Objective To study the engraftment syndrome (ES) and the possible etiology after haploidentical allognneic hematopoietic stem cell transplantation (al]o-HSCT). Methods The clinical manifestation, treatment and outcome of a chronic myeloid leukemia patient who after allo-HSCT were presented. Results The patient started to cough on day 2 after allo-HSCT, dry cough at beginning, white foam sputum, non-infectious fever, fluid retention, weight gain, transient encephalopathy on day 4. The clinical symptoms were improved after treatment with corticosteroids, in which ES was diagnosed. Conclusion ES is a series of clinical syndromes following transplantation which is different from acute graft versus host disease. It occurred after HSCT, and corticosteroids are often effective. Therefore early recognition and accurate diagnosis is very important.

Objective To explore the prevalence and related risk factors of thyroid nodule in elderly patients(age ≥ 60 years old) with type 2 diabetes mellitus(T2DM)) in Xinjiang region.Methods Two hundreds and two elderly patients with T2DM were selected,including 91 cases of thyroid nodule(thyroid nodule group) and111 cases of non-thyroid nodule (control group).The disease history,body mass index(BMI),fasting blood-glucose (FBG),2-h postprandial blood glucose(2 h PBG),glycosylated hemoglobin(HbA1c),triglyceride(TG),cholesterol(TC),high-density lipoprotein(HDL-C) and low density lipoprotein(LDL-C) were collected for statistical analysis.Results The age,gender,BMI,TC and HbA1c had statistical difference between the two groups (P<0.05);the disease course,pulse pressure,systolic pressure,abdominal perimeter,smoking history,HDL,TG,FBG and 2 h PBG had no statistical differences netween the thyroid nodule group and non-thyroid nodule group (P>0.05).The multivariable Logistic regression analysis showed that the age,gender,TC,HbA1c and BMI were the risk factors of thyroid nodule occurrence.Conclusion Conducting the thyroid nodule related imaging examination has an important clinical significance for diabetic elderly women patients with obesity and cholesterol increase.

Objective To evaluate the clinical features,therapies and prognosis in patients with mucosa-assoeiated lymphoid tissue (MALT) lymphoma in ocular adnexal marginal zone (OAML).Methods A retrospective analysis was made upon clinical data from 21 patients with OAML admitted into Beijing Tongren Hospital from June,2008 to December,2011.Results There were 12 (57.1 ％) men and 9(42.9％) women,with a median age of 57 (23-79) years old.Majority of patients had localized pathological changes.Among them,16 patients (76.2％) were in stage Ⅰ E,and 5 (23.8％) in stage Ⅳ E.Surgical resection as the sole treatment was performed in 13 patients (61.9％),and positron emission tomography CT(PET-CT) imaging demonstrated normal fluorine 18-fluorodeoxyglucose (FDG) uptake after surgical resection,who were managed with no further therapy.All the 13 patients were followed up for median 14 (5-38) months,and all in complete remission.Combination chemotherapy was given to 8(38.1％) patients.Three patients in stage Ⅰ E treated with COP (cyclophosphamide,vineristine and prednisone) or CHOP (cyclophosphamide,adriamycin,vincristine and prednisone) were all in partial remission.Five patients in stage ⅣE were treated with COP/CHOP in combination with rituximab,and all in complete remission.The 3-year overall survival rate and disease-free survival rate in the total patients were 100.0％ and 74.9％ respectively.Conclusions The patients with OAML generally have localized disease,show indolent clinical course,and present low lymphoma-related mortality.Surgical resection is a very important treatment in the patients with local disease.Systemic chemotherapy should be considered in patients at advanced stages.Rituximab in combination with chemotherapy can improve the remission rate.

Objective To explore the clinical related prognostic factors of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in treating malignant hematological diseases. Methods From September 1997 to August 2008,a total of 26 patients with hematological diseases were treated with allo-HSCT from HLA identical-sibling and haplo-identical donors in our hospital, including 14 patients with acute leukemias,10 with chronic myeloid leukemias,and 2 myelodysplastic syndromes. Results All patients achieved sustained full donor type engraftment. The cumulative overall survival (OS) was 63.9 %,and cumulative disease free survival (DFS) was 62.6 %. Fifteen patients had graft-versus-host disease (GVHD) (57.7 %),including 8 acute GVHD(aGVHD) (30.8 %) (grade Ⅲ-Ⅳ aGVHD was 15.4 %) and 7 chronic GVHD. GVHD between HLA identical-sibling and haplo-identical donors was different and there was statistic difference between the two groups (P=0.014). 4 patients relapsed,7 patients died. The univariate analysis showed OS were correlated with grade Ⅳ aGVHD (P=0.05) and CMV infection (P=0.027). Conclusion Allo-HSCT is effective for the cure of patients with malignant hematological diseases. The key to improve the efficacy of HSCT is to reduce the incidence of transplant-related complications,especially GVHD and infection.

Objective:To analyze the relationship between the clinical medical college students' time investment (including study, activities, entertainment and exercise) and general self-efficacy (GSE) in a medical university in Liaoning province, China.Methods:The first-year medical students were asked to participate the survey. Their GSE was measured by using general self-efficacy scale (GSES) in 2018. One year later, the independent variable table was used to investigate the extracurricular activity time, and 683 valid questionnaires were collected. Ordered logistic regression method was used to analyze the correlation between students' extracurricular activities and GSE.Results:Medical students' GSE was positively associated with their time in extracurricular study ( OR = 1.94, 95%CI = 1.49-2.54), volunteer activities ( OR=1.36, 95%CI = 1.01-1.83), and physical activities ( OR = 1.37, 95%CI = 1.01-1.85). However, there was no significant correlation with the time in activities organized by students ( OR = 1.09, 95%CI = 0.79-1.50) or activities organized by school ( OR = 1.15, 95%CI = 0.84-1.59). Furthermore, compared with clinical students of "5+3" year program, the 5-year program clinical students had a stronger correlation between medical students' GSE and the input of extracurricular study time. Conclusion:There is a positive correlation between medical students' GSE and their extracurricular time investment, which indicates that increasing medical students' GSE could be an effective method to improve their extracurricular time investment and eventually improve their comprehensive quality.

Skin sensitization (allergic contact dermatitis, ACD), is a serious condition caused by small reactive molecules and is characterized by a delayed-type hypersensitivity .Animal tests were usually used in the evaluation of sensitizing potential of chemical substances in the past .However , there is an increasing interest from the public for reducing and ultimately replacing animal tests .The European Union (EU) has posed a ban on animal testing of cosmetic ingredients that includes skin sensitization since 2013.Therefore, alternative in vitro tests are the main tendency in chemical substances and cosmetic sensitizing potential research in the future .In this study, different kinds of in vitro test methods that were adopted by OECD or on research (LLNA, DPRA, KeratinoSens TM, h-CLAT) were reviewed through recent years literature , comprehensive introduction and evaluation were made to obtain reliable hazard and potency information on potential skin sensitizers .

PURPOSE: Methylenetetrahydrofolate reductase (MTHFR) has been implicated in lung cancer risk and response to platinum-based chemotherapy in advanced non-small cell lung cancer (NSCLC). However, the results are controversial. We performed meta-analysis to investigate the effect of MTHFR C677T polymorphism on lung cancer risk and response to platinum-based chemotherapy in advanced NSCLC. MATERIALS AND METHODS: The databases of PubMed, Ovid, Wanfang and Chinese Biomedicine were searched for eligible studies. Nineteen studies on MTHFR C677T polymorphism and lung cancer risk and three articles on C677T polymorphism and response to platinum-based chemotherapy in advanced NSCLC, were identified. RESULTS: The results indicated that the allelic contrast, homozygous contrast and recessive model of the MTHFR C677T polymorphism were associated significantly with increased lung cancer risk. In the subgroup analysis, the C677T polymorphism was significantly correlated with an increased risk of NSCLC, with the exception of the recessive model. The dominant model and the variant T allele showed a significant association with lung cancer susceptibility of ever smokers. Male TT homozygote carriers had a higher susceptibility, but the allelic contrast and homozygote model had a protective effect in females. No relationship was observed for SCLC in any comparison model. In addition, MTHFR 677TT homozygote carriers had a better response to platinum-based chemotherapy in advanced NSCLC in the recessive model. CONCLUSION: The MTHFR C677T polymorphism might be a genetic marker for lung cancer risk or response to platinum-based chemotherapy in advanced NSCLC. However, our results require further verification.
Carcinoma, Non-Small-Cell Lung/*drug therapy/enzymology/genetics ; Genetic Predisposition to Disease ; Humans ; Lung Neoplasms/drug therapy/*enzymology/*genetics ; Methylenetetrahydrofolate Reductase (NADPH2)/*genetics ; Platinum/*therapeutic use ; Polymorphism, Genetic/genetics

Objective:To investigate the use of proton pump inhibitors (PPIs)in gynecological patients in a hospital and analyze the use rationality of PPIs for the prevention of stress ulcer so as to provide reference for the clinical application of PPIs. Methods:To-tally 1000 patients' medical records admitted to the gynecological department for the first time from January 1st to December 31st in 2016 were randomly selected to conduct a retrospective analysis,and the rationality of PPIs was evaluated. Results:The preventive use rate of PPIs was 90.72%(880/970). Among the 880 patients, 28.18%(248/880) of the patients were without indications for the preventive medication,95.68%(842/880) of the patients were with wrong administration time, and 91.46%(578/632) of the pa-tients were with wrong usage and dosage. Conclusion:When PPIs are used for the prevention of SU in gynecological surgery,irrational use such as without indications, unsuitable variety selection and wrong usage and dosage still exists. It is suggested that regulators should strengthen technical and administrative interventions and establish standard for the rational use of PPIs in hospitals so as to avoid the excessive use of PPIs and improve the situation of inappropriate application.

Objective: To investigate the mechanism of emodin ( EM) in the expression of related protein for the fibrosis of the transforming growth factor-β1(TGF-β1)-stimulated human renal tubular epithelial (HK-2) cells. Methods: HK-2 cells were randomly divided into the normal control group, TGF-β1-stimulated model control group and emodin ( TGF-β1 +EM) group. The contents of Collage Ⅰ and fibronectin in the culture supernatant were determined by ELISA. After HK-2 cells were stimulated with TGF-β1 for 24 h, the cells were collected for immunofluorescence, Western blot and RT-PCR analysis. RT-PCR was used to detect PI3K, p-Akt and mTOR. The protein expressions of PI3K, p-Akt and mTOR were detected by Western blot. Immunofluorescence was used to detect PI3K. Results: Compared with those in the model control group, the contents of CollageⅠand fibronectin in the supernatant of emod-in group significantly decreased (P<0. 05), the expression of PI3K protein was inhibited, the expression of downstream p-Akt protein decreased, and the downstream mTOR decreased (P<0. 05), the expression levels of PI3K, p-Akt and mTOR mRNA decreased, the differences were statistically significant (P<0. 05), and the expression of PI3K decreased. Conclusion: Emodin can alleviate fibrosis of HK-2 cells stimulated by TGF-β1 through the classical Akt/mTOR pathway of autophagy.

Objective To study the clinical efficacy and follow-up study of ketogenic diet adding treatment for refractor epilepsy in children.Methods Cluster sampling method was employed to select children in children's hospital from January 2015 to June 2017,a total of 25 cases were diagnosed refractor epilepsy and adding ketogenic diet.Engel grade was used to evaluate the efficiency,the side effects,electroencephalogram (EEG) changes and intellectual development at 3 months,3-6 months,and more than 6 months.Results The effective rate of epileptic seizure control was 0,66.7％ and 87.5％ at 3 months,3 -6 months and ＞ 6 months respectively.The improvement rate of EEG discharge index was 33.3％,50％ and 81.3％ respectively.The improvement of intelligence development was 33.3％,50％ and 68.8％ respectively.Gastrointestinal disturbances were the main side effects.Severe side effect occurred in two cases--they had severe food refusal and were stopped the ketogenic diet adding treament.Conclusions The ketogenic diet is effective,safe,few side effects and tolerable in infants and children with refractory epilepsy.The ketogenic diet may improve cognition and behavior in addition to reducing seizure frequency,the interical epileptiform discharges (IED) index and improve the quality of life of epileptic children.However,the acceptance of ketogenic diet therapy for children is not satisfactory.The sample size is small and needs further promotion.While large samples and long-term observations are still desired to better recipes,and to provide possibly effective altemative to other therapies for refractor epilepsy.