Objective:To compare the difference between 20 cases of subcutaneous panniculitis-like T-cell lymphoma (SPTL) and 19 cases of cutaneous extra-nodal nasal-type NK/T-cell lymphoma (cutaneous NK/T-cell lymphoma). Methods:The two types of lymphoma were compared in clinical pathology, immunological marker, Epstein-Barr (EB) virus infection, and T-cell receptor (TCR) gene rearrangement. Results:Differentiated diagnosis of the two types of lymphomas was not easy based on their clinical manifestations,but the cutaneous NK/T-cell lymphoma was always followed by extracutaneous dissemination and had a poor prognosis. Histopathologically, SPTL was usually limited in subcutaneous fatty tissues while the cutaneous NK/T-cell lymphoma showed diffused infiltration around the dermis and it often infiltrated into the subcutaneous fat tissues. Coagulation necrosis, angiocentric infiltration and epidermotropism were often observed in cutaneous NK/T-cell lymphoma. When compared with immunophenotypes, SPTL often expressed βF1, membrane CD3 and CD8 but did not express CD4 and CD56, while most of the cutaneous NK/T-cell lymphomas expressed CD56 and cytoplasm CD3ε and only a few cases expressed CD3 and CD8. The differences in the expression of CD56, CD3, CD8, and βF1 were significant between the two types of lymphomas(P<0.05). The positive rate of EBER1/2 was 25% (5/20) in SPTL while it was 100% in cutaneous NK/T-cell lymphoma. The difference was statistically significant (P<0.05). Monoclonal TCR-γ gene rearrangement was found in 16 out of 20 cases of SPTL (80%) but only in 4 of 18 cases in the cutaneous NK/T-cell lymphoma (22.2%). The difference was significant(P<0.05). Conclusion:The key points to distinguish the two lymphomas are (1) extracutaneous dissemination, coagulation necrosis, angiocentric infiltration and epidermotropism; (2) the expressions of CD56, CD3, CD3ε, CD8, and βF1; (3) the positivity of in situ hybridization of EB virus; (4) detection of the monoclonal TCR-γ gene rearrangement. To make an acute differentiated diagnosis of the two lymphomas, comprehensive analysis is necessary to integrate the results of clinical manifestation, histopathology, immunophenotype, infection of EB virus and gene rearrangement.

BACKGROUND:Whether controling of post-injury inflammatory response combined with neural stem cel (NSC) transplantation can improve the curative efficacy for spinal cord injury stil remains unclear. OBJECTIVE:To investigate the repair of spinal cord tissue, myelin regeneration, axon regeneration, motor function recovery and the possible mechanism after early application of tumor necrosis factor α antagonist (Etanercept) combined with tyrosine kinase C (TrkC) gene-modified NSC transplantation. METHODS:TrkC-overexpressed NSCs (TrkC-NSCs) were constructed by lentiviral transfection technique. The rat models of spinal cord transection injury were prepared, and then subjected to Etanercept combined with TrkC-NSCs transplantation. The number of neurons and neuroregeneration after injury were measured by Nissl's staining, immunofluorescence and western blot. The rat motor function was detected by Basso Beattie Bresnahan score and evoked potential. The myelin regeneration was detected by electron microscopy and toluidine blue staining. RESULTS AND CONCLUSION:Compared with the other groups, the Etanercept combined with TrkC-NSCs transplantation group had more survived anterior horn motor neurons at 28 days after injury, more myelin-encapsulated axons, higher Basso Beattie Bresnahan score, greater amplitude of the evoked potentials, and relatively shorter latency (alP < 0.05). These findings indicate that early application of tumor necrosis factor-α antagonist combined with TrkC-NSCs transplantation after spinal cord injury in rats can effectively promote myelin regeneration, axon regeneration, and further promote motor function recovery.

Objective Through conducting the project of quality improvement for intrahospital transport of critically ill patients from ward to ICU,to establish graded management under early warning to improve transport efficiency and quality.Methods Through setting up project team,setting goals of quality improvement,measuring and analyzing transport status,the graded management under early warning was established from three aspects:condition,equipment and transport personnel.The graded management under early warning was applied to clinical nursing practice to evaluate the effects.Results There was no statistical difference before and after the implementation of graded management under early warning in gender,age and condition of critical ill patients between two groups,but the time of transport was significantly reduced after the implementation,while there was no equipment failure,and the incidence of adverse events associated with devices decreased effectively.Conclusion The establishment and application of graded management under early warning has effectively reduced the risks of transport,improved efficiency and quality of transport.

Objective To evaluate the use of transfer statements in inhouse transport of critical patients.Methods By means of continuous enrollment,123 critical patients were enrolled as a control group for conventional transport,and 111 such patients were enrolled as an observation group for transport using the transfer statement.Then the incidence of adverse events,transport during and nurse-nurse collaboration level of the two groups were compared.Results In the control group,its incidence of adverse events was 13.8%,the mean transport during was(19.5 ± 8.4)minutes,and the mean score for nurse-nurse collaboration level was ( 101.87 ± 7.13 ).In the observation group,its incidence of adverse events was 5.4%,the mean transport during was(13.5 ± 5.4)minutes,and the mean score for nurse-nurse collaboration level was(106.15 ± 8.86).Implementing the transfer statement has cut back the incidence of adverse events (P<0.05)and the transport duration significantly(t=3.833,P<0.01),while improving the level of nurse-nurse cooperation significantly(t= -4.261,P<0.05).Conclusions The transfer statement can increase the safety of patient transport,promote organization and coordination of nurses,and improve the efficiency of transport.

Objective To evaluate the efficacy and safety of oral magnesium sulfate solution in split doses as bowel preparation in elderly patients undergoing colonoscopy.Methods A total of 368 elderly patients undergoing colonoscopy were enrolled at PLA General Hospital.The patients were randomly divided into magnesium sulfate solution orally in split doses group (group A,n=178) and single dose group (group B,n=190).Parameters including general information,defecation frequency,Boston bowel preparation score (BBPS),detection rate of lesions and adverse reactions.Results The frequency of defecations in group A was (7.6± 1.4),more than that in group B (6.6± 1.5) with statistical significance (P＜0.05).The duration of bowel preparation in group A was (128.6±25.3) min,shorter than that of group B (165.4±29.7) min (P＜0.05).The BBPS in group A was (8.09±0.67),better than that of group B (7.34±0.58) (P＜0.05).The detection rates of intestinal polyps and micropolyps (diameter＜0.5 cm) in group A were 73/178 (41.0％) and 51/178 (28.7％) respectively,compared with 58/190 (30.5％) and 37/190 (19.5％) in group B (both P＜0.05).In group A,8 patients reported adverse reactions as abdominal distension and discomfort.One patient had ST-T abnormality of electrocardiogram (ECG).No nausea or vomiting occurred,yet 2 cases needed enema for inadequate bowel preparation.Twenty-one cases in group B reported adverse events including 7 with nausea and vomiting.There were 13 patients treated with enema.Abnormal ECG was found in 4 patients in group B.The satisfaction rate of group A was 97.8％,higher than that of group B (91.6％) (P＜0.05).Conclusions The effect of bowel preparation of elderly patients with magnesium sulfate solution in split dose has a better tolerance,good cleaning effect and low incidence of adverse reactions.It is an ideal choice for the elderly to prepare colonoscopy.

OBJECTIVETo construct an eukaryotic expression plasmid for AY358935 gene and explore its function.

METHODScDNA of the AY358935 gene was amplified by reverse transcription-PCR and cloned into pGEM-Teasy. The pGEM-T-AY was validated by sequencing and served as a template for the construction of eukaryotic expression plasmid. The pcDNA3.1-AY recombinant was validated by double enzyme digestion and used for transient transfection of M14 cells. Expression of the AY358935 protein and proliferation of the M14 cells were determined respectively by Western blotting and 3-(4,5)-dimethylthiahiazo(-z-y1)-3,5-di-phenytetrazoliumromide (MTT) colorimetry.

RESULTSThe amplicons of RT-PCR were confirmed to have similar size with the cDNA fragment of the AY358935 gene as well as cloned region of pcDNA3.1-AY. The cloned region of pGEM-T-AY was sequenced to be identical with cDNA sequence of the AY358935 gene. M14 cells were transfected by the AY358935 gene, pcDNA3.1 and liposomes, respectively. After 48 h, expression of the AY358935 protein in M14 cells transfected with the AY358935 gene was significantly higher than other two groups. They also had a significantly higher absorbance value (A=0.74) than other two groups (A=0.39 and 0.46, respectively; P<0.05).

CONCLUSIONAn eukaryotic expression plasmid of the AY358935 gene was successfully constructed. Product of the AY358935 gene may promote the proliferation of M14 cells.

OBJECTIVETo observe the effect of oversized occluder on endothelialization post percutaneous closure of experimental atrial septal defect (ASD) in dogs.

METHODSASD was established with the help of transthoracic echocardiography in 18 dogs. ASD size was (6.0 ± 0.2) mm. Dogs were randomly divided into normal size group (implanted with 8 mm occlude, n = 9) and oversized group (implanted with 12 mm occluder, n = 9). Dogs were randomly killed at 3, 6 and 14 months after percutaneous closure. The endothelialization process on device surface was observed by scanning electron microscope.

RESULTSFour animals died around 1 month post procedure. Microscopic sections from normal group showed nearly complete endothelialization at 3 months after device implantation and complete endothelialization at 6 and 14 months after device implantation. While microscopic sections showed lack of endothelialization at 3 months post implantation, nearly endothelialization at 6 months, and complete endothelialization at 14 months after device implantation in oversized group.

CONCLUSIONIncomplete endothelialization of occluder surface is observed at 6 months after implantation of an oversized ASD occluder device in this model.

OBJECTIVE: To discuss the value of chromosomal microarray analysis (CMA) for the identification of DMD gene deletions during prenatal diagnosis. METHODS: G-banded karyotyping and CMA were performed on fetuses with ultrasonographic soft markers but no family history for Duchenne/Becker muscular dystrophy (DMD/BMD). Denaturing high-performance liquid chromatograghy (DHPLC) was used to detect DMD gene mutations in umbilical cord blood and peripheral blood samples from the mothers. RESULTS: For fetus 1, analysis of amniocytes showed a normal karyotype, while CMA detected a 119 kb deletion at Xp21.1 (32 565 489 - 32 681 461), which encompassed exons 10 to 16 of the DMD gene. The result was confirmed by DHPLC analysis. The mother was found to have loss of heterozygosity in the same region. For fetus 2, karyotyping of amniocytes also showed a normal male karyotype, while CMA detected a 254 kb deletion at Xp21.1 (32 104 604 - 32 358 874), which encompassed exons 41 to 44 of the DMD gene. The same deletion was not detected in the mother. DHPLC analysis confirmed the presence of both deletions. CONCLUSION Two fetuses harboring DMD gene deletions but without a family history were discovered. CMA can improve the efficiency for detecting single gene diseases caused by deletions.
Dystrophin ; genetics ; Exons ; Female ; Fetus ; Gene Deletion ; Humans ; Incidental Findings ; Male ; Microarray Analysis ; Muscular Dystrophy, Duchenne ; genetics ; Pregnancy

We hereby reported a case of ring chromosome 18 complicated by the deletion of 18p11.32p11.31 and 18q21.33q23 diagnosed prenatally by G-banding karyotype and chromosomal microarray analysis (CMA). Ultrasound scan indicated a single umbilical artery and intrauterine growth retardation at the second trimester. The result of G-banding karyotyping was 46, XN, r(18)(p11.3q21.3) and CMA indicated that there was a 3.3 Mb deletion at 18p11.32p11.31 and a 16.9 Mb deletion at 18q21.33q23. All these suggested that the fetus might present with clinical manifestations such as growth retardation, epilepsy, speech delay and growth hormone deficiency after birth, so the couple decided to terminate the pregnancy after genetic counseling.

OBJECTIVE: To study the correlation between dosage and curative effect of blood coagulation factor VIII in the prevention and treatment of haemophilia A in children and to determine the suitable dose for prevention of hemophilia in developing countries. METHODS: For different body weights of child patient, every time we used the same dosage of blood coagulation factor VIII (250 U each time, 3 times a week) and observed and recorded the number of hemorrhages in child patients. Then we compared the number of hemorrhages with children without treatment to determine the curative effect. According to the different body weights, we calculated the dosage of VIII factor of blood coagulation per kilogram (hereinafter referred to as the dose), and used Spearman correlation coefficient to study the correlation between dose and curative effect. RESULTS: The number of hemorrhages in 58 child patients before the treatment was 4.36 ± 1.78, while after the treatment was 2.22 ± 1.04 (t=7.91, P<0.001). The Spearman correlation coefficient of child patients of 5-10 U/kg was -0.421 (P=0.005); the Spearman correlation coefficient of child patients of 10-15 U/kg was -0.331 (P=0.030); the Spearman correlation coefficient of child patients over 15 U/kg was -0.16 (P=0.325). CONCLUSION Prevention and treatment can significantly reduce the times of hemorrhage in hemophilia patients.
Blood Coagulation ; Child ; Factor VIII ; administration & dosage ; therapeutic use ; Hemophilia A ; therapy ; Hemorrhage ; prevention & control ; Humans