Objective To evaluate correlations between CT features and clinical activity index of Crohn’s disease(CD).Methods The CTE datasets from 37 patients with moderate active,severe active and remission stages CD were retrospectively analyzed.To ob-serve imaging features of intestinal wall,parenteral and complications.And analyze whether there was an association between imaging findings and clinical activity.Results A total of 147 bowel segments in 37 cases were involved.Wall thickening (intestinal wall≥4 mm)were observed in 121 segments.An average thickness was (12.1±3.2)mm.There are 42 bowel segments of trilaminar mural stratifica-tion,71 of the double-layed stratification and 34 of non-stratification.Enlarged mesenteric lymph nodes were observed in 20 patients. Comb sign was observed in 27 patients.Higher density of surrounding fat appeared in 22 cases.The other 37 cases inluced 4 cases with abdominal abscess,7 cases with fistula,1 6 cases with intestinal obstruction or stenosis and 1 7 cases of perianal disease.The in-testinal stratification,wall thickening,comb sign,mesenteric fat density increased,abdominal abscess,intestinal stenosis and obstruc-tion were closely associated with clinical activity.Conclusion CTE images could provide information about intestinal wall,parenteral changes and complications of Crohn’s disease,and effectively help identifying remission and active stages of Crohn’s disease.

Objective To study the characteristics of cognitive development of newborns with auditory event related potentials (aERP).Methods Thirty full-term neonates who were admitted to Changzhou Children's Hospital and met the inclusion criteria, those with neonatal neural behavioral score over 37 and both ears passed the hearing screening, and exclusion criteria, those who suffered from perinatal brain injury, were sclccted randomly.Thcy wcre divided into three groups according to the days of age (group 1 : 1-10 days;group 2:11-20 days;group 3:21-28 days).aERP was recorded with auditory Oddball paradigm.The data were collected and analyzed by Brain Electrical Source Analysis software.Relationship between N2latencies/areas among the three groups and their age was researched with Pearson correlation analysis.Results During the neonatal period, there was a significant negative correlation between N2 latency and neonatal age in days (r=-0.609, P ＜ 0.05), while significant positive correlation was shown between N2 area and the age (r=0.689, P ＜ 0.05).In Fz and Cz leads, the total average waveform diagram of the three groups showed spacious flat, less smoothed curve, and mostly jagged pattern.N2 area in group 1 showed a complex plurality of peaks, and regular, soaring waves, which changed into single wave thereafter, in group 2 and 3.The N2 latencies tended to shorten gradually.Conclusions Neonatal cognitive competence, including concentration and discrimination ability, would be improved with their growth.

Objective To explore Chinese character semantic processing feature and the relationship with behavioral problems in early childhood with ADHD.Methods Twenty ADHD children and twenty normal children (7-8 years old) performed a Chinese character semantic judgment task through event related potential (ERP),meanwhile Conners parent rating scale (PSQ) was completed by parents to analyze behavior problems in children.The relationship between behavioral problems and ERPs was analyzed.Results (1) ADHD group showed smaller amplitudes of P200 compared to the normal group (related (6.6±4.8) μV vs (11.6±6.4) μV;unrelated (6.7±3.7) μN vs (10.8±5.0) μV),and longer latency (related(240±30) ms vs (198±17)ms;the unrelated (232±26)ms vs (194±16)ms;psudoword (233±26)ms vs (197±15)ms),all P＜0.05).The amplitudes of N400 wave only showed a decreasing trend in ADHD group(P＞0.05),while the latency of N400 was significantly longer than that in normal children in three conditions(P＜0.05).(2) Four subscale scores of CPSQ(conduct problem,learning problem,hyperactivity-impulsion and hyperactivity index) were significantly higher in ADHD children compared with normal group.(3)The amplitudes of P200 in related condition had negative correlation with the scores of CPSQ subscale (conduct problem,psychoso matic disorder,hyperactivity-impulsion and hyperactivity index) (r=-0.51,-0.47,-0.45,-0.46,all P＜0.05.The latency of P200 in related condition had positive correlation with psychosomatic disorder scores (r =0.54,P=0.01).Conclusion Early semantic recognition disorder exists in 7～ 8 years old ADHD children.P200 can be used as an objective index to evaluate early childhood ADHD's language cognition,and P200 is related to behavior problems (such as conduct problem,impulsions).

Objective To investigate methods for prenatal molecular diagnosis of fetuses at high risk for X-linked adrenoleukodystrophy(X-ALD).Methods The amniotic fluid was obtained and genomic DNA was isolated from amniotic fluid cells.Maternal contamination was evaluated by paternity test.PCRRFLP,sequencing and denaturing high performance liquid chromatography(DHPLC)were used to detect the ABCD1 gene of fetal genome.Results In the pedigree 1,the PCR product(799 bp)of the fetus 1 and her father(normal control)could be digested with BcnI. No P560L mutation,which was present in the index patient,was detected in the ABCD1 gene from the genomic DNA of the fetus 1 using direct sequencing.In the pedigree 2,the PCR product(232 bp)of the fetus 2 and her father could not be digested with MaeI and no Q177X mutation,which was present in the propositus,was detected in the ABCD1 gene from the genomic DNA of the fetus 2 using direct sequencing.In the pedigree 3,the PCR product(271 bp)was digested with AciI.the pattern of the fetus 3 and the propositus being the same,and the R617C mutation was found in the ABCD1 gene from the genomic DNA of the fetus 3 using direct sequencing.In the pedigree 4,the PCR product(269 bp)was analyzed with the DHPLC,and the pattern of elution peaks of the fetus 4 and her father was similar,but different from that of the propositus.No K276E mutation was detectable in the ABCD1 gene from the genomic DNA of the fetus 4 by using direct sequencing.Judging from the sex of the fetuses,fetuses 1 and 2 were normal homozygotes,fetus 3 was an ALD hemizygote,and fetus 4 was a normal hemizygote.Conclusion A new protocol for X-ALD prenatal molecular diagnosis is proposed,which would ensure the accuracy of prenatal diagnosis.

Objective To know the stability of 3 kinds of traditional Chinese drug injection with different solvent under different temperature and different storage time,and then reference to safty of clinical durgs. Methods Use particle analyzer,UV SpectropHotometer,pH Determination of three traditional Chinese medicine injection,at different temperatures and different times,the nuanber of particles,pH value,the value of UV absorbance Observe changes. Results The records of experimental data by repeated measures analysis of statistics: Ciwujia Injection,Aidi injection combined with normal saline solution after the particles of ≥ 10μm excess pharmacopoeia standards; ≥ 2μm number of particles is considerable,in the 32～35℃,Ciwujia at T=O min Aidi at T=I80 min ,the number of particles are smaller and with statistical significance,its pH value of the standard range. Xuesaitong injection with glucose injection ≥ 10μm particulate mixture at a higher temperature in excess of pH annacopoeia standards,number of ≥ 2 μm particles in the 4～8℃ and 20～23℃,T=30 min and 60 min time less with statistical significance,and its range of pH value less than pHarmacopoeia. Three kinds of Chinese medicine in the Department's largest UV absorbance peak value and appearance almost unchanged. Conclusions Different drugs in their relative Suggestions of temperature,time and place under intravenous drug use,or better terminal filter,in order to improve the safety of clinical medication.

Objective The aim of this study is to evaluate the safety and efficacy of partial pancreatectomy as part of primary cytoreductive surgery in advanced epithelial ovarian cancer (EOC). Methods A total of 8 patients were recruited in this study who underwent partial pancreatectomy during the primary cytoreductive surgeries for advanced EOC in Fudan University Shanghai Cancer Center from April 2009 to July 2015. Their clinicopathological characteristics, diameter of metastatic tumors, the scope of cytoreductive surgeries, residual diseases after cytoreductive surgeries, postoperative complications and survival situation were retrospective analyzed. Results (1) Clinicopathological characteristics:the median age of these patients was 58 years old(range: 39-63 years old). The median value of preoperative serum CA125 was 1 688 kU/L(range: 119-5 000 kU/L). The median diameter of metastatic tumors involved in pancreatic body or tail was 4.5 cm (range:3-10 cm). All the tumors from the 8 patients were confirmed to be high-grade serous carcinoma. Four patients were staged as International Federation of Gynecology and Obstetrics (FIGO)Ⅳ, and the other 4 patients were staged as FIGOⅢc. (2) Tumor metastases and the scope of cytoreductive surgeries:all of these 8 patients had widely disseminated ovarian cancer, with involvement of upper abdominal, middle abdominal and pelvic cavity. Each patient underwent extensive intra-abdominal cytoreductive surgeries, including hysterectomy, bilateral salpingo-oophorectomy, omentectomy, pelvic periton-ectomy, splenectomy, partial pancreatectomy. Each patient had cytoreductive surgeries of 9.6 different sites on average. Of all 8 patients who underwent partial pancreatectomy, 7 patients had pancreatic tails removed;the other 1 patient had pancreatic body and tail removed. The median volume of blood loss during surgery was 1 350 ml(range:300-3 500 ml), blood transfusion was performed in 7 patients with the median volume of 1 150 ml (range: 500-1 800 ml). (3) Residual diseases after cytoreductive surgeries: optimal cytoreduction was achieved in all patients, with microscopic residual disease in 3 patients, residual tumors diameter < 0.5 cm in 3 patients, and residual tumors diameter between 0.5 and 1 cm in 2 patients. (4) Postoperative complications: 4 patients suffered from complications including pancreatic leakage (2/8), intraperitoneal hemorrhage (1/8) and pancreatic pseudocyst accompanied by infection (1/8). These complications were treated successfully by conservative managements. (5) Survival situation: during the median follow-up duration of 17 months (ranged from 2 to 46 months), 5 patients were still alive until the end of follow-up, including 4 cases under treatment and 1 case survived 29 months without relapse after treatment. Three patients were respectively died in 5, 20 and 46 months after surgery. Conclusion There is a higher risk of postoperative complications of pancreas resection as part of primary cytoreductive surgery in advanced epithelial ovarian cancer, but the resection of pancreatic metastases and part of the pancreas is feasible and necessary.

Objective To investigate the clinical effects of acupuncture combined with enema in the treatment of acute pelvic inflammatory, and its effects on uterine hemodynamics and seurm levels of high mobility group box-1 protein (HMGB1), toll-like receptor 4 (TLR4). Methods A total of 66 patients with acute pelvic inflammatory were enrolled in the study, randomly divided into the combination treatment group (n=33) and conventional treatment group (n=33). The patients in the combination treatment group were given with acupuncture combined with enema on the basis of conventional therapy. After 10 d treatment, the effective rate was observed. The changes of serum HMGB1 and TLR4 were compared and analyzed. Results After 10 d treatment, the total effective rate was 90.91% (30/33) in the combination treatment group, and 69.70% (23/33) in the conventional treatment group. There were statistically significant differences between the two groups (χ2=8.246,P<0.05).After treatment,the left Vmax(39.16 ± 0.73 cm/s vs.35.47 ± 0.83 cm/s),right Vmax(41.23 ± 1.12 cm/s vs.36.24 ± 0.75 cm/s),left PI(2.23 ± 0.25 cm/s vs.3.11 ±0.45 cm/s),right PI(2.17 ± 0.22 cm/s vs. 2.62 ± 0.23 cm/s),left RI(0.48 ± 0.08 cm/s vs.0.73 ± 0.13 cm/s)and right RI(0.43 ± 0.11 cm/s vs.0.71 ± 0.16 cm/s)of the combined treatment group were significantly superior to the conventional treatment group (all P<0.01). The levels of serum HMGB1(17.45 ± 5.01 ng/ml vs.21.32 ± 6.15 ng/ml,t=2.803)and TLR4(1.05 ± 0.64 ng/ml vs. 1.75 ± 0.91 ng/ml, t=3.614) in the combination treatment group were significantly lower than those in conventional treatment group (all P<0.01). Conclusions Acupuncture combined with traditional Chinese medicine enema treatment of acute pelvic inflammatory disease is better, improve the uterine hemodynamics. The mechanism may be related to inhibit the release of HMGB1, TLR4 and its induced inflammatory response.

OBJECTIVE: Distal pancreatectomy with splenectomy may be required for optimal cytoreductive surgery in patients with epithelial ovarian cancer (EOC) metastasized to splenic hilum. This study evaluates the morbidity and treatment outcomes of the uncommon procedure in the management of advanced or recurrent EOC. METHODS: This study recruited 18 patients who underwent distal pancreatectomy with splenectomy during cytoreductive surgery of EOC. Their clinicopathological characteristics and follow-up data were retrospectively analyzed. RESULTS: All tumors were confirmed as high-grade serous carcinomas. The median diameter of metastatic tumors located in splenic hilum was 3.5 cm (range, 1 to 10 cm). Optimal cytoreduction was achieved in all patients. Eight patients (44.4%) suffered from postoperative complications. The morbidity associated with distal pancreatectomy and splenectomy included pancreatic leakage (22.2%), encapsulated effusion in the left upper quadrant (11.1%), intra-abdominal infection (11.1%), pleural effusion with or without pulmonary atelectasis (11.1%), intestinal obstruction (5.6%), pneumonia (5.6%), postoperative hemorrhage (5.6%), and pancreatic pseudocyst (5.6%). There was no perioperative mortality. The majority of complications were treated successfully with conservative management. During the median follow-up duration of 25 months, nine patients experienced recurrence, and three patients died of the disease. The 2-year progression-free survival and overall survival were 40.2% and 84.8%, respectively. CONCLUSION: The inclusion of distal pancreatectomy with splenectomy as part of cytoreduction for the management of ovarian cancer was associated with high morbidity; however, the majority of complications could be managed with conservative therapy.
Adult ; Aged ; *Cytoreduction Surgical Procedures ; Disease-Free Survival ; Female ; Humans ; Middle Aged ; Neoplasms, Glandular and Epithelial/mortality/pathology/*surgery ; Ovarian Neoplasms/mortality/pathology/*surgery ; *Pancreatectomy/adverse effects ; Postoperative Complications/epidemiology/therapy ; *Splenectomy/adverse effects ; Splenic Neoplasms/pathology/*secondary/*surgery

OBJECTIVETo evaluate the validity and reliability of Diabetes Self-management Knowledge, Attitude, and Behavior Assessment Scale (DSKAB).

METHODSWe selected 460 patients with diabetes in the community, used the scale which was after two rounds of the Delphi method and pilot study. Investigators surveyed the patients by the way of face to face. by draw lots, we selected 25 community diabetes randomly for repeating investigations after one week. The validity analyses included face validity, content validity, construct validity and discriminant validity. The reliability analyses included Cronbach's α coefficient, θ coefficient, Ω coefficient, split-half reliability and test-retest reliability.

RESULTSThis study distributed a total of 460 questionnaires, reclaimed 442, qualified 432. The score of the scale was 254.59 ± 28.90, the scores of the knowledge, attitude, behavior sub-scales were 82.44 ± 11.24, 63.53 ± 5.77 and 108.61 ± 17.55, respectively. It had excellent face validity and content validity. The correlation coefficient was from 0.71 to 0.91 among three sub-scales and the scale, P<0.001. The common factor cumulative variance contribution rate of the scale and three sub-scales was from 57.28% to 67.19%, which achieved more than 50% of the approved standard, there was 25 common factors, 91 items of the total 98 items held factor loading ≥0.40 in its relevant common factor, it had good construct validity. The scores of high group and low group in three sub-scales were: knowledge (91.12 ± 3.62) and (69.96 ± 11.20), attitude (68.75 ± 4.51) and (58.79 ± 4.87), behavior (129.38 ± 8.53) and (89.65 ± 11.34),mean scores of three sub-scales were apparently different, which compared between high score group and low score group, the t value were - 19.45, -16.24 and -30.29, respectively, P<0.001, and it had good discriminant validity. The Cronbach's α coefficient of the scale and three sub-scales was from 0.79 to 0.93, the θ coefficient was from 0.86 to 0.95, the Ω coefficient was from 0.90 to 0.98, split-half reliability was from 0.89 to 0.95.Test-retest reliability of the scale was 0.51;the three sub-scales was from 0.46 to 0.52, P<0.05.

CONCLUSIONThe validity and reliability of the Diabetes Self-management Knowledge, Attitude, and Behavior Assessment Scale are excellent, which is a suitable instrument to evaluate the self-management for patients with diabetes.

Objective: To investigate the expression of SMARCA4 (BRG1) and SMARCB1 (INI-1) protein in endometrial dedifferentiated carcinoma (DDC) and undifferentiated carcinoma (UDC), and their correlation with clinicopathologic features. Methods: Clinicopathological information was gathered for 26 cases of DDC and UDC and consulting hospitals from January, 2006 to December, 2018 in Fudan University Shanghai Cancer Center, including 10 cases of DDC and 16 cases of UDC. Morphologic features and diagnosis were reviewed by two pathologists. Immunohistochemistry for expression of BRG1 and INI1 protein was performed. The correlations with clinicopathologic features were analyzed. Results: BRG1 and INI1 loss were present in 14 of 26 cases of DDC/UDC, including 12 BRG1-deficient cases and 2 INI1-deficient cases, respectively. Six cases demonstrated variable amounts of rhabdoid cells in 14 BRG1/INI1-deficient cases, and only 1 case showed rhabdoid cells in the 12 intact expression cases. However, there was no significantly statistical difference (P=0.060). Age, invasive depth, lymph node status and FIGO stage were not associated with the expression of the BRG1 and INI1 (P=0.437, P=0.672, P=0.242, P=0.348). Remarkably, the BGR1/INI1-deficient patients had worse survival than those with intact expression (4.7 vs. 22.9, P=0.033). Conclusion BRG1/INI1-deficient is observed in approximately half of DDC and UDC. Identification of these tumors is clinically relevant due to their more aggressive behavior and poor prognosis. Hence, BRG1 and INI1 immunohistochemical stains should be performed for DDC and UDC in order to help the pathologists to distinguish these tumors from other carcinomas, and to predict the clinical prognosis.