Described in this paper is the application of electronic medical records, hand-holding mobile terminals,bid data collection and analysis, and data security in medical quality control.

Objective To evaluate the efficacy of different methods in preventing pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP).Methods Databases including PubMed,EMBASE,Cochrane Library,Chinese Journal Full-text Database,China Biomedicine Database were searched with key words including endoscopic retrograde cholangiopancreatography,ERCP,post-ERCP pancreatitis,pancreatitis,pancreatic duct stent,non-steroid anti-inflammatory drugs,indometacin,diclofenac,protease inhibitors,nafamostat,ulinastatin,gabexate,somatostain,内镜逆行胰胆管造影,内镜逆行胰胆管造影术后胰腺炎,胰腺炎,胰管支架置入,非甾体类抗炎药,吲哚美辛,双氯芬酸,抑酶剂,萘莫司他,乌司他丁,加贝酯and生长抑素.Literatures published between January 2000 and January 2014 were searched.Randomized controlled studies on prevention of pancreatitis after ERCP which were enrolled in this study were analyzed by 2 independent reviewers.The quality of the literatures was evaluated.All data were analyzed using the RevMan 5.0 software.Data were expressed in odds ratio (OR) and 95％ confidence interval (95％ CI).The heterogeneity of the studies was analyzed using the I2 test.Results Twenty-seven literatures were enrolled in the study.There were 4 701 patients in the experimental group (including patients who were treated by pancreatic stent installation,non-steroidal antiinflammatory drugs,nafamostat,ulinastatin,gabexate,intravenous infusion of somatostain for more than 6 hours,intravenous infusion of somatostain for less than 6 hours,bolus injection of somatostain) and 3 592 patients in the control group (including patients treated without pancreatic duct installation or placebo).The results of Meta analysis showed that pancreatic stent installation,non-steroid anti-inflammatory drugs,nafamostat,intravenous infusion of somatostain for more than 6 hours and bolus injection of somatostain could significantly decrease the incidence of pancreatitis after ERCP (OR =0.18,0.45,0.31,0.33,0.25,95％ CI:0.09-0.35,0.33-0.61,0.19-0.52,0.20-0.56,0.11-0.55,P ＜ 0.05).Conclusion Pancreatic stent installation,non-steroid anti-inflammatory drugs,nafamostat,intravenous infusion of somatostain for more than 6 hours and bolus injection of somatostain could effectively prevent the incidence of pancreatitis after ERCP.

Objective To establish the methodology of flow cytometry for detecting human cells in human/goat chimerisra.Methods Human hemopoietic stem/progenitor cells (CD+34 cells) or MIG-tranadueed-GFP CD+34 cells were transplanted into the peritoneal cavity of fetal goats in utero to obtain human/goat chimera modeL The peripheral blood cells from the chimeras were labeled with multiple mouse anti-human antibodies and the monoelonal antibodies that were specific for human but had not or only minimal cross-reaction with goat were screened as the primary antibodies for routine analysis in flow cytometry.Human cord blood was proportionally (25% ,50% ,75%,100%) added into the blood of the untransplanted goats and the cells were labeled with CD+34 monoclonal antibody.The region and size of the "gate" were chosen based on to the distribution of CD+34 cells or human cord blood.One human/goat chimera marked with GFP (MIG goat) was sacrificed and the substantial liver cells from its perfused liver were analyzed for the GFP+cells percentage and DNA contents by flow cytometry.Results CD7,CD15,CD38,CD45CD20CD34CD14and GPA monoclonal antibodies were chosen as the primary antibodies in rou tine detection by flow cytometry.The size and area of the "gate" were also defined.29.1% (29100/100 000 ) of the substantial liver cells from the MIG goat expressed GFP.DNA content analysis showed that the GFP+ cells obtained from the liver of MIG goat mainly manifested two peaks that were correspond to those of human.Conclusions Flow cytometry is rapid,simple and effective for the investigation of differentiation,homing and biological characteristics of stem cells in vivo.The selections of suitable surface antibodies and the "gate" are very important for detecting human cells accurately in the human/goat chimerism.

Objective To investigate the effect of histone deacetylase inhibitor LBH589 on proliferation,apoptosis and drug resistance of chemoresistant acute myeloid leukemia cells HL60/ADM.Methods HL60/ADM cells were treated with LBH589.Proliferation,apoptosis and adriamycin IC50 were evaluated by MTT assay and AnnexinV-FITC/PI stain.The change in MRP1 expression and intercellular adriamycin accumulatiom were analyzed by flow cytometry.Results Effective proliferative inhibition and apoptotic induction in HL60/ADM cells were observed after treatment with 10-80 nmol/L LBH589 with maximal effect detected after treatment with 70 nmol/L LBH589 for 60 hours.However,inhibition ratio remain unchanged with the further increase of drug dose and incubation time (P ＞ 0.05).Downregulation of MRP1 [(93.90±4.20) ％ vs (76.19±6.53) ％],upregulation of adriamycin accumulation [(8.53±0.68) ％ vs (25.67±1.34) ％] and decrease in adriamycin IC50 [(6.833±0.319) μg/ml vs (1.382±0.104) μg/ml] were induced by the treatment with 20 nmol/L LBH589 (P ＜ 0.01),whose reversal fold was 4.9.The expression of acetylated histone 3 after treatment with LBH589 was higher than that before treatment (P ＜ 0.01).However,relative p-Akt levels after treatment for 24 h and 48 h were 1.07±0.09 and 0.59±0.01,respectively,which were lower than that before treatment (2.03±0.12) (P ＜ 0.01).Meanwhile,expression levels of p53 were 0.57±0.04 and 1.31±0.09,respectively,which were higher than that before treatment (0.21 ±0.02) (P ＜ 0.01).Conclusion Treatment with LBH589 has the capability of inhibiting proliferation and inducing apoptosis,as well as increasing intercellular adriamycin accumulation and sensitivity through downregulation of MRP1 expression and inhibition of PI3K-Akt signaling pathway in HL60/ADM cells.

Objective To study the expression levels and its clinical significance of angiopoietin 2 (Ang-2) gene in acute lymphatic leukemia(ALL). Methods The qualitative detection method was established with SYBR Green Ⅰ by real-time fluorescent quantitative PCR, and Ang-2 mRNA was measured in 51 cases of pre-therapeutic ALL. In addition, the expression of Ang-2 gene was also analyzed in 20 cases of non-malignant hematological diseases. Results The expression of Ang-2 gene was found in all the patients, and Ang-2 expression level in ALL patients was significantly higher than that of the controls (P<0.05). No significant relationship was found between Ang-2 expression level and clinical characteristics (age, haematogloblin, WBC count, platelet count, LDH, blast cells in peripheral blood, blast cells in bone marrow). The expression level of Ang-2 have no effect on one year replase rate and survival rate in ALL. Conclusion Ang-2 expression level in ALL patients was higher than that in non-malignant hematological diseases, and there may be no relationship with clinical manifestation, treatment and prognosis.

ObjectiveTo explore the clinical efficacy and safety of autologous peripheral blood stem cell transplantation(APBSCT) in the treatment of pemphigus.MethodsTotally,3 patients with pemphigus vulgaris who responsed poorly to 6-month treatment with glucocorticoids or immunosuppressants or experienced aggrevation of disease and developed treatment-related complications,received APBSCT and were followed up for more than 5 years.There were 1 male and 2 females with an average age of 27.3(21-39) years.The mobilization program included cyclophosphamide (CTX) 4 g/m2,recombinant human granulocyte colonystimulating factors(G-CSF) and Rituximab 375 mg/m2,and the preconditioning regimen included intravenous CTX (50 mg/kg per day on days -6,-5,-4,-3),antithymocyte globulin at 2.5 mg/kg per day(on days -3,-2,-1 and 0) and Rituximab (600 mg/d on days 0 and 7).ResultsAll the 3.patients were successfully engrafted.The mean time for peripheral reconstruction:white blood cells 13.3 days (from day 11 to 16),platelet 16.3 days (from day 16 to 17).Monitoring of immunity indices and related antibodies showed no abnormality and the immune system was well reconstructed.No serious complications occurred during the follow up,and the patients' quality of life was obviously improved.ConclusionAPBSCT may be an effective and safe option for the treatment of pemphigus.

Objective: To explore the neural processing differences in inhibitory control and cognitive flexibility associated with motor development levels in preschool children, so as to provide a basis for motor learning and cognitive development in preschool children. Methods: From March 20 to 31 in 2023, a total of 84 preschool children aged 4-6 were recruited from two kindergartens in Xi an City. The MOBAK-KG Motor Development Assessment Scale was used to assess the children s motor development levels. The Go/no go task paradigm was employed to test inhibitory control ability, and the Dimensional Change Card Sort (DCCS) task paradigm was utilized to evaluate cognitive flexibility. Functional near infrared spectroscopy (fNIRS) was used to monitor the preschool children s prefrontal cortex oxygenation dynamics during inhibitory control and cognitive flexibility tasks. Malab software and Homer 2 plugins were used to calculate prefrontal oxygenated hemoglobin concentration of preschool children during the tasks. Results: The high motor skills group exhibited significantly higher task accuracy during inhibitory control and cognitive flexibility tasks [0.95(0.92, 0.97),(0.54±0.12)] compared to the low motor skill group[0.93(0.85, 0.97),(0.45±0.13)] ( Z/t =-2.09, 3.14 , P <0.05). During the inhibitory control task, the high motor skill group [0.24(0.10,0.41), 0.34(0.16,0.62), 0.30(0.07, 0.52 ), 0.26(0.09, 0.53), 0.15(0.01, 0.43), 0.34(0.10, 0.67)mol/L] showed significantly higher oxygenated hemoglobin concentrations in the left and right dorsolateral prefrontal cortices (L-DLPFC, R-DLPFC), left and right pars triangular Broca s areas ( L- PTBA, R-PTBA), and left and right frontopolar areas (L-FPA, R-FPA) compared to the low motor skill group [0.04( -0.13 , 0.15), 0.00(-0.12, 0.11), -0.01(-0.17, 0.14), 0.04(-0.14, 0.16), -0.01(-0.16, 0.12), -0.03(-0.21, 0.15) mol/L ] ( Z=-4.83, -5.57, -4.77, -4.10, -3.45, -5.74, P ＜0.01). During the cognitive flexibility task, the high motor skill group[0.21(0.03, 0.36), 0.28(0.15, 0.45), 0.15(0.05, 0.30), 0.20(0.05, 0.37), 0.04(-0.17, 0.26), 0.14(-0.08, 0.40) mol/L ] exhibited significantly higher oxygenated hemoglobin concentrations in the L-DLPFC, R-DLPFC, L-PTBA, R-PTBA, L- FPA, R-FPA brain regions compared to the low motor skill group [0.02(-0.20, 0.23), 0.02(-0.12, 0.21), 0.00(-0.22, 0.16 ), 0.00(-0.16, 0.15), -0.05(-0.25, 0.06), 0.01(-0.23, 0.20)mol/L] ( Z=-3.63, -4.45, -3.58, -3.75, -2.18, -1.98 , P ＜0.05). Conclusions The motor development level in preschool children is closely related to inhibitory control and cognitive flexibility. It is crucial to emphasize motor learning in early childhood to further promote holistic development of both mind and body.

Objective To evaluate the efficacy and safety of lenalidomide in a real-world clinical practice in Chinese patients with multiple myeloma (MM).Methods It was a prospective,multi-center,observational study.A total of 165 consecutive patients with MM treated with lenalidomide-based regimens were enrolled in 12 hospitals from June 2013 to November 2015.Relevant information was recorded,such as baseline clinical data,cytogenetic abnormalities,treatment regimens,and duration of treatment,safety,and survival.Results (1)There were 126 relapsed and refractory MM (RRMM) patients,25 newly diagnosed patients and 19 maintenance patients.The evaluable RRMM patients accounted for 120 cases,among which 74 cases(61.7％) reached the partial response (PR) or above,and a very good partial response (VGPR) in 16 patients (13.3％),a complete response (CR) in 14 cases (11.7％),a strictly complete response (sCR) in 4 cases (3.3％).Thus,a VGPR or above in 34 patients accounted for 28.3％.(2)The median follow-up was 13 months,the median time to progression 12 months.The median survival after receiving lenalidomide was 19 months,and the median overall survival (OS) was 62 months.(3) The univariate analysis in 120 RRMM patients suggested that prognostic factors for significant improvement in PFS included normal karyotype,international staging system (ISS) Ⅰ-Ⅱ,t(4;14) negative (detected by fluorescence in situ hybridization),non-bortezomib resistance and response to previous regimens.As to OS,nonbortezomib resistance,response to previous regimens and non-primary refractoriness were positive factors.Multivariate analysis showed that the response to previous regimens (PR or better) was an independent good prognostic factor for progress-free survival (PFS),non-bortezomib resistance and non-primary refractoriness for OS.(4) Grade 3 or 4 adverse events that occurred in more than 10％ of all enrolled patients were neutropenia (12.7％),leukocytosis (11.5％) and thrombocytopenia (12.7％).Owing to intolerance of toxic side effects,7 cases withdrew lenalidomide.Conclusions No matter what combination,regimens containing lenalidomide are effective to RRMM patients with overall response rate 61.7％,a time to progression 12 months and an overall survival 62 months.The toxicity is quite tolerable and manageable.In addition,the response to previous treatment (reached PR or above) is the independent good prognostic factor for PFS,non-bortezomib resistance and non-primary refractoriness for OS.Clinical trail registration Clinicaltrials.gov,NCT01947309

Objective To analyze the therapeutic effects of chemotherapy after chidamide pretreatment in 16 cases of high-risk and refractory lymphoid malignancy. Methods The efficacy and adverse reactions of 16 patients with high-risk and refractory lymphoid malignancy who received chidamide combined with chemotherapy after 3 days pretreatment of chidamide were analyzed. Results Sixteen patients included 6 males and 10 females, and the median age was 49.5 years old (23-88 years old). The median course of previous systemic chemotherapy was 4 (range 0-22). Among 14 patients who received induction chemotherapy, 7 patients achieved complete remission (CR), 7 patients achieved partial remission (PR). Fourteen patients had achieved clinical efficacy, and the overall response rate (ORR) was 100 %. After 2 cases had remission , the patients who entered this regimen for consolidation chemotherapy also had durable CR. The median follow-up time was 13 months (range 2-24 months) until December 2017. Nine cases had overall survival (OS), 7 cases died and 9 cases had progression-free survival. Common adverse effects of the chemotherapy included mild and controllable gastrointestinal reactions after chidamide. Conclusion Chemotherapy after chidamide pretreatment may improve the effect and prognosis of high-risk or refractory lymphoid malignancy.

Objective To describe the demographic and clinical characteristics of patients with the diagnosis of multiple myeloma(MM)and to analyse the outcome of difierent regimens for the treatment of MM.Methods The study reviewed 332 MM cases diagnosed within the period from January 1,2002 to December 31,2002.These patients were tracked via their records to a total period of three years.Results First-line treatment:Totally 332 patients were included,among them 325(97.9%)patients received chemotherapy and 7(2.1%)patients received stem cell transplantation(SCT);Second-line treatment:197 patients were included,among them 190(96.5%)patients received chemotherapy and 7(3.6%)patients received SCT;Third-line treatment:92 patients were included,among them 88(95.7%)patients received chemotherapy and 4(4.4%)patients received SCT.Major adverse effects were follows:severe infection 19.3%,severe anaemia 19.3%,phlebothrombosis 1.2%,thrombocytopenia 16.9%,fever associated with neutropenia 18.1%.Conclusions Some curative effects can be achieved by using traditional treatment plans to treat patients suffering from MM,but new methods are expected to improve the prognosis.