To investigate the early changes of peripheral blood leukocyte differential counts in patients with COVID-19. Ten patients with COVID-19 and 30 patients with other viral pneumonia (non-COVID-19) admitted to The Sixth People′s Hospital of Shanghai and Jinshan Branch Hospital from January 22 to February 17, 2020 were enrolled in this study. The differential counts of white blood cells (WBC) were analyzed. Patients in COVID-19 group showed relatively lower absolute WBC count 4.95(3.90,6.03)×10 9/L, lymphocyte absolute count 1.20(0.98,1.50)×10 9/L and eosinophil absolute count 0.01(0.01,0.01)×10 9/L. Leukopenia developed in two patients(2/10), lymphocytopenia also in two patients(2/10). Seven over ten patients presented with eosinophil cytopenia. In non-COVID-19 group, absolute WBC count was 8.20(6.78,9.03)×10 9/L ( P<0.001), lymphocyte absolute count 1.75(1.20,2.53)×10 9/L( P=0.036), eosinophil absolute count 0.02(0.01,0.03)×10 9/L( P=0.005). Lymphocytopenia occurred in 16.7% patients, eosinophil cytopenia in 16.7% patients too. In conclusion, leukopenia, lymphocytopenia and eosinophil cytopenia are more common in COVID-19 patients than those in non-COVID-19 patients.

To investigate the early changes of peripheral blood leukocyte differential counts in patients with COVID-19. Ten patients with COVID-19 and 30 patients with other viral pneumonia (non-COVID-19) admitted to Shanghai Jiao Tong University Affiliated Sixth People’s Hospital and Jinshan Branch Hospital from January 22 to February 17, 2020 were enrolled in this study. The differential counts of white blood cells were analyzed. Patients in COVID-19 group showed relatively lower absolute white blood cell (WBC) count 4.95(3.90,6.03)×10⁹/L, lymphocyte absolute count 1.20(0.98,1.50)×10⁹/L and eosinophil absolute count 0.01(0.01,0.01)×10⁹/L. Leukopenia developed in two patients(2/10), lymphocytopenia also in two patients(2/10). Seven over ten patients presented with eosinophil cytopenia. In non-COVID-19 group, absolute WBC count was 8.20 (6.78,9.03) ×10⁹/L (P<0.001), lymphocyte absolute count 1.75(1.20,2.53)×10⁹/L(P=0.036), eosinophil absolute count 0.02(0.01,0.03)×10⁹/L(P=0.05). Lymphocytopenia occurred in (16.7%) patients, eosinophil cytopenia in 16.7% patients too. In conclusion, leukopenia, lymphocytopenia and eosinophil cytopenia are more common in COVID-19 patients than those in non- COVID-19 patients.

Objective:To observe the size and density of adrenal gland, and the dynamic changes in patients with COVID-19.Methods:Study sample consisted of 67 patients diagnosed as COVID-19 (COVID-19 group) and 70 normal controls. COVID-19 group were divided into two groups: ordinary cases and severe cases. The CT value and thickness of adrenal gland in the control group (uni-temporal) and the COVID-19 group (multi-temporal) were measured, the CT value of adreal/erector spinae were calculated.Results:Compared with the control group, the COVID-19 group had bigger body, medial and lateral branches of bilateral adrenal gland ( P<0.05) . There was no significant difference between the CT value of adrenal/erector spinae for the two groups. Receiver operating characteristic curve analysis showed the thickness of right medial adrenal limb in detecting diffuse adrenal hyperplasia was the best (0.881) . And there was no significant difference in the CT value of adrenal/erector spinae, thickness of bilateral adrenal body, medial and lateral branches in COVID-19 group at different times. Conclusion:The bilateral adrenal glands of COVID-19 patients were slightly swollen, adrenal body, medial and lateral branches were slightly bigger than the normal adrenal glands, but the density was normal, and there were no dynamic changes during the course of the disease.

Objective To explore the expression of miR-146a and its target gene LIN52 in advanced gastric cancer and their potential impact on clinical prognosis.Methods Total RNAs were extracted from 93gastric cancer tissues and their corresponding adjacent non-tumor tissues to quantify the relative expression of miR-146a by using real-time quantitative PCR (RT-qPCR).Expression of LIN52 was detected in tumors and normal tissues by immunohistochemistry.Correlation analysis was assessed between the expression of miR-146a and LIN52 and clinicopathological parameters,including clinical diagnostic specificity,tumor TNM staging,lymph node metastasis,differentiation grade,curative effect and prognosis of gastric cancer.Results The expression of miR-146a in gastric carcinoma was negatively correlated with lymph node metastasis (P ＜0.05).The expression of miR-146a had a significant correlation with the prognosis of the patients (P ＜ 0.01).The patients with high expression of miR-146a had higher survival rate (P ＜ 0.05),but the patients with high expression of LIN52 had lower survival rate (P ＜ 0.05).The receiver operating characteristic curve regression analysis showed that sensitivity and specificity of miR-146a were 94.1％ and 61.5 ％ to diagnose gastric cancer.Conclusions As a tumor suppressor gene in gastric cancer,miR-146a has significantly negative correlation with LIN52.High expression of miR-146a in the gastric cancer tissue might be associated with improved treatment efficacy of chemotherapy,suggesting that miR-146a may be a molecular marker for the diagnosis and prognosis of gastric cancer.

Objective To analyze the clinical characteristics,prognosis and molecular biological changes of tonsillar squamous cell carcinoma(TSCC).Methods Retrospective analysis of 61 TSCC cases treated from January 1999 to December 2012.Demographic data and clinical charts,including histologic grade of tumor,treatment and outcome of the patients,were reviewed.Human papillomavirus (HPV)-DNA were detected using SPF10-DNA enzyme immunoassay and LiPA genotyping method.Expressions of p16 and p53 proteins were examinated by immunohistochemistry.Survival rate was calculated with SPSS 19.0 software using the Kaplan-Meier method.Results There were 55 males and 6 females,with a median age of 57 years.Of the 61 TSCC,21 were with well differentiation,19 with moderate differentiation and 21 with poor differentiation,including 7 patients at stage Ⅱ,10 at stage Ⅲ and 44 at stage Ⅳ.HPV-positive rate of TSCC was 29.5％ (18/61) and high-risk HPV-16 subtype accounted for 72.2％ (13/18).The percentage of famel patients in HPV-positive TSCC was higher than HPV-negative TSCC(22.2％ vs 4.7％).HPV-positive TSCC was more common in non-smoking patients (50.0％ vs 79.1％,x2 =5,155,P =0.023) and non-drinking patients (27.8％ vs 51.2％,x2 =4.346,P =0.037).HPV-positive TSCC mostly presented with high expression of p16 protein (88.9％ vs 16.3％,x2 =28.481,P =0.000),and low expression of p53 protein(72.7％ vs 46.5％,x2 =5.028,P =0.025).The prognosis of patients with HPV-associated TSCC was significantly better than non-HPV-associated TSCC,and The 3-year and 5-year overall survival rates of patients with HPV-positive TSCC were higher than those of patients with HPV-negative TSCC (87.7％ vs 49.5％ and 78.9％ vs 33.0％,respectively).Conclusion HPV-associated TSCC had unique clinicopathological and molecular biological features,showing better prognosis compared to HPV-negative TSCC.

Objective To explore the status and risk factors of the dyslipidemia among health examination population of Lanzhou for providing the intervention measures .Methods According to the stratified cluster random sampling method ,4 505 health exami-nation individuals were recruited for the study from 5 hospitals in the Lanzhou region through questionnaire ,biochemical analysis . Results Prevalence of dyslipidemia of the population was 45 .79% ,high TG was the main type .The level of serum TC ,TG ,HDL-C and LDL-C were (5 .27 ± 1 .08) ,(1 .74 ± 1 .38) ,(1 .41 ± 0 .43) and (2 .83 ± 0 .82)mmol/L .The prevalence was 53 .49% in male , and 34 .93% in female .The prevalence was higher among the group of 35- <45 years old for male and 55- <65 years old for fe-male .The level of HDL-C was low among young people .There was aggregation of risk factors among the participants with dyslipi-demia .Non-conditional logistic regression analysis showed that the risk factors were age (OR=1 .701) ,overweight (OR=5 .560) , abdominal obesity(OR=2 .398) ,smoking(OR=0 .545) ,intake of greasy diet(OR=5 .313) ,sleep quality(OR=2 .005) and diastolic blood pressure(OR=3 .061) .Conclusion Lipid disorders becomes a serious problem in the health examination population ,measures such as rational diet ,weight control ,sleep improvement ,pressure control and quiting smoking must be taken .

Objective To analyze CT features and related factors of mediastinal lymphoma with necrosis in order to identify other mediastinal tumor with necrosis.Methods CT features were retrospectively reviewed and related factors of necrosis were analyzed in 37 cases of mediastinal lymphoma confirmed by pathology.Results 37 cases appeared as mediastinal masses,in which 25 cases were cross-regional growth of the mediastinum,1 1 cases in anterior mediastinum and 1 case in posterior mediastinum.The largest cross-sectional area of tumors was 1.6-129.6 cm2 ,in which there were 1 case (0-10)cm2 ,8 cases (10-25)cm2 ,10 cases (25-50)cm2 ,1 5 cases(50-100)cm2 and 3 cases >100 cm2 .24 cases had necrosis ,among which 23 cases were slight enhanced and 1 case was seriously enhanced.Necrosis of mediastinal lymphoma was related to the size and CT enhancement of tumor by the logistic regression analysis(P <0.05).Conclusion Mediastinal lymphoma with necrosis is common .The necrosis of mediastinal lymphoma is related to the size and CT enhancement.Slight CT enhancement is one of differential points between mediastinal lymphoma with necrosis and other mediastinal tumor.

Objective To investigate the setup errors of super chest segment of esophageal cancer patients before radiotherapy delivery by KV cone beam CT,and evaluate the margin from CTV to PTV.Methods From 2010 to 2012,13 patients with super chest segment of esophageal cancer whose IMRT planning CT images were included in this study.Delineate target on the CT images of treatment planning and enlarge the margin of CTV to form ITV,then enlarge the margin of ITV gradually 10 times by 1 mm each time to form varied PTV,and create the plan according to the size of the PTV,simulate setup errors in the new plan to obtain the simulation of the actual exposure curve and find a suitable PTV to assure 95％ ITV volume as ever to approach the prescription dose,obtained the outside enlarge distance of CTV → PTV.Results The maximum setup errors in the direction of the anterior and posterior positioning was (3.42 ±2.19) mm.The margin of ITV→PTV is 5 mm which was figured out by PTN enlarging method.Compared to the original plan that under the condition of draw up the radiotherapy plan that based on the method of PTV enlarging obtained the CTV→PTV and simulate the actual dose distribution according to the setup errors:total lung V5,spinal cord D1cm3,increased by about 0.87％,4.95 Gy,heart V40,PTV D95,PTV V100,ITV D95,ITV V100 were reduced about 0.62％,4.95 Gy,8.38％,1.84 Gy,1.87％,all of them have statistically difference.Conclusions Range of external expansion of the left to right,superior to inferior and anterior to posterior is 7 mm,8 mm and 7 mm respectively,according to the method of PTV enlarging obtained the margin of CTV→PTV of super chest segment of esophageal cancer patients.