytic phenomena shoWed in bone marroW smears,alanine aminotransferase,albumin,triglyceride,ferritin and fibrinogen betWeen mutation group and non－mutation group(all P＞0. 05). Conclusions Pediatric hemophagocytic syndrome is mostly accompanied by fever,liver,spleen and lymph node enlargement,and most of them are accompanied by gene mu﹣tations. LYST,ITK and UNC13D gene are commonly seen. But there is no significant correlation betWeen gene mutation and general condition,biochemical index and severity of the disease.

Objective:To explore the expression of fructose bisphosphate aldolase A (ALDOA) in the bone marrow of patients with acute myeloid leukemia (AML) and the correlation with clinical features and prognosis.Methods:The bone marrow samples of 90 newly diagnosed AML (non-acute promyelocytic leukemia) patients and 18 allogeneic hematopoietic stem cell transplantation donors who were treated from January 2013 to December 2015 in the First Affiliated Hospital of Zhengzhou University and the Children's Hospital Affiliated to Zhengzhou University were collected. The relative expression level of ALDOA mRNA in bone marrow samples was detected by using real-time quantitative polymerase chain reaction (qRT-PCR). Clinical data of these patients were retrospectively analyzed, and the patients were divided into continuous complete remission (CR) group and refractory recurrent (RR) group according to the clinical response and follow-up results. The differences of the relative expression level of ALDOA mRNA between AML group and the normal control group, CR group and RR group were analyzed. Univariate and multivariate Cox regression risk model were used for analysis of factors influencing prognosis of AML patients.Results:The relative expression level of ALDOA mRNA in AML group was higher than that in normal control group [(5.71±0.44) vs. (1.10±0.08), t = 4.74, P<0.001]. The relative expression level of ALDOA mRNA in the RR group was higher than that in the CR group [(6.69±0.67) vs. (4.30±0.36) , t = 2.79, P < 0.001]. In addition, there were statistically significant differences in the proportion of patients with ALDOA mRNA high expression and those with ALDOA mRNA low expression stratified by the number of white blood cell, the proportion of bone marrow blasts and whether complete remission could be achieved or not after 1 course of induction therapy (all P < 0.05). Overall survival in patients with ALDOA high expression was worse than that in patients with ALDOA low expression ( χ2 = 5.59, P = 0.018). Multivariate analysis showed that white blood cell count, prognosis stratification, whether complete remission could be achieved or not after 1 course of induction therapy and ALDOA expression were the independent prognostic factors for the death of AML patients (all P < 0.05). Conclusions:ALDOA may play an important role in the development and progression of AML, and the expression level of ALDOA in the bone marrow can be used as an index for the prognosis assessment of AML patients and may be a potential therapeutic target for AML.