SUMMARY Therapy-related acute myeloid leukemia (tAML) is one of the two forms of secondary acute myeloid leukemia, with one derived from de novo myelodysplastic syndrome (MDS) and the other from exposure to environmental or therapeutic agents such as radiation and toxins. There has been a marked increase in the number of incidences of therapy-related acute myeloid leukemia. It has become a distinctive disease because of its etiology and genetic tumorigenesis. The majority of tAML resulting from the use of cytotoxic agents can be divided into two groups based on the drugs administered to the patient. The first group includes the use of alkylating agents, and the second group includes agents that bind to the enzyme DNA-topoisomerase Ⅱ. Due to the unfavorable outcome of the disease and the need for prompt intensive treatment, a timely accurate diagnosis of tAML is critical to patient care. Cytogenetic study can detect abnormalities most commonly associated with tAML and thus providing important diagnostic information. However, utilizing cytogenetic analysis alone cannot guarantee prompt and accurate results. In this study, an interesting case with therapy-related myelodysplastic syndrome and acute myeloid leukemia (tMDS/tAML) will be presented. A laboratory diagnostic strategy for tAML laboratory diagnosis will also be proposed.

Objective To analyze the epidemic characteristics of HIV/AIDS among older adults in Chongqing,and to provide scientific evidence for developing prevention and control measures.Methods The data were collected through the national AIDS reporting information system,SPSS 17.0 was used to analyze the data.Results From 2001 to 2015,a total of 10495 cases had been reported accumulatively,and HIV/AIDS cases was accounting for 31.1％.The study was showed that the main infection people was man and the main professional was the main farmer.Moreover,the main infection was heterosexual transmission and accounting for 91.5％.Conclusion The epidemic of HIV/AIDS aged over 50 was on the rapid rise from 2001 to 2015 in Chongqing,the publicity and education should be focused on them,to improve the relevant awareness and reduce their risk behavior.

The paper introduces the definition of smart phone,operating mobile communication network and hidden danger about safety,and definition and advantages of SSL VPN,states the application of SSL VPN technology in the direct network report of epidemic situation information of infectious diseases combining with SSL VPN technology and remote connection,analyzes the work principle and specific operation process,achieves safety login to the China Information System for Disease Prevention and Control with smart phones,and completes normal business data processing.

In China, fall ranks the top 3 among adverse events in hospital and it is the first cause of death in the elderly aged 65 and above. Fall risk factors and characteristics, nursing assessment and nursing care interventions are reviewed in this paper to explore risk factors and further improve the nursing care interventions for falls in hospitalized elderly patients.

Objective To compare clinical biochemical and pathological characters among antimitochondrial antibody-negative primary biliary cirrhosis (AMA PBC),AMA positive PBC (AMA+ PBC)and autoimmune hepatitis (AIH),and try to find serum biomarkers in the diagnosis of AMA-PBC.Methods From January 2005 to May 2013,23 patients with AMA-PBC,102 patients with AMA+ PBC and 55 patients with AIH were collected.Clinical features of patients were observed.Biochemical indexes (total bilirubin (TBil),direct bilirubin (DBil),alanine aminotransferase (ALT),aspartate transaminase (AST),alkaline phosphatase (ALP),γ-glutamyltransferase (GGT) and globulin) were tested.Immunological indexes immunoglobulin ((Ig)G,IgM and IgA) were also measured.Antinuclear amibody,anti smooth muscle antibody (SMA) and AMA were detected by indirect immunofluorescence.Soluble acidic phosphorylation nucleoprotein antibody and anti-nuclear membrane glycoprotein antibody were detected by Western blotting.Non parameter test was for non normal distributed measurement data and grade data comparison.The cut off value,sensitivity and specificity of IgM in the diagnosis of PBC were calculated with receiver operating characteristic (ROC) curve.The sensitivity and specificity of soluble acidic phosphorylation nucleoprotein antibody and anti-nuclear membrane glycoprotein antibody in the diagnosis of PBC were analyzed with fourfold table.Results The rates of fatigue and jaundice of AMA-PBC group (39.1％,9/23 ; 43.5 ％,10/23) were both higher than those of AIH group (16.4 ％,9/55; 14.5 ％,8/55),and the differences were statistically significant (x2 =4.735 and 7.648,both P＜ 0.05).The levels of ALP and GGT of AMA PBC group were higher than those of AIH group,and the levels of ALT and AST were lower than those of AIH group (Z=-4.577,-4.257,-2.820 and -2.055,all P＜0.05).The level of IgM of AMA PBC group (417(270,610) mg/L) was higher than that of AIH group (97(69,195) mg/L),however lower than that of AMA+ PBC group (546(419,704) mg/L),and the differences were statistically significant (Z=-4.362 and-0.210,both P＜0.05).The level of IgG of AMA PBC group was lower than that of AIH group (Z=-2.202,P＜0.05).The positive rates of antinuclear antibody and SMA of AMA PBC group (95.7％ (22/23),8.7％ (2/23)) were both higher than those of AMA+ PBC group (33.3％(34/102),1.0％(1/102)),and the differences were statistically significant (x2 =29.474 and 4.769,both P＜0.05).The positive rates of soluble acidic phosphorylation nucleoprotein antibody and anti nuclear membrane glycoprotein antibody of AMA PBC group (60.9％,14/23; 30.4％,7/23) were both higher than those of AIH group (2.0％,1/55; 0),and the differences were statistically significant (x2=36.409 and 24.329,both P＜0.05).The karyotype of antinuclear antibody of AMA PBC and AMA+ PBC group mainly was granules pattern (60.9 ％,14/23;75.5％,77/102),however of AIH group was mainly homogeneous pattern (38.2％,21/55).If the cut off value of IgM was 277 mg/L,the sensitivity and specificity of IgM in the diagnosis of PBC was 72.2％ and 94.4 ％.The sensitivity and specificity of soluble acidic phosphorylation nucleoprotein antibody in the diagnosis of PBC was 24.1％ and 97.2％.The sensitivity and specificity of anti-nuclear membrane glycoprotein antibody was 35.2 ％ and 100.0 ％.The sensitivity and specificity of any one of anti-nuclear membrane glycoprotein antibody positive,soluble acidic phosphorylation nucleoprotein antibody positive or IgM＞277 mg/L in the diagnosis of PBC was 88.9％ and 94.4％.Conclusions AMA-PBC and AMA+ PBC have similar clinical manifestations and serum biochemical test results.Antinuclear antibody and/or SMA positive is the feature of AMA-PBC and which should be distinguished with AIH.The sensitivity and specificity of any one of the followiags:anti nuclear membrane glycoprotein antibody positive,soluble acidic phosphorylation nucleoprotein antibody positive or IgM＞277 mg/L is high in the diagnosis of PBC.

Objective To investigate the value of spiral CT in therapy observation during and after radiofrequency ablation (RFA) for lung or liver tumors. Methods Spiral CT-guided RFA were performed in 35 patients (38 lesions) with lung or liver tumors. CT value of lesions during operation and the changes of lesions after operation were observed. Results Thirty-eight lesions were accurately located under spiral CT. The position of the electrode and the expension of claw-like thin needle electrode could be observed directly. CT value of lesions decreased and some gasification foci in some lesions were observed after RAF therapy. One month after RFA, tumor volume decreased, and the tumors present as slightly low-density mass on contrast-enhanced CT. The total effective rate of RFA was 85.71% (30/35). Conclusion Spiral CT is able to accurately guide RFA treatment for lung or liver tumors and evaluate the efficacy of therapy.

This study explored the molecular mechanisms underlying the time-dependent autophagy and apoptosis induced by nutrient depletion in human multiple myeloma cell line RPMI8226 cells. RT-PCR and qRT-PCR were used to evaluate the transcriptional levels of Deptor, JNK1, JNK2, JNK3, Raf-1, p53, p21 and NFκB1 at 0, 6, 12, 18, 24 and 48 h after nutrient depletion in RPMI8226 cells. We found that transcriptional levels of Deptor were increased time-dependently at 0, 6, 12 and 18 h, and then decreased. Its alternation was consistent with autophagy. Transcriptional levels of Raf-1, JNK1, JNK2, p53 and p21 were increased time-dependently at 0, 6, 12, 18, 24 and 48 h accompanying with the increase of apoptosis. Transcriptional levels of NFκB1 at 6, 12, 18, 24 and 48 h were decreased as compared with 0 h. It was suggested that all the studied signaling molecules were involved in cellular response to nutrient depletion in RPMI8226 cells. Deptor contributed to autophagy in this process. Raf-1/JNK /p53/p21 pathway may be involved in apoptosis, and NFκB1 may play a possible role in inhibiting apoptosis. It remained to be studied whether Deptor was involved in both autophagy and apoptosis.

Objective Investigations regarding the status of pediatric emergency and relevant facilities distribution in our province represent a crucial prerequisite for further setting up emergency network and improving our first aid capabilities.Methods We had conducted relevant surveys on the medical institutions within our province,including lever 2 and lever 3 hospitals as well as maternal and child care service centers.Results The feedback from 151 institutions indicated that they had 4485 pediatric beds and treated 5 308 severe patients in 2010.Among all,38 hospitals had ventilators for children and 4 hospitals could perform pediatric blood purification treatment.However,no one had mastered the children ECMO technique.Conclusion There is an inadequacy of some emergency equipments and the development in emergency and first aid is uneven.There is a strong request to launch and develop the blood purification and bronchfiberscope techniques,in combination with improvements in the first aid capabilities and emergency network.

Objective To study the factors related with balance ability of the elder.Methods 37 persons above 60 years were assessed with the balanced function reflectoscope reflector,grouped according to their exercise practice.Results The length of locus and length/envelope area as eyes closed increased significantly compared with that as eyes opened in the less exercise group(P<0.05),while they were increased significantly compared with those in the more exercise group either when eyes closed or opened(P<0.05).Conclusion The exercise practice can improve the balances function of the old persons.