Objective To study the expression of PI3K and Akt mRNA in acute leukemia(AL) and chronic myelocytic leukemia (CML) and try to find out a relationship between the prognostic significance of acute leukemia and the expression level of PI3K and Akt. Methods The samples were collected from 63 ALpatients, 7 relapsed AL patients, 14 CML patients and 10 AL patients in complete remission(CR) patients, 11samples of normal controls(NC). The expression of PI3K, Akt mRNA were measured by semi-quantity reverse transcription polymerase chain reaction(RT-PCR). Results The expression of PI3K mRNA in AL and relapse group were significantly higher than that in normal control. In CML, the P13K mRNA expression level was higher than that in NC and CR. The similar results of the expression of Akt mRNA were observed in CML, NC and CR. At the same time, the expression level of Akt mRNA in relapse group was significantly higher than that in NC. The complete remission rate in PI3K (+) was lower than that in PI3K (-). Similar result was obtained in Akt (+) and Akt (-). Conclusion The PI3K/Akt pathway may contribute to the occurrence of leukemia. The patients with positive expression of the members of this pathway had a lower remission rate.

A nutrition survey, covering a total of 4801 preschool children in 6 provinces, autonomous regions and municipalities, has been carried out. The objective was to determine the effects of various dietary patterns on the blood hemoglobin, free erythrocyte proporphyrin, and serum ferritin values. The results indicated a high prevalence of iron deficiency (average 51.9%). Iron deficiency anemia was detected in 16.4% of the children examined and the incidence rate was particularly high among infants at the age group of 6 months and one year, which was 28.7% and 22.9% respectively. The dietary patterns were different in the above geographic areas. The results of dietary survey revealed that a low incidence of iron deficiency was found in those children who consumed more animal food and protein.

AIM: To investigate the effect of IL-10 on IL-1?-induced prostaglandin E 2(PGE 2) release and cyclooxygenase-2(COX-2) expression in human mesangial cells and to examine whether IL-10 has effect on the biological function of IL-1?.METHODS: The PGE 2 concentration in supernatants of HMC was measured by radioimmunoassay. The COX-2 mRNA and protein were measured by RT-PCR and Western blot, respectively. RESULTS: PGE 2 and COX-2 were significantly increased after treatment with IL-1?( P0.05 , respectively), while it inhibited IL-1?-elicited PGE 2 production, as well as COX-2 mRNA and protein expression in a concentration-dependent fashion. CONCLUSIONS: These results indicated that IL-10 depressed the IL-1?-induced release of PGE 2 and expression of COX-2. These data suggested that IL-10 could exert anti-inflammatory actions at several levels, not only by inhibiting the production of pro-inflammatory cytokines but also by suppressing their biological function.

BACKGROUND: At present, the prosthesis is made by three steps: Taking, trimming and shaping. Because the process of trimming is manual, it is closely related to the experience and technology of clinical technicians. If the prosthesis is not beautiful, it is difficult to make full contact between the receiving cavity and the residual limb. OBJECTIVE: To collect MRI data of thigh in healthy volunteers, evaluate the anatomical symmetry of thigh amputation range (10-25 cm above knee joint space), and establish MRI data as a database so as to provide reference data for patients with lower limb amputation to match the appropriate prosthesis after operation. METHODS: Totally 40 healthy volunteers were recruited and basic information was collected, including age, height, weight, the circumference of the knee, the circumference of the knee at 5 cm, the circumference of the knee at 10 cm, and the circumference of the knee at 15 cm. All volunteers signed the informed consent. This study was approved by the Hospital Ethics Committee. Three-dimensional reconstruction was carried out in thigh amputation range. Taking the surface area and volume of the model as parameters, the thighs of each volunteer were anatomically measured. Three-dimensional reverse engineering software was used to analyze the three-dimensional deviation of the measurement results so as to conduct quantification and visualization of the thigh symmetry. RESULTS AND CONCLUSION: (1) Self symmetric analysis: Regarding the surface area, the maximal percent difference between the left and right thigh amputation was no more than 0.56% (P=0.109). Regarding the volume, the maximal percent difference between the left and right thigh amputation was no more than 1.19% (P=0.182). Results of the three-dimensional deviation analyses showed that the maximal mean negative deviation was -1.47 mm, while the maximal mean positive deviation was 1.14 mm. Moreover, the three-dimensional deviation distribution of 40 subjects was within 2 mm (78.02%), between 2.1 and 3.0 mm (20.97%), and more than 3 mm (1.01%). (2) Allogeneic symmetric analysis: Results of the three-dimensional deviation analyses showed that the maximal mean negative deviation was -1.97 mm, while the maximal mean positive deviation was 1.89 mm. (3) The results confirmed that adult bilateral thigh amputation range has a high degree of anatomical symmetry. When differences between two adults' right thighs are no more than 2 cm in the circumference of the knee, the circumference of the knee at 5 cm, the circumference of the knee at 10 cm, and the circumference of the knee at 15 cm, their surface profiles of thigh amputation ranges are considered to be highly similar, but are not associated with gender, height and weight.

Objective To investigate the risk factors of delayed gastric emptying (DGE) after pancreaticoduodenectomy,in order to provide a theoretical basis for prevention and treatment of this complication.Methods The term DGE was searched in Pubmed,Medline,EMBASE,Cochrane Library,CNKI,Wanfang,and published literatures were collected to determine the risk factors of DGE after pancreaticoduodenectomy.The Review Manager 5.3 software was used in the analysis.Results A total of 52 articles were included.The results of Meta-analysis showed that age and preoperative bilirubin levels did not significantly influence the incidence of DGE.Preoperative cholangitis (OR =3.39,95％ CI 1.97 ～ 5.82),hypoalbuminemia (OR =2.53,95％ CI 1.59 ～4.02),and intraoperative blood loss of more than 1 L (OR =1.98,95％ CI 1.18 ～ 3.33) significantly increased the incidence of DGE.Pyloric resection (RR =2.06,95％ CI 1.05 ～4.05),antecolic reconstruction (RR =0.74,95％ CI 0.56 ～ 0.99) and Braun enteroenterostomy (OR =0.36,95％ CI 0.17 ～0.77) significantly decreased the risk of DGE.When compared with Roux-enY enteroenterostomy,Billroth Ⅱ enteroenterostomy reduced the incidence of clinically relevant DGE (RR =0.30,95 ％ CI 0.11 ～ 0.79).Postoperative pancreatic fistula (OR =3.84,95 ％ CI 2.71 ～ 5.44) and intraabdominal infection/abscess (OR =3.95,95％ CI 2.87 ～ 5.43) were significantly associated with a high incidence of DGE.Conclusions Hypoalbuminemia,cholangitis,large blood loss,and postoperative abdominal complications were the risk factors of DGE.Pyloric resection,antecolic reconstruction,Billroth Ⅱ enteroenterostomy,and Braun enteroenterostomy significantly reduced the incidence of DGE.Subgroup analysis showed that differences on DGE definition in studies might be an important cause for the heterogeneity in the results of the different studies.

Abstract: Objective To analyze the epidemiological characteristics of viral hepatitis E in Fujian Province from 2012-2021, and to provide scientific evidence for the prevention and control of hepatitis E in the future. Methods Descriptive epidemiological method was used to analyze hepatitis E cases in Fujian Province from 2012 to 2021. Results From 2012 to 2021, a total of 8 877 cases of hepatitis E were reported in Fujian Province from 2012-2021. The overall incidence rate showed a decreasing trend (χ2trend =458.14, P<0.001), with the lowest incidence rate of 1.32/100 000 in 2020 and an annual average incidence rate of 2.29/100 000 per year. The incidence was higher in winter and spring, with the months of March and April having the highest number of reported cases (2 146, 24.17%) and the fewest cases were reported in September (571, 6.43%). The difference in reported incidence rates between cities was statistically significant (χ2=1 877.75, P<0.01). The comprehensive experimental zone of Pingtan had the highest average reported incidence rate of 6.03/100 000, while Zhangzhou had the lowest at 0.94/100 000. The number of male cases was higher than the number of female cases, with a male to female ratio of 2.04∶1. The disease was most prevalent among middle-aged and elderly individuals, with the age group of 40-<65 years having the highest number of reported cases, accounting for 57.44% (5 099/8 877) of all cases. The age group of 50-<55 years had the highest reported incidence, with the number of reported cases increasing with age below 50 years, but decreasing with age over 50 years. As for occupational distribution, peasants had the highest proportion of the disease, accounting for 34.49% (3 062 cases) of the total cases. Conclusions The reported incidence rate of hepatitis E in Fujian showed a downward from 2012 to 2021. Due to the impact of COVID-19, incidence of the lowest was 2020, but it did not reflect the true situation of the disease, which may have affected trend of hepatitis E. In order to control and reduce the incidence of hepatitis E, efforts should be made to increase publicity and education on health knowledge and vaccination among key areas and populations, strengthen monitoring and diagnostic capability, and implement comprehensive prevention and control measures.

Objective To study the Janus Kinase 2 V617F (JAK2V617F) point mutation in bcr-abl-negative myeloproliferative disorders (MPD) and explore its clinical significances. Methods Genomic DNA was isolated from bone marrow or peripheral-blood granulocytes. Allelespecific-polymerase chain reactions (AS-PCR), restriction enzyme digestion in combination with PCR product sequencing were performed to detect the mutation in genomic DNA. 110 patients were detected, including 41 with bcr-ablnegative MPD, 25 with bcr-abl-positive chronic myelogenous leukemia (CML), and 44 with acute leukemia.Results JAK2V617F was presented in 11 cases(91.7 %) of 12 polycythemia vera (PV), 8 cases(53.3 %) of 15 essential thrombocythemia(ET), 4 cases (57.1%) of 7 idiopathic myelofibrosis (IMF), while in other patients including 7 hypereosinophilic syndrome (HES), 25 bcr-abl-positive CML, 24 acute myelocytic leukemia (AML), 18 acute lymphoblastic leukemia(ALL), and 2 acute mixed lineage leukemia, JAK2V617F can not be detected. All positive samples and 10 negative samples identified by AS-PCR and restriction enzyme digestion were confirmed further by DNA sequencing. Conclusion The frequency of JAK2V617F mutation was more than 90 % among patients with PV, more than 50 % among patients with ET and IMF. The detection of JAK2V617F mutation will be of great significanees in the diagnosis and differential diagnosis of MPD. This mutation can be a molecular marker of MPD and might be a treatment target in the future.

Objective: To investigate the changes of myo cardial contractile function during myocardial stunning in calcium overload rats and the protective effects of tetrandrine. Methods: Forty-six rats were randomized into control, myocardial ischemia, myocardial stunning, low and high dose of tetrandrine groups. Another 10 rats were used to identify the calcium overload. vitamin D3 (0.3 million Unit/kg) and nicotinic acid were adm inistered. After 16 d when calcium overload occured, left anterior descending ar tery was ligated. Twenty minutes of myocardial ischemia followed by 60 min of re perfusion was induced. The contractile function parameters were determined dynam ically. At the end of experiment, myocardial cytosolic ［Ca2+］i was deter mined in various groups. In tetrandrine groups, tetrandrine (62.2 or 93.6 μmol/ kg ) was administered by gastrogavage daily.After 16 d, the rats undergone the e xperiments mentioned above. Results: Sixteen days after vitamin D3 , nicotinic acid were given, ［Ca2+］i increased by 2.6 folds (146.8±10.8 ) vs (368.5±22.6) nmol/L, (P<0.01). Whereas, ［Ca2+］i in tetrand rine groups were (210.8±16.4) and (198.6±15.3) nmol/L, which were significantl y lower than that of calcium overload group. Twenty minutes of myocardial ische mia resulted in the decrease of dp/dtmax and Vmax in all groups with the most si gnificant in stunning and calcium overload groups. The contractile function rest ored gradually after reperfusion. At all time points, dp/dtmax and Vmax in both tetrandrine groups were higher than those in both stunning and calcium overload groups. And effect with higher dose of tetrandrine were more significant than in low dose of tetrandrine. After 60 min of reperfusion, dp/dtmax in stunning, cal cium overload, low and high dose of tetrandrine groups were 49.7%, 51.5%, 71.0% and 83.4% of that in control, respectively， and Vmax were 55.0%, 49.8%, 73.9% and 77.5% of that in control, respectively. Conclusion: T he myocardial contractile function in vitamin D3-induced calcium overload gro up is impaired. On basis of myocardiocyte calcium overload, transient ischemia l eads to myocardial stunning. At the stage of ischemia, the impaired degree of my ocardial contractile function is similar to that in stunning group, suggesting a t this stage the effect of ischemia on myocardial function is greater than that of calcium overload. Tetrandrine chronically improves the myocardial function in Vitamin D3-induced calcium overload rats.

Objective To analyze the possible risk factors of esophageal stenosis after endoscopic mucosal resection (EMR). Methods From January 2008 to December 2009, a total of 219 procedures of esophageal EMR were performed to resect early esophageal squamous carcinoma and its precancerous lesions,and esophageal stenosis was observed in 9 cases. Data of these 9 patients ( stenosis group) were collected and compared with those of patients without stenosis ( control group, n = 202, 8 patients were excluded because of being diagnosed as squamous carcinoma with submucosal infiltration after EMR and being transfered to surgery). Results There was no significant difference between two groups in regard of gender, age, location of the lesion, length of the lesion or pathological diagnosis after EMR, while the rate of patients with mucosal defect larger than 3/4 circumference in stenosis group ( 8/9, 88.9% ) was significantly higher than that in control group (9/202, 4. 5%, P ＜ 0. 01 ). Conclusion In EMR for early esophageal squamous carcinoma and its precancerous lesions, post-EMR mucosal defect larger than 3/4 circumference is a risk factor for esophageal stenosis.

Objective To summarize the coronary artery pattem of arterial switch operation(ASO),operative skill and surgical results.Methods Between October 1999 to October 2005,102 patients underwent arterial switch operation.The mean age was(8? 16)months ranged from 3 days to 7 years.The mean body weight was(5.9?3.2)kg,ranged from 2.5 kg to 20.0 kg.Most com- monly(74/102),the aorta was more or less to the right of the pulmonary artery.In 10 patients,the aorta was directly anterior to the pulmonary artery,and in 11 patients,the aorta was to the left of the pulmonary artery.The great arteries were side by side in 7 pa- tients.We used Leiden classification for coronary artery pattern by operative descriptions.The most prevalent coronary pattern [1LCx2R]was found in 69(67.6%),abnormal coronary artery pattern in 33(32.3%).Intramural course of coronary artery was fotmd In three patients.The Leeampte maneuver was used in all cases.In most patients,the "open trap door" or "bay window" tech- nique for coronary osfia transfer.Results Total mortality rate was 14.7 %(15 eases),6 cases(8.7 %)with normal coronary pattem and 9(27.3%)deaths 33 patients with abnormal coronary pattern.3 cases with coronary event occurred in 5 deaths of simple rIGA, 4 cases with coronary event in 6 deaths of complex TGA and 3 eases with coronary event in 4 deaths of Taussing-Bing anomaly.Con- clusion Complex coronary artery anatomy increases the operative risk.With experience or improving surgical technique,we may get better results.