Objective To establish a five-color flow cytometric immunophenotyping protocol and valuate its clinical application in leukemia and lymphoma. Methods Samples from 73 cases of acute leukemia and 30 cases of lymphoma were analyzed using a comprehensive antibody panel with five-color combination. The antibody combination CD7/CD33/CD19/CD13/CD45 and MPO/cCD79a/cCD3/CD117/CD45,composed of different lineage distinctive and lineage sensitive markers of B, T and myeloid cells, were applied to determine the lineage originality of leukemia and lymphoma celia. The markers used in the second step analysis were based on the findings of the first step. Results Five-color compensation can be performed automatically and easily with the advanced digital compensation program. The results showed that the expression ratio of CD19 in B-ALL was 100% (27/27), cCD79, pesitivity was 92.6% (25/27) and CD7,cCD3 was expressed in all T-ALL cases (8/8). The B-ALL could be staged depending on the expression level of CD34 ,CD10 ,cμ,sIgM and the T-ALL could be dearly staged dependent on the expression level of CD2,CD1a,,CD4,CD4,CD8. The expression ratio of cMPO, CD117 was 89. 5% (34/38) and 81.6% (31/38) in AML respectively, however CD7 was also expressed in 26.3% (10/38) of AML cases. Combined with morphology, immanophenotypes could be used for diagnosing AML with subtyping. The CD19/SSC gating can be used for immunophenotyping of B cell lymphoma with differential diagnosis. The number of robes required was significantly reduced with our panel from 12 tubes of 3-color to 6 tubes of 5-color. Implementation of the five-color protocol had resulted in 20% reduction in reagent costs. Conclusions The application of fivecolor staining protocol significantly improve the sensitivity and accuracy of measurement of immunophenotypes of acute leukemia and lymphoma. It reduces the cost and can be widely applied in the clinical laboratory diagnosis.

The hippocampus plays an important role in fear learning and memory processing.It is a key brain area in the pathogenesis of post-traumatic stress disorder (PTSD). Neuroimaging studies have confirmed that the hippocampal structure and functional connectivity of patients with PTSD are abnormal, but the changes in hippocampal subregions are still unclear.The results of brain structure studies showed that the cornu ammonis and dentate gyrus atrophy in adult PTSD patients and the symptom of re-experience may be related to pattern separation dysfunction caused by reduced dentate gyrus neurogenesis.Among children diagnosed with PTSD, there is no significant change found in cornu ammonis and dentate gyrus, while atrophy in presubiculum was observed, which could result in fear extinction and deficits in episodic memory.The alteration of hippocampal volume in PTSD may have a gender-specific lateralization phenomenon.The results of brain function studies show that the functional connectivity of hippocampal subregions in PTSD patients is selectively damaged, especially the connectivity with key brain regions in the default mode network is reduced.This article systematically reviews the structural and functional connectivity changes of hippocampal subregions in patients with PTSD from the perspective of neuroimaging, in order to promote the understanding of the pathogenesis of PTSD and identify the therapeutic targets of hippocampal subregions.

OBJECTIVETo detect hFgl2 expression in peripheral blood mononuclear cells in patients with chronic hepatitis B and liver cancer and explore its association with the severity of chronic hepatitis B.

METHODSThe protein expression of hFgl2 in peripheral blood mononuclear cells was detected in 78 patients with chronic hepatitis B (including mild, moderate, or severe cases), chronic severe hepatitis, or liver cancer, with 20 healthy volunteers as controls. The data were analyzed in comparison with the patients' alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBiL and) levels.

RESULTShFgl2 protein expression was significantly higher in patients with chronic severe hepatitis and liver cancer than in the healthy volunteers and patients with chronic hepatitis B. The patients with chronic severe hepatitis had significantly higher hFgl2 protein expression than patients with liver cancer. In severe cases of chronic hepatitis B, hFgl2 protein expression was positively correlated with ALT, AST and TBiL, but these correlations were not found in mild or moderate cases.

CONCLUSIONSPeripheral blood mononuclear cells express hFgl2 protein, whose expression level increases with the severity of chronic hepatitis B.

Case-Control Studies ; Fibrinogen ; metabolism ; Hepatitis B, Chronic ; blood ; classification ; Humans ; Leukocytes, Mononuclear ; metabolism ; Liver Neoplasms ; blood ; classification

Objective: To investigate the risk factors of ventricular arrhythmias in patients with Brugada syndrome. Methods: Clinical data of 60 Brugada syndrome patients admitted in the department of cardiology of the First Affiliated Hospital of Nanjing Medical University from March 2003 to December 2016 were collected and retrospectively analyzed. The age at diagnosis was (43.2±13.1) years (0.6-83.0 years), 98.3% were males (n=59), and the patients were followed up to (92±41) months (12-169 months). The 12-lead surface electrocardiogram (ECG) recorded at the time of diagnosis and showing the highest type 1 ST elevation, either spontaneously or after provocative drug test, was used for the analysis. Patients were divided into ventricular arrhythmia (VA, n=12) group and non-ventricular arrhythmia (non-VA, n=48) group depending on the presence or absence of clinical VA event. The demographic data and ECG data of the 2 groups were compared, and the independent risk factors of VA events were analyzed by stepwise logistic regression. Results: Incidence of family history of sudden death (7/12 vs. 22.9% (11/48)) and percentage of type 1 ST elevation in the peripheral ECG leads (6/12 vs. 16.67% (8/48)) were significantly higher in VA group than in non-VA group (both P<0.05). Max Tpeak-Tend (Max-Tpe) interval ((144±53)ms vs. (110±16)ms) and dispersion of Tpe ((74±50)ms vs. (43±17)ms) were significantly higher in VA group than in non-VA group (both P<0.05). The area under receiver operating characteristic (ROC) curves for the Max-Tpe interval was 0.693 and Max-Tpe interval ≥140 ms was determined as an optimized cutoff point with increased risk of VA event, which had a sensitivity of 50.0%, a specificity of 98.0%, a positive predictive value of 85.7%, and a negative predictive value of 88.7% for predicting VA event. The ROC curves for the dispersion of Tpe was 0.775 and dispersion of Tpe ≥45 ms was determined as an optimized cutoff point for predicting VA event, which had a sensitivity of 91.7%, a specificity of 64.6%, a positive predictive value of 39.3%, and a negative predictive value of 96.9% for predicting VA event. In multivariate analysis, Max-Tpe interval ≥140 ms (OR=27.53, 95%CI 1.07-706.77, P=0.045) and family history of sudden death (OR=24.63, 95%CI 2.05-295.38, P=0.011) were found to be the independent risk factors of arrhythmic events. Conclusions Max-Tpe interval ≥140 ms and family history of sudden death are risk factors of VA event in included patients with Brugada syndrome.

Objective To explore what kind of strategies should be adopted by the medical disciplines of comprehensive universities in China,taking into account and respect the particularity nature of medical science,inspiring innovative creation to build the First-Class disciplines.Methods Literature review and quantitative research were adopted in this paper.By reviewing published articles to better understand the special laws of medical disciplines and identify current development problems.Furthermore,the data from ESI,QS Ranking,and the Ministry of Education were collected to reveal problems and to propose strategies.Results The future development of Medicine disciplines possesses the characteristics of integration,technology dependence,heterogeneity,etc.In the new era of building world-class disciplines and first-class universities,compared with international first-class disciplines,peaks of medical disciplines in Chinese universities are still relatively scarce.The comprehensive university medical discipline should adhere to the principle of ‘connotative development’.In the process of construction,medical discipline should pay full attention to cross-integration,promote cross-disciplinary,adjust and optimize the former system.Strengthen the construction of new disciplines development to build medical disciplines with distinctive features.Optimize top-level design to foster disciplines peaks.Attach great importance to the construction of talents to build up high-level talent team with sustainable development ability.Emphasize on medical education to improve the quality of personnel training.Promote institutional innovation to activate the vitality of integration.Build an effective evaluation system to promote construction.Conclusions With the premise of fully respecting the special laws and characteristics,the medical discipline constructions of comprehensive universities should be guided by the future development model of medicine and clinical needs,and adhered to the ‘connotative development’.With the development of medical disciplines,the level of clinical diagnosis and treatment will be improved,the original innovation will be enhanced,as well as the social service capabilities of comprehensive universities,furthermore,the frontiers of scientific development and national strategic development needs will be effectively supported.

Objective To investigate the pattern of nodal recurrence after curative resection in adenocarcinoma of the gastroesophageal junction ( AGE ) , and to provide a basis for delineation of the radiation range in the high-risk lymphatic drainage area.Methods A retrospective analysis was performed in 78 patients with locally advanced AGE who were newly treated in our hospital from January 2009 to December 2013 and had complete clinical data.All patients received curative resection and were pathologically diagnosed with stage T3/T4 or N (+) AGE.Those patients were also diagnosed with SiewertⅡor Ⅲ AGE by endoscopy, upper gastroenterography, macroscopic examination during operation, and pathological specimens.None of the patients received preoperative or postoperative radiotherapy.All patients were diagnosed by imaging with postoperative nodal recurrence.The computed tomography images of those
patients were accessible and had all the recurrence sites clearly and fully displayed.Results The median time to recurrence was 10 months ( 1-48 months) , and 90%of the recurrence occurred within 2 years after surgery.The lymph nodes with the highest risk of recurrence were No.16b1( 39%) , No.16a2( 37%) , No.9 (30%), and No.11p (26%), respectively.There was no significant difference in the recurrence rate within each lymphatic drainage area between patients with SiewertⅡandⅢAGE ( P=0.090-1.000) .The lymph nodes with the most frequent recurrence were No.16b1, No.16a2, No.9, No.16b2, No.11p, and No.7 in patients with stage N3 AGE and No.11p, No.16b1, No.16a2, No.9, No.8, and No.7 in patients with stage non-N3 AGE.Patients with stage N3 AGE had a significantly higher recurrence rate in the para-aortic regions (No.16a2-b2) than those with stage non-N3 AGE (67%vs.33%, P=0.004, OR=4.00, 95% CI=1.54-10.37) .Conclusions The lymph nodes with the highest risk of recurrence are located in the celiac artery, proximal splenic artery, and retroperitoneal areas ( No.16a2 and No.16b1) in patients with SiewertⅡorⅢlocally advanced AEG.Moreover, patients with stage N3 AGE have a higher risk of retroperitoneal recurrence.The above areas should be involved in target volume delineation for postoperative radiotherapy.

In this paper, we propose a multi-scale mel domain feature map extraction algorithm to solve the problem that the speech recognition rate of dysarthria is difficult to improve. We used the empirical mode decomposition method to decompose speech signals and extracted Fbank features and their first-order differences for each of the three effective components to construct a new feature map, which could capture details in the frequency domain. Secondly, due to the problems of effective feature loss and high computational complexity in the training process of single channel neural network, we proposed a speech recognition network model in this paper. Finally, training and decoding were performed on the public UA-Speech dataset. The experimental results showed that the accuracy of the speech recognition model of this method reached 92.77%. Therefore, the algorithm proposed in this paper can effectively improve the speech recognition rate of dysarthria.
Humans ; Dysarthria/diagnosis* ; Speech ; Speech Perception ; Algorithms ; Neural Networks, Computer

OBJECTIVETo analyze the clinical characteristics and survival depending on biological subtypes in breast cancer patients with brain metastases (BM).

METHODSA retrospective analysis was performed on 152 breast cancer patients with BM admitted to the Cancer Institute & Hospital, Chinese Academy of Medical Sciences from January 2003 to December 2012. Depending on the biological characteristics, these patients were divided into three subtypes: Luminal, human epidermal growth factor receptor 2 (HER-2)-overexpressing, and triple-negative subtypes. The clinicopathological characteristics, recurrence status, and prognostic factors were analyzed at the initial diagnosis. The systemic therapy after BM was further studied.

RESULTSAmong the 152 patients, the number of Luminal, HER-2-overexpressing, and triple-negative breast cancer (TNBC) subtypes were 60, 53, and 39 cases, respectively. The median time from first recurrence to BM of all patients was 7.3 months, the median time of Luminal, HER-2-overexpressing, and TNBC subtypes was 11.0 months, 9.6 months, and 5.5 months, respectively (P < 0.001). Compared with the TNBC subtype, BM occurred later in the HER-2-overexpressing subtype (P < 0.001). In the HER-2-overexpressing subtype, trastuzumab could delay the occurrence of BM in advanced breast cancer patients (17.1 vs. 1.7 months, P < 0.001, 95%CI 5.21-13.98). The median time of overall survival (OS) in the whole group was 56.5 months (7.5-240.2 months, 95%CI 52.6-60.4). The median survival time of Luminal, HER-2-overexpressing and TNBC subtypes was 70.9 months, 53.9 months, and 40.9 months, respectively (P = 0.013). The median survival time of after BM was 11.5 months in the whole group, and the median survival time of Luminal, HER-2-overexpressing and TNBC subtypes was 11.2 months, 12.7 months, and 11.6 months, respectively, with a difference of no statistical significance. Compared with non-BM as the first site, the patients with BM as the first site had a longer survival (14.8 months vs. 8.0 months, P = 0.001). Systemic therapy could prolong the survival after BM. The median survival of chemotherapy, chemotherapy in combination with trastuzumab, and without systemic therapy was 13.6 months, 19.0 months, and 6.5 months, respectively (P = 0.043).

CONCLUSIONSThe survival after BM is influenced by biological subtypes. Compared with the Luminal subtype, brain meatastases occurr earlier in HER-2-overexpressing and TNBC subtypes. Trastuzumab can delay the occurrence of BM from advanced breast cancer, and systemic therapy can improve the survival of patients after brain metastasis.

Brain ; Brain Neoplasms ; diagnosis ; secondary ; Breast Neoplasms ; diagnosis ; pathology ; Female ; Humans ; Neoplasm Recurrence, Local ; diagnosis ; Prognosis ; Receptor, ErbB-2 ; Receptors, Estrogen ; Receptors, Progesterone ; Retrospective Studies