Objective To analyse and summarize the MRI characteristics of tumor‐like inflammatory demyelinating diseases (TIDD) .Methods MRI findings of 10 cases with pathologically proved TIDD were analyzed retrospectively ,all patients received plain and enhanced MRI scan .Results 3 cases showed multiple lesions in bilateral frontal and parietal lobes ,and 7 cases showed soli‐tary mass ,in which 2 lesions located in the occipital lobe ,2 in the basal ganglia ,2 in the second to fifth segment of cervical cord ,and 1 lesion located in the left frontal parietal lobe .The shape of 7 lesions were irregular ,2 were stripped ,while 1 lesion was oval .6 cases had clear boundary ,while 4 showed ambiguous .Solitary lesions were 1 .7 cm -5 .6 cm in diameter(mean 4 .0 cm ± 1 .48 cm) .8 cases manifested mild edema while 2 had no edema .On MRI plain scan ,lesions were hypointensity on T1WI and hyperintensity on T2WI in 8 cases ,isointensity on T1 WI and hyperintensity on T2 WI in 2 cases ,and all lesions were hyperintensity on FLAIR sequence .DWI were performed in 3 cases ,all lesions showed hyperintensity ,2 of them had patchy hypointensity signal .Hemorrhage was detected in 3 lesions ,cystic lesions or calcification were not found in all cases .On post‐contrast scan ,3 lesions showed ring like enhancement ,2 showed obviously heterogeneous enhancement ,2 had mild enhancement and 2 cases had no enhancement ,1 presented with open ring like enhancement .Conclusion TIDD shows some specific MRI features ,and MRI is helpful to the diagnosis of TIDD .

Objective To study the change characteristics of erythrocyte parameters in carriers of deletional alpha-thalassemia gene.Methods 389 patients with deletional alpha-thalassemia gene determined by the gap-PCR technique were classified into three groups based on different genotypes of alpha-thalassemia including silent thalassemia group,alpha-thalassemia trait group (265 ca-ses)and intermediate thalassemia group,and contemporaneous 188 healthy adults were randomly selected as the normal control-group(NC).The erythrocyte parameters including RBC,Hb,MCV,MCH,RDW were retrospectively analyzed and their differences were compared among aboved-mentioned groups by the analysis of variance and the multiple comparison.Results Alpha-thalasse-mia manifested by different degrees of microcyte hypochromia.There were statistically significant differences in the erythrocyte pa-rameters among various genotypes and phenotypes about erythrocyte indices(P <0.05).Moreover,the Hb,MCV and MCH values were lower than those in the control group,and had the decreasing tendency with the increase of deletedα-globin gene numbers;but the RDW value was higher than that in the control group,showing the increasing tendency,the differences had statistical siginifi-cance(P <0.05).Conclusion With the increase of deleted α-globin gene number,the characteristic of small-cell low-hemoglobin is more and more remarkable.RBC has a overall increase,while Hb,MCV and MCH have a decreasing tendency,and the heterogeneity of erythrocyte volume is increased.When MCV and MCH decreasing in high risk region,thalassemia should be highly suspected, but normal MCV and MCH can not exclude silent thalassemia and alpha-thalassemia trait.

BACKGROUND:Mesenchymal stem cells possess characteristics such as rapid renewal,targeted homing,tissue repair,and immune regulation,which provide potential for the treatment of inflammatory diseases.In most inflammatory diseases,interleukin-1β is highly expressed.Both exogenous and endogenous mesenchymal stem cells unavoidably exist in an environment with high interleukin-1β concentration. OBJECTIVE:To study the interaction of interleukin-1β with mesenchymal stem cells in inflammatory environment and the mechanism of its influence on the migration and adhesion of mesenchymal stem cells to provide a theoretical basis for adjusting stem cell therapy strategies. METHODS:The first author searched for studies involving interleukin-1β enhancing migration and adhesion of mesenchymal stem cells by computer on CNKI,WanFang,VIP,PubMed,and Web of Science using search terms"interleukin-1β,mesenchymal stem cell,nuclear factor-κB,MAPK,ERK,p38,migration,adhesion"in Chinese and English.The literature tracing method was also used to search for some of the literature.Finally,65 articles were included in the review analysis. RESULTS AND CONCLUSION:(1)In the inflammatory environment,interleukin-1β can regulate the migration and adhesion ability of mesenchymal stem cells.This effect may be achieved by recruiting IRAK1 through interleukin-1RI and then activating TAK1 and IKK in turn.After IKK phosphorylation,nuclear factor-κB and ERK signaling pathways are activated or CXCR expression is upregulated through the p38 pathway to promote mesenchymal stem cell migration and adhesion.However,further standardized research needs to be carried out based on the genetic background of mesenchymal stem cells,the dose and processing time of interleukin-1β.(2)In vitro experiments using pre-stimulated mesenchymal stem cells with interleukin-1β can change the survival environment of mesenchymal stem cells and alter their secretion factors to make them develop towards a more anti-inflammatory direction.On the other hand,under the premise of producing higher levels of anti-inflammatory and pro-nutrient factors,extracted mesenchymal stem cell exosomes can exert anti-inflammatory effects.(3)It has been observed in various animal disease models that pre-stimulating mesenchymal stem cells with interleukin-1β regulates their immune regulation ability,thereby affecting the development and outcome of inflammation.However,this is limited to preclinical basic research only;further verification on efficacy and safety of stem cell therapy with interleukin-1β pre-treated mesenchymal stem cells is required in clinical settings.

Objective To explore the diagnostic value ofcerebrospinal fluid (CSF) lactic acid (LA) level in bacterial meningitis after craniotomy for cerebral hemorrhage in adults.Methods The clinical data of 162 patients with cerebral hemorrhage,admitted to and accepted craniotomy in our hospital from April 2013 to April 2018,were retrospectively collected;patients were divided into infected group (n=75) and non-infected group (n=87) according to whether postoperative bacterial meningitis occurred;univariate analysis was used to compare the differences of CSF-LA concentration and other indicators of CSF between patients of the two groups;multivariate Logistic regression analysis was used to screen the independent factors affecting the occurrence of postoperative bacterial meningitis;receiver operating characteristic (ROC) curve was used to analyze the predictive values of CSF-LA and other indicators in postoperative bacterial meningitis.Furthermore,17 patients with positive bacterial CSF were divided into Gram-positive (G+) bacteria group (n=9) and Gram-negative (G-) bacteria group (n=8);the predictive values of CSF-LA and other indicators for postoperative meningitis of G-bacteria patients were analyzed in the same way.Results (1) The CSF-LA concentration in infected group ([6.3±2.8] mmol/L) was significantly increased as compared with that in non-infected group ([3.3±1.6] mmol/L,P＜0.05);the results of multivariate Logistic regression analysis showed that CSF-LA was an independent influencing factor for postoperative bacterial meningitis (odd ratio=l.547,95％ confidence interval:1.029-2.326,P=0.036);ROC curve results revealed that the area under the curve of CSF-LA concentration in the diagnosis of bacterial meningitis after craniotomy was 0.854 (95％ confidence interval:0.790-0.904),and the optimal cut-off value was 4.61 mmol/L,with sensitivity of 69.3％,specificity of 92.0％,positive predictive value of 88.1％ and negative predictive value of 77.7％.(2) The CSF-LA concentration in G-bacteria group ([9.9±2.9] mmol/L) was significantly increased as compared with that in G+ bacteria group ([5.2±3.1] mmoi/L,P＜ 0.05);ROC curve results revealed that,in patients with positive bacterial CSF,the area under the curve of CSF-LA concentration in diagnosis of meningitis with G-bacteria after craniotomy was 0.861 (95％ confidence interval:0.610-0.978),and the optimal cut-off value was 7.20 mmol/L with sensitivity of 87.5％,specificity of 88.9％,positive predictive value of 87.5％,and negative predictive value of 88.9％.Conclusion Detection for concentration of CSF-LA can help predicting bacterial meningitis afier craniotomy for cerebral hemorrhage and identify G+ and G-bacteria meningitis.

Objective:To analyze the clinical phenotypes and molecular genetic characteristics of hereditary spherocytosis (HS) in children.Methods:The clinical data of children with HS in the Affiliated Children′s Hospital of Zhengzhou University from June 2014 to June 2018 were collected and analyzed retrospectively.The peripheral blood samples of 20 children and their parents were collected and targeted capture or whole exon group sequencing was performed using the second generation sequencing technique, and the suspicious mutation sites were verified by Sanger sequencing.Results:A total of 43 pediatric patients (23 males, 20 female) were included in this study.The median age of onset of 1 year old and 11 months (1 month to 10 years old). Pallor (27/43 cases, 62.79%) was the main symptom.Typical clinical manifestations were anemia (36/43 cases, 83.72%), jaundice (35/43 cases, 81.40%), splenomegaly (33/43 cases, 76.74%), and hepatomegaly (27/43 cases, 62.79%). The proportion of spherical erythrocytes in peripheral blood of 23 cases (23/43 cases, 53.49%)≥ 0.1, and the proportion of spherical erythrocytes in bone marrow smears of 17 cases (39.53%) was ≥ 0.1, and 20 cases were positive in erythrocyte osmotic fragility test (20/43 cases, 46.51%). Comparison of 29 children before and after blood transfusion: post-transfusion hemoglobin (Hb) [(88.69±11.22) g/L vs. (78.24±14.47) g/L], mean corpuscular volume (MCV) [(89.37±7.15) fL vs.(84.08±7.49) fL], mean corpuscular hemoglobin (MCH) [(29.12±2.70) pg vs.(27.36±1.95) pg], mean corpuscular hemoglobin corpuscular (MCHC) [(361.79±32.27) g/L vs.(356.31±31.43 ) g/L] were increased, and the total bilirubin (TB) level was lower after blood transfusion than before blood transfusion [(33.27±16.42) μmol/L vs.(41.58±15.40) μmol/L], the differences were statistically significant ( t=-3.538, -5.187, -5.412, -7.404, 2.527, all P<0.05). Seven children underwent splenectomy: postoperative Hb[(116.00±5.54) g/L vs.(75.71±9.96) g/L], MCH[(29.87±1.62) pg vs.(24.61±1.65) pg], MCHC [(391.14±12.99) g/L vs.(315.14±51.99) g/L] all increased, the difference was statistically significant ( t=-9.234, -4.330, -4.031, all P<0.05). The Hb in the operation group was significantly higher than that in the blood transfusion group, including the treatment effect of operation was more significant ( t=-9.247, P<0.05). Thirteen pathogenic mutations (11 new mutations not reported) were detected in 3 genes ( ANK1, SPTB and SPTA1) in 13 children, 8 of who were mutations in ANK1, 4 cases of which were mutations in SPTB and 1 case of which was mutation in SPTA1.Among the 13 mutations, 12 cases were de novo except one inherited from the mother. Conclusions:Anemia and pallor are the initial symptoms of HS in children.Blood transfusion can temporarily improve the symptoms of anemia and jaundice.Splenectomy is an effective and fundamental treatment.The gene diagnosis of 13 pediatric patients got gene diagnosis, which provided basis for genetic consultation of the next fetus.Eleven new mutations were found in ANK1, SPTB, SPTA1 genes, which exten-ded the gene mutation spectrum of HS.

OBJECTIVE: To construct a multiple linear regression model of forced expiratory volume in 1 second (FEV1) for estimating FEV1 in special populations unable to receive or uncooperative in pulmonary ventilation function tests. METHODS: The multiple linear regression model of FEV1 was constructed based on the data of 813 individuals undergoing pulmonary function tests in First Affiliated Hospital of Zhejiang Chinese Medical University between September, 2017 and September, 2019, and was validated using the data of another 94 individuals from the same hospital between January and July, 2020. FEV1 of the individuals was measured by pulmonary ventilation function test, and respiratory resistance (Rrs) was measured using forced oscillation technique (FOT). Pearson correlation analysis was used to assess the correlation between the factors, and the model equation was established by multiple stepwise regression analysis. The calculated FEV1 based on the model was compared with the measured FEV1 among both the individuals included for modeling and validation. RESULTS: FEV1 was not significantly correlated with BMI ( CONCLUSIONS The multiple linear regression model for calculating FEV1 constructed in this study is suitable for clinical application.
Adult ; Forced Expiratory Volume ; Humans ; Linear Models ; Lung ; Respiratory Function Tests ; Sex Factors

Brain Ischemia ; Cerebral Infarction ; Humans ; Subarachnoid Hemorrhage ; Vasospasm, Intracranial/etiology*

ObjectiveTo analyze the polarized light microscopic characteristics， the composition of physical phases and their relative contents of Maifanitum from different origins， and to establish the Fourier characteristic fingerprint of Maifanitum powder crystals by X-ray diffraction（XRD）. MethodA total of 26 batches of Maifanitum samples were selected， and the microscopic characteristics of the sample powders and grinding flakes were observed by polarized light microscopy under single polarized light and orthogonal polarized light， and the main phase compositions and their relative contents were analyzed by powder crystal XRD technique， and the XRD Fourier characteristic fingerprint of Maifanitum was established. The incident light source of XRD was Cu target Kβ radiation， the light tube voltage and light tube current were 40 kV and 40 mA， respectively， the divergence slit was 1°， the scattering slit was 1°， the receiving slit was 0.2 mm， the scanning speed was 5°·min^-1 with continuous scanning and scanning range of 5-90°（2θ）， and the step length was 0.02°. ResultThe polarized light micrographs of powders and grinding flakes of Maifanitum were obtained， and the main phases were plagioclase， potassium feldspar and quartz， and a few samples also contained illite， pyrite， iron dolomite， calcite， iron amphibole and chlorite， etc. The relative total content of feldspar phases was 61.9%-82.4%， and the relative content of quartz was 12.6%-33.6%. The XRD Fourier fingerprint analysis method of Maifanitum with 13 common peaks as the characteristic fingerprint information was established， and the similarity calculated by the mean correlation coefficient method was 0.920 9-0.997 7， the similarity calculated by the mean angle cosine method was 0.940 5-0.998 4， the similarity calculated by the median correlation coefficient method was 0.921 1-0.997 5， and the similarity calculated by the median angle cosine method was 0.947 5-0.998 2. ConclusionThe polarized light microscopic identification characteristics of Maifanitum are mainly plagioclase， quartz and potassium feldspar， and the technique of powder crystal XRD Fourier fingerprint analysis can be used for the identification of Maifanitum.