Objective : To investigate the relationship between vitamin D receptor (VDR) gene polymorphisms and the clinical prognosis of acute pancreatitis (AP) , and to provide a genetic basis for early identification of critically ill patients. Methods : A total of fourteen single nucleotide polymorphisms (SNPs) on the VDR gene were detected in 508 AP patients by using improved ligase detection reaction (imLDR) technology. Unconditional Logistic regression analysis was used to explore the association of VDR gene polymorphisms with outcome ( sepsis/severe AP/death) of AP patients after adjusting for age , sex , body mass index(BMI) , smoking and drinking status and APACHE II score under different genetic models. Results : Rs12721375 GA/AA genotype had a lower risk of sepsis than GG (P = 0. 02) and the A allele had a lower risk of sepsis than G (P = 0. 009) . Rs2853559 GA and GA/AA had higher risks of sepsis than GG (P = 0. 022 and 0. 026 respectively) . Rs11168287 AA had a higher risk of severe AP than GG and GG/GA (P = 0. 030 and 0. 022 respectively) . Rs2853559 AA genotype had a higher risk of severe AP than GG and GG/GA ( P = 0. 022 and 0. 021 respectively) . The risk of death of rs11168283 CT/TT genotype was lower than that of CC (P = 0. 046) . Conclusion VDR gene polymorphisms are related to the clinical outcome of AP patients in Chinese Han population. VDR gene is involved in the progression of AP.

Neurocysticercosis is the most common parasitic disease of the central nervous system. It is an important cause of headache and epilepsy in developing countries. This article will discuss the latest progress in the diagnosis and treatment of neurocysticercosis, and provide help for early diagnosis and individualized treatment of patients by doctors in different regions.

Objective: To evaluate the role of combination of multiple MRI sequences in the differential diagnosis of esophagus cancer and to assess the accordance among radiologists with different experience. Methods: Thirty-fifty patients underwent conventional MRI including T₂ weighted (T₂) sequences, gadolinium fat-suppressed T₁ weighted sequences (post-contrast T₁), and DWI sequences. Three radiologists with different experience determined the possibility of local recurrence (LR) on T₂, T₂+post-contrast T₁, T₂+DWI, and T₂+post-contrast T₁+DWI. ROC and Kappa were used. Results: In total, 13 patients had LR. On T₂WI, the ROC curve (AUC) achieved by the senior,intermediate and junior groups were 0.701,0.407,and 0.584, respectively.Compared with simple T₂WI sequences, DWI and T₁ Gd significantly improved the AUC value for the intermediate radiologist. The great difference was observed between radiologists of different experience (Kappa coefficient was from 0.227 to 0.884). Combination of multiple sequences significantly reduced the diagnostic differences between radiologists with different experience for the senior radiologists particularly. Conclusions The addition of DWI and T₁ post-contrast MRI increased diagnostic ability for LR of esophagus cancer and reduced the diagnostic differences between radiologists with different experience compared to T₂WI.

Objective: To explore the clinical efficacy and prognostic factors of first-generation and second-generation tyrosine kinase inhibitors (TKI) based regimen in the treatment of patients with BCR-ABL positive acute lymphoblastic leukemia (ALL) . Methods: Retrospectively analyze the clinical characteristics and prognostic factors of 89 patients with BCR-ABL positive ALL from April 2012 to June 2018 in our hospital, the clinical efficacy of first-generation and second-generation TKI was compared. Results: 60 patients were classified into the first-generation TKI (imatinib) group, and 29 patients were in the second-generation TKI (dasatinib) group. There were no significant differences in gender, age, WBC, hemoglobin concentration, PLT, chromosomal karyotype, the types of fusion genes, allogeneic hematopoietic stem cell transplantation (allo-HSCT) and TKI initiation time between the two groups. The first-generation and second-generation TKI groups, for which the complete remission (CR) rate at the fourth week of induction therapy was 83.3% and 89.7% (P=0.637) , respectively, and the complete molecular remission (CMR) was 48.3%and 58.6% (P=0.363) , respectively, the difference was not statistically significant. The 2-year overall survival (OS) rate of first-generation and second-generation TKI group was 34.9% and 64.0% (χ²=4.743, P=0.029) , the 2-year relapse free survival (RFS) rate was 17.2% and 55.0% (χ²=8.801, P=0.003) , respectively. Multivariate analysis showed that complete molecular remission (HR=0.281, 95%CI 0.151-0.523, P<0.001) was independent favorable prognostic factor for overall survival (OS) , complete molecular remission (HR=0.209, 95%CI 0.112-0.390, P<0.001) and second-generation TKI (HR=0.318, 95%CI 0.158-0.641, P=0.001) were independent favorable prognostic factors for RFS. Conclusion For TKI-based regimen of BCR-ABL positive ALL, second-generation TKI is superior to first-generation TKI in OS and RFS time.

Sarcopenia is an aged-related progressive and systemic loss of skeletal muscle mass and functions.It may be caused by factors such as exercise,nutrition,genetic factors,endocrine factors,and inflammation.The pathophysiological mechanisms include mitochondrial dysfunction,excessive activation of apoptosis,dysregulation of autophagy,abnormal function of satellite cells,and aggregation of reactive oxygen species.This article summarizes the relationships of autophagy and apoptosis with sarcopenia and discusses the values of autophagy regulation and apoptosis reduction in the management of sarcopenia.

Objective:To evaluate the uncertainty in 6-methylthiopurine (6-MMP) determination by LC-MS/MS. Methods:The uncertainty sources during the whole process of 6-MMP determination were established and evaluated. The combined and expanded un-certainties were also calculated. Results:The expanded uncertainty at low (2 995 pmol) and high (140 900 pmol) concentration of 6-MMP was 275. 6 pmol and 11 396 pmol, respectively (P=95%, k=2). Conclusion: The uncertainty in 6-MMP determination by LC-MS/MS is mainly caused by recovery, matrix effect and sample preparation at low concentration, and by recovery and sample prep-aration at high concentration.

OBJECTIVETo explore the clinical and survival significance of CD20 positive adult patients with B-lineage acute lymphoblastic leukemia (B-ALL).

METHODSThe clinical features and survival of 168 adult patients with B-ALL diagnosed and treated in our department from May 2007 to July 2011 were analyzed retrospectively, 58 expressed CD20 and 110 not.

RESULTSThe sex, distribution of age, anemia, thrombocytopenia, infiltration of liver, spleen and lymph nodes, the expression of myeloid lineage marker, incidence of Ph chromosome, complete remission within 4 weeks showed no significant differences in CD20 positive and negative groups (P>0.05); median white blood cell count at diagnosis and the rate of patients with high white blood cell count in CD20 positive group were 19.2×10⁹/L and 37.9% respectively, which were significantly higher than those of 6.93 × 10⁹/L and 20.9% in CD20 negative group (P<0.05); cumulative incidence of relapse between two groups showed significant difference (P<0.05); multivariable analysis for overall survival and progress-free survival identified CD20 positivity as independent predictor.

CONCLUSIONThe expression of CD20 in adult patients with B-ALL appeared to be associated with high white blood cell count and poor prognosis.

Adult ; Antigens, CD20 ; Cell Lineage ; Disease-Free Survival ; Humans ; Leukocyte Count ; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma ; Recurrence ; Remission Induction ; Retrospective Studies ; Survival Analysis

Objective To explore the impact of season and latitude on multiple sclerosis by study the onset/relapse season and latitude distribution in multiple sclerosis (MS) patients.Methods A total of 264 MS patients , with 88 males and 176 females, who were hospitalized in Beijing Tiantan Hospital from January 2002 to December 2012, were enrolled in the study and all the clinical data were retrospectively analyzed.The mean age was (33.9 ± 12.3) years old, with the disease duration of (6.3 ±4.5) years and 453 cases of relapse.The recurrence of MS was collected by four seasons, with March to May defined as spring, June to August as summer, September to November as autumn and December to February as winter.MS patients lived in Beijing (39.39° N-41.07° N) were chosen to test the correlation between the incidence/recurrence and monthly mean temperature, sunlight exposure intensity and duration.All the patients were divided into the high latitude group and the low latitude group, taken the latitude median (40.22° N) of Beijing area as the boundary.Gender composition, age of onset, disease duration and recurrence rate were compared between the two groups.Results Most of the onset/ relapse of MS were observed in winter (134 cases), while summer (97 cases) took the least.In the same latitude region (Beijing area), the onset/ relapse of MS was negatively correlated to the mean temperature and sunlight exposure intensity (r =-0.699, P =0.006;r =-0.623, P =0.015).Recurrence was higher in the high latitude group than in the low latitude group [68.7％ (123/179) vs 63.0％ (51/81), P =0.000], while no significant difference was found in gender composition, age of onset and disease duration between the two groups.Conclusion The onset/recurrence of MS has obvious seasonal characteristics.The onset/recurrence of MS is correlated with latitude, temperature and sunlight exposure intensity of the habitation of MS patients.Environmental factors are important cause of the onset/recurrence of MS, with sunshine exposure as the most key factor.

Objective:To explore whether different phospholipid peptides could induce different pathological features of EAE in Lewis rats.Methods:Lewis rats were immunized with myelin basic protein 82-99 (MBP82-99),MBP68-86,and myelin oligodendroglia glycoprotein 35-55 (MOG35-55),respectively,and evaluated everyday for neurological scores.The cerebrum,brain stem,cerebellum and spinal cord of every rat were removed and pathological features observed.Results: Rats immunized with the two MBP peptides exhibited neurological signs of EAE wherein the central nervous system had extensive inflammation infiltration.The number of infiltrates in spinal cords in the two MBP peptides groups was higher than that in the cerebrums,brain stems and cerebellums.In spinal cords, there was no statistical difference of infiltrates between MBP82-99 and MBP68-86 groups;however,the both groups had more infiltrates than MOG35-55 group.Inflammatory cells were observed only in spinal cords of animals immunized with MOG35-55.Conclusion:This study provides certain evidence for understanding the diversity of pathological manifestations of EAE in Lewis rats.

Acute Disease ; Breast Neoplasms ; therapy ; Humans ; Leukemia ; therapy