T lymphoblastic leukemia/lymphoma (T-ALL/LBL) is a kind of lymphoblastic malignant tumors orientated in T-cell line with poor clinical effects. Its molecular genetics is mainly correlated with antigen receptor gene, abnormal chromosome, oncogene activation, tumor-suppressor gene inactivation and molecular pathways. This article will review the latest research progress of the molecular genetics in T-ALL/LBL to explore the index of prognosis and possible therapeutic targets.

Fetal alloimmune thrombocytopenia (FAIT) is a severe perinatal complication, which can seriously affect fetal development, and may even lead to intrauterine hemorrhage and intrauterine death. There are controversies in the clinical diagnosis and treatment of the disease due to its low incidence and limited treatment experience. This paper reviews the progress to date in understanding the condition, incidence, screening of high-risk factors, prenatal and delivery management of FAIT based on domestic and foreign guidelines, in order to help obstetricians in the clinical management of FAIT.

Objective: To establish a UPLC-MS/MS method for the determination of the residual quantity of potential genetoxic impurity 1-(3-dimethylaminopropyl)-3-ethylcarbodiimide (EDC) in ledipasvir.Methods: The chromatographic conditions were as follows: an Agilent ZORBAX SB-C18 (75 mm×4.6 mm, 3.5 μm) column was used with methanol-0.1% formic acid (50∶50) as the mobile phase.The flow rate was 0.3 ml·min-1.The column temperature was 30 ℃ and the injection volume was 5 μl.The mass spectrometry conditions were as follows: electrospray ionization source (ESI), multistage reaction monitoring (MRM), positive ion scanning mode, ion spray voltage of 2 500 V, ion source temperature of 500 ℃, atomization gas of 379.0 kPa, auxiliary gas of 275.6 kPa, curtain gas of 137.8 kPa, collision gas of 41.3 kPa, ion collision energy of 15 V and scan time of 100 ms.The MRM ion pair for quantitative analysis was m/z→156.2/86.1.Results: The linear range of EDC was 0.03-2.25 μg·ml-1 (r=0.999 0).The limit of detection was 0.03 ng and the limit of quantitation was 0.08 ng.The average recovery was 98.3%(RSD=5.7%, n=9).Conclusion: The method is simple, rapid and accurate, and can be used for the quality control of EDC in ledipasvir.

Objective:To explore the effects of Bufalin on the growth and proliferation of human glioma cells U251. Methods:Methyl thiazolyl tetrazolium(MTT)assay was used to detect the effect of Bufalin on the proliferation of human glioma cells U251. An in-verted microscope was used to observe the changes of cell number,morphology and activity. AnnexinV/ PI was used to measure the in-duction of cell apoptosis caused by Bufalin. Results:Bufalin at different concentrations(0. 001 - 10. 0μmol·L - 1 )inhibited the pro-liferation of U251 cells in a dose and time-dependent manner. Compared with that of the control group,the apoptosis rate of Bufalin group was increased significantly(P < 0. 01). Conclusion:Bufalin can inhibit the growth and proliferation of U251 cells in a dose and time-dependent manner,and induce the apoptosis of U251 cells.

Objective To verify whether miR-498 can inhibit A549 cell migration and invasion by down-regulating FOXM1.Methods miR-498 mimic and miR-NC were transfected into A549 cells.Wound healing and Transwell method were employed to test the migratory ability and invasion ability of A549 cells;Western blot was used to detect the expressions of COL1A1,COL1A5 and FOXM1 in A549 cells.Luciferase assay was used to confirm whether FOXM1 is the target gene of miR-498.Results Compared with those in the control group,the expressions of COL1A1,COL1A5 and FOXM1 were decreased,and the migration and invasion abilities of A549 cells were decreased in the miR-498 group (both P<0 .01 ).The luciferase activity of the FOXM1-3′-UTR plasmid was significantly suppressed by miR-498 (P<0 .05 );over-expression of FOXM1 could reverse the effect of miR-498 on A549 cells.Conclusion miR-498 inhibits A549 cell migration and invasion by down-regulating FOXM1.

Objective To investigate the effect of α-crystallin on the proliferation of rat retinal microglia after optic nerve injury. Methods The effect of α-crystallin on number and proliferation of microglia were analyzed by MTT assay.After the rat model with optic nerve injury was established,α-crystallin was iniected into vitreous cavity and the microglia cell number were counted and compared by retinal fiat counting and immunofluorescence labeling in different groups. Results The proliferation and activation of microglia cells could be stimulated by LPS at 10-6g/L to 10-2g/L.α-crystallin at 10-4g/L and 10-6g/L could inhibit proliferation and activation of microglia cells.Compared to BSA iniection group,α-crystallin could inhibit more significantly the number of microglia cells 1-3 weeks after injury (P＜0.05). Conclusions α-crystallin can inhibit proliferation and activation of retinal microglia and alleviate overphagocytosis and secondary damage of retinal microglia to retinal ganglion cells(RGCs),which may be another mechanism that α-crystallin contributes to indirect protection of RGCs.

Objective To investigate the level of spirituality in cancer patients in a 3A grade hospital of Changsha and to analyze the influencing factors. Methods In this study, convenience sampling method was used to select 196 patients with cancer from three hospitals in a 3A grade hospital of Changsha from October 2016 to October 2017. The general situation questionnaire, the functional assessment of chronic illness therapy (FACIT-Sp-12), the social support scale and the post traumatic growth inventory were used to investigate the patient′s spiritual status and to analyze the influencing factors. Results The total spiritual score of cancer patients was 31.09 ± 8.89, the score of meaning dimension was 10.71±2.75, and the peace dimension was 9.84±3.19 and the belief dimension was 10.54± 2.98. The results of multiple regression analysis showed that age, cancer stage, education level, the subjective support of Social Support, relating to others and personal strength of The Posttraumatic Growth were the influencing factors for the spiritual status of cancer patients. Conclusions the spiritual status of cancer patients in a 3A grade hospital of Changsha is at medium level, and the spiritual status is closely related to age, education level, cancer stage, social support and post traumatic growth level. Medical staff should provide spiritual care for patients to improve their psychology and Mental Health and quality of life.

Objective:To determine the role and mechanism of tranilast preventing the progression of tubulointerstilial ifbrosis in diabetic kidney disease (DKD).
Methods:Sprague-Dawley rats were randomly divided into a control group (n=6), DKD model group (n=8), low dose tranilast group [200 mg/(kg.d), n=8], and high dose tranilast group [400 mg/(kg.d), n=8]. Tranilast was administered daily after the model was built. Rats were sacrificed at day 56, 24 hour urine was collected to measure 24-hour urine albumin excretion, and blood was collected to determine the renal function and serum albumin. Then the kidneys were harvested and subjected to studies. The expression of C3aR, E-cadherin,α-SMA, fibronectin(FN), collagen I (Col I), stem cell factor (SCF) and c-kit were detected by immunohistochemical staining respectively. The expression of E-cadherin,α-SMA, FN, Col I, SCF and c-kit protein was analyzed by Western blot, and the expression of FN, Col I, SCF and c-kit mRNA was examined by RT-PCR. Results:Tranilast can inhibit the inifltration of mast cells in the kidneys of DKD rats. The expression ofα-SMA in the kidneys of DKD rats inereased signiifcantly (P<0.05), while the expression of E-cadherin decreased (P<0.05). Tranilast increased the expression of E-cadherin and decreased the expression ofα-SMA in the prophase of DKD dose dependently. The expressions of FN and Col I were increased in the tubulointerstitial ifelds in DKD model rats (P<0.05). After the tranilast treatment, these changes were relieved to a certein degree (P<0.05). The expression of SCF and c-kit in the tubular and interstitial tissue was slight. The increased expressions of SCF and c-kit protein and mRNA in DKD model rats were downregulated by tranilat (P<0.05). The expressions of SCF and c-kit were positively correlated with the infiltration degree of mast cells and the expressions of FN, Col I.
Conclusion:Mast cells participate in and aggravate the renal tubulointerstitial fibrosis in DKD rats. Tranilast can reverse the EMT of renal tubular cells and inhibit the tubulointersitial fibrosis of DKD by blocking the inifltration of mast cells induced by SCF/c-kit pathway.

Objective:To construct a reliability management index system of cardiology medical equipment supply,to form a reliability evaluation strategy,and to improve the effectiveness of reliability management.Methods:13 supply management items were decomposed from the three links of spare parts before use,tracking during use and post-use processing of 126 medical equipment,and the probability of work error,probability of quality problems and risk expectation of diagnosis and treatment were evaluated in the whole process management,and the whole-process management countermeasures of grading and stratification,quality standardization and department cooperation was formed.2,000 pieces(sets)of medical equipment used in The People's Hospital of Longhua from 2021 to 2022 were selected by random sampling method,and the department cooperative management[referred to as collaborative management mode,1,000 pieces(sets)times]and reliability evaluation management[referred to as evaluation management mode,1,000 pieces(sets)times]were adopted respectively.The reliability and satisfaction of medical equipment under different management modes were compared.Results:The work error probabilities of pre-use spare parts,in-use tracking,post-use processing and supply of medical equipment adopting evaluation management mode were(4.74±2.19)%,(4.39±1.85)%,(5.75±1.88)%and(8.29±1.30)%,respectively,which were lower than the collaborative management mode,the difference was statistically significant(t=5.367,5.663,5.432,6.847;P<0.05);the probabilities of quality problems were(4.13±1.67)%,(3.89±1.25)%,(5.28±1.84)%and(7.64±1.18)%,respectively,which were lower than the collaborative management mode,the difference was statistically significant(t=6.504,6.229,5.123,6.166,P<0.05);the risk expectations of diagnosis and treatment were(2.74±0.89)%,(2.47±0.96)%,(3.42±0.95)%and(4.02±1.09)%,respectively,which were lower than the collaborative management mode,the difference was statistically significant(t=7.027,6.509,8.915,9.266,P<0.05).The satisfaction of the relevant staff on the performance quality,sterilization specifications,supply timeliness,level of collaboration and safety of the medical equipment adopting the evaluation management mode were(93.54±4.65)%,(91.67±4.11)%,(94.58±4.34)%,(92.39±3.82)%and(90.97±3.76)%,respectively,which were higher than the collaborative management mode,the difference was statistically significant(t=2.809,3.030,2.843,4.939,3.739,P<0.05).Conclusion:The reliability management model can reduce the work errors and security risks in medical equipment supply,improve the reliability of supply and improve the quality of supply service.

Objective To study the C-myc gene and protein in T lymphoblastic lymphoma/leukemia ( T-LBL/ALL) and its relationship to prognosis.Methods 60 cases of T-LBL/ALL with follow-up data were studied by using immunohistochemical EnVision method for CD 1a, CD3,εCD3, CD7, CD10, CD34, CD43,CD45RO,CD99,TDT,CD20,CD23,MPO,Ki-67 and C-myc.20 cases of reactive lymph nodes were selected as normal control group of C-myc gene and protein.Fluorescence in-situ hybridization ( FISH) for C-myc gene ( located on chromosome8q24 ) was performed to detect its breakage and gain.Results Among the 60 cases of T-LBL/ALL, immunohistochemistry results showed:the percentages of tumor cells expression of CD1a, CD3, εCD3, CD7, CD10, CD34, CD43, CD45RO, CD99and TDT were 38.3%(23/60), 75.0%(45/60), 45.0%(27/60),95.0%(57/60),36.7%(22/60),23.3%(14/60), 60.0%(36/60),41.7%(25/60),96.7%(58/60)and 93.3%(56/60).Separately, while CD20 ,CD23 and MPO were all negative.A figure of Ki-67 expression≤80% was found in 36 cases and >80% was found in 24 cases.The positive rate of C-myc protein was 66.7%(40/60) in 60 cases of T-LBL/ALL,was 0%(0/20) in 20 cases of reactivated lymphoid tissue (χ2 =26.67,P<0.05).C-myc protein expression was positively correlated with the mediatinal width and Ki-67 index ( P <0.05 ).Fluorescence in-situ hybridization results showed that among the 60 cases of T-LBL/ALL, C-myc gene with breakage of 8q24 was detected in 6 cases ( 10.0%) , and gains in 11 cases ( 18.3%).20 cases of reactive lymph nodes were not occurred breakage and gains of C-myc gene .It is not significant between C-myc gene and protein expression (P>0.05).In addition, in 60 cases of T-LBL/ALL, 12(20.0%) cases of C-myc protein and genetic abnormalities coexist.Log-rank analysis results: The prognosis of C-myc protein positive group was worse than negative group ( P<0.05 ).The relationship of C-myc gene and prognosis was not significant ( P>0.05).C-myc protein and genetic abnormality coexist is related with worse prognosis ( P<0.05 ).COX analysis results show that the C-myc protein positive group may be a independent poor prognosis factors ( P<0.05).Conclusions C-myc may play an important role on the development of T-LBL/ALL.It may be a independent prognosis factors .