Objective To research the imaging classification and dynamic changing of bronchioloalveolar carcinoma (BAC). Methods The imaging types of BAC proved by operation and pathology in 32 cases were divided into single nodules, single segment or lobe consolidation, multiple segments or lobar consolidation and multiple diffuse nodules according to the features of plain chest films and CT at first examination. The spreading lesions in lung were recorded.The developing course and changes in size of lesions on the followed-up plain films and CT were observed, then the developing rules of different types of BAC were analyzed. Results The single noduli were enlarged and became poor defined opague shadows gradually. The single segment or lobar consolidation enlarged until the whole lobe. All single lesions progressed and coexisted with diffused nodular or opaque pulmonary involvement eventually. Multiple segments or lobar consolidation developed from peripheral to center of the segment or lobar, diffused pneumonia-like shadows appeared simultaneous. Multiple extensive nodules showed a trend of getting larger and then fused.Conclusion Different types of BAC have theirown developing rule,but they finally form a consequence that the primary lesion coexisted with the spread ones from different way.

Objective To analyze the difference in changes of upper airway between obstructive sleep apnea syndrome (OSAS) patients and normal population using dynamic radiography under sleeping and awake conditions.Methods 20 normal subjects and 20 OSAS patients underwent the dynamic digital radiography of the upper airway under sleeping and awake conditions.And the dynamic diameter changes of the upper airway at velopharyngeal,oropharynx and hypopharynx levels were measured and recorded.Results The velo-pharyngeal upper airway collapse in normal subjects under sleeping condition was significantly larger than that under awake condition (P <0.014).However no significant differences in the collapse of upper airway at oropharynx and hypopharynx level were observed between sleeping and awake conditions.For the OSAS patients,the upper airway collapses at velopharyngeal,oropharynx and hypopharynx levels under sleeping condition were significantly larger than those under awake condition respectively (P <0.000,P =0.001,P <0.013). During awake state,there were no significant differences in upper airway collapse at velopharyngeal,oropharynx and hypopharynx levels between normal subjects and OSAS patients under awake condition.During sleeping state,the upper airway collapses of OSAS patients were significantly larger than that of normal subjects at velopharyngeal and oropharyngeal levels (P =0.000,P =0.003). However,no significant difference was observed at hypopharynx level.Conclusion The normal upper airway represents obvious col-lapse at velopharyngeal level under sleeping condition.However,the upper airway in OSAS patients at velopharyngeal,oropharynx and hypopharynx level showed significant collapse under sleeping condition compared with that under awake condition.The upper airway of the OSAS patients represents obvious collapse at velopharyngeal and oropharyngeal level under sleeping condition,however no abnormal changes can be observed under awake condition.

Objective To establish the database of diameter and length of the pulmonary artery branches in different phase of cardiac cycle in healthy adult chest MDCT.Methods Normal enhanced chest MDCT with ECG-gating was selected and slab thin slice maximaun intensity projection(STS MIP) reconstruction were performed in different periods on ECG represent systole and diastole respectively.The diameter and length of pulmonary artery on the plane which showed the whole length of the aim artery were measured.Doppler UCG with ECG-gating was performed in healthy adults to measure the inner diameter of pulmonary trunk and right and left pulmonary artery in different phases of the cardiac cycle as contrast method.Results Normal enhanced chest MDCT with ECG-gating showed the diameter in systole period of the main pulmonary artery was larger than that in diastole period,while it went conversely to that of the proximal part of two pulmonary arteries,distal part of the right pulmonary artery,right media-lobe artery,both S10 segmental arteries and the difference were statistic significantly,only the length in diastole period of the right upper lobe artery was larger than that in systole period.The distance between the measured point of the main artery and the right one showed larger in diastole than systole period.On ECG-gating UCG,in addition to that the diameter change of the main pulmonary artery during the two periods were coincident with MDCT,the two pulmonary artery had no significant difference during the two periods.Conclusion It is necessary using branching geometry data of the main artery to segmental arteries in different period of the cardiac cycle with normal enhanced chest MDCT for flowing model building of pulmonary artery.

Objective To investigate the clinic characteristics of hepatosplenic γδT cell lymphoma (γδ HSTCL) and analyze the important role of morphology,immunology,cytogenetics and molecular(MICM) in the early diagnosis of γδHSTCL.Methods The clinical features of MICM of a rare case of childhood γδHSTCL had been analyzed,and the related literatures were reviewed.Results Bone marrow aspiration showed approximately 0.365 abnormal cells infiltrated.The immune phenotype analysis displayed 0.245 of the nuclear cells were abnormal ones,which possessed CD2/CD3/CD7/CD19/CD3s/cCD3 and TCRγδ expression.The immunohistochemical staining of spleen tissues showed clusters of differentiation (CD) 3/CD45 RO/CD8/Cytotoxic-granule associated protein (TIA-1)/leukocyte common antigen (LCA)/Granzyme B positive,CD4/CD20/T cell receptor (TCR) β/CD79 α/CD30/terminal deoxynucleotidy transferase (TdT) /CD10/ myeloperoxidase (MPO)/anaplasticlymphoma kinase (ALK) negative and 80.00％ of tumor cells displayed Ki-67 positive.The detection of spleen tissues by flow cytometry displayed that 72.26％ of the karyocytes were lymphocytes,with 88.90％ T lymphocytes.And 92.09％ of the T lymphocytes showed Ki-67/CD7dim,TCRγδ/CD2/CD8/CD34 positive,and TCRαβ/CD5/CD4/CD56 negative.And about 59.16％ of these karyocytes were abnormally matured T lymphocytes.The cytogenetic karyotype of bone marrow showed 46,XY.The detection of T cell receptor gene rearrangement showed TCRβ,TCRγ and TCRδ positive.The patient had been given prednisone of 60 mg/m2 when the diagnosis of γδHSTCL affirmed.But his parents discontinued chemotherapy for him and died.Conclusions MICM has shown a significant value in the diagnosis of γδHSTCL,a rare lymphoma in childhood.

Aim To investigate the HIV-1 entry inhibitory activities of myriceric acid B and C isolated from Rhoiptelea chiliantha Diels et Hand-Mazz and their mechanism of action.Method The plasmids encoding envelope proteins of HIV-1 (pHXB2) and VSV (pVSV-G) were cotransfected 293T cells with pNL4-3.Luc.R-E- to produce HIV-1 Env pseudovirus and VSV-G pseudovirus,respectively,which were used for testing the antiviral activities of these compounds.ELISA and molecular docking were used to study the mechanism of action of the active compounds.Results Myriceric acid B could significantly inhibit the infection of HIV-1 Env pseudovirus with an IC_(50) of(8.3±0.2)mg·L~(-1).The carbonoxyl group at C-28 position and the hydroxyl group at the C-3 position of myriceric acid B are important for its anti-HIV-1 activity.Like other HIV-1 entry inhibitors targeting gp41 (eg,ADS-J1 and NB-64), myriceric acid B could also block the gp41 six-helix bundle formation.Molecular docking analysis suggests that myriceric acid B may bind to the hydrophobic cavity of the gp41 N-trimeric coiled coil.Conclusion Myriceric acid B is a potent HIV-1 entry inhibitor targeting gp41 and can serve as a lead compound for developing novel anti-HIV-1 drug.

This paper aims to define the concept of autonomous learning and explore the purpose and significance of medical students' autonomous learning by combing the literature review at home and abroad in this field.Through analyzing the research progress and research methods of autonomous learning,this paper attempts to raise problems and provide countermeasures accordingly.In the current research of autonomous learning,researchers' perception of this study is insufficient.The scope of the current research is too limited and the research fields need to be further widened.In addition,the classification of disciplines in this subject is unbalanced and the coverage also needs to be further expanded.There are many theoretical studies but few empirical studies so far,and thus empirical research should be strengthened.

OBJECTIVETo study the inhibitory activities of 3-trifluoromethyl benzamide derivatives against the entry of H5N1 influenza viruses.

METHODSThe lead compound was structurally modified to obtain 3 compounds with inhibitory activities against H5N1 influenza viruses. Specs compound librany was screened and 4 compounds were identified to have such inhibitory activities. The inhibitory activities of these compounds were tested at a celluar level against H5N1 influenza viruses.

RESULTS AND CONCLUSIONThe compounds 1a, 1b, 1e and 1f showed signifcant inhibitory activities against the entry of A/AnHui/1/2005 pseudovirus into the target cells with an IC50 value of 4.7 ± 0.3 µmol/L.

Antiviral Agents ; pharmacology ; Benzamides ; pharmacology ; Humans ; Influenza A Virus, H5N1 Subtype ; drug effects ; physiology ; Influenza, Human ; Virus Internalization ; drug effects

Even though mutations in LMNA have been reported in patients with typical dilated cardiomyopathy (DCM) and atrioventricular block (AVB) previously, the purpose of this study was to disclose this novel genetic abnormality in one Chinese family with the atypical phenotype of progressive AVB followed by DCM with normal QRS interval. Genome-wide linkage analysis mapped the AVB gene in this family to a marker at chromosome 1q21.2, where the LMNA gene was located. Direct DNA sequence analysis revealed a heterozygous G to A transition at nucleotide 244 in exon 1 of LMNA, which resulted in an E82K mutation. The E82K mutation co-segregated with all affected individuals in the family, and was not present in 200 normal controls. Further clinical evaluation of mutation carriers showed that 5 of 6 AVB patients exhibited mild DCM with a late onset of age in the fourth and fifth decades. Ejection fractions were documented in 5 patients with DCM, but 4 showed a normal value of [Symbol: see text]50%. Echocardiography showed that atrial dilatation occurred earlier than ventricular dilatation in the patients. This study suggests that progressive AVB with normal QRS interval and accompanying DCM at later stages may represent a distinct type of DCM. The molecular mechanism by which the E82K mutation causes AVB as the prominent phenotype in DCM may be a focus of future studies.

Objective:Through the analysis of the evaluation index system of the major rankings of universities and hospitals, this paper aims to provide a reference for the discipline construction of affiliated hospitals in universities.Methods:This paper comprehensively analyzes and compares the evaluation objectives and indicators of the five major rankings of universities and the three major rankings of hospitals in China and abroad.Results:Each main rankings have its own characteristics that both positive and with possible limitations.Conclusions:Hospital management departments can refer certain indicators in order to identify possible gaps of the hospital discipline development. Also, tailored corresponding measurements for discipline development can be developed in combination with real-needs.

2019 novel coronavirus(2019-nCoV) outbreak is one of the public health emergency of international concern.Since the 2019-nCoV outbreak, China has been adopting strict prevention and control measures, and has achieved remarkable results in the initial stage of prevention and control.However, some imported cases and sporadic regional cases have been found, and even short-term regional epidemics have occurred, indicating that the preventing and control against the epidemic remains grim.With the change of the incidence proportion and the number of cases in children under 18 years old, some new special symptoms and complications have appeared in children patients.In addition, with the occurrence of virus mutation, it has not only attracted attention from all parties, but also proposed a new topic for the prevention and treatment of 2019-nCoV infection in children of China.Based on the second edition, the present consensus further summarizes the clinical characteristics and experience of children′s cases, and puts forward recommendations on the diagnostic criteria, laboratory examination, treatment, prevention and control of children′s cases for providing reference for further guidance of treatment of 2019-nCoV infection in children.