OBJECTIVE: To investigate the clinical manifestations and laboratory features of B-ALL patients with EP300-ZNF384 fusion gene positive, so as to improve the understanding of this subtype disease. METHODS: The clinical data of 3 B-ALL patients with EP300-ZNF384 fusion gene positive admitted in Department of Hematology, the first medical center of Chinese PLA general hospital from February 2017 to February 2018 were collected and analyzed retrospectively. The clinical and laboratory characteristics as well as the therapentic outcome in B-ALL patients with EP300-ZNF384 fusion gene positive were analyzed. RESULTS: The fusion gene of EP300-ZNF384 was detected in 8.1%(3/37) of B-ALL patients. All cases showed the normal karyotype and aberrant CD13 and/or CD33 expression for immunophenotype. 3 patients were sensitive to traditional chemotherapy. CONCLUSION The B-ALL with EEP300-ZNF384 fusion gene positive may be a subgroup of B-ALL with a uniqe clinical characteristis and laboatorial features. EP300-ZNF384 positive patients show a good response to conventional chemotherapy, suggesting a favorable prognosis.

The current document is based on a consensus reached by a panel of experts from the Chinese Society of Allergy and the Chinese Society of Otorhinolaryngology-Head and Neck Surgery, Rhinology Group. Chronic rhinosinusitis (CRS) affects approximately 8% of Chinese adults. The inflammatory and remodeling mechanisms of CRS in the Chinese population differ from those observed in the populations of European descent. Recently, precision medicine has been used to treat inflammation by targeting key biomarkers that are involved in the process. However, there are no CRS guidelines or a consensus available from China that can be shared with the international academia. The guidelines presented in this paper cover the epidemiology, economic burden, genetics and epigenetics, mechanisms, phenotypes and endotypes, diagnosis and differential diagnosis, management, and the current status of CRS in China. These guidelines—with a focus on China—will improve the abilities of clinical and medical staff during the treatment of CRS. Additionally, they will help international agencies in improving the verification of CRS endotypes, mapping of eosinophilic shifts, the identification of suitable biomarkers for endotyping, and predicting responses to therapies. In conclusion, these guidelines will help select therapies, such as pharmacotherapy, surgical approaches and innovative biotherapeutics, which are tailored to each of the individual CRS endotypes.
Adult ; Asian Continental Ancestry Group ; Biomarkers ; China ; Consensus ; Diagnosis ; Diagnosis, Differential ; Drug Therapy ; Eosinophils ; Epidemiology ; Epigenomics ; Genetics ; Humans ; Hypersensitivity ; Inflammation ; International Agencies ; Medical Staff ; Neck ; Phenotype ; Precision Medicine

OBJECTIVE: To compare the distribution characteristics of pressing sensitive acupoints on the body surface between bronchial asthma (BA) patients and healthy subjects, and to analyze the distribution rules of pressing sensitive acupoints in BA patients. METHODS: Seventy BA patients and 70 healthy subjects were selected in this study. The pressing sensitive acupoints were checked with finger pulp and marked on human nerve segment graph. The numbers of pressing sensitive acupoints were counted and the positional relationship between distribution of pressing sensitive acupoints and the position of meridians and nerve segment was observed. RESULTS: (1) The incidence rates of pressing sensitive acupoints in BA patients group and healthy subjects group were 91.4% (64/70) and 15.7% (11/70) respectively, and the BA patients group was higher than the healthy subjects group (<0.01). (2) The top 3 meridians with pressing sensitive acupoints occuring in BA patients were bladder meridian of foot-, lung meridian of hand- and large intestine meridian of hand-, and the most frequent pressing sensitive acupoints were Feishu（BL 13）, Xinshu（BL 15）, Chize（LU 5） and Jueyinshu (BL 14). (3) The pressing sensitive acupoints in BA patients were distributed mainly on C, C and T-T nerve segment. CONCLUSION Pressing sensitive acupoints have a close correlation with physical condition, and there is a close relation between pressing sensitive acupoints distribution and corresponding meridians and nerve segments in BA patients.

Objective: To investigate the effects of clustered warming intervention on spontaneous hypothermia and coagulation function in patients with emergency trauma. Methods: A total of 118 cases of emergency trauma patients admitted from January 2017 to December 2018 in Changzhou Second People′s Hospital were selected as subjects. According to the time of admission, there were 62 cases in the control group from January 2017 to December 2017 and 56 cases in the treatment group from January 2018 to December 2018. The control group used routine emergency nursing intervention and warming measures, and the treatment group combined with clustered warming intervention. The changes of body temperature, coagulation function, spontaneous hypothermia and prognosis were compared between the two groups. Results: When entering the Emergency Department and entering the Emergency Department for 60 minutes, the body temperature of the emergency trauma patients in the treatment group were (36.41±0.75) and (36.74±0.65)℃, and the control group were (35.42±0.80) and (35.54±0.76)℃. The difference between the two groups was statistically significant (t value was 6.914, 9.168, P<0.01). After entering the Emergency Department for 60 minutes, the activated partial thromboplastin time, prothrombin time, and thrombin time in the treatment group were (35.24±2.25), (13.56±1.02), (17.45±1.52) s, and the control group was (39.45±3.42), (15.12±1.34), (19.20±1.23) s. The difference between the two groups was statistically significant (t value was 7.802, 7.058, 6093, P<0.01). The incidence of spontaneous hypothermia and duration of hypothermia in the treatment group were 16.07%(9/56), (7.32±1.14) h, and that in the control group was 41.94%(26/62) and (18.42±3.20) h. The difference between the two groups was statistically significant (χ² value was 9.432, t value was 24.579, P<0.01). The incidence of chills, infection and death in the observation group was 16.07%(9/56), 7.14%(4/56), and 5.36%(3/56), and that in the control group was 51.61%(32/62), 24.19%(15/62), and 17.74%(11/62). The difference between the two groups was statistically significant (χ² value was 16.393, 6.322, 4.316, P< 0.05 or 0.01). Conclusions Clustered warming intervention can help prevent the risk of spontaneous hypothermia in emergency trauma patients, antagonize coagulation dysfunction and improve patient prognosis.

Objective To investigate the significance of blood oxygenation level dependent functional magnetic resonance imaging (BOLD-fMRI) and ambulatory urodynamics monitoring (AUM) to find the cause of primary monosymptomatic nocturnal enuresis (PMNE) in children.Methods Thirty-seven children with PMNE (20 males and 17 females) were selected,with a mean age of (11.3 ±4.1) years old.A clinical management tool,3-day urination record,daytime BOLD-fMRI scan,conventional urodynamics (CUD) and AUM were performed respectively.Thirty-seven gender-age matched children(19 males,18 females) who would receive surgery treatment because of upper urinary tract disease and were confirmed to have no lower urinary tract dysfunction by CUD were enrolled as controls,with a mean age of (11.1 ± 2.9) years old,and 13 cases underwent BOLD-fMRI scanning.Results It was found that the ALFF value of the left middle frontal gyrus of PMNE was decreased and the ReHo value of the left superior occipital gyrus was increased compared with the control group by the resting BOLD-fMRI.The maximum voiding volume of PNME children was (303.11 ± 87.48) mL,the total urine volume at night was (568.65 ± 208.48) mL,and the nighttime bladder volume was (217.43 ± 81.53) mL.The incidence of maximum voiding volume reduction,nocturnal polyuria and decreased nocturnal bladder volume were 24.32％ and 56.76％,and 64.86％,respectively.However,AUM results showed that maximum detrusor pressure in the PMNE group was (39.22 ± 7.78) cmH2O (1 cmH2O =0.098 kPa),which was statistically significantly higher than that in CUD (32.22 ±9.00) cmH2O,and the difference was statistically significant (P ＜0.05).In PMNE group,29 cases (78.37％) had detrusor overactivity (DO),which was significantly higher than that in CUD group [16 cases (43.24％)],and the difference was statistically significant(t =-3.047,P =0.004).CUD and AUM were all detected in children with DO,the frequency of DO detected by AUM was significantly higher than that detected by CUD[(2.00 ±0.55 times/h) vs.(1.38 ±0.50) times/h,P ＜0.05],and the maximum amplitude of detrusor pressure when DO occurring was significantly higher in AUM than in CUD [(19.56 ± 6.01) cmH2O vs.(14.38 ± 3.07) cmH2O],and the differences were statistically significant (all P ＜ 0.05);however,there was no significant difference in bladder compliance detected by AUM or CUD (P ＞ 0.05).Conclusions The abnormal functions of the left middle frontal gyrus and left superior occipital gyrus,nighttime DO and the decrease of bladder capacity at night are considered to be key causes of enuresis in children with PMNE.AUM and resting state BOLD-fMRI evaluations are helpful in differentiating the pathogenesis of PMNE.

The training of residents majoring in ultrasound needs not only to pay attention to the teaching of speculative knowledge,but also to "look at pictures and talk",which is based on a large number of diagnostic ultrasound cases,training the residents to find,discover and discriminate the lesions from the ultrasonic images to finally form a sharp recognition and diagnosis ability.This study used the instant messaging tool WeChat to establish a virtual learning platform and implement a case based teaching process through this platform,which can avoid the limitations of time and space,and make the communication between teachers and students faster.According to the questionnaire survey,residents generally believed that the training mode can effectively improve learning efficiency and professional ability and hope to add this training mode to the basis of traditional teaching mode.The results of resident case analysis showed that the diagnostic accuracy of residents gradually increased during the training process.The model of WeChat platform combined with case teaching can provide new ideas and methods for standardized training of resident doctors in ultrasound specialty.

Objective To evaluate the effect of different gargling liquid on colony number in air during oral ultrasound scaling for patients with periodontitis.Methods Patients with mild (n=54), moderate (n=54), and severe chronic periodontitis (n=54) were selected, then patients with same degree of periodontitis were randomly divided into three groups, with 18 in each group. Before scaling, patients in each group of mild, moderate, and severe periodontitis were given honeysuckle liquid (gargle A), 3％ hydrogen peroxide (gargle B), and normal saline (gargle C) respectively. Bacterial culture and identification of air specimens were conducted at 0 and 30 minutes after the beginning of ultrasonic scaling as well as 10, 20 minutes after the end of ultrasonic scaling.Results Variance analysis of three-factor factorial design data showed that degree of periodontitis, types of gargling liquid, and sampling time had interaction (F=2.666, P=0.002). Comparisons of air colonies: At the beginning of scaling, there was no significant difference in colony number of air around patients using different gargling liquid in mild, moderate and severe groups (all P＞0.05). Among patients using the same gargling liquid at 30 minutes after the beginning of scaling, colony number of air was the lowest around patients with mild periodontitis and the highest around patients with severe periodontitis, colony numbers of air around patients with gargle A and B were lower than that of patients with gargle C. Comparison of each sampling points showed that colony number of air around the right side of patients' head was highest, differences were all statistically significant (all P＜0.05). 20 minutes after the end of scaling, there was no significant difference in colony number among groups compared before scaling (all P＞0.05). The main isolated strains in the air were Streptococcus viridans (32.53％), coagulase negative staphylococcus (24.56％), and filamentous fungi (18.48％).Conclusion There are variety of opportunistic pathogens in the air during oral ultrasound scaling, and the number of colonies is positively correlated with the degree of periodontitis. honeysuckle liquid has a good effect on reducing the number of air colonies during and after scaling.

Objective: To discuss the application principle in tuina manipulation for lumbar intervertebral disc herniation (LIDH) in Chinese literatures published in recent 30 years. Methods: The three major Chinese databases, Wanfang Academic Journal Full-text Database (Wanfang), Chongqing VIP Database (CQVIP) and China National Knowledge Infrastructure (CNKI), were searched to collect the studies of tuina manipulations in treatment of LIDH published in recent 30 years. Clustering analysis was applied to analyze the top 20 tuina manipulations for LIDH. Results: The top 20 most frequently used manipulations for LIDH were Gun-rolling, Rou-kneading, Dian-digital pressing, oblique Ban-pulling, An-pressing, Tanbo-plucking, Bashen-pulling and extending, horizontal Tui-pushing, Na-grasping, Anrou-pressing and kneading, Dou-shaking, Yao-rocking, Ca-scrubbing, Pai-patting, post-extension Ban-pulling, Mo-rubbing, Zhen-vibrating, Nie-pinching, fist-back Ji-tapping, and dorsal Shen-extending methods. The involved manipulations can be divided into two categories by the treated body areas. One category is applied to the soft tissues, including Gun-rolling, Rou-kneading, Dian-digital pressing, An-pressing, Tanbo-plucking, horizontal Tui-pushing, Na-grasping, Anrou-pressing and kneading, Ca-scrubbing, Pai-patting, Mo-rubbing, Zhen-vibrating, Nie-pinching, and fist-back Ji-tapping methods. The other category is applied to bones and joints, including oblique Ban-pulling, Bashen-pulling and extending, Dou-shaking, Yao-rocking, post-extension Ban-pulling, and dorsal Shen-extending methods. Conclusion: Based on the treated body area, the tuina manipulations applied to treat LIDH are predominated by the ones performed on soft tissues, assisted by those on bones and joints. From the way of force exertion, the involved manipulations are majorly the swinging methods, followed by squeezing and pressing ones. The manipulations applied to bones and joints are predominated by the Ban-pulling ones, followed by the Bashen-pulling and extending ones.

Objective The present study aimed to establish a bone mineral density (BMD) reference database in China and to investigate the prevalence of osteoporosis in Chinese adults aged 50 years and older using dual energy X-ray absorptiometry (DXA). Method A total of 75321 examineers over 25 years old who underwent health checkups in 7 health check centers between 2008 and 2018 were included. All centers used a GE Lunar-DXA system to measure BMD of the lumbar spine (L1-L4), femoral neck, and total femur. The same European Spine Phantom (ESP) was used for scanning 10 times at every center, a regression equation was generated, and BMD data were cross-calibrated in each center. Peak BMD and standard deviation (SD) were identified according to 5-year age groups, and T scores were calculated based on the peak BMD and SD. Osteoporosis was defined according to the World Health Organization criteria. The prevalence of osteoporosis was standardized based on 2010 national census data for the Chinese population. Result The mean BMD values decreased with age, were highest in North China, followed by Northeast China, East China, and Southwest China, respectively, and increased with body mass index. Males aged 20-30 years and females aged 35-40 years had peak BMD values. Peak BMD values of the lumbar spine, femoral neck, and total femur were 1.09 g/cm2, 0.97 g/cm2, and 0.97 g/cm2 in males, and 1.11 g/cm2, 0.84 g/cm2, and 0.88 g/cm2 in females, respectively. Among all scanned sites, the prevalence of osteoporosis was highest in the femoral neck in males (4.58％) and in the lumbar spine in females (23.38％). The age-standardized prevalence of osteoporosis at any site was 6.46％ in males and 29.13％ in females aged 50 years and older. Based on the 2010 national census data, 10879115 males and 49286542 females currently have osteoporosis. Conclusion Mean BMD values varied according to geographic region, body mass index, age group, and sex in Chinese adults. The age-standardized prevalence of osteoporosis was 6.46％ in males and 29.13％ in females aged 50 years and older.

Objective To screen Oxalobacter formigenes (OxF) from fresh feces of healthy adults,and study its effect on the the prevention of calcium oxalate kidney stones.Methods OxF was screened and cultured from fresh feces of healthy adults.The rat model of calcium oxalate stone was established by esophageal gavage of 0.8％ of ethylene glycol.Rats were divided into a control group and four groups of rats with ethylene glycol-induced calcium oxalate kidney stones according to random number table.Three groups were treated with 106 CFU,107 CFU,108 CFU viable OxF every day,respectively,for 4 weeks.The blood and 24-hour urine samples were collected to detect the serum creatinine,urea nitrogen,serum and urine calcium,phosphorus,magnesium and urine oxalate every week.At the end of the 4th week,the rats were sacrificed and the kidney tissues were stained with HE and Yasue.The deposition and content of calcium oxalate crystals were observed under a light microscope.Results The bacteria strain isolated from fresh feces of healthy adults was 100％ as same as the known ATCC35274 bacteria strain,which means the strain screened is OxF.Among the 5 groups,there were no significant differences in body weight,Scr,BUN,serum calcium,blood magnesium,blood phosphorus,urinary magnesium and urinary phosphorus.The 24-hour urinary calcium excretion in the model group was significantly lower than that of the control group (P ＜ 0.05).After intervention with OxF solution,the 24-hour urinary calcium excretion in the 108 CFU OxF group was significantly higher than that in the model group (P ＜ 0.05),while there was no significant difference between the other intervention groups and the model.The oxalic acid excretion of 106 CFU OxF group and 107 CFU OxF group was lower than that of the model,but the difference did not reach statistical significance (P＞ 0.05).The 24 h oxalic acid excretion in the 108 CFU OxF group was significantly lower than that of the model at the end of first week (P ＜ 0.05),and continued to decrease for the next 3 weeks.After 4 weeks of intervention,no crystal formation was observed in the control group under the deflection microscope,but a large amount of calcium oxalate crystals were formed in the renal cortex and renal medulla.The crystals were piled up and connected to each other.Yasue staining coincided with the calcium oxalate crystal in the same part of the kidneys.Compared with the model,there was no significant change in the score of calcium oxalate crystal in the kidneys of 106 CFU OxF group and 107 CFU OxF group,while the score of calcium oxalate crystal in the kidneys of 108 CFU OxF group was significantly lower (P ＜ 0.05).Conclusions OxF are successively screened from healthy adults.Daily administration of 108 CFU OxF can safely and effectively reduce the urinary oxalic acid excretion,prevent the formation of calcium oxalate crystals and inhibit the formation of stones in kidneys of rats.