Castleman disease(CD)is a rare lymphoproliferative disorder with an unclear etiology and pathogenesis.This article reports a case of unicentric Castleman disease(UCD)occurring in the submandibular region.The patient presented with a painless submandibular mass.Imaging studies revealed a well-defined,hypervascular lesion,and histopathological examination confirmed the diagnosis of plasma cell-type CD.Submandibular CD is exceptionally rare and can be easily misdiagnosed as lymphadenitis or lymphoma,necessitating a com-bination of imaging and pathological examinations for differential diagnosis.This case report provides valuable insights into diagnosis and management of CD.

Castleman disease(CD)is a rare lymphoproliferative disorder with an unclear etiology and pathogenesis.This article reports a case of unicentric Castleman disease(UCD)occurring in the submandibular region.The patient presented with a painless submandibular mass.Imaging studies revealed a well-defined,hypervascular lesion,and histopathological examination confirmed the diagnosis of plasma cell-type CD.Submandibular CD is exceptionally rare and can be easily misdiagnosed as lymphadenitis or lymphoma,necessitating a com-bination of imaging and pathological examinations for differential diagnosis.This case report provides valuable insights into diagnosis and management of CD.

Objective: To investigate the efficiency and safety of domestic tyrosine kinase inhibitor (TKI) dasatinib (Yinishu) as second-line treatment for patients with chronic myeloid leukemia in chronic phase (CML-CP). Methods: A retrospective analysis of clinical data of CML-CP patients who received domestic dasatinib as second-line treatment in the CML collaborative group hospitals of Hubei province from March 2016 to July 2018 was performed. The optimal response rate, the cumulative complete cytogenetic response (CCyR), the cumulative major molecular responses (MMR), progression free survival (PFS), event free survival (EFS) and adverse effects (AEs) of the patients were assessed at 3, 6 and 12 months of treatment. Results: A total of 83 CML-CP patients were enrolled in this study. The median follow-up time was 23 months. The optimal response rates at 3, 6 and 12 months in 83 CML-CP patients treated with dasatinib were 77.5% (54/71), 72.6% (61/75) and 60.7% (51/69), respectively. By the end of follow-up, the cumulative CCyR and MMR rates were 65.5% (55/80) and 57.1% (48/73), respectively. The median time to achieving CCyR and MMR was 3 months. During follow-up time, the PFS rate was 94.0% (79/83) and the EFS rate was 77.4% (65/83). The most common non-hematological AEs of dasatinib were edema (32.5%), rash itching (18.1%) and fatigue (13.3%). The common hematological AEs of dasatinib were thrombocytopenia (31.3%), leukopenia (19.3%) and anemia (6.0%). Conclusion Domestic dasatinib was effective and safe as the second-line treatment of CML-CP patients and it can be used as an option for CML-CP patients.

Objective To observe the change ofbrain water content,levels of cAMP response element binding protein(CREB)and phosphorylated CREB(p-CREB) in the early stage of traumatic brain injury(TBI) and to investigate the effect of TBI and p-CREB on learning and memory.Methods Fifty-four male adult Wistar rats were randomized into the normal group(18 cases),control group(18 cases) and TBI group(18) according to the random number table method.The TBI model was built according to the modified Feeney method and previous experimental parameters.At 12 h after TBI,Western blot analysis were performed to measure the expressions of hippocampal tissue CREB and p-CREB,the Morris water maze test was used to detect the behavior of rats in each group and the wet-dry method was applied to test brain water content.Results The brain water content at 12 h after TBI in the TBI group was remarkably risen compared with the normal group and control group;the expression levels of hippocampal CREB and p-CREB at 12 h after TBI in the TBI group were significantly decreased compared with the normal group and control group,the latent stage was increased and the frequency searching the accuracy within 2 min was decreased.Conclusion Brain edema is obvious after TBI and the levels of CREB and p-CREB are decreased,which maybe one of the reasons for the impairment of learning and memory function after TBI.

Objective To compare the clinical efficacy and safety of nilotinib and imatinib as frontline therapy in newly diagnosed patients with chronic myeloid leukemia in chronic phase ( CML-CP ) . Methods Until December 31st 2016, 18 patients using nilotinib and 83 using imatinib were recruited in our study.The efficacy and safety of two groups were evaluated .Results A total of 101 patients with CML-CP included 18 receiving nilotinib and 83 imatinib.The optimal response rates at 3, 6, 12 and 18 months in nilotinib and imatinib group were 88.9%(16/18) vs 57.3%(47/82) (P=0.012), 82.4%(14/17) vs 55.7%(44/79) (P=0.041), 9/12 vs 63.9% (39/61) (P=0.460), 6/9 vs 68.9% (31/45) (P=0.896) respectively.The optimal response rates by 3 months in low sokal risk group on nilotinib and imatinib were 9/9 vs 76.5%(26/34) (P=0.107), in intermediate and high sokal risk group were 7/8 vs 45.2%(14/31) (P=0.032).At the end of follow-up, the rate of major molecular response (MMR) in nilotinib group was 72.2%, which was higher than 56.6% in imatinib group (P=0.021).The rate of complete cytogenetic response ( CCyR ) in nilotinib group was 100%, which was higher than 71.1% in imatinib group (P =0.002).Progression free survival (PFS) rates in nilotinib and imatinib groups were 94.4%and 98.8%(P=0.019) respectively; whereas event free survival (EFS) rates were 88.9% and 48.2%(P=0.045).The incidence of drug related adverse reactions in nilotinib and imatinib was similar with only minor proportion of grade 3/4 adverse reactions .Conclusions Nilotinib achieves a deeper molecular response in a shorter time than imatinib in newly diagnosed patients with CML-CP, especially in patients with high risk outcome .Good safety is obtained in both groups so as to ensure a long-term administration and improving prognosis .

Objective To evaluate the clinical characteristics and pathological features of Meckel's diverticulum(MD) in children.Methods 244 MD cases admitted between January 2010 and December 2014 were retropectively analyzed.Results In fifty patients,MD was an incidental finding at laparotomy or laparoscopy for unrelated entities.Among the remaining 194 symptomatic patients,there were 76 patients presenting GI bleeding,forty eight patients were identified with perforated Meckel's diverticulum,thirty six patients suffered from intestinal obstruction.34 patients had MD caused severe complications such as volvulus and intestinal necrosis,diverticular perforation and peritonitis.61 out of 76 GI bleeding patients underwent a 99mTc scan,and positive tracer was found in 42 patients.Among the 19 negative 99mTc scan patients,8 received capsule endoscopy and only 3 patients were suspected of diverticulum.242 patients underwent one stage resection of the diverticulum.Histology revealed ectopic gastric mucosa or ectopic pancreatic tissue in 128 patients.One patient died of volvulus and intestinal necrosis postoperatively,and two suffered from adhesive intestinal obstruction during one to five year's follow up.Conclusions It is necessary to maintain a high suspicion of MD in the pediatric age group with symptoms of abdominal pain,gastrointestinal hemorrhage or intestinal obstruction.Ectopic mucosa assumes the ultimate responsibility for major complications of MD.

Objective To analyze the equity of health human resource allocation in public hospitals of Zhaotong city during 2008-2012,and to provide theoretical basis for the reasonable allocation of health resources.Methods The statistical description was used to analyze the number of the medical health resource,and Gini coefficient and Theli index were used to analyze the equity of health resource allocation in public hospitals of Zhaotong city.Results The amount of medical health resource showed an increasing tendency with low speed,and gaps among different areas were still existed.From 2008 to 2012,Gini coefficients of three medical health resources including the doctors,nurses and health technicians were all under 0.3.And the fluctuant tendency of the Theli Indexes and Gini coefficients were accordant with no significant increase or decrease as a whole.The combination of differences within region and difference between regions leaded to the inequity of health human resource allocation in Zhao tong city,and within region in the contribution rate of the total Theil index was greater than the difference between regions.Conclusions The quantity of health human resource is not enough in Zhaotong.The equity fluctuation of three health resources has no significatnt change.The differences within region mainly cause the inequity of health resource allocation in public hospitals of Zhao tong city.

Objective To study the short-term clinical outcomes of unicompartmental knee arthroplasty for medial compartmental knee osteoarthritis,and to compare 2 kinds of unicompartmental prosthesis.Methods From March 2010 to June 2013,data of 43 patients underwent unicompartmental knee arthroplasty (UKA) were retrospectively analyzed.17 patients (17knees) used rotating platform prosthesis,and 26 patients (28 knees) used fixed bearing prosthesis.There were 7 males (7 knees)and 9 females (10 knees) in rotating platform group,with an average age of 64.1 years (range,54-82 years);while 10 males (10knees) and 17 females (18 knees) in fixed bearing group,with an average age of 62.2 years (range,43-79 years).All patients presented signs of narrowed medial joint space,medial tenderness and pain on weight-bearing.X-ray and MRI were used for documenting joint narrowing and cartilage defect.The pain and the knee functions were recorded both pre and post-operatively with knee society score (KSS),2 cases of simultaneous anterior cruciate ligament (ACL) reconstruction were assessed with TegnerLysholm knee scoring scale as well.Results All 43 patients were followed up for 6 month to 37 months,and the average duration was 21.1 months.There were no dislocations,joint infection,deep venous thrombosis,prosthetic loosening,etc.The KSS in rotating platform group was 56.11 ±9.51 preoperatively,and 92.23±5.46 postoperatively.While the KSS in fixed bearing group was 57.11 ±9.56,and 93.69±6.37,respectively.There were statistical differences comparing between preoperative and postoperative KSS knee scores.There was no significant difference in KSS scores between rotating platform group and fixed bearing group.Conclusion Unicompartmental knee arthroplasty is a less invasive and effective method for knee osteoarthritis in medial compartment with less complications.There was no significant difference in clinical outcomes between rotating platform and fixed bearing design in terms of patients' satisfactory rate,clinical and functional outcomes in this short-term follow-up study.

Informationization teaching resources contain a large number of information so rea-sonable and effective application of the resources is of great significance to the teaching. The article tries to explore and work out some teaching strategies for effective application of informationization teaching resources through action research combined with literature research , questionnaire survey method , interview and other methods. The research process: the original teaching strategies of infor-mationization teaching resources were implemented , implicated and verified in the first round action research; the problems in the first round were summarized and analyzed and the original teaching strategies were adjusted and optimized in the next round action research; finally, the teaching effec-tiveness between the two rounds action research was evaluated and analyzed by the “classroom teach-ing effectiveness criteria based on the use of information technology teaching resources”. The results show that effective application of informationization teaching resources is of great help to the teaching effect. It can enhance the learners' interest in learning and improve their academic performance. Ap-propriate and rational teaching strategy should be provided flexibly according to the learning back-ground and characteristics of students as well as learning contents.

OBJECTIVETo investigate the effect of gradually induced disordered occlusion (GIDO) on the expression of osteoprotegerin (OPG) and receptor activator of nuclear factor-kappaB ligand (RANKL) in mandibular condylar cartilage of rats.

METHODSTotally 48 rats, aged 8 weeks were included, and were divided into experimental and control groups randomly at 4 time points, with same gender distribution (n=3). By inserting elastic rubber band the right side mandibular first molar and the left side maxillary first molar were moved mesially. Four weeks later, the right side mandibular third molar and the left side maxillary third molar were moved distally with same method. In this way, the GIDO was established in rats. The rats were sacrificed at the end of 2th, 4th, 6th and 8th week respectively after the application of the GIDO. The expression of OPG and RANKL in condylar cartilage was examined with immunohistochemical method and calculated by the area of positive cell percentage.

RESULTSOPG and RANKL expressed predominantly in condylar cartilage hypertrophic layer. The rats in experimental group expressed a higher OPG level in all of the 4 time points than their age-matched controls (P<0.05), while RANKL were higher in 2, 6, 8 weeks subgroups (P<0.05), but not in 4 weeks subgroup. No differences were found between male and female subgroups.

CONCLUSIONThe present results suggest that both OPG and RANKL take part in the condylar cartilage remodeling procedure in the present rat model.

Animals ; Cartilage ; Female ; Humans ; Male ; Mandibular Condyle ; Molar ; Osteoprotegerin ; RANK Ligand ; Rats