Objective At present study,we sought to further define the significance of endoscopic and pathological findings in the diagnosis of acute intestinal GVHD.Methods The clinical、endoscopic and pathological data in 23 patients with proven acute intestinal GVHD were retrospectively reviewed.Results The endoscopic features of the ileum and colon varied from being grossly normal、loss of vascular markings、diffuse mucosal erythema、edema and friability to erosion、ulceration、mucosal sloughing and bleeding.Pathological findings included crypt epithelial cell apoptosis and dropout、crypt destruction and variable lymphocytic infiltration of epithelium and lamina propria.Conclusion Endoscopic and pathological evaluation of the ileum and colon can be used to diagnose acute intestinal GVHD.Endoscopy may play a significant role in establishing early diagnosis for acute intestinal GVHD in patients following allogeneic BMT,but pathological evaluation of the ileal and colonic mucosa is needed to confirm the final diagnosis.

Objective To evaluate the prognostic significance of metastastic lymph node ratio in patients with gastric cancer. Methods Clinical data of 319 patients with gastric cancer who underwent radical gastrectomy with at least 15 lymph nodes dissected per patient were analyzed retrospectively. Patients were divided into 4 groups according to the TNM staging system (1997,5th edition): pN0 (no positive lymph node), pN1(with 1～6 metastatic lymph nodes), pN2 group (with 7～15 metastatic lymph nodes), and pN3 group (with more than 15 metastatic lymph nodes), or into 4 groups according to the lymph node metastatic ratio: rN0 group (without metastasis of lymph node), rN1 group (with a lymph node metastatic ratio of <30%), rN2 group (with a lymph node metastatic ratio of 30%～60%), and rN3 group ( with a lymph node metastatic ratio of >60%). Survival was determined by the Kaplan-Meier method and differences were assessed by the Log-rank test. Multivariate analysis was performed using the COX proportional hazard regression model in forward stepwise regression with SPSS 13.0. Results Kaplan-Meier survival analysis demonstrated that the metastatic lymph node ratio significantly influenced the postoperative survival time. According to the lymph node metastasis system 77 patients were in group 1, 109in group 2, 60 in group 3, and 73 in group 4. The 2-year survival rate was 84.4%,66.1%, 35.0%,and 15.1% respectively, 3-year survival rate was 80.5%,45.0%,15.0% and 5.5% respectively, and 4-year survival rate was 71.4%,33.0%,5.0% and 1.4% respectively. If cases with the same positive number of lymph node (pN) group were stratified futher by lymph node metastatic ratio, there were no significant differences in the 3-year survival rate among the new rN groups (P>0.05), but there was a great difference in the distribution of prognosis among different groups. COX proportional hazard regression model analysis showed that the metastatic lymph node ratio was an independent factor for poor prognosis. Lymph node metastatic ratio was closely related with the location, modality of the operation and infiltration depth. Conclusions The staging system based on metastatic lymph node ratio is more reliable than the system based on the number of metastatic lymph nodes in the prediction of the prognosis of gastric cancer.

Objective To study the effect of different personality on procrastination behavior of university students.Methods 126 university students were assessed by the General Procrastination Scale (GPS) and the big five personality inventory short form(NEO-FFI).Results GPS score of the student was(53.26±9.92).There were 84.9％ students respectively had different level of procrastination behavior.There were no significant differences in university students by gender and grades.There were significant negative correlation between procrastination and personality factor of conscientiousness (r=-0.563,P＜0.01) and significant negative correlation with agreeableness (r=-0.236,P＜0.01) and extraversion.The big five personality factors of conscientiousness can effectively predict the procrastination behavior of college students.Conclusion Procrastination is a very common phenomenon in the university students.The students with lower conscientiousness,agreeableness and extraversion of big five personality have more procrastination behavior.

Objective:To investigate the clinical effect of ginger-partitioned moxibustion combined with manual repositioning for benign paroxysmal positional vertigo (BPPV). Methods:A total of 76 BPPV cases were randomly allocated into an observation group (n=38) and a control group (n=38). Patients in the observation group received ginger-partitioned moxibustion at Tinggong (SI 19) plus manual repositioning, whereas patients in the control group received the same manual repositioning alone. Results: After 48 h of treatment, the total effective rate was 94.7% in the observation group, versus 86.8% in the control group; after 7 d of treatment, the total effective rate was 78.9% in the observation group, versus 73.7% in the control group, both showing between-group statistical differences (P<0.05). The follow-up after 3 months showed that 2 cases (6.7%) got relapse in the observation group, versus 8 cases (28.6%) in the control group, showing a statistical difference (P<0.05). The adverse reaction rate was 2.6% in the observation group, versus 21.1% in the control group, showing a statistical difference (P<0.05).Conclusion: Ginger-partitioned moxibustion at Tinggong (SI 19) plus manual repositioning can obtain better effect for BPPV than manual repositioning alone. In addition, this therapy has stable efficacy and causes less adverse reactions.

AimTo find out the comprehensive strength and trends in scientific research area,and to provide foundation for decision-making on pushing the paediatric research forward,we reviewed the achievements of the scientific papers publication and the professional background of the authors between 2001 and 2010. Methods We extracted data and described the distribution characteristics of the paper publication amount,degree in the 10 years,as well as age,construction of professional and technical title,the education qualification of the authors. Moreover,we statistically analyzed the variability of the publication conditions within statistical source journals among the authors with different technical title.ResultsThe amount of paper publication increased anually in the 10 years,but with few published in statistical source journals,and the core authors group have not formed yet.Meanwhile,the general internal medicine maintained the dominant propotion.Authors aged 30 -50 years old,with middle technical title and with bachelor degree published the majority of the papers.The propotion of the papers published in statistical source journals and in the Zhonghua series medical journals were significantly higher in authors with master degree and above.ConclusionsIn order to construct a stable core authors group and increase the amount of the paper publication,we should continue to encourage those author groups with high output rate and make greater support on the potential authors.Furthermore,we must take more effort on impoving publication quality in the future.

Objective To investigate the potential association between 163A/G and 950T/C polymorphisms of osteoprotegerin(OPG)gene and severe pre-eclampsia.Methods Eighty-five severe preeclamptic patients and 81 normal term pregnant women(as control group)were recruited from the Department of Obstetrics and Gynecology,West China Second University Hospital,Sichuan University during the period from July 2007 to March 2009,and they were all Han population living in Chengdu,China.Genotype and allele frequencies of 163A/G and 950T/C were determined by the PCR-restriction fragment length polymorphism(RFLP)assay.Clinical and biochemical parameters for different alleles between the patients and controls were compared for statistical significance respectively,such as blood pressure,serum creatinine and 24-hour urine protein.Results The observed and expected genotype counts were consistent with Hardy-Weinberg equilibrium.No significant differences were found in the genotype and allele frequencies of 163A/G and 950T/C polymorphisms between the two groups(P ＞ 0.05).However,in the preeclamptic group,serum creatinine was significantly higher in women with the AG + GG genotypes [(76 ±24)μmol/L]compared with AA genotype[(56 ± 18)μmol/L].Reversely,birth weight was lower in the AG + GG genotypes[(2040 ± 721)g]than those in the AA genotype[(2520 ± 810)g],and the P ＜0.05,respectively.In the severe pre-eclampsia,950T/C TT genotype carriers exhibited significantly higher systolic blood pressure[(153 ± 16)mm Hg(1 mm Hg =0.133 kPa)]and 24-hour urine protein [(4.0±2.5)g]compared with TT + TC carriers[(145 ±17)mm Hg,(2.9±1.8)g],respectively,furthermore the P ＜ 0.05.Conclusions In severe pre-eclampsia,carriers with G allele at position 163A/G has more genetic predisposition than A allele carriers,as well as 950T/C T allele carriers compared with C carriers.Taken together,this study suggested that OPG gene polymorphisms might be associated with some clinical parameters of severe pre-eclampsia.

Objective:To explore the clinical efficacy of single-center infant kidney donor adult dual kidney transplantation to explore the difference of different operation methods and the operation options of different donor kidney conditions so as to improve the success rate of children kidney donor adult dual kidney transplantation and reduce complications.Methods:A total of 42 cases of infant and adult dual kidney transplantations at Department of Kidney Transplantation in The Second Xiangya Hospital of Central South University from December 2012 to May 2019 were divided into two groups according to whether or not donor kidney fulfilled the criteria of three " 5" . According to different surgical approaches, they were divided into three groups of A (classical En-Bloc operation), B (separated dual kidney transplantation) and C (modified operation). The clinical data and prognoses were analyzed.Results:The median follow-up period was 55(11-92) months. The estimated glomerular filtration rate was 123.4(92.2-156.6) ml/min for operation A, 97.2(81.3-116.6) ml/min for operation B and 133.9(133.9-133.9) ml/min for operation C. In donor group not fulfilling the " 5" principle, no thrombotic event occurred for operation A/C and 3 cases of transplantation for operation B. There were single renal embolism ( n=2) and dual renal embolism ( n=1)(3/5, 60%)( P<0.05). Urinary protein was positive in the last follow-up: operation A (1/2, 50%) and operation B (3/5, 60%) ( P<0.05). The estimated glomerular filtration rate at the last follow-up was 82.4(80.9-83.9) ml/min for operation A, 71.8(46.1-114.2) ml/min for operation B and 122(83.3-142.4) ml/min for operation C. The 1-year graft survival rate was 100% and 89.5% in three " 5" donor group and 3-year graft survival rate was 100% and 84.2% respectively. Conclusions:Satisfactory outcomes might be obtained during dual kidney transplantation for infants and adults. The incidence of thrombosis, urine leakage and urinary protein is lower in improved kidney transplantation group than that in previously operated group. The problem of graft hyperperfusion injury is well solved. And the long-term follow-up outcome is excellent.

Objective: To investigate the clinicopathological, and molecular characteristics of myoepithelial tumors (MTs) of salivary glands. Methods: A total of 37 MTs cases including 13 malignant epithelial tumors (MMTs) and 24 benign epithelial tumors (BMTs) of salivary glands were identified from the archives of the Department of Pathology, General Hospital of Eastern Theater Command, dating from 2006 to 2016. Clinical features, histological patterns, immunohistochemical characteristics and status of EWSR1 gene rearrangement by fluorescence in situ hybridization (FISH) analysis were reviewed in all cases. Results: Clinically, 37 MTs cases mainly occurred in the parotid glands, when most of the patients presented with painless masses. Of the 13 MMTs cases, male to female ratio was 7∶6, and the median age was 62 years old. Of the 24 BMTs cases, male to female ratio was 5∶7, and the median age was 54 years old. Immunohistochemically, 37 MTs cases were positive for CKpan, and at least one myoepithelial marker. Twenty six of 37 MTs cases were analyzable for the EWSR1 gene break by FISH. Based on the previous evaluation criterion, the EWSR1 translocation was detected in 4 cases of 11 MMTs, and 4 cases of 15 BMTs. According to the main histological composition of tumor cells, 4 EWSR1-positive MMTs covered 2 clear-cell cases and 2 epithelioid-cell cases, when 4 EWSR1-positive BMTs covered 2 clear-cell cases, 1 plasmacytoid-cell case, and 1 spindle-cell case. Conclusions Males and females are affected equally. MTs express immunoreactivity for CKpan, and at least one myoepithelial marker. The EWSR1 rearrangement is present in a subset of MTs, with variable morphological characteristics, and has no statistical significance on clinical behavior.

Objective: To investigate the clinicopathological features of mammary analogue secretory carcinoma (MASC) of salivary glands, and its diagnosis, differential diagnosis, immunohistochemistry and molecular pathology. Methods: Seventeen cases of MASC were enrolled, with 9 cases of salivary acinar cell carcinoma and 18 cases of adenoid cystic carcinoma as control groups from Nanjing General Hospital from 1997 to 2014 were included in this retrospective study, combined with immunohistochemistry and molecular detection of ETV6-NTRK3 gene fusion. All cases were histologically reviewed with immunohistochemical staining (EnVision) for S-100 protein, SOX10, GATA3, CD117 expression in each group. Fluorescence in situ hybridization (FISH) was used to detect the ETV6-NTRK3 gene fusion. Results: The age of MASC patients ranged from 27 to 74 years with mean age of 47 and ratio of male and female was 4∶3. All cases showed infiltrative growth and diverse cytology and histology, including lobular (8 cases), cystic papillary (3 cases), cribriform mixed with papillary and glandular structures (6 cases) at various proportions. Some tumors of MASC also exhibited solid growth areas with occasional microcystic honeycombed pattern composed of small cysts merged into larger cysts resembling thyroid follicles. S-100 protein and SOX10 were strongly positive in all MASC cases (17/17). In addition, there was insignificant positivity for GATA3 (3/17) and CD117 (4/17). ETV6 gene fusion detection was informative in 12 MASC cases by FISH with 10 positive cases and 2 negative cases. Conclusions Combined immunohistochemical positivity of S-100 protein, CD117 and SOX10 are useful in the diagnosis and differential diagnosis of MASC. FISH detection of ETV6-NTRK3 fusion offers an additional molecular diagnostic marker for the diagnosis.

Objective: To investigate the season, age and gender distribution of Mycoplasma pneumoniae (MP) infection in children in Beijing, and to analyze the epidemiological characteristics of MP infection. Methods: A total of 4 271 children with community acquired pneumonia hospitalized at the Respiratory Department of Children′s Hospital Affiliated to Capital Institute of Pediatrics were collected between January 2006 and December 2015.MP 16S rRNA and tandem repeat locus-Mpn16 were amplified by nested polymerase chain reaction(PCR). Results: Among 4 271 specimens, 1 042 were positive for MP by PCR, and the positive rate was 24.4% (1 042/4 271 cases). There were 3 MP outbreaks (2006-2007, 2012-2013 and 2015, respectively). The positive rate was up to 44.6% in the epidemic year, but as low as 13.0% in the non-epidemic year.The positive rates of MP in spring, summer, autumn and winter were 21.2% (217/1 022 cases), 22.0% (230/1 044 cases), 28.9% (320/1 108 cases) and 25.1% (275/1 097 cases), respectively.There were mild epidemic peaks in April to May and August to September every year.The infection rates of MP in autumn were significantly higher than those in other 3 seasons(χ²=16.50, 13.30, 4.07, all P<0.05). The positive rates of children in each age group were 10.6% (69/651 cases) in < 1 year old group, 17.5% (216/1 233 cases) in 1- 2 years old group, 28.5% (369/1 294 cases) in 3-6 years old group, and 35.5% (388/1 093 cases) in > 7 years old group, respectively.The positive rate of preschool and school-age children was 31.7% (757/2 387 cases), which was higher than that of the infants (15.1%, 285/1 884 cases), and there was a statistical significance (χ²=157.0, P<0.05). The positive rate of MP in girls was 28.3% (481/1 699 cases), which was significantly higher than that in boys [21.8% (561/2 572 cases)], and there was a statistical significance (χ²=23.4, P<0.05), especially during the epidemic years. Conclusions The detection rate of MP infection in children in Beijing is high in autumn and winter, and low in summer.The positive rate of MP increases with age.The high incidence of MP infection is in preschool and school-age children, especially girls.There is a significant difference between the prevalence of MP infection and the prevalence intervals.The prevalence of MP infection may be closely related to the long-term closed and semi-closed living habits.