Comparative Analysis of Primary and Reactivated EB Virus Infection Associated Hemophagocytic Lymphohistiocytosis / 中国实验血液学杂志

OBJECTIVE@#To compare the clinical characteristics of children with hemophagocytic lymphocytosis (HLH) associated with primary Epstein-Barr virus (EBV) infection and EBV reactivation, and explore the effects of different EBV infection status on the clinical indexes and prognosis of HLH.@*METHODS@#The clinical data of 51 children with EBV associated HLH treated in Henan Children's Hospital from June 2016 to June 2021 were collected. According to the detection results of plasma EBV antibody spectrum, they were divided into EBV primary infection-associated HLH group (18 cases) and EBV reactivation-associated HLH group (33 cases). The clinical features, laboratory indexes and prognosis of the two groups were analyzed and compared.@*RESULTS@#There were no significant differences in age, gender, hepatomegaly, splenomegaly, lymphadenopathy, neutrophil count in peripheral blood, hemoglobin content, platelet count, plasma EBV-DNA load, lactate dehydrogenase, alanine aminotransferase, aspartate aminotransferase, albumin, fibrinogen, triglyceride, ferritin, hemophagocytosis in bone marrow, NK cell activity and sCD25 between the two groups(P>0.05). The central nervous system involvement and CD4/CD8 in EBV reactivation-associated HLH group were significantly higher than those in primary infection-associated HLH group, but the total bilirubin was significantly lower than that in primary infection-associated HLH group (P<0.05). After treatment according to HLH-2004 protocol, the remission rate, 5-year OS rate and 5-year EFS rate of patients in EBV reactivation-associated HLH group were significantly lower than those in EBV primary infection-associated HLH group (P<0.05).@*CONCLUSION@#EBV reactivation-associated HLH is more likely to cause central nervous system involvement and the prognosis is worser than EBV primary infection-associated HLH, which requires intensive treatment.

Effects of electrophysiological technique combined with pelvic floor muscle training on the rapid recovery of urinary incontinence after electroresection of prostatic hyperplasia / 现代泌尿外科杂志

【Objective】 To investigate the clinical effects of electrophysiological technique combined with pelvic floor muscle training on urinary incontinence after electroresection of benign prostatic hyperplasia (BPH) based on the concept of enhanced recovery after surgery (ERAS). 【Methods】 A total of 86 patients with urinary incontinence treated with electroresection of BPH during Oct.2019 and Feb.2022 were randomly divided into control group and observation group, with 43 cases in either group. All patients received health education plus pelvic floor muscle training, and the observation group also received electrophysiological treatment. The differences in the indexes before and after treatment were compared between the two groups. 【Results】 There were no significant differences in the 1 h pad test, ICIQ-SF score, maximum urinary flow rate (Qmax), post void residual (PVR), International Prostate Symptom Score (IPSS), 24 h urinary incontinence frequency, and Urinary Incontinence Quality of Life Questionnaire Score (I-QoL) before treatment between the two groups (P>0.05). However, after treatment, Qmax and I-QoL score were significantly higher in the observation group than in the control group, while the other 5 indicators were significantly lower in the observation group than in the control group (all P<0.05). The total clinical effective rate was significantly higher in the observation group than in the control group (P<0.05). 【Conclusion】 Electrophysiological technique combined with pelvic floor muscle training can effectively improve the symptoms of urinary incontinence and promote the recovery of urinary control function, which is in line with the concept of ERAS and is worthy of further research and promotion.

Effect of Yangqing Chenfei Formula on epithelial-mesenchymal transition in silicon dioxide-induced silicosis rats / 中国职业医学

@# Objective Yangqing Chenfei Formula - To investigate the effect of (YCF) on epithelial mesenchymal transition (EMT) Methods in lung tissues of silicosis model rats. Specific pathogen free adult male SD rats were randomly divided into control group, model group, tetrandrine group and YCF group, with eight rats in each group. The rats in the model group, tetrandrine group and YCF group were intratracheally injected with 1.00 mL of silica suspension with a mass concentration of 50.0 g/L, and the rats in the control group were given an equal volume of 0.9% sodium chloride solution. On the 15th day after modeling, the tetrandrine group was given tetrandrine at a dose of 27.0 mg/kg body weight, the YCF group was given YCF with a dose of 8.91 g/kg body weight, while both the control group and model group were given 2.00 mL 0.9% sodium chloride solution. Gavage wasperformed twice a day in the morning and evening for 14 days. On day 29 of the experiment, after evaluating the tidal volume, - functional residual volume (FRC) and vital capacity of rats in each group, lung tissues were collected, and hematoxylin eosin staining and Masson staining were performed to examine the histopathological changes, and the fibrosis score was evaluated. - - Hydroxyproline level was detected by colorimetry. The expression of type Ⅰ collagen (COL Ⅰ), type Ⅲ collagen (COL Ⅲ), - - - - - - E cadherin (E Cad), N cadherin (N Cad) and α smooth muscle actin (α SMA) protein was detected by immunohistochemistry. - The expression of epithelial cell adhesion molecule (EpCAM) and fibroblast specific protein 1 (FSP 1) was detected by Results immunofluorescence. The lung structure was intact and the alveolar structure was normal in the control group. The alveolar structure was destroyed, the alveolar wall was thickened, and cellular nodules were observed/n the model group. The lung tissue lesions of rats in the tetrandrine group and YCF group were reduced compared with that in the model group, and there was no difference in the degree of lesions between the two groups. The tidal volume, FRC and vital capacity of rats in model P< - P< group decreased (all 0.05), the relative expression of E Cad protein in lung tissue decreased ( 0.05), the fibrosis score and - - - - the level of hydroxyproline, the protein relative expression of COL Ⅰ, COL Ⅲ, N Cad and α SMA in lung tissue increased (all P< - 0.05), while the fluorescence intensity of EpCAM protein decreased, and that of FSP 1 protein increased compared with the P< control group. The tidal volume, FRC and vital capacity of rats in tetrandrine and YCF groups increased (all 0.05), the fibrosis - - - score and the level of hydroxyproline, the protein relative expression of COL Ⅰ, N Cad and α SMA in lung tissue decreased (all P< - P< 0.05), the relative expression of E Cad protein in lung tissues increased ( 0.05), while the EpCAM protein fluorescence - intensity increased and FSP 1 protein fluorescence intensity decreased compared with the model group. The relative expression - P< Conclusion of N Cad protein in lung tissues of YCF group was lower than that of the tetrandrine group ( 0.05). YCF can - improve the lung function, alleviate collagen deposition in lung tissues, and inhibit the epithelial mesenchymal transition in silicosis model rats, and then attenuates the progression of silicotic fibrosis.

Review of factors in pterygium pathology / 国际眼科杂志(Guoji Yanke Zazhi)

Pterygium is an ocular surface disease formed by many factors and associate with a series of changes caused by ultraviolet irradiation and radiation, its pathogenesis is still uncertain. Elevated vascular endothelial growth factor(VEGF), inflammatory infiltrates, angiogenesis, oxidative stress, epithelial-mesenchymal cell transition(EMT), and tumor suppressor gene inactivation are currently recognized causes of pterygium. The mechanism of this factor in pterygium deveopment is still not completely understood. This review aimed to investigate the role of these factors in pterygium formation and provide targeted therapy and effective preventive measures for clinical diagnosis and treatment.

Effect of miR-124a on collagen-induced arthritis in mice and the underlying mechanisms / 中南大学学报(医学版)

OBJECTIVES@#Rheumatoid arthritis (RA) is a chronic autoimmune disease. MicroRNA has been shown to play an important role in RA. MicroRNA-124a (miR-124a) has anti-proliferative and anti-inflammatory effects in RA fibroblast synovial cells. This study aims to explore the effects of miR-124a overexpression on arthritis in collagen-induced arthritis (CIA) mice and the underlying mechanisms.@*METHODS@#Bovine type II collagen and complete Ferris adjuvant were used to induce CIA model from DBA/1 mice. Twenty-eight days after initial immunization (D28), CIA mice were randomly divided into a model group, a miR-124a treatment group, and a negative control (NC) group. Physiological saline, miR-124a agomir, and miR-124a agomir NC were injected into the skin at the tail root of mice every 3 days for 4 times, respectively. The degree of joint swelling and arthritis index of mice were recorded accordingly. Sixty-three days after initial immunization (D63), the mice were sacrificed to obtain the synovial tissue of ankle joint. HE staining was used to observe the proliferation of synovial cell, infiltration of inflammatory cell, pannus, and bone erosion of synovial tissues; TUNEL staining was used to detect cell apoptosis; qRT-PCR was used to detect the mRNA expression of miR-124a, phosphatidylinositol-3-kinase catalytic subunit alpha (PIK3CA) and its downstream genes Bcl-2 and Bax. Immunohistochemistry was used to detect the protein expression of PIK3CA, Bcl-2, and Bax protein in synovial tissues of each group.@*RESULTS@#Different degrees of swelling presented in the paws of DBA/1 mice at D28, which indicated the CIA model was constructed successfully. Forty-eight days after initial immunization (D48), the paws of mice in the miR-124a treatment group were only slightly red and swollen, while the paws of mice in the model group and the NC group were obviously red and swollen. The arthritis index of mice in the miR-124a treatment group were decreased significantly compared to the NC group at D51, D53, D59, and D62 (51, 53, 59, 62 days after initial immunization) (all P<0.05). Sixty-three days after initial immunization (D63), HE staining indicated that the scores of synovial cell proliferation, inflammatory cell infiltration, synovial pannus, and bone erosion were significantly reduced in the miR-124a treatment group (P<0.05 or P<0.01), while cell apoptosis was increased in the miR-124a treatment group compared with the model group and NC group (P<0.01 or P<0.001). Besides, the expression of miR-124a and Bax in the synovial tissue in miR-124a treatment group was significantly higher than those in the model group and NC group (P<0.01 or P<0.001), while the expressions of PIK3CA and Bcl-2 were decreased (P<0.05 or P<0.01 or P<0.001), and the ratio of Bcl-2 to Bax was significantly decreased (P<0.01 or P<0.001).@*CONCLUSIONS@#Overexpression of miR-124a can reduce arthritis in CIA mice bacause it could promote synovial cell apoptosis and inhibit synovial cell proliferation via targeting PIK3CA and regulating its downstream pathways.

Analysis of clinical characteristics of elderly patients with rheumatoid arthritis and lung cancer / 中华老年医学杂志

Objective:To investigate the clinical features of elderly rheumatoid arthritis(RA)patients with lung cancer, and to improve clinicians' understanding of this condition.Methods:Retrospective analysis was conducted over general information, clinical manifestations, laboratory results, pathological types, clinical stages, treatment and prognosis in elderly inpatients(≥60 years old)diagnosed with RA and lung cancer admitted to the Second Xiangya Hospital, Central South University from January 2012 to December 2019.Differences between male and female patients were compared.Results:There were 12 elderly patients with RA combined with lung cancer, including 7 males and 5 females, with an average age of(65.8±5.7)years(60-78). The median years from the diagnosis of RA to lung cancer was 11(7.5, 17.3). Eleven patients had clinical symptoms before the diagnosis of lung cancer, with cough and sputum as the most common initial manifestations(9/11). The proportion of smokers in male patients was 71.4%(5/6). Most patients(11/12)had elevated erythrocyte sedimentation rates(ESR)and C-reactive protein(CRP). Eight patients underwent rheumatoid factor(RF-IgM, IgA, IgG)and anti-cyclic citrullinated peptide(ACPA)examinations, and the positive rate was 100% for RF and 87.5% for ACPA.Among 10 patients undergone tumor marker examination, 6 had elevated CEA, 4 had elevated CYFRA21-1, 2 had SCC, 2 had NSE, and 2 had elevated CA125.Among the 12 patients, 7 had adenocarcinoma, 2 had squamous cell carcinoma, 2 had small cell lung cancer, and 1 had carcinoma in situ.Except for 1 case of carcinoma in situ, the remaining 11 patients were all at stage Ⅲ or Ⅳ at the time of diagnosis.Three patients gave up anti-cancer treatment, while the remaining 9 patients received different therapies.In the end, 10 patients died and 2 patients survived so far.The average follow-up time was 17.5(5, 25)months.Further analysis showed that there was no significant difference in clinical manifestations, laboratory test results, pathological types, treatment and prognosis between male and female patients, except that the ESR level was higher in the female group than in the male group(Z=-2.589, P=0.010). However, the average age of male patients was older than that of female patients(68±6.2, 62.6±3.1), and the age of male patients at the diagnosis of RA was also older (56.4±3.8, 52.0±9.5). The proportion of smokers in male patients was significantly higher than in female patients(71.4%, 20.0%), while women had higher proportions than men with elevated CEA(75%, 50%)and NSE(50%, 0.0%). The proportion of women with adenocarcinoma was slightly higher than that of men(80.0%, 42.9%), while the proportions of men with squamous cell carcinoma(28.6%, 0.0%)and small cell carcinoma(28.6%, 0.0%)were slightly higher than those of women.Male patients had a higher mortality rate(100.0%, 60.0%)and a shorter median follow-up time[16.0(2.0, 18.0), 26.0(11.5, 50.0)monthes]. Conclusions:Elderly RA patients with lung cancer are more common in men, and the average age is older than that of female patients.The occurrence of lung cancer is more likely in RA patients with longer disease duration.Most patients are positive with RF and ACPA.Adenocarcinoma is the most common pathological type of lung cancer, and most patients are at clinical stages Ⅲ and Ⅳ.Mortality is high and prognosis is poor.Thus, for elderly RA patients, it is necessary to receive regular monitoring in changes in pulmonary imaging for early detection of lung cancer and improved prognosis.

Research progress on immune mechanism of dry eye / 国际眼科杂志(Guoji Yanke Zazhi)

The dry eye is a common ocular surface disease caused by multiple factors with multiple pathogenesis. With the increasing morbidity of dry eye in our country year by year, dry eye has gradually attracted people's attention. The pathogenesis of dry eye is more complicated whose critical influencing factors include inflammation, corneal and conjunctival epithelial cell changes, tear film composition changes, corneal nerve changes, and meibomian gland dysfunction and so on. The tear film hypertonicity leads to the hypertonicity of the ocular surface epithelial cells, stimulating the cascade of inflammation, which is the most critical part among the pathogenesis of dry eye. A variety of inflammatory mediators and immune cells are involved in this process, and more and more people have reached a consensus that the dry eye is an antigen-specific autoimmune inflammatory disease and they are closely correlated with each. In clinical treatment, various anti-inflammatory drugs and drugs promoting tear secretion mark the rapid development of drug therapy for dry eye to some extent, but dry eye treatment is not only to improve symptoms, but to carry out treatment according to specific etiology. Recently, researches on the immune mechanism of dry eye have been increasing. This article reviewed on the immune progress of dry eye to realize the clinical significance and systematically understand the role of which in the occurrence and development of dry eye.

Banxia Xiexintang and Its Disassembled Prescriptions Regulate Colonic Mucosal Immunity in Young Rats with Flora Disorder / 中国实验方剂学杂志

ObjectiveTo explore the therapeutic effect and possible mechanism of Banxia Xiexintang and its disassembled prescriptions in regulating the flora disorder induced by mixed antibiotics in young rats. MethodSeventy male BALB/C young rats were randomly assigned into 7 groups： blank group， model group， Bifidobacterium tetralogy viable tablets （0.68 g·kg-1） group， Banxia Xiexintang （9.1 g·kg-1） group， Xinkai （3.19 g·kg-1） group， Kujiang （1.82 g·kg-1） group， and Ganbu （4.1 g·kg-1） group， with 10 rats in each group. Except the blank group， the other groups were given mixed antibiotics by gavage to induce intestinal flora disorder. After 14 days， the rats in different drug groups were administrated with corresponding drugs by gavage， and those in the blank group and model group with the same amount of normal saline once a day for 14 days. After that， fecal samples were collected aseptically for 16S rDNA sequencing of intestinal flora， and lipopolysaccharide （LPS， 10 mg·kg-1） was injected intraperitoneally to induce inflammatory reaction. The tissue morphology of colonic mucosa was observed via hematoxylin-eosin （HE） staining， and the macrophage infiltration of colonic mucosa was observed via toluidine blue staining and immunohistochemistry. The expression of interleukin-1β （IL-1β）， interleukin-6 （IL-6）， interleukin-8 （IL-8）， tumor necrosis factor-α （TNF-α）， and interleukin-10 （IL-10） mRNA were determined by real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）. ResultCompared with the blank group， the modeling changed the intestinal flora structure of the young rats （P<0.01）， damaged the colonic mucosa， reduced the macrophage infiltration， and down-regulated the mRNA levels of IL-1β， IL-6， IL-8， TNF-α， and IL-10 （P<0.01）. Compared with the model group， bifidobacterium quadruple viable tablets， Banxia Xiexintang and its disassembled prescriptions increased the diversity of intestinal flora and the relative abundance of beneficial bacteria such as Bacteroidetes and Firmicutes （P<0.01）. At the same time， they ameliorated colonic mucosal injury （P<0.05， P<0.01）， increased macrophage infiltration （P<0.05， P<0.01）， and up-regulated the mRNA levels of IL-6， IL-8， and TNF-α （P<0.01）. The mRNA level of IL-1β was up-regulated in Bifidobacterium tetralogy viable tablets， Banxia Xiexintang， Kujiang， and Ganbu groups （P<0.01）， and that of IL-10 was up-regulated in Bifidobacterium tetralogy viable tablets， Banxia Xiexintang， Xinkai， and Ganbu groups （P<0.01）. ConclusionBanxia Xiexintang and the disassembled prescriptions can adjust the intestinal flora of young rats exposed to antibiotics and protect the immune barrier of colonic mucosa after intestinal flora disorder. In particularly， the whole prescription of Banxia Xiexintang demonstrates the best performance.

Isolation and identification of cholesterol-degrading intestinal bacteria by culturomics and evaluation of their functions / 生物工程学报

High cholesterol is one of the important factors inducing cardiovascular and cerebrovascular diseases. Drug therapy is the main method for reducing cholesterol, but has the disadvantages such as high cost and side effects. Studies have shown that intestinal bacteria play important roles in cholesterol metabolism. However, there are few reports on the screening and functional evaluation of cholesterol-lowering intestinal bacteria. In this study, 36 bile-tolerant bacteria were screened from healthy people stool through culturomics using bovine bile acid or artificial mixed bile acids as substrates. Taking Lactobacillus rhamnosus GG (LGG) as a positive control, three bile acid concentration groups (0 g/L, 0.3 g/L, 3 g/L) were set up to evaluate the cholesterol-lowering ability of bile-tolerant bacteria in vitro. Ten bacteria (including Proteus mirabilis, Providencia stuartii, Proteus vulgaris et al) were identified as the dominant cholesterol-lowering bacteria. Six of the above bacteria, Proteus mirabilis, Providencia stuartii, Proteus vulgaris, Proteus penneri, Wohlfahrtiimonas chitiniclastica, Providencia rettger, were evaluated for their ability to reduce triglycerides in vitro and tolerance to artificial gastric juice. Comparing with strain LGG, the six bacteria showed better triglyceride-lowering ability in vitro. With the decrease of pH value of artificial gastric juice and the increase of treatment time, the survival rate of six bacteria decreased. The above screening experiments and functional evaluation provide a basis for further development of potential cholesterol-lowering bacterial products.

Effect of electroacupuncture on small airway function in patients with stable chronic obstructive pulmonary disease / 中国针灸

OBJECTIVE@#To observe the regulatory effect of electroacupuncture (EA) on small airway function and exercise tolerance in patients with stable chronic obstructive pulmonary disease (COPD).@*METHODS@#A total of 62 patients with stable COPD were randomized into an observation group (31 cases, 1 case dropped off) and a control group (31 cases, 5 cases dropped off). On the base of routine medication and aerobic exercise, the patients of the two groups all received EA at Danzhong (CV 17), Rugen (ST 18), Guanyuan (CV 4), Zhongwan (CV 12), Tianshu (ST 25) and Yingchuang (ST 16). In the observation group, filiform needles were used and inserted perpendicularly, 3 mm in depth. In the control group, the placebo needling method was performed, in which the needle was not inserted through skin at each point. In both groups, electric stimulation with low-frequency electronic pulse instrument was exerted, with continuous wave, 2 Hz in frequency, lasting 30 min each time in the two groups. The treatment was given once every other day, 3 times a week, for 14 treatments totally. Before and after treatment, the following indexes were compared in patients between the two groups, i.e. the lung function indexes (forced expiratory volume in first second [FEV1], forced vital capacity [FVC], the ratio of FEV1 to FVC [FEV1/FVC], maximal voluntary ventilation [MVV], the percentage of maximal expiratory flow [MEF] at 25% of FVC exhaled [MEF25], MEF50 and MEF75 in predicted value), cardiopulmonary exercise test indexs (metabolic equivalent [METS], oxygen uptake per kg body weight [VO@*RESULTS@#After treatment, FVC%, MVV%, MEF75%, MEF50%, VO@*CONCLUSION@#Electroacupuncture can improve the respiratory function and exercise tolerance in COPD patients through removing small airway obstruction and increasing ventilation.

Effective-constituent compatibility-based analysis of Bufei Yishen formula, a traditional herbal compound as an effective treatment for chronic obstructive pulmonary disease / 中西医结合学报

OBJECTIVE@#Critical effective constituents were identified from Bufei Yishen formula (BYF), a traditional herbal compound and combined as effective-constituent compatibility (ECC) of BYF I, which may have potential bioactive equivalence to BYF.@*METHODS@#The active constituents of BYF were identified using four cellular models and categorised into Groups 1 (Bufeiqi), 2 (Bushen), 3 (Huatan) and 4 (Huoxue) according to Chinese medicinal theory. An orthogonal design and a combination method were used to determine the optimal ratios of effective constituents in each group and the ratios of "Groups 1 to 4" according to their pharmacological activity. We also comprehensively assessed bioactive equivalence between the BYF and the ECC of BYF I in a rat model of chronic obstructive pulmonary disease (COPD).@*RESULTS@#We identified 12 active constituents in BYF. The numbers of constituents in Groups 1 to 4 were 3, 2, 5 and 2, respectively. We identified the optimal ratios of effective constituents within each group. In Group 1, total ginsenosides:Astragalus polysaccharide:astragaloside IV ratio was 9:5:2. In Group 2, icariin:schisandrin B ratio was 100:12.5. In Group 3, nobiletin:hesperidin:peimine:peiminine:kaempferol ratio was 4:30:6.25:0:0. In Group 4, paeoniflorin:paeonol ratio was 4:1. An orthogonal design was then used to establish the optimal ratios of Group 1, Group 2, Group 3 and Group 4 in ECC of BYF I. The ratio for total ginsenosides:Astragalus polysaccharide:astragaloside IV:icariin:schisandrin B:nobiletin:hesperidin:peimine:paeoniflorin:paeonol was determined to be 22.5:12.5:5:100:12.5:4:30:6.25:25:6.25. A comprehensive evaluation confirmed that ECC of BYF I presented with bioactive equivalence to the original BYF.@*CONCLUSION@#Based on the ECC of traditional Chinese medicine formula method, the effective constituents of BYF were identified and combined in a fixed ratio as ECC of BYF I that was as effective as BYF itself in treating rats with COPD.

Clinical features and treatment outcomes in primary central nervous system lymphoma: a descriptive analysis of 62 patients / 中华病理学杂志

Objective@#To assess clinical features and treatment outcomes in immunocompetent patients with primary central nervous system lymphoma (PCNSL).@*Methods@#Sixty-two patients with PCNSL who attended Guangdong General Hospital between January 1998 and January 2012 were included. Survival curves were estimated using Kaplan-Meier survival methodology and statistical significance of continuous was assessed via the Cox proportional hazard model.@*Results@#The median age of the patient cohort was 56 years, and the male to female ratio was 1.14∶1.00. The common presentations were increased intracranial pressure symptoms and neuron damage. Performance status of 54 (54/62, 87.1%) patients were the international prognostic index (IPI) 0-2. Diffuse large B-cell lymphoma (57/62, 91.9%) was most common, and the rest were T-cell lymphoma (4/62,6.4%) and extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (1/62, 1.6%). In the series, 32 patients (32/62, 51.6%) had multiple lesions. Involvement of deep structures was found in 30 (30/62, 48.4%) patients. An elevated serum LDH level was detected in 19 (19/62, 30.6%) patients and the Ki-67 index was ≥90% in 38 (38/62, 61.3%) patients. Univariate analysis showed patients who were female, age<60 years, had WHO Eastern Cooperative Oncology Group performance status grade 0-2, single lesion, absence of deep structures involvement and normal LDH level showed better 2-year survival rate and longer median survival time. Significance was only seen in the normal LDH level group. Multivariate Cox regression analysis revealed that radical surgery only and Rituximab+ high-dose of methotrexate+ whole brain radiation therapy (WBRT) were independent prognostic indicators in PCNSL patients (P<0.05).@*Conclusions@#PCNSL is a rare but aggressive tumor with poor prognosis. Patients treated with high-dose of methotrexate combining with rituximab, followed by WBRT have a better prognosis and longer survival time, and thus these could probably be a promising treatment.

Clinical Efficacy of Modified BU/CY as Conditioning Regimen Combined with Autologous Peripheral Blood Hematopoietic Stem Cell Transplantation in Young Acute Myeloid Leukemia Patients with Low or Intermediate Risk / 中国实验血液学杂志

OBJECTIVE@#To investigate the safety and efficacy of autologous peripheral blood hematopoietic stem cell transplantation (auto-PBHSCT) using modified BU/CY conditioning regimen for young AML patients of low and middle risk in the first complete remission (CR1).@*METHODS@#Ten young AML patients of low and middle risk who did not want to accept allogeneic hematopoietic stem cell transplantation（allo-HSCT）and underwent auto-PBHSCT in CR1 during May 2013 to December 2016 were retrospectively analyzed. From 3 months after auto-PBHSCT, the maintenance therapy with interleukin-2 (IL-2) or IL-2 combined with histamine dihydrochloride was performed for these patients in the next 18 months. The side effects of the conditioning regimen, hematopoietic recovery time, transplant-related mortality (TRM) within 100 days and 1 year after auto-PBHSCT, relapse rate, leukemia-free survival (LFS) rate at 2 years and 3 years, overall survival (OS) were evaluated at 3 years and 4 years.@*RESULTS@#Gastrointestinal side effects were the major non-hematologic toxicity reaction, among which, 7 cases relatively mild and 3 cases displayed moderate, just one case suffered from severe reaction. In 4 cases, the mild liver damage occurred, but no hemorrhagic cystitis occurred. All the patients experienced different kinds of infection, including 5 cases of bloodstream infection, 2 cases of gastrointestinal infection, 3 cases of crissum infection and 2 cases of oral infection. The myeloablative effect occurred in all ten patients. The median times for absolute neutrophil count (ANC)0.5×10/L at 10 to 19 days, median was 13 days after auto-PBHSCT. The patients achieved platelet count >20×10/L at 10 to 72 days; median was 32 days after auto-PBHSCT. The TRM within 100 days and 1 year after transplantation was 0. The relapse occurred in 2 cases at 6 and 14 months after auto-PBHSCT raspectively. The median follow-up time was 48.1 months, and the median survival time was 54.7 months after transplantation. The 2-year and 3-year LFS were 100% (10 cases) and 80% (8 cases), respectively. The 3-year and 4-year OS were 80% (8 cases) and 70% (7 cases), respectively.@*CONCLUSION@#Modified BU/CY as conditioning regimen for auto-PBHSCT can achieve the myeloablative effect without raising TRM and obtain good LFS and OS. As for young AML patients without high risk, it is a valuable therapeutic option, especially for those lacking the chance of allo-HSCT.

Diagnostic and prognostic implications of MAML2 gene translocation in primary pulmonary mucoepidermoid carcinoma / 中华病理学杂志

Objective@#To investigate MAML2 gene-translocation in primary pulmonary mucoepidermoid carcinoma (PMEC) and pulmanary adenosquamous carcinoma, and the optimal diagnostic immunohistiochemical (IHC) panel in distinguishing PMEC from adenosqumous carcinoma.@*Methods@#Twenty-four cases of PMEC and 44 adenosqumous carcinoma diagnosed in the Guangdong General Hospital were tested for MAML2 translocation by fluorescent in-situ hybridization (FISH) using tissue array. An IHC panel including TTF1, Napsin A, CK5/6, p63, p40 and Ki-67 was performed on the cohort. The clinical data for all cases were collected and all PMEC patients had follow-up information.@*Results@#The patients′ age ranged form 6 to 73 years, with a median age of 32 years. The male to female ratio was 1.4∶1.0. MAML2 translocation was found in 16/24 (66.7%) cases of PMEC whereas all 44 cases adenosqumous carcinoma were negative for translocation. All the cases of the PMEC were negative for TTF1 and Napsin A but positive for CK5/6, p63 and p40 in the intermediate cells and epidermal-like cells. In most PMEC cases, the Ki-67 expression index was lower than 10%. In contrast, most cases of adenosqumous carcinomas expressed TTF1 and Napsin A in the adenomatous component and CK5/6, p63 and p40 in the squamous component, which expression pattern was different from that of PMEC. Based on IHC staining, 2 cases of highly invasive ALK-positive adenocarcinoma mimicing PMEC were also found in the study.@*Conclusions@#MAML2 gene translocation can be detected in about two-third of PMEC. Translocation of MAML2 gene and lower morphology grading are associated with good prognosis. The combined use of IHC antibodies panel is helpful to distinguish PMEC from the adenosqumous carcinoma and adenocarcinoma mimicing PMEC.

Clinicopathological Analysis of Children's Systemic EBV-Positive T-Cell Lymphoma / 中国实验血液学杂志

OBJECTIVE@#To explore the clinical and pathologic features as well as prognosis of systemic EBV-positive T-cell lymphoma in children.@*METHODS@#The clinical data including clinical manifestation, pathologic changes and treatment in 16 patients with children's systemic EBV-positive T-cell lymphoma were analyzed retrospectively, and follow-up of patients were carried out.@*RESULTS@#The 16 cases included 12 males and 4  females with median age of 3.3 years old. It was demonstrated that the clinical and pathological features of the children's systemic EBV-positive T-cell lymphoma were as followed fever, hepatosplenomegaly, cytopenia, lymphadenopathy, and hemophagocytosis in bone marrow or organ. Histologically, the structures of lymph node was normal, partially or completely destoryed. The paracortical zone was expanded with prominent infiltration of small to medium-sized atypical lymphocytes. The major immunophenotypic characteristics were as follows: (1) Almost all biopsies exhibited prominent T cell proliferation. (2) CD3 was expressed in 16 patients (100%, 16/16), CD4 in 5 patients (31.3%, 5/16)，CD5 in 13 patients (81.3%, 13/16)，CD7 was expressed in 11 patients (68.8%, 11/16)，CD8 in 15 patients (93.8%, 15/16)，CD4 and CD8 were expressed in 5 patients (31.3%, 5/16)，CD4 and CD8 double-negative in patients (6.3%, 1/16)，16 patients were CD56 negative (100%, 16/16). (3) TCR gene cloning rearrangement in 16 patients (93.8%, 15/16). (4) EBV-EBER was expressed in 16 patients (100%, 16/16). 11 out of 16 cases died, 1 cese failed to be followed up, 1 case relapsed，and 3 cases survived, reseptively. The media survival time was 4 months.@*CONCLUSION@#Systemic EBV-positive T-cell lymphoma predominantly occurred in childhood and early teen-age, and lacks specific clinic features, usually combined with hemophagocytic syndrome. The confirmed diagnosis requires comprehensive analysis of clinical manifestation, pathomorphology, immunohistochemical detection, EBV-EBER insite hybridization, and TCR gene test. The overall prognosis of the disease is poor and the fatality rate is high.

Expression Levels of HES1, C-MYC and NF-kB in Peripheral Blood of Patients with T Cell Acute Lymphoblastic Leukemia and Their Significance / 中国实验血液学杂志

OBJECTIVE@#To analyze and investigate the expression levels of HES1, C-MYC and NF-kB in peripheral blood of patients with T cell acute lymphoblastic leukemia (T-ALL) and their significance.@*METHODS@#Sixty patients with T-ALL and 60 patients with acute myelogenous leukemia (AML) diagnosed in our hospital from June 2012 to March 2015 were enrolled in T-ALL group and AML group, respectively. Another 30 healthy people were enrolled in the control group. Peripheral blood was collected to detect the expression levels of HES1, C-MYC and NF-kB by RT-PCR. The general data and the expression of HES1, C-MYC and NF-kB in peripheral blood were compared among the patients with different type of leukemia, cytogenetical types and different prognosis.@*RESULTS@#There was no significant difference in baseline data, such as age and sex among the 3 groups (P＞0.05). The Hb level, WBC and Plt count, BM blast cell ratio in T-ALL and AML groups all were significantly higher than those in control group (P＜0.01), but there were no statistical difference in above-mentioned indicators between T-ALL and AML groups (P＞0.05). The expression levels of HES1, C-MYC and NF-kB in peripheral blood among 3 groups were significantly differenct (P＜0.01), the expressions levels of HES1, C-MYC and NF-kB in T-ALL and AML groups were significantly higher than those in control were significantly group (P＜0.01), moreover, the expression levels of above-mentional indicators in T-ALL groups were significantly higher than than those in AML group (P＜0.01). The expression levels of HES1, C-MYC and NF-kB iin T-ALL patients with poor prognosis were significantly higher than those in T-ALL patients with favorable prognosis (P＜0.01); the expression levels of HES1, C-MYC and NF-kB in peripheral blood of patients with different theraptic efficacy were follow: complete remission group＜partial remission group＜no remission group (P＜0.01).@*CONCLUSION@#The HES1, C-MYC and NF-kB are highly expressed in peripheral blood of the patients with T-ALL, moreover, the expression levels maybe different, because of the cytogenetic, and theraptic efficacy.

Association of short-term efficacy for infliximab in rheumatoid arthritis with plasma concentration and anti-drug antibody / 中南大学学报(医学版)

To investigate the correlation between peripheral concentration of infliximab (IFX) or anti-IFX antibody titers and short-term therapeutic effect of IFX in patients with active rheumatoid arthritis (RA).
 Methods: Twenty patients with active RA were treated with combination of methotrexate (MTX), leflunomide (LEF) with IFX, and the clinical and laboratory index and the side effects were recorded before and after IFX treatment. Twenty healthy subjects were chosen as a control group.
 Results: After 14-week treatment, patients were categorized into good, moderate or no responders according to EULAR remission criteria. There were no significant differences in peripheral IFX concentration, anti-IFX antibody titers and TNF-α levels among the 3 groups, and there were no significant correlations among ΔDAS28-CRP, peripheral IFX concentration, anti-IFX antibody titers and TNF-α levels.
 Conclusion: Peripheral IFX concentration, anti-IFX antibody titers and TNF-α levels can not be used as reliable predictive index for short-term effect of IFX in active RA.

Research progress in renal injury relevant to primary Sj(o)gren's syndrome / 中南大学学报(医学版)

Primary Sj(o)gren's syndrome (pSS) is a chronic autoimmune disease characterized by lymphoplasmacytic infiltration of the exocrine glands that results in multiple organs and systems damage.Renal injury affects 0.3％-27.0％ patients,The most frequent form of nephropathy in pSS is tubulointerstitial nephritis.The main clinical manifestation is renal tubular acidosis.The renal prognosis in patients with pSS is usually favorable,but renal failure may occur.At present,it still lacks of strict consensus or guideline for the treatment.

Measurement of RNFL thickness in the normals and open angle glaucoma patients by OCT / 国际眼科杂志(Guoji Yanke Zazhi)

· AIM:To investigate the retinal nerve fiber layer thickness (RNFL) in normal subjects and primary open angle glaucoma (POAG) patients by optical coherence tomography (OCT),and to provide a theoretical basis for the diagnosis of POAG.· METHODS:Totally 100 patients (123 eyes) with POAG treated in our hospital from November 2014 to November 2017 were selected as the observation group,and 50 cases (100 eyes) matched with age and sex were selected as the control group.Patients with POAG were divided into the early group (36 cases,44 eyes),the advanced group (40 cases,50 eyes) and the late group (24 cases,29 eyes) according to the mean defect(MD).The average RNFL and the MD of the whole visual field,temporal visual field,nasal visual field,inferior visual field,and upper visual field were measured by OCT and automatic perimetry respectively,then their corrections were analyzed.· RESULTS:The average RNFL of the whole visual field,temporal visual field,nasal visual field,inferior visual field,and superior visual field of the observation group were significantly lower than those of the control group,the difference was statistically significant (P＜0.001).The MD of the whole visual field,temporal visual field,nasal visual field,inferior visual field,and superior visual field of the observation group were significantly higher than those of the control group,with a statistically significant difference (P＜0.001).The mean RNFL of the early group,the advanced group and the late group were thinned successively,paired comparison showed a statistically significant difference (P＜ 0.001).The MD of the early group,the advanced group and the late group increased successively,paired comparison showed a statistically significant difference (P＜0.001).The average RNFL of the whole visual field,temporal visual field,nasal visual field,inferior visual field,and superior visual field were negatively correlated with those fields of the MD (r =-0.675,-0.667,-0.560,-0.711,-0.660;all P＜0.001).· CONCLUSION:OCT examination shows that the RNFL of POAG patients is thinner than that of the normal people,and the RNFL becomes thinner with the progression of the disease.And it has a close relationship with MD.

Mechanism of differences in prolactin levels in patients with schizophrenia after antipsychotics treatment / 上海交通大学学报（医学版）

Antipsychotics have been the mainstay of schizophrenia treatment, but the frequency of adverse reactions (ARs) related with antipsychotics usage is high. Of all the ARs, hyperprolactinemia is relatively common and the controversy over it remains ongoing, as different patients manifest different prolactin levels and different clinical syndromes. In order to understand this heterogeneity, this review stated the mechanisms underlying the different prolactin levels in schizophrenia patients after antipsychotics treatment, including the ability to block dopamine D2 receptor (DRD2), the influence on blood-brain barrier permeability, varying affinity to DRD2, the inhibition / excitatory effect on DRD2 and genetic polymorphisms.