Objective To investigate the expression of multidrug resistance protein 1 (MDR1) and brain and acute leukemia cytoplasm (BAALC) genes and its relationship with prognosis in patients with newly diagnosed acute myeloid leukemia (AML).Methods A total of 100 adults with newly diagnosed AML were enrolled in the study.All patients were treated with anthracyclines induced chemotherapy combined with cytarabine.The expression levels of MDR1 and BAALC genes were detected,and the relationships with the clinical characteristics of patients with AML,genetic type,therapeutic effect and prognosis were analyzed.Results There was no significant differences in white blood cells,hemoglobin and platelet between patients with high and low expression of MDR1 gene and BAALC gene (P>0.05).There were significant differences in the expression level of MDR1 gene between patients with different chromosome risk stratification (P<0.05) but there was no significant difference in the expression level of BAALC gene (P>0.05).After chemotherapy intervention,CR of patients with high expression of MDR1 gene was significantly lower than patients with low expression of MDR1 gene (60.78% vs.87.76%)(P<0.05),CR of patients with high expression of BAALC gene was slightly lower than patients with low expression of MDR1 gene (67.31% vs 81.25%)(P>0.05).Comparison of median overall survival (OS) and overall survival (OS) in patients with high and low expression of MDR1 gene.The difference was statistically significant (P<0.05).Comparison of median overall survival (OS) and overall survival (OS) in patients with high and low expression of BAALC gene.There was no significant difference(P>0.05).Conclusion Compared with the expression of BAALC gene,the value of expression of MDR1 gene is higher in evaluating the curative effect in patients with newly diagnosed AML.Combined detection of MDR1 and BAALC genes can improve the accuracy in predicting the prognosis of patients.

OBJECTIVE:To investigate the number of insoluble particle in total parenteral nutrition(TPN)solutions and to pro-vide reference for clinical application. METHODS:6 kinds of commonly used TPN prescriptions were selected. After prepared ac-cording to sterile operation procedure,TPN at 25℃was investigated at 0,1,4,8 and 24 h in terms of appearance,pH value,os-motic pressure and the numbers of insoluble particles. RESULTS:The appearance and pH value of TPN had no significant change within 24 h after preparation,and osmotic pressures were all lower than 900 mOsm/L. Study results showed that the numbers of in-soluble particles quickly increased,and ≥10 μm and ≥25 μm insoluble particles exceeded the limitation of Chinese Pharmacopoe-ia after Lipid-soluble vitamin for injection were injected into TPN. Medium/long chain fat emulsion injection,water-soluble vita-min,electrolytes and trace elements also increased the numbers of insoluble particles. CONCLUSIONS:Medium/long chain fat emulsion injection,lipid-soluble/water-soluble vitamin,vitamin C,electrolytes and trace elements have certain influence on the number of insoluble particle of TPN. To analyze the reason for the forming of insoluble particles has great meaning both for improv-ing the TPN quality and reducing the harm of particles for patients.

Objective:To explore the clinical significance of the combined detection of Clara cell secretory protein 16 (CC16) and soluble receptor for advanced glycation end product (sRAGE) in the diagnosis and prognosis of acute respiratory distress syndrome (ARDS).Methods:100 ARDS patients admitted to the intensive care unit (ICU) of Chu Hsien-I Memorial Hospital of Tianjin Medical University from July 2019 to September 2020 were enrolled as the ARDS group, and 100 non-ARDS patients admitted to the ICU during the same period were enrolled as the control group. The general information, vital signs, blood gas analysis, serum CC16 and sRAGE levels, duration of mechanical ventilation, length of ICU stay and prognosis during hospitalization were collected. The receiver operating characteristic (ROC) curve was drawn and the area under ROC curve (AUC) was calculated to evaluate the clinical value of CC16 and sRAGE lonely or combination in the diagnosis and prognosis of ARDS.Results:The duration of mechanical ventilation in the ARDS group was significantly longer than that in the non-ARDS group (days: 15.44±3.04 vs. 12.61±3.73, P < 0.01), and the hospitalization mortality was higher (38.0% vs. 9.0%, P < 0.01), but there was no significant difference in gender, age, body mass index (BMI), acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score or the length of ICU stay between the two groups. There were 62 ARDS patients survived and 38 ARDS patients died during hospitalization. The APACHEⅡ score of the death group was significantly higher than that of the survival group (23.55±2.83 vs. 19.40±4.10, P < 0.01), but there was no significant difference in age, BMI, oxygenation index, mean arterial pressure, duration of mechanical ventilation or the length of ICU stay between the two groups. The serum levels of CC16 and sRAGE in the ARDS group were significantly higher than those in the non-ARDS group [CC16 (mg/L): 38.78±14.70 vs. 21.87±2.45, sRAGE (pg/L): 2 470.95±288.70 vs. 2 013.22±131.15, both P < 0.01]; and the serum levels of CC16 and sRAGE of ARDS patients in the death group were significantly higher than those in the survival group [CC16 (mg/L): 42.02±10.81 vs. 30.52±9.47, sRAGE (pg/L): 2 638.34±324.07 vs. 2 279.91±163.70, both P < 0.01]. ROC curve showed that the AUC of CC16 and sRAGE in the diagnosis of ARDS alone were 0.859 [95% confidence interval (95% CI) was 0.808-0.911] and 0.821 (95% CI was 0.762-0.879), and the best cut-off values were 25.76 mg/L and 2 203.00 pg/L, respectively; the AUC of combined detection of CC16 and sRAGE was 0.932 (95% CI was 0.900-0.965) with the sensitivity of 89.0% and the specificity of 87.6%. The AUC of CC16 and sRAGE in predicting the death of patients with ARDS during hospitalization were 0.747 (95% CI was 0.651-0.843) and 0.819 (95% CI was 0.737-0.902), and the best cut-off values were 32.95 mg/L and 2 554.50 pg/L, respectively; the AUC of combined detection of CC16 and sRAGE was 0.900 (95% CI was 0.828-0.972) with the sensitivity of 88.7% and the specificity of 84.5%. Conclusions:Serum CC16 and sRAGE have clinical value for the diagnosis and prognosis of ARDS. The combined detection of them is superior to individual detection for early prediction of ARDS and prognosis.

Objective:To investigate ?-catenin expression during check pouch carcinogenesis in golden hamster.Methods:Expression of ?-catenin was examined with immunohistochemical SABC method in 23 cases of check normal buccal epithelium of golden hamster,22 of hyperplasitic epithelium,22 of dysplastic epithelium,29 of squamous cell carcinoma.Results:Normal buccal epithelium showed strong pericellular staining in the basal,suprabasal and prickle cell layers.Positive rates(%) of ?-catenin in normal buccal epithelium,hyperplastic epithelium,dysplastic epithelium and squamous cell carcinoma were 100,100,77.3 and 41.4 respectively.Conclusion: The decreased expression of ?-catenin may be related to the carcinogenesis of golden hamster check pouch.

Herpes simplex virus type 1 (HSV-1), as a pathogen usually leading to herpes labialis, has been found to cause more cases of genital herpes and be associated with the occurrence of neurological diseases such as Alzheimer′s disease (AD). AD is a chronic and progressive degenerative disease of the central nervous system, the pathogenesis of which has not been fully elucidated, and currently there is a lack of drugs that can effectively treat the disease. The hypothesis that HSV-1 infection is involved in the pathogenesis of AD has been discussed for a long time, but there is no definite evidence to prove it. This article briefly reviewed the research progress in the pathogenesis of AD caused by HSV-1.

Objective To investigate the clinical value of Color Doppler Ultrasound in diagnosis of lymph node diseases. Methods We observed the ultrasound features of the 93 cases of swelled lymph nodes with Color Doppler ultrasound. The ultrasound features included pseudokidney sign, assessment on blood flow distribution, the Doppler resistive Index (RI), maximal flow rate (Vmax),the longitudinal axis compared to the diameter of a node (L/D ratio) . Results Out of 93 cases of clinically confirmed swelled lymph nodes,the concordance rate of Color Doppler Ultrasound was 86%and 88%in diagnosis of malignant lymph node disease and benign lymph node disease, respectively. 4 cases of lymph tuberculosis were misdiagnosed as lymphoma due to the similar ultrasound characteristics found in malignant lymph group,the rate of misdiagnosis was 8%. In the cases of proliferative lymph node diseases with Pseudokidney sign, 93% of the blood flow distribution was classified as grade 0-I. 90% of lymphadenitis were found with Pseudokidney sign,and 95%of those cases with blood flow distribution was classified as grade II-III. Malignant lymph diseases had no Pseudokidney sign, and 86%of blood flow distribution grade was as III. There was statistically significant difference in the L/D ratio and RI between benign lymph group and malignant lymph group (P<0.01) . There was statistically significant difference in Vmax between lymphoproliferative group and other groups (P<0.01) . Conclusions Pathological characteristics on different lymph node disease determin the ultrasound characteristics. Combined clinical data based on Pseudokidney sign, Blood Flow Distribution, RI value,Vmax value and L/D ratio can enhance the accuracy of various lymph node disease diagnosis.

Objective To explore the value on the treatment of severe acute pancreatitis (SAP) by hemofiltration combined with Dan Sen and catheterizing drainage through laparoscope. Methods Thirty patients of SAP were divided into two groups. On the basis of routine treatment(supportive treatment,suppressing excrine of pancreas stilamin,trypsin inhibitor and antibiotics),hemofiltration,catheterizing drainage,stilamin and Dan Sen were added in group A,while only routine treatment were administered in group B. TNF,IL-6,IL-8,score of Balthazar CT and score of APACHEⅡ were studied in both groups. Results The value of TNF,IL-6,IL-8,score of Balthazar CT and score of APACHEⅡ in group A were significantly lower than those in group B(P

Objective To assess the cerebral CT findings and clinical correlation in eclampsia.Methods Cranial CT scan was performed in 18 patients with eclampsia,3 cases underwent contrast-enhanced CT.Eight of them followed-up by CT scan.Results 14 cases had extensive low-density lesions represented cerebral edema involving the subcortical white matter in cerebrum with predominance in the occipital lobes,the frontal and parietal lobes also involved.4 cases appeared as small low-density foci in the brain,2 cases accompanied with multiple small intracranial hemorrhage.Conclusion CT scan is a good method in showing the cerebral lesions in patients with eclampsia,which can early find the lesions and can be used for follow-up.

Objective:To investigate the expression of human telomerase reverse transcriptase (hTERT) in urine exfoliated cells of benign and malignant urothelial diseases, in an attempt to evaluate the role of detecting hTERT gene expression in cytologic diagnosis of transitional cell carcinoma. Methods: The expressions of hTERT gene were detected by immunocytochemistry staining in 54 patients with transitional cell carcinoma(25 cases with grade Ⅰ, 26 with grade Ⅱ and 13 with grade Ⅲ) and 20 controls, including 10 patients with urinary tract stone and 10 healthy volunteers. The urine exfoliative cells of both groups were also stained by H-E and the results were compared with those of immunocytochemistry.Results: hTERT was detected in 74.1% (40/54) of patients with transitional cell carcinoma and in 5%(1/20) of the controls (P

Objective To introduce the strategies of coronary artery bypass grafting (CABG) surgery for elderly patients over 65 years old. Methods Three hundred and ninety four elderly patients were retrospectively studied, 92.4% of whom were complicated with other diseases. Off-pump CABG (OPCAB) was used in 248 cases (62.4%). For the remaining patients with severely compromised cardiac function or small target vessel with diffuse lesion, conventional CABG (CCABG) was selected. Left internal mammary artery (LIMA) was harvested with extrapleural harvesting technique and grafted to left anterior descending artery (LAD) in 96.2% of patients. Saphenous vein or radial artery was utilized for the other coronary arteries. Transit-time flowmeter (TTFM) was utilized to make sure that grafts were patent with satisfactory blood flow. Perioperative blood sugar level was controlled at 6-10mmol/L by insulin. Results Grafts of per patient were 3.14?0.55 for on-pump CABG and 2.40?0.81 for OPCAB. Three patients died resulting in a mortality of 0.76%. The incidence of complication was 2.28%. The rest recovered uneventfully. Intubation time of OPCAB was significantly shorter than that of CCABG. Patients were discharged within 11.84?4.95 days after operation. Conclusion Good short-term result, namely low incidence of mortality and complication, could be obtained in elderly patients over than 65 years old undertaking CABG.