Objective To investigate the symptom,esophageal motility characteristics and the prevalence of gastroesophageal reflux disease(GERD)in patients with typeⅠ,Ⅱand Ⅲ gastroesophageal junction (EGJ)diagnosed by high resolution esophageal manometry(HREM).Methods From 6th January to 27th December in 2012,the clinical data of 171 patients with reflux symptoms and received HREM were retrospectively analyzed.According to the Chicago classification V.3.0,the patients were divided into EGJ type Ⅰ,Ⅱ and Ⅲ groups.The age,body mass index(BMI),GERD related symptoms,esophageal motility parameters and the incidence of GERD were compared among the three groups.Chi-square test, t test and analysis of variance were used for statistical analysis.Relationship between EGJ types and other variables were analyzed by Spearman rank correlation.Results In 171 patients,136 cases(79.5%)with type Ⅰ EGJ,22 cases(12.9%)with type Ⅱ EGJ and 13 cases(7.6%)with type Ⅲ EGJ.The age of patients with type Ⅱ EGJ was significantly older than that of patients with type Ⅰ EGJ((56.5 ± 2.3) years vs(48.6 ± 1.0)years,t=2.992,P=0.003),however the differences were not statisticant when compared with type Ⅲ EGJ patients((51.2 ± 3.8)years,P> 0.05).The BMI of patients with typeⅢ EGJ was higher than that of typeⅠand typeⅡEGJ patients((26.0 ± 1.3)kg/m2vs(21.9 ± 0.3)kg/m2and (23.5 ± 0.6)kg/m2),and the difference was statistically significant(t=4.082 and 2.108,both P<0.05). The resting pressure of lower esophageal sphincter(LES)of patients with type Ⅱ and Ⅲ EGJ were lower than that of typeⅠEGJ((10.6 ± 1.5)mmHg(1 mmHg=0.133 kPa)and(3.4 ± 0.7)mmHg vs(17.1 ± 0.7)mmHg),and the resting pressure of LES of type Ⅲ EGJ was lower than that of type Ⅱ EGJ((3.4 ± 0.7)mmHg vs(10.6 ± 1.5)mmHg),and the differences were all statistically significant(t= -3.882,-6.411 and -2.769,all P< 0.01).The amplitude of contraction at 11 cm above LES and distal contractile integral(DCI)of patients with type Ⅲ EGJ were both lower than those of patients with typeⅠ EGJ((32.2 ± 5.4)mmHg vs(48.5 ± 2.5)mmHg,and(392.0 ± 94.1)mmHg·s·cm vs(805.1 ± 61.4)mmHg·s·cm),and the differences were statistically significant(t= -2.580 and -2.041,both P<0.05).The incidences of GERD in patients with type Ⅰ,Ⅱ and Ⅲ EGJ were 68.4%(93/136), 77.3%(17/22)and 10/13,respectively,and the difference was not statistically significant(χ2 =1.021, P=0.600).EGJ types were positively correlated with age and BMI(r= 0.214 and 0.290,both P<0.01).However,EGJ types were negatively correlated with the LES resting pressure,contraction amplitudes at 7 cm and 11 cm above the LES,and DCI(r= -0.474,-0.182,-0.333 and -0.191,all P<0.05).Conclusions Aging,overweight and obesity are risk factors of the LES and crural diaphragm separation.EGJ types are not predictable based on symptoms.The esophageal motility seems to decrease in patients with type Ⅱ and Ⅲ EGJ,the incidence of GERD in patients with type Ⅰ,Ⅱ and Ⅲ EGJ are all high.

Objective To analyze the literatures about artificial intelligence in cancer research in Web of Science (WOS) core collection database in 2010-2019 and summarize research hot spots and development trends. Methods Through bibliometrics methods and CiteSpace information visualization software, we applied the visual analysis of relevant literature on artificial intelligence in the field of cancer research retrieved from the Web of Science core collection database from 2010 to 2019. Results The number of published articles about artificial intelligence in the field of cancer research had been increasing year by year. The United States ranked first in the number of published articles in this field, the number of citations and cooperation capabilities. Although the number of published articles in China ranked the second, the number of citations was low. The hot spots of artificial intelligence in cancer research were mainly breast cancer and lung cancer. Machine learning, neural network and other methods were used to build models, which were used in basic cancer research, clinical diagnosis, treatment and prognosis prediction. The research frontiers were the methodological research of artificial intelligence, the research on the occurrence and classification of cancer and the research of protein in this field. Conclusion It will effectively promote the development of artificial intelligence in cancer research in China by learning the hot spots and cutting-edge technologies of international research, focusing on international cooperation and cooperation among national institutions and strengthening cross-disciplinary research.

Objective:To investigate the genotype and genetic characteristics of the pathogens associated with the epidemic outbreak of acute gastroenteritis (AGE) in Deyang city, Sichuan province, and to provide perspectives on disease prevention and vaccine development.Methods:Norovirus (NoV) nucleic acid in the sixty-three samples collected from three AGE outbreaks were detected by Real-time RT-PCR. The genes of RNA-dependent RNA polymerase (RdRp) and capsid protein (VP1) of the positive samples were amplified by conventional RT-PCR and sequenced and made phylogenetic analysis.Results:Three AGE outbreaks were all caused by NoV, and twenty-one samples were positive for NoV GII. Two of the outbreaks were caused by GII.17[P17] NoV and shared high similarities with global reference sequences from 2014. One of the outbreaks was caused by GII.2[P16] NoV and shared high similarities with global reference sequences from 2016.Conclusions:The three AGE outbreaks in Deyang city in 2018 were caused by two different NoV genotypes.

Objective: To investigate the genotype and genetic characteristics of the pathogens associated with the epidemic outbreak of acute gastroenteritis(AGE) in Guangyuan city, Sichuan province. Methods: Eighteen stool samples and 15 anal swab samples from 4 AGE outbreaks were collected from Feb 2017 to May 2017. Norovirus (NoV) nucleic acid was detected by Real-time PCR method , and the positive samples were amplified by conventional reverse transcription-polymerase chain reaction (RT-PCR) and nucleotide sequencing. Results: Four AGE outbreaks were all caused by NoV. And 20 (60.6%) samples were positive for NoV GⅡ. Gene sequence comparison and phylogenetic analysis showed that 4 AGE outbreaks were all caused by GⅡ.P16/GⅡ.2 NoV. All the strains of GⅡ.P16/GⅡ.2 NoV shared high homology in nucleotides. One of the outbreaks was caused by GⅡ.P16/GⅡ.2 and GⅡ.P7/GⅡ.14 NoV co-infection. Conclusions The 4 outbreaks of AGE in Guangyuan city, Sichuan province were major caused by GⅡ.P16/GⅡ.2 NoV, meanwhile GⅡ.P16/GⅡ.2 and GⅡ.P7/GⅡ.14 NoV co-infection existed.

Objective:To evaluate the predictive role of ETV6-RUNX1 fusion gene in protocol CCLG-ALL-2008 as well as identify the prognostic factors that influence the outcome of ALL with ETV6-RUNX1 fusion gene.Methods:One hundred and seventy-eight patients newly diagnosed with pediatric acute lymphoblastic leukemia with ETV6-RUNX1 rearrangement from April 2008 to April 2015 were enrolled in CCLG-ALL-2008. The follow up period ended in July 2018; we performed retrospective analyses of their data to determine the efficacy of the regimen and the prognostic factors.Results:The median age of the study population (178 pediatric patients) , including 100 boys and 78 girls was 4 (1-13) y, and the median white blood cell count at diagnosis was 9.46 (1.25-239.83) ×10 9/L. Three patients died, and 1 was lost to follow up by the end of the first induction chemotherapy, resulting in an induced remission rate of 97.8% (174/178) . The cumulative incidence of relapse was 15.9% with a median follow up of 73.5 mon. Total 83.3% of the relapse cases were those of isolated bone marrow relapse, while 79.2% of the cases were those of late relapse. The median interval time between relapse and first complete remission was 35.5 mon (range, 1-62 months) . One of the 5 patients with early recurrence and 7 of the 19 with late recurrence cases survived. The 5-year-OS and 5-year-EFS of ETV6-RUNX1 positive children was (89.4±2.4) % and (82.1±6.9) %, respectively. The estimated 10-year-OS and 10-year-EFS of ETV6-RUNX1 positive children was (88.6±2.5) % and (77.3±4.0) %, respectively. The Kaplan-Meier method and Log-rank test were used to estimate and compare the survival. Univariate statistical analysis showed that poor prognostic factors that influenced survival included central nervous system state 2 at diagnosis, poor prednisone response, high risk, gene positivity after induction chemotherapy, as well as MRD positivity and gene positivity at the 12 th week. In the multivariate analysis, only the central nervous system state 2 at diagnosis and MRD positivity at the 12 th week were associated with the outcome. Conclusion:ETV6-RUNX1-positive ALL is a subgroup with a favorable prognosis as per the CCLG-ALL-2008 protocol. Patients with ETV6-RUNX1 should be given more intensive therapy, including hematopoietic stem cell transplantation when they are CNS2 at diagnosis or have high level of MRD at the 12 th week after treatment.

Objective:To analyze the clinical features, bone marrow features, and gene mutations of children with familial platelet disorder with predisposition to myeloid leukemia (FPD/AML) caused by a RUNX1 germline mutation as well as their family members.Methods:The clinical data and gene mutations of a child with FPD/AML hospitalized in the Pediatric Blood Disease Center, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, and some family members were extracted and analyzed. The literature was searched using "RUNX1 germline mutation" and "FPD/AML" as keywords in the Chinese databases; also PubMed was reviewed until September 2020.Results:A male patient aged 5 with dermatorrhagia was admitted due to thrombocytopenia for more than 3 years. The laboratory tests revealed a peripheral blood routine (WBC 6.38×10 9/L, HGB 113 g/L, PLT 54×10 9/L, NEUT 4.03×10 9/L, and MPV 9.1 fl) . Bone marrow smear revealed dysplasia of megakaryocytes. The immunohistochemistry for CD42b and CD41 highlighted small mononuclear megakaryocytes. Second generation sequencing revealed RUNX1 (exon3:c.520delC: p.R174Efs*10, NM_001001890) frameshift mutations, and its germline mutation was verified via genetic detection of oral epithelial cells. Five members of the family had blood diseases and successively died. The child's mother and maternal grandfather were sequenced for the second generation, and RUNX1 frameshift mutation was detected in the same locus as the child. However, the clinical features among them were different. A total of 37 English literatures were retrieved, and more than 70 FPD/AML families were reported. No relevant Chinese literature was retrieved. Conclusion:Runx1 germline mutations cause FPD/AML with a high risk of progression to myeloid malignancy. Family members carrying the same mutations may exhibit different clinical features and severity.

Objective:To retrospectively analyze hemogram and bone marrow characteristics of pediatric patients infected with parvovirus B19 (HPV-B19) after hematopoietic reconstitution following allo-hematopoietic stem cell transplantation.Methods:The clinical course of nine patients with HPV-B19 infection, including hemogram and bone marrow smear analysis during infection, were retrospectively analyzed.Results:Despite the hematological heterogeneity, all patients exhibited reduced hemoglobin levels accompanied by reticulocytes. The proportion and absolute count of reticulocytes decreased by 90.4% (24.7% -98.7% ) and 90.7% (18.6% -99.0% ) , respectively, in one week. Additionally, five patients manifested a decline in neutrophil granulocyte count in peripheral blood whereas granulocytic hypoplasia was not observed in bone marrow. Furthermore, six patients exhibited megakaryocytic hypoplasia in bone marrow, including five patients with decreased platelet counts in peripheral blood. Importantly, only some patients exhibited erythroid hypoplasia although all patients exhibited a decline in hemoglobin in peripheral blood. Erythroid hypoplasia in bone marrow was present in five patients.Conclusion:There was heterogeneity in hemogram and bone marrow smear characteristics among pediatric patients infected with HPV-B19 following allo-hematopoietic stem cell transplantation. Anemia accompanied by decreased reticulocyte count should prompt screening for HPV-B19 in these patients