Objective:To evaluate the performance for the Sysmex XN20 A1 automation blood cell analyzer.Methods: The precision, contaminative rate, linear range, blank, accuracy and various sample models were verified, and low values of blood platelet were compared with the methods of microscopy and dye.Results:The contaminative rate was lower than 0.4%. The linear arrange and precision were well for the analyzer. The values of RBC, HGB and PLT were within the range of 1±0.05 and the correlation coefficients were higher than 0.975. The bias of average and constant values by the accuracy verification samples test met the demands of accuracy. And the relative differences of various sample models meet the requirements of the comparability. The variable coefficient of low values of PLT was lower than 4% by the dye method.Conclusion: The Sysmex XN20 A1 automation blood cell analyzer has the characteristics of perfect precision, accuracy, low contaminative rate, broad linear arrange and good repeatability for the low level PLT. It can be applied in clinical laboratory.

Case-based learning model was applied in teaching the course of Clinical Biochem-istry and Diagnosis for postgraduates with professional degree. Dyslipidaemia was chose as teaching content and one distinctly characterized case along with four typical cases were selected. Information of cases and core problems were submitted to students to prepare before the class. In the class, stu-dents were grouped and discussed independently. Students put forward the pathogenesis of the disease and the clinical laboratory test items for diagnosis and differential diagnosis. Teachers should adhere to the following principles: making the class student-centered and highlighting consciousness of stu-dents; creating clinical environment to stimulate enthusiasm for learning; problem-oriented and taking capacity building as the priority. After the class, teaching evaluation was designed to promote the con-tinuous improvement of teaching cases.

Specialty English of Medical Laboratory is a comprehensive and overlapping discipline and plays a major role in multiple medical courses, including Life Science, Clinical Medicine and Laboratory Medicine.However, its teaching practices are limited due to the extensive contents, scattered basic knowledge points, complexities of language learning processes and high demanding of sophisticated teaching skills.Since internet technology′s breakout and the web-based education expanding in the past decade, personalized flipped classroom has drawn considerable attention in the education field and became a hop-spot in teaching practice system.In the present study, the concepts of flipped classroom and basic characteristics of Specialty English of Medical Laboratory were elaborated, as well as the reconstructing teaching processes, exploring the concrete plan for teachers and students in undergraduate program.

Objective To evaluate the myocardial protective effects of Histidine-TryptophanKetoglutarate (HTK) solution on infants with tetralogy of fallot in cardiac operation through comparison with St.Thomas Ⅱ cardioplegia(STH) and HTK cardioplegia in the operation of tetralogy of fallot.Methods Forty infants with tetralogy of fallot(TOF) were enrolled in this study.Their age ranged from 7 to 35 months,and body mass from 5.3 to 9.5 kg.The infants were randomly divided into HTK (n =20) group and STH (n =20) group who received HTK or STH solution respectively.Then 3 ml blood sample were got at 1,2,4,8,24 and 48 h after the opening of ascending aorta.The serum levels of cardiac troponin Ⅰ(cTnI),creatine kinase(CK) and creatine kinase MB(CK-MB) were measured.Results There was significant difference between two groups in terms of the level of cTnI at different time (F(inner group)=49.94,P＜0.001;F(between group) =10.23,P＜0.001;F (across group) =28.49,P＜0.001),and the level of cTnI in HTK group was lower than that of STH group at 1,2,4,8,24 and 48 h after the opening of ascending aorta (P＜0.05).There was significant difference between two groups in terms of the level of CK at different time (F(inner group) =58.85,P＜0.001;F(between group) =16.43,P＜0.001;F(across group)=18.32,P＜0.001),and the level of CK in HTK group was lower than that of STH group at 1,2,4,8,24 and 48 h after the opening of ascending aorta (P＜0.05).There was significant difference between two groups in terms of the level of CK-MB at different time (F(inner group)=34.51,P ＜0.001;F(between group)=11.03,P＜0.001;F(across group)=10.28,P＜0.001),and the level of CK-MB in HTK group was lower than that of STH group at 1,2,4,8,24 and 48 h after the opening of ascending aorta (P ＜0.05).Conclusion HTK is more valid than STK for improving the ability of anti ischemia of myocardium and cardiac function,reducing arrhythmia and ischemia reperfusion injury on infants with TOF in cardiopulmonary bypass.

Objective To study the effective composition of Aster ageratoides Turcz for relieving asthma and its toxicity . Methods Seventy‐two qualified male guinea pigs ,body mass(300 ± 20)g ,were randomly divided into the control group ,aminophyl‐line group(0 .047 g/kg) and different ratio group of total saponins and total flavonoids (8∶1 ,4∶1 ,2∶1 ,1∶1 ,1∶2 ,1∶4 ,1∶8) . Every group received at dose of 0 .38 g/kg once a day for 3 days by intragastric administration .The effect of relieving asthma was taken as the indicators for the optimization of compositions ,which was detected by observing the latent period of asthma induced by acetylcholine‐histamine in guinea rats .The relaxation percentage of smooth muscle retracted by acetylcholine was detected by Pow‐erlab biological signal collecting system when aminophylline(1 .25 mg/mL) and different matching drugs(0 .02 g/mL) were added in Krebs′solution .The acute toxicities of total saponins ,total flavonoids and mixture of total saponins with total flavonoids (ratio of 1∶2) were detected by classical acute toxicity test of mice .Results Compared with the control group ,aminophylline group ,each group latent period of inducing asthma significantly or very significantly prolonged (P<0 .05) ,among them ,1∶1 ,1∶2 ,1∶4 group and other matching group were significantly different(P<0 .05) ,but 1∶2 group cited the longest incubation period .Aminophylline group and the ratio could significantly relaxe guinea pig tracheal smooth muscle retracted by acetylcholine .Aminophylline group di‐astolic percentage was the largest(24 .12 ± 1 .20)% ,all the groups were less than the percentage of diastolic aminophylline group (P<0 .05) ,but in 1∶2 group with the closest .Aster ageratoides Turcz ,tatarian aster total saponins ,total flavonoids and the ratio of 1∶2 to mice maximum tolerance was respectively 300 ,345 ,325 g/kg .Conclusion For the same total dosage ,the relieving asth‐ma effects of proportions of 1∶2 Aster ageratoides Turcz were obvious .There are no abnormal changes in the acute toxicity trila with total flavonoids ,total saponins ,as well as the ratio of 1∶2 ,safety is relatively good .

OBJECTIVETo assess the association of PEX10 gene and 1p36 copy number variations in 1p36 region with concurrent epilepsy through analyzing 3 cases.

METHODSThe karyotypes of 3 patients were determined by high resolution chromosome banding, multiplex ligation dependent probe amplification (MLPA), fluorescence in situ hybridization (FISH) combined with single nucleotide polymorphism array (SNP) technology. Real-time PCR was carried out to determine the mRNA levels of PEX10 gene in peripheral blood of the patients.

RESULTSNo abnormality was found upon high resolution karyotyping. MLPA analysis showed that all of the 3 patients had a copy number variation of subtelomeric region in the short arm of chromosome 1, which was confirmed by FISH and SNP chip analyses. Case 1 and case 2 both had an epilepsy phenotype, and their copy number variations have encompassed the PEX10 gene. On the other hand, case 3 has absent epilepsy, and its PEX10 gene copy number was normal. Family investigation confirmed that the chromosome abnormalities in all of the 3 cases were of de novo type. Compared with healthy controls, real-time PCR showed that mRNA of the PEX10 gene was increased in case 1 but decreased in case 2.

CONCLUSIONThe abnormal expression of PEX10 gene resulting from copy number variations of 1p36 region may be associated with the epilepsy phenotype.

Child ; Chromosomes, Human, Pair 1 ; DNA Copy Number Variations ; Epilepsy ; genetics ; Female ; Humans ; Peroxins ; Polymerase Chain Reaction ; Polymorphism, Single Nucleotide ; Receptors, Cytoplasmic and Nuclear ; genetics

Objective To evaluatc the efficacy and safcty of recombinant endostatin (Endostar)combined with concurrent radio-chemotherapy (CRCT) in patients with unresectable stage Ⅲ non-small cell lung cancer (NSCLC).Methods From March 2009 to November 2011,47 patients received threedimensional conformal radiotherapy of 60-66 Gy in 30-33 fractions over 6-7 weeks And concurrent chemotherapy of docetaxel 65 mg/m2 and cisplatin 65 mg/m2.Endostar was administered once a week before and on week 2,4,6 during CRCT at a dose level of 7.5 mg/m2/d.Tumor response was evaluated with thoracic CT scans performed 4 weeks after completion of treatment in accordance with RECIST 1.1 criteria.Acute toxicities were evaluated in accordance with CTCAE 3.0.Results Forty-four patients completed treatment and toxicity evaluation,42 patients completed evaluation of efficacy.Five patients achieved complete response,29 partial response,3 stable disease,and 5 progressive disease,2 were net assessed.Overall response rate was 77％.One-year overall survival rate was 81％,and one-year progression-free survival rate was 51％.Twelve patients died,2 died of treatment related toxicities,8 of cancer,and 2 of unknown causes.Nineteen patients developed grade 3/4 neutrocytopenia,grade 3 acute esophagitis and pneumonitis were observed in 4 and 4 patients,respectively,and 1 patient died of pneumonitis.No patient developed cardiovascular toxicities and hemorrhage.Conclusions Endostar combined with CRCT for unresectable stage Ⅲ NSCLC was safe and the short term outcomes were promising.Further investigations are warranted.

Objective:To study the clinical features of neonatal hyperthyroidism.Methods:From September 2013 to September 2020, clinical data of neonates with hyperthyroidism admitted to the neonatal intense care unit of our hospital were retrospectively collected and analyzed.Results:A total of 7 neonates were included. The average gestation age was (35.8±2.3) weeks with 5 cases had GA<37 weeks. The median age of diagnostic was 16 d (7~18 d). The common clinical manifestations included tachycardia, irritability, low-grade fever, hyperhidrosis, bulimia, poor weight gain, diarrhea and jaundice. The levels of serum free triiodothyronine (FT 3) and thyroxine (FT 4) were elevated in all 7 cases and thyroid stimulating hormone (TSH) were decreased. The Doppler ultrasound of thyroid gland in two neonates revealed enlarged thyroid gland with abundant blood flow. All 7 mothers had hyperthyroidism with 4 mothers provided the history of hyperthyroidism and the other 3 were also confirmed after their infants were diagnosed. All 7 infants were treated with anti-thyroid drugs (ATD) and 2 were additionally given β-blockers to control heart rate. The median ATD duration was 40 d (7~58 d). 2 cases (both preterm infants) had slight decrease in FT 4 during medication. FT 4 of all 7 cases returned to normal before TSH. Conclusions:Neonatal hyperthyroidism has various and nonspecific clinical manifestations. Early diagnosis and timely treatment are important to prevent short-term and long-term adverse outcomes. Whether their mothers provide definite history of thyroid disorder or not, the thyroid function of the suspected neonates should be carefully monitored.

The new wave of artificial intelligence pushed by deep learning algorithms has dramatically promoted the development of big data analysis technology. On the other hand, advances in life sciences represented by high-throughput genome sequencing have provided massive medical data. Artificial intelligence technology has also provided a powerful tool for hematological malignancy research. This article introduces related research progress in the 61st American Society of Hematology Annual Meeting.

OBJECTIVE: To detect fusion gene with pathological significance in a patient with refractory and relapsed acute B cell lymphoblastic leukemia (B-ALL) and to explore its laboratory and clinical characteristics. METHODS: Transcriptome sequencing was used to detect potential fusion transcripts. Other laboratory results and clinical data of the patient were also analyzed. RESULTS: The patient was found to harbor TCF3 exon 17-ZNF384 exon 7 in-frame fusion transcript. The minimal residual disease (MRD) has remained positive after multiple chemotherapy protocols including CD19-, CD22- targeted chimeric antigen receptor T cells immunotherapy. The patient eventually achieved complete remission and sustained MRD negativity after allogeneic hemopoietic stem cell transplantation (allo-HSCT). CONCLUSION Transcriptome sequencing can effectively detect potential fusion genes with clinical significance in leukemia. TCF3-ZNF384 positive B-ALL has unique laboratory and clinical characteristics, may not well respond to chemotherapy and immunotherapy, and is more likely to relapse. Timely allo-HSCT treatment may help such patients to achieve long-term disease-free survival. TCF3-ZNF384 positive B-ALL is not uncommon in pediatric patients but has not been effectively identified.
B-Lymphocytes ; Basic Helix-Loop-Helix Transcription Factors/genetics* ; Child ; Hematopoietic Stem Cell Transplantation ; Humans ; Laboratories ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy* ; Trans-Activators/genetics* ; Transcriptome