[Analysis of High-Risk Clinical Factors of Early Death in Secondary Hemophagocytic Lymphohistiocytosis].

OBJECTIVE: To explore the high-risk clinical factors of early death in patients with secondary hemophagocytic lymphohistiocytosis (sHLH), and further identify the clinical factors related to the rapid progression of sHLH in the short term. METHODS: The clinical manifestations, laboratory examination and prognosis of sHLH patients were retrospectively analyzed. Continuous variables were grouped by median, univariate and multivariate Cox regression analysis and Kaplan-Meier survival curve were used to explore the risk factors affecting early death of sHLH. Then, a nomogram model was established with independent risk factors, Bootstrap resampling method was used for verification, and consistency index (C-index) and calibration curve were used to detect the prediction accuracy. RESULTS: A total of 126 sHLH patients were enrolled, with a median age of 48.5(16-88) years, including 74 males and 52 females. Fifty-five patients (43.6%) died within 30 days, including 39 males and 16 females. Univariate regression analysis showed that lymphocyte count <0.45×109/L, platelet count (PLT) <39.5×109/L, prothrombin time (PT)≥13.3 s, activated partial thromboplastin time (APTT)≥39.7 s, albumin (ALB) <25.9 g/L, lactate dehydrogenase (LDH)≥811 U/L, creatinine (Cr) ≥67 µmol/L and procalcitonin (PCT)≥0.61 ng/ml were risk factors for death within 30 days in sHLH patients. Multivariate regression analysis showed that lymphocyte count <0.45×109/L, APTT≥39.7 s and ALB <25.9 g/L were independent risk factors for death within 30 days in sHLH patients. A nomogram model was established based on the above three risk factors, its C-index was 0.683, and the calibration chart showed good agreement between the observed and predicted values of sHLH. CONCLUSIONS: Lymphopenia, prolonged APTT, and hypoalbuminemia are risk factors for early death of sHLH patients. Early identification and positive intervention are expected to reduce early mortality in sHLH patients. The nomogram model based on the above risk factors provides a method for clinicians to evaluate sHLH.

Crystal structure of aqua-bis-[4-(methyl-sulfan-yl)benzoato-κO](1,10-phenanthroline-κ(2) N,N')copper(II) monohydrate.

In the title compound, [Cu(C8H7O2S)2(C12H8N2)(H2O)]·H2O, the central Cu(II) atom is five-coordinated in a slightly distorted square-pyramidal environment by two N atoms from a 1,10-phenanthroline ligand, one O atom from the carboxylate group of one 4-(methyl-sulfan-yl)benzoate anion and one water O atom in the equatorial plane while the apical position is occupied by the O atom of a carboxylate group of the second anion. In the crystal, a three-dimensional supra-molecular network is formed through weak inter-molecular C-H⋯O and C-H⋯S inter-actions and π-stacking between the 1,10-phenanthroline ligand and the aromatic rings of symmetry-related 4-(methyl-sulfan-yl)benzoate ligands.

Crystal structure of poly[bis-(µ-2-amino-4,5-di-cyano-imidazolato-κ(2) N (1):N (3))-trans-bis-(N,N'-di-methyl-formamide-κO)cadmium].

In the title structure, [Cd(C5H2N5)2(C3H7NO)2] n or [Cd(adci)2(DMF)2] n , the Cd(2+) ion is located on a twofold rotation axis and is six-coordinated in a CdN4O2 manner by four imidazole N atoms of four symmetry-related 2-amino-4,5-di-cyano-imidazolate (adci) anions in the equatorial plane and by two O atoms of symmetry-related N,N-di-methyl-formamide (DMF) ligands in axial positions. The adci(-) anions bridge adjacent Cd(2+) ions [shortest Cd⋯Cd separation = 6.733 (3) Å] into a layered coordination polymer extending parallel to (001). The primary amino group and the non-coordinating cyano groups of adci(-) anions are involved in hydrogen-bonding inter-actions with DMF ligands to stabilize the crystal structure.

[Mechanism study on leptin resistance in lung cancer cachexia rats treated by Xiaoyan Decoction].

OBJECTIVE: To study the leptin resistance mechanism of Xiaoyan Decoction (XD) in lung cancer cachexia (LCC) rats. METHODS: An LCC rat model was established. Totally 40 rats were randomly divided into the normal control group, the LCC model group, the XD group, and the positive control group, 10 in each group. After LCC model was set up, rats in the LCC model group were administered with normal saline, 2 mL each time. Rats in the XD group were administered with XD at the daily dose of 2 mL. Those in the positive control group were administered with Medroxyprogesterone Acetate suspension (20 mg/kg) by gastrogavage at the daily dose of 2 mL. All medication lasted for 14 days. The general condition and tumor growth were observed. Serum levels of leptin and leptin receptor in the hypothalamus were detected using enzyme-linked immunosorbent assay. Contents of neuropeptide Y (NPY) and anorexia for genomic POMC were detected using real-time PCR technique. RESULTS: Serum leptin levels were lower in the LCC model group than in the normal control group with statistical significance (P < 0.05). Compared with the LCC model groups, serum leptin levels significantly increased in the XD group (P < 0.01). Leptin receptor levels in the hypothalamus increased significantly in the LCC model group (P < 0.01). Increased receptor levels in the LCC model group indicated that either XD or Medroxyprogesterone Acetate could effectively reduce levels of leptin receptor with statistical significance (P < 0.01). There was also statistical difference between the XD group and the positive control group (P < 0.05). Contents of NPY was higher in the LCC model group than in the other groups with statistical difference (P < 0.05). There was no statistical difference in NPY between the normal control group and the rest 2 treatment groups (P > 0.05). There was statistical difference in POMC between the normal control group and the LCC model group (P < 0.05). POMC could be decreased in the XD group and the positive control group with statistical significance (P < 0.05), and it was more obviously decreased in the XD group (P < 0.05). CONCLUSIONS: Leptin resistance existed in LCC rats. XD could increase serum leptin levels and reduce leptin receptor levels in the hypothalamus. LCC could be improved by elevating NPY contents in the hypothalamus and reducing POMC contents, promoting the appetite, and increasing food intake from the periphery pathway and the central pathway.

Penta-carbonyl-1κC,2κC-(ferrocenyl-diphenyl-phosphine-1κP)[µ-2-(4-methyl-phen-yl)-2-aza-propane-1,3-dithiol-ato-1:2κS,S':S,S']diiron(I)(Fe-Fe).

The title compound, [Fe(2)(C(9)H(11)NS(2)){Fe(C(5)H(5))(C(17)H(14)P)}(CO)(5)], was prepared as an aza-dithiol-ato-iron model for the iron-only hydrogenase active site. The Fe(2)S(2) unit exhibits a butterfly conformation and the ferrocenyldiphenyl-phosphine ligand is trans to the Fe-Fe bond. The Fe-Fe distance of 2.5160 (8) Šis longer than found in related model structures. Intra-molecular C-H⋯S and inter-molecular C-H⋯O hydrogen bonds are observed.

Diagnosis of breast diseases by mammography in combination with MRI / 中国医疗器械杂志

<p><b>OBJECT</b>To study the diagnosis of breast diseases and its clinical application value of mammography in combination with MRI.</p><p><b>METHODS</b>The 46 patients suspected of having breast tumors by mammography, received dynamic contrast-enhanced MRI scanning, and the image features of breast tumors were compared and analyzed.</p><p><b>RESULTS</b>MRI was superior to mammography not only in revealing the location, the shape, the border, internal structure of the mass and its chest-wall invasion, but also in revealing the axillary lymph nodes and the internal mammary lymph nodes and the mammary plugger, and in determining the mass nature in displaying microcalcification.</p><p><b>CONCLUSION</b>Mammography in combination with dynamic contrast-enhanced MRI can help to make an accurate diagnosis of breast diseases.</p>