OBJECTIVE To investigate the impact of the methionine synthase reductase （MTRR） rs10380 C＞T gene polymorphism on methotrexate （MTX） plasma concentration， adverse drug reaction， and prognosis in children with intracranial tumors. METHODS Peripheral blood was collected from children with intracranial tumors， and genomic DNA was extracted. The MTRR rs10380 C＞T genotype was analyzed using matrix-assisted laser desorption/ionization-time of flight-mass spectrometry. The association of the MTRR rs10380 C＞T gene polymorphism with the ratio of MTX plasma concentration to dose （C/D ratio）， adverse drug reaction， tumor recurrence， and metastasis was analyzed. Bioinformatics analysis was used to explore the association of the rs10380 genotype and MTRR gene expression and its possible mechanisms. RESULTS A total of 75 children were included in the study. The distribution frequencies of the wild-type CC genotype and C allele of rs10380 were 62.67% and 81.33%， respectively， while the distribution frequencies of the variant CT genotype and T allele were 37.33% and 18.67%， respectively， which were in accordance with Hardy-Weinberg equilibrium（P＞0.05）. The incidence of electrolyte disorders （51.06%） and tumor metastasis rate （57.45%） in children with the CC genotype were significantly higher than those with the CT genotype （P＜0.05）. No significant differences were observed in the 24-hour and 42-hour C/D ratios and recurrence rates between the two genotypes of children （P＞0.05）. Bioinformatics analysis showed that MTRR protein mainly works in conjunction with 10 proteins， including MMAA， and was involved in various biological processes such as sulfur amino acid biosynthesis. CONCLUSIONS The MTRR rs10380 CC genotype may be a risk factor for electrolyte disorders and tumor metastasis in children with intracranial tumors after MTX chemotherapy.

OBJECTIVE: To investigate the relation of blood arsenic concentration (BAC) with clinical effect and safety of arsenic-containing Qinghuang Powder (, QHP) in patients with myelodysplastic syndrome (MDS). METHODS: Totally 163 patients with MDS were orally treated with QHP for 2 courses of treatment, 3 months as 1 course. The BACs of patients were detected by atomic fluorescence spectrophotometry at 1, 3, and 6 months during the treatment, and the effective rate, hematological improvement and safety in patients after treatment with QHP were analyzed. RESULTS: After 2 courses of treatment, the total effective rate was 89.6% (146/163), with 31.3% (51/163) of hematological improvement and 58.3% (95/163) of stable disease. The hemoglobin increased from 73.48 ± 19.30 g/L to 80.39 ± 26.56 g/L (P<0.05), the absolute neutrophil count increased from 0.81 ± 0.48 × 10/L to 1.08 ± 0.62 × 10/L (P<0.05), and no significant changes were observed in platelet counts (P>0.05). Among 46 patients previously depended on blood transfusion, 28.3% (13/46) completely got rid of blood transfusion and 21.7% (10/46) reduced the volume of blood transfusion by more than 50% after treatment. The BACs were significantly increased in patients treated for 1 month with 32.17 ± 18.04 μ g/L (P<0.05), 3 months with 33.56 ± 15.28 μ g/L (P<0.05), and 6 months with 36.78 ± 11.92 μ g/L (P<0.05), respectively, as compared with those before treatment (4.08 ± 2.11 μ g/L). There were no significant differences of BACs among the patients treated for 1, 3 and 6 months (P>0.05). The adverse reactions of digestive tract during the treatment were mild abdominal pain and diarrhea in 14 cases (8.6%), and no patients discontinued the treatment. The BACs of patients with gastrointestinal adverse reactions were significantly lower than those without gastrointestinal adverse reactions (22.39 ± 10.38 vs. 37.89 ± 11.84, μ g/L, P<0.05). The BACs of patients with clinical effect were significantly higher than those failed to treatment (40.41 ± 11.69 vs. 23.84 ± 12.03, μ g/L, P<0.05). CONCLUSION QHP was effective and safe in the treatment of patients with MDS and the effect was associated with BACs of patients.

Objective To explore the spatial-temporal characteristics and changing regularities of Schistosoma japonicum in-fections among human from 2004 to 2011. Methods The township level spatial databases of schistosomiasis in Hunan Province from 2004 to 2011 were established,and the related spatial analysis was performed by SPSS 17.0,ArcGIS 10.1 and SaTScan 7.03. Results The schistosome infection rate among human in Hunan Province sharply decreased from 3.0％in 2004 to 0.8％in 2011. However,the rate among residents in parts of some townships in 2011 was still hovering at a higher level (P90=2.12％),and the higher rate was distributed along the Oncomelania hupensis snail ridden areas outside embankment. The auto-correlation analysis showed that the global Moran's I for schistosome infection rate among human was 0.34 to 0.53 from 2004 to 2011,and was higher than the expected value(Z>8.71,P<0.05). The local G statistics indicated that the positive hotspot high-high clustering areas were mainly near the coast of Dongting Lake from 2004 to 2011,and the number of townships with schistosomiasis endemic in the clustering areas reached 30 to 70. The spatial scan analysis showed that the number of townships in the clustering areas ran up to 145 to 183 from 2004 to 2011. Conclusions The schistosome infection rate among human de-creased significantly in Hunan Province from 2004 to 2011. However,the rate in parts of some townships still remains at a com-paratively high level,and there are positive spatial correlation and spatial agglomerations in the schistosome infection rate among human,suggesting that the prevention and control work on schistosomiasis in these areas should be strengthened in the fu-ture.

Advanced schistosomiasis,encompassing a wide range of pathologic entities and multi-complications,poses a se-rious threat on the patients'health. Through comprehensive analysis and evaluation on related aspects regarding clinical classifi-cation,main methods of auxiliary examination and treatment(including types of surgical procedure)of advanced schistosomia-sis,we think that the individual based multidisciplinary comprehensive treatment according to varying conditions of patients is the most optimal treatment mode of advanced schistosomiasis. It is further proposed that multidisciplinary collaborative diagnosis and treatment system should be undoubtedly established,multidisciplinary case discussions be regularly organized,and treat-ment expert teams be stably formed,in order to significantly improve the level of diagnosis and treatment of advanced schistoso-miasis,so as to reduce the misdiagnosis and improve the therapeutic effect in advanced schistosomiasis control.

Objective To understand the Oncomelania hupensis snail distribution in the working areas of Yangtze River hy?drologic agencies located in the middle and lower reaches of the Yangtze River in 2016,so as to provide the evidence for assess?ing the risk of schistosome infection of hydrological workers and establishing the control strategies. Methods The suspicious en?vironments with O. hupensis snails in the above working areas were selected as study areas,and the snail situation was surveyed by the system sampling method combined with the environmental sampling method. The survey data were collected and analyzed statistically. Results Totally 19 working areas from 17 hydrological agencies were selected as the investigation sites,among which,10 working areas from 9 agencies were found with O. hupensis snail distribution. The constituent ratio of the areas with snails reached to 38.81%of the investigation areas,the occurrence rate of frames with snails was 3.08%,and the average densi?ty of living snails was 0.07/0.1 m2. By comparison,the average density of living snails and occurrence rate of frames with snails in hydrological agencies under the jurisdiction of the Middle Reaches Administrative Bureau were the most serious among three administrative bureaus of the Yangtze River Water Resources Commission. Conclusions There are various degrees of O. hupen?sis breeding in the working areas of hydrological agencies located in the middle and lower reaches of the Yangtze River ,and the hydrological workers are facing with the risk of schistosome infection.

Objective To comprehensively evaluate the effect of the program of treatment and assistance to advanced schis-tosomiasis patients in Hunan Province from 2004 to 2013. Methods The fund investment of the program,the profits of hospi-tals and the improvement of the patients’health were investigated by data collection and questionnaire survey. The evaluation index system of treatment and assistance to advanced schistosomiasis in Hunan Province was constructed by the Delphi method and analytic hierarchy process,and the program was assessed comprehensively. Results The evaluation index system includ-ing 6 primary indices and 33 secondary indices was established. Among all the primary indices,the score of the treatment and assistance(22.25)was the highest,and that of the satisfaction assessment(8.15)was the lowest,and the score of the compre-hensive assessment was 87.06. The average cure rate of the patients was 13.08%from 2004 to 2013. More than 60%of the pa-tients’disease condition got better,and nearly 70%of the patients’psychological condition improved,and more than 70%of patients’self-help ability and social contact improved,as well as family happiness increased. In addition,the annual average cost for caretakers decreased by 2000 Yuan,and the profits of all the fixed-point hospitals for treatment and assistance in-creased. Conclusion The effectiveness and efficiency of the treatment and assistance to advanced schistosomiasis patients in Hunan Province is obvious,and the government should continuously invest in the program.

Objective To explore the risk factors of newly emerging advanced schistosomiasis patients in endemic areas.Methods The study areas were selected in two counties of Dongting Lake regions and a 1 :2 match case-control study was designed.Sixty schistosomiasis patients,who newly evolved into advanced schistosomiasis from 2006 to 2007,were selected into the case group,and 120 cases with chronic schistosomiasis into the control group.Questionnaires including potential risk factors of advanced schistosomiasis were designed and the information was collected based on face to face interviews.SPSS 12.0 was used to analyze the simple factors and multi ones (logistic regression) attributable to the development of advanced schistosomiasis.Results The history of hepatitis B (OR = 10.729),models of water contact (OR = 3.919) ,yearly exposure days to the infested water (OR = 5.457) and times of chemotherapy in the nearly 10 years(OR = 1.578) were the risk factors of development of advanced schistosomiasis.The times of examinations with positive schistosome eggs were protective factors.No association was found between yearly income,education degree,times of checking for schistosomiasis,times of examination with sera positive results and the emergence of advanced schistosomiasis.Conclusion The high frequency of exposure to the infested water,repeated infections,incomplete diagnosis and treatment are the risk factors of advanced schistosomiasis.The concurrent infection with hepatitis B is associated with the acceleration of development of advanced schistosomiasis.

BACKGROUND¹⁸F-fluorodeoxyglucose positron emission tomography (¹⁸F-FDG PET) is considered as one of the most valuable diagnostic methods of chest malignant tumors, except for pathological diagnosis. But in clinic, the cases whose diagnosis of ¹⁸F-FDG PET is different from pathological diagnosis are not rare. This study is to evaluate the initial value of ¹⁸F-FDG PET in the diagnosis and staging of the chest malignant tumors.

METHODSFifty-one cases of chest tumors in Xi'an who underwent ¹⁸F-FDG PET were collected. Additionally, pathologic diagnosis had also been experienced on the patients through operation, percutaneous puncture, bronchoscopy or film preparation of pleural fluid. By the comparison of ¹⁸F-FDG PET diagnosis and the pathologic diagnosis, accuracy, sensitivity, specificity, false positive rate, positive predictive and negative predictive of ¹⁸F-FDG PET were calculated.

RESULTSIn 51 patients, there were 34 patients whose ¹⁸F-FDG PET diagnoses were consistent with the pathological diagnoses, including 31 true positive, 3 true negative. Out of another 17 patients, 11 were false positive, including 2 sarcoidosis, 6 tuberculosis of the lung, 2 inflammatory pseudotumor of the lung and 1 pulmonary cryptococcosis, and 6 were false negative. The calculated values were 66.67% on the overall accuracy, 83.78% on sensitivity, 21.43% on specificity, 78.57% on false positive rate, 16.21% on false negative rate, 73.81% on positive predictive value and 33.33% on negative predictive value.

CONCLUSIONSCurrently, ¹⁸F-FDG PET is still one of the most advanced unwounded technologies for the chest malignant tumor diagnosis. However, this technology experiences difficulties in detection of some high metabolized benign disease, such as tuberculosis from malignant tumor. Hence, in order to take advantage of ¹⁸F-FDG PET technology and have more accurate diagnosis of chest tumors, both results from the ¹⁸F-FDG PET and the clinic actuality should be considered.

BACKGROUNDIt has been known that vasoactive intestinal peptide (VIP) has the effect of promoting the growth of some malignant tumors, but its mechanism is not clear. The aim of this study is to use c-fos antisense oligodeoxynucleotide (ASO) to block c-fos expression and to explore whether c-fos can directly regulate VIP-induced VEGF expression in small cell lung cancer (SCLC) cells.

METHODSExpression levels of c-fos and VEGF genes were detected in SCLC cell line H446 treated with VIP by RT-PCR. After c-fos ASO was added to the H446 cells, the change of VEGF mRNA expression level was analyzed.

RESULTSAdministration of VIP resulted in increased expression of c-fos and VEGF mRNA in the H446 cells. The expression of c-fos mRNA reached the peak level at 2h and 4h after VIP treatment, which was significantly higher than that at 0h (P < 0.01). Whereas, the highest expression level of VEGF mRNA was observed at 8h and 16h after VIP treatment, which was significantly higher than that at 0h (P < 0.01). c-fos ASO significantly reversed VIP-induced upregulation of VEGF mRNA expression (P < 0.01)

CONCLUSIONSVIP can increase the expression and secretion of VEGF in lung cancer cells by activating the transcription factor c-fos, then promote the angiogenesis of lung cancer and thus play an important role in the pathogenesis of lung cancer.

BACKGROUNDSome researches have found that the development of tumor could be encouraged by vascular endothelial growth factor (VEGF) and vasoactive intestinal peptide (VIP), but how about the mode of VIP? The aim of this study is to examine the effects of VIP on expression of VEGF mRNA in non-small cell lung cancer (NSCLC) cells.

METHODSExpression of VEGF mRNA was detected in NSCLC and small cell lung cancer (SCLC) cell lines by reverse transcriptase-polymerase chain reaction (RT-PCR) technique.

RESULTSVEGF mRNA was detected in NSCLC cell lines A549, GLC-82, H157, H460 and SCLC cell line H446. VIP could enhance the expression level of VEGF mRNA in NSCLC cell lines A549 and H157. The expression level of VEGF mRNA reached a peak at 8h and 16h after VIP administration, which was significantly higher than that at 0h (P < 0.01).

CONCLUSIONSVIP may promote the angiogenesis of lung cancer through increasing the expression and secretion of VEGF in lung cancer cells, and thus plays an important role in the pathogenesis of lung cancer.