Objective To evaluate the significance of dual-color interphase fluorescence in situ hybridization (FISH) in the engraftment estimation and minimal residual disease (MRD) monitoring after sex-mismatched allogeneic hematopoietic stem cell transplantation (allo-HSCT).Method The fluorescence signal of samples from 35 cases in different periods after sex-mismatched allo-HSCT were detected by interphase FISH using chromosome enumeration probes (CEP) X and Y. Results All of 35 patients had been determined to obtain engraftment after allo-HSCT. When the disease relapsed,FISH showed that the percentage of donor chromosomes was decreased and when the disease got remission,the percentage of donor chromosomes increased. When conventional cytogenetics showed 100 % XX or 100 % XY,FISH showed different percentage of host chromosomes.Conclusions The test of dual-color interphase FISH is reliably sensitive and simple for engraftment evaluation and MRD monitoring post HSCT. It is a good complement method to cell morphology and traditional karyotype analysis.

To maintain the global consistency of the authorizing is a challenge when the system authorization is changed in grid environments. This paper proposes a policy-based automatically negotiating method to deal with this issue. An effective system framework, which includes the certificate management, the access policy repertory, the negotiator and the automatcally negotiating mechanism, is designed and implemented. The experimental results show that automated negotiation can quickly regain the global authorization consistency and only cause a little system overhead increasing. Compared with the manual authorization maintaining, the presented method can reduce the negotiating time significantly, and reduce the meaningless grid jobs because the inconsistent privileges are controlled timely.

To maintain the global consistency of the authorizing is a challenge when the system authorization is changed in grid environments. This paper proposes a policy-based automatically negotiating method to deal with this issue. An effective system framework, which includes the certificate management, the access policy repertory, the negotiator and the automatcally negotiating mechanism, is designed and implemented. The experimental results show that automated negotiation can quickly regain the global authorization consistency and only cause a little system overhead increasing. Compared with the manual authorization maintaining, the presented method can reduce the negotiating time significantly, and reduce the meaningless grid jobs because the inconsistent privileges are controlled timely.

Objective To validate analytical performance of electrochemiluminescent immunoassay ?-HCG and explore a suitable validation mode on electrochemiluminescent immunoassay system of Elecsys 2010 under the guidance of evidence-based laboratory medicine.Methods The analytical performance of the electrochemiluminescence immunoassay(ECLIA)system of Elecsys 2010 including precision,analytical sensitivity,linear range,accuracy and reference range was validated by detecting the specimens of different concentrations.The results were analysed by statistical package for social science 10.0.Results Imprecision studies yielded with-run CV of 0.43%-2.12% and between-day CV of 1.07%-3.73%;CV for total imprecision were 1.81%-4.90%.Recovery after dilution of high-concentration samples in assay diluent were within the rang of 94%-110%.Analytical sensitivity was

Objective To compare the effect of inhibiting neointimal hyperplasia between domestic sirolimus eluting stent(Firebird TM stent)and the TaxusTM stent by IVUS.Methods From May 2003 to June 2007,168 patients with 236 native lesions underwent DES implantation,of which,108 patients(147 lesions)were implanted with the FirebirdTM stents and the other 60 patients(89 lesions)were implanted with the TaxusTM stent.Quantitative angiography(QCA)and intravascular ultrasound(IVUS)analysis were performed at one-year follow-up.Results The baseline clinical and angiographic characteristics between the two groups were similar.There were less in-stent late loss(0.17?0.29 mm vs 0.43?0.51 mm,P0.05).But the Absolute and relative measwements of intimal hyperplasia including manifested as intimal hyperplasia area(0.35?0.58 mm2 vs 1.29?1.26 mm2),percentage of intimal hyperplasia area(5.45%?9.26% vs 17.38%?13.75%),percentage of maximal intimal hyperplasia area(9.41%?14.15% vs 31.56%?20.99%),intimal hyperplasia volume(2.09?5.46 mm3 vs 13.43?18.59 mm3)and percentage of intimal hyperplasia volume(1.68%?5.84% vs 8.62%?9.90%)were lower in the Firebird stent group than those in the Taxus stent group(all P

Objective To explore the regularity of heat shock protein 70(HSP70)expression and its function in renal ischemia/reperfusion injury(IRI),and to reveal whether traditional Chinese medicine, Xuebijing injection(血必净注射液),induces HSP70 synthesis and has a protective effect on IRI.Methods One hundred and eight female Sprague-Dawley(SD)rats,(200?20)g in weight,were used in this experiment,and randomly divided into three groups(each n=36):control(A),model(B)and treatment group(C).The I/R model was established by clamping renal pedicles on both sides for 45 minutes to cause ischemia and then reperfusion was made.In group A,a similar model procedure was performed,but without ischemia.At 5-10 minutes before the IRI was performed,5 ml/kg of normal saline and 5 ml/kg of Xuebijing injection was injected through the femoral vein in group B and C respectively.In B and C groups,according to the durations of reperfusion for 0,6,12,24,36 and 48 hours,the rats were subdivided into six subgroups (each n=6).At the end of each time point,blood and renal tissue were collected to measure blood creatinine (SCr)and urea nitrogen(BUN),and Western blotting method was used to examine the expression of HSP70. In another kidney,renal tissue was obtained for hematoxylin and eosin(HE)staining pathological and immunohistochemical examinations.Results In B and C groups,the SCr and BUN levels at 6 hours after I/R were significantly higher than those in the A group,and those in the C group were lower than those in the B group(P

OBJECTIVETo investigate the value of thyroglobulin measurement in ultrasound guided fine-needle aspiration(FNA-Tg)for detecting neck node metastasis in patients with papillary thyroid carcinoma(PTC)after thyroidectomy.

METHODSA total of 128 suspicious metastatic lymph nodes in 112 patients were retrospectively analyzed. Postoperative pathologic results were taken as the gold standard. The values of FNA and FNA-Tg combined FNA in the diagnosis of metastatic lymph nodes were compared with different ultrasonic features.

RESULTSThe sensitivity, specificity and accuracy of single FNA for the diagnosis of neck node metastasis were 67.5%, 98.0% and 79.7% respectively, and those of FNA-Tg combined FNA were 87.0%, 100.0% and 92.2% respectively. Compared with single FNA, the sensitivity and accuracy of FNA-Tg combined FNA were increased significantly(χ(2)=8.319, P=0.004; χ(2)=8.275, P=0.004). When the ultrasonographic characteristics met any one of five indicators for neck node metastasis, the sensitivity, specificity and accuracy of single FNA for the diagnosis of neck node metastasis were 38.1%, 95.7% and 68.2% respectively, and those of FNA-Tg combined FNA were 71.0%, 100.0% and 86.4% respectively. Compared with single FNA, the sensitivity and accuracy of FNA-Tg combined FNA were increased significantly(χ(2)=4.709, P=0.030; χ(2)=4.141, P=0.042). When the ultrasonographic characteristics met any two of five indicators for neck node metastasis, the sensitivity, specificity and accuracy of single FNA for the diagnosis of neck node metastasis were 55.0%, 100.0% and 73.5% respectively, and those of FNA-Tg combined FNA were 90.0%, 100.0% and 94.1% respectively. Compared with single FNA, the sensitivity and accuracy of FNA-Tg combined FNA were increased significantly(χ(2)=6.140, P=0.013; χ(2)=5.314, P=0.021). The ultrasonographic characteristics met any three, four or five of five indicators or did not meet any of the indicators, there was no significant difference in the value of the diagnosis of metastatic lymph nodes between single FNA and FNA-Tg combined FNA(P>0.05).

CONCLUSIONSThe combination of FNA with FNA-Tg could be helpful in diagnosis of lymph node metastasis. When the suspicious lymph nodes had one or two ultrasound characteristics for neck node metastasis, FNA-Tg could raise the sensitivity and accuracy of FNA, and FNA-Tg could not significantly improve in the diagnosis of FNA when presenting with no or with more than 2 ultrasonographic features.

Biopsy, Fine-Needle ; Carcinoma ; pathology ; Carcinoma, Papillary ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; diagnosis ; Postoperative Period ; Retrospective Studies ; Sensitivity and Specificity ; Thyroglobulin ; analysis ; Thyroid Neoplasms ; pathology ; Thyroidectomy

Objective : To construct an appropriate technology catalogue for general practice based on Delphi method,and to provide reference for promoting appropriate techniques and training general practitioners. Methods : The catalogue was briefly constructed based on literature reviews and the data of the top twenty diseases diagnosed in out-patient department of Sir Run Run Shaw Hospital and two community health service centers in Hangzhou. Two-round Delphi consultation was conducted by fourteen general practitioners coming from upper first-class hospitals and community hospitals. The final catalogue was established according to evaluation of the degree of involvement,authority coefficient and Kendall's W values of the fourteen specialists. consultations : Results Of the fourteen specialists,nine had bachelor's degrees and five had master's degrees or above;twelve were deputy chief physicians or chief physicians and two were physicians. They were engaged in general practice for 17.21 years in average. The positive coefficients of the two rounds of were both 100.00%. The authority coefficient of the specialists was 0.891. After the first round of consultation,the W values for importance and feasibility of 6 first-class indicators were 0.170 and 0.244,and the ones of 56 second-class indicators were 0.236 and 0.250（all P<0.05）. Six of second-class indicators were excluded because their coefficent of variation（CV）for importance and feasibility were more than 0.25. After the second round of consultation,the W values for importance and feasibility of 6 first-class indicators were 0.245 and 0.247,and the ones of 50 second-class indicators were 0.355 and 0.370（all P<0.05）. The CV for each indicator was less than 0.25. Finally,an instructional catalogue was defined,consisting of 6 first-class indicators（basic diagnosis and treatment skills,first aid skills,symptomatic diagnosis and treatment skills,chronic disease management skills,common disease diagnosis and treatment skills,and common manipulative skills）and 50 second-class indicators. Conclusion The degrees of involvement,authority and consistency of the specialists were relatively high. The catalogue of appropriate technology for general practitice had good reliability and feasibility,which was worthy of promotion and application.

Narcolepsy is the most common cause of excessive daytime sleepiness (EDS) following obstructive sleep apnea. Its treatment aims to reduce EDS and cataplexy, improve nighttime sleep disturbance, sleep paralysis and sleep-related hallucinations. Pitolisant (a histamine H3 receptor antagonist) and solriamfetol (a norepinephrine reuptake inhibitor) have recently been approved effective for narcolepsy in the United States and the European Union. Pitolisant has proved to be effective for both EDS and cataplexy. Besides being effective on EDS, solriamfetol seems to have advantages in abuse potential and withdrawal syndrome. As potential treatments for EDS and cataplexy associated with narcolepsy, several new drugs are being developed and tested. These new drugs include new hydroxybutyrate preparations (controlled release sodium hydroxybutyrate FT218, low sodium hydroxybutyrate JZP-258), selective norepinephrine reuptake inhibitor (AXS-12), and modafinil combined with astroglial junction protein inhibitor (THN102). This paper reviews the recently approved drugs and potential treatments for narcolepsy.

OBJECTIVE: To investigate the effect of obstructive sleep apnea (OSA) on different sleep stages, and the relationship between N3 stage of non-rapid eye movement sleep and respiratory abnormal events. METHODS: A total of 188 adult patients who underwent overnight polysomnography(PSG)monitoring in Sir Run Run shaw Hospital of Zhejiang University from June 24th to December 26th 2019 were enrolled in the study. OSA patients were classified into 3 groups (mild, moderate and severe) according to the apnea-hypopnea index (AHI). PSG data, AHI and the lowest SPO in each stage of sleep were compared among three groups. RESULTS: There was no significant difference in total sleep time and sleep efficiency among patients with different severity of OSA (all >0.05). The proportion of N3 stage in moderate and severe OSA groups were significantly smaller than that in mild OSA group (all <0.05). The proportion of N3 stage in severe OSA group was also smaller than that in moderate OSA group (<0.05). In addition, severe OSA group had a longer latency of N3 stage than mild and moderate OSA groups (all <0.05). The latency of N3 stage in moderate OSA group was longer than that in mild OSA group (<0.05). The AHI in N3 stage was markedly lower than that in other sleep stages (all <0.01), regardless of the severity of OSA. Supine AHI in N3 stage in mild and moderate groups was significantly lower than that in N1, N2 and rapid eye movement (REM) stages (all <0.01). Supine AHI in N3 stage in severe group was also lower than that in N2 and REM stages (<0.05 or <0.01). The lowest SPO in N3 stage was significantly higher than that in N1, N2 and REM stages (<0.05 or <0.01), regardless of the severity of OSA. CONCLUSIONS s The proportion of N3 stage is lower in OSA patients, and N3 stage has less sleep respiratory events than non-N3 stages. The results suggest that the increased N3 stage proportion may indicate less severity of OSA.