Diffuse alveolar hemorrhage (DAH) is a life threatening clinical syndrome caused by a variety of causes.Early identification and etiological diagnosis of DAH in children are challenging.Despite some advances have been made in the identification and management of DAH,the mortality rate is still high.This article aims to raise the cognition of clinicians on DAH by providing a general review of some recent researches.

Objective:To establish the quality standard for Aitongxiao granules. Methods:TLC was used to identify Herba Hedy-otis Diffusa, Herba Scutell Barbatae, Radix Astragali and Radix Paeoniae Rubra in Aitongxiao granules, and the content of scutellarin was determined by HPLC. The stationary phase was a Kromasial C18 column (250 mm × 4. 6 mm,5μm), the mobile phase was metha-nol-3% acetic acid (33∶67), the flow rate was 1. 0 ml·min-1, the detection wavelength was at 335 nm, and the temperature was 25℃. Results:The characteristic TLC spots of the granule samples were the same as those of the standard samples without any inter-ference from the negative control. Scutellarin had a good linear relationship within the range of 2.18-10.90μg·ml-1(r=0.999 9), and the average recovery was 96. 65% with RSD of 1. 45﹪(n=6). Conclusion:The method is simple, accurate, reliable and repro-ducible, which could be used in the quality control of Aitongxiao granules.

With regard to the bounded linear continuous-time system, a universal chaotic anti-controlling method was presented on the basis of tracking control. A tracking controller is designed to such an extent that it can track any chaotic reference input, thus making it possible to chaotify the linear system. The controller is identical in structure for different controlled linear systems. Computer simulations proved the effectiveness of the proposed method.

Objective:To explore features and relevant influencing factor of ecological executive function in children with childhood absence epilepsy (CAE).Methods:Forty children with CAE (CAE group) and 40 healthy children with physical examination (control group) from April 2017 to July 2020 in Anhui Provincial Children′s Hospital were selected. The behavior rating inventory of executive function (BRIEF) parental questionnaire was used to evaluate the executive function of children. The differences of ecological executive function between 2 groups were compared.Results:The BRIEF total score, behavioral regulation index (BRI) and metacognition index (MI) in CAE group were significantly higher than those in control group: (52.03 ± 10.89) scores vs. (44.05±5.06) scores, (49.45 ± 9.93) scores vs. (43.85 ± 4.70) scores and (53.18 ± 11.24) scores vs. (44.95 ± 5.32) scores, and there were statistical differences ( P<0.01). Multiple stepwise regression analysis result showed that inhibit inhibition, shift, emotional control, initiation, working memory, planning, organization, monitoring, MI and total score were correlated with disease control ( P<0.01), and disease control had a negative predictive effect on them ( R2 = 0.174, 0.158, 0.234, 0.325, 0.383, 0.337, 0.378, 0.199, 0.463 and 0.435); BRI was correlated with onset age and disease control ( P<0.01 or <0.05), and onset age and disease control had a negative predictive effect on BRI ( R2 = 0.336). Conclusions:Children with CAE have ecological executive dysfunction. The control of the disease and the onset age are the main factors affecting the ecological executive function.

Purpose:To compare taxol,cisplatin(TP) and mitomycin, vinorelbine and cisplatin (MNP) with mitomycin,vindesine and cisplatin (MVP) and to evaluate the efficacy of the three regimens in patients with advanced non small cell lung cancer (NSCLC).Methods: One hundred and ten patients were enrolled in this study, 27 on TP, 40 on MNP and 43 on MVP. The characteristics of patients were comparable.Results:An objective response rate was observed in 51.9% of patients in the TP arm, 45.0% of patients in the MNP arm versus 32.6% in the MVP arm. The median duration of survival was 11.2 months in the TP arm, compared with 10.5 months in the MNP arm and 8.1 months in the MVP arm. The progression free survival was 9.0 months、8.0 months and 6.8 months in the TP、MNP and MVP arms, respectively. The major toxicities were bone marrow suppression、nausea、vomiting and alopecia.Conclusions:TP had a higher response rate than MNP and MVP, with acceptable toxicity. Its efficacy should be confirmed through a randomized study.

Objective To evaluate the clinical significance of carcinoembryonic antigen (CEA),cancer antigen 125 (CA125),carbohydrate antigen 19-9 (CA19-9) and eytokeratin 21-1 fragment (CYFRA21-1) assays of sputum in patients with lung cancer. Method Fifty-two cases with lung cancer and 46 cases with benign lung diseases underwent detection of CEA ,CA125 ,CA19-9 and CYFRA21-1 in sputum by using the method of chemi-luminescent enzyme immunoassay. Results The levels of CEA,CA125,CA19-9 and CYFRA21-1 in sputum of 52 cases with lung cancer were (27.6±31.2) μg/L, (76.4±65.2)kU/L, (56.1±31.6) kU/L and ( 25.2±9.1 )μg/L respectively. But the levels of those of 46 cases with benign lung diseases were (6.1±7.5)μg/L, (23.7±7.9) kU/L, (17.3±10.2) kU/L and (1.2±1.7)μg/Lrespectively. The levels of these tumor markers in sputum in patients with lung cancer were significantly higher than those in patients with benign lung diseases(P< 0.01 ). The diagnostic sensitivity of CEA,CA125,CA 19-9 and CYFRA21-1 in sputum in 52 cases with lung cancer was 42.3%( 22/52 ), 46.2% (24/52), 36.5%( 19/52 ) and 51.9% (27/52) respectively ( P > 0.05 ). Among the cancer patients, the sensitivity of sputum CEA in patients with adenocareinoma was significantly higher than that in patients with squamons cell carcinoma (X2= 4.193, P < 0.05 ) ; while the sensitivity of sputum CYFRA21-1 in patients with squamous cell carcinoma was significantly higher than that in patients with adenocarcinoma ( X2 = 4.806,P < 0.05 ). The sensitivity of CA125 in advanced lung cancer( Ⅲ +Ⅳ stage) was higher than that in early lung cancer( Ⅰ+Ⅱstage) (X2= 5.202,P < 0.05 ). Compared with the single tumor marker assaying, the combination of CEA,CA 125, CA 19-9 and CYFRA21-1 in sputum could significantly improve the sensitivity and accurate value in the diagnosis of lung cancer (P<0.05). Conclusion To assay CEA,CA125,CA1g-9 and CYFRA21-1 in sputum is valuable in diagnosis of lung cancer, and the combination of CEA,CA125,CA19-9 and CYFRA21-1 in sputum can significantly improve sensitivity and accurate value in the diagnosis of lung cancer.

A 19-year-old Chinese woman presented with progressive ulcers and recurrent fever for 1 year.The lesions originally began with purplish red maculopapules,then rapidly developed into ulcer with severe pain and spread to the trunk and extremities accompanied by intermittent fever.Histopathology revealed lymphoid infiltration of middle and large atypical T cells throughout the dermis and subcutaneous fat laver along with focal epidermotropism.The lymphoid infiltrates were positive for CD3,CD8,T-cell intercellular antigen(TLA)and T-cell receptor β(TCR-β).Gene analysis showed the rearrangement of T-cell receptor gene.According to the above findings,the patient was diagnosed as primary cutaneous aggressive epidermotropic CD8-positive cytotoxic T-cell lymphoma. Combined thempy with cyclophosphamide,vincristine,prednisone and bleomycin resulted in partial remission of skin lesions,but she eventually died 22 months after the onset of disease.

Objective:Since malignant fibrous histiocytoma (MFH) may be taken as an undifferentia-ted pleomorphic sarcoma (UPS), this study was conducted to reassess 33 previously diagnosed MFH cases in the past 10 years based on the latest WHO concept. And then to search for the clinicopathological features, probably tumorigenesis, and the line of differentiation of the remaining MFH/UPS cases.Methods: Thirty-three cases in tissue microarray were studied by immunohistochemistry with panels of neurogenic, myogenic, and lipogenic antibodies. Three expertise pathologists reevaluated the slides separately. Results: Among the 33 cases, 17 cases (51.5%) of MFH had their diagnoses changed, including 5 leiomyosarcomas, 3 malignant peripheral nerve sheath tumors, 1 fibrosarcoma, 1 inflammatory myofibrosarcoma, 1 giant cell tumor and 1 angiomatoid fibrous histiocytoma. The remaining 16 cases (48.5%) were finally diagnosed as MFH/UPS, among which patients were mainly old adults (median age: 63 years; range: 38 to 76 years). The median tumor size was 6.0 cm (range: 3.0 to 14.0 cm), 8 cases (50%) located in lower limb and 5 cases (31.3%) located in thigh. These tumors had marked cytological and nuclear pleomorphism. Immunohistochemistry showed that Vimentin was strongly positive in all 16 MFH/UPS (100%), Muscle-specific actin was variously positive in 8 cases (50%) and 1 case focally expressed Desmin. Eleven cases (68.8%) variously expressed CD68 (KP1) and 7 cases (43.8%) expressed CD68 (PG-M1), which were much higher than leiomyosarcoma, malignant peripheral nerve sheath tumor and liposarcoma with significant difference. Moreover, Ki67 expression rates were from 10% to 100%, including 14 cases more than 50% and 11 cases more than 70%. However, only 2 cases (12.5%) showed P53 positive. Conclusion: MFH/UPS often show marked histological pleomorphism, and the diagnosis must be made by exclusion of other definitive sarcomas, especially myogenic and neurogenic sarcoma. Only Vimentin was always expressed in MFH/UPS, while some of the tumors were positive for myogenic antigen and CD68. It was suggested that MFH/UPS might arise from primary mesenchymal cells, and some cases exhibited fibroblastic and/or myofibroblastic features. In addition, histiocytic phenotypic marker did have more expression in MFH/UPS than in other sarcomas. MFH/UPS still had certain clinicopathological characteristics.

Objective:To explore the clinicopathologic features and diagnostic criteria of hepatosplenic T-cell lymphoma (HSTCL). Methods: Three cases of HSTCL were seached for morphology, immunophenotypings, Epstein-Barr virus (EBV) in situ hybridization and T-cell receptor? (TCR?) gene rearrangement. Results: In the bone marrow, the infiltrative pattern of tumour cells was interstitial and sinusoidal infiltration in one case,while the other two cases showed diffuse infiltration. In the liver of one case and the spleen of another case, tumour cells respectively showed sinusoidal infiltration. The immunophenotyping: three cases showed strongly positive for CD3 and TIA-1, but negative for Granzyme B, CD56 and TCR?. EBV in situ hybridization was not detected in all the cases. TCR? monoclonal rearrangements were detected in two cases. Conclusion: HSTCL is a rare entity which is classified into peripheral T cell lymphomas. And it is regarded as a subset of unactived cytotoxic T-cell lymphomas. The negative results of EBV in situ hybridization and the presentation of TCR? gene monoclonal rearrangements may be helpful in diagnosis and differential diagnosis of HSTCL. These three cases showed similar characters to those of international cases reported.

Objective:To evaluate angioimmunoblastic T-cell lymphoma(AITL) completely, we gave in-depth investigation of histopathological features, specific immunochemical markers, antigen receptor gene rearrangements and in situ hybridization for Epstein-Barr virus (EBV). Methods: 15 cases of typical AITL displayed effacement of the normal lymph node architecture partially or completely, abundance of arborizing high endothelial vessels, infiltration of polymorphic cells and hyperplastic atypical T lymphocytes with or without clear cytoplasm. Clinical characteristics, histological manifestations, and immunohistochemical staining for CD3, CD20, CD4,CD21, CXCL13, CD10, and BCL6 were analyzed. Polymerase chain reaction for immunoglobulin heavy chain (IgH) and T cell receptor ? (TCR?) rearrangements and in situ hybridization for Epstein-Barr virus encoded RNA (EBER-1) were performed.Results: Histologically, we found eight cases with regressed lymphoid follicles, six with absence of follicles and one with hyperplastic follicles with interfollicular lesions. We also found eight cases displaying aggregation of clear cells, four infiltration of large lymphoid cells, five abundant epithelioid histiocytes. CD20 staining showed hyperplasia of large B cells in four cases. CD21 expression exihibited extrafollicular expansion of follicular dendritic cell meshworks in 11 cases (73.3%), partially with a tendency of perivascular distribution. Positive rate for CXCL13 and CD10 are 73.3% and 6.7% respectively. Monoclonal rearrangements of TCR? were detected in 6/15 (40%) of cases, IgH rearrangements in 7/15 (46.7%), of which five were monoclonal, while two oligoclonal. 8 out of 15 cases (53.3%) contained EBV-positive cells. Among the four cases with large B cell proliferation, three were EBV-positive. Conclusion: AITL display great complexity and diversity clinicopathologically. Only when we recognize such diversity, can we reasonably apply and properly evaluate immunochemical markers and molecular techniques, and thus give a correct diagnosis.