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Objective:To investigate the significance of plasma pentraxin 3 (PTX3) in patients with secondary hemophagocytic lymphohistiocytosis (sHLH).Methods:Plasma PTX3 levels were tested by ELISA in 48 newly diagnosed sHLH patients, 18 healthy volunteers and 9 lymphoma controls in the First Affiliated Hospital of Nanjing Medical University from January 2017 to July 2019. Clinical parameters were collected, and the correlations with PTX3 levels were analyzed.Results:PTX3 level in newly diagnosed group was significantly higher than that of healthy control group [16.29(1.17-66.00) vs. 0.76(0.01-7.86) μg/L, P<0.01]. Patients with lymphoma-associated HLH(LHLH) had higher plasma level of PTX3 than Fhose with infection-associated HLH (IHLH) [24.29(3.36-66.00) vs. 9.56(1.17-36.50)μg/L, P<0.05]. Plasma PTX3 levels in 48 sHLH patients were positively correlated with serum ferritin ( P<0.05). Receiver operating characteristic (ROC) curve for plasma PTX3 levels of sHLH and healthy controls produced a cutoff value at 3.9 μg/L, with its 86.7% sensitivity and 94.4% specificity. And ROC analysis showed that PTX3 17.5 μg/L was the critical value for diagnosis of LHLH from non-LHLH group, that the sensitivity and specificity were 63.0% and 76.2% respectively. The 1-year overall survival (OS) rate in patients with PTX3≥17.5 μg/L was significantly lower in those with PTX3<17.5 μg/L (18.5% vs. 75.8%, P<0.01). Conclusion:These results indicate the potential of PTX3 as a biomarker for diagnosis and prognosis in patients with sHLH.
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Objective@#To investigate the clinical characteristics of secondary hemophagocytic lymphohistiocytosis (sHLH) complicated with capillary leak syndrome (CLS) .@*Methods@#The clinical and laboratory data of 87 sHLH patients, who were treated in our hospital between January 2015 and December 2017, were retrospectively analyzed. Depending on whether they were complicated with CLS, 21 sHLH patients were classified as the CLS-sHLH group, while 66 were classified as the non-CLS-sHLH group. The differences of clinical manifestations, laboratory tests, treatment and prognosis between the two groups were compared.@*Results@#There was no significant difference in the etiology of sHLH between the CLS-sHLH group and the non-CLS-sHLH group (P>0.05) . The neutrophil, fibrinogen and albumin levels in the CLS-sHLH group were lower than those in the non-CLS-sHLH group, while the triacylglycerol levels were higher than those in the non-CLS-sHLH group (P<0.05) . Varying degrees of edema, weight gain, hypotension, hypoproteinemia, oliguria and multiple serous effusions were observed in the CLS-sHLH group. Among them, there were 15 patients that CLS get improved, and the medial time of improvement was 7 (5-14) days. The other 6 patients did not get remission, while they died within 6-30 days. The median overall survival of the CLS-sHLH group was lower than that of the non-CLS-sHLH group (75 days vs not reached, P=0.031) .@*Conclusions@#There may be no correlation between the cause of sHLH and the occurrence of CLS. Severity of neutropenia, fibrinogen and albumin levels, and triglyceride levels may be accompanied for sHLH patients complicated with CLS. Patients with sHLH who complicated with CLS have a poor prognosis. Active treatment of HLH and its primary disease, reasonable fluid replacement and oxygen supply are crucial, which can effectively control disease progression.
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Objective@#To investigate the clinical significance of serum calcium concentrations and albumin levels in patients with secondary hemophagocytic lymphohistiocytosis (sHLH) .@*Methods@#The clinical and laboratory data of 68 patients with newly diagnosed sHLH from April 2013 to April 2016, and 20 healthy controls were retrospectively analyzed. The patients were classified as the clinical remission group and the progression group according to the response criteria. To explore the changes of serum calcium concentrations and albumin levels in the patients, its correlations with other laboratory indexes and the impact on survival.@*Results@#①The serum calcium concentrations and albumin levels in lymphoma-related HLH group and non-tumor HLH group were lower than control group (P<0.05) ; The serum calcium concentrations and albumin levels in the clinical remission group after treatment was higher than that before treatment (P<0.01) , while in the progression group the serum calcium concentrations after treatment decreased (P=0.002) , the albumin levels did not changed significantly (P=0.086) .②The serum calcium concentrations in newly diagnosed sHLH patients was positively correlated with ANC, PLT, HGB (P<0.05) , and negatively with ferritin (P<0.05) ; The overall survival (OS) was significantly longer in patients with serum calcium concentration≥1.92 mmol/L than that<1.92 mmol/L (266 d vs 95 d, P=0.006) . ③The serum albumin levels in newly diagnosed sHLH patients was positively correlated with ANC, HGB (P<0.05) , and negatively with ferritin (P<0.05) ; The overall survival was longer in patients with serum albumin level ≥ 26.7 g/L than that<26.7 g/L (263 d vs 95 d, P=0.023) . ④The serum calcium concentrations in patients before treatment was positively correlated with serum albumin levels (P<0.001) , and no significant correlation was found in control group (P=0.079) .@*Conclusion@#The serum calcium concentrations and albumin levels have clinical significance for disease diagnosis, decision-making therapy and treatment outcomes in the patients with sHLH.
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Objective To analyze the expression of peripheral blood CD13+CD4+CD25hi regulatory T cells (Treg cells) in patients with diffuse large B-cell lymphoma (DLBCL) and its clinical significance. Methods The expression of peripheral blood CD13+CD4+CD25hi Treg cells in 58 newly diagnosed patients with DLBCL and 30 healthy adults was detected by flow cytometry, and the relationship between its expression and the clinical indicators were analyzed statistically. Results The levels of peripheral blood CD13+CD4+CD25hi Treg cells in newly diagnosed DLBCL and healthy adults were different, with statistically significant difference [(36.37 ±11.89) % vs. (9.03 ±2.10) %, t = 7.168, P 0.05). Conclusion The levels of peripheral blood CD13+CD4+CD25hi Treg cells are higher in DLBCL patients, which has a close relationship between the expression of CD13+CD4+CD25hi Treg cells and clinical stage and prognosis.
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Objective To investigate the significance of plasma neopterin (Npt) and adenosine deaminase (ADA) in patients with secondary hemophagocytic lymphohistiocytosis (sHLH).Methods Serum specimens from 39 patients with newly diagnosed sHLH,10 sHLH patients who had achieved clinical remission after treatment,and 15 healthy controls were collected.Serum Npt level was detected by enzyme linked immunosorbent assay (ELISA) and ADA activity was tested by kinetic method.Results Npt and ADA values in sHLH group were significantly higher than those in control group [Npt:(164.6 ± 90.0) nmol/L vs (7.9 ± 3.6) nmol/L; ADA:(117.2 ± 70.2) U/L vs (11.6 ± 4.0) U/L; all P ＜ 0.001].Among the 10 sHLH patients who obtained effective clinical treatment,posttreatment levels of Npt and ADA were significantly lower than pretreatment data [Npt:(17.5 ± 10.9) nmol/L vs (170.6 ± 117.9) nmol/L ; ADA:(22.5 ± 15.5) U/L vs (98.8 ± 52.6) U/L; all P ＜ 0.05].The Npt level in sHLH patients was positively correlated with the levels of serum soluble interleukin-2 receptor (sCD25) and serum ferritin (r =0.526 and r =0.507) ; while ADA activity had linear relationship with the level of lactate dehydrogenase (r =0.646).Receiver operating characteristic (ROC) curve analysis showed that 148.1 nmol/L was the critical value of serum Npt for the diagnosis of lymphoma associated hemophagocytic syndrome (LAHS) and the sensitivity and specificity were 70.0％ and 78.9％,respectively.As to ADA,103.1 U/L was the critical value for the diagnosis of LAHS and the sensitivity and specificity were 75.0％ and 84.2％,respectively.The sensitivity and specificity of combined parameters of Npt and ADA were 90.0％ and 94.7％,respectively.Conclusions It is concluded that Npt and ADA have great importance in the diagnosis and evaluation of therapeutic effect in patients with sHLH.Npt and ADA provide potential evidence to diagnose patients who are suspected with LAHS.
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<p><b>OBJECTIVE</b>To investigated the curative effect of autologous hematopoietic stem cell transplantation (ASCT) for malignant lymphoma.</p><p><b>METHODS</b>The clinical data of 81 patients with malignant lymphoma received ASCT from April 1999 to October 2013 were retrospectively analyzed. Of 81 patients, 70 were non-Hodgkin's lymphoma (NHL) and 11 Hodgkin's lymphoma (HL). High dose of etoposide combined with G-CSF was used to mobilize peripheral hematopoietic stem cell. Preconditioning regimen was BEAM (carmustine + cytarabine + etoposide + melphalan).</p><p><b>RESULTS</b>Enough peripheral blood stem cells were collected from all patients. All of the patients after transplantation achieved hematopoietic reconstitution, the median time of the absolute neutrophil count (ANC) recovery to >0.5×10⁹/L time was 10(7-16) d, and the median time of platelet count recovery to >20×10⁹/L was 10(6-17) d. With the follow-up of 23(2-139) months, progression free survival (PFS) was 72.7%, and overall survival (OS) was 88.6%. The median PFS and OS were not reached. Complete remission (CR) before ASCT was an independent prognostic factor of PFS. No transplant related death happened.</p><p><b>CONCLUSION</b>ASCT was a safe and effective method for treatment of malignant lymphoma.</p>
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Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Hematopoietic Stem Cell Transplantation , Lymphoma , Therapeutics , Retrospective Studies , Transplantation, AutologousABSTRACT
Objective To study the correlation between histology and serological index changes in the patients with HBeAg-neg-ative chronic hepatitis B(CHB).Methods 135 cases of HBeAg-negative CHB underwent the liver biopsy,HBV-DNA copy and de-tection of serum alanine aminotransferase(ALT),total bilirubin(TBiL),aspartate aminotransferase(AST),albumin(ALB),pro-thrombin activity(PTA),hyaluronic acid(HA)and laminin(LN).The relationship between the histopathological findings and the se-rological examination results were analyzed.Results There were statistically significant differences between serum HBV-DNA copy levels and the liver tissue inflammation grades(χ2 =23.64,P <0.05);serum ALT,TBiL,AST,ALB,PTA and HA concentrations in the high grade of inflammation were higher than those in the low grade of inflammation,the difference was statistically significant (P <0.05);in which the concentrations of serum ALT,TBiL,AST and HA were positively correlated with the inflammation grades (P <0.05);while ALB and PTA and HA were negatively correlated with the inflammation grades(P <0.05).Conclusion The ser-um level of HBV-DNA copy,TbiL,ALT,AST,ALB and PTA concentrations are related with the inflammatory grade of liver tissue in the patients with HBeAg negative CHB,the serum HA level is related with the fibrosis level of liver tissue.These indicators could provide the reference value for judging the disease condition and prognosis of HBeAg negative CHB patients.
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Objective To investigate the expression levels of phospholipase C(PLC)-γ1 and PLC-γ2 in the peripheral blood mononuclear cells (PBMCs) of patients with systemic lupus erythematosus (SLE),and explore the relations between these genes expression levels and disease activity of SLE.Methods Reverse transcription polymerase chain reaction (RT-PCR) method was used to detect the expression levels of PLC-γ1 and PLC-γ2 in 30 patients with SLE and 25 controls.The associations between the expression levels of PLC- γ1 and PLC-γ2,complement C3,C4,antidouble stranded DNA antibody and SLEDAI scores in patients with SLE were analyzed by Pearson correlation analysis.Results ①The expression levels of PLC-γ1 and PLC-γ2 in the SLE patients were significantly higher than those of the normal controls (P＜0.01).) The expression levels of PLC-γ1 and PLC-γ2 showed positive correlations with each other (r=0.726,P＜0.01 ).③ The expression levels of PLC-γ2 were negatively correlated with serum complement C3,C4 (P＜0.05),but positively correlated with anti-double stranded DNA antibody,at the same time,they were not correlated with SLEDAI scores (P＞0.05).There was no correlation between complement C3,C4,anti-double stranded DNA antibody and the expression levels of PLC-γ1 (r=0.220,0.256,0.116,P＞0.05),but the expression levels of PLC-γ1 were positively correlated with SLEDAI scores.Conclusion We have shown that the expression levels of PLC-γ1 and PLC-γ2 is positively correlated and the PLC-γ1 and PLC-γ2 in patients with SLE are significantly higher than those of the normal controls.PLC-γ2 is negatively associated with complement C3,C4,PLC-γ1 is positively correlated with SLEDAI scores.Both PLC-γ1 and PLC-γ2 are be helpful in evaluating SLE disease activity and severity.
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Objective To explore predictive effects of organism weak magnetic field analytic technology on heart diseases among adults with hypertension,hyperglycemia and hyperlipidemia.Method A total of 1534 individuals who received health examinations and organism weak magnetic field tests in Health Science Center of Chinese PLA General Hospital from May to June 2009 were enrolled.Statistical analysis were carried out to detect if the heart function index of organism weak magnetic field tests could identify different conditon for the incident dysfunction of heart in low-,potential-,high-risk groups classified by the three high agent using the nonparametric test.High-dangerous three-high groups include simple,compound,additional and assembling sorts of combining types.Results The quantitative values of heart meridian of one potential-risk and nine high-risk three-high groups differs evidently from the low-risk high-risk three-high groups by Moses test(P ＜ 0.05).There was statistically significant difference of the quantitative values of heart meridian,potassium,magnesium,manganese,cardiovascular,circulaton,heart endocrine,and T2 among the low-,potential-and high-risk levels and other different types of three-high groups by Wilcoxon rank sum test(P ＜ 0.05).Conclusion Organism weak magnetic field analytic technology could reveal change of heart dysfunction in individuals with normal electrocardiogram.
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An 81-year-old male presented with an 8-year history of recurrent ulcer on the left dorsal foot which gradually spread to involve both lower limbs. Physical examination revealed no abnormality of any organ systems and no palpable superficial lymph nodes. Skin examination showed erythematous swelling of the left dorsal foot with an ulcer sized 7 cm × 10 cm on the surface. Tendon was visible at the base of the ulcer, and the ulcer margin was elevated giving a dyke-like appearance. The perilesional skin was purple-brown. There were several millet-like papuloid lesions circularly arranged at the inner side of the right foot as well as dark erythematous or brown nodules and pigmented patches with tenderness on both lower limbs. Histopathology of the ulcer of the left dorsal foot and papuloid lesions on the right foot revealed a visible epidermotropic infiltrate in the epidermis as well as an infiltration throughout the entire dermis with medium-sized atypical lymphoid cells with obvious mitoses. Immunohistochemical examination showed the coexpression of both T cell markers (including CD3, CD45RO, CD43) and B cell marker (CD20), with scatted positive staining for PAX-5and negative staining for CD79α or CD1 9. PCR confirmed the rearrangement of T cell receptor (TCR)-γgene. A diagnosis of peripheral T cell lymphoma unspecified was made in view of the rearrangement of TCR-γgene and above findings. The patient was treated with the following modified CHOP regimen: intravenous cyclophosphamide 0.8 g, leurocristine 2 mg and epirubicin hydrochloride 60 mg, as well as oral prednisone 15 mg twice daily for 5 days every 3 weeks (one treatment session). After 3 treatment sessions, the lesions improved markedly.
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Objective To explore the predicting role of organism weak magnetic field analytic technology on heart functions in individuals with normal electrocardiogram(ECG).MethodsA total of 1534 subjects who receired health examinations and organism weak magnetic field tests in Health Science Center of Chinese PLA General Hospital from May to June 2009 were enrolled.Positive rates of organism weak magnetic field analytic technology,echocardiography,and myocardium enzyme test for heart dysfunction among populations with hypertension,hyperglycemia and hyperlipidemia were compared.Statistical analysis was carried out to detect if there was close correlation between different heart risk and the weak magnetic field index.Results(1)The positive rate of the organism weak magnetic field analytic technology for heart dysfunction among subjects with normal ECG was 96.0%(1472/1534),which was significantly higher than echocardiography(27.5%,200/726)and myocardium enzyme testing(6.9%,106/1532).The positive rate of organism weak magnetic field analytic technology was increased with the seriousness of hypertension ,hypergjycemia and hyperlipidemia(P＜0.05＝.(2)Different heart risks showed close correlation with heart meridian and potassium(P＜0.05＝.Conclusion The prediction of organism weak magnetic field analytic technology on potential heart dysfunction(as a result fromhypertension,hylperglycemia and hyporlipidemia)in individuals with normal ECG is highly sensitive andrelatively objective.
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Objective To explore the CD38 expression in T-cens(CD38-T)of chronic lymphocytic leukemia(CLL).Methods Multi-parameter flow cytometry was used to detect the expression of CD38,ZAP-70 and CD4/CD8 in 83 CLL patients.Results CD38 was positively expressed in 49.4%(41/83)T-cells(CD38-T)and 50.6%(42/83)tumor cells(CD38-B)of all CLL patients.The expression of the CD38-T was highly correlated with CD38-B(r=0.553,P＜0.01).ZAP-70+CD38+-T and ZAP-70-CD38-T constituted 67.5%(56/83)of CLL patients.There was significant correlation between CD38-T and ZAP-70 (r=0.349,P＜0.01).There was 33.3%(14/42)patients with CD38-T in Binet A patients,and 65.9% (27/41)in Binet B+C patients.There was also significant correlation between CD38-T and Binet B+C(r=0.312,P＜0.05),and CD4/CD8(r=0.453,P＜0.05).Conclusions Aberrant expression of CD38 in T-cells might be of prognostic relevance in CLL Most of the patients with high level CD38-T expression are accompanied with disorder or imbalance of immune function.CD38 expression in T cells might be a new prognostic factor in CLL.
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Objective To investigate the diagnosis and treatment of Waldenstrom's macrogiobulinemia(WM).Methods The clinical information of 15 patients with WM were analyzed retrospectively.Results 3 cases had achieved complete response(CR).9 cases had achieved partial response(PR).7 cases remained alive,one of them lived beyond 79 months.Conclusion The traditional diagnosis of WM is not enough,and immunophenotype described for WM diagnosis is more important.WM is an incurable disease.Treatment with plasmapheresis and chemotherapy appears highly effective and safe for WM.
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DNA computer is a new research field which combines bot h the computer science and molecular biology. DNA computer is proposed to solve a class of hard problems of mathematical complexity by using a set of DNA sequen ces encoding all candidate solutions to the computational problem of interest an d find out the correct answers by serial manipulations of biochemical reactions. DNA computer is exactly a biomolecular computer which stores a vast quantity of information with high density. DNA computer, by means of its huge parallel comp utation and brute force search strategy, can solve the NP complete problems with polynomial time. The recent advances and principle of DNA computer are introduc ed. The future development and the bioinformatical significance of DNA computer are also analyzed and discussed.