Objective: To evaluate the clinical characteristics of T-cell acute leukemia/lymphoma (T-ALL) and explore the prognosis significance of early T-cell precursor leukemia/lymphoma. Methods: A cohort of 126 patients diagnosed with T-ALL from 2008 to 2014 in West China Hospital, Sichuan University were enrolled in this study. They were further categorized by immunophenotype according to the expression of T-cell lineage markers CD1a, CD8, CD5 and one or more stem cell or myeloid markers. The laboratory indicators and prognosis factors were also statistically analyzed. Results: Of all patients, the ratio of male to female was 2.5∶1, with the median age of 25 years old (range 14 to 77) . The percentage of ETP-ALL was up to 47.6%. T-ALL patients showed higher ratio in first clinical remission rate (CR₁) than T-LBL ones (64.4% vs 30.8%, P=0.032) . Group with WBC count higher than 50×10⁹/L at presentation showed higher ration of achieving CR₁ than those lower than 50×10⁹/L (78.4% vs 50.9%, P=0.010) . In comparison with the non-ETP-ALL, ETP-ALL patients had older age of onset (P<0.001) , lower WBC count (P<0.001) , lower risk of CNS involvement (10.0% vs 30.2%, P=0.009) and slightly inferior overall survival (P=0.073) . T-cell lineage markers CD1a^-, CD8^- and CD4^- positive patients had higher CR₁ than their corresponding negative ones (P=0.002, P=0.000, P=0.001) , while CD33^- and CD56^- positive patients had lower ratio of achieving CR₁ than their negative ones, respectively (P=0.035, P=0.035) . Conclusion Flow cytometry and associated markers for immunophenotyping was of significance in the diagnosis and prognosis monitoring of T-ALL/LBL. The percentage of ETP-ALL/LBL subtype was high in Chinese adolescent and adult T-ALL patients. ETP-ALL/LBL was a high risk subtype, which needs more precise standard for diagnosis and advanced therapies for better outcome.

Objective To analyze the clinical characteristics and screen pathogens and prognosis of anti-N-methyl-D-aspartate receptor(NMDAR)encephalitis in children and so as to improve the diagnosis and treatment of anti-NMDAR encephalitis in children.Methods A retrospective and follow-up analysis of 38 cases of pediatric anti-NMDAR encephalitis was performed,who were admitted to the West China Second University Hospital,Sichuan University from May 2012 to June 2016,and their clinical features,associated pathogen screening,treatment and progno-sis were reviewed.Results Those 38 cases included 14 males and 24 females.The age ranged from 1 year and 10 months to 17 years and 6 months.The most common symptoms were psychiatric symptoms(33 cases),and dyskinesias and movement disorders(33 cases),speech disturbances(31 cases).Twenty-four cases(63.2%)received positive pathogenic screening and only one case had right ovarian mature cystic teratoma.Among them,11 cases had positive mycoplasma pneumonia immunoglobulin M(IgM)antibodies,10 cases had positive virus screening,and 1 case had toxoplasma gondii IgM antibodies positive,and 2 cases had mix infection.Symptoms of one case were relieved after anti-toxoplasma treatment without immunosuppression treatment,and another case had partial symptom relief after mycoplas-ma pneumonia treatment.Thirty-seven cases received immunosuppressant therapy(4 cases were treated with glucocor-ticoid,12 cases were treated with glucocorticoid combined with immune globulin,2 cases were treated with glucocorti-coid combined with plasma exchange,still 19 cases were treated with glucocorticoid combined with immune globulin and plasma exchange).After follow-up for median 12 months,3 cases relapsed,29 cases were fully recovered,5 cases had mild language impairment,2 cases had mild memory impairment,and 2 cases had involuntary movement.Conclusions The most common symptoms of the patients were psychiatric symptoms,dyskinesias and movement disorders,and speech disturbances.Children with anti-NMDAR encephalitis had a low incidence of tumors,while various pathogen infections including mycoplasma pneumonia,virus and toxoplasma gondii,which may trigger abnormal immune response of anti-NMDAR encephalitis.Pathogen screening needs to be done for pediatric anti-NMDAR encephalitis and anti-patho-genic treatment may be helpful for disease remission.

Objective To observe the clinical efficacy of dye laser combined with Xin'an repair solution in the treating superficial infantile hemangioma(IH). Methods 100 patients with superficial IH were randomly divided into observation group and control group.The observation group received dye laser combined with Xin'an re-pair solution,while the control group was treated only with dye laser.The clinical efficacy and the rate of complica-tions after treatment were compared between the two groups,and the different efficacy between the head neck group and the non head neck group in the observation group was further analyzed. Results The total effective rate of the observation group(90%)was significantly higher than the control group(70%),and the difference was sta-tistically significant(P<0.05).The rate of complications in the observation group was significantly lower than that in the control group(6%vs.32%,P<0.05).In the observation group,the total effective rate of head neck group was better than that the non head neck group(P<0.05). Conclusion Dye laser combined with Xin'an repair so-lution is effective in the treatment of superficial IH,and it can significantly reduce complications.It is evidently ef-fective for head and neck superficial IH.

Objective To assess the changes of white matter microstructure in neuromyelitis optica spectrum disorders (NMOSD) with DTI based on tract-based spatial statistics (TBSS) method.Methods Conventional MR and DTI were performed in 20 NMOSD patients (NMOSD group) and 20 healthy volunteers (control group).DTI data were analyzed with TBSS procedure,which was a part of FSL software packages,and non-parametric statistical analysis was performed on the whole brain.Correlation between FA value of tracts with significant difference in NMOSD group and expanded disability status scale (EDSS) scores was analyzed.Results TBSS analysis revealed significantly (P＜ 0.05,FWE corrected) extensive decrease of FA value in cerebrum and cerebellum white matter fiber bundles,i.e.corpus callosum,fornix,corticospinal tract,unciform fasciculus,cerebellar peduncles etc.in NMOSD group,and decrease of AD value,increase of RD value in cingulum bundle,corpus callosum and fornix,while MD value only increased in fornix and retrolenticular part of the left internal capsule (P＜0.05,FWE corrected).Negative correlations were found between FA value of left uncinate fasciculus,right external capsule,left inferior cerebellar peduncle,bilateral anterior limb of internal capsule,medial lemniscus and EDSS scores (all P＜0.05).Conclusion Widespread white matter damage is observed in cerebrum and cerebellum in NMOSD patients by using TBSS analysis,which may partly correspond to the disabilities of NMOSD patients.However,the other microstructural changes of white matter tracts may suggest complicated pathological mechanism of NMOSD.

Multiple sclerosis (MS) is a disease characterized as inflammatory demyelinating of the central nervous system,which is the main cause of non-traumatic neurological disability in young and middle-age adults.The main manifestations of MS are memory and information processing speed,executive function and other cognitive impairments.MS associated with memory impairment (MSMI) is often overlooked because of the occult onset,which seriously affecting patients' life quality.In recent years,with the rapid development of neuro-functional imaging,MRI has become an important method to observe and diagnose MS,providing imaging evidence for diagnosis of MSMI.The clinical and MRI research progresses of MEMI were reviewed in this article.

Objective To assess the damage of limbic system pathways in relapsing-remitting multiple sclerosis (RRMS) by diffusion tensor imaging (DTI) tractography.Methods DTI tractography was used to acquire fiber numbers,fractional anisotropy (FA),mean diffusivity (MD) of cingulum,fornix,and uncinate fasciculus (UF) in 20 RRMS patients (MS group) and 20 healthy volunteers (control group),and statistical analysis was performed.Results Compared with control group,lower FA value (P＜0.01) and higher MD value (P＜0.05) were found in cingulum,fornix and UF of MS group,and the fiber numbers of fornix decreased in MS group (P＜0.001).There were significant differences between the left and the right UF in fiber numbers and FA value of control group and the fiber numbers of MS group.Negative correlations were found between FA value of cingulum and UF and EDSS scores in MS group (r=-0.572,-0.665,both P＜0.05),and positive correlations were found between MD value and EDSS scores (r=0.627,0.603,both P＜0.05).Conclusion DTI tractography is valuable in assessing MS associated limbic system damage and in monitoring the clinical progression of the disease.

OBJECTIVE: To explore. HRCT and MRI three-dimensional fast imaging employing steady state ac-quisition(3D-FIESTA) imaging features and clinical characteristics of bilateral large vestibular aqueduct syndrome(LVAS). METHOD: The imaging and clinical features of 14 cases of bilateral LVAS identified over a 5-year periodwere retrospectively analyzed. All patients underwent HRCT and MRI 3D-FIESTA scanning of head and neck;MRI three dimensional reconstructions of internal acoustical meatus were also completed at the same time. RESULT: Audiogram showed mild to moderate hearing loss and was progressive. The cut-off values for the coronal midpointand operculum planes on the HRCT scan to diagnose an EVA were 1. 5 mm and 4. 3 mm respectively; the averagevalue was 2. 4 mm. VA expansion degree were not linked to the degree of hearing loss. MRI showed VA andlymph sac abnormalities. Concomitant image finding was cochlear hypoplasia. CONCLUSION HRCT and MRI 3D-FI-ESTA are important examinations for accurate diagnosis of LVAS. HRCT can acquire the specific size of reamedVA. MRI and 3D reconstructions of internal acoustical meatus can noninasive show more intuitive display ofLVAS and other inner ear malformations than HRCT.
Ear, Inner ; Head ; Hearing Loss ; Hearing Tests ; Humans ; Imaging, Three-Dimensional ; Magnetic Resonance Imaging ; Retrospective Studies ; Temporal Bone ; Tomography, X-Ray Computed ; Vestibular Aqueduct ; pathology ; Vestibular Diseases ; diagnosis

Objective There is a significant increase of squamous cell carcinoma antigen ( SCCA) in patients with common skin diseases .The aim of this study was to investigate the difference expression of serum SCCA in patients with common skin diseases . Methods A total of 497 patients with 14 kinds of common skin diseases from the Department of Dermatology were recruited , and the serum SCCA was measured . Results The positive rates of SCCA in 116 patients with psoriasis and 37 patients with erythroderma were 90 .5% and 100%, respectively .The common skin diseases with positive rate of SCCA greater than 60% includes eczema (61.7%), generalized dermatitis (65.1%),pemphigus (61.1%), bullous pemphigoid (62.2%).The SCCA values in pustulosa (1.76 ±1.22 ng/mL) and arthropathica psoriasis (1.69 ±1.05 ng/mL) were decreased compared with pustular (2.86 ±1.46 ng/mL) and arthropathica psoriasis (3.56 ±1.84 ng/mL) (P<0.05). Conclusion The SCCA value may have a relationship with the increase of the performance of keratinization and desquamation in the skin diseases , and it could be used as a valuable indicator for the diagnosis and treatment in patients with cutaneous diseases .

Objective To investigate the efficacy of acupoint injection of Astragalus on contents of SOD,HYP and MDA in skin of aging mice in-duced by D-galactose. Methods The mice were randomly divided into normal group,model group,Astragalus group,and saline group(n=15). Except for the normal control group,the mice of other groups were treated with continuous subcutaneous injection of D-galactose to establish mice ag-ing model. The Astragalus group mice was injected with 0.01mL Astragalus in Sanzuli acupoint per day,The saline group mice received an injection of same amount of saline. SOD,HYP and MDA changes in the skin tissue and serum were evaluated after 21 days. Results All the index in the skin tissue and serum showed significant difference(P<0.01)between model group mice and normal control group. Compared with model group,SOD activity and MDA content in the skin tissue and serum of the Astragalus group mice were significantly raised,HYP content was significantly reduced (P<0.01). There also were significant differences of these index between the saline group mice and the model group(P<0.05),but the effect was not as good as the Astragalus group mice. Conclusion Acupoint Injection of Astragalus can prevent and protect against skin aging induced by D-galactose.

Objective To explore the effect of problem-based 1earning (PBL) combined with PICO model in clinical nursing internship teaching.Methods A retrospective case-control study was adopted,133 undergraduate nursing students in grade 2010 were selected as theexperimental group,and 128 undergraduate nursing students in grade 2009 were selected as the control group.The students in the experimental group received a teaching method which combined PBL with PICO model,while the students in the control group received traditional teaching methods.The two groups were evaluated by Objective Structured Clinical Examination (OSCE) and questionnaire survey.Results The OSCE grade and evaluation of teaching method in the experimental group students were higher than the control group,the difference was statistically significant.Conclusions PBL combined with PICO model teaching methods are not only beneficial to cultivate and improve the clinical nursing competency and comprehensive qualities of the nursing students,but also let the students gradually learn and permeate the ideas of any decision made by clinician should be based on the scientific research results,which from the main thought of the evidence-based practice.It can lay a good foundation for going to work in the future,and is also worthy of being popularized and applied in clinical internship teaching of undergraduate nursing students.