Objective To evaluate the mucosal microvascular morphological changes in superficial nasopharyngeal carcinoma (NPC) and its clinical value under narrow band imaging (NBI).Methods From 2015.01 to 2016.01, 182 patients at high risk for NPC received biopsy of superficial nasopharyngeal lesions due to the existence of irregular vessel under NBI while they were examined with electronic nasopharyngolaryngoscope quipped with white light mode and NBI mode. Compared the mucosal microvascular morphological characteristics of different diseases based on pathological result and evaluated the diagnostic efifcacy of NBI.Result Under NBI, the mucosal microvascular morphological characteristics of nasopharyngeal carcinoma under NBI mode were of that concentrated brown spots (CBS, 38.24 %) and irregularly dilated branching vessels (IDBV, 41.18 %) with demarcation line (DL, 52.94 %). In addition, IDBV were the main microvascular pattern in fresh NPC cases (57.89 %,P = 0.000), while CBS were the main microvascular pattern in post-radiation local recurrent NPC cases (60.00 %,P = 0.000). The sensitivity, speciifcity, positive predictive value, negative predictive values and diagnostic coincidence rate of NBI in NPC screening were 79.41 %, 95.95 %, 81.82 %, 95.30 % and 92.86 %, respectively.Conclusion NBI endoscopy is a promising tool for improving the early diagnosis of NPC by detecting mucosal microvascular morphological changes in superifcial NPC.

As highly active anti-retroviral therapy continues, large numbers of drug-resistant strains appeared in human immunodeficiency virus ( HIV) infectors, which always leads to a decline of treatment results or even a treatment failure.The genotypic resistance analysis technique of the bioinformatics is a powerful tool to forecast the HIV resistance and also determines the success or failure of antiviral therapy.This review will be focus on the advantages and disadvantages, influence factor of the genotype resistance prediction and improve measure of the primary HIV drug resistance genotype interpretation system, depending on the principle and characteristics of the genotypic drug resistance analysis as the breakthrough point, in order to provide guidance for reasonable application of different genotypes drug resistance analysis system in China.

Objective To assess the application values of real-time three-dimensional transesophageal ultrasound (RT3D-TEE) technology in the diagnosis and treatment of artificial mitral paravalvular leak (PVL). Methods Fifty-one cases of artificial mitral PVL patients were received two-dimensional transesophageal ultrasound (2D-TEE) and RT3D-TEE examination before and after surgery. Accuracy analysis was performed between the two kinds of test. Results The diagnostic accuracy of RT3D-TEE technique in patients with PVL drain port positionwas significantly higher than that of 2D-TEE technology , and the data of PVL drain port size by RT3D-TEE technique is significantly larger than that of 2D-TEE technique (P < 0.05, respectively). Conclusion The PVL laboratory diagnosis based on RT3D-TEE is accurate and reliable , and RT3D-TEE can assist doctors to diagnose before operation , and can provide real-time ultrasound information from intraoperative monitoring , and monitor the postoperative efficacy of patients .

Objective To evaluate the role of conventional protein kinase Cγ (cPKCγ)/growthassociated protein-43 (GAP-43) signaling pathway in ketamine-induced apoptosis in hippocampal neurons of developing rats in an in vitro experiment.Methods Primarily cultured hippocampal neurons were seeded in culture plates at a density of 1×10.6 cells/ml and divided into 2 groups (n=10 each) using a random number table:control group (C group) and ketamine group (K group).Group C received no treatment.Ketamine was added with the final concentration of 300 μmol/L in group K.At 12 h of culture or incubation,the apoptosis in hippocampal neurons was detected by flow cytometry.The apoptotic rate was calculated.The expression of cPKCγ,GAP-43 and phosphorylated GAP-43 in hippocampal neurons was measured by Western blot.Results Compared with group C,the apoptotic rates of hippocampal neurons were significantly increased,and the expression of cPKCγ,GAP-43 and phosphorylated GAP-43 was down-regulated in group K (P<0.01).Conclusion The mechanism by which ketamine induces apoptosis in hippocampal neurons of developing rats may be related to inhibition of cPKCγ/GAP-43 signaling pathway activation in an in vitro experiment.

【Objective】 To explore the precautions of pre-transfusion examination in patients with antibodies to erythrocyte protective solution, discrepant ABO blood typing results, and positive unexpected antibodies, so as to ensure the safety of blood transfusion. 【Methods】 The screen cells were divided into two groups according to the presence or absence of washing reagent red blood cells in normal saline. One group had untreated forward typing cells, antibody screening cells and identification panel, and the other group had saline-washed reverse typing cells, antibody screening cells and identification panel. The experiments were carried out by microcolumn gel method, saline medium method and polyamine method to analyze the effect of red blood cell preservation solution on serum agglutination reaction of specific patients. 【Results】 Among the 8 patients, forward typing was AB (+ ) in 1 patient, B (+ ) in 4, and A(+ ) in 3, and the reverse typing were interfered. The plasma of 8 patients agglutinated with unwashed reverse typing cells (saline tube method), screen cells and identification panels (saline tube method plus cassette method), while not agglutinated with the polybrene method. The interference was eliminated as using washed reverse typing cells (salinetube method), screen cells and identification panels (saline tube method plus cassette method). 【Conclusion】 The erythrocyte preservation solution affected patients’ blood group typing, but not affected the outcome of blood transfusion as no adverse reactions occurred.

Objective:To explore the efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in acute myeloid leukemia (AML) patients with BCR::ABL1 fusion.Methods:The clinical data of seven AML patients with BCR::ABL1 fusion from November 2012 to January 2022 were retrospectively analyzed, and their survival status was followed up.Results:The median age of patients at the time of diagnosis was 35 years. Four cases (57.1%) were diagnosed with high leukocyte counts. All cases were assayed as BCR::ABL1 positive and accompanied by four types of gene mutations (NPM1, RUNX1, ASXL1, PHF6) . Seven patients received tyrosine kinase inhibitor (TKI) combined with induction chemotherapy and bridged to allo-HSCT, and six patients received maintenance therapy with TKI. Before allo-HSCT, six patients achieved complete remission, and four patients achieved complete molecular remission (CMR) . After allo-HSCT, the three remaining cases also achieved CMR. All patients were in remission post-allo-HSCT. One case died of infection, and the remaining cases survived without relapse. The 3-year cumulative overall survival rate was (80.0±17.9) %.Conclusions:TKI combined with traditional chemotherapy could achieve a high response rate in AML patients with BCR::ABL1 fusion. In addition, allo-HSCT could enhance the molecular response rate. Maintenance therapy post-HSCT with TKI could improve prognosis.

Objective:The outcomes of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for myelodysplastic syndromes-evolved acute myeloid leukemia (MDS-AML) were explored.Methods:A retrospective review was conducted for 54 patients with MDS-AML treated with allo-HSCT in the Institute of Hematology and Blood Disease Hospital from January 2018 to August 2022. The clinical effects after transplantation were observed, and the related risk factors influencing prognosis were explored.Results:Of the total 54 patients, 26 males, 28 females, and 53 patients achieved hematopoietic reconstruction. After a median follow-up of 597 (15-1 934) days, the 1 year overall survival (OS) rate, disease-free survival (DFS) rate, relapse rate (CIR) and non-relapse mortality (NRM) rate were 75.8%±5.8%, 72.1%±6.1%, 12.7%±4.9%, and 17.1%±5.2%, respectively. The 3 year estimated OS, DFS, CIR, and NRM rates were 57.8%±7.5%, 58.1%±7.2%, 23.2%±6.6%, and 23.7%±6.6%, respectively. The cumulative incidence of acute graft-versus-host disease (aGVHD) was 57.5%±6.9%, and the cumulative incidence of chronic graft-versus-host disease (cGVHD) was 48.4%±7.7%. Hematopoietic cell transplantation comorbidity index (HCT-CI) before transplantation was ≥2, minimal residual disease (MRD) was positive on the day of reconstitution, grade Ⅲ/Ⅳ aGVHD, bacterial or fungal infection and no cGVHD after transplantation were adverse prognostic factors for OS ( P<0.05). COX regression model for multivariate analysis showed that HCT-CI score before transplantation, bone marrow MRD on the day of response, grade Ⅲ or Ⅳ aGVHD, and cGVHD after transplantation were the independent adverse factors for OS ( P=0.001, HR=6.981, 95% CI 2.186-22.300; P=0.010, HR=6.719, 95% CI 1.572-28.711; P=0.026, HR=3.386, 95% CI 1.158-9.901; P=0.006, HR=0.151, 95% CI 0.039-0.581) . Conclusion:For patients with MDS-AML and high risk of relapse, allogeneic transplantation must be considered as soon as possible. The enhanced management of post-transplantation complications and maintenance treatment should be provided whenever possible after transplantation.