Objective: To identify the differentially expressed genes (DEGs) between hepatocellular carcinoma (HCC) tissues and normal liver tissues by bioinformatic methods, and to explore the intrinsic mechanism of these candidate genes involving in the occurrence and development of HCC from transcriptome level as well as the clinical significance of their associations with the prognosis of HCC patients. Methods: Gene expression profiles of GSE45267, GSE64041, GSE84402 and TCGA were downloaded from GEO (Gene Expression Omnibus) and TCGA(The Cancer GenomeAtlas), respectively. R software and Bioconductor packages were used to identify the DEGs between HCC tissues and para-cancer tissues, and then Gene Ontology (GO) Enrichment analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis, Protein-Protein Interaction (PPI) network analysis and survival analysis were performed. Results: Forty-six up-regulated genes and 154 down-regulated genes were screened out,and GO enrichment analysis showed that these DEGs were mainly related to cell division, proliferation, cycle regulation, oxidation-reduction process and certain metabolic pathways. KEGG pathway analysis revealed that DEGs were mainly involved in tryptophan metabolism, retinol metabolism and other metabolic pathways as well as p53 pathway. Over-expression of a panel of up-regulated genes (CCNA2, CDK1, DLGAP5, KIF20A, KPNA2 and MELK) was shown to be significantly negatively correlated with the prognosis of HCC patients in the TCGA dataset (all P<0.01). Conclusion: A set of up-regulated hub genes that are negatively correlated with prognosis will provide potential guiding value for the clinical research on the diagnosis and treatment of HCC.

Objective To find a proper way for accurate results on complete blood counts.Methods Based on the results from automatic hematology analyzer, set up criteria for blood cell microscopic examination. 9 992 blood specimens were detected and the results were analyzed according to the criteria, statistics on the data were made to find out the reliability of the policy.Results The criteria could help to find more abnormal cells, it was very useful for clinical diagnosis and proper treatment.There were 29.3% of CBC specimens needed for microscopic examination, 32.2% of which had increased bands or increased atypical lymphocytes or other abnormalities.Conclusions It was very important to set up the criteria for performing peripheral blood smear. It can provide more accurate and reliable information to clinical doctors.

Objective To evaluate the international blood smear review criteria for improvement using Beckman-Coulter hematology analyzers and find out proper slide review criteria suitable for Chinese population. Methods 3 600 random-selected blood samples were tested in three hospitals using MAXM, GENS and LH750 5-diff automated analyzers and a manual differential with a smear review was performed on all samples in the study. True positive rate, true negative rate, false positive rate and false negative rate were calculated according to the international blood smear review criteria. We have set up smear review criteria for Chinese population by analyzing false positive and false negative cases according to Chinese clinical conditions. Another 240 blood samples were tested in three hospitals using the same analyzers to verify the new slide review rules. Results According to international blood smear criteria, the true positive rate was 4.9%, false positive rate was 24.2%, true negative rate was 70.4% and false negative rate was 0.5%. The international smear review criteria were modified into 23 criteria by analysis of above statistical data. In addition, we added four WBC differential ratio rules in positive smear criteria. After modification, the true positive rate was 9.9% (355/3 600) ,false positive rate was 17.1% (617/3 600), true negative rate was 71.2 % (2 563/3 600) and false negative rate was 1.8% (65/3 600). No blast cell was missed using both smear review criteria. A little higher false negative rate after modification was caused by supplemented differential ratio roles in positive smear criteria. Verification results were satisfactory;The tree positive rate was 13.7% (33/240) ;false positive rate was 15.8% (38/240) ;false negative rate was 2.5% (6/240) and true negative rate was 68.0% (163/240). Conclusions Although the smear review criteria suggested by the International Consensus Group is clinically important, the false positive rate increases when they are used in Chinese population. The modified slide review criteria used on Beckman-Coulter hematology analyzers in this study are more suitable for Chinese laboratories.

Objective To explore the value of laparoscopy in the diagnosis and treatment of recurrent inguinal hernia in children.Methods The clinical data of 67 cases receiving laparoscopic treatment for recurrent inguinal hernia in children at the Department of General Surgery,Wuhan Children's Hospital,Tongji Medical College,Huazhong University of Science & Technology were retrospectively analyzed,including the type of hernia recurrence,operation time,intraoperative and postoperative complications,such as short-term hydrocele formation and testicular atrophy and so on.Results In 67 cases,there were 65 males and 2 females.Open repair surgery and laparoscopic surgery were respectively performed in 48 cases and 19 cases for the first operation and the hernia defects were found after operation.Contralateral patent vaginal process deformities were found in 11 sides in the reoperation.Among 67 cases of recurrent inguinal hernia,incomplete ligation of hernia sac was found in 21 cases,low level ligation of hernia sac in 17 cases,no ligation of hernia sac in 14 cases,omissive direct inguinal hernia in 4 cases,loose ligation of hernia sac in 4 cases,overlarge inner ring in 4 cases,weak abdominal muscles in 2 cases,and increased abdominal pressure (long-term constipation,asthma) in 1 case.All the patients were treated by laparoscopic hernia repair and no serious complications occurred during the operation.The average time of unilateral operation was (15.0±2.2) minutes (13-25 minutes),and bilateral operation was (27.0±4.3) minutes (18-41 minutes).All patients were discharged on the second day.Two patients showed short-term postoperative hydrocele and were cured with conservative treatment.During the follow-up time of (23±2) months (9-39 months),no recurrence or testicular atrophy was found.Conclusions Laparoscopy can confirm the type of recurrent inguinal hernia and contribute to reduce postoperative recurrence.Laparoscopic management of recurrent inguinal hernia in children is safe and feasible,which is expected to replace open hernia repair.

Objective:To evaluate the operation effect of remote imaging network platform in a regional medical center.Methods:The workload data of remote imaging network in a regional medical center from 2017 to 2019 were analyzed.Results:137 medical institutions were connected to the remote imaging diagnosis network platform, and the number of imaging examinations in grass-roots medical institutions increased significantly. Part of the imaging examination in the superior medical center was gradually diverted to the subordinate medical institutions. However, limited by the ability of image diagnosis, grass-roots medical institutions relied on remote diagnosis of higher-level hospitals.Conclusions:Remote image diagnosis network is an important platform support for Internet plus medical health service, which can rapidly and effectively enhance the ability and level of imaging diagnosis in primary medical institutions.