Evidence-based medicine (EBM) is a science that uses the best available research data to make decisions, and the core is that clinical decision-making is supported by the best research evidence. Incorporating EBM into traditional standardized residency training in hematology can foster residents' professional theoretical knowledge and clinical skills, improve the quality of standardized training, and provide ideas and methods for standardized training of hematology residents, which is worthy of further research and exploration.

Japan is one of the main trading partners for the import and export of experimental animals in China,and its quarantine and supervision policies for the import and export of experimental animals are very detailed and strict.This article takes experimental dogs,cats,and monkeys as examples to provide an in-depth analysis of the quarantine and supervision policies for the main experimental animals exported to Japan.At the same time,it reflects on the current laws and regulations,import and export management method,standards,biosafety,breeding and management status,as well as the import and export business status of experimental animals in China.Suggestions are provided in improving the laws and regulations,import and export management method,ensuring national biosafety,improving the management level of experimental animal breeding,and promoting the import and export trade of experimental animals,in order to provide reference for comprehensively improving the production,use,and breeding management level of experimental animals in China and strengthening the trade between China and Japan.

Objective To investigate the effect of bronchoscopic balloon dilation treatment of different intervals on the tracheal intubation-induced subglottic stenosis in children. Methods Children with tracheal intubation-induced subglottic cicatricial stenosis were selected as the research objects. Among the 36 children with pure balloon dilation treatment, 20 cases were enrolled in the observation group and 16 cases were enrolled in the control group. In the observation group, electronic bronchoscopy was performed at 3 days after the first-time balloon dilation treatment, and those with grade 2 or higher stenosis received the second-time balloon dilation treatment. The follow-up treatment principle was as follows. If there was obvious retraction compared with the previous time and the stenosis was grade 2 or higher, the balloon dilation treatment would be performed again after an interval of 3 days; if there was no obvious retraction, the evaluation would be performed again after an interval of 2 weeks until there was no obvious retraction in the stenosis site under endoscopy for 3 times in 6 consecutive weeks, and the degree of stenosis was less than 25%, and then the electronic bronchoscopy evaluation would be stopped. In the control group, electronic bronchoscopy was performed 7 days after the first-time balloon dilation treatment, and those with grade 2 or higher stenosis received the second-time balloon dilation treatment. The follow-up treatment principle was as follows. If there was obvious retraction compared with the previous time and the stenosis was grade 2 or higher, the balloon dilation treatment would be performed again after an interval of 7 days; the evaluation method for those without obvious retraction was the same as the observation group. The follow-up duration ranged from 6 to 9 months. Results There was no significant difference in the total number of treatments and outcomes between the two groups (P>0.05). The treatment duration of the observation group was significantly shorter than that of the control group (P < 0.05). There were no significant differences in intraoperative complications such as bleeding, oxygen saturation decrease, heart rate decrease, and blood pressure decrease during anesthesia between the two groups (P>0.05). There were no significant differences in postoperative fever, aggravated laryngeal stridor, and dyspnea between the two groups (P>0.05). There were no significant differences in dyspnea, activity tolerance, and the need for long-term oxygen therapy between the two groups (P>0.05). Conclusion Most of the tracheal intubation-induced subglottic cicatricial stenosis in children has a good medium- and long-term effect through pure balloon dilation treatment. Shortening the interval of pure balloon dilation to 3 days can shorten the total treatment duration, alleviate the psychological burden of parents, but does not increase their economic burden. There are no significant differences in intraoperative and postoperative complications, outcomes, and long-term follow-up compared with the original interval of 5 to 7 days.

BACKGROUND: Exploring the underlying mechanism of rituximab resistance is critical to improve the outcomes of patients with diffuse large B-cell lymphoma (DLBCL). Here, we tried to identify the effects of the axon guidance factor semaphorin-3F (SEMA3F) on rituximab resistance as well as its therapeutic value in DLBCL. METHODS: The effects of SEMA3F on the treatment response to rituximab were investigated by gain- or loss-of-function experiments. The role of the Hippo pathway in SEMA3F-mediated activity was explored. A xenograft mouse model generated by SEMA3F knockdown in cells was used to evaluate rituximab sensitivity and combined therapeutic effects. The prognostic value of SEMA3F and TAZ (WW domain-containing transcription regulator protein 1) was examined in the Gene Expression Omnibus (GEO) database and human DLBCL specimens. RESULTS: We found that loss of SEMA3F was related to a poor prognosis in patients who received rituximab-based immunochemotherapy instead of chemotherapy regimen. Knockdown of SEMA3F significantly repressed the expression of CD20 and reduced the proapoptotic activity and complement-dependent cytotoxicity (CDC) activity induced by rituximab. We further demonstrated that the Hippo pathway was involved in the SEMA3F-mediated regulation of CD20. Knockdown of SEMA3F expression induced the nuclear accumulation of TAZ and inhibited CD20 transcriptional levels via direct binding of the transcription factor TEAD2 and the CD20 promoter. Moreover, in patients with DLBCL, SEMA3F expression was negatively correlated with TAZ, and patients with SEMA3F low TAZ high had a limited benefit from a rituximab-based strategy. Specifically, treatment of DLBCL cells with rituximab and a YAP/TAZ inhibitor showed promising therapeutic effects in vitro and in vivo . CONCLUSION Our study thus defined a previously unknown mechanism of SEMA3F-mediated rituximab resistance through TAZ activation in DLBCL and identified potential therapeutic targets in patients.
Humans ; Animals ; Mice ; Rituximab/therapeutic use* ; Hippo Signaling Pathway ; Lymphoma, Large B-Cell, Diffuse/pathology* ; Prognosis ; Semaphorins/therapeutic use* ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Membrane Proteins/genetics* ; Nerve Tissue Proteins/genetics*

Crossmodal information processing in sensory cortices has been reported in sparsely distributed neurons under normal conditions and can undergo experience- or activity-induced plasticity. Given the potential role in brain function as indicated by previous reports, crossmodal connectivity in the sensory cortex needs to be further explored. Using perforated whole-cell recording in anesthetized adult rats, we found that almost all neurons recorded in the primary somatosensory, auditory, and visual cortices exhibited significant membrane-potential responses to crossmodal stimulation, as recorded when brain activity states were pharmacologically down-regulated in light anesthesia. These crossmodal cortical responses were excitatory and subthreshold, and further seemed to be relayed primarily by the sensory thalamus, but not the sensory cortex, of the stimulated modality. Our experiments indicate a sensory cortical presence of widespread excitatory crossmodal inputs, which might play roles in brain functions involving crossmodal information processing or plasticity.
Animals ; Auditory Cortex/physiology* ; Neuronal Plasticity/physiology* ; Neurons ; Rats ; Thalamus ; Visual Cortex/physiology*

Objective:To evaluate the image quality of dual-source computed tomography pulmonary angiography (DE-CTPA) with low-dose contrast agent using the advanced modeled iterative reconstruction (ADMIRE) method with 70 kVp and non-linear blending in overweight patients.Methods:Seventy patients (normal BMI, 35; overweight, 35) with suspected pulmonary embolization who underwent DE-CTPA between October 2018 and March 2019 were included in this study. The imaging protocol included assessments at 70 kV/sn150 kV with 30 ml of contrast agent, and images were obtained at 70 kVp and 150 kVp with and without linear blending. The CT value, SD value, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) of pulmonary arteries were compared and analyzed among groups 1 (70 kVp, normal BMI), 2 (non-linear blending, normal BMI), 3 (70 kVp, overweight), and group 4 (non-linear blending, overweight). The radiation dose parameters included CT volume dose index (CTDI vol), dose length product (DLP), and effective dose ( E). Results:The CT values for the pulmonary artery did not show significant differences among the four groups ( P>0.05). The SD value of the segmental artery in group 1 was higher than that in group 4 ( t=2.69, P<0.05). The SNR values of the pulmonary artery trunk and sub-segmental artery in group 2 were higher than those in group 3 ( t=1.44, 5.40, P<0.05), while the corresponding value of the left pulmonary artery trunk in group 2 was higher than those in groups 3 and 4 ( t=1.52, 1.52, P<0.05). The CNR values of the pulmonary artery trunk and sub-segmental artery in group 2 were higher than those in group 3 ( t=1.45, 5.01, P<0.05) and that of the left pulmonary artery trunk in group 2 was higher than those in groups 3 and 4 ( t=1.50, 1.50, P<0.05). The E values for normal BMI and overweight patients were(1.60±0.54)mSv and(1.88±0.45)mSv, respectively. Conclusions:For overweight patients, the CTPA protocol using ADMIRE with a 70 kV/sn150 kV scanning mode could yield diagnostic image quality with significantly lower radiation and contrast material doses.

Objective: To analyze the risk factors of frequent gout flare, and to evaluate its susceptibility to identify patients with≥2 acute attacks per year. Methods: A total of 579 of cases gout patients with no history of taking urate lowering treatment (ULT) in recent 12 months were enrolled. The patients were divided into frequent group (gout episodes≥twice per year) and non-frequent group(gout attacksResults: There were significant differences in involvement of upper limb joints, tophi, combining hypertension and renal stone between two groups. The two groups had no statistical differences in family history, gender, history of smoking and drinking, ratios of regular exercise, and combining diabetes, hepatic insufficiency, hypertriglyceridemia, hypercholesterolemia, and overweight/obesity. There was significant differences in the number of joints involved, the history of disease duration, the level of SUA and TG[(4.66±2.54) vs (2.77±1.64), (6.68±5.11) vs (5.14±3.89) years, (525.82±132.11) vs (489.33±139.81) μmol/L, (2.51±1.94) vs (2.05±1.22) mmol/L, P<0.05 or P<0.01]; There were no statistical differences in age of onset, SBP, DBP, age of initial diagnosis, fasting blood glucose, TC, creatinine, glomerular filtration rate, AST, ALT, body mass index, waist circumference, and waist-to-hip ratio. Logistic regression analysis indicated that a large number of joints involved and higher serum uric acid level were risk factors of frequent gout attacks. The ROC curve showed that the number of joints involved had qualified performance in identifying patients with frequent gout attacks. When the number of joints involved was >2, and the sensitivity, specificity, positive predictive value and negative predictive value were 77.8%, 43.3%, 85.6%, and 56.6%, respectively, and the difference was significant. Conclusion Higher SUA and a larger number of joints involved associate independently with frequent gout attacks. The number of joints involved at initial diagnosis>2, which can predict the frequent flare, and start ULT as earlier as possible. Patients with joints involved at initial diagnosis>2 are at greater risk of frequent gout flare.

We reported a case of mosaic trisomy 2.The patient was a 29-year-old gravida who underwent amniocentesis at 20 weeks of gestation because of high risk of trisomy-21 in the first trimester screening.The test result revealed a karyotype of 47,XN,+2[10]/46,XX[40].At 26 gestational weeks,the fetus was found severe fetal growth restriction and oligohydramnios which was considered to be at risk of mosaic trisomy 2.The pregnancy was terminated at 27+ gestational weeks.The fetus had obviously abnormal appearances,including dolichocephaly,low-set ears,and micromandible.Autopsy was not performed due to the parents' refusal.

Purpose To quantitatively evaluate the ability of advanced virtual monoenergetic technique (monoplus) in improving the display of pulmonary arteries with dual-source CT dual-energy pulmonary angiography.Materials and Methods Thirty patients whose CT values in pulmonary artery and its branches were lower than 300 HU in mixed images while image quality was poor in distal branches were enrolled in this study.All these patients underwent dual-source dual-energy (100/Sn140 kVp) CT pulmonary angiography (CTPA) with small amount of contrast medium (30 ml) from September 2016 to December 2016.Non-linear blending images were assigned in group A,100 kVp images from one tube were assigned in group B,and optimized monoenergetic images with low keV monoplus (40+,50+,60+ keV) were assigned in group C,D and E,respectively.CT and SD values of segmental,subsegmental and distal branches were measured,and signal noise ratio (SNR) and contrast noise ratio (CNR) were calculated.Results Among all the 5 groups,CT values of pulmonary artery in group C,D and E were significantly higher than in group A and B (P＜0.05).SNR values of segmental artery in group C were significantly higher than those in group A (P＜0.05).SNR values of subsegmental artery in group C and D were significantly higher than those in group A (P＜0.05).SNR values of segmental and subsegmental pulmonary artery in group C,D and E were all significantly higher than those in group B (P＜0.05).The SNR values of distal branches in group C,D and E were not significantly different from those in group A (P＞0.05),but were significantly higher than those in group B (P＜0.05).CNR values in group C,D and E were not significantly different from those in group A (P＞0.05),but were significantly higher than those in group B (P＜0.05).Conclusion Combined with dual-source dual-energy CT pulmonary angiography,low keV monoplus images can effectively increase CT values of pulmonary artery and clearly display the distal branches.Meanwhile,the image quality is comparable with non-linear blending images,better than that of low tube voltage (100 kVp) images.

Objective To investigate the conditions of diabetes-related knowledge as well as the influencing factors in elderly people in Changchun so as to provide basis for regulation of health education policy.Method A total of 400 community elderly people in Changchun involved in the survey by questionnaire for investigating the knowledge on diabetes and the influencing factors. Results The elderly people in the community in Chuangchun knew much better about the typical symptoms,diet and treatment by 74.0%,80.8%and 75.8%,respectively,but they knew little about the causes of the disease and complications by 52.7%and 25.7%respectively.The factors influencing their acquisition of diabetes related knowledge included education level,income and disease condition.Conclusions The elderly people in the communities lack diabetic knowledge,which is unbeneficial for the prevention and control of diabetes.Therefore,it is a need to strengthen diabetes-related knowledge education in order to prevent and reduce the complications.