Anemia, Refractory ; Humans ; Male ; Middle Aged ; Thrombocytosis

Objective To discuss the diagnostic value of dynamic contrast-enhanced MRI in differentiating vertebral metastatic tumors from benign deseases after studying the early changes of signal intensity.Methods Twenty patients were scanned by dynamic contrast-enhanced MRI.The parameters of signal intensity were measured and calculated,and time-intensity cures(TICs)were drawn.Then,they were compared with those of normal verte- braes,the characteristics were analyzed.Results The parameters of vertebral metastatic tumors:peak signal intensi- ty,signal intensity minimum signal intensity of post-peak,peak slope,initial ratio of enhancement,maximum ratio of enhancement was respectively(50.61?11.38),(46.75?10.23),(0.73?0.12),(0.33?0.08),(1.03?0.31); that of normal vertebraes was respectively(40.53?12.12),(34.72?14.06),(0.31?0.11),(-0.25?0.05), (0.69?0.28);and ten normal cases showed negative in initial percent of enhancement,but only two abnormal ver- tebraes showed that.All of the above had significant statistical difference.Four types of TICs were concluded:early rapid rise and early rapid descent followed by steady phase(type A),persistently rise(type B),rise phase followed by steady phase(type C),rise phase followed by rapid descent phase(type D).TICs of abnormal vertebraes were respec- tively 6,5,5,5 cases;types of normal vertebraes were mainly type C,15 cases.Type A and type B and the type with the characteristic of early rapid descent phase were features of abnormal vertebraes;type C was the feature of normal ones.Conclusions Dynamic contrast-enhanced MRI could quantitatively show the characteristics of early changes of signal intensity of vertebral metastatic tumors,which were significant statistically different from those of normal ver- tebraes.Dynamic contrast-enhanced MRI was worth performing in the early diagnosis of vertebral metastatic tu- mors.

AIM:To evaluate the efficacy and safety of large sized continuous curvilinear capsulorhexis ( CCC ) involving zonular area in manual small incision cataract surgery ( MSICS) .
METHODS:Totally 1 443 cataract patients ( 1 965 eyes ) underwent MSICS, in which large CCC up to 7-8mm were performed . The related conditions such as success rate of performing CCC, capsule rupture, corneal edema and visual acuity after surgery were recorded and statistically analyzed.
RESULTS:In total of 1 965 eyes, 1 942 eyes ( 98. 83%) had successful CCC, 15 eyes (0. 76%) had a radial tear which could not be saved when performing CCC, 8 eyes (0. 41%) had anterior capsule opened with a cystotome or a scissor due to capsule membrane calcification. No posterior capsule rupture occurred, and intraocular lens was transplanted in all cases. Transient corneal edema was noted in 36 eyes (1. 83%). One day after surgery, 1650 eyes (83. 97%) had visual acuity ≥0. 5, 1867 eyes (95. 01%) ≥0. 3. No unstable intraocular lens was noted in all cases.
CONCLUSION:Large CCC technique for MSICS is safe and reliable, not decreasing stability capsular bag and intraocular lens. It is of high originality despite zonular area is involved so that it is worthy of application in basic medical institutions.

125 strains of the symbiotic and epiphyte microorganisms were isolated from marine organisms (sea cucumber, sea urchin,anemone, sea actinia, Ulra, Sargassum, Undaria). Among them,21 strains of bacteria,8 strains of actinomycetes and 2 strains of fungi showed antagonistic activity on bacterial or fungal growth. In the 21 strains of bacteria, 7 strains belong to Bacillus sp., 11 strains Vibrio sp., and 3 strains Pseudomonas sp.. In the 8 strains of actinomycetes, 5 strains belong to Streptomyces sp., 3 strains Micromonospora sp., 2 strains fungi Penicillum sp..

Objective To investigate the expression of antinuclear antibodies(ANA) ,anti‐cyclic citrullinated peptide antibody (anti‐CCP) in elderly patients with rheumatoid arthritis(RA) ,and analyze its relation with depression .Methods ANA ,anti‐CCP were detected in 58 elderly RA patients ,50 non‐RA and 50 healthy people .Self‐rating Depression Scale(SDS) was used to assess the incidence of depression .Results The positive rate of anti‐CCP in RA group was significantly higher than that in control group and non‐RA group(P<0 .05) ,while there was no significantly difference in positive rate of ANA compared between RA group and non‐RA group(P>0 .05) .The positive rates of anti‐CCP and ANA in active stage were significantly higher than those in stable stage(P<0 .05) .The positive rates of anti‐CCP and ANA in RA complicated with depression were significantly higher than those in RA without depression(P<0 .05) .Multiple linear regression analysis showed that positive rates of anti‐CCP and ANA were all in‐dependent influence factors of depression in elderly RA patients(P<0 .05) .Conclusion Anti‐CCP and ANA in elderly RA patients over express ,and the positive rates are positively related with disease activity and depression .

There is a variety of gut microbiota in human body, which is closely associated with the health and disease. Normal gut microbiota can produce colonization resistance to pathogens. Antibiotics can affect the composition of gut microbiota and change the intestinal microenvironment, resulting in intestinal microecological disorders, which in turn cause intestinal pathogenic infections and other diseases. In this paper, the concept of intestinal microecology, the mechanism of intestinal colonization resistance, the effect of antibiotics on intestinal microecology, and the treatment methods were reviewed, aiming to provide the information for the rational use of antibiotics and the development of more effective treatment methods to maintain the stability of intestinal microecology.

Objective To detect the levels of retinol binding protein(RBP)and adiponectin during the second trimester in the serum of women in normal pregnancy and women who subsequently develop gestational diabetes mellitus(GDM )and to evaluate their role in predicting GDM .Methods A case‐control study was performed to detect and compare the levels of RBP and adiponec‐tin between women who subsequently develop GDM (n= 88)and normal control from 16 to 20 pregnancy weeks (n= 88) . Results Maternal serum RBP levels and the RBP/adiponectin ratio were significantly higher in GDM women than that in normal controls(P<0 .01) .The levels of maternal serum adiponectin were significantly lower in GDM women than that in normal controls (P<0 .01) .The levels of RBP≥30 .45 mg/L ,adiponectin≤9 .93 mg/L and the ratio of RBP/adiponetin≥3 .18 as early markers for predicating development of GDM ,their sensitivities were 63 .6% ,80 .7% and 81 .8% ,and specificities were 75 .0% ,65 .1% and 79 .7% ,respectively .Conclusion The combination of RBP and adiponetin as early marker for predicating development of GDM from 16 to 20 pregnancy weeks was more valuable than single use of them .

Objective To analyze the outcome of childhood B-cell acute lymphoblastic leukemia treated (ALL) with SCMC-ALL-2005 protocol. Methods Newly diagnosed B-cell ALL from May 1, 2005 to April 30, 2009 in ifve hospitals were treated and followed up according to SCMC-ALL-2005 protocol. Results A total of 601 cases with newly diagnosed B-cell ALL were enrolled. Among them, 539 cases (89.68%) were followed up until September 30, 2011. In 601 patients, there were 284 low-risk cases (LR group), 231 moderate-risk cases (MR group) and 86 high-risk cases (HR group) which were treated with SCMC-ALL-2005 protocol. The total complete remission rate during the period of induction was 98.84%and 7 cases did not achieve complete remission. The median time of the ifrst event occurring was 35 months (2.94 years). Among 539 cases completing follow-up, 403 cases (74.77%) completed treatment including 223 cases (86.43%) in LR group, 150 cases (73.17%) in MR group and 30 cases (39.47%) in HR group. The rate of cases completing treatment was signiifcantly different among three groups (P=0.001). The completion rate was highest in LR group and lowest in HR group. The 3-year overall survival (OS) rate was (83.3±1.8)%, and the 3-year EFS (event-free survival) rate was (79.2±1.9)%using a Kaplan-Meier method. The 5-year OS rate was (79.5±3.3)%, and the 5-year EFS rate was (70.9±3.7)%. There were signiifcant differences in 3-year EFS rate and 5-year EFS rate among three groups (P<0.05). Conclusions Childhood B-ALL treated with SCMC-ALL-2005 protocol achieved a better therapeutic effect and prognosis. The multi-center collaborative research is useful for the standard treatment of ALL.

The research on clinical efficacy evaluation of traditional Chinese medicine (TCM) is a hot and difficult issue in the field of TCM. However, the overall level of current related research also needs to be improved. There are still a lot of academic controversies in the field of TCM clinical efficacy evaluation. The author believed that before conducting research, it is necessary to sort out core issues of TCM clinical efficacy evaluation, which in-clude the concept of TCM clinical efficacy and its evaluation. In recent years, Chinese scholars have conducted a series of studies on these issues and have some achievements. To think and answer these questions will play an important role for the ultimate resolution of problem of TCM clinical efficacy evaluation.

ObjectiveTo determine the correlation of real-time contrast-enhanced ultrasonography (CEUS) patterns and quantitative parameters with microvessel density (MVD) and vascular endothelial growth factor (VEGF) expression of breast tumors.Methods One hundred and five patients with 128 breast lesions(62 benign,66 malignant) underwent CEUS examination.CEUS patterns were analyzed and parameters were obtained by time-intensity curve analysis software.Immunohistochemical staining using anti-factor CD34 was performed to evaluated the MVD and VEGF expression was detected.Results All CEUS patternsweresignificantlyassociatedwithMVDandVEGFexpressionexceptboundary characteristics( P ＜ 0.05).The enhancement parameters showed that the time to peak was significantly faster in malignant tumors than that in benign lesions,and the peak intensity and area under the curve were significantly higher in malignant tumors than those in benign lesions( P ＜0.05).The time to peak,the peak intensity,area under the time-intensity curve were statistically correlated with MVD (P ＜0.05),the highest correlation was between the area and MVD( r =0.81,P ＜0.001).Only the area under the timeintensity curve was significantly associated with VEGF expression (P ＜ 0.05).Conclusions CEUS patterns and parameters of breast lesions are closely correlated with MVD,which can be used to evaluated the angiogenesis in breast tumors.