Objective:To investigate therapeutic effect of cisplatin sequential recombinant human vascular endostatin thoracic perfusion in treatment of malignant pleural effusion.Methods:A total of 80 patients with malignant pleural effusion in Maoming People's Hospital from January 2018 to February 2021 were enrolled, and all patients were divided into 2 groups according to the random number table methods, each group with 40 cases. The control group was treated with small-bore catheter minimally invasive drainage combined with cisplatin thoracic perfusion, and the study group was treated with small-bore catheter minimally invasive drainage combined with cisplatin sequential recombinant human vascular endostatin thoracic perfusion. And then the clinical efficacy, expressions of vascular endothelial growth factor (VEGF) expression, pain degree and adverse reactions were compared of both groups.Results:The treatment efficacy rate of the study group was higher than that of the control group [90% (36/40) vs. 75% (30/40)], and the difference was statistically significant ( χ2 = 5.04, P < 0.05). After treatment, the level of VEGF in pleural fluid and serum of the study group was lower than that of the control group [(304±106) pg/ml vs. (598±159) pg/ml,(103±43) pg/ml vs. (189±49) pg/ml], and the difference was statistically significant ( t = 6.62, P < 0.001; t = 6.23, P < 0.001). After treatment, the visual analogue scale (VAS) score of the study group was lower than that of the control group [(3.7±0.3) scores vs. (4.4±0.7) scores], and the difference was statistically significant ( t = 2.10, P < 0.05). The incidence of adverse reactions including stethalgia, fever, nausea and vomiting in both groups had no statistically significant differences (all P > 0.05). Conclusions:Cisplatin sequential recombinant human vascular endostatin thoracic perfusion combined with small-bore catheter minimally invasive drainage can effectively ameliorate clinical symptoms, inhibit the expression of VEGF, and alleviate pain degree with no serious adverse reactions in patients with malignant pleural effusion.

Primary central nervous system T-cell lymphomas (PCNSTL) are rare, the clinical symptoms and radiographic imaging of which are unspecific, and the pathological morphology is antypical, leading to misdiagnosis and delays in treatment. A 45-year-old male patient with diplopia accompanied by numbness and dysarthria was reported in this paper, which was considered as "lymphoma or lymphoproliferative lesions" on magnetic resonance imaging (MRI) while no typical tumor cells in brain biopsy. The clinical symptoms worsened one month later and the reexamined MRI showed that the scope of the lesion was enlarged and the enhancement was more obvious than before, which was still considered as lymphoma or lymphoproliferative lesion. The second biopsy was performed and still no typical tumor lymphocytes were seen. Finally, gene rearrangement was carried out and showed the β and γ chains both present positive mutations in T cell receptor (TCR) gene rearrangement. Combined with cell morphology, immunophenotype and TCR gene rearrangement results, the patient was finally diagnosed as PCNSTL. This article reviewed the clinical symptoms, imaging features, laboratory examinations, pathological characteristics, diagnosis and differential diagnosis of PCNSTL, so as to improve the understanding of this rare disease.

Objective: To analyze the clinicopathological characteristics and prognosis of diffuse midline glioma (DMG) with H3K27M mutation. Methods: Thirty cases of DMG were collected in Guangdong Sanjiu Brain Hospital from October 2016 to May 2018. The patients′ clinicopathological data including age, tumor site and histological grade, treatment and follow-up data were collected and analyzed. Results: There were 21 males and 9 females, with a mean age of 26 years (range 5-53 years). Fourteen tumors were located in thalamus, 12 in brainstem (one involved both thalamus and brainstem), and one each in hypothalamus, fourth ventricle, and sellar region, respectively. Two cases presented as diffuse intracranial lesions. Three cases (10.0%) were of WHO grade Ⅰ, 10 cases (33.3%) were grade Ⅱ, eight cases (26.7%) were grade Ⅲ, and nine cases (30.0%) were grade Ⅳ.All patients with gradeⅠ tumors were older than 20 years. Histologically, all were pilocytic astrocytoma-like. Immunohistochemical staining demonstrated that all tumors were IDH1 negative. Twenty-eight tumors showed diffuse expression of H3K27M, and two showed focal expression. Twenty-one tumors(100.0%, 21/21) showed absent expression of H3K27me3. Sixteen tumors (57.1%, 16/28) showed strongly positive expression of p53, and ATRX was negative in eight tumors (38.1%, 8/21). The Ki-67 proliferation index ranged from 5% to 40%. Eight cases (including two cases of H3K27M expression of individual cells) showed K27M mutation in H3F3A gene. Intracranial and spinal cord dissemination occurred in six cases (20.0%, 6/30). Median progression-free survival (PFS) was 9.5 months and median overall survival (OS) was 34 months. Mean PFS was 11.2 months and mean OS was 24.3 months. Compared with adults (>20 years old), children/adolescents (no more than 20 years old) had significantly shorter median OS (8 months vs. 34 months, P=0.013). There was no significant difference in PFS and OS between DMGs located in the brain stem/thalamus and other sites within midline (P>0.05). There was no significant difference in PFS and OS between WHO grade ⅠDMGs and WHO grade Ⅱ-Ⅳ DMGs (P>0.05). Conclusions DMGs occur more commonly in children and adolescents with male predominance. DMGs present with WHO Ⅰ-Ⅳ tumors morphologically, and pilocytic astrocytoma-like lesions with WHO Ⅰ are more common in adults. Expression of H3K27M but not H3K27me3 is helpful for diagnosis of DMG. The prognosis of children/adolescents is significantly worse than that of adults, whereas histological grade and tumor location do not affect prognosis.

Objective:To retrospectively summarize the clinicopathological features of epithelioid glioblastoma (Ep-GBM) and to explore new treatment for Ep-GBM.Methods:The clinical data of 13 patients with Ep-GBM,who were treated in our department from March 2016 to July 2017,were retrospectively analyzed.The clinicopathological features were summarized and the efficacy was evaluated.Results:The positive rate of BRAFV600E mutant and INI-1 was 76.9％ (10/13) and 80％ (8/10),respectively,while the median Ki-67 index was 30％.Meningeal metastases occurred in 9 cases (69.7％) during the course.The median follow-up time was 12 (6-25) months,and the median progression-free time was 8.6 (2.2-16.5) months.Three patients died and the 1-year overall survival rate was 54％.Conclusion:Ep-GBM has a high degree of malignancy and is prone to spread to leptomeninges.INI-1 expression and BRAFV600E mutation are common for Ep-GBM.BRAF inhibitor might be a potential therapeutic drug for it.

Objective To evaluate the quality of six kinds of radix salvia miltiorrhizae tables and verify the methods of the quality evaluation . Methods Identification, detection and quantitative test method in Chinese Pharmacopoeia Part One 2005 edition and the HPLC-FPC analysis method were used to evaluate the quality of six kinds of radix salvia miltiorrhiza tables.Results The content of tanshinone IIA of six samples is not in accordance with that in the Chinese Pharmacopoeia and the content of lithospermate B of three samples is not in accordance with that in the Chinese Pharmacopoeia.Both the content of lip-soluble component and the water-soluble component of all the samples differ from those of standard radix salvia miltiorrhiza tables.Conclusion The HPLC-FPC analysis method is useful and effective to identify and detect the quality of the HPLC-FPC analysis method.More attention shall be paid to the quality of the radix salvia miltiorrhiza tables and the supervision of the radix salvia miltiorrhizae tables market should be strengthened.

Objective To analyze the effect of salvia tetramethylpyrazine on hemorheology in patients with vertebrobasilar transient ischemia attack (VB-TIA). Methods 84 patients with VB-TIA were divided into observation group and control group, 42 cases in each group. They both received the treatment of Ginkgo-diyidamolum injection. The observation group were treated by salvia tetramethylpyrazine, and the control group were treated by compound Danshen injection. The therapeutic effect of the two groups and the changes of blood rheology were compared. Results The clinical remission rate of the observation group was significantly higher than that of the control group, and the time of onset and symptoms of the drug were shorter than those of the control group (P < 0.05). The blood flow velocity of vertebral basilar artery in the two groups were significantly higher than those in the observation group (P < 0.05). After treatment, the hemorheology of the two groups were significantly improved, the high shear viscosity and low shear viscosity, platelet aggregation rate, erythrocyte deformation index, erythrocyte aggregation index and blood haematocrit of observation group improved more obviously (P < 0.05). The incidence of adverse reactions in the two groups was not statistically significant. Conclusion Salvia tetramethylpyrazine could effectively shorten the drug onset time, improve the blood velocity of vertebrobasilar artery, recover blood rheology and stability on the condition of not increasing the adverse reactions, which has a positive effect on the clinical remission rate.

Objective To establish the method of identifying MRSA with Taqman-fluorescence quantitative PCR basing on mecA/nuc/fem B three gene combined detecting.Methods Taking the coagulase positive MRSA,which isolated from the clinical samples and confirmed by VITEK 2 compact microbial analyzer,as the research obj ect,designed mecA/nuc/fem B specific PCR primers and Taqman fluorescent probe by bio-software PrimerPremier 5 and Designer Beacon 7,FAM,HEX and ROX markers were used to label the fluorescent probe at 5’,and the end of 3’was labeled with BHQ1,detected by fluo-rescence quantitative PCR instrment.Results ①1 g/dl gel electrophoresis results showed that the primer’s specificity of mec A/nuc/fem B were good,and molecular weight of the amplification band consistent with the expected molecular weight and no non-specific amplification band.②Three genes were obtained specific amplification in a single tube single channel and single tube multiple channel detection in PCR,and the three gene amplification effect in a single tube single tube single chan-nel and multichannel PCR similar.Conclusion Successfully established a method of multi channel Taqman-probe fluores-cence quantitative PCR identification of MRSA,mec A/nuc/fem B combined detection can effectively differentiate coagulase negative and positive MRSA,improve the accuracy of identification.

Objective To understand the relationship between the positive rate of Epstain‐Barr virus (EBV) and human cyto‐megalovirus (HCMV) nucleic acid detection with the age in the patients with aplastic anemia ,acute lymphoblastic leukemia and my‐eloid leukemia .Methods The patients clinically diagnosed as aplastic anemia ,acute lymphoblastic leukemia ,and myeloid leukemia after bone marrow puncture in the Navy General Hospital from January 2012 to December 2013were collected as the research sub‐jects .the nucleic acid test kit from DAAN Gene Company was adopted for conducting the EBV and HCMV nucleic acid testing and analyzing the relationship between the positive rate of the EBV and HCMV infection with the patient′s age .Results There were different testing positive rate among 3 kinds of hematonosis .As a whole ,the positive rate of HCMV was lower than that of EBV (15 .8% vs .43 .7% ) .The EBV nucleic acid detection positive rate had statistically significant difference among different ages of pa‐tients with aplastic anemia and myeloid leukemia .(P< 0 .01) .Conclusion For children patients with aplastic anemia disease and myeloid leukemia ,more attention should be paid to monitoring of EBV and HCM V nucleic acid .

Objective To compare the cognitive function of children with behavior problems and normal children. Methods 87 children with behavior problems were choosed as study group,according to Rutter' s Children Behaviour Qestionnaire. And 87 normal children were choosed randomly as normal control. Chinese Wechsler Intelligence Scale for Children (C-WISC) ,Clinical Memory Scale (CMS) ,Number Cancellation Test (NCT) and the Forth Exceptional Test (FET) were adopted to assess the cognitive function of children in two groups. Results Compared with normal control, arithmetic scale ( ( 10.40 ± 3.02 ) vs ( 12. 13 ± 3.26 ) ), verbal IQ ( ( 121.55 ±12.54) vs ( 129.40 ± 13.98) ), object assembly scale ( ( 9.98 ± 2.79 ) vs ( 11.70 ± 2.78 ) ), performance IQ((97.40±10.84) vs ( 103.93 ±14.22)),full IQ ((112.28±11.14) vs (119.03 ± 12.57)),verbal comprehension IQ ( ( 110.48 ± 11.23 ) vs ( 115.80 ± 12.31 ) ), memory/concentration IQ ( ( 101.25 ± 11.66 ) vs ( 109.40 ± 15.45 ) ),the net scale ( (67.05 ± 33.85 ) vs ( 88.72 ± 22.51 ) ) and error rate( ( 32.27 ± 35.77 ) %vs ( 15.41 ± 10.35 ) % ) were lower in children with behavior problems ( all P ＜ 0.05 ). In study group, the total scale of Rutter' s Children Behaviour Qestionnaire was negatively correlated with memory/concentration IQ, and with net scale(r = - 0. 335, - 0. 367, P ＜ 0.05 );but it was positively correlated with error rate (r = 0. 333, P ＜ 0.05 ). Conclusion Cognitive defects may exist in children with behavior problems.

Objective To observe the effect of the aloe juice reducing skin injury of face and neck caused by radiotherapy in nasopharyngeal cancer patients. Methods Eighty nasopharyngeal cancer patients admitted in hospital from March 2007 to January 2009 were randomly recruited into a control group and a treatment group. The treatment group (n=48) was treated by smearing on face and neck skin with aloe juice after the conventional fractionation radiotherapy. The control group (n=32) received no therapeutic measures after the conventional fractionation radiotherapy. Results In the treatment group there were 21 patients and 13 patients had I degree and II degree of skin lesion respectively; and in the control group, there were 5 patients and 10 patients had the I degree and II degree of skin lesion respectively. There was a significant difference between the two groups (χ~2= 10.6. P<0.05). Conclusion Aloe juice can reduce the injury of skin caused by radiotherapy.