Purpose To investigate the pathological characteristics of loco-regional recurrent nasopharyngeal carcinoma ( rNPC ) . Methods Nasopharyngeal biopsy specimens of 46 rNPCs and 63 primary NPCs were collected. HE staining, immunohistochemistry and EBV small RNAs ( EBERs) in-situ hybridization were performed. Results The over-expression rates of both p63 and CK5/6 in rNPC were significantly higher than those of primary NPCs (P=0. 005, P=0. 026), while no statistical significance of Ki-67 over-ex-pression existed between the two groups ( P=0. 387 ) . More necrotic tissues, inflammatory exudates, giant bizarre carcinoma cells, desmoplastic stroma, giant bizarre tumor cells and higher degree of squamous differentiation were found in rNPCs. The carcinoma cells of 5 rNPCs were negative for both EBERs in-situ hybridization and LMP-1 immunohistochemical staining. Conclusion The loco-re-gional rNPC has two peaks of latency interval:2~5 and 9~11 years. The loco-regional rNPC cells have higher degree of squamous differentiation with higher expression of p63 and CK5/6, as well as more invasive ability. In addition, both EBERs in-situ hybridization and LMP-1 immunostaining are negative in 10. 87% (5/46) of loco-regional rNPC.

Objective:To investigate the expression of sal-like 4 (SALL4) gene in children with acute leukemia and analyze its clinical significance. Methods:Real-time PCR and immunohistochemistry were used to detect SALL4 mRNA and SALL4 protein ex-pressions in 50 patients initially diagnosed with acute leukemia and in 15 patients with immune thrombocytopenic purpura (ITP), which served as controls. Changes were detected in SALL4 mRNA expression from preliminary diagnosis and after complete remission of 5 acute leukemia patients. The relationship between SALL4 mRNA expression and clinical indicators was analyzed. Results: SALL4 mRNA expression is higher in initially diagnosed B-ALL [13.89 (1.00-63.15)] and AML [11.12 (2.31-56.59)] than in ITP controls [1.00 (0.29-1.71)] (P<0.01). SALL4 mRNA expression in initially diagnosed T-ALL [1.48 (0.87-4.81)] and in controls showed no significant difference (P>0.05). SALL4 protein expression is in agreement with SALL4 mRNA expression. SALL4 mRNA expression significant-ly decreased in complete remission stage [0.98 (0.22-1.09)] than in acute phase [28.64 (11.20-87.46)] in acute-leukemia patients (P<0.01). High SALL4 mRNA expression level is positively correlated with high white blood cell count, high risk classification, and high minimal-residual disease at the end of induction chemotherapy (r=0.424, r=0.40, and r=0.393, respectively;P<0.05), but not with age, gender, hepatomegaly, splenomegaly, and lymphadenectasis (P>0.05). Conclusion:SALL4 was found to play an important role in pro-moting childhood B-ALL and AML, which promises a new target for monitoring the therapeutic effects and evaluating the prognosis of childhood B-ALL and AML.

Objective To explore the expression and significance of matrix metalloproteinase (MMP)-9, IV collagen and CD34 in epithelial ovarian tumor. Methods Eighty-two patients with epithelial ovarian tumor, among them,there were 48 malignant epithelial ovarian carcinomas, 23 borderline epithelial ovarian tumors and 11 benign epithelial ovarian tumors. The expression of MMP-9, IV collagen and CD34 were detected by immunohistochemistry. Results The expression of MMP-9 was strongly linked to the degree of malignant ovarian carcinomas (F= 39.306,P< 0.01). The expression of CD34 was also strongly linked to the degree of malignant ovarian carcinomas [benign epithelial ovarian tumors was (17.18±5.64)%,borderline epithelial ovarian tumors was (29.76±7.18)%,well-differentiated malignant epithelial ovarian carcinomas was (57.20±8.55)%,moderately-differentiated malignant epithelial ovarian carcinomas was (71.20±8.48)%, poorly-differentiated malignant epithelial ovarian carcinomas was(90.38±20.03)%](F= 100.072, P < 0.01). The expression of IV collagen in malignant epithelial ovarian carcinomas was different from that in borderline epithelial ovarian tumors and benign epithelial ovarian tumors (F = 11.554,P<0.0l). The expression of MMP-9 was positive correlation with the loss expression of IV collagen and the expression of CD34 (r=0.796,0.802,P< 0.01).Conclusions The positive expression of MMP-9,CD34 and the negative expression of IV collagen are obviously relevant to degree of malignant ovarian carcinomas.The combined testing on expression of MMP-9,CD34, IV collagen on ovarian carcinomas is significant to decide degree of malignant ovarian carcinomas and evaluate future development.

Objective To determine the half-effective target effect-site concentration (Ce) (EC50) of sufentanil required to inhibit the body movement during insertion of ureteroscopes when combined with propofol in patients undergoing transureteroscopic holmium laser lithotripsy. Methods Fifty ASA Ⅰ or Ⅱ patients of both sexes, aged 20-60 yr, BMI ＜ 30 kg/m2 , undergoing transureteroscopic holmium laser lithotripsy were randomly divided into 5 groups according to the different C es of sufentanil ( n = 10 each): group S1 (Ce 0.21 ng/ml), group S2(Ce 0.14 ng/ml), group S3(Ce 0.09 ng/ml), group S4(Ce 0.06 ng/ml), group S5(Ce 0.04 ng/ml). TCI of propofol with target plasma concentration set at 2.5-3.0 μg/ml was given. Sufentanil with the corresponding Ce was infused in each group. The ureteroscopes were inserted as soon as the patients lost consciousness and the effect-site concentration of sunfentanil was achieved. The response was defined as positive when body movement occurred within 1 min after insertion of ureteroscopes. The EC50 of sufentanil required to inhibit the body movement during insertion of ureteroscopes when combined with propofol and 95% confidence interval (CI) were calculated. Results The EC50 of sufentanil required to inhibit the body movement during insertion of ureteroscopes when combined with propofol was 0.084 ng/ml and 95% CI was 0.066-0.107 ng/ml. Conclusion The EC50 of sufentanil required to inhibit the body movement during insertion of ureteroscopes was 0.084 ng/ml when combined with propofol.

OBJECTIVE: To explore the influence of hypoxemia on the hearing of children with childhood obstructive sleep apnea-hypopnea syndrome (OSAHS). METHOD: Auditory brainstem response (ABR) and distortion-product otoacoustic emission (DPOAE) was recorded in 68 ears and 60 ears respectively of children suffering from OSAHS with "A" tympanogram. Meanwhile, ABR and DPOAE was also recorded in 30 controls of children with "A" tympanogram. RESULT: There was no statistical difference between the mild OSAHS group and the control group in the latency of wave I, III and V, the interval between wave I and III, III and V, I and V. There was significant difference between the moderate and severe OSAHS group and the control group in the delayed latency of wave I. There was significant difference between the mild OSAHS group and the control group in the amplitudes of DPOAE at 8 kHz. There was significant difference between the moderate and severe OSAHS group and the control group in the amplitudes of DPOAE at 6 kHz and 8 kHz. CONCLUSION Cochlear function was affected when AHI > or = 10/h. ABR and DPOAE could be used to detect the early damagement of auditory function in childhood OSAHS.
Adolescent ; Child ; Child, Preschool ; Evoked Potentials, Auditory, Brain Stem ; Female ; Humans ; Male ; Otoacoustic Emissions, Spontaneous ; Sleep Apnea, Obstructive ; physiopathology

Objective To investigate the outcomes and relative risk factors in subjects with impaired fasting glucose in Inner Mongolia,China.Method A total number of 32 villages in Kezuohou Banner and Naiman areas in Inner Mongolia were selected as the baseline surveys study fields from 2002 to 2003.Patients with IFG(5.6 mmol/L≤FPG＜7.0 mmol/L) but without history of diabetes were selected as the study subjects.A follow-up study was conducted in 2013.Multinomial logistic regression analysis was used to evaluate the correlated factors.Results There were 384 patients with IFG recruited in the study.Out of them,150 (39.1％) progressed to normoglycaemia,174 (45.3％) remained as IFG,and 60 (15.6％) developed into type 2 diabetes mellitus.Through adjustment multivariately,patients that returning to the status of normoglycaemia were significantly associated under the function of TG (OR=0.692,95％CI:0.502-0.952,P＜0.05) and those developed to diabetes were significantly associated with factors as age (OR=1.052,95％CI:1.014-1.090,P＜ 0.05) or obesity (OR=2.924,95％ CI:1.353-6.320,P＜0.05).Conclusion 15.6％ of the IFG patients developed diabetes mellitus among the Inner Mongolian population.Elevated TG was an inhibition factor for patients returning to normoglycaemia while both age and abdominal obesity were risk factors for the development of diabetes in the Inner Mongolian population.

Objective:To explore the incidence of vascular leakage after acute hemodilution in patients with traumatic orthopedics by using 6% hydroxyethyl starch 130/0.4 (HES).Methods:Using prospective cohort study method, 48 orthopedic trauma patients in in Yantaishan Hospital from June 2018 to December 2018 were selected as the subjects of observation.The American Society of anesthesiologists (ASA) grade was divided into grade I-III.According to the degree of trauma, they were divided into two groups: general orthopedic patients group (24 cases) and severe trauma orthopedic patients group (24 cases). According to the formula of blood volume, the blood volume of the patients in the two groups was calculated.After intubation, 10% of the blood volume of HES was infused intravenously at the rate of 0.5 ml/(kg·min) for acute hemodilution.Plasma colloidal osmolality and hemoglobin were measured immediately before acute hemodilution (T0), 15 minutes (T1) and 30 minutes (T2) after acute hemodilution.The concentrations of HES in T1 and T2 plasma were measured.The urine volume from the beginning of infusion to 30 minutes after the end of infusion was saved.The urine volume and hes concentration were measured to calculate the urine hes content.Results:The amount of HES input was the same in the general orthopedic patients group and the severe trauma orthopedic patients group, which were (7.71±0.3) ml/kg and (7.70±0.2) ml/kg, and the expansion ratio was about 100%.Compared with T0, plasma colloid osmotic pressure at T1 and T2 were (27.9±1.5) mmHg(1 mmHg=0.133 kPa)) and (27.7±1.5) mmHg in the general traumatic orthopedics patients, which was higher than T0((26.5±1.5) mmHg, P<0.05). There was no significant difference of COP at T1 and T2 ((27.0±1.6) mmHg and(26.9±1.5) mmHg) compared with T0((26.3±1.7) mmHg, P>0.05) in the severe trauma orthopedic patients). The concentration of plasma HES in the severe trauma orthopedic patients ((6.8±0.6) g/L and (5.8±0.5) g/L) was lower than in the general traumatic orthopedics patients ((7.7±0.5) g/L and (7.1±0.5) g/L, t=5.660 and 6.755, all P<0.05) at T1 and T2.There was no significant difference of the urine HES content ((29.0±3.5 ) mg vs.(28.4±3.3) mg, t=0.61, P>0.05 )between the two groups after infusion. Conclusion:The ratio of acute hemodilution and volume expansion of HES was the same in the two groups.The changes of plasma colloid osmotic pressure and HES concentration were lower in patients with severe trauma orthopedics, and there was more obvious extravascular leakage in patients with severe trauma orthopedics.

OBJECTIVETo investigate the expression level and analyze the clinical significance of NT5C2, which is an nucleoside analogues metabolism related gene, in children with acute leukemia (AL).

METHODSReal-time PCR and immunohistochemistry were presented to detect the level of NT5C2 mRNA and its protein product cN- Ⅱ in bone marrow samples of 63 patients initially diagnosed with AL, 15 patients who achieved complete remission, 7 patients who relapsed and 16 non- hematologic malignancie controls. The expression of NT5C2 mRNA in different groups of AL and its relevance with clinical indicators were analyzed.

RESULTS①The expression of NT5C2 mRNA in newly diagnosed B-ALL, TALL, AML and controls were 1.16 (0.89-2.25, 0.96 (0.74-1.25, 1.66 (0.84-3.15) and 0.88 (0.61-1.21), respectively. NT5C2 mRNA expression in AML (P<0.01) and B-ALL (P<0.05) cases were higher than that in controls; NT5C2 mRNA expression in T- ALL and in controls showed no significant difference (P>0.05). Changes of NT5C2 mRNA level were observed between preliminary diagnosis and complete remission in 15 patients. NT5C2 mRNA levels were significantly decreased in complete remission stage than that in newly diagnosis AL (P<0.01). NT5C2 mRNA levels of relapsed-refractory group were higher than that of complete remission group and controls (P<0.01). ② Immunohistochemical staining results revealed that NT5C2 protein levels were consistent with the trend of mRNA levels. ③NT5C2 mRNA levels in AML (r=0.434) and T-ALL (r=0.389) were positively correlated with risk classification (P<0.05). ④ During chemotherapy of patients with AML, the NR rate of bone marrow in NT5C2 high expression group was higher than that of low expression group after 9 days induction chemotherapy (35.2% vs 0) and before consolidation therapy (25.0% vs 0); The positive rate of minimal-residual disease (36.4% vs 14.3%) and relapse rate of AL (38.5% vs 28.6%) were increased in NT5C2 high expressed patients than that in low expressed patients, but all the differences were insignificant (P>0.05).

CONCLUSIONHigh expression of NT5C2 was found to be a related risk factor of AL children with unfavourable prognosis. NT5C2 promises a new target for guiding individualized chemotherapy and evaluating the prognosis of childhood acute leukemia and monitoring recurrence.

5'-Nucleotidase ; metabolism ; Bone Marrow ; metabolism ; Child ; Humans ; Leukemia, Myeloid, Acute ; metabolism ; Neoplasm, Residual ; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma ; metabolism ; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma ; metabolism ; Prognosis ; RNA, Messenger ; metabolism ; Real-Time Polymerase Chain Reaction ; Recurrence ; Remission Induction

OBJECTIVETo investigate the outcomes and relative risk factors in subjects with impaired fasting glucose in Inner Mongolia, China.

METHODA total number of 32 villages in Kezuohou Banner and Naiman areas in Inner Mongolia were selected as the baseline surveys study fields from 2002 to 2003. Patients with IFG (5.6 mmol/L≤FPG<7.0 mmol/L) but without history of diabetes were selected as the study subjects. A follow-up study was conducted in 2013. Multinomial logistic regression analysis was used to evaluate the correlated factors.

RESULTSThere were 384 patients with IFG recruited in the study. Out of them, 150 (39.1%) progressed to normoglycaemia, 174 (45.3%) remained as IFG, and 60 (15.6%) developed into type 2 diabetes mellitus. Through adjustment multivariately, patients that returning to the status of normoglycaemia were significantly associated under the function of TG (OR = 0.692, 95%CI:0.502-0.952, P < 0.05)and those developed to diabetes were significantly associated with factors as age(OR = 1.052, 95%CI:1.014-1.090, P < 0.05) or obesity (OR = 2.924, 95% CI:1.353-6.320, P < 0.05).

CONCLUSION15.6% of the IFG patients developed diabetes mellitus among the Inner Mongolian population. Elevated TG was an inhibition factor for patients returning to normoglycaemia while both age and abdominal obesity were risk factors for the development of diabetes in the Inner Mongolian population.

Blood Glucose ; analysis ; China ; epidemiology ; Diabetes Mellitus, Type 2 ; epidemiology ; Fasting ; blood ; Follow-Up Studies ; Humans ; Obesity ; epidemiology ; Prediabetic State ; epidemiology ; Risk Factors

OBJECTIVETo establish a hemophagocytic lymphohistiocytosis (HLH)-like mouse model induced by CpG oligodeoxynucleotide (CpG-ODN1826) and interferon (IFN)-γ for further study on therapy.

METHODSWild type adult C57BL/6 mice were administered with PBS or CpG-ODN1826 (50 μg) by intraperitoneal injection every two day and IFN-γ subcutaneous injection every day. Parameters of HLH were evaluated on day 10.

RESULTSAs compared to control, HLH-like symptoms in CpG group were characterized with pancytopenia accompanied by increased ratios of monocytes, alanine aminotransferase [(198.7±54.2)IU/L], triglyceride level [(12.1±0.6)g/L], and serum ferritin [(708.4±11.8)pmol/L]; decreased albumin [(217.7±4.3)g/L], fibrinogen [(17.1±1.9)g/L] (all P<0.05). Hepatosplenomegaly was obvious in CpG group. The liver in CpG group had multifocal hepatocytes necrosis and perivascular inflammations. Spleen had expanding red pulp and hyperplastic nucleated cells. Furthermore, macrophages in the liver and spleen were largely activated. Hemophagocytosis were observed in liver, spleen and bone marrow smear. The CpG group was alive during experiment, other than significant decreased activity after the first injection of CpG-ODN.

CONCLUSIONThese data demonstrate that repeated administration of CpG-ODN1826 and IFN-γ could induce HLH-like symptoms without fatal condition in wild type C57B/L mice. This protocol could establish a mild HLH-like mouse model, which could be useful for further study on HLH.

Animals ; Disease Models, Animal ; Injections, Intraperitoneal ; Interferon-gamma ; Lymphohistiocytosis, Hemophagocytic ; chemically induced ; Mice ; Mice, Inbred C57BL ; Oligodeoxyribonucleotides ; toxicity ; Spleen