Objective: To observe the therapeutic efficacy of pediatric tuina plus Chinese patent medicine for preschool kids with diarrhea due to spleen deficiency. Methods:Ninety-two eligible kids were divided into a tuina plus Chinese patent medicine and a Chinese patent medicine group by the random number table, with 46 cases in each group. The Chinese patent medicine group was intervened by oral administration of Qi Wei Bai Zhu San (Seven-ingredientAtractylodes MacrocephalaPowder); the tuina plus Chinese patent medicine group was additionally given pediatric tuina therapy once a day, 20 min each time. Efficacy and safety were evaluated after 7-day treatment in both groups, and a 14-day follow-up was conducted. Results:After treatment, the symptom scores all changed significantly in the two groups (allP<0.05). After intervention, the symptom scores in the tuina plus Chinese patent medicine group were significantly different from those in the Chinese patent medicine group (allP<0.05). The total effective rate was 78.3％ in the Chinese patent medicine group, versus 89.1％ in the tuina plus Chinese patent medicine group, and the between-group difference was statistically significant (P<0.05). Three cases got a relapse in the Chinese patent medicine group, versus one case in the tuina plus Chinese patent medicine group, and the between-group difference was statistically insignificant (P>0.05). The two groups each had one case of vomiting, which were treated properly and turned better. No other adverse reactions occurred. Conclusion: Tuina plus Chinese patent medicine and Chinese patent medicine alone both are effective for diarrhea due to spleen deficiencyin kids, but the combined therapy can produce more significant efficacy.

In order to investigate the role of Twist gene in the metastasis of hepatocellular carcinoma (HCC), total RNA was respectively extracted from three HCC cell strains with different metastatic potentials, HepG2, MHCC-97L and MHCC-97H. The first strand cDNA was synthesized by reverse transcription, which was then used as template to perform fluorescent quantitative polymerase chain reaction (FQ-PCR). The quantity of Twist gene expression was normalized by that of the housekeeping gene, GAPDH for each sample. ANOVA was used to estimate the relationship between Twist gene and metastasis potential of HCC. The results showed that the normalized initial cDNA concentrations of Twist gene in HepG2, MHCC-97L and MHCC-97H were (9.45+/-0.25)x10(-4), (1.82+/-0.41)x10(-3), (3.06+/-0.62)x10(-3), respectively. FQ-PCR revealed significant differences in the expression level of Twist among HCC cell strains with different metastatic potentials. It was concluded that high expression level of Twist was closely associated with more aggressive behaviors of HCC. Twist provides a novel indicator for HCC metastasis.
Carcinoma, Hepatocellular/*metabolism ; Cell Line, Tumor ; DNA, Complementary/metabolism ; Dose-Response Relationship, Drug ; Gene Expression Regulation, Neoplastic ; Liver Neoplasms/*metabolism ; Neoplasm Metastasis ; Nuclear Proteins/*biosynthesis ; Polymerase Chain Reaction ; RNA/metabolism ; Twist Transcription Factor/*biosynthesis

Objective To study the relevance between blood loss, widespread brain contusion injury and consumptive coagulopathy. Methods One hundred and fifty-three cases with severe brain injury was studied about their coagulation data. Analyzed the relationship between blood loss group according to ≥3000 ml and ＜ 3000 ml and coagulation features, the relationship between widespread brain contusion injury and disorder of coagulation;according to whether with brain contusion injury,kinds of bloods transplant and prognosis were asseseed;according to whether with widespread brain contusion injury in ≥ 3000 ml blood loss group,kinds of bloods transplant and prognosis were assessed. Results Compared with ＜ 3000 ml blood loss patients, ≥ 3000 ml patients' blood coagulation changed obviously, with PT prolonging, Fbg and Plt decreasing, the differences were statistically significant (P ＜ 0.05). Compared with no extensive brain contusion injury patients, in extensive brain contusion injury patients, APTT, PT, TT prolonged, Fbg and Plt decreased,and the difference was statistically significant (P ＜0.05). Extensive brain contusion injury patients with blood loss compared with those without such loss, needed more blood transfusion volume,larger amount of input of fresh frozen plasma Plt volume,the former survival rate was lower [68.29%(28/41)vs. 96.43%(108/112)], the difference between them was statistically significant (P＜ 0.05 ). In 41 patients who had brain widespread contusion ,the cases with extensive blood loss ( ≥ 3000 ml) were compared with those ＜ 3000 ml, and the differences in blood transfusion treatment, fresh frozen plasma, Plt volume,survival rate were statistically significant (P ＜ 0.05). Conclusion When blood loss ≥ 3000 ml after trauma,patients show various degrees of coagulopathy,and when accompanied with extensive brain tissue injury,coagulation disorders are more obvious, and the prognosis is even worse.

Objective To analyze the diagnostic process of a rare case of acute myeloid leukemia with minimal differentiation undergoing a lineage switch to mixed phenotype acute leukemia, NOS-rare types,and to investigate its difference from other acute myeloid leukemia and mixed phenotype acute leukemia. Methods Following tests were performed on the patient with switched mixed phenotype acute leukemia and three control leukemia patients ( including two acute myeloid leukemia with minimal differentiation and one mixed phenotype acute leukemia ). Cell morphology was analyzed by bone marrow smear and related cell chemical staining. Immunophenotyping of bone marrow was performed by flow cytometry ( FCM ). G-banding technique was used for karyotype analysis and RT-PCR was used for fusion gene detection. All the laboratory data of the switched patient were compared to that of three control patients in order to reveal the characteristics of such a rare phenotype switch in acute leukemia. Results Before switching, the morphology of acute myeloid leukemia with minimal differentiation demonstrated 0.82 blasts occurring in bone marrow, distinct nucleoli and absence of Auer rods. Blast cells expressed hematopoieticassociated antigens ( CD38, HLA-DR ), myeloid antigens ( CD13, CD56, CD11b ) and CD7. And these blasts were negative for MPO, CD33, CD15, CD79, CD19, CD22, cytoplasmic CD3, CD4 and CD8. After switching, 0. 42 blasts were found in bone marrow, showed eosinophilia and presence of basophile. Blast cells expressed hematopoietic-associated antigens ( CD38, HLA-DR ), myeloid antigens ( MPO, CD13 ),lymphoid antigens ( CD19, CD79a ,cytoplasmic CD3, and CD7 ). The control group showed typical morphology and immunophenotyping. No abnormal karyotype and fusion gene were detected. Conclusions It is a rare and complicated case that acute myeloid leukemia with minimal differentiation switched to mixed phenotype acute leukemia, NOS-rare types. The laboratory features, especially the change of immunophenotyping play an important role in the diagnosis.

Objective To investigate the relationships among perceived stress,mindfulness level,and sleep problems,and to indicate the mediating role of mindfulness level in the relationship between perceived stress and sleep problems.Methods For 179 undergraduate students,the Five Facet Mindfulness Questionnaire (FFMQ),Chinese Perceived Stress Scales (CPSS) and Athens Insomnia Scale (AIS) were used to measure.Results The scores of the scales were (120.43 ± 1 1.23) for FFMQ,(40.17 ± 6.86) for CPSS and (5.28 ± 4.04)for AIS.Pearson correlation analysis showed that perceived stress was negatively correlated to mindfulness level (r =-0.602,P =0.000) and positively correlated to sleep problems (r =0.459,P =0.000) and that there was significant negative correlation between mindfulness level and sleep problems (r =-0.427,P =0.000).Hierarchical linear modeling showed significant partial mediation of mindfulness level on the association between perceived stress and sleep problems.Conclusion Mindfulness level partly mediated the positive link between perceived stress and sleep problems.

Objective To survey the social support status and demands for family caregivers of the disabled elderly.Methods A cross-sectional survey based on convenience sampling was conducted among 779 disabled elderly and their family caregivers from May to June 2013 in five communities of Beijing Dongcheng District.Barthel index was used to measure the degree of functional impairment of the elderly.Self-rating Depression Scales (SDS) was used to evaluate depression symptoms of caregivers.Social Support Rating Scale (SSRS) and social support demand questionnaire were used to measure the social support status and social support demands of caregivers,respectively.Multiple linear regression analysis was used to analyze the influence factors of social support.Results Total 779 caregivers were identified and 744 caregivers completed the questionnaires with a valid response rate of 95.5％.Among 744 family caregivers the social support levels were low with an average SSRS score of 31.16 ± 6.86.There were significant differences in SSRS scores among caregivers of disabled elderly with different characteristics (age,married status and the Barthel index score) (all P ＜ 0.05);and there were significant differences in SSRS scores among caregivers with different characteristics (age,educational level,married status,current employment,relationship with patients,caregiving time daily,subjective care burden,living with patients,number of caregivers and depression status) (all P ＜ 0.05).Multiple linear regression analysis showed that the Barthel index score of the disabled elderly,the relationship with the elderly,depression status of the caregivers and the subjective care burden were correlated with the social support level of family caregivers (all P ＜0.05);the standard regression coefficients of above significant factors were 0.098,0.190,0.134 and 0.155,respectively.The social support demands of family caregivers were various;the average score was 2.44 ± 0.64,the top three demands were provision of care subsidy for the disabled elderly (average score was 2.95 ± 0.93),provision of care allowance for family caregivers (average score was 2.90 ± 0.93) and the guidance of safe medication (average score was 2.83 ± 0.83).Conclusions Family caregivers for the disabled elderly obtain low level social support in the surveyed area.Since the earegivers have various social support demands,the social support and assistance for them should be specific,effective and comprehensive.

With the recent success of the Bruton's tyrosine kinase (BTK) inhibitor, ibrutinib, and the phosphoinositide-3-kinase (PI3K) inhibitor idelalisib in the treatment of patients with relapsed or refractory chronic lymphocytic leukemia (CLL), a number of new agents targeting the B cell receptor (BCR) pathway are in clinical development. In the 57th American Society of Hematology (ASH) annual meeting, great interests are still focused on these two drugs, either monotherapy or combination in the treatment of CLL. On the other hand, SYK inhibitors, new BTK and PI3K antagonists are also coming to the forefront, casting a new light on the treatment of ibrutinib/idelalisb-resistant patients. The progresses of BCR pathway inhibitors in CLL will be summarized in this paper based on the reports in the 57th ASH annual meeting.

Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma with highly heterogeneous both clinically and biologically. So the prediction for prognosis of DLBCL and identifying patients with high risk are coming into the focus of the 58th American Society of Hematology (ASH) Annual Meeting. International prognostic index (IPI) risk model is widely known as the powerful prognostic indicator for DLBCL but in rituximab-era is challenged by a variety of new prognosis systems. Biological markers and mutation and expression of genes play an important role in the pathogenesis and progression of lymphoma, and its prognostic value draw much more attention. The prognostic factors of DLBCL, specific types, such as primary breast DLBCL, intravascular large B-cell lymphoma, the presence of a DLBCL component in a follicular lymphoma and relapsed/refractory DLBCL have been paid more attention in this meeting.

Objective:The expression patterns of TLR4,9,10 in the rat spleen were compared between the rat model of acute skin-transplant rejection and physiologically normal rats ,and their physiological significance were accessed.Methods:6 Wistar and 6 SD rats were used as donors ,and another 24 SD rats were used as recipients which were divided into 4 groups of 6.The same back skin slices were transplanted from donor to recipient , Group A:allograft ( Wistar to SD );Group B:homograft ( SD to SD );Group C:autograft;and Group D:normal SD rats as control.Rat spleens were collected at 1,4,7,10,14,and 21 days after surgery ,and mRNA levels of TLR4,9,10 in splenic mononuclear cells were determined by real-time PCR and corresponding protein expression was accessed by immunohistochemistry.Results:TLR4,9,10 mRNA levels of Group A were significantly higher than that of Group B and C ( P<0.05);TLR4,9,10 mRNA levels showed no significant difference between Group B and C (P>0.05).TLR4,9,10 expressions were moderate (++) to strong (+++) in Group A,and generally weak (+) in Group B,C and D.Conclusion:The patterns of TLR4,9,10 mRNA and protein expression in the rat model of acute skin-transplant rejection indicate that the three genes are involved in acute transplant rejection;the three genes may be expressed coordinately;inhibition of the Toll-like receptors may provide therapeutic targets for acute transplant rejection.

Objective:To investigate the relationship between college freshman adaptation and adverse childhood events,and to explore the mediating role of personality characteristics.Methods:A sample of 523 college freshmen from a key university in Sichuan Province was assessed with the China College Student Adjustment Scale (CCSAS),Adverse Childhood Events Questionnaire (ACEQ) and Eysenck Personality Questionnaire-Revised,Short Scale for Chinese(EPQ-RSC).Results:The rate of adverse childhood events of college freshmen was 87％ in current study.The total scores of adaptation were negatively correlated with the scores of adverse childhood events influence and neuroticism (r ＝-0.13,-0.51,Ps ＜ 0.01),while positively correlated with introversion-extroversion and lie (r ＝ 0.47,0.25,Ps ＜ 0.01).The scores of adverse childhood events influence were negatively correlated with scores of introversion-extroversion (r ＝-0.08,P ＜0.05) and lie (r ＝-0.12,P ＜0.01),while positively correlated with scores of neuroticism (r ＝ 0.17,P ＜ 0.01).Introversion-extroversion and neuroticism mediated the relationship between adverse childhood events influence and college freshman adaptation,the mediating effects were 51.65％ and 58.10％.Conclusion:College freshman adaptation may be closely associated with adverse childhood events influence and personality characteristics.Personality characteristics may play a mediating role between adverse childhood events influence and adaptation in college freshman.