Objective To explore the application value of spiral CT angiography in etiological diagnosis of spontaneous intracranial hematoma before surgery. Methods 48 patients with spontaneous intracranial hematoma following surgical indication assessed by CT scan were ascertained etiological diagnosis performed by CT angiography before surgery.Results The causes of intracranial hematoma were cerebral aneurysm(2 patients), arteriocenous malformation (5 patients), hypertension(40 patients), and no image in one patient performed by CT angiography.Conclusion CT angiography has important value in etiological diagnosis of spontaneous intracranial hematoma before surgery.

Objective To evaluate the relationship between plasma imatinib and its effect in the treatment of chronic myeloid leukemia(CML). Methods Fifty-one CML patients were included in this study,who began taking imatinib from July 2005 to February 2008, with 34 cases of male, and 17 cases of female.Nine patients took imatinib at dose of 300 mg/d, 37 patients took imatinib at dose of 400 mg/d, and 5 patients took imatinib at dose of 600 mg/d. High-performance liquid chromatography was used to test imatinib plasma levels. Results The imatinib plasma levels was imatinib dose-related, and the imatinib plasma trough levels significantly varied between individuals[(342-4688)ng/ml]. The imatinib plasma levels was significant lower in 300 mg/d dose group [(1037±514) ng/ml] than 400 mg/d dose group [(2123±1016) ng/ml] (t =2.34, P =0.032),and the effective rate was 66.7 % (6/9) in 300 mg/d dose group, which was lower than 400 mg/d dose group of 89.19 % (33/37) (χ2=7.14, P =0.008). In 300 mg/d and 400 mg/d dose groups, 39 patients achieved effective treatment, and their imatinib plasma levels was significant higher than that of 7 patients who did not achieved effective treatment (t =2.25, P =0.037). The ROC curve results suggested that clinical treatment may be poor when the imatinib plasma level was lower than 1050 ng/ml (sensitivity was 84.6 %, specificity was 71.1 %).Conclusion The imatinib plasma levels was dose-related, and significantly varied between individuals.Clinical treatment effect may be poor when the imatinib plasma level was lower than 1050 ng/ml.

Objective To explore the changes ofintegrin α4β7 and L-selectin levels and the possible relationship between the changes and intestinal mucosal immune function in critical children with gastrointestinal dysfunction.Methods Forty-eight admitted critical children were divided into non-gastrointestinal dysfunction group (29 cases) and gastrointestinal dysfunction group (19 cases),and also compared with 25 healthy people (control group).The expression of integrin α 4β 7 and L-selectin was measured by flow cytometry.Results The expression of integrin α 4β 7 in gastrointestinal dysfunction group [(11.11 ± 1.15)％] was lower than that in non-gastrointestinal dysfunction group [(15.36 ± 1.26)％]and control group [(19.62 ±0.89)％] (P ＜0.05),but there was no significant difference between nongastrointestinal dysfunction group and control group(P ＞ 0.05).The expression of L-selectin in gastrointestinal dysfunction group [(60.68 ±3.72)％] was lower than that in non-gastrointestinal dysfunction group [(69.43 ± 1.52)％] and control group [(88.65 ± 2.41)％] (P ＜ 0.05),and there was significant difference between non-gastrointestinal dysfunction group and control group (P ＜ 0.05).Conclusion The expression of integrin α 4β 7 and L-selectin is decreased at the early stage of gastrointestinal dysfunction in critical childern,and integrin α 4 β 7 is decreased sharply.

Objective Comparative evaluation of flow cytometric immunophenotyping in the diagnosis and differentiation of lymphadenopathy,lymphoma and reactive lymphoid hyperplasia. Methods Ninty-nine fine-needle aspiration specimens from patients with tentative clinical lymphoprofierative disorders were consecutively analyzed by both cytology and flow cytometry with histology results as the gold standard. The three color antibodies including CD3,CD3,CD4,CD5,CD10,CD19,CD20,CD23,CD45,K,λ,FMC7 and CD34 were used for cell composition evaluation and cells with abnormal phenotype. Lymphoma cases were classified according to new WHO classification and subtypes were categorized by immunophenotypic analysis. The results from flow cytometry and cytology were compared. Results By cytological study, 40 of 99 cases were diagnosed with lymphoma, 29 cases were diagnosed with metastatic carcinoma, and 30 cases were diagnosed with reactive lymphoid hyperplasia, necrosis or tuberculosis. Among them, 2 non-Hodgkin lymphoma(NHL) cases were misdiagnosed as reactive lymphoid hyperplasia by cytology. Biopsy was performed in 18 cases of NHL including 16 B-NHL and 2 T-NHL By flow cytometry study, 35 of 99 eases were diagnosed with lymphoma, including 4 cases of lymphoblast lymphoma, 1 case of T-cell lymphoma, and 30 eases of other B-NHL For those 30 cases of B-NHL, 28 cases showed monoclonal light chain expression, and k: λ orλ: k atios exceed 3: 1, and B-cell proportion was (73. 2±27. 2)%. Twenty-six cases could be sub-classified by immunophenotyped. Among 16 histologically confirmed B-NHL cases, only 2 cases diagnosed with follicular lymphoma showed discrepancy with flow cytometry results. In all cases diagnosed with reactive lymphoid hyperplasia and metastasis carcinoma , no abnormal lymphocytes can be found, and k: λ or k: λ ratios were less than 3: 1. Conclusions Fine-needle aspiration analysis with flow eytometrie immunophenotyping can be helpful in diagnosis and differential diagnosis as well as sub-classification of NHL

The treatment of hepatobiliary malignant tumor is characterized by the coexistence of multiple treatment methods and multiple disciplines. In order to evaluate the clinical efficacy of different treatment measures or multiple treatment combinations, and to promote the standardized development of comprehensive treatment patterns for hepatobiliary malignant tumor, the Hepatobiliary Center of the First Affiliated Hospital of Nanjing Medical University constructs the registry and follow-up database in hepatobiliary tumor patients based on the information-based platform of the hospital, which will help guide clinicians to make scientific decisions and improve the level of clinical diagnosis and treatment. This study describes the framework design, function modules, data acquisition process and quality control of the database of hepatobiliary malignant tumor. Based on the observational bidirectional cohort study design, the previous clinical data can be sorted to match the current database, on the other hand, the clinical data can be prospectively collected including basic information, admission evaluation, surgical information and postoperative situation, comprehensive treatment measures, regular reexaminations and long-term follow-up, etc. The data quality control system can be improved by formulating standardized operation procedures, regularly personnel training and full-process data management plans. This database will provide high-quality real-world data for clinicians, researchers, and guideline experts, and then provide high-level medical evidence for the standardized development of comprehensive treatment patterns of hepatobiliary malignancies.

Since March 2013,China had experienced five seasonal epidemics related to Avian influenza A (H7N9).An unprecedented outbreak of H7N9 epidemic started from September 2016,with 730 cases reported till June 30th 2017,in mainland China that caused profound influences on both social development and health of the people.As an emerging infectious disease,information on pathogenic characteristics,transmission patterns and other epidemiological features of H7N9 virus somehow remained unclear.Data from previous studies suggested that the live poultry market (LPM) seemed to have served as main places where H7N9 virus got originated,mutated,spread and thus infected the human beings.Hence,closure of LPMs was suggested a major measure to control and prevent H7N9 epidemics in China.However,the effectiveness of different ways of LPM closures on H7N9 epidemics had been controversial.This study systemically summarized the effects of different ways of LPM closures on H7N epidemics from previous studies,aiming to provide references for developing a better program on H7N9 control and prevention in the country.

Pancreatic diseases is a kind of complex, high-risk gastrointestinal diseases. Pancreatic cancer is highly malignant and seriously endangers people′s health. Developing multi-center, large-scale real world research can better understand the incidence patterns and treatment outcomes of pancreatic diseases. Based on the multi-center and heterogeneous data, the authors for-mulate data standards for real world studies of pancreatic diseases, and build a database of pancreatic cancer, integrating and sharing data from multi-center sources, in order to fully explore the scientific research value of pancreatic cancer clinical information, and provide experience and reference for the construction of other real world research specific disease databases in the future.

BACKGROUNDStudies have shown that the drug resistance of gastric cancer cells can be modulated by abnormal expression of microRNAs (miRNAs). We investigated the role of miR-503 in the development of cisplatin resistance in human gastric cancer cell lines.

METHODSMiR-503 expression was measured by quantitative real-time PCR. MTT (3-(4,5-dimethylthiazol-2-yl)-2,5- diphenyltetrazolium bromide) and clonogenic assays were used to examine changes in cell viability and the drug resistance phenotype of cancer cells associated with upregulation or downregulation of the miRNA. A dual-luciferase activity assay was used to verify target genes of miR-503. Immunohistochemistry, Western blotting analysis, and a flow cytometric apoptosis assay were used to elucidate the mechanism by which miR-503 modulates drug resistance in cancer cells.

RESULTSMiR-503 was significantly downregulated in gastric cancer tissues and several gastric cancer cell lines. Additionally, downregulation of miR-503 in the cisplatin (DDP)-resistant gastric cancer cell line SGC7901/DDP was concurrent with the upregulation of insulin-like growth factor-1 receptor (IGF1R) and B-cell lymphoma 2 (BCL2) expression compared with the parental SGC7901 cell line. An in vitro drug sensitivity assay showed that overexpression of miR-503 sensitized SGC7901/DDP cells to cisplatin. The luciferase activity of reporters driven by IGF1R and BCL2 3'-untranslated regions in SGC7901/DDP cells suggested that IGF1R and BCL2 were both direct target genes of miR-503. Enforced miR-503 expression in SGC7901/DDP cells reduced expression of the target proteins, inhibited proliferation, and sensitized the cells to DDP-induced apoptosis.

CONCLUSIONOur findings suggest that hsa-miR-503 modulates cisplatin resistance of human gastric cancer cells at least in part by targeting IGF1R and BCL2.

Apoptosis ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Cisplatin ; pharmacology ; Humans ; Immunohistochemistry ; MicroRNAs ; genetics ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; genetics ; Real-Time Polymerase Chain Reaction ; Stomach Neoplasms ; genetics