Objective To understand the clinical characteristics and treatment outcomes of primary gastrointestinal non-Hodgkin lymphomas (PGINHL) and analyze the differences between T-cell and B-cell lymphomas.Methods.The characteristics of 51 PGINHL patients were analyzed regarding to their clinical manifestations,diagnosis,treatments and outcomes.Results 51 cases of PGINHL meeting the WHO(2008) criteria were identified.The median age of the patients at the time of diagnosis was 56 years old and the male ∶ female ratio was 1.44∶1,35 cases (68.7 ％) had B-lineage and 16 cases (31.3 ％) had T-cell lineage lymphomas.Compared to those with B-cell lymphoma,patients with T-cell lymphoma presented with a greater incidence of such symptoms as hematochezia,diarrhea and night sweating (P ＜ 0.05).After eliminating MALT lymphoma,prognosis of T-cell lymphoma and B-cell lymphoma had no significant difference.Conclusion In PGINHL cases,B-cell lymphomas appeare to be more common and have better prognosis than T-cell lymphomas.

Progressing vasopressor-refractory hypotension is a major contributor to the high mortality of septic shock.The effect of corticosteroids on peripheral vascular circulation recovery and immune modulation is crucial to the survival of patients with septic shock .However, despite more than fifty years of animal experiments and human trials, the role of corticosteroid therapy in septic shock , its proper applications including dosage, duration and withdrawal remain uncertain and controversial .This paper reviews the development of research , the mechanism, application, and the future direction of low-dose glucocorticoids in the treatment of septic shock .

Objective To investigate the similarities and differences of incomplete Kawasaki disease and typical Kawasaki disease,in order to provide basis for early diagnosis and treatment.Methods The clinical and laboratory data of 60 children with Kawasaki disease were retrospectively analyzed.Results The incidence rate of symptoms in clinical diagnostic criteria was lower in incomplete Kawasaki disease than that in typical Kawasaki disease(x2 =16.46,10.10,11.71,34.43,all P ＜ 0.01).No statistical differences of leukocytes,platelet,erythrocyte sedim-entation rate and C-reactive protein were found in the incomplete Kawasaki disease and typical Kawasaki disease(x2 =0.04,0.12,0.04,0.26,all P ＞ 0.05).The incidence rate of coronary artery lesions had significant difference between incomplete Kawasaki disease and typical Kawasaki disease (x2 =31.43,P ＜ 0.01).Conclusion The early diagnosis of Kawasaki disease could be confirmed by representative clinical characteristics,laboratory examination and ultrasound cardiogram.

WHO has issued three editions of pathologic classification of bladder urothelial carcinoma in 1973,1999 and 2004.The 1973 version classification had been widely and the longest applied.However,WHO 2004 classification had been prevalent in past years.There were two issues in the applications of WHO 2004 classification.On one hand,there were some difficulties in quick grading in a given case.On the other hand,there were some misunderstandings in the conversion of different WHO classification.In this article,the changes of different pathologic classification of bladder urothelial carcinoma were reviewed and the outline of different pathologic classification was generalized.The criterion of all the systems was cell anaplasia.In WHO 1973 version classification,the definition of the various grades was vague.It was relatively precise in WHO 1999 classification.However,the grading of Ⅰ,Ⅱ and Ⅲ in WHO 1999 classification still remained confusions.The major changes in WHO 2004 classification was that this system divided urothelial carcinoma into low-and high-grade,which may solve the heterogenesis of grade Ⅱ in the other two classifications.

The reform in cultivating professional-degree programs in Clinical Medicine Education contributes to the transformation of training mode, which surpasses the connotative bounds of the inherent education management. The personalized training of students has made it more challenging for both the tutor and the faculty to involve in education management, the effectiveness of which is highly valued due to the pressing need for sound medical ethics. Furthermore, the development of information technology calls for the reform of education management as well as the emphasis of student-centered approach. This article summa-rizes the existing problems of current education management mode for master degree programs of profes-sional clinical medical education. In addition, a three-level management system composed of medical experts is brewed and put forth. This system, based on compensation and restraint, assessment and incentive, ser-vice as well as security, is meant to facilitate the training of application-oriented medical talents.

MicroRNA (miRNA) are a class of endogenous single -stranded non-coding RNA, which regulate gene expression post-transcriptionally by combining with the target mRNA and play a vital role in biological and pathological processes including the growth of organism , metabolic regulation, disease prediction and intervention.Thus miRNA detection is of considerable significance in disease diagnosis and the research of miRNA function.Because of the restriction factors about miRNA itself such as short sequence, low abundance and highly homologous , traditional methods for miRNA detection cannot meet the current demands due to the limitations like unsatisfactory sensitivity and complicated operation .This review summarizes the newly development about signal amplification -based methods for miRNA, including the advantages and limitations of all kinds of novel methods , and highlights the future trends as well.

Objective To evaluate the effects of different depths of anesthesia with sevoflurane on cerebrovascular autoregulation in infants.Methods Twenty pediatric patients,of ASA physical status Ⅰ,aged 1-3 yr,undergoing elective hypospadias plasty surgery,were enrolled in the study.Single tube laryngeal mask was inserted after anesthesia was induced with 6％ sevoflurane inhalation.Caudal block was performed with 1 ml/kg of 0.2％ ropivacaine.Anesthesia was maintained with sevoflurane inhalation.The end-tidal sevoflurane concentration was adjusted to 1.8％,2.5％,3.3％ and 4.0％,and each concentration was maintained at this level for 15 min.The cerebral blood flow was collected from the middle cerebral artery immediately before adjusting the next concentration to record the Doppler spectrum and transient hyperemic response ratio (THRR) was measured.Results THRR at different depths of anesthesia with sevoflurane was larger than 1.09,and was within the normal range.THRR was significantly lower when the end-tidal concentration was 2.5％,3.3％ and 4.0％ than that obtained when end-tidal concentration was 1.8％.No significantdifference was detected in THRR between 2.5％ and 3.3 ％.THRR was significantly lower when the end-tidal concentration was 4.0 ％ than that obtained when the end-tidal concentration was 2.5％ and 3.3％.Conclusion Although the inhibitory effect on cerebrovascular autoregulation provided by sevoflurane anesthesia provides no obvious clinical significance,it shows statistical significance in infants.

Objective To explore the iodine status of pregnant women after 17 years of salt iodization in rural areas of Shijiazhuang City.Methods Probability proportionate to size sampling was employed in which 30 towns were selected from the 211 towns in the rural areas of Shijiazhuang City.In each town selected,40 pregnant women were randomly selected to collect their spot urine samples,edible salt samples and drinking water samples from their households to measure iodine content.The iodine content of salt was determined quantitatively using a titration method (GB/F 13025.7-2012).The urinary iodine content was determined using the method of ammonium persulfate digestion arsenic cerium catalytic spectrophotometry (WS/T 107-2006).The iodine content in drinking water was determined by the method of standard test for drinking water.Results A total of 1 200 salt samples was collected from the pregnant women's households in 30 towns,with the overall median iodine content being 27.2 mg/kg.The median salt iodine content in 30 towns varied from 23.4 to 32.6 mg/kg.A total of 478 water samples were collected,with a median of 5.3 μg/L.The median urinary iodine content (UIC) of 1 200 pregnant women in 30 towns was 146.4 μg/L.The median UIC in the first (≤ 13 weeks),second (14 ～ 26 weeks) and third (≥27 weeks) trimesters was 166.3,145.1 and 133.5 μg/L,respectively.The median UIC in the first trimester was significantly higher than that in the third trimester (Mann-Whitney Test,U =18 265,P ＜ 0.05).Except for the 9-20 and 37-40 weeks period of pregnancy,the median UIC was lower than the WHO criteria (150 μg/L).Tested by linear correlation,the pregnant women's median UIC did not correlate with median salt iodine (r =0.725,P ＞ 0.05).Conclusion Under the current universal salt iodization,the pregnant women's iodine intake could almost meet their requirement in the rural areas of Shijiazhuang City,however,mild iodine deficiency has existed in the third trimester.Alternative measures of iodine supplement could be implemented.

Objective To assess the relationship between fat metabolic parameters and androgen concentration in the cord blood of newborns of mothers with polycystic ovary syndrome (PCOS). Methods This cross-sectional study included PCOS women (n=55) and neonatal, and 40 cases with matched body mass index (BMI) were used as control. The clinical data including height, body mass, waist circumference, hip circumference of PCOS group, and length and head circumference in newborns after delivery were measured and compared. Blood lipid level, serum insulin and testosterone level were detected using umbilical artery-vein mixed cord blood after delivery. Regression analysis was used to analyze the influence factors of neonatal cholesterol and testosterone levels. Results The neonatal birth weight, head circumference, cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol and triglyceride level were significantly lower, birth height and testosterone level were significantly higher, in PCOS group than those of control group (P＜0.05). Values of waist to hip ratio, BMI, cholesterol, high density lipoprotein cholesterol and testosterone levels were significantly higher in PCOS group than those of control group (P＜0.05). The insulin, cholesterol and triglyceride levels of PCOS mother were risk factors for neonatal cholesterol level(P ＜ 0.05). The cholesterol, triglyceride and free testosterone levels of PCOS mother were risk factors for increased neonatal free testosterone (P ＜ 0.05). Conclusion Mother with PCOS may affect fetal birth weight, head circumference and cord blood lipid metabolism, which may be related with the elevated level of testosterone during the fetal period.