EGFR Mutation Status and PD-L1 Expression in Patients ≤40 Years Old with NSCLC / 肿瘤防治研究

Objective To retrospectively analyze the clinical data of 47 young NSCLC patients mutation style of EGFR and PD-L1 expression in tumor cells, to understand their clinicopathological and molecular characteristics. Methods We enrolled 47 young (≤40 years old) patients confirmed as NSCLC who underwent surgical resection, and 94 old patients (≥60 years old) were matched as 1:2 by R language. EGFR mutation status was detected by ARMS-PCR, and the expression of PD-L1 was detected by immunohistochemistry. Results The median age of 47 young patients with NSCLC was 37 years old. The disease was more common in women and the majority type was adenocarcinoma. In youth group, the 19del and 20ins were more frequent, but the exon 21 L858R point mutation proportion was higher in elder group. The expression of PD-L1 was significantly increased in the solid predominant histological subtype. The PD-L1 expression in 19del patients was higher than that in the patients with L858R mutation in youth group. Conclusion The majority of young NSCLC patients are female, nonsmokers and suffered from adenocarcinoma cancer. The proportion of EGFR alteration in 19del and 20ins in youth group is higher than that in elder group. The positive rate of PD-L1 expression in solid predominant histological subtype is higher than that with other subtypes. The expression of PD-L1 in young patients with EGFR 19del is higher than that with L858R.

The SACT Template: A Human Brain Diffusion Tensor Template for School-age Children / 神经科学通报·英文版

School-age children are in a specific development stage corresponding to juvenility, when the white matter of the brain experiences ongoing maturation. Diffusion-weighted magnetic resonance imaging (DWI), especially diffusion tensor imaging (DTI), is extensively used to characterize the maturation by assessing white matter properties in vivo. In the analysis of DWI data, spatial normalization is crucial for conducting inter-subject analyses or linking the individual space with the reference space. Using tensor-based registration with an appropriate diffusion tensor template presents high accuracy regarding spatial normalization. However, there is a lack of a standardized diffusion tensor template dedicated to school-age children with ongoing brain development. Here, we established the school-age children diffusion tensor (SACT) template by optimizing tensor reorientation on high-quality DTI data from a large sample of cognitively normal participants aged 6-12 years. With an age-balanced design, the SACT template represented the entire age range well by showing high similarity to the age-specific templates. Compared with the tensor template of adults, the SACT template revealed significantly higher spatial normalization accuracy and inter-subject coherence upon evaluation of subjects in two different datasets of school-age children. A practical application regarding the age associations with the normalized DTI-derived data was conducted to further compare the SACT template and the adult template. Although similar spatial patterns were found, the SACT template showed significant effects on the distributions of the statistical results, which may be related to the performance of spatial normalization. Looking forward, the SACT template could contribute to future studies of white matter development in both healthy and clinical populations. The SACT template is publicly available now ( https://figshare.com/articles/dataset/SACT_template/14071283 ).

Clinical observation of consolidation chemotherapy combined with microtransplantation in the treatment of elderly patients with acute myeloid leukemia / 中国医师进修杂志

Objective:To explore the clinical efficacy of consolidation chemotherapy combined with microtransplantation in the treatment of elderly patients with acute myeloid leukemia (AML).Methods:The clinical data of 45 elderly patients with AML in Suzhou Yongding Hospital from January 2016 to December 2018 were retrospectively analyzed. After 1 or 2 courses of induced chemotherapy, the patients achieved complete response (CR). Among them, 20 patients were given consolidation chemotherapy (single group), and 25 patients were given consolidation chemotherapy combined with microtransplantation (combined group). After 3 courses of treatment, the minimal residual disease (MRD), quantitative expression of WT1 gene and adverse reactions were compared between 2 groups; the quality of life before treatment and after treatment was evaluated by quality of life-BREF (QOL-BREF). The patients were followed up to November 1, 2020, and the median follow-up was 30 months. The overall survival and progress-free survival (PFS) were recorded.Results:The MRD negative rate and WT1 gene negative rate after treatment in combined group were significantly higher than those in single group: 60.00% (15/25) vs. 25.00% (5/20) and 52.00% (13/25) vs. 20.00% (4/20), and there were statistical differences ( P<0.05). The recovery times of neutrophils and platelets in combined group were significantly shorter than those in single group: 10 (8, 12) d vs. 16 (13, 20) d and 14 (11, 17) d vs. 24 (19, 30) d, and there were statistical differences ( Z = 3.152 and 4.285, P<0.05). No adverse reactions such as liver and kidney abnormalities or gastrointestinal reactions occurred in 2 groups; and no specific graft versus host disease (GVHD) occurred in the combined group. The each item scores of QOL-BREF after treatment in combined group were significantly higher than those in single group, and there were statistical differences ( P<0.01). The 2-year overall survival rate and PFS rate in combined group were significantly higher than those in single group: 60.00% (15/25) vs. 35.00% (7/20) and 52.00% (13/25) vs. 25.00% (5/20), and there were statistical differences ( χ2 = 4.235 and 4.742, P = 0.040 and 0.029). Conclusions:Consolidation chemotherapy combined with microtransplantation is effective and safe in the treatment of elderly patients with AML. It can significantly improve the quality of life, and improve the overall survival rate and PFS rate.

Analysis of monitoring results of plague natural foci in Yinchuan City, Ningxia from 2015 to 2018 / 中华地方病学杂志

Objective:To analyze the dynamic characteristics of rodents population density distribution in plague foci of Yinchuan City, Ningxia, and to provide reference for early warning of the plague.Methods:The plague surveillance results and epidemic reports of Yinchuan City from 2015 to 2018 were collected retrospectively, and the data were obtained from the database of Yinchuan City Center for Disease Control and Prevention. Descriptive method was used to analyze the species, number, density, fleas, vector index, etiology and serology results of rodents in the plague foci.Results:From 2015 to 2018, 4 families, 8 genera, 13 species, and 8 843 rodents were captured in the plague foci of Yinchuan City, and Meriones unguiculatus (4 557 rodents) was the dominant species. The survey area of host animal density was 1 459 hm 2, 3 805 rodents were captured, and the average density was 2.61/hm 2, of which the Meriones unguiculatus density was 1.98/hm 2. A total of 41 488 traps of nocturnal rodents were investigated, and 2 660 rodents were captured, with an average capture rate of 6.41%. A total of 6 952 fleas were obtained, belonging to 4 families, 7 genera, and 8 species; Xenopsylla conformis conformis (4 597 fleas) and Nosopsyllus laeviceps kuzenkovi (1 761 fleas) were the dominant species. Among them, there were 2 286 flea-infected rodents, the body flea-infected rate was 25.85% (2 286/8 843), and the body flea-infected index was 0.76. A total of 220 gerbils nests were investigated, and the nest flea-infected rate was 34.55% (76/220), and the nest flea-infected index was 0.98. No plague bacterium was isolated by pathogen detection of rodents and fleas. The results of indirect hemagglutination test were all negative. Conclusion:The Meriones unguiculatus is the dominant species in the plague foci of Yinchuan City, the average density is still high, attention should be paid to the occurrence of plague outbreaks.

Clinical characteristics of endocrine glands involvement in patients with IgG4-related diseases / 中华内分泌代谢杂志

Objective To explore the clinical manifestations, imaging and pathology features, treatment, and prognosis of endocrine glands involved patients with IgG4-related disease ( IgG4-RD) . Methods Ten patients admitted in Peking Union Medical College Hospital from 1 January 2014 to 30 June 2018 diagnosed as IgG4-RD with endocrine glands involved were enrolled in this study. All the clinical data were collected and analyzed. Results Ten patients, 4 males and 6 females, median 55 years old at the onset were enrolled, five patients with single organ involvement ( 1 case involved in pituitary, and 4 cases involved in thyroid) , while another 5 patients with 2 and more organs involved. C-reactive protein or erythrocyte sedimentation rate was elevated in 8 patients, antinuclear antibodies were positive in 7, and serum total IgE was elevated in 6 patients. Nine patients were treated with oral glucocorticoids, among whom 3 patients were treated in combination with immunosuppressive agents or rituximab. After treatment, the clinical symptoms were alleviated and imaging was improved in all patients. Serum IgG levels were significantly decreased in all patients and normalized in 5 patients. Conclusion For the patients with multiple endocrine gland diseases and elevated IgG4 level, the possibility of IgG4-RD should be carefully considered and should be confirmed by tissue biopsy and histopathology.

The epidemic situations of animal plague in the animal plague foci of Yinchuan City from 2004 to 2014 / 中华地方病学杂志

Objective To analyze the changes of gopher density and epidemic situations of animal plague in the natural plague foci of Yinchuan from 2004-2014,to sum up the epidemic regularity of the epidemic situation,and to provide a scientific basis for prevention and treatment of the plague.Methods Retrospective analysis was used in the study.The plague monitoring data were collected;the number of host animals,density of rat,media index,aetiological and serological test results were analyzed.Results From 2004 to 2014,a total of 15 664 rats in 14 species,4 families and 9 genera were captured.The dominant populations were Meriones unguiculatus and Meriones meridianus.The density of rats was 4 919 km2,the number of rats was 6 196,the density of each rat was 0.21 to 3.85/hm2,and the average density was 1.26/hm2.A total of 15 664 rats were examined,the number of positive rats was 33,and the positive rate was 0.21％ (33/15 664).Among them,gerbils were 29,accounted for 87.88％ (29/33);18 strains of Yersiniapestis were detected in dead rats,which accounted for 54.54％ (18/33).A total of 5 810 groups of 22 070 fleas were cultured,the number of positive fleas was 42,and the positive rate was 0.12％ (7/5 810).Plague fleas were 2 kinds,the same type cheopis subspecies in 6 groups of 37 fleas,Nosopsyllus laeviceps vole subspecies in 1 group of 5 fleas.The positive number of F1 antibody was 3,and the positive rate was 0.12％ (3/ 2 446).Conclusions Yinchuan City,the natural foci of plague epidemic,is in the active state.We should pay attention to the density changes of Meriones unguiculatus and strengthen the monitoring work to pick up the dead rats,and found the epidemic of animal plague as soon as possible,in order to prevent the occurrence of human plague.

Ecological characteristics of plankton and aquatic vegetation in Lake Qiluhu.

Investigations of the phytoplankton, zooplankton, zoobenthos and aquatic vegetation in Lake Qiluhu were carried out in February, 2009. Over the whole lake, 13 sampling sites were set up for the analysis of phytoplankton and zooplankton, and 22 profiles for the collection of macrophytes and zoobenthos. In the survey, 7 phyla, 65 algae species were identified. The average abundance of phytoplankton was 7.16 × 10(8) cells/L, and the dominant specie was Limnothrix redekei. No obvious surface accumulation of algae was detected. The concentration of Chlorophyll a ranged from 85 to 101 µg/L, and the average value was 93 µg/L. Nineteen species of zooplankton were observed, including 4 species of rotifers, 6 species of cladocerans and 9 species of copepods. Copepods were the dominant species, their abundance reaching 68%, whilst Cladocerans took second place with an abundance proportion of 28%. Six species of submerged vegetation were identified: Potamogeton Pectinatus, Myriophyllum, Elodea Canadensis, Ceratophyllum demersum and Potamogeton crispus. Amongst them, the dominant vegetation was P. Pectinatus, the biomass of which was up to 63% of the total biomass. Emerged macrophytes were cluster distributed across the whole lake, mainly consisting of Scirpus tabernaemontani, phragmites communis and cane shoots. Unfortunately, no living zoobenthos were found at the sites. The results indicated that, in Lake Qiluhu, the abundance of phytoplankton was maintained at a high level. The ecological function of submerged vegetation was gradually being lost because of its low standing crop and coverage, and the benthic animal habitat was severely damaged.

Phytoplankton and bacterioplankton abundances and community dynamics in Lake Erhai.

The composition and seasonal variation of the phytoplankton and bacterioplankton community were investigated, and SPSS and redundancy analysis (RDA) were used to explore the relationship between the phytoplankton and bacterioplankton community dynamics in the typical plateau Lake of Lake Erhai from July 2009 to April 2010. Obvious seasonal variation of phytoplankton was observed, and the abundance of phytoplankton ranged from 2.02 × 10(6) to 57.9 × 10(6) cells/L. The dominant species in autumn and summer was Microcystis sp., Psephonema aenigmaticum Skuja was dominant in winter, and Microcystis sp., Aphanizonmenon flos-aquae, Asterionella sp., P. aenigmaticum, etc. were dominant in spring. The abundance of bacterioplankton in the whole lake changed between 1.93 × 10(9) and 4.61 × 10(9) cells/L showing distinct seasonal variation characteristics. The results of correlation and RDA indicated that the abundance and community diversity of bacterioplankton were significantly correlated with the abundance of phytoplankton, and the group of Bacteroidetes had obvious correlation with Microcystis sp. and other cyanobacteria, which might have some links with the harmful algal blooms in Lake Erhai. Further research is needed to study the mechanisms of interactions between phytoplankton and bacterioplankton communities.

Clinical analysis of 8 cases of primary pigmented nodular adrenocortical disease / 基础医学与临床

Objective To summarize the clinical characteristics of primary pigmented nodular adrenocortical disease (PPNAD).Methods Eight patients with PPNAD from 2001 to 2009 in PUMC Hospital were reviewed,their clinical data were collected.Results PPNAD often occurred in adolescents.62.5% of patients with PPNAD were complicated with Carney complex(CNC).In addition to general features of Cushing's syndrome,amenorrhea and growth retardation in stature were very frequent in clinical manifestations of PPNAD.Plasma ACTH was undetectable,circadian rhythm of plasma cortisol was disappeared,glucocorticoid excretion was increased paradoxically during the dexamethasone suppression test in 50% patients with PPNAD.Adrenal imaging from 75% patients revealed normal-sized adrenal glands or suspectable micronodular changes.Adrenal pathologic analysis revealed numerous brown cortical nodules containing lipofuscin pigmentation.Unilateral adrenalectomy may relieve symptoms of Cushing's syndrome,but plasma ACTH and circadian rhythm of plasma cortisol were difficult to recovere.Hypercorticoidism might re-occure after unilateral adrenalectomy.Conclusion PPNAD should be bewared in ACTH independent Cushing's syndrome patients without apparent adrenal mass,and CNC should be screened and followed up.

Syndrome of Inappropriate Antidiuresis-report of 40 cases / 中国实用内科杂志

Objective We have summarized the clinical characteristics of inappropriate antidiuresis(SIAD).Methods We adopted retrospective analysis to analyze the clinical and lab data of 40 cases.Results The most common causes of SIAD were malignant tumor,lung disease,and central nervous system disease.The five major abnormal lab data were:hypochloraemia,hypouricemia,hyponitremia,hypocalcemia,and low hematocrit.Conclusion It is important to diagnose SIAD as soon as possible,and patient presented hyponatremia combined with hypouricemia must be suspected to have SIAD.