Objective To investigate the application of low-dose computed tomography virtual colonoscopy(LDCTVC)in colorec-tal tumor.Methods Forty-seven colorectal tumor were given low-dose CT abdominal scan(low-dose group),15 patients with normal body mass index(BMI)who received routine-dose CT abdominal scan at the same period(routine-dose group).Volume CT dose index(CTDIvol),dose length product(DLP),virtual colonoscopy and optical colonoscopy results were recorded.Results The effective dose with normal BMI was(2.86±0.47)mSv and(4.87±1.15)mSv in the low-dose and routine-dose groups,respectively.The CTDIvol and DLP between the two groups were statistically significant(P＜0.05).There were 14 cases of true positive,4 cases of false positive,5 cases of false negative and 24 cases of true negative in the low-dose group.The sensitivity,specificity and Kappa value of LDCTVC in the diagnosis of colorectal mucosal lesions were 73.7％,85.7％,and 0.6.Conclusion LDCTVC can reduce the effective dose by 50％and has a good diagnostic value for colorectal mucosal lesions,which can make up for the deficiency of colonoscopy and make accurate judgment of extra-mucosal lesions of the bowel wall.

Objective:This study aimed to explore the application of interaction-dependent fucosyl-biotinylation (FucoID), a chemical biology-based proximity labeling technique, in capturing tumor antigen-specific T cells and its clinical value in chronic myelogenous leukemia (CML) .Methods:Flow cytometry and fluorescence microscopy were employed to evaluate the experimental parameters for FucoID in CML. Peripheral blood samples were obtained from 14 newly diagnosed CML patients in the chronic phase. These samples underwent flow cytometry-based sorting and were subsequently labeled with FucoID to facilitate the isolation of tumor cells and T cells, followed by the immunophenotypic identification of tumor antigen-specific T cells. Finally, the diagnostic and therapeutic potential of FucoID in CML was assessed.Results:Initially, the experimental parameters for FucoID in CML were established. The proportion of CD3 + T cells in patients was (8.96±6.47) %, exhibiting a marked decrease compared with that in healthy individuals at (38.89±22.62) %. The proportion of tumor-specific antigen-reactive T cells was (3.34±4.49) %, which demonstrated interpatient variability. In addition, the proportion of tumor-specific antigen-active T cells in CD4 + T cells was (3.95±1.72) %, which was generally lower than the proportion in CD8 + T cells at (5.68±2.18) %. Compared with those in tumor-specific antigen-nonreactive T cells, CCR7 -CD45RA - effector memory T cells and CCR7 -CD45RA + effector T cells were highly enriched in tumor-specific antigen-reactive T cells. Moreover, the intensity of tumor immune reactivity in patients exhibited a significant correlation with white blood cell count (WBC) and hemoglobin (HGB) levels in peripheral blood, while no such correlation was observed with other clinical baseline characteristics. Conclusion:The combination of FucoID and flow cytometry enables the rapid identification and isolation of tumor antigen-specific T cells in CML. The successful application of this method in CML and the implications of our findings suggest its potential clinical value in the field of hematologic malignancies.

Objective:To explore the effects of tibial cortex transverse transport for long-term chronic wounds after serious lower limb trauma.Methods:From January 2016 to July 2021, 11 patients with long-term chronic wounds after lower limb trauma were treated at Department of Orthopedic Surgery, 920 Hospital of Joint Logistics Support Force of PLA. They were 7 males and 4 females, aged from 19 to 57 years (average, 32.3 years). There were 7 lesions of the popliteal artery and 4 ones of the anterior and posterior tibial arteries. The wound was located at the distal leg in 5 cases and at the foot and ankle in 6 ones. The wound size ranged from 3.2 cm × 2.8 cm to 9.5 cm × 7.3 cm. An external fixator for transverse transport was installed after the cortical bone fenestration was performed on the medial tibia more than 10 cm away from the wound surface, with a fenestration area of 5.0 cm × 1.8 cm. The wound was limitedly debrided, irrigated thoroughly and bandaged. Transverse transport began on the postoperative day 7, with the wounds opened for care and dressing change. The transverse transport lasted 25 days and the external fixators were dismantled 2 months after surgery. The healing of the wounds and incisions for transverse transport was observed.Results:The 11 patients were followed up for 3 to 20 months (average, 5.6 months). The wounds healed after 35 to 277 days. By the last follow-up, all the wounds healed without recurrence. Incision infection occurred in 2 patients, whose transverse transport was continued and wounds healed after local debridement; another patient suffered from poor incision healing, which responded gradually to decreased speed of transverse transport.Conclusion:Tibial cortex transverse transport can significantly improve the local blood supply and promote granulation and healing of long-term chronic wounds after serious trauma at the lower leg, foot and ankle.

Objective:To study the effect of adapted rhythmic gymnastics based on International Classification of Functioning, Disability and Health-Children and Youth Version (ICF-CY) on the fundamental motor skill development for children with low function autism spectrum disorder (ASD). Methods:Three boys aged 7.2 to 8 years with low function ASD (IQ 47 to 53) participated in the exercise since September, 2019. Their activities and motor function were analyzed with ICF-CY to develop a 12-week rehabilitation exercise, including physical fitness, gymnastics skills content and game. They were assessed with ICF-CY based Questionnaire and gross motor of Peabody Developmental Motor Scales (PDMS-2) before and after training. Results:The qualifiers of body structure, body function, activity and participation improved somehow after training. The scores of gross motor skills of PDMS-2 improved. Conclusion:The adapted rhythmic gymnastics training based on ICF-CY may improve the functioning, especially motor function, for children with low function ASD, which can be a kind of rehabilitation exercise.

Objective: To investigate the efficacy and safety of ketogenic diet (KD) and antiepileptic drugs(AEDs) in the children with drug refractory Dravet syndrome (DS). Methods: Thirty-two cases of drug refractory DS were enrolled into the Department of Neurology, Shenzhen Children′s Hospital Affiliated to Shantou University Medical School from July 2016 to December 2017, and they were divided into 2 groups: KD group and AEDs group (16 cases for each group), respectively.KD was added to as an additional therapy for KD group, and oral AEDs were administered only in AEDs group.In KD group, oral AEDs were not adjusted for the first 3 months.AEDs could be adjusted within a limited range in 2 groups after 3 months.The clinical efficacy, improvement of cognitive function, retention rate and side effects were observed and compared after 3, 6, 12 months of treatment.The average monthly seizure frequency within 3 months before enrollment was recorded as the baseline.The clinical efficacy was assessed by comparing the seizure frequency of each observation period with the baseline. Results: In KD group, after 3, 6, 12 months′ follow-up, KD the-rapy was maintained in 15, 14, 12 patients.The number of patients whose seizure reduction over 50% was 10, 12, 11 cases, respectively.The number of patients whose seizure reduction over 90% was 7, 9, 10 cases, respectively.The number of patients who were seizure free was 3, 6, 8 cases, respectively.In AEDs group, after 3, 6, 12 months′ therapy, the number of patients whose seizure reduction over 50% was 6, 7, 8 cases, respectively, the number of patients whose seizure reduction over 90% was 3, 3, 4 cases, respectively.The number of patients who were seizure-free was 2, 1, 2 cases, respectively.There was a significant difference in the seizure reduction between 2 groups after 6, 12 months (P<0.05). Furthermore, the incidence of status epilepticus (SE) was significantly reduced in KD group, and non-fever related status epilepticus (NFSE) was preferentially improved.There was a significant difference in the incidence of SE between before and after treatment in the KD group (P<0.05). After 12 months, there was a significant difference in the incidence of SE between 2 groups (P<0.05). After 6, 12 months of treatment, the patients in KD group had significant improvements in adaption, gross motor and language quotients by Gesell Developmental Scale compared to the AEDs group (all P<0.05). Eleven of 12 children who adhered to the therapy for 1 year in KD group had improvement of developmental quotient ≥ 1 grade, however, 7 cases of 16 children in AEDs group had this improvement.The incidence of adverse effect in the KD group and the AEDs group was 37.5%(6/16 cases) and 56.3%(9/16 cases), respectively, and the difference was not significant (P>0.05). Conclusions KD can not only reduce seizure frequency and relieve SE, but also improve the cognitive function of drug refractory DS.The adverse reaction ratio of KD does not increase significantly compared to AEDs.Therefore, KD is effective and safe therapy for children with drug-resistant DS.

Objective To explore the clinical distribution and significant of 23 kinds of human papillomavir-us(HPV)genetypes in normal cells and atypical squamous cells(ASC-US),meanwhile analysis result of cervi-cal histological pathology diagnosis in cases of ASC-US.Methods A total of 1 000 women with normal cells specimens were recruited into control group,and 236 women with ASC-US were selected into the ASC-US group.Polymerase chain reaction(PCR)and gene-chips technology were utilized for the detection of 23 kinds of HPV genetypes,all cases of ASC-US diagnosis of cervical pathological histology.Results A total of 106 ca-ses of HPV infection were detected in the control group,as the total HPV infection rate was 10.6%,in which the single genotypes infection rate was 9.3% and the multiple genotypes infection rate was 1.3%.A total of 139 cases of HPV infection were detected in ASC-US group,as the total HPV infection rate was 58.9%,in which the single genotypes infection rate was 38.1%,and the multiple genotypes infection rate was 20.8%. There were significant differences on the total HPV infection rate,the infection rates of type 1 and multiple geontypes between the control group and ASC-US group(P<0.05).The top six of constituent ratio in the control group were type 43,16,58,33,52,18,42,those in the ASC-US group were type 16,18,52,58,33,51,66.Conclusion PCR combined with the gene-chip technology could be used in the HPV genotypes detection in cervical cells,which has important clinical significance on the further distribution management of ASC-US,and should be draw great attention.

OBJECTIVETo analyze the ultra microstructures and the expression of platelet peroxidase (PPO) of megakaryocytes from bone marrow, their clinical manifestations and laboratory characteristics in patients with acute megakaryoblastic leukemia (AMKL).

METHODSKaryocytes from bone marrow of 22 AMKL patients were divided into two parts by lymphocyte separation liquid, one part was used to prepare the ordinary transmission electron microscope specimens to observe the morphological structures of megakaryocytes, the other was used to prepare the histochemical specimens of platelet peroxidase to analyze the positive reaction of PPO in AMKL, which were coupled with the patients' data of with bone marrow morphology, cell chemistry, and chromosome karyotype examination.

RESULTSMegakaryocytes from 17 of 22 patients were in the first stage, less than 20 µm in diameter, the nucleis were round, the cytoplasm contained microtubules, membranous vesicles and minute dense granules, no demarcation membrane system and surface-connected canalicular system, less dense granules and α-granules; Megakaryocytes in 5 cases were mainly in the first stage, while containing second and third stage megakaryocytes; the positive rate of PPO in megakaryocytes of 22 patients was 0-80%. The primitive and naive megakaryocytes were found in bone marrow smears of 22 cases, CD41 staining of the megakaryocytes was detected in the primitive and naive megakaryocytes, and more complex chromosome karyotype anomalies were observed.

CONCLUSIONThe majority of megakaryocytes in AMKL patients were the first stage ones, the rest were second and third stage ones, and the positive PPO reaction was significantly different. CD41 staining of the megakaryocytes was specific with complex chromosome karyotypeswere.

Blood Platelets ; enzymology ; Bone Marrow ; pathology ; Cell Count ; Chromosome Aberrations ; Chromosome Disorders ; Humans ; Karyotyping ; Leukemia, Megakaryoblastic, Acute ; diagnosis ; pathology ; Megakaryocytes ; pathology ; Peroxidase ; metabolism ; Staining and Labeling

Objective To analyze the clinical manifestations of familial acute necrotizing encephalopathy (ANE)and to improve the recognition of this disease. Methods The clinical data of a 25 - month - old girl with fa-milial and recurrent ANE with evidence of mutation in the RANBP2 gene were collected and analyzed,and the gene examination of their family members was performed. Results A previously healthy girl experienced recurrent ANE epi-sodes at the ages of 8 months,18 months and 25 months,respectively. At each beginning of each episodes the patient presented with lethargy and tremor of limbs following febrile illness of 3 - 4 days,even developed coma and convulsions in the last time. Brain magnetic resonance imaging showed bilateral and high T2 signal changes in thalamus,cerebellum and hippocampus. Abnormal signals also appeared in the brainstem,claustrum,corpus scallosum and cortex(temporal, parietal and cingulate)also appeared abnormal signals. Spinal MRI showed spinal cord involvement. The girl recovered after her first episode;she could speak but could not walk steadily after the second time;after the third episode,al-though she regained consciousness from coma,she could no longer speak or walk. The patient's sister died of encephali-tis at the age of 18 months. Her paternal uncle had suffered from dysnoesia from meningitis at his 17 months of age. The patient and her grandmother,father,uncle and one of her aunts harbored a mutation(c. 1754C ﹥ T)in RANBP2 gene. Conclusions Familial ANE has typical clinical manifestations and characteristic MRI findings. The patient with recur-rent history,especially with positive family history,should have the mutation in RANBP2 gene detected earlier in order to clarify the diagnosis of ANE.

Objective To compare the distribution situation of human papillomavirus(HPV)genotypes in the tissue specimens of cervical intraepithelial neoplasia(CINⅠ,CINⅡ and CINⅢ)and its clinical significance.Methods The polymerase chain reaction (PCR)and gene-chips technology were utilized for detecting 23 kinds of HPV genotypes in the cervical tissue specimens from 53 ca-ses of CINⅠ,67 cases of CINⅡ and 188 cases of CINⅢ.And the related data of all subjects were analyzed.Results Among 53 ca-ses of CINⅠ,29 cases of HPV infection were detected with the total HPV infection rate of 54.72%9;among 67 cases of CINⅡ,52 cases of HPV infection were detected with the total HPV infection rate of 76.12%;among 188 cases of CINⅢ,175 cases of HPV infection were detected with the total HPV infection rate of 93.09%.Conclusion The significant difference of the total HPV infec-tion rate exists in the tissues of CINⅠ,CINⅡ and CINⅢ.PCR and the gene-chip technology can be applied in the detection of the cervical tissue specimens,23 kinds of genotypes can be detected by once detection,which has very important significance to the mo-lecular epidemiological survey of female cervical HPV infection,prevention and treatment of cervical cancer and the HPV vaccine re-search.

Objective To evaluate the risk factors of electrocardiographic abnormality in patients with acute cerebral infarction.Methods The clinical data of patients with acute cerebral infarction were collected,including the National Institutes of Health Stroke Scale (NIHSS),electrocardiogram (ECG),lipid,glucose,glycosylated hemoglobin,body mass index,homocysteine,high-sensitivity C-reactive protein,white blood cells,and medical history.Logistics regression was used to search the risk factors of ECG abnormality in patient with acute cerebral infarction.Results ECGs of 189 cases of patients with acute cerebral infarction were divided into normal (n =83) and abnormal (n =106).The rate of abnormal ECG was 56.09％,and abnormal ECG ST-T change was the most common.NIHSS,systolic blood pressure,total cholesterol,and white blood cells were correlated with the ECG abnormality with the one-way Logistic regression analysis.In addition,NIHSS,systolic blood pressure,and white blood cells were correlated with the ECG abnormality with the multiple Logistic regression analysis (r =1.18,P ＜0.01 ; r =1.02,P ＜0.01 ; r =1.19,P ＜ 0.05).Conclusions NIHSS,systolic blood pressure,and white blood cells were independent risk factors in patients with acute cerebral infarction.ECG monitoring should be performed especially in patients with high NIHSS,systolic blood pressure,and white blood cells count.