Since 2015, US government announced the Precision Medicine Initiative, the concept of“precision medicine” is spreading rapidly, which has seemingly become the mainstream of future medicine.Laboratory medicine based on personalized information brought by the development of precision medicine will be an entirely new area, however its complexity is far beyond the current knowledge and laboratory medical scientists are encouraged to be actively involved in this emerging field.Opportunities and challenges may coexist, which mainly include: screening and evaluation of circulating biomarkers, selection and standardization of appropriate molecular diagnostic techniques, acquisition of high quality biological specimens and establishment of sample library, and comprehensive interpretation of the results in order to achieve and improve individualized precise prevention, diagnosis, and treatment for specific diseases and patients.

Cerebralischemiacaninducecelnecrosisincoreoftheinfarction,andapoptosisinthe ischemic penumbra. The mitogen-activated protein kinases (MAPKs) signaling pathw ays are activated after cerebral ischemia, causing programmed cel death, including apoptosis. This article review s the relationship betw een the MAPKs signaling family and neuronal apoptosis after cerebral ischemia.

Objective To observe the clinical efficacy and adverse reactions of intensity modulated radio-therapy(IMRT)syn -chronization TP chemotherapy combined with afterloading radiotherapy for advanced cervical cancer.Methods 58 cases of advanced cervical cancer patients were randomly divided into the chemotherapy combi-nation with radiotherapy(observation group,30cases)and radiotherapy alone(control group,28cases),Both groups were treated with external IMRT combined with afterloading radiotherapy,patients of the observation group were accepted concurrent chemoradiotherapy for TP regimen,and the patents of the control group were only accepted radio-therapy,the short -term curative effect,adverse reactions of the two groups were compared.Results The effective rate of the control group was 71.4%,which of the observation group was 83.3%.the observation group short -term curative effect was better than that of control group,with a significant difference(χ2 =4.247,P <0.05),whereas the incidence rates of radiation cystitis,radiation proctitis,myelosuppresson and digestive tract reaction were not signifi-cantly different between two groups(P >0.05)no serious.Conclusion It can allow the patients with advanced cervi-cal cancer to benefit from the concurrent chemoradiotherapy.

Child, Preschool ; Facial Asymmetry ; congenital ; pathology ; Growth Disorders ; congenital ; pathology ; Humans ; Hypertrophy ; congenital ; Infant ; Male

Objective To study the clinical characteristics and current treatment options of neonatal congenital portosystemic shunt (CPSS).Method A newborn infant diagnosed with CPSS complicated with iliac artery-umbilical vein fistula was studied.CNKI,VIP,WanFang and Pubmed databases were searched using CPSS and Abernethy malformation as keywords.A total of 8 papers on neonatal CPSS were retrieved from 2006 to 2016.Result The case treated in our hospital was a boy with symptom of dyspnea and cyanosis.His ultrasound cardiograph showed pulmonary hypertension,and the heart and abdominal CT scan showed portosystemic shunt,dilated portal vein and umbilical vein,patent ductus venosus (PDV) and iliac artery-umbilical vein fistula.A total of 25 patients were analyzed including our patient and 24 cases reported in 8 papers.Cases of intrahepatic shunt (n =22) were nore common than extrahepatic shunt (n =3),and most cases could be diagnosed with ultrasound.Congenital heart diseases,intrauterine growth retardation,cutaneous hemangioma were common complications of CPSS.Abnormal liver function (52.0％),hyperammonemia (28.0％),pulmonary arterial hypertension (12.0％),dyspnea (12.0％) were common clinical manifestations of neonatal CPSS.Most CPSS cases were treated non-operatively during neonatal periods,and in 40.0％ of cases the shunts were closed spontaneously,but mortality was 20.0％ among previous cases.Conclusion Abnormal hepatic function is the most common clinical symptom of neonatal CPSS.Cases of extrahepatic shunts and complicated with PDV are dangerous and operation should be done as soon as possible,meanwhile complications should be treated appropriately.

Objective To evaluate the clinical effect of complex Radix Sophorae Flavescentis injection in treating advanced cancer pain. Methods 90 patients with advanced cancer and pain were selected randomly. The patients' general information was analyzed, their pain was ranked, and the score of quality of life was estimated. Results Among the patients with gentle pain,ratio of CR is 28.57 % (10/35), ratio of PR is 54.29 % (19/35), ratio of slight response is 5.71 %, total effective rate is 88.57 % (31/35). Among the patients with medium pain, the ratio of CR is 10% (3/30), ratio of PR is 23.33 % (7/30), ratio of slight response is 36.67 % (11/30), total effective rate is 70 % (21/30). Among the patients with severe pain, the ratio of CR is 0, ratio of PR is 4.00 % (1/25), ratio of slight response is 12.00 % (2/25), total effective rate is 16.00 % (4/25). The score of quality of life was improved from (21.04±4.92) to (33.52±5.98). The difference was statistical significant (t =14.07, P =0.00). TCM type: in all the 90 patients, the total effective rate of mixture of phlegm and blood phlegm are the highest (88.46 %), and the total effective rate of yang asthhenia of the spleen and kidney is 20.00 %. Rash was found in only one patient and no other adverse effect, such as in digestive tract, bone marrow, heart, liver or kidney was found among all patients. Conclusion Complex Radix Sophorae Flavescentis injection has significant analgesic effect in treating light and medium cancer pain and could improve the patients' quality of life, and it has significant therapeutic effect especially in the mixture of phlegm and blood stasis patients. So Complex Radix Sophorae Flavescentis injection is safe and effective traditional Chinese medical drug.

Purpose To investigate the value of three-dimensional speckle tracking echocardiography in evaluating the cardiac function in breast cancer patients treated with Anthracycline. Materials and Methods Thirty-two breast cancer patients were followed with three-dimensional echocardiography prechemotherapy (group A), 2 cycles (group B) and 4 cycles (group B) postchemotherapy to compare left ventricle global longitudinal strain (GLS), global radial strain (GRS), global circular strain (GCS), global area strain (GAS), early diastolic global area strain rate (EASR), and early diastolic 3D velocity (3DVe). Results GCS, GAS and EASR were signiifcantly lower in group C than group A (t=3.555, 3.692 and 3.590, P<0.01);EASR was lower in group B than group A with statistical significance (t=2.190, P<0.05). GLS, GRS and 3DVe were not significantly different among three groups (F=2.305, 1.957 and 1.205, P>0.05). EASR was negatively correlated with IVRT (r=-0.44, P<0.01); EASR was positively correlated with Em (r=0.49, P<0.01) and Em/Am (r=0.32, P<0.01). GSR was positively correlated with Sm (r=0.21, P<0.05). Conclusion Three-dimensional echocardiography sensitively detects the early changes in diastole function in breast cancer patients treated with Anthracycline.

Objective To investigate the effect of progressive neurological deterioration ( PND) of cerebral watershed infarction on early prognosis. Methods The consecutive patients with cerebral watershed infarction admitted in the Department of Neurology,Jinling Hospital,Nanjing University School of Medicine and their cerebral watershed infarctions confirmed by the imaging examination from March 2009 to March 2014 were enrolled. The clinical features, laboratory indicators and imaging features of internal watershed infarction,cortical-type watershed infarction,and mixed watershed infarction were identified and analyzed. The National Institutes of Health Stroke Scale was used to score neurological deficit. The modified Rankin scale ( mRS) was used to score the prognosis of patients. Single factor analysis was used to compare the differences between the groups. At the same time,the correlation between PND and poor prognosis of cerebral watershed infarction at day 90 was analyzed by multivariable Logistic regression analysis. Results A total of 89 patients with cerebral watershed infarction were enrolled,including 43 cortical-type watershed infarctions,36 internal watershed infarctions, and 10 mixed watershed infarctions. Single factor analysis indicated that the incidences of PND of internal watershed infarction and mixed watershed infarction were significantly higher than the cortical-type watershed infarction (36. 1% [n=13],50. 0% [n=5], and 16. 3% [n=7],respectively;P=0. 018). At day 90,28 patients had poor prognosis,and mRS was (3.4±1. 0) scores at day 90. There was significant difference in the types of infarction between the patients with poor prognosis and patients with good prognosis (P<0. 05). In patients with poor prognosis, most of them were internal watershed infarctions,accounting for 50. 0% (14/28),while in patients with good prognosis,most of them were cortical-type watershed infarctions(57. 4% [35/61]). The incidence of PND in patients with poor prognosis was significantly higher than that in patients with good prognosis (57.1% [16/28] vs. 14. 8% [9/61];P<0. 05). The result of multivariate Logistic regression analysis showed that after adjustment for confounding factor, PND was independently associated with the poor prognosis of cerebral watershed infarction at day 90 (OR 6. 969,95%CI 2. 451-19. 869;P<0. 01). Conclusion Compared with the cortical-type watershed infarction, the patients with internal watershed infarction is more prone to have PND, and PND is independently correlate with the poor prognosis at day 90.

Objective To explore the value of intelligent optimum tube voltage technology at dual-source CT coronary angiography.Methods One hundred and fifty patients with normal body mass index (＜25 kg/m2) with clinically suspected coronary heart disease requiring coronary artery CTA examination were collected.According to the different scanning method,patients were randomly divided into 5 groups,30 cases of each group were tested by coronary artery CTA examination.The intelligent optimum tube vohage scanning technology was set to Semi,the tube voltage of A,B,C group were 120,100 and 80 kV (Ref 120 kV,400 mAs),respectively.D and E group were set to on,the reference voltage of group D was 120 kV,and reference current was 400 mAs.The reference voltage of group E was 100 kV,reference current was 400 mAs.Using the 15 section improved segment method for evaluation of coronary artery (lumen diameter＞ 2 mm and no severe calcification).They were assessed by subjective evaluation (image quality score) and objective evaluation (including vascular CT value,signal-to-noise ratio and contrast to noise ratio).Analyses of the differences between groups were compared with image quality,objective evaluation index and radiation dose by single factor variance.Results The image quality scores in patients scanned with five groups were (3.42±0.63),(3.41±0.54),(3.49±0.33),(3.45±0.43) and (3.48±0.81),there was no statistical difference between the five groups (F=0.634,P=0.105).Each image quality was good,all could clearly show thewhole range of vessels.The CT values of the coronary artery with above groups respectively were (486±82),(554±71),(742±90),(506±81),(561±81) HU.The image noises were (25±12),(32±12),(46±14),(28± 11),(34±12) HU (F=3.430 and 4.332,P＜0.05).And the SNR and CNR was no statistic difference between the five groups (P＞0.05).The effective radiation dose of five groups are (9.3± 1.3),(6.3± 1.4),(2.8±1.5),(5.7 ± 1.2),(3.9 ± 1.3) mSv,which the difference was statistically significant (F=2.332,P＜0.05).Conclusions Intelligent optimum tube voltage technology (Ref.100 kV,400 mAs) at dual-source CT coronary angiography may be feasible in patients with normal BMI.To ensure the quality of the image at the same time,it can effectively reduce the radiation dose.

Objective To establish a new quality control standard for danshen capsules. Methods The qualitative identification of danshen capsules was characterized by ultraviolet fluorescence and thin-layer chromatography( TLC ). The contents of tanshinoneⅡA,cryptotanshinone,salvianolic acid B,danshensu and protocatechuic aldehyde in danshen capsules were determined by high performance liquid chromatography(HPLC)on a C18 column. The flow rate was 1 mL·min-1,and the column temperature was 35 ℃. Results The HPLC linear ranges of tanshinone ⅡA,cryptotanshinone,salvianolic acid B, danshensu and protocatechuic aldehyde were 2. 046-40. 92 μg · mL-1 ,1. 482 25 -59. 29 μg · mL-1 ,1. 502 55 -60. 102 μg·mL-1 ,11. 49-459. 582 μg·mL-1 ,and 0. 617 4-24. 696 μg·mL-1 ,respectively,and r values were 0. 999 9. The average recoveries were 99. 66%(RSD of 0. 91%)for tanshinoneⅡA,99. 26%(RSD of 0. 88%)for cryptotanshinone,99. 09%(RSD of 0. 76%)for salvianolic acid B,100. 51%(RSD of 0. 62%)for danshensu,and 100. 62%(RSD of 0. 82%)for protocatechuic aldehyde,respectively. The contents of the tanshinoneⅡA,cryptotanshinone,salvianolic acid B,danshensu showed a certain high level in the 3 batches of danshen capsule samples,but protocatechuic aldehyde was low by comparison. Conclusion The HPLC method is proven to be sensitive,accurate,repeatable,and can be used for quality control of the danshen capsules.