Volume 94  ·   Issue 02  ·  2014

Pancreatic cystic tumors broadly refer to all pancreatic tumors containing cystic components. In 2000, the World Health Organization (WHO) classified pancreatic cystic tumor into serous cystic tumor (SCN), mucinous cystic tumor (MCN) and intraductal papillary myxoma (IPMN) according to tumor morphology and epithelial cell characteristics^[1]。 With the improvement of understanding of pancreatic cystic tumor and the advancement of imaging technology, the detection rate of pancreatic cystic tumor is increasing year by year^[2]。 However, the controversy over how to deal with it clinically has always existed.

Malignant tumor is a major disease that endangers the health of our people. Although the national support for related research is increasing year by year, and the number and amount of scientific research projects are increasing year by year, its morbidity and mortality rate are still on the rise. The economic burden and labor loss caused by malignant tumors have become important factors restricting social and economic development. Such a situation urgently needs new ideas and ideas to solve. Translational medicine is a medical concept that gradually formed in order to solve the disconnect between scientific research and disease prevention and treatment. It has gone through a natural process from conceptual interpretation to widespread spread^[1,2,3]。 With the establishment of physical translational medicine centers at home and abroad, it indicates that translational medicine has really entered the practical stage. However, due to the differences in national conditions and scientific research models, the development paths and research models of translational medicine centers in different countries are very different in practice. At present, how to carry out translational medicine research in the field of oncology according to the actual situation in China is worth thinking in depth.

To summarize the institutional experiences of diagnosis, treatment and prognosis for solid-pseudopapillary carcinoma of the pancreas (SPCP).

Retrospective analyses were performed for 11 cases of SPCP diagnosed in recent 15 years at Department of Abdominal Surgery, Cancer Institute and Hospital, Chinese Academy of Medical Sciences.

There were 10 females and 1 male with an average age of 33 years.The locations included head (n=7) and body and tail (n=4). Five of them had pain in abdomen or back while another 6 were found accidentally.Their images were of solid-cystic tumors and all serum markers stayed within a normal range.All received en bloc resection.The average maximum diameter was 6 cm and the percentage of patients with lymph node metastases was 36.4% (4/11). Their average follow-up period was 80.5 months.Two patients died postoperatively from hepatic metastases.And another 9 survived without relapse or metastasis.

As one of rare pancreatic neoplasms with non-specific clinical characteristics, SPCP primarily affects young females.A definite diagnosis depends on pathological confirmation.Surgery is the first-choice treatment with a favorable prognosis.Radical resection with R0 margin is crucial to long-term postoperative survival.

To explore the expression of leukemia inhibitory factor (LIF) and its clinicopathological significance in human pancreatic ductal adenocarcinoma (PDAC) and examine its regulatory role of biological behaviors of pancreatic cancer cells.

The expression of LIF protein in 53 paired paraffin-embedded PDAC specimens and adjacent non-cancerous pancreatic tissues were detected by immunohistochemistry.The relationship between their expressions and clinicopathological characteristics was analyzed.Western bolt was used to examine the expression of LIF level in 14 paired fresh PDAC specimens and adjacent non-cancerous pancreatic tissues.Furthermore, Western blot and polymerase chain reaction (PCR) were used to detect the LIF-R mRNA and protein level of LIF in 6 pancreatic cancer cell lines (AsPC-1, BxPC-3, PANC-1, SW-1990, Capan-2 and Miapaca-2). And the assays of MTT, invasion and migration were used to detect the effects of LIF in regulating cell proliferation, invasion and migration in pancreatic cancer cell lines.

The expression of LIF increased in 53 cases of PDAC versus paired normal tissues (66.0% vs 35.8%; t=3.031, P=0.004). And its positive association with tumor TNM stage (χ²=3.635, P=0.057) and invasion depth (χ²=3.726, P=0.054) had no statistical significance.Univariate analysis revealed that LIF may be a correlative adverse prognostic indicator for patients with PDAC (χ²=3.233, P=0.072). The expression of LIF was much higher in 14 cases of PDAC than that in adjacent normal pancreatic tissues (t=5.283, P<0.01). The protein level of LIF was lower in Capan-2 cells than that in other 5 pancreatic cancer cell lines while mRNA level of LIF receptor was higher than that in other 5 cell lines.Also LIF could promote the proliferation, migration and invasion of Capan-2 cell (P<0.05).

An over-expression of LIF may contribute to the development and progression of PDAC.LIF can promote the proliferation, migration and invasion in some pancreatic cancer cells.

To investigate the expression of protein phosphatase 2A catalytic subunit (PP2Ac) in pancreatic cancer and the regulation of this gene on JNK/c-Jun/AP-1 pathway and cell growth.

Expression of PP2Ac was determined by real-time PCR.Cell viability was tested by MTT.Expression and phosphorylation levels of proteins were detected by Western blotting.Cell cycle was assayed by flow cytometry.Transcription activity was measured by luciferase reporter gene assay.

Suppressed PP2Ac expression was detected in pancreatic cancer tissues.PP2Ac expression in the pancreatic cancer cell lines was also at a low level.Overexpression of the two isoforms of PP2Ac, PP2Acα and PP2Acβ, in pancreatic cancer cells repressed cell growth.Cell viability decreased (33.89±2.05)% (t=28.607, P<0.001) and (16.66±2.81)% (t=10.257, P=0.001) respectively 72 hours after transfection.Overexpression of PP2Acα and PP2Acβ down-regulated the phosphorylation levels of JNK and c-Jun, and made the transcriptional activity of AP-1 decrease (47.18±2.28)% (t=11.230, P<0.001) and (30.89±8.09)% (t=6.612, P=0.003) respectively, indicating the down-regulation of PP2Ac up-regulated the activity of JNK/c-Jun/AP-1 pathway.Blocking the JNK pathway using a selective inhibitor, SP600125, induced G2/M cell cycle arrest and repressed cell proliferation.Cell viability decreased (31.38±1.33)% (t=40.930, P<0.001) after treatment with JNK inhibitor for 72 hours.

Suppressed expression of PP2Ac in pancreatic cancer facilitated cell growth through up-regulating the activity of JNK/c-Jun/AP-1 pathway.

To explore the efficacies and safety of laparoscopic-assisted rectal resection and transvaginal removal for middle or low rectal endometriosis.

A total of 48 patients with middle or low rectal endometriosis undergoing laparoscopic-assisted transvaginal resection from May 2010 to December 2012 at First Affiliated Hospital, Sun Yat-sen University were enrolled.Postoperative short and long-term complications and clinical efficacies were retrospectively analyzed.

All cases underwent laparoscopic-assisted transvaginal rectal resection successfully.Neither conversion into laparotomy nor preventive colostomy was needed.Their average age was 34.4 (22-43) years.The locations were above peritoneal reflection (n=19) and below (n=29). The incidence of anastomotic leakage was 2.1%(n=1). The mean operative duration was 78 (62-180) min and the length of hospital stay 7.5 days.Compared with preoperative period, their postoperative digestive and gynecological symptoms improved significantly (intestinal bleeding 0 vs 18(37.5%), dysmenorrhea 1(2.1%) vs 48(100.0%) all P<0.05). However, there was no change of constipation symptoms (6(12.5%) vs 5(10.4%),P>0.05).

Laparoscopic-assisted transvaginal resection for middle or low rectal endometriosis was efficacious, safe and worth popularizing.

To analyze the impact of mRNA expression of oral fluoropyrimidine (S-1) metabolism on treatment outcomes in locally advanced gastric cancer patients on preoperative S-1 oxaliplatin-based chemotherapy.

Between June 2012 and March 2013, 32 patients with preoperative AJCC stage Ⅱ-Ⅲ gastric cancer patients were enrolled.They received S-1 (80 mg·m^-2·d^-1, days 1-14) and oxaliplatin (130 mg/m², day 1) every 3 weeks and subsequently underwent gastrectomy with D2 lymphadenectomy.Paired tumor and normal fresh frozen tissues were collected to evaluate the mRNA levels of thymidylate synthase (TS), thymidine phosphorylase (TP), dihydropyrimidine dehydrogenase(DPD)and OPRT with quantitative reverse transcription(RT) -PCR.

Among them, 21 (65.6%) patients had clinical tumor response and histological response occurred in 10 (31.3%) patients.Quantitative RT-PCR results showed that OPRT mRNA expression was significantly higher in clinical tumor responders than non-responders (3.95±0.81 vs 1.79±0.64, P=0.005). Diffuse-type gastric cancer patients (n=22) demonstrated higher OPRT expression levels than intestinal-type(n=10) ones (2.54±0.75 vs 1.49±0.56, P=0.014). The mRNA expressions of TS and TP in gastric cancer tissues with lymph node (LN) metastasis(n=13) were significantly higher than those in gastric cancer tissues without LN metastasis(n=19, both P<0.05). Similar results were not found for comparing dihydropyrimidine dehydrogenase expression levels(allP>0.05).

OPRT, TS and TP may become potential predictive biomarkers in advanced gastric cancer patients on oral fluoropyrimidine (S-1)-based chemotherapy.

To explore the effects of penehyclidine inhalation on the incidence of pulmonary complications in elderly patients after long-duration surgery.

For this prospective, double-blind and randomized controlled trial, 90 elderly patients undergoing long-duration surgery (≥3 hours) under general anesthesia and transferred into intensive care unit (ICU) of Peking University First Hospital during February 14, 2012 to September 13, 2012 were enrolled.After extubation, they were randomized into 3 groups to receive an inhalation of penehyclidine hydrochloride, ipratropium bromide or normal saline for 3 consecutive days.The primary endpoint was the incidence of pulmonary complications within 6 days post-extubation.

The incidence of bronchospasm was 3.3%, 3.2% and 20.7% respectively.And the rate of aminophylline use was 0, 0 and 10.3% respectively (P=0.025 and P=0.038); the airway tract spasm-free duration within 6 days after extubation was 5.8 (5.5-6.2), 5.8 (5.5-6.2) and 5.3 (4.8-5.9) days (P=0.028); the overall incidence of pulmonary complications was 70.0%, 71.0% and 75.9% (P=0.865).

For elderly patients after long-duration surgery, a prophylactic atomizing inhalation of penehyclidine decreases the incidence of bronchospasm and the rate of aminophylline use after extubation.However, the overall incidence of pulmonary complications has no change.

To explore the prognostic value of currently used clinical tests in neonatal patients over 35-week gestational age with perinatal asphyxia and hypoxic-ischemic encephalopathy (HIE).

"Neonate" "hypoxic-ischemic encephalopathy " and "prognostic test" were used as key words.Searches were made on the databases of PubMed, EMBASE, CNKI and WanFang for studies published between January 1980 and December 2012.Studies were included if they (1) evaluated outcome in over 35-week gestational age neonates with perinatal asphyxia or HIE; (2) reported outcomes at minimal follow-up age of 18 months; (3) confirmed neurodevelopment with favorable or adverse outcomes.RevMan 5.2 software 1.4 was used for meta-analysis.And the evaluation criteria of each study were employed to assess and analyze the results comprehensively.

Among 260 relevant studies, 20 were included.There are 7 tests contented our inclusion criteria: amplitude-integrated electroencephalography(aEEG), magnetic resonance imaging (MRI: T1/T2 weighted imaging, diffusion weighted imaging (DWI), apparent diffusion coefficient (ADC), magnetic resonance spectroscopy (MRS)), cerebral ultrasound (CUS) and HIE stage.The most promising tests were aEEG: sensitivity 0.936 (95%CI: 0.897-0.964); specificity 0.884(95%CI: 0.836-0.921). In imaging, T1/T2-weighted MRI sensitivity 0.913(95%CI: 0.850-0.956), specificity 0.630(95%CI: 0.544-0.711); diffusion weighted MRI sensitivity 0.933(95%CI: 0.817-0.956), specificity 0.694(95%CI: 0.546-0.817); ADC sensitivity 0.778(95%CI: 0.664-0.867), specificity 0.971(95%CI: 0.898-0.996); MRS sensitivity 0.918(95%CI: 0.804-0.977), specificity 0.642(95%CI: 0.515-0.755). CUS sensitivity 0.683(95%CI: 0.519-0.819), specificity 0.459(95%CI: 0.295-0.631). HIE stage sensitivity 0.967(95%CI: 0.924-0.989), specificity 0.314(95%CI: 0.241-0.394).

These evidence suggests an important role for aEEG, MRI (T1/T2-weight, DWI, ADC), CUS and HIE stage.The sensitivity and specificity of aEEG are both relatively high; HIE stage has good sensitivity; in imaging, T1/T2-weight, DWI and MRS yield better sensitivity while ADC has the best specificity.Mild hypothermia treatment reduces the predictive value of evaluation system.Each test has its advantages and disadvantages.Thus an integrated use of a variety of prognostic tests centering on clinical neurological assessment is optimal.

To evaluate the distribution of IgG subclasses of TgAb and TPOAb in sera from patients with Graves′ disease (GD), Graves′ disease plus Hashimoto′s thyroiditis (GH) and Hashimoto′s thyrotoxicosis.

Patients with GD (n=33), GH (n=31) or Hashimoto′s thyrotoxicosis(n=18)diagnosed by fine needle aspiration cytology at Department of Endocrinology of Peking University First Hospital, Beijing Haidian Hospital, China-Japan Friendship Hospital and Civil Aviation General Hospital during the period from January 2010 to May 2013 were enrolled. All of them had TgAb and TPOAb. The total serum IgG and IgG subclasses of TgAb and TPOAb were detected by antigen-specific enzyme-linked immunosorbent assay (ELISA). The prevalence and relative amount of IgG subclasses were calculated and compared among three groups.

The levels of TRAb in GD group (21.80(7.53, 40) U/L) were significantly higher than those in GH (7.30(3.10, 25.40) U/L) (P=0.000) and Hashimoto′s thyrotoxicosis groups (4.90(1.69, 16.43) U/L) (P=0.003). And no significant differences were found in the levels of TgAb and TPOAb. The prevalence of TgAb IgG3 subclass in Hashimoto′s thyrotoxicosis group (66.7%) was higher than GD group (35.5%) and GH group (36.4%) and the difference was close to significance (P=0.066). There were significant differences of relative amount of TgAb IgG2 and TgAb IgG4 among three groups (P=0.039 and 0.013), and GD patients had higher relative amounts of TgAb IgG2 (0.59(0.34, 0.94)) and TgAb IgG4 (0.57(0.28, 0.97)) than GH patients (TgAb IgG2, 0.31(0.23, 0.34); TgAb IgG4, 0.26(0.09, 0.48)) or patients with Hashimoto′s thyrotoxicosis (TgAb IgG2, 0.32(0.24, 0.83); TgAb IgG4, 0.33(0.10, 0.65)) (for TgAb IgG2, P=0.009 and 0.167; for TgAb IgG4, P=0.005 and 0.041 respectively). No significant difference was found in the prevalence of each TPOAb IgG subclass. The difference of relative amount of TPOAb IgG2 among three groups was close to significance (P=0.069). And the relative amount was higher in sera from GD patients (0.39±0.04) than that in GH patients (0.29±0.13) or patients with Hashimoto′s thyrotoxicosis (0.26±0.02) (P=0.104 and 0.002 respectively).

The patients with high levels of TgAb IgG2, TgAb IgG4 and TPOAb IgG2 subclasses have a greater risk of GD. The IgG subclass distribution of TgAb and TPOAb might help to differentiate the causes of thyrotoxicosis in autoimmune thyroid diseases.

To compare the status of blood glucose control in elderly type 2 diabetics under different health care levels and analyze its influencing factors.

Using cross-sectional and field survey methods, 688 elderly type 2 diabetics aged over 60 years undergoing long-term annual physical examination at PLA General Hospital in May 2009(veteran group) were recruited. And 409 patients aged over 60 years with type 2 diabetes were selected from a community health survey in Beijing from September 2009 to June 2010(community group). According to the diabetic control standards of Chinese Type 2 Diabetes Prevention Guide(2010), a comparison of blood glucose control status between two groups were conducted.

The mean HbA1c level was 6.6%±1.0% in the veteran group. And there were 50.6% patients with HbA1c <6.5% and 76.3% with HbA1c <7%. In the community group, the mean HbA1c level was 7.1%±1.4% and the success rates of HbA1c were 40.6% and 55.7% respectively. The status of blood glucose control in the veteran group was significantly superior to that in the community group( P<0.05). The comprehensive rates of achieving control target goals for blood glucose, blood pressure and blood lipids were higher in the veteran group than that in the community group(11.5% vs 2.0%,P<0.001). The success rates of HbA1c for diabetics diagnosed after age 60 years were better than those diagnosed before age 60 years(P<0.05). Logistic regression analysis showed that different health care levels, gender, duration of diabetes, age of onset and total cholesterol were crucial factors for achieving target goal of HbA1c in both groups(P<0.05).

The status of blood glucose control was much better in the veteran group than that in the community group. And the blood glucose control level in the patients diagnosed as diabetes after age 60 years was superior to that in those diagnosed before age 60 years.

To explore the distribution of Ureaplasma urealyticum (UU) serotypes in cervix secretion and examine the relationship between serotype and host age, clinical phenotypes and vaginal Lactobacilli.

A total of 444 cervical secretion samples were collected from healthy subjects and 342 cervical secretion samples from females with genital diseases between October and December 2012 at Sir Run Run Shaw Hospital, Zhejiang University School of Medicine.Biovar-typing was performed by PCR based on multiple-banded antigen (MBA) gene.And serotyping was performed by real-time PCR based on specific nucleotide sequences.

The positive rate of UU in disease group (62.6%, 214/342) was significantly higher than that in healthy group (44.1%, 196/444, P<0.05). The main serotypes in both groups were 1, 3, 6, 9 and mixed infection.No significant difference existed between host age and UU serotype(P>0.05). The distribution of serotype 3 in disease andLactobacilli abnormal group was significantly higher than that in healthy and Lactobacilli normal groups (13.1%(28/214)vs 5.1%(10/196), 12.2%(27/221)vs 5.8%(11/189), both P<0.05) whereas the distribution of serotype 6 in disease andLactobacilli abnormal groups was significantly lower than that in healthy and Lactobacilli normal groups(14.0%(30/214) vs 30.1%(59/196), 16.3%(36/221) vs 28.0%(53/189), both P<0.05).

1, 3, 6, 9 and mixed infection are the main UU serotypes in female cervix.Serotype 3 and mixed infection may be associated with female genital infection.

To explore the expression of S100A7 in esophageal squamous cell carcinoma (ESCC) and examine the effect of S100A7 down-regulated expression mediated via RNA interfering on cell proliferation and invasion.

The expressions of S100A7 mRNA and protein were analyzed by in situ hybridization and immunohistochemistry.S100A7 siRNA was transfected into ESCC cell line EC9706 and the expressions of S100A7 mRNA and protein were detected by real-time polymerase chain reaction (PCR) and Western blot.Furthermore, the effects of down-regulated of S100A7 on cell proliferation and invasion were examine by Cell Counting Kit-8 (CCK-8) and Boyden chamber respectively.Finally the effect of down-regulated expression of S100A7 on matrix metalloproteinase-2 (MMP-2) protein was analyzed by Western blot.

Positive expression ratios of S100A7 mRNA and protein expressions in ESCC tissues (72.0% and 69.3%) were significantly higher than those in normal esophageal tissues (10.7% and 8.0%) (χ²=58.174 and 59.483, both P=0.000). The expressions of S100A7 mRNA and protein in S100A7 siRNA group were markedly lower than those in untreated group (mRNA: 0.235±0.056 vs 1, protein: 0.119±0.025 vs 0.518±0.129, both P<0.05). Additionally, the down-regulated expression of S100A7 resulted in the proliferation inhibition and the decreased invasiveness in EC9706 cells.And it was coupled with a down-regulation of MMP-2 protein.

S100A7 may play an essential role in the occurrence and development of ESCC and the decreased invasiveness of EC9706 cells mediated by the down-regulated expression of S100A7 may be closely associated with the down-regulation of MMP-2 protein.

To explore the effects of digoxin on hypoxia-induced pulmonary artery hypertension (PAH) and the possible mechanisms.

A total of 48 Sprague-Dawley rats were randomly divided into 4 groups: normoxia control, normoxia+ digoxin, hypoxia control and hypoxia+ digoxin.The animals were exposed to chronic intermittent hypoxia (PO_2:(10.5±0.5) %, 8: 00-16: 00) or room air for 21 days.Each rat received a daily intraperitoneal injection of either digoxin (1.0 mg·kg^-1·d^-1) or an equal volume of vehicle, starting at the first day of hypoxia or normoxia.At Day 21, mean pulmonary arterial pressure (mPAP), right ventricular hypertrophy (RV/(LV+ S)) and index of wall thickness of small pulmonary artery (WT% and WA%) among groups were compared.And in vitro the changes of pulmonary artery smooth muscle cells (PASMCs) proliferation were determined by methyl thiazolyl tetrazolium (MTT) assay.Migration assay was performed with a Transwell chamber.Real-time quantitative polymerase chain reaction (PCR) was performed to quantify the mRNA levels of smooth muscle cell phenotype markers such as smooth muscle-α-actin, calponin and smooth muscle 22α under normoxic or hypoxic conditions in the absence or presence of digoxin.And the protein expressions of matrix metalloproteinase(MMPs)were determined by Western blot.

Digoxin treatment significantly lowered mPAP, reduced WT% and WA% and right ventricular hypertrophy compared with those of the hypoxic group (mPAP: (27.3±2.7) vs (38.5±2.3) mmHg(1 mmHg=0.133 kPa); RV/(LV+ S): (30.9±3.3)% vs (42.8±2.6)%, WT%: (21.7±3.6)% vs (39.3±2.0)%; WA%: (56.3±4.7)% vs (79.5±5.7)%, all P<0.05). Andin vitro, digoxin restored the hypoxia-induced inhibition of the expression of smooth muscle cell phenotype markers and prevented the hypoxia-induced activation of MMPs in PASMCs.

Early digoxin therapy reduces pulmonary artery remodeling in hypoxia-induced PAH rat model and this effect is probably correlated with the inhibitions of proliferation, migration, phenotype switching and expression of MMPs induced by hypoxia in PASMCs.

To explore the relationship between growth factor independence 1 (Gfi-1)and apoptosis as well as proliferation in 32D cell and observe the effects of Gfi-1 and N382S on 32D cell so as to further explore its possible mechanism of apoptosis and proliferation in hemopoietic stem cells.

32D cells expressed a high level of Gfi-1 or its mutant N382S by plasmid transduction, cell apoptosis was examined by flow cytometry and the levels of Bax, signal transducer and activator of transcription 3(STAT3)and Gfi-1 protein by Western blot.

The apoptotic cell ratios were lower in the 32D/Gfi-1 groups than those in the 32D/puro groups (4.0%±1.8%, 7.0%±1.6%, 10.0%±2.4% vs 6.0%±1.0%, 11.0%±1.5% and 23.0%±1.5% respectively, all P<0.05)after culture for 48, 96 and 144 h. The apoptotic rates were compared between the 32D/N382S and 32D/puro groups.However, there were no marked statistical difference(5.0%±1.3%, 12.0%±2.1%, 21.0%±2.2% vs 6.0%±1.0%, 11.0%±1.5%, 23.0%±1.5% respectively,P>0.05). Interestingly, the number of 32D cells expressed Gfi-1 decreased compared to the controls (0.96×10⁶, 2.03×10⁶, 3.47×10⁶ vs 1.42×10⁶, 3.26×10⁶, 6.12×10⁶ respectively, all P<0.05). But no marked difference existed between 32D/N382S groups and the controls (1.51×10⁶, 3.36×10⁶, 6.54×10⁶ vs 1.42×10⁶, 3.26×10⁶ and 6.12×10⁶ respectively, P>0.05) after culturing for 48, 96 and 144 h. The expression level of Bax decreased significantly in 32D/Gfi-1 groups(1.090 ±0.062 vs 1.707±0.025,P<0.05), but showed no marked in 32D/N382S groups (1.710±0.062 vs 1.707±0.025,P>0.05), compared to 32D/puro groups.The expression level of STAT3 increased significantly in 32D/Gfi-1 groups (1.723±0.168 vs 1.203±0.168,P<0.05) and 32D/N382S groups (1.797±0.292 vs 1.203±0.168,P<0.05) compared to 32D/puro groups.

Gfi-1 inhibits cell apoptosis and proliferation.Such an effect is associated with Bax down-regulation.Zinc finger structure of Gfi-1 has no marked interaction with the expression of STAT3.And Gfi-1 is both unique and complicated in hemopoietic stem cells.

Burkitt's lymphoma (BL) is a highly aggressive B-cell non-Hodgkin's lymphoma, often occurring outside the lymph nodes, with rapid clinical progression and high mortality. BL is common in children and adolescents, and is rare in adults. It is reported in Western Europe and the United States to account for about 1% to 2% of adult lymphomas, and the prognosis of adults is worse^[1]。 Due to the limitation of cases, there are few relevant studies at present. This study retrospectively analyzed 18 adult patients with pathologically confirmed sporadic BL, which are reported below.

Obstructive sleep apnea (OSA) is a disease in which upper airway obstruction occurs repeatedly during sleep with the main symptoms of snoring, apnea evidenced by others, holding breath, and daytime sleepiness^[1], is a potential risk factor for hypertension, cardiovascular disease, cerebrovascular accident, diabetes, etc^[2]The prevalence rate is 3% ~7%^[3]。 Postural OSA is associated with posture during sleep, with apnea during sleep in the supine position and disappearance or relief in the lateral position. Studies have shown that postural OSA accounts for more than 55% of OSA patients^[4,5,6]。 The diagnostic criteria, pathogenesis and treatment of postural OSA are summarized as follows.

microRNA (microRNA) is a type of non-coding single-stranded RNA with a length of about 18 to 25 nucleotides. It enters the RNA-induced silencing complex (RISC) and specifically binds to the 3' untranslated region (UTR) of the target gene mRNA through base complementarity. If it is not completely complementary, it prevents the translation of the target gene mRNA through RISC; If completely complementary, RISC degrades target gene mRNA and regulates about 60% of gene expression in humans^[1]。 Acute myeloid leukemia (AML) is a highly heterogeneous group of hematological malignancies. Cytogenetics is an important indicator of AML prognosis. According to different karyotypes, AML can be divided into three types: good, moderate and poor prognosis. However, nearly 50% of patients are AML with normal karyotype (CN-AML). With the progressive study of leukemia pathogenesis, some gene mutations such as nuclear phosphate protein 1 (NPM1), FMS-like tyrosine kinase 3 (FLT3), c-kit, CCAAT/enhancer binding protein-A (CEBPA), DNA methyltransferase 3A (DNMT3A) and tet oncogene family member 2 (TET2) have been discovered in recent years. However, about 15% of AML patients have no related gene mutations^[2]。 In 2002, Calin et al.^[3]It is reported that the deletion of miR-16-1 and miR-15a plays an important role in B-cell chronic lymphocytic leukemia. Subsequently, a large number of studies have shown that microRNA is abnormally expressed in AML, acute lymphocytic leukemia, myelodysplastic syndrome and B lymphoproliferative diseases, and plays an important role in the occurrence and development of diseases, which is related to prognosis^[4]。 This paper reviews the pathogenesis of microRNA in AML, its relationship with karyotype, gene mutation, drug resistance and prognosis, in order to deeply understand the pathogenesis of leukemia, and provide scientific basis for individualized and targeted therapy of AML.

A 5-month-old child was seen in the outpatient department of rehabilitation department of our hospital in September 2012 due to lagging growth and development. The reaction of the child was general, with unstable head vertical, poor muscle tone, and bilateral testicles explored in the inguinal area. Color B-ultrasound of outside hospital heart showed patent foramen ovale and patent ductus arteriosus. The child is the second birth and the second birth, and has an elder brother with normal intelligence and phenotype. Normal parental phenotype, non-consanguineous marriage, denial of history of exposure to harmful substances, denial of family genetic history. Lymphocytes were cultured in peripheral blood of children for 72 h, chromosomes were prepared by conventional methods, and karyotypes were described according to the International Nomenclature System of Human Cytogenetics (ISCN2005). Forty-seven schizomorphs were analyzed (Figure 1), of which 33 mitotic images are small loops formed by chromosome 10, and the karyotypes are: 46, XY, r (10) (:: p15 → q26::); There are 9 mitotic images that delete 1 chromosome 10, and the karyotype is: 45, XY, -10; Three mitotic images are two macrocycles formed by chromosome 10, with karyotypes: 46, XY, dic r (10; 10) (:: p15→q26:: p15→q26::); There is one mitotic image of two small rings No. 10 with a karyotype of: 47, XY, r (10) (:: p15 → q26::) ×2; There is also a split image containing two macrocycles formed by No. 10, with karyotypes: 47, XY, dic r (10; 10) (:: p15→q26::p15→q26::) ×2. The parent's karyotype was normal, but the brother's karyotype was not detected. Clinical diagnosis: Congenital heart disease, cerebral palsy, bilateral cryptorchidism.