Objective To assess the effect of transitional empowerment education on the quality of life of patients with inflammatory bowel disease (IBD) and to analyze the factors affecting the quality of life, so as to pro-vide clinicians with information on effective intervention strategy. Methods From January 2015 to June 2016, 155 IBD patients were randomly divided into traditional care group (n=78) and transitional empowerment educa-tion group (n=77). The patients in the traditional care group received clinic outpatient follow-up, and the patients in the transitional empowerment education group received follow-up led by IBD management team. IBD patients in the two groups were investigated with self-management ability questionnaire, self-efficacy scale, and quality of life questionnaire before discharge and the six month after intervention. Results After the sixth month, the total scores on self-management ability (t=7.219, P=0.000), self-efficacy (t=2.845, P=0.005) and quality of life (t=7.705, P=0.000) in the transitional empowerment education group were higher than those of the traditional care group. Conclusion The transitional empowerment education can improve self-management ability, self-efficacy, quality of life of IBD patients.

Objective To explore the clinical characteristics of pancytopenic acute leukemia(PAL) and hyperleukocytic acute leukemia(HAL). Methods 183 patients with primary AL were analyzed retrospectively and divided into three groups according to patients' hemogram. Results Among these patients, 38 cases(20 8%) were PAL(group A), 42 cases(23 0%) were HAL(group B) and 103 cases(56 3%) were generic type(group C). 23 0% cases of acute myeloid leukemia(AML), 56 3% acute promyelocytic leukemia and 16 9% acute lymphoblastic leukemia( ALL) appeared PAL. The manifestations of group A were mainly milder infiltration of extra-bone marrow, more severe cytopenias. The early mortality, short and long-term effectiveness were similar to those of group C. 23 8% AML, 51 2% acute monoblastic leukemia and 18 6% ALL presented HAL. There were higher tumor burden,obviously infiltration of extra-bone marrow, higher early mortality, more refractory treatment, poorer prognosis in group B as compared with group A or C. Conclusions Pancytopenia or hyperleukocytosis were common manifestations in primary AL. It is important to understand these features of patients' hemogram for diagnosis, treatment and prognosis evaluation of leukemia.

Objective To evaluate the agreement between colposcopic diagnosis with 2011 colposcopic terminology of the International Federation for Cervical Pathology and Colposcopy (IFCPC) and cervical pathology in cervical lesions. Methods A retrospective cohort study was performed, which included 376 patients who underwent colposcopy with 2011 international terminology of colposcopy at Obstetrics and Gynecology Hospital of Fudan University from September 2014 to November 2014. With conization or cervical biopsy pathology as the gold standard, the agreement between colposcopic diagnosis and pathologic diagnosis was calculated and correlations between variables were analyzed. Results With 2011 international terminology of colposcopy, agreement of colposcopic diagnosis and cervical pathology was 60.9%(229/376)perfectly matched, and the strength of agreement with weighted Kappa statistic was 0.401 (P<0.01), and agreement within one grade was 97.6%(367/376), which were improved compared with traditional methods. Colposcopic diagnosis were 19.9%(75/376) overestimated and 19.1%(72/376) underestimated. There were no significant difference between agreements in various grade lesions (χ2=1.996, P=0.573). Positive predictive value of high grade colposcopy or more was 84.4%, the negative predictive value of low grade colposcopy or less was 88.8%, whereas false positives were 3.5%and false negatives were 39.3%. A linear trend among three types of transformation zone and patient ages was found (χ2=45.910, P<0.01), whereas lesion sizes were not linearly correlated with lesion degrees (χ2=0.690, P=0.406). In grade 1, grade 2 and nonspecific findings, thin acetowhite epithelium, dense acetowhite epithelium and Lugol′s non-staining were most frequent, the Youden indexes of each were 0.170, 0.373 and 0.145, 0.069 respectively. Positive predictive value of some other findings (such as fine mosaic) and two new signs (inner border sign and ridge sign) were 100.0%. There were no significant difference between agreements in examiners with different levels of experience (χ2=1.197,P=0.550). Conclusions Compared to traditional methods (such as Reid index), 2011 international terminology of colposcopy could improve the agreement between colposcopic diagnosis and pathologic diagnosis, without significant differences by the severity of lesion and the level of examiners′experience. Common findings were classified reasonably, and some signs were highly reliable, which is important for guiding biopsy. However, the reproducibility of transformation zone types and the implication of lesion size need to be further discussed.

Background and purpose:MicroRNA (miRNA) belongs to a class of 19 to 30 nucleotide-long, endogenous noncoding RNA expressed in eukaryotes and predominantly inhibits gene expression at the post-transcriptional level. The miRNAs play critical roles in cell proliferation and differentiation, apoptosis, metabolism, and immune regulation. This study aimed to detect the expression of miR-216a-5p in lung cancer tissues and lung cancer cell lines, and to discuss the effects of miR-216a-5p on the invasion ability of lung cancer cells and the mechanism.Methods:Quantitative real-time PCR (qRT-PCR) was used to detect the expression of miR-216a-5p in lung cancer tissues of 55 cases and 7 lung cancer cell lines. Three lung cancer cell lines of A549, 95D and H460 were transiently transfected by miR-216a-5p, and Transwell was used to detect the effects of miR-216a-5p on the invasion of lung cancer cell lines. The dual luciferase reporter plasmids containing the miR-216a-5p candidate target gene and the gene of matrix metalloproteinase 16 (MMP16) were predicted and constructed. qRT-PCR and Western blot were used to detect the changes in mRNA and protein levels of target geneMMP16 by miR-216a-5p. The interference of MMP16 by siRNA and up-regulation miR-216a-5p by transfection were compared on the invasion of lung cancer cells.Results:The miR-216a-5p expression levels were all signiifcantly reduced in 90.91% (50 of 55 patients) tumor tissues compared with corresponding adjacent normal lung tissues (P<0.05). The miR-216a-5p expression levels were only 7.00%-32.00%in 7 lung cancer cells compared with the control group (P<0.05). Up-regulation of the expression of miR-216a-5p inhibited the invasion of lung cancer cells; interference of MMP16 by siRNA, as well as up-regulating miR-216a-5p by transfection, inhibited the expression of MMP16 in lung cancer leading to inhibition of the invasion of lung cancer cells. Conclusion:miR-216a-5p can be a candidate marker in clinical diagnosis and it can inhibit the invasion of lung cancer cells by down-regulating the expression of MMP16.

Objective To investigate effects of different ventilation methods during pulmonary surfactant(PS) administration on cerebral oxygen metabolism in preterm infants with neonatal respiratory distress syndrome.Methods Newborns met the inclusion criteria were enrolled into this study,and they were randomly divided into manual group and mechanical group.During PS administration,the proximal end of the tracheal tube was connected to a bag valve mask device in the manual group or a mechanical ventilator in the mechanical group.Brain near infrared spectroscopy monitoring was carried out to detect the cerebral oxygen saturation(ScO2),and the mean arterial blood pressure (MABP) was simultaneously recorded.Results For all 49 preterm infants,PS was administered to preterm infants with severe respiratory distress syndrome treated with mechanical ventilation,including 24 cases of manual ventilation and 25 cases of mechanical ventilation.The left cerebral ScO2 and correlation coefficient of ScO2 and MABP(rScO2-MABP) showed no difference in both groups before PS administration.During administration,ScO2 dramatically increased in both groups [manual group:(85.88 ± 5.54) ％ vs.(77.31 ± 5.40) ％,t =5.521,P =0.000;mechanical group:(83.88 ± 3.18) ％ vs.(76.53 ±4.38)％,t =6.741,P =0.000],and gradually decreased after administration,the level of ScO2 didn't return to the baseline till the 2nd 5 minutes after PS administration [manual group:(79.25 ± 3.02) ％ vs.(77.31 ± 5.40) ％,t =1.560,P =0.220;mechanical group:(78.59 ± 3.45) ％ vs.(76.53 ± 4.38) ％,t =1.832,P =0.074].The same trend of ScO2 change rate was shown simultaneously in both groups.The rScO2-MABP markedly increased during administration in both groups (manual group:2.34 ±0.16 vs.1.86 ±0.21,t =9.022,P =0.000;mechanical group:2.12 ± 0.15 vs.1.87 ±0.21,t =4.810,P =0.000).The rScO2-MABt,in mechanical group rapidly decreased to baseline during the 1st5 minutes (1.84 ± 0.18 vs.1.87 ± 0.21,t =0.538,P =0.635) but went back to baseline in manual group during the 2nd 5 minutes(1.84 ±0.19 vs.1.86-0.21,t =0.350,P =0.809).Change rates of rScO2-MABP were markedly higher in manual group than those in mechanical group during the 1 st 5 minutes (1.15 ± 0.13 vs.1.00 ± 0.15,t =4.943,P =0.000).Conclusions ScO2 could be affected transiently by PS administration with different methods of ventilation.The effect on cerebral autoregulation in mechanical group is shorter than that in manual group.

Objective To observe the changes of abdominal oxygen saturation in very low birth weight infants (VLBWI)with feeding intolerance (FI)within 1 4 days after birth monitored by near infrared spectroscopy (NIRS).Methods VLBWI fitting entry criteria were enrolled into this study.NIRS monitoring was carried out to detect cerebral oxygen saturation (ScO2 )and abdominal oxygen saturation (SsO2 ).Data were analyzed between FI infants and feeding tolerance (FT)infants.FI was defined as follows:gastric residual of more than 50% of the previous feeding volume;emesis or abdominal distention or both;decrease,delay or discontinuation of enteral feedings. Results 93 VLBWI were enrolled.52 cases(55.91 %)presented with FI,including 29 cases(31 .1 9%)of gastric residual increasing and 23 cases(24.73%)of emesis with or without abdominal distention within 1 4 days after birth. The levels of SsO2 and SsO2 /ScO2 showed no differences in infants with FT and with FI within 24h after birth (P >0.05).The change rates of the median of SsO2 and SsO2 /ScO2 in FT infants were similar during 1 4 days (P >0.05).While both the change rates of SsO2 and SsO2 /ScO2 were markedly decreased 1 day before and the day of FI (P <0.01 ).The decreasing degree of SsO2 was similar between infants with gastric residual increasing and infants with emesis with or without abdominal distention[(1 6.2 ±5.1 )vs (1 7.4 ±3.6)%,t =0.733,P =0.476]. Conclusion Abdominal oxygen saturation measured by NIRS may be a useful method for infants adjusting the feeding plan.

Objective To analyze the clinical significance of lymph node metastasis-related indexes in evaluating the prognosis of initially treated stage N2b colorectal cancer. Methods Two hundred and six patients with initially treated stage N2b colorectal cancer in Shenzhen People′s Hospital from January 2009 to November 2013 were retrospectively analyzed. All patients underwent radical resection of colorectal cancer. The correlation between lymph node metastasis-related indexes and postoperative 5-year overall survival rate was analyzed, including number of negative lymph nodes, number of positive lymph nodes, lymph nodes ratio (LNR), log odds of positive lymph nodes (LODDS). Results The postoperative 5-year overall survival rate was 54.4% (112/206), and the postoperative 5-year recurrence-free survival rate was 48.1% (99/206). Univariate analysis result showed that angioma thrombus or nerve invasion, T stage, postoperative adjuvant therapy, number of positive lymph nodes, number of negative lymph nodes, LNR and LODDS were significantly correlated with the postoperative 5-year overall survival rate (P＜0.01 or ＜0.05). Multivariate analysis result showed that number of negative lymph nodes, number of positive lymph nodes, LNR and LODDS were independent risk factors of postoperative the 5-year overall survival rate ( RR=2.371, 2.295, 2.758 and 2.671; 95% CI 1.598 to 3.485, 1.556 to 3.360, 1.880 to 4.058 and 1.814 to 3.915; P＜0.01). The areas under curve of negative lymph nodes, number of positive lymph nodes LNR and LODDS in predicting postoperative the 5-year overall survival rate were 0.668, 0.657, 0.692 and 0.684, and there was no statistical difference (P＞0.05). Conclusions The number of negative lymph nodes, number of positive lymph nodes, LNR and LODDS in initially treated stage N2b colorectal cancer patients are independent prognostic factors.

Objective To study the chest radiographic appearances of the non-tuberculous mycobacterial(NTM) pulmonary infection in patients with acquired immune deficiency syndrome (AIDS).Methods Ten patients with AIDS and NTM underwent chest X-ray radiography and 7 patients performed high-resolution CT (HRCT) scan. Chest radiographic features of NTM in patients with AIDS were retrospectively analyzed. Results The chest radiograph showed bilateral pulmonary involvement in 6 cases and single lung involvement in 4 cases (3 cases in the right, 1 case in the left). Patchy air space consolidation (6 cases), large consolidation (5 cases), cavitation (5 cases), small nodules (3 cases),military nodules (2 cases), linear opacity ( 1 cases) were demonstrated on radiography. On HRCT, air space consolidation (7 cases), small nodules (6 cases), large consolidation (5 cases) with cavitation and cylindric bronchiectasis after the absorption of consolidation, enlarged hilar and mediastinal lymph nodes (4 cases), ground-glass opacities (3 cases), military nodules and "tree-in-bud" sign (2 case), pleural effusion ( 1 case), pericardial effusion ( 1 case) and fibrotic band ( 1 case) were found. Conclusion The most common radiographic appearances of NTM in patients with AIDS are bilateral small nodules, large consolidation with cavitation and cylindric bronchiectasis, enlarged hilar and mediastinal lymph nodes.

Objective To manifest the imaging appearances of the pulmonary mucormycesis in patients with acquired immunodeficiency syndrome(AIDS).Methods The radiographic and hiish resolution computed lomography(HRCT)features of the pulmonary mucormycosis in 13 patients with AIDS were retrospectively analyzed.Results On radiography,the infiltrative lesions were found in 5 patients,7 cases had reticular pattem,4 cages had pleural effusion,4 cages had enlarged hilar and mediagtinal lymph nodes,3 cases had diffuse milliary lesions,3 Cages had masses,2 cases had ground-slags shadows,2 cages had cystic lesions,cavity,pleural thickening,pericardia]effusion and focal pneumothorax Wag presented in 1 cage respectively.On HRCT,7 cages had enlarged mediagtinal lymph nedes,7 cages had interlobular septal thickening,the infiltrative lesion were found in 6 patients,5 cages had diffuse milliary lesions,4 cages had pleural effusion,3 cases had inasses,2 cages had ground-glass shadows,2 cases had cystic lesions,cavity,pleural thickening,focal bronchiectagis,pericardial effusion and focal pneumothorax was presented in 1 case respectively.Conclusion The main imaging appearances of the pulmonary mucormycesis in patients with AIDS include diffuse milliary lesion,enlarged hilar and mediagtinal lymph node,interiobular septal thickening,infiltrative lesion,pleural effusion and mass.

OBJECTIVE:To investigate the effects of blood concentration monitoring of cylosporin A(CsA) in patients with nephrotic syndrome(NS)on efficacy and safety. METHODS:The medical records of 154 NS patients receiving CsA and blood concentration monitoring in nephrology department of China-Japan Friendship Hospital during Jan. 2014-Aug. 2017 were analyzed retrospectively. The results of blood concentration monitoring in 63 adult inpatients with refractory NS receiving CsA for the first time within 6 months of initial treatment were analyzed statistically. The relationship of blood concentration monitoring with efficacy and safety was analyzed. RESULTS:The blood concentration of CsA in 154 patients were monitored for 512 times with an average of 3.32 times/person,and average blood concentration was(125.98±105.13)ng/mL. The patients with blood concentration of CsA＜100 ng/mL accounted for 44.14%. There was no statistical significance in average monitoring times or average blood concentration between male and female,average blood concentration of CsA among different age groups (P＞0.05). The blood concentration was monitored for 237 times in 63 adult inpatients with refractory NS receiving CsA for the first time within 6 months of initial treatment(induction period). Average blood concentration of effective group were significantly higher than ineffective group;the proportion of effective group with blood concentration＜100 ng/mL was significantly lower than that of ineffective group,with statistical significance (P＜0.05). Among 63 patients,17 patients suffered from ADR (the incidence of ADR was 26.98%). The average blood concentrations of ADR patients were significantly higher than those without ADR;the monitoring times of ADR patients with blood concentration＞150 ng/mL was significantly higher than those without ADR,with statistical significance(P＜0.05). There was no statistical significance in the incidence of ADR between effective group and ineffective group (P＞0.05). Among effective group,there was no statistically significance in average blood concentration between ADR patients and patients without ADR(P＞0.05);the monitoring times of ADR patients with blood concentration＞150 ng/mL was significantly higher than patients without ADR,with statistical significance(P＜0.05). With the increase of monitoring times,the incidence of ADR decreased gradually. There was no statistical significance in the incidence of ADR among patients who were monitored for different times (P＞0.05). CONCLUSIONS:The pharmacokinetics of CsA varies in different patients and many factors affect its blood concentration. The changes of blood concentration affect the efficacy and safety of CsA. It is difficult to determine the dosage of CsA based on experience in the treatment of NS with CsA. Great importance should be attached to blood concentration monitoring of CsA and the implementation of individualized dosage regimen based monitoring results so as to improve therapeutic efficacy and reduce the occurrence of ADR.