Objective To explore the diagnostic value of protein induced by vitamin K absence or antagonist-Ⅱ (PIVKA-Ⅱ) in non-infant with acquired deficiency of vitamin K-dependent coagulation factors (ADVKCF).Methods PIVKA-Ⅱ levels were measured by ELISA in 50 patients with ADVKCF on day 0,3,7 after vitamin K treatment.Prothrombin time(PT),APTT,FⅡ ∶ C,FⅦ∶ C,FⅨ∶ C,and FⅩ∶ C were analyzed simultaneously.Twenty healthy subjects were enrolled as controls.Results The average level of PIVKA-Ⅱ in ADVKCF group was (3.83 ± 1.40) μg/L,while (1.30 ± 0.54) μg/L in the control group (P ＜ 0.05).The PIVKA-Ⅱ levels on day 0 and 3 did not show significant difference [(3.83 ± 1.40) μg/Lvs (3.79 ± 0.66) μg/L,P ＞ 0.05],but decreasing significantly on day 7 compared to the control group (P ＜ 0.05).The PIVKA-Ⅱ level was (3.78 ± 1.30) μg/L in patients receiving plasma transfusion,while (3.91 ± 1.49)μg/L in no-plasma-transfusion group (P ＞ 0.05).Coagulation factors Ⅱ,Ⅶ,Ⅸ and Ⅹ activity which decreased significantly before treatment returned to normal range after one week use of vitamin K,leading to complete correction of prolonged APTT and PT (＞ 100 seconds).Conclusions The PIVKAⅡ level in ADVKCF patients is significantly higher than that of healthy subjects within one week treatment of vitamin K,which is not influenced by plasma transfusion.This study suggests that PIVKA-Ⅱ is a more sensitive parameter than APTT,PT and the activity of coagulation factor,which could be a valuable factor in the early diagnosis of ADVKCF.

AIM:To explore the therapeutic effect of a novel Rho kinase inhibitor WAR 5 on the experimental autoimmune encephalomyelitis (EAE) and its possible mechanism.METHODS: Female C57BL/6 mice were randomly divided into EAE group and WAR5 group.EAE model was induced by the application of MOG 35-55 peptide.WAR5 was in-jected intraperitoneally every other day from post-immunization (PI) day 3 to PI day 27.The clinical score and body weight were recorded every other day .On PI day 28, the animals were sacrificed and spinal cords were obtained for HE and mye-lin staining .The splenocytes were isolated and the expression of CD 16/32 and CD206 were analyzed by flow cytometry . The protein extracts from the brains and spinal cords were collected for the measurement of inducible nitric oxide synthase ( iNOS) by Western blotting .RESULTS:The administration of WAR 5 delayed the onset of EAE and attenuated the clini-cal symptoms .The results of the pathological examination revealed that WAR 5 inhibited the infiltration of inflammatory cells and improved myelination in spinal cords , accompanied with the poralization of M 1 macrophages to M2 phenotype in the spleen.WAR5 inhibited the expression of iNOS in the central nervous system , especially in the spinal cords .CON-CLUSION:The therapeutic effect of WAR5 on EAE may be related to the shift of M1 macrophages to M2 phenotype and inhibition of inflammation in the central nerve system .

Objective To explore the clinical features and causes of misdiagnosis of the patients with acquired deficiency of vitamin K-dependent coagulation factors (ADVKDCF). Methods Retrospective analysis was performed with the data from 62 patients with ADVKDCF for etiological factors, clinical manifestations,laboratory examinations, diagnosis and treatments. Results Among the 62 patients, 51 patients were with unknown causes( subgroup A) and 11 were with clear histories of anticoagulant rodenticide poisoning( subgroup B). The presentations of hemorrhage of the patients varied with hematuria as the most common first symptom,followed by skin, mucosa, muscle, internal organs bleeding (28/62). The most common hemorrhage symptom is hematuria. 35 of the 62 patients had hemoglobin(Hb) levels less than 100 g/L due to blood loss( the lowest level was 32 g/L). Thirty-eight patients were misdiagnosed at the first visit and the median time from hemorrhage manifestation to definite diagnosis was 8 days (range,2 to 192 days). ADVKDCF was mostly misdiagnosed as the urinary system diseases (23/38), followed by hemophilia (8/38). Laboratory examinations showed normal platelet count , throm bin time (TT) and normal fibrinogen(Fg) concentration, but prolonged plasma prothrombin time (PT), activated partial prothrombin time (APTT) and international normalized ration (INR). All of patients received high dose vitamin K ( intravenous vitamin K1 with a initial dose of 20 to 240 mg/d and then oral vitamin K4 maintenance) . The bleeding symptoms disappeared 1 day after treatment and the Hb levels increased dramatically. There were significant differences in PT, APTT and INR of the patients before and after treatment( P ＜0. 01 ). Followed by a median follow - up of 8 months , no patient had severe adverse effects or recurrence. Conclusion The hemorrhage presentations of the patients with ADVKDCF are various. The most common hemorrhage symptom is hematuria. The misdiagnosis rate of ADVKDCF is high with urinary systems disorders as the most common misdiagnosis. Sequential treatment with vitamin K is an effective and safe method to prevent recurrence. Early detection of coagulation function is helpful to reduce misdiagnosis possibility.

Objective:To study the relationship between cognitive ability and plasma monoamine neurotransmitters in children with acute lymphoblastic leukemia.Methods:The clinical data of 31 children with acute lymphoblastic leukemia from October 2018 to April 2019 in Tongji Hospital Affiliated to Tongji University were retrospectively analyzed. Among them, 20 cases were in consolidation or intensive treatment stage after complete remission (treatment stage group), and 11 cases were in complete remission and drug withdrawal after treatment (withdrawal group). The plasma levels of dopamine (DA), 5-hydroxytryptamine (5-HT) and 5-hydroxyindoleacetic acid (5-HIAA) were measured, the cognitive function was measured by continuous performance test (CPT) and Stroop test, and the results were compared with those of 20 healthy children (healthy control group).Results:There were no statistical differences in plasma DA and 5-HIAA among 3 groups ( P>0.05). The 5-HT in treatment stage group was significantly lower than that in healthy control group: 1 769.69 (912.86, 2 812.56) ng/L vs. 3 085.29 (2 191.79, 5 310.13) ng/L, and there was statistical difference ( P<0.05). There was no statistical difference in 5-HT between withdrawal group and healthy control group ( P>0.05). CPT results showed that there was no statistical difference in the number of errors among 3 groups ( P>0.05); the correct number in treatment stage group and withdrawal group was significantly less than that in healthy control group: (28 ± 12) and (33 ± 11) pieces vs. (43 ± 10) pieces, the missed number was significantly higher than that in healthy control group: (53 ± 14) and (52 ± 13) pieces vs. (39 ± 14) pieces, and there were statistical differences ( P<0.05). Stroop test results showed that, there was no statistical difference in word-color consistency test among 3 groups ( P>0.05); in word-color contradiction test, the correct number in treatment stage group and withdrawal group was significantly less than that in healthy control group, the number of errors and missed were significantly more than those in healthy control group, and there were statistical differences ( P<0.05); in word color irrelevance test, there was no statistical difference in the number of errors among 3 groups ( P<0.05); the correct number in treatment stage group and withdrawal group was significantly less than that in healthy control group, the number of missed errors in withdrawal group was significantly more than that in healthy control group, and there were statistical differences ( P<0.05). The correlation analysis results showed that plasma DA was negatively correlated with the number of errors in Stroop word-color consistency test, and positively correlated with the number of errors in Stroop irrelevance test ( P<0.05); 5-HIAA was negatively correlated with the correct numbers in CPT test and error number in Stroop consistency test ( P<0.05 or<0.01); 5-HT was positively correlated with the correct number in the word-color contradiction test ( P<0.05) in children with acute lymphoblastic leukemia. Conclusions:Children with acute lymphoblastic leukemia could have continuous and selective attention injury, after being diagnosed with leukemia, the level of 5-HT in plasma monoamine neurotransmitter is lower than that in healthy children. The change of attention may be related to the change of monoamine neurotransmitter.

Subcutaneous panniculitis-like T-cell lymphoma (SPTL) is an extremely rare, indolent skin malignancy that can be difficult to distinguish from autoimmune disease-associated panniculitides. Here, we describe a 12-year-old boy who was diagnosed at age 7 years with dermatomyositis with classical manifestations, including poikiloderma, Gottron’s sign, and symmetric muscle weakness. Recently, the boy presented multiple subcutaneous nodules and fever. Histopathological examination and immunohistochemical staining revealed coexistence of SPTL. To our knowledge, this is the first case of dermatomyositis accompanied with SPTL. This case alert clinical physicians of the possibility of SPTL should be considered when a patient with dermatomyositis has new lesions presenting as nodules and unknown fever.

Objective To establish a mathematical model of tumor growth and invasion under radiotherapy, so as to numerically simulate the effect of radiotherapy on tumor growth and make sensitivity analysis.Methods The mathematical model of tumor growth and invasion with time evolution before and after radiotherapy was established. The model included four key variables in the process of tumor invasion: tumor cells, extracellular matrix (ECM), matrix-degradative enzymes (MDEs) and oxygen. The linear quadratic (LQ) model was used to simulate the survival probability of tumor cells after radiotherapy, and the effects of different radiotherapy schemes and radiotherapy coefficients on the treatment effect were discussed. Traditional radiotherapy and intraoperative targeted radiotherapy were compared.Results Under the premise of constant total dose, the results of radiotherapy were directly proportional to the radiotherapy coefficient, but not related to the radiotherapy frequency; the therapeutic effect of intraoperative targeted radiotherapy was better than that of standard treatment.Conclusions Simulation results are basically consistent with clinical experimental results. As a more efficient treatment method, intraoperative targeted radiotherapy can provide new ideas for clinical tumor treatment.

How to extract high discriminative features that help classification from complex resting-state fMRI (rs-fMRI) data is the key to improving the accuracy of brain disease recognition such as schizophrenia. In this work, we use a weighted sparse model for brain network construction, and utilize the Kendall correlation coefficient (KCC) to extract the discriminative connectivity features for schizophrenia classification, which is conducted with the linear support vector machine. Experimental results based on the rs-fMRI of 57 schizophrenia patients and 64 healthy controls show that our proposed method is more effective ( ., achieving a significantly higher classification accuracy, 81.82%) than other competing methods. Specifically, compared with the traditional network construction methods (Pearson's correlation and sparse representation) and the commonly used feature selection methods (two-sample -test and Least absolute shrinkage and selection operator (Lasso)), the algorithm proposed in this paper can more effectively extract the discriminative connectivity features between the schizophrenia patients and the healthy controls, and further improve the classification accuracy. At the same time, the discriminative connectivity features extracted in the work could be used as the potential clinical biomarkers to assist the identification of schizophrenia.
Algorithms ; Brain ; Brain Mapping ; Humans ; Magnetic Resonance Imaging ; Schizophrenia ; diagnostic imaging