Medulloblastoma is the most common malignant tumor of childhood.Over the past decade,progress in improving survival using conventional therapies has stalled.As advances in the molecular and genetic profiling of pediatric medulloblastoma evolve,associations with prognosis and treatment are found and research is directed at molecular therapies.The vast amount of genomic and molecular data generated over the last years encourages optimism that improved new molecular targets will improve outcomes.

Objective To investigate the value of PCT in the diagnosis of severe infection in children.Methods The clinical data of patients with infectious diseases treated in our hospital from December 2013 to February 2016 were retrospectively analyzed.According to the degree of infection,the patients were divided into local infection group and severe infection group,At the same time,the clinical data of 50 children with non infectious diseases were selected as control group.The differences of serum PCT and cytokine levels were observed between the three groups,at the same time,according to the prognosis of patients with severe infection group were divided into improvement group and deterioration group,The differences of serum PCT and inflammatory cytokines levels in the patients with severe infection in the improvement group and the worsening group,Analysis of the correlation between PCT levels and serum inflammatory cytokines levels in children with severe.Results There were significant differences in the levels of PCT,IL-18,IL-6 and hs-CRP between the three groups,which were from high to low: severe infection group,local infection group and control group; Deterioration of PCT,IL-18,IL-6,hs-CRP and levels were higher than the improvement group(t=-10.099,-8.949,-10.827,-2.088,P<0.05); The level of PCT were positively correlated with IL-18,IL-6 and hs-CRP levels in children with severe infection(r=0.385,0.412,0.408,P=0.012,0.008,0.017).Conclusion PCT has a good diagnostic value in children with severe infection,and it is closely related with the level of inflammatory cytokines in children with severe infection.

Objective To explore the cultural method of lingual keratinocytes and make preparations for further investigation in using lingual keratinocytes as a new choice of seed cells for the reconstruction of tissue engineered corneal epithelium.Methods Keratinocytes were enzymatically dissociated from lingual tissue specimens using 0.25%disepase and 0.05%trypsin.The biological characteristics of the cells were observed through phase microscope.Meanwhile.1ingual kemtinoeytes were immtmohistochemically labeled with broad spectrum keratin antibody (AE1/AF3).Results The cells revealed the form of "road metal" and could be passed for 3 or 4 generations.Immunohistochemistry indicated that lingual keratinocytes were positive for AE1/AE3 staining.Condusion Lingual kemtinocytes of rabbits can be cultured with KSFM in vitm and magnitude quantity can be attained,laying a favorable foundation for lingual keratinocytes as a new choice of seed cells for corneal epithelium reconstruction with tissue engineering.

Aim To observe the influences of dexmen-detomidine on the spontaneous contraction of duodenal smooth muscle of rabbits in vitro and explore the mech-anisms.Methods The rabbits ( male or female ) were stunned and the duodenums were isolated .The sam-ples of duodenal segments were connected with tension transducer , which were then put into oxygen saturation Krebs-Henseleit ( K-H) solution .The influences of dex-mendetomidine on amplitude ( AM ) and frequency ( FR ) of duodenal smooth muscle were recorded by BL-420 F biological signal processing system .The cu-mulative dosing method was used to observe the differ-ent concentrations of dexmedetomidine on duodenal smooth muscle spontaneous contraction .Glibenclamide ( Gli) was added to K-H solution before dexmendeto-midine.In the calcium-free K-H solution, calcium chloride and rynodine were added before dexmendeto-midine.The mechanisms of dexmendetomidine were studied .Results ① Dexmendetomidine reduced the amplitude of spontaneous contraction of duodenal smooth muscle in rabbits in a dose-dependent manner ( P<0.05 or P<0.01 ) , while the frequency was not obviously influenced ( P >0.05 ) .② Gli ( P <0.05 ) partly abolished the inhibitory effects of dexmendetomi-dine on duodenal smooth muscle .③ Dexmendetomi-dine inhibited the contraction of duodenum smooth muscle induced by calcium chloride ( P <0.05 ) and rynodine ( P<0.05 ) application into calcium-free K-H solution.Conclusion Dexmendetomidine inhibits the spontaneous contraction of duodenal smooth muscle of rabbits in vitro.The mechanisms may be related to ac-tivating ATP sensitive potassium channels , inhibition of the extracellular calcium influx via cell membrane and intracellular calcium release via sarcoplasmic reticulum in duodenal smooth muscle .

OBJECTIVE To evaluate the association between the results of skin prick test (SPT) of dust mites and serum specific IgE (S-IgE). METHODS A total of 170 patients with allergic rhinitis received SPT and detection of S-IgE of Der p and Der f. The positive rates and grades of S-IgE to different diameters of skin reaction or skin index (SI) were compared. RESULTS The positive rates and grades of S-IgE showed significant differences among different diameters of skin reaction or skin index (SI) patients. The positive rates and grades of S-IgE increased significantly according to the diameters of skin reaction or SI. CONCLUSION There is a significant association between SPT of dust mites and S-IgE.

With the popularity and development of minimally invasive surgery such as laparoscopic cholecystectomy, the incidence of iatrogenic biliary tract injury and biliary duct stenosis after injury has been increased significantly. The biliary duct injury of laparoscopic cholecystectomy is mainly heat damage, and the biliary duct tissue is prone to biliary duct stenosis after heat injury. Currently the treatment of complex iatrogenic biliary stricture has still been a difficult and unfinished problem. It’s necessary to explore the therapy options of iatrogenic biliary stricture based on animal models of biliary stricture. According to the literature at home and abroad, this article reviewed the methods and advantages and disadvantages of several models of benign biliary stricture.

This study performed phylogenic analysis on a dengue strain isolated from an outbreak of dengue fever in 2009 at Yiwu City of Zhejiang Province,China,and further to analyze the immunogenicity of E protein of this viral isolate.Firstly,the viral genome was amplified by RT-PCR and phylogenetic trees were constructed by MEGA 4 based on both nucleotide and amino acid sequences of E and NS1 proteins.The phylogenetic analysis showed that the similarity of Yiwu strain with the Guangzhou GZ1D3 strain and the India GWL-25 strain was over 99％.Secondly,the expression plasmid of E protein was constructed and transfected into 293T cells.The secreted E protein were then purified by sucrose density gradient centrifugation and used to inoculate BALB/c mice.The humoral immunity was evaluated by ELISA and neutralizing antibody analysis.Resuits showed that the E protein of Yiwu strain could induce dengue specific IgG antibodies and neutralizing antibodies.Therefore,the study found that the Yiwu strain was classified into the subtype Ⅲ of dengue virus type 3 (DENV-3),and the E protein of this strain had strong immunogenicity

Objective To investigate the effect of folic acid intervention on plasma homocysteine (Hcy) metabolic changes and pulse wave velocity(PWV)in patients with type H hypertension. Methods Patients(hos-pitalized from March 2014 to December in our hospital)with H type hypertension were randomly divided into treat-ment group and control group randomly ,and were given routine antihypertensive drug therapy. Treatment group was given oral folic acid 0.8 mg,1 times a day,the control group was given placebo,1 times a day. All patient were treated for 12 months. Changes of plasma Hcy and PWV levels were observed. Results 432 patients(Han nationality)with type H hypertension were enrolled in this study with the age of 61.7 ± 13.6 years old and the ratio of men and women is 1.3:1. The most common diseases were coronary heart disease and type 2 diabetes mellitus. 2 groups were treated for a period of 12 months,with follow-up time from 6 to 10 months(average duration in 8 months). After treatment,the difference between plasma Hcy(Z=-7.63,P=0.000)and PWV(Z=-3.16,P=0.002)levels of the two groups were statistically significant. Conclusion Folic acid intervention can significantly reduce the level of plasma Hcy in patients with type H hypertension ,slow down the progression of atherosclerosis and reduce the risk factors of cardiovascular disease.

Objective To investigate clinical and pathological characteristics of insulin-induced localized lipoatrophy and treatment.Methods We retrospectively analyzed clinical manifestation, skin biopsy pathology, treatment regimen and follow-up of 6 diabetic patients with insulin-induced localized lipoatrophy in Peking Union Medical College Hospital from January, 2010 to March, 2016, with systemic review of related literatures.Results Among 6 cases with insulin-induced localized lipoatrophy, 5 patients were with insulin allergy.5 patients were with positive insulin-autoimmune antibody, which was similar to the ratio reported in the systematic review (18 out of 19).Insulin-induced lipoatrophy could be caused by various types of preparations of insulin and insulin analogs.Subcutaneous biopsy, performed on the atrophied area, revealed the decrease of the number and volume of adipocytes and tissue fibrosis, probably accompanied with lymphocytes, eosinophils or mast cells infiltration.Lipoatrophy could sometimes be relieved by changing injection sites, types of insulin preparations or drug-delivery way, sometimes by application of systemic/local glucocorticoid or local cromolyn sodium.Conclusions Insulin-induced localized lipoatrophy is a rare adverse reaction of insulin preparations.It might be related to immune response of local tissue and heterogeneous pathological manifestations.The lipoatrophy might be improved by changing injection sites, changing the type of insulin preparations or drug-delivery way, and with possibility to carry out targeted immunosuppressive therapy according to the biopsy pathology in the future.

Objective:To study the effect of diabetes mellitus (DM) on sepsis in patients with pyogenic liver abscess (PLA).Methods:The clinical data of 116 patients with PLA treated in the Affiliated Hospital of Jiangnan University from January 2021 to May 2022 were retrospectively analyzed, including 64 males and 52 females, aged (62.3±12.6) years old. Patients were divided into DM group ( n=56) and non-DM group ( n=60), which were also divided into the sepsis group ( n=29) and the non-sepsis group ( n=87). The clinical features were compared among the groups, the risk factors of PLA complicated with sepsis were analyzed by multivariate logistic regression. Mediation model was used to analyze how DM affects the development of sepsis. Results:Compared with the non-DM group, patients in DM group had higher incidences of hypertension and acute physiology and chronic health evaluation II, a higher proportion of blood neutrophil count, a higher serum levels of triglyceride, urea nitrogen, fasting blood glucose and glycated hemoglobin at admission. The DM group also higher incidences of hypoproteinemia, pleural effusion, and sepsis, with longer hospital stay and higher hospitalization cost (all P<0.05). The levels of hemoglobin, albumin and hematocrit were lower in DM group (all P<0.05). Multivariate logistic regression analysis showed that comorbidity of DM ( OR=3.431, 95% CI: 1.245-9.455) and abscess with a larger diameter ( OR=1.664, 95% CI: 1.258-2.220) were associated with a higher risk of developing sepsis (all P<0.05). Mediation model showed that neutrophil count and triglyceride were the mediating variables of sepsis in patients with PLA. Conclusion:Comorbidity of diabetes is an independent risk factor of developing sepsis in patients with pyogenic liver abscess. Diabetes may induce sepsis by affecting the neutrophils and triglyceride.