Purpose/Significance To improve the performance of named entity recognition(NER)model of Chinese electronic medi-cal records(EMR)for better organization and mining of medical information.Method/Process The ERNIE-BiGRU-Attention-CRF NER model of Chinese EMR is constructed.Firstly,the ERNIE1.0 pre-training model is used to generate word vectors with semantic features,and then BiGRU is utilized to capture the global semantic features and grammatical structural features,which are fed into the Attention mechanism to further enhance the capture of the semantic features,and finally,the CRF decoding layer is connected to output the label sequences with the maximum global probability.Result/Conclusion Comparison experiments and ablation experiments are car-ried out on the publicly available medical text dataset CCKS2017,and examples analysis is conducted using the generated model.The model proposed in this paper achieves better recognition results.

This article reports a case of Prader-Willi syndrome(PWS) diagnosed in adulthood. PWS is a rare genetic disease with most of the reported cases being diagnosed in infancy and childhood, and adulthood case is rarely reported. The patient had insidious symptoms in infancy and was diagnosed as PWS using genetic test in adulthood due to diabetes and menstrual disorders. This article focuses on the patient′s clinical manifestations in adulthood, and reviews relevant literature to improve the understanding of the disease.

Objective To analyze the clinical courses and outcomes of COVID-19 cases and the influencing factors in Guangdong province and provide basis for the formulation or adjustment of medical care and epidemic control strategy for COVID-19. Methods We collected demographic data, medical histories, clinical courses and outcomes of 1 350 COVID-19 patients reported in Guangdong as of 4 March 2020 via epidemiological investigation and process tracking. Disease severity and clinical course characteristics of the patients and influencing factors of severe illness were analyzed in our study. Results Among 1 350 cases of COVID-19 cases in Guangdong, 72 (5.3%) and 1049 (77.7%) were mild and ordinary cases, 164 (12.1%) were severe cases, 58 (4.3%) were critical cases and 7 (0.5%) were fatal. The median duration of illness were 23 days ( P 25 - P 75 : 18-31 days) and the median length of hospitalization were 20 days ( P 25 - P 75 : 15-27 days). For severe cases, the median time of showing severe manifestations was on the 12th day after onset ( P 25 - P 75 : 9th to 15th days), and the median time of severe manifestation lasted for 8 days P 25 - P 75 : 4-14 days). Among 1 066 discharged/fetal cases, 36.4% (36/99) and 1.0% (1/99) of the mild cases developed to ordinary cases and severe cases respectively after admission; and 5.2% (50/968) and 0.6% (6/968) of the ordinary cases developed to severe cases, and critical cases respectively after admission. In severe cases, 11.4% developed to critical cases (10/88). The influencing factors for severe illness or worse included male (a HR =1.87, 95% CI : 1.43-2.46), older age (a HR =1.67, 95% CI : 1.51-1.85), seeking medical care on day 2-3 after onset (a HR =1.73, 95% CI : 1.20-2.50) pre-existing diabetes (a HR =1.75, 95% CI : 1.12-2.73) and hypertension (a HR =1.49, 95% CI : 1.06-2.09). Conclusions The course of illness and length of hospitalization of COVID-19 cases were generally long and associated with severity of disease clinical outcomes. The severe cases were mainly occurred in populations at high risk. In the epidemic period, classified management of COVID-19 cases should be promoted according to needs for control and prevention of isolation and treatment for the purpose of rational allocation of medical resources.

Objective:To study on the effects of micro-plasma radio frequency technology on guinea pig skin pigmentation animal model induced by narrow band ultraviolet B (NB-UVB).Methods:We selected ten healthy guinea pigs (common grade), removed the brown hair of the guinea pig and established UVB to induce the skin pigmentation model of guinea pig. The pigmentation zone was randomly divided into four groups: Group A was used as blank control with no treatment and Groups B , C and D were treated with micro-plasma radio frequency technology using different energy parameters. Group B treatment parameters were as follows: output power was 10 watts, and treatment energy was 0.06J. Group C treatment parameters were as follows: output power was 20 watts, and treatment energy was 0.12J. Group D treatment parameters were as follows: output power was 30 watts, and treatment energy was 0.18J. They were compared before treatment and at 2, 4, and 6 weeks after treatment, based on melanin cell staining (epidermis separation-dopa staining) and melanin granules dyeing method (Masson-Fontana). Immunohistochemical staining (c-kit protein) was used to observe the tyrosinase activity in the melanocytes, melanin granule percentage area of the skin area, and the change in melanin cell activity. SPSS13.0 statistical software was used for statistical analysis of the experimental data. The significance of the difference ( P< 0.05) was measured. Results:The results showed that micro-plasma radio frequency (RF) technology treatment could reduce the tyrosinase activity in the melanocytes, 2, 4 and 6 weeks after the end of treatment: Groups B, C and D were lower than group A, and the difference was statistically significant ( P<0.05), and as the treatment energy increased, the speed of reduction was increased. Micro-plasma radio frequency technology could reduce skin pigmentation and decrease the amount of epidermal melanin granules, 2 and 4 weeks after the end of treatment: Groups B, C and D were lower than Group A; 6 weeks after the end of treatment, only Group D was lower than Group A, with statistically significant differences ( P< 0.05). An increase in the energy of the micro-plasma radio frequency sped up the decline in the amount of epidermal melanin granules.The number of c-kit positive cells was not increased in this experiment. Two weeks after the end of treatment, the number of c-kit positive cells was higher than those of Groups B, C and D. There were no statistically significant differences in Groups B, C and D ( P<0.05). No c-kit positive cells were found in Groups A, B, C and D at 4 and 6 weeks after the irradiation. Conclusions:Micro-plasma radio frequency technology could accelerate the fading of guinea pig skin pigmentation. It is effective to improve pigmentation of guinea pig skin after NB-UVB irradiation.

Objective:To study on the effects of micro-plasma radio frequency technology on guinea pig skin pigmentation animal model induced by narrow band ultraviolet B (NB-UVB).Methods:We selected ten healthy guinea pigs (common grade), removed the brown hair of the guinea pig and established UVB to induce the skin pigmentation model of guinea pig. The pigmentation zone was randomly divided into four groups: Group A was used as blank control with no treatment and Groups B , C and D were treated with micro-plasma radio frequency technology using different energy parameters. Group B treatment parameters were as follows: output power was 10 watts, and treatment energy was 0.06J. Group C treatment parameters were as follows: output power was 20 watts, and treatment energy was 0.12J. Group D treatment parameters were as follows: output power was 30 watts, and treatment energy was 0.18J. They were compared before treatment and at 2, 4, and 6 weeks after treatment, based on melanin cell staining (epidermis separation-dopa staining) and melanin granules dyeing method (Masson-Fontana). Immunohistochemical staining (c-kit protein) was used to observe the tyrosinase activity in the melanocytes, melanin granule percentage area of the skin area, and the change in melanin cell activity. SPSS13.0 statistical software was used for statistical analysis of the experimental data. The significance of the difference ( P< 0.05) was measured. Results:The results showed that micro-plasma radio frequency (RF) technology treatment could reduce the tyrosinase activity in the melanocytes, 2, 4 and 6 weeks after the end of treatment: Groups B, C and D were lower than group A, and the difference was statistically significant ( P<0.05), and as the treatment energy increased, the speed of reduction was increased. Micro-plasma radio frequency technology could reduce skin pigmentation and decrease the amount of epidermal melanin granules, 2 and 4 weeks after the end of treatment: Groups B, C and D were lower than Group A; 6 weeks after the end of treatment, only Group D was lower than Group A, with statistically significant differences ( P< 0.05). An increase in the energy of the micro-plasma radio frequency sped up the decline in the amount of epidermal melanin granules.The number of c-kit positive cells was not increased in this experiment. Two weeks after the end of treatment, the number of c-kit positive cells was higher than those of Groups B, C and D. There were no statistically significant differences in Groups B, C and D ( P<0.05). No c-kit positive cells were found in Groups A, B, C and D at 4 and 6 weeks after the irradiation. Conclusions:Micro-plasma radio frequency technology could accelerate the fading of guinea pig skin pigmentation. It is effective to improve pigmentation of guinea pig skin after NB-UVB irradiation.

OBJECTIVE To analyze and compare the clinical efficacy of subtotal-parathyroidectomy and totalparathyroidectomy with forearm autotransplantation in the treatment of hyperparathyroidism secondary to uremia. METHODS The clinical data of 31 cases of secondary hyperparathyroidism(SHPT) who were operated in Dalian Friendship Hospital from January 2012 to June 2018 were retrospectively analyzed. The cases were divided into two groups. Subtotal parathyroidectomy was performed in group one(20 cases) and total parathyroidectomy with forearm autotransplantation were performed in group two(11 cases). Preoperative, postoperative one week, 1 month, 3 months, 6 months of patients with the levels of blood calcium, blood phosphorus and blood iPTH, clinical symptom improvement degree and other data were analyzed. RESULTS Postoperative, the levels of blood calcium, blood phosphorus and blood iPTH all decreased significantly compared with that before operation, and the difference was statistically significant(P ＜0.05). There was no significant difference in preoperative and postoperative levels of blood calcium, blood phosphorus and blood iPTH at 6 months after surgery between the two groups(P ＞0.05). Postoperative bone pain, skin itching and restless leg syndrome were significantly reduced in both groups. There was no significant difference in symptom relief between the two groups(P ＞0.05). CONCLUSION Both of the surgical methods can effectively manage the hyperparathyroidism secondary to uremia, they have high surgical safety, there was no significant difference in the effects of serum calcium and phosphorus between the two groups, and the parathyroid hormone decreased more significantly in the parathyroid total excision and forearm autologous transplantation group in the short term. Both of them have the possibility of recurrence. The second operation in total parathyroidectomy and forearm autotransplantation group is simple and easy, which has certain advantages.

Objective: Microtia is a relatively common birth defect, and its etiology is still unclear. In this paper, Phenolyzer, a kind of phenotype-based gene analyzer, was used to prioritize candidate genes involved in microtia. Methods: The search term " Microtia" was entered in the Phenolyzer interface. Through the steps of disease matching, gene query, gene scoring, seed gene expansion, the genetic information results of microtia were finally generated. This article traced 10 candidate genes in detail. Results: There were 13485 genes associated with microtia or related syndromes, of which 130 were seed genes. Each gene had a corresponding score, and the higher the score, the greater the correlation with the microtia. Among them, the top 10 genes included HOXA2, CHD7, CDT1, CDC6, ORC1, ORC4, ORC6, SMAD4, GLI3 and MED12. Conclusions Phenolyzer provides a detailed summary of candidate genes for microtia, providing accurate research directions for screening high-throughput sequencing results and subsequent studies.

Objective: To investigate the application of metagenomic next-generation sequencing (mNGS) in detection of the rare or difficult-to-cultivate pathogens. Methods: One patient with acute lymphoblastic leukemia who went through allogeneic hematopoietic stem cell transplantation (allo-HSCT) developed symptoms of infection after transplantation. Conventional microbial culture, polymerase chain reaction (PCR), and mNGS combined with biological information analysis were performed with plasma and cerebrospinal fluid samples, the anti-infective treatment was adjusted according to the test results, and the efficacy was assessed. Results: No suspected pathogens were detected by microbial culture and PCR in the cerebrospinal fluid and plasma samples since the patient developed infection symptoms. However, Legionella pneumophila was analyzed by mNGS in the cerebrospinal fluid specimen on day 23 after allo-HSCT (reads count: 19 655), and it was considered as the principal pathogen after comprehensively evaluating the patient's clinical manifestations and the test results. Then the antimicrobial treatments were adjusted according to the patient's clinical manifestations and laboratory test results, and the number of gene sequences of Legionella pneumophila was monitored by mNGS method. Azithromycin, tigecycline, and other antibiotics effective for Legionella pneumophila were used after detecting this pathogen. A total of 15 mNGS analysis were performed during the 5-month period, and the highest number of Legionella pneumophila sequences monitored in the cerebrospinal fluid was 2 226, the lowest was 253 and eventually turned negative. The clinical symptoms and treatment outcomes were consistent with the mNGS monitoring results. Conclusions The mNGS technology has significant value in detection of the rare and difficult-to-cultivate pathogens. The mNGS technology provides a valuable supplement to microbial culture and PCR methods.

Objective To investigate the clinical features of pulmonary lymphoma and to get a better understanding of this disease. Methods Clinical data of 253 lymphoma patients in the Department of Lymphoma and Hematology in Jilin Cancer Hospital from October 2014 to March 2017 were retrospectively analyzed. The patients were divided into 30 cases of pulmonary lymphoma (lung lymphoma group) and 223 cases of non-pulmonary lymphoma (the control group). Rate assay and latex turbidimetry was used to detect lactic dehydrogenase (LDH) and β2macroglobulin (β2-MG) respectively. The expressions of programmed death 1 (PD-1), programmed death ligand 1 (PD-L1) and cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) in peripheral blood CD4 +CD8 +T lymphocytes were detected by using flow cytometry. The count and measurement data of both groups were compared by using χ 2test and t test respectively. Results The patients in pulmonary lymphoma group showed secondary lesions. The proportion of smoking people in pulmonary lymphoma group was higher than that in the control group [43.3 % (13/30) vs. 24.2 % (54/223), χ 2＝ 4.964, P＝ 0.026]. The proportion of the patients in Ⅲ-Ⅳ stage in pulmonary lymphoma group was higher than that in the control group [93.3 % (28/30) vs. 57.0 % (127/223), χ2＝ 14.750, P < 0.001]. The proportion of the patients with higher international prognostic index (IPI) score in pulmonary lymphoma group was higher than that in the control group (χ2＝ 21.888, P < 0.001). The proportion of the patients with increased expression of β2-MG in pulmonary lymphoma group was higher compared with the control group [66.7 % (20/30) vs. 50.2 % (112/223), χ2＝6.682, P ＝0.091]. The proportion of the patients with the increased LDH was higher compared with the control group [63.3 % (19/30) vs. 41.5 % (86/223)], and the difference was statistically significant (χ2＝ 6.682, P ＝ 0.010). Diffuse large B-cell lymphoma (DLBCL) was the common pathological type in pulmonary lymphoma group (15 cases), followed by Hodgkin lymphoma (7 cases); imaging showed single mass or nodular type, multiple masses or nodular type, bilateral pulmonary infiltration, pleural effusion were 36.7 % (11/30), 30.0 % (9/30), 63.3 % (19/30) and 36.7 % (11/30), respectively. There were no statistical differences in the protein expression of immune check points such as PD-1, PD-L1 and CTLA-4 in both groups (all P ＞ 0.05). Conclusions Pulmonary DLBCL should be considered a secondary disease, but not a primary lesion. Smoking history is a risk factor for lymphoma patients with pulmonary involvement. Pulmonary lymphoma is similar to other extra-nodal lymphoma with high IPI scores, advanced stage and elevated LDH.

Objective To explore the presence of myeloid-derived suppressor cells (MDSC) in patients with non-Hodgkin lymphoma (NHL) and its clinical value. Methods Peripheral blood samples were collected from 69 NHL patients and 21 healthy controls admitted in Jilin Cancer Hospital from January 2014 to February 2015. Flow cytometry was conducted to identify unique cell surface markers of MDSC using antibodies against CD11b, CD33, CD14 or HLA-DR. MDSC were enriched by immunomagnetic beads, then arginase 1 (Arg-1), inducible nitric oxide synthase (iNOS) and cyclooxygenase 2 (COX-2) in which were detected by real time-PCR. In vitro, cell proliferation assay was used to test T cell function. Statistical analysis was used to explore the correlation between MDSC and clinical features. Results There were a high level of CD11b+CD14+CD33+cells in peripheral blood of NHL patients. The morphology of the cells belonged to mononuclear cells. The ratio of monocytic CD11b+CD14+CD33+cells in NHL patients was higher than those in healthy controls [(42±10) ％ vs. (34±11) ％, t= 0.300, P= 0.005]. The expressions of Arg-1, COX-2 and iNOS in CD11b+CD14+CD33+and CD11b+CD14+CD33-cells were 0.12±0.04 vs. 1.00±0.25 (t= 6.095, P=0.024), 3.03±0.45 vs. 1.00±0.78 (t= 7.766, P= 0.016) and 0.29±0.11 vs. 1.00±0.04 (t= 1.987, P= 0.209), respectively. In addition, the CD11b+CD14+CD33+cells inhibited T cell proliferation. The levels of MDSC in patients with different international prognostic index (IPI) score were significantly different (F= 2.536, P=0.049), but the levels of MDSC in patients with different sex, age, pathological type, stage, serum lactate dehydrogenase, physical status staging criteria and β2-microglobulin had no differences (all P < 0.05). Conclusions CD11b+ CD14+ CD33+ cells are characterized as MDSC in terms of higher level in NHL patients, expressing myeloid-specific proteins, and inhibiting T cell proliferation. The expression of MDSC is associated with IPI score, implying it might be a novel biomarker in clinical practice for NHL patients.