Objective To review the treatment effect of limited disease small cell lung cancer (LD-SCLC) and to evaluate the prognosis factors for SCLC. Methods From Aug. 2002 to Feb. 2006, 212 patients of SCLC confirmed with pathology and cytology were. Treated by combined modality. All patients were treated with chemotherapy 2-6 cycles, 59 patients of which were treated with only chemotherapy, 108 patients of which were treated with chemotherapy plus radiotherapy, 45 patients of which were treated with surgery plus chemotherapy with or without radiotherapy. The patients of radiotherapy were exposed to 6 or 10 MV X-ray with a total dose of 40-66 Gy in 4-7 weeks. Results The overall median survival time was 15 months. The 1-,2- and 3-year overall survival rate were 58.0%, 33.2% and 22.1%, respectively. Univariate analysis indicated that weight loss, age, LDH, ECOG performance status, operation, response to radio-chemotherapy, cycles for chemotherapy, radiotherapy irflueoced survival significantly in LD-SCLC. Multivariate analysis suggested that ECOG performance status, response to therapy, cycles for chemotherapy were the independent prognostic factors for LD-SCLC. Conclusions For LD-SCLC patients, ECOG performance ≤ 1, good response to radio-chemotherapy, and ≥ 4 cycles chemotherapy show encouraging survival rate, Distance metastasis is still the mainstay of treatment failure.

Objective To analyze the composition and distribution of pathogens from 1366 superficial candidiasis cases in Shanghai.Methods Candida species identification was carried out for 1366 adults or children with superficial candidiasis by using CHROMagar Candida plates,API20C AUX system,etc.Pal's agar,Xylose assimilation and the test for growth at 45 ℃ were utilized to differentiate Candida dubliniensis.Newly identified pathogenic Candida species including Candida orthopsilosis,Candida metapsilosis,Candida fermentati,Candida nivariensis and Candida bracarensis were differentiated by molecular biological methods.Finally,the composition and distribution of pathogens in superficial candidiasis cases were statistically analyzed.Results A total of 1366 Candida strains,included 2 Candida orthopsilosis strains and 4 Candida metapsilosis strains,were isolated from these cases.Among these isolates,Candida albicans predominated(79.0％),followed by Candida parapsilosis(9.5％),Candida tropicalis(2.9％)and Candida guilliermondii(1.9％).The composition of Candida species was significantly different between child and adult patients(x2 =196.46,P ＜ 0.01),with the isolation rate of non-albicans Candida species being 14.4％ and 45.8％ respectively in child and adult patients.Conclusions Candida albicans is still the dominant pathogen of superficial candidiasis.Candida orthopsilosis and Candida metapsilosis can cause superficial candidiasis.The isolation rote of non-albicans Candida species is higher in adult patients than in child patients.

Objective To investigate the value of CT perfusion imaging in evaluation of therapeutic effect and prognosis in radiotherapy for lung cancer.Methods Fifty-one cases of lung cancer who were unable or refused to be operated on,36 males and 15 females,aged 37 - 80,underwent CT perfusion imaging,29 of which only before radiotherapy and 22 before and after radiotherapy twice.The images were collected by cine dynamic scanning (5 mm/4 slices ) and input into the GE AW4.0workstation for data processing.The slice positions of CT imaging were determined according to the largest tumor size in CT scan.Regions of interest of tumor were drawn at the region corresponding to the original images of CT perfusion.Radiotherapy was performed after CT perfusion imaging.Relevant parameters,including blood flow ( BF),blood volume ( BV),mean transit time ( MTT),and permeability surface (PS) were calculated.The treatment response after radiotherapy was evaluated by RECIST.At 2 -4 weeks after the treatment,CT examination was conducted once more.Results The tests of the 51 patients showed that the BV was 13.6 ml·100 g-1,the BF was 129.5 ml·min-1 ·100 g-1,the MTT was 9.1 s,and the PS was 10.0 ml· min- 1· 100 g-1 before radiotherapy.The tests of the 22 of the 51 patients showed that the values of BV and BF after radiotherapy were 7.6 ml· 100 g-1 and 97.8 ml·min-1· 100 g-1,respectively,both lower than those before radiotherapy (11.2 and 108.7 ml·min-1·100g-1,respectively),however,both not significantly ( t =1.28,0.40,P ＞ 0.05 ) ; and the values of MTT and PS after radiotherapy were 8.9 s and 7.8 ml·min-1· 100 g-1,respectively,both not significantly higher than those before radiotherapy ( 7.2 s and 6.8 ml· min -1· 100 g-1,respectively,t =- 1.15,- 0.57,P ＞0.05 ).The mean area of tumor after radiotherapy was 1189.6 mm2,significantly less than that before radiotherapy ( 1920.3 mm2,t =3.98,P ＜0.05).The MTT of the SCLC patients was 12.9 s,significantly longer than that of the NSCLC patients (6.5 s,t =2.54,P ＜0.05).The MTT of the tumor with the area ≤ 10 cm2 was 11.2 s,significantly longer than that of the tumors with an area ＞ 10 cm2(5.8 s,t =2.59,P ＜ 0.05 ).The BV of the responder group was 19.2 ml· 100 g- 1,significantly higher than that of the nonresponder group (4.6 ml· 100 g - 1,t =3.62,P ＜ 0.05 ).There were not significant differences in all the perfusion characteristics between the cases with the disease-free advanced survival time ≤ 10 months and those with disease-free advanced survival time ＞ 10 months.Conclusions CT perfusion imaging helps in diagnosis and radiotherapy of lung cancer to a certain degree.

Objective To analyze the therapeutic effect of three-dimensional conformal involvedfield radiotherapy (3D-CRT)combined with chemotherapy on limited disease stage small cell lung cancer (LD-SCLC).Methods The clinical data of 85 patients of LD-SCLC treated with 3D-CRT at the dose of 2 Gy/fraction,5 fractions per week for 5 - 7 weeks,with the median dose of 50 Gy ( 46 - 66 Gy),combined with 4 -8 cycles chemotherapy,64 males and 21 females,aged 29 -76,were collected and analyzed.Results The complete remission rate,partial remission rate,stability rate,and total effective rate were 36.5％,52.9％,10.6％,and 89.4％,respectively.The median survival time was 18 months,with the 1-,2-,and 3-year overall survival rates of 65.9％,33.8％,and 15.9％,respectively.The local recurrence rate,distant metastasis rate,and local recurrence + distant metastasis rate were 15.2％ (9/85),49.2％ (29/85),and 35.6％ (21/85),respectively.Body weight,response to therapy,cycles for chemotherapy,and concurrent chemo-radiotherapy were all independent prognostic factors for LD-SCLC.Cox muhivariable regression was used to analyze the prognostic factors.Conclusions Involved-field radiotherapy is effective for LD-SCLC.Distance metastasis is the main cause of treatment failure.

Objective To investigate the expression and distribution of plasmacytoid dendritic cells(pDC) in peripheral blood and renal tissues in children with Henoch-SchSnlein purpura(HSP),and explore the role of pDCs in the pathogenesis of Henoch-Schtnlein purpura nephritis(HSPN).Methods Among the 40 children with HSP,28 cases were in the active phase(renal biopsy performed in 8 cases of them) and the other 12 in remission phase.Peripheral blood mononuclear cells were isolated,and the expression of pDC was detected by flow cytometry.The normal control group was established (n =15).Total RNA of peripheral blood was extracted and transcripted into cDNA.Sybr green dye based real-time quantitative PCR method was used to compare the expression(indicated as 2-△Ct value) of CXC motif chemokine 10 (CXCL10),CC chemokine ligand 5 (CCL5),chemokine CXC subfamily receptor 3 (CXCR3),CC chemokine receptor 5 (CCR5) in children with HSP and those in the controls.Immunohistochemistry labeling technique was used to detect the distribution of pDC in renal tissues from renal biopsy,and the normal controls were established (n =3).Results The expression percentage of pDC in peripheral blood in active phase was 0.051 ± 0.039,significantly lower than those in remission phase (0.181 ± 0.082) and the normal controls (0.166 ± 0.079) (P ＜ 0.000 1).Chemokines genes CXCL10 and CCL5 were overexpressed in peripheral blood ceils of acute phase HSP children,but chemokine receptors CXCR3,CCR5 were lowly expressed compared with normal controls.There was almost no expression of pDC in the normal control renal tissues,while pDC was infiltrated in glomeruli of HSPN children.Conclusions The number of pDC and chemokines' expression in peripheral blood is abnormal,and the pathogenesis of nephritis may be involved with the pDC in peripheral blood to migrate to the renal tissues.

Artificial intelligence (AI) is an emerging science and technology that studies and develops theories, methods, technologies, and application systems for simulating and expanding human intelligence. AI has made great breakthroughs in the field of intelligent medicine, and has shown great potential in the diagnosis and treatment of diabetic retinopathy (DR), retinopathy of prematurity, and other fundus diseases. A number of clinical trials on the application of AI technologies to DR screening have been carried out in the domestic and overseas, which not only have a high accuracy rate, but also save doctors' reading time and reduce the burden of society, medical work and patients. However, due to the lack of evaluation system for DR intelligent diagnosis technology, the accuracy of AI system still lacks of big data verification. Secondly, most of the color fundus photographs are taken in the posterior 45°, which only show the most vulnerable areas, making some lesions undetectable. In addition, the current DR screening system has not yet been applied to the clinic, most of which are in the stage of prospective research and trials. There are still many obstacles from the environment to the hospital or the clinic. Doctors cannot use real patient data to evaluate the AI system, so it is not popular in clinical practice. In the future, DR screening algorithms and diagnostic models can be further improved and established to make DR AI screening more accurate.

Objective:To investigate the clinical significance of serum resistin in juvenile idiopathic arthritis(JIA) patients.Methods:A prospective observational study was performed and 32 cases of patients with systemic onset JIA(SOJIA)(SOJIA group) in children admitted to the nephrorheumatology and outpatient were enrolled at Children′s Hospital of Shanghai between October 2013 and September 2015, 52 cases of other types(N-SOJIA group), and 33 cases of other rheumatic diseases(other rheumatic diseases group), 30 cases of children undergoing health checkups in the child health outpatient clinic(healthy control group)were involved as well.Serum resistin levels were measured by enzyme-linked immunosorbent assay(ELISA), and comprehensive analysis was carried out with clinical data and related laboratory findings.The basic data of gender, age and body mass index(BMI) of each group were collected, and the duration of disease in children in JIA group, rheumatoid factor, antinuclear antibody, white blood cell, hemoglobin, platelet, C reacting protein(CRP), erythrocyte sedimentation rate(ESR), clinical manifestations and current drug use were collected.Using the receiver operating characteristic(ROC)curve analysis of sensitivity and specificity resistin levels in diagnostic systemic juvenile idiopathic arthritis.Results:There was no statistically significant difference in the age, gender and BMI of children in SOJIA group, N-SOJIA group, other rheumatism group and healthy control group.Children in the SOJIA group and the N-SOJIA group had arthritis in clinical manifestations.Fever and rash were more common in the SOJIA group, and the difference was statistically significant ( P<0.01). Laboratory results showed that the sedimentation rates of white blood cells, CRP, and red blood cells were in the SOJIA group was significantly elevated.The antinuclear antibody was mainly found in the N-SOJIA group with a higher positive rate ( P<0.05). The mean serum resistin in the SOJIA group [(17.98±13.78) mg/L] was higher compared to the healthy control group [(1.84±1.66) mg/L], other rheumatic diseases group [(8.00±6.28) mg/L]and the N-SOJIA group [(9.86±6.11) mg/L], the differences were statistically significant ( F=21.625, P<0.01). Resistin was positively correlated with white blood cells and CRP( r=0.532, 0.351, all P<0.05), and had no correlation with BMI, hemoglobin, platelets, and ESR( r=0.059, -0.176, 0.152, 0.203, all P>0.05). Based on serum resistin≥5.55 mg/L as the positive threshold value, the area under ROC curve was 0.802, and the sensitivity and specificity in diagnosis of SOJIA was 96.9% and 49.6%, respectively. Conclusions:Serum resistin is increased in patients with JIA, especially in SOJIA increased significantly; Serum resistin can be used for the diagnosis of SOJIA, and ≥5.55 mg/L can be a suitable cut-off level.