Objective To analyze retrospectively the MR features of MELAS patients,in order to improve the early diagnosis of MELAS.Methods MR data of 1 6 MELAS patients confirmed by clinical diagnose and muscle biopsy were retrospectively analyzed. MR features of plain scan(n=1 6),ASL(n=3),MRA(n=1 5),DWI(n=14)and MRS(n=3)were analyzed.Results MRI data demonstrated brain lesions mainly distributed in posterior cerebral hemisphere extending to subcortical area,which was not consistent with the vascular supply territories.The lesions were observed as low signal on Spin-echo sequence of T1 WI,while high signal on T2 WI, FLAIR and DWI.The focal lesions showed increasing Lac peak on MRS.Fifteen of 16 patients underwent MRA and one showed increased arterial branches in lesion zones.Three patients had ASL scanning demonstrating high irrigation in lesion zones which would wander once relapsed.Meanwhile,old lesions showed encephalatrophy and cerebromalacia.All patients’muscle biopsy pathology showed ragged red muscle fibers.Under electron-microscopic,bioblasts were bigger and more than average level and muscle fibers atrophied.Mitochondrial DNA sequence of 3 patients showed mtDNA A3243G transgenation.Conclusion The DWI,MRS and ASL sequences show good ability in MELAS diagnosis and differential diagnosis.

This paper summarizes that to strengthen the construction of national key disciplines Clinical Laboratory Diagnostic and build professional post-graduate education platform for innovation,the exploration and practice of reform have been done in Chongqing Medical University,in the teaching ranks and exercise disciplinary research direction to enhance the level of scientific research and laboratory construction.

According to the characteristics of the Laboratory Medicine and our twenty years' medical educational experience ,we explore to improve the quality of education and cultivate the students' practical ability and creative ability. And we construct an educational mode for clinical practice, laboratory medical practice and research project.

Objective To investigate the influence of endothelial progenitor cells on the proliferation and differenti-ation of neural stem cells in vitro under the condition of co-culture. Methods We used the mature methods of iso-lation, culture and identification on cells to get the spinal cord NSCs and peripheral blood EPCs from the SD rats, and then put them together in the Transwell chamber in vitro. Set the untreated NSCs as a control group. On the 4th day, we calculated the number and diameter of neurospheres. After that, removing the insert of transwell with EPCs, and inducing the NSCs to differentiate. On the 7th day, we conducted MAP-2 immunofluorescence staining on the cells of induced-differentiation group with fluorescence microscopy, then observed the expression of the anti-gen and calculated the percentage of the differential neurons in the NSCs. All the data were analyzed using statisti-cal method. Results The average number of neurosphere in co-culture group was 10.3±2.2,it was significantly more than that in the control group, and the diameter was under the same situation,the average diameter was up to (49.0±5.3)μm. The percentage of the cells which differentiated into neurons in the co-culture group was signifi-cantly higher than that in the control group, the percentage was(32.1±1.8)%. Conclusion EPCs promote the proliferation of NSCs and induce the differentiation of NSCs into neurons in vitro.

Objective To Analyze the proprietary usage of Chinese medicine prescriptions in our hospital and to improve the level of rational drug use.Methods 1780 prescriptions were randomly collected from our hospital during January to June,2011 and analyzed.Results The rational prescriptions had a 83.01％ share in the whole.while the irrational prescriptions had a 21.2％ share in the whole,among which 13.37％ were unqualified writing,3.45％ were irrational drug use.The irrationality mainly manifested as missing items in the prescription,and improper usage and dosage.Conclusion It is suggested to strengthen the awareness of physicians on standard prescription writing,strict pharmacist review,and establish prescription quality management system to improve the quality of prescription.

Objective To detect the changes of the brain white matter microstructure at the acute stage of posttraumatic stress disorder(PTSD)resulting from a single,extreme and long-lasting trauma.Methods DTI scans were performed on 1 7 survivors of coal mine disaster(PTSD group)and 1 7 cases of normal control(control group).The differences of the mean diffusivity(MD)values measured from the whole brain DTI between the two groups were analyzed based on tract based spatial statistics (TBSS).MD data were statistically compared between the two groups based on nonparametric random permutation test(RPT),and the brain areas of significant differences between the two groups were obtained.Results Compared with the control group,MD values were increased in the bilateral rostral corpus callosum body and left precorona radiata,and decreased in the bilateral superior and posterior corona ra-diate,posterior limb of the left internal capsule,left cerebral peduncle and left thalamic.The differences were statistically significant (P <0.01 TFCE-corrected).Conclusion TBSS is a comprehensive and accurate method for evaluate the changes of brain white mat-ter in PTSD cases.TBSS can provide an objective basis of the pathological brain neural structures imaging for early diagnosis and in-tervention of PTSD.

Objective TostudythevalueofquantitativeparametersofDCE-MRIandthreedimensionalarterialspinlabeling(3D-ASL) inpreoperativegliomagrading.Methods 70patientsdiagnosedpathologicallywithinitialgliomawereassessedretrospectively,including 32caseswithlow-gradeglioma(LGG)and38caseswithhigh-gradeglioma(HGG).Allpatientsunderwentconventional,enhanced, DCEand3D-ASL MRIat3.0Tbeforesurgery.TheparametricvaluesofDCEsuchasvolumetransferconstant(Ktrans),extravascular extracellularspacevolumefraction(Ve),therateconstant(Kep),fractionalplasmavolume(Vp),cerebralbloodflow (CBF)andcerebral bloodvolume(CBV)wereobtainedbycorrespondingpost-processingsoftware.ThecerebralbloodflowofASL (ASL-CBF)wasalso obtained.Ttestoftwoindependentsampleswasusedtoanalyzewhetherthemaximumandaveragevaluesofeachparameterwere statisticallydifferentbetweenLGGand HGG.Thediagnosticaccuracyofdifferenttechniqueforgliomagradingwasdeterminedby ROCcurveanalysis.Results ThemaximumvaluesofDCE-Ktrans,Ve,rCBVandmaximumvalueofASL-rCBFwerestatisticallydifferent betweentheHGGandLGG (P＜0.05).AlltheparametricaveragevalueswerestatisticallydifferentbetweentheHGGandLGG (P＜0.05).ThemaximumandaveragevaluesofKtranshadarelativelyhighestdiagnosticefficiencyinallparameters,withtheAUCwere0.986 and0.971,theoptimumthresholdwere0.264and0.068,thesensitivitywere93.3%and94.1%,andthespecificitywere100%and 100%,respectively.ThemaximumvaluesofVe,rCBV,ASL-rCBFandtheaveragevaluesofallparametershadarelativelyhigher diagnosticefficiency.Conclusion ThemaximumvaluesofKtrans,VeandrCBFofDCE,themaximumvalueofASL-rCBFandtheaverage valueofeachparameterwereusefultodistinguishbetweenLGGand HGG.ThemaximumandaveragevaluesofKtransarethebest parametersforidentifyingHGGandLGG.

Objective:To investigate the correlation between perioperative new onset atrial fibrillation and the prognosis of colorectal cancer.Methods:This study involved 180 colorectal cancer patients undgoing radical resection at the Department of Gastrointestinal Surgery, Longyan First Hospital from Jan 2014 to Jan 2015. Among them, 47cases suffered from perioperative new onset atrial fibrillation.Results:The perioperative new onset atrial fibrillation group had a higher mean age and a higher mean postoperative C-reactive protein level than the control group ( t=-3.080, P=0.002; t=-2.184, P=0.030). Hence these patients had a longer hospital stay ( t=-5.072, P=0.001; t=-2.577, P=0.011). Multivariate analysis showed that postoperative new onset atrial fibrillation, high postoperative mean C-reactive protein level, poor tumor differenciation and late tumor stage were independent risk factors for the prognosis of colorectal cancer ( HR=1.835, P=0.018; HR=1.008 P=0.017; HR=1.950 P=0.046; HR=1.300, P=0.047). The median survival time of perioperative new onset atrial fibrillation group and control group were 59.05 months and 63.23 months, respectively ( P=0.005). Conclusions:Colorectal cancer patients suffering from perioperative new onset atrial fibrillation were more common among advanced age and high postoperative mean C-reactive protein level with higher all-cause mortality.

Objective To assess the safety, feasibility and short?term outcome of totally laparoscopic distal gastrectomy(TLDG). Methods Seventy?five patients who underwent laparoscopic distal gastrectomy in Cancer Hospital of Chinese Academy of Medical Science between August 2015 and April 2018 were enrolled in this study. A total of 46 laparoscopy?assisted distal gastrectomy ( LADG) cases and 29 TLDG cases were included. The Short?term outcomes and safeties of the two groups were compared. Results The operation time of TLDG group was significantly longer than that of LADG group (207±41 vs. 156± 34 min, P＜0.001), while the length of wound was shorter in the TLDG group (3.6±0.6 vs. 5.8±0.8 cm, P＜0.001). The time to first flatus in TLDG group was (3.3±0.6) days, significantly shorter than (3.7±0.8) days in LADG group ( P＝0.034). There were no significant differences between the two groups in the estimated blood loss, intraoperative blood transfusion, extraction of gastric tube, drainage tube removal, interval of the first time to eat semi?liquid food, postoperative hospital stays, surgical complications, number of retrieved lymph nodes, proximal and distal resection margin lengths ( all P＞0.05). The white blood cell count at postoperative day 1 in the TLDG group was (10.96±1.96)×109／L, significantly lower than (12.49± 3.46)×109／L of the LADG group ( P＝0.017).While the CRP level at postoperative day 1 in the TLDG group were lower than that of LADG group, no statistical difference was observed (P＝0.072). Conclusions Our study shows that TLDG is safe and feasible. TLDG has better cosmesis, less blood loss, and faster recovery compared to LADG.

Objective To assess the safety, feasibility and short?term outcome of totally laparoscopic distal gastrectomy(TLDG). Methods Seventy?five patients who underwent laparoscopic distal gastrectomy in Cancer Hospital of Chinese Academy of Medical Science between August 2015 and April 2018 were enrolled in this study. A total of 46 laparoscopy?assisted distal gastrectomy ( LADG) cases and 29 TLDG cases were included. The Short?term outcomes and safeties of the two groups were compared. Results The operation time of TLDG group was significantly longer than that of LADG group (207±41 vs. 156± 34 min, P＜0.001), while the length of wound was shorter in the TLDG group (3.6±0.6 vs. 5.8±0.8 cm, P＜0.001). The time to first flatus in TLDG group was (3.3±0.6) days, significantly shorter than (3.7±0.8) days in LADG group ( P＝0.034). There were no significant differences between the two groups in the estimated blood loss, intraoperative blood transfusion, extraction of gastric tube, drainage tube removal, interval of the first time to eat semi?liquid food, postoperative hospital stays, surgical complications, number of retrieved lymph nodes, proximal and distal resection margin lengths ( all P＞0.05). The white blood cell count at postoperative day 1 in the TLDG group was (10.96±1.96)×109／L, significantly lower than (12.49± 3.46)×109／L of the LADG group ( P＝0.017).While the CRP level at postoperative day 1 in the TLDG group were lower than that of LADG group, no statistical difference was observed (P＝0.072). Conclusions Our study shows that TLDG is safe and feasible. TLDG has better cosmesis, less blood loss, and faster recovery compared to LADG.