Objective To study the clinicopathologic features,effective therapeutic regimen and prognosis of human immunodeficiency virus (HIV) infection with acute promyelocytic leukemia (APL) and chronic myeloid leukemia (CML).Methods Two cases of HIV infection concurrent with leukemia,one with APL,one with CML,were studied and relevant literatures were reviewed.Results Case 1 was HIV infection concurrent with APL,ATO was used to induce remission,in the eight day of therapy,the patient died of brain disorder.Case 2 was HIV infection concurrent with CML,hydroxycarbamide and interferon were used to induce remission,three month later,state of an illness progressed to acute phase,after combination chemotherapy,concurrent with lung multiple infection (fungus and pneumocystis carinii),at last,the patient died of respiratory failure.Conclusion HIV infection concurrent with acute and chronic leukemia has poor therapeutic effect,and is easy to infect seriously.

Objective To investigate the correlation between serum interleukin-8 (IL-8 )and immunoglobulin/complement 3A (IgA/C3)and immune imbalance in Henoch-Schonlein Purpura(HSP)in children,and provide evidence and guidance for clinical therapy of HSP.Methods Serum IL-8 was measured by Enzyme-linked immunosorbent assay(ELISA),and IgA and C3 were de-tected by automatic biochemistry analyzer,and calculate the ratio of IgA/C3.Results Serum IL-8 levels were (389±5 1.68)ng/L, significantly higher than that in healthy children (P < 0.05 ).Serum IgA levels were(306.2 ± 32.21 )mg/L,significantly higher (P <0.05).Serum C3 levels were (1 14.5 ±20.7)mg/L,of no statistical difference.IgA/C3 were (3.041 ±0.508 5),significantly higher(P <0.05).There was a positive correlation between IL-8 and IgA/C3 (r =0.534,P <0.05 ).Conclusion The children of HSP has cytokine and immunoglobulin disturbance,and presents a hyperreactivity in both humoral immunity and cellular immunity. Positive correlation between IL-8 and IgA/C3 was observed.

Objective To evaluate the distribution and significance of IgG subclasses of anti-cyclic cirullinated peptide antibody (anti-CCP) in sera from patients with rheumatoid arthritis (RA).Methods A total of 83 patients with RA at the Department of Endocrinology of Taizhou Hospital , 51 disease controls and 50 healthy controls during the period from August 2012 to June 2013 were enrolled.The total serum IgG and IgG subclasses of anti-CCP antibodies were detected by antigen specific enzyme linked immune-sorbent assay( ELISA ).The prevalence and relative amount of IgG subclasses were calculated and compared.Statistical analysis was performed by χ2 test and Kruskal-Wallis H test.Results The positive rates of IgG subclasses of anti-CCP were anti-IgG 71.1%(59/83), anti-IgG1 78.3%(65/83), anti-IgG2 26.5%(22/83), anti-IgG3 60.2%(50/83), anti-IgG4 74.7%(62/83) respectively.The diagnostic value of anti-CCP-IgG1, anti-CCP-IgG3 and anti-CCP-IgG4 alone or combined (AUC =0.818-0.901),compared with anti-CCP-IgG(AUC=0.857), had no significant difference(Z=0.028-0.045,P>0.05).The DAS28 score of anti-CCP-IgG1(DAS28 =6.5), and anti-CCP-IgG4(DAS28 =6.5)positive in patients with RA were significantly higher than those in negative groups (DAS28=4.5,4.6)(U=396.0,427.5,P<0.01).The T28(T28=4.0,4.0)and SW28(SW28=4.0,4.0) results of CCP-IgG1and CCP-IgG4 positive in patients with RA were significantly higher than those in negative groups (T28=3.0,3.0,SW28 =3.0,3.0)(U=377.5,406.0,255.5,286.5,P<0.05).Conclusions The distribution of IgG subclasses of anti-CCP in sera from patients with RA was predominantly anti-CCP-IgG1, anti-CCP-IgG3 and anti-CCP-IgG4 associated with RA disease activity.However , whether joint detection of IgG subclasses can replace conventional anti -CCP is questionable.

Objective:To understand the mastery of occupational hygienic knowledge and the implementing of occupational health protection measures in the group which were exposed to the procedure of manufacture and use in glass fiber company, and to explore the feasibility of the prevention of the skin injury by occupational health education in glass fiber workers.Methods:We selected 257 on-the-job employees as the research object in a ceramic enterprise in Nanjing from June 2018 to August 2019, with the method of cluster random sampling. According to Solomon's design, the intervention group in which we took measures with health education was divided into RG 1 (O 1XO 2) and RG 3 (XO 5) group, and the control group where we didn't take any intervention was divided into RG 2 (O 3-O 4) and RG 4 (-O 6) group. The intervention effect of health education on the occupational protection of glass fiber workers was evaluated by the results of questionnaire. Results:After training, the average score of occupational health knowledge in the intervention group was 27.34 points higher than that before training, the intervention index was 1.42, 23.62-27.73 points higher than the control glass fiber workers and 33.62-35.52 points higher than the control glass non-glass fiber workers; Compared with the control group, the positive attitude rate of fiber glass workers in the intervention group increased by 13.28%, 13.51%, 11.68% and 11.48%, and the intervention indexes were 1.18, 1.17, 1.14 and 1.15, which was corresponding to using protective cream, wearing gloves, wearing working clothes, washing hands and bathing after work, respectively; Compared with the control group, the implementation rate of occupational protection measures which were represented by wearing gloves、washing hands and bathing for glass fiber workers in the intervention group increased by 29.25% and 7.27% respectively, and the intervention indexes were 1.43 and 1.08 respectively; The skin injury rate of fiberglass workers in the intervention group was reduced by 11.43% comparing to the control group, the intervention index was 1.67.Conclusion:According to the occupational health education of fiberglass workers, it improves the mastery of occupational health knowledge, positive atti-tude rate and the implementation rate of occupational protection measures, meanwhile, it reduces the skin injury rate of the intervention objects to a certain extent.

Objective:To understand the mastery of occupational hygienic knowledge and the implementing of occupational health protection measures in the group which were exposed to the procedure of manufacture and use in glass fiber company, and to explore the feasibility of the prevention of the skin injury by occupational health education in glass fiber workers.Methods:We selected 257 on-the-job employees as the research object in a ceramic enterprise in Nanjing from June 2018 to August 2019, with the method of cluster random sampling. According to Solomon's design, the intervention group in which we took measures with health education was divided into RG 1 (O 1XO 2) and RG 3 (XO 5) group, and the control group where we didn't take any intervention was divided into RG 2 (O 3-O 4) and RG 4 (-O 6) group. The intervention effect of health education on the occupational protection of glass fiber workers was evaluated by the results of questionnaire. Results:After training, the average score of occupational health knowledge in the intervention group was 27.34 points higher than that before training, the intervention index was 1.42, 23.62-27.73 points higher than the control glass fiber workers and 33.62-35.52 points higher than the control glass non-glass fiber workers; Compared with the control group, the positive attitude rate of fiber glass workers in the intervention group increased by 13.28%, 13.51%, 11.68% and 11.48%, and the intervention indexes were 1.18, 1.17, 1.14 and 1.15, which was corresponding to using protective cream, wearing gloves, wearing working clothes, washing hands and bathing after work, respectively; Compared with the control group, the implementation rate of occupational protection measures which were represented by wearing gloves、washing hands and bathing for glass fiber workers in the intervention group increased by 29.25% and 7.27% respectively, and the intervention indexes were 1.43 and 1.08 respectively; The skin injury rate of fiberglass workers in the intervention group was reduced by 11.43% comparing to the control group, the intervention index was 1.67.Conclusion:According to the occupational health education of fiberglass workers, it improves the mastery of occupational health knowledge, positive atti-tude rate and the implementation rate of occupational protection measures, meanwhile, it reduces the skin injury rate of the intervention objects to a certain extent.

Objective This study analyzed the incidence and mortality trends of four types of digestive tract tumors in China from 1990 to 2019,including gastric cancer,esophageal cancer,colorectal cancer,and liver cancer,in order to provide scientific basis for the formulation of prevention and control strategies for digestive tract tumors in China.Methods The Global Burden of Disease Study 2019(GBD 2019)database was used to analyze the trends of standardized incidence and standardized mortality of digestive tract tumors in China by the Joinpoint regression model.The age-period-cohort model was used to explore the age-period and cohort effects on the incidence and mortality of digestive tract tumors.Results The incidence order of digestive tract tumors in 2019 was stomach cancer(43.09/100,000),Colon and rectum(42.74/100,000),esophageal cancer(19.55/100,000)and liver cancer(14.80/100,000).The death order was gastric cancer(29.64/100,000),Colon and rectum(18.40/100,000),esophageal cancer(18.09/100,000)and liver cancer(13.20/100,000).After eliminating the influence of population age structure,the standardized in-cidence and standardized mortality of liver cancer,gastric cancer and esophageal cancer from 1990 to 2019 showed a decreasing trend year by year(AAPC liver cancer incidence=-3.1％,AAPC gastric cancer incidence=-0.07％,AAPC esophageal cancer inci-dence=-1.5％;AAPC liver cancer death=-3.4％,AAPC gastric cancer death=-1.9％,AAPC esophageal cancer death=-1.8％)(P＜0.001),and the standardized incidence and standardized mortality of Colon and rectum showed an increasing trend year by year(AAPC Colon and rectum incidence=3.1％,AAPC Colon and rectum death=1.1％)(P＜0.001).The results of age-period-cohort model showed that the incidence and mortality of gastric cancer,esophageal cancer and Colon and rectum were increas-ing with age,reached the peak in 85+group,80-84 group and 85+group,respectively.The incidence and mortality of liver cancer peaked in the 55-59 group and then decreased.The risk of Colon and rectum showed an increasing trend year by year,and the risk of death showed a first increasing trend and then decreasing trend.The incidence and mortality of liver cancer showed a decreasing trend followed by an increasing trend,while the overall incidence and mortality of gastric cancer and esophageal cancer showed a decreasing trend year by year.The earlier birth cohort of esophageal cancer and liver cancer,the higher risk of morbidity and mortality,while the later birth cohort of Colon and rectum,the higher risk of morbidity and mortality.The risk of gastric cancer showed the fluctuation.Conclusion The disease burden of digestive tract tumors in China is still heavy in China,especially the standardized incidence and standardized mortality of Colon and rectum are still increasing year by year.It is necessary to implement targeted prevention and treat-ment measures to effectively reduce the disease burden of digestive tract tumors.

Objective To explore the clinical value of MCV combined with Hb electrophoresis in detection of tha-lassemia. Methods Selected 150 cases of patients with thalassemia as the observation group, and other 150 cases of non-thalassemia patients were selected in our hospital as control group. MCV and Hb electrophoresis examination were conducted in two groups of patients, and the positive rates were recorded. And then we analyzed the specificity and sensitivity of the two methods as well as the combined examination. Results In the single MCV or Hb electrophoresis detection, the positive rate in observation group patients was higher than this in the control group, and the differences were statistically significant (P<0.05). The sensitivity and specificity of MCV detection were separately 91.33% and 76.67%, and the sensitivity and specificity of Hb electrophoresis were separately 85.33% and 79.67%. And when we conducted the combined detection, the sensitivity decreased, but the specificity increased. Conclusion For the patients with thalassemia, by using the method of MCV combined with Hb electrophoresis, we can improve the specificity in de-tection of disease. It is worthy of promotion in clinical use.

Objective To explore the clinical effect of surgery-first approach (SFA) for correcting adult skeletal class Ⅲ malocclusion deformity patients.Methods A total of 28 adult patients diagnosed with skeletal class Ⅲ malocclusion were treated.Bilateral sagittal split ramus osteotomy (BSSRO) and geniplasty were performed without presurgical orthodontics treatment;postoperative orthodontics treatment was carried out after a healing period of 2-4 weeks.Lateral cephalometric radiographs were taken preoperatively (T1),within a week posoperatively (T2) and six months posoperatively (T3);cephalometric measurements were carried out by the software.Results All the patients were satisfied with the effect,no complications occured.The mean postoperative orthodontics treatment duration was 13.2 months.The mean setback of mandible at Po and B point was (7.74 ± 3.93) mm (P＜0.01) and (8.13±3.84) mm (P＜0.01),and superior movement lengths were (2.73±1.83) mm and (2.76±1.67) mm,respectively.Compared to T2,Po and B point moved forwardly with (2.36±1.23) mm and (2.66±1.65) mm,and inferior movment were (2.16±1.37) mm and (1.21±0.87) mm,respectively.The mean decrease of SNB and GA was (3.74± 1.61)° (P＜ 0.01),(3.41± 1.87)° (P＜0.01),respectively.During postoperative period,both of them increased,although these were no statistical differences.Conclusions SFA combined postoperative orthodontics therapy is feasible for the correction of adult skeletal class Ⅲ malocclusion,which has shorter treatment duration than traditional joint orthognathic-orthodontic.With the advantages of earlier improvements in patient's facial aesthetics and dental function,the reduction in difficulty and treatment duration of orthodontic management,and increasing patient acceptance.

We reviewed and developed an indicator system framework for assessing teaching effect of laparoscopic simulation training through literature research, expert consultation, analytic hierarchy process and factor analysis. We also made an empirical study on the constructed index system. The system included 3 domains (A1: evaluation of laparoscopic simulator; A2: operation evaluation of experimental animals; A3: evaluation of clinical practice), 10 second-level indicators and 23 third-level indicators for assessing teaching effect of laparoscopic simulation training. The indicator system framework has good internal consistency (Cronbach α= 0.968) and external consistency (>0.72). The empirical study found that: in the results of A1-A3 in the first level indicator, the score of the experienced group was significantly higher than that of the inexperienced group ( P<0.05). In the evaluation results of the 10 secondary indicators in the secondary indicators B1-B10, the score of the experienced group was significantly higher than that of the inexperienced group ( P<0.01). For the first time, we have established and evaluated a comprehensive evaluation indicator system which is reliable and effective and can be used for further evaluation of teaching effect of laparoscopic simulation training. The following empirical studies have verified the effectiveness and practicability of the evaluation system.

Objective: To investigate the expression characteristics of Tim-3 on natural killer (NK) cells of peripheral blood in patients with acute myeloid leukemia (AML) and its clinical significance. Methods: Peripheral blood was obtained from 39 patients with newly diagnosed AML before intervention, with peripheral blood from 28 cases of healthy volunteers collected as normal control. Using CD3, CD56 and Tim-3 as markers, expression levels of Tim-3 on the peripheral blood NK cells were detected by immune fluorescence labeling and flow cytometry. Results: The ratio of the peripheral blood CD3^-CD56⁺ NK cells in newly diagnosed AML patients (5.74±5.31) %decreased significantly, compared with the normal control (12.55±6.33) % (t=4.596, P<0.001) . Tim-3 expression on the peripheral blood NK cells in newly diagnosed AML patients (42.67±19.08) % decreased significantly, compared with the normal control group (60.99±20.69) % (t=3.781, P<0.001) . CD3^-CD56⁺NK cell ratio of peripheral blood in AML patients was significantly correlated with Chromosome karyotype (t=2.915, P<0.005) . Expression level of Tim-3 on NK cells in the peripheral blood of AML patients had significant correlation with ratio of CR and NCCN high risk group (P<0.05) . Conclusion The rate of NK cells in peripheral blood and the expression level of Tim-3 on NK cells in AML patients decreased significantly.The lower expression level of Tim-3 on NK cells correlate with prognosis of AML.