This paper comprehensively reviewed the practice and meanings of non-invasive prenatal test (NIPT) in China and discussed the ethical issues.NIPT,as a step of prenatal diagnosis,brought conflicting values and moral economic influences.Its widely application also imposes higher requirements on policy regulation and lead to some ethical issues,including whether the client really informed consent.Genetic counselling is also crucial before and after the test.However,the subjects,doctors and medical staff have not yet fully prepared.Furthermore,this technique is relatively simple and cheap,and its application relates to many aspects.It is necessary to discuss the influence at the early stage and put forward the ethical issues that need to be paid attention to.Therefore,life ethics expert participation is extremely important,and to some extent will leadfetal and maternal supervision,management and supervision to a new level,especially with the development of NIPT and the application of whole genome sequencing (WGS).

Objective To settle the "bottleneck" disputes existed in the key aspect of emergency treatment care of emergency department, long delayed time of medical workers or patients, perplexity of first-aid personnel, less standard in medical records. Methods Comparison experiment was carried out with the traditional model of emergency care in contrast with the new model, besides the service attitude was improved,the awareness of responsibility was strengthened and the first-aid technique was increased. Number of nursing errors and disputes, hospitalization time, satisfaction degree of patients and record trace-ability were observed. Results The nursing errors and disputes reduced by 46%, hospitalization time re-duced by an average of (7.2±0.2) minutes, satisfaction degree of patients increased by 10.99%, leaving 1673 record traceability of care. Conclusions The application of new management processes of nursing interface in emergency department can settle the "bottleneck" disputes of key interface, make the green passage of emergency patients more convenient and is conducive to safe care, less mortality, high work effi-ciency, which proves to be a reference for fellows.

Objective To investigate serum uric acid (UA) levels and related clinical features in patients with high risk syndrome of neuromyelitis optica. Methods UA levels were measured in 51 patients with high risk syndrome of neuromyelitis optica including 34 with longitudinally extensive transverse myelitis (LETM) and 17 with optic neuritis (ON), 48 with neuromyelitis optica (NMO), 45 with other neurological diseases (OND) and 65 with healthy controls (HC). The disability severity was assessed by the expanded disability status scale (EDSS). Spinal lesions were viewed by MRI. Serum aquaporin-4(AQP4) antibody was tested in cell based immunofluorescence assay. Results Serum UA levels in LETM ( ( 189. 84 ±85. 65) μmol/L) and ON patients ( (222. 12 ±61.68) μmol/L) were significantly lower than that in OND ((315.90±71.36) μ mol/L) and HC ((291.05 ±76.64) μ mol/L) subjects (P＜0.01). No difference was found between LETM, ON and NMO groups. UA levels were significantly lower in females ( ( 158.24 ±55.92), (187.00±47.52), (198.21 ±62.62), (274.51 ±70.66)and (243.26±60.65) μmol/L)than in males ( ( 262. 09 ± 101.63 ), ( 262. 45 ± 62. 13 ), ( 298.90 ± 74. 14 ), ( 355.37 ± 50. 30 ) and (340. 34 ±58. 23) μmol/L) in all groups (t=3. 183, 2.578, 4.356, 4.365 and 6.579, all P＜0.05).UA levels in patients with high risk syndrome of NMO were not correlated with mono or relapse course,duration or status of serum AQP4 antibody. UA were negatively correlated with EDSS in patients with LETM (r= -0.714, P＜0.01). Conclusion Lower serum UA levels were found in patients with high risk syndrome of NMO and related to more severe symptoms in LETM group.

Objective To investigate serum uric acid (UA) levels and related clinical characteristics of neuromyelitis optica (NMO). Methods The serum uric acid levels were measured in 65 patients with NMO, compared to control groups which were 76 cases with multiple sclerosis ( MS), 126 cases with cerebral vascular diseases (CVD) and 130 healthy controls(HC). The disability severity in NMO was assessed by the Expanded Disability Status Scale (EDSS). Magnetic resonance imaging ( MRI ) was performed to strengthen assessment the involved lesions. Serum AQP4 antibody was tested in a cell based immunofluorescence assay. Results In male groups, serum UA levels in NMO patients [ (298.90±74.14) μmol/L] were significantly lower than that in CVD [ (355.37 ±50. 30) μmol/L] and HC subjects [ (340.33 ± 58.23 ) μmol/L, P ＜ 0.05 ]. No difference was found between NMO and MS [ ( 292.36 ±92.95) μmol/L] groups. In female groups, serum UA levels in NMO patients [(198.21 ± 62.62)μmol/L] were significantly lower than that in CVD [(274.51 ± 70.66) μmol/L] and HC subjects [(243.26 ±60.65) μmol/L,P ＜0.05]. No difference was found between NMO and MS [(232.29 ±71.95 ) μmol/L ] groups. UA levels were significantly lower in females [ ( 198.21 ± 62. 62) μ mol/L] than in males [ (298.90 ±74.14) μmol/L]. UA levels were significantly lower in patients with EDSS≥5 [ ( 195.48 ± 83.70 )μmol/L] than EDSS ＜ 5 [ (241.00 ± 63.20)μmol/L] NMO patients. In our study UA levels were not correlated with longitude of spinal lesions, activity revealed by MRI and AQP4 antibody tires.Conclusion Lower serum UA levels were found in patients with NMO and related to more severe symptoms.

Objective To improve the recognition of precursor T- lymphoblastic lymphoma (T-LBL)of the breast. Methods One case of breast T- LBL was reported, the development of breast non-Hodgkin lymphoma and T-LBL presenting as breast masses was reviewed. Results One case of breast T-LBL was diagnosed, the patient with a high leukocyte count, breast mass and peripheral lymph nodes was treated with Hyper-CVAD regimen after active therapy and achieved complete remission (CR). Followed by maintenance therapy with Hyper-CVAD regimen for three times, disease free survival had been obtained five month.Conclusion Lymphoma of the brest is a rare malignancy. T-LBL is a highly aggressive disease with adverse prognosis, it is very uncommon for presenting as lymphoma of breast. Initiation of intensive muhiagent chemotherapy can improve the free survival and the prognosis.

Objective To investigate the protective effect of crocin on oxidative stress cell model of PC 12 cell and the effect of crocin on PI3K/Akt signal pathway,as well as further explore the mechanism of protective effect on model cells.Methods Cells were divided into control group,model group,crocin group and VE group.The cell survival rate was detected by MTT method,and the expression of mRNA and protein of PI3K/Akt were detected by RT-PCR and Western blot.Results With the crocin concentration in 0.625 μM and 5 μM,the cell survival rate increased in a dose-dependent manner.The average optical density rate of PI3K and Akt mRNA were 0.435±0.044 and 0.375 ± 0.034,and the PI3K and Akt protein were 0.378± 0.038 and 0.386± 0.043 of crocin group.Compared with the model group,the expression levels of PI3K/Akt increased in crocin group (P＜0.05).Conclusion These results indicate that the antioxidant and antiapoptosis effects of crocin are induced via increasing expression of PI3K and pAkt.

Purpose Recently the incidence of bone and joint degeneration is increased,with the increasing of cardiovascular disease complication.This study aims to utilize realtime three-dimensional echocardiography (RT-3DE) in evaluating left ventricular remodeling index (LVRI),to guide treatment and improve the survival rate.Materials and Methods Fifty-seven cases of healthy volunteers (normal control group) and sixty-seven patients with bone and joint degeneration (research group) were respectively divided into two subgroups according to the age.Both groups underwent conventional echocardiography and RT-3DE.The LVRI,left ventricular end diastolic volume index (LVEDVI),left ventricular mass index (LVMI),left ventricular end systolic volume index (LVESVI) and left ventricular ejection fraction (LVEF) measured by different methods were analyzed,and the differences and correlations between groups and within each group were compared.Results The age of normal control group and research group was not significantly different (P＞0.05).The LVMI and LVRI in research group were significantly higher than those in the normal control group with same age (P＜0.05).The LVEDVI,LVMI and LVRI measured by two-dimensional echocardiography and M-mode echocardiography were higher than those measured by RT-3DE,and the difference was statistically significant (P＜0.05).Bland-Altman agreement analysis showed good agreement of measured LVRI using 2D echocardiography and RT-3DE.Conclusion Patients with bone and joint degeneration have left ventricular remodeling.RT-3DE can accurately assess LVRI with the advantages of convenience and lack of radiation,which can be widely used in clinic.

Objective:To investigate the dynamic changes of the luminal microbiota in the jejunum following administration of proton pump inhibitors (PPIs) in a rat model.Methods:Rats were randomized into six groups (n =6 each group).A group of rats were sacrificed just after anesthesia as normal control (0 d) and,other five groups were continuously administered with omeprazole (10 mg/kg twice daily,intraperitoneally) and were euthanized at 5,9,14,21,28 days following the treatment,respectively.Total DNA in the luminal contents of jejunum was extracted and was used for polymerase chain reaction (PCR) amplification with the primer set targeted the hypervariable V3 region of 16S ribosomal RNA genes.Subsequently,the amplicons were separated by denaturing gradient gel electrophoresis (DGGE).After the gels were stained and photographed,the bands were cut out and sequenced to determine the closest bacterial relatives with the BLAST.The DGGE profiles were analyzed to evaluate the shifts of the microbiota composition and diversity following treatments.Results:Changes of the jejunal microbiotas in rats were observed at 5 and 9 days post PPI administration,as characterized by outgrowth of Streptococcus pneumonia,Clostridium saccharolyticum and Lactococcus garvieae compared to those of the controls (0 d).With time extension of PPI treatment,the mictobiotas significantly shifted toward dysbiotic state,in which the opportunistic pathogens,including Ertterococcus faecalis and Clostridium difficile,were strikingly expanded,especially 21 days later.However,the commensals such as Lactobacillus reuteri and Weissella koreensis were markedly declined in PPI-treated animals compared with the controls.The similarity of the jejunal microbiotas between PPI-treated animals and controls was markedly reduced following PPI treatment,reaching (56.1 ± 16.7) ％ at 28 days.Conclusion:Our data demonstrate that the gastric acid suppression could induce shifts of the jejuna microbiota in a rat model.More importantly,long-term use (＞ 14 d) of PPI could lead to the dysbiosis of the jejunal microbiota,which might be related causally to increased susceptibility to enteric infection.

Objective:To explore the clinical application of NanoString fluorescent barcode technology in the molecular subtyping of diffuse large B-cell lymphoma (DLBCL), and to analyze the correlation between the cell-of-origin subtype and prognosis of patients.Methods:The tumor tissue samples of 12 patients with DLBCL at the Third People's Hospital of Datong of Shanxi Province and 8 patients with DLBCL at Peking University, Health Science Center between January 2014 and December 2019 were collected. According to Hans algorithm, all patients were divided into 1 case of germinal center-derived B-cell (GCB) type and 19 cases of non-GCB type. NanoString platform was used to analyze the expression level differences of 15 genes-related to Lymph2Cx molecular subtyping of all samples at mRNA level. Hierarchical clustering was used to subgroup 20 DLBCL cases and to contrast the prognosis in different subgroups according to the subtyping.Results:NanoString fluorescent barcode technology was used to detect samples of 20 DLBCL cases and hierarchical clustering analysis was performed, and then subtyping results showed that 11 cases were GCB-like type and 9 cases were activated B cell (ABC)-like type. Based on Hans algorithm, 10 GCB-like cases were non-GCB type. According to the survival analysis, GCB-like group had a better overall survival compared with that in ABC-like group ( P=0.019). Conclusion:NanoString fluorescent barcode technology can be successfully applied to the cell-of-origin subtyping of DLBCL, and the molecular subtyping strategy can effectively predict the prognosis of patients.