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Objective:To compare the effect of F7.5 ureteroscope and other types of ureteroscope (F8.5, F9.0, F9.2, F9.6) in the control of intrapelvic pressure during operation.Methods:F7.5 super thin flexible ureteroscope and other 4 kinds of disposable flexible ureteroscopes (F8.5, F9.0, F9.2, F9.6) were combined with 3 kinds of ureteral guidance sheaths to form 15 endoscope-sheath combinations. The real outer diameter of each flexible ureteroscope was measured and the effective ratio of endoscope-sheath diameter was calculated. The real outer diameter of each soft mirror was measured and the effective sheath ratio was calculated. The irrigation during lithotripsy was simulated in a 3D printed kidney model, the irrigation pressure of 50-500 cmH 2O was set, and the stable intrapelvic pressure and flow rate were measured. The line chart was drawn and the relationship between intrapelvic pressure and irrigation pressure was analyzed by linear regression. The intrapelvic pressure between different endoscope-sheath combinations and different endoscope groups were compared respectively. Results:The ratio of endoscope-sheath diameter for all combinations ranges from 0.62 to 0.92, with 0.75, 0.68 and 0.62 for the F7.5 flexible ureteroscopes and F10/12, F11/13 and F12/14 sheath combinations respectively. Intrapelvic pressure and flow rate showed an approximately linear relationship with irrigation pressure in all groups. The F7.5 flexible scope with the F10/12, F11/13 and F12/14 sheaths all provided intrapelvic pressures below 40 cmH 2O. The F12/14 sheath-F7.5 scope combination produced the lowest intrapelvic pressure of 1.47 cmH 2O at 50 cmH 2O irrigation pressure and the highest flow rate of 74.24 ml/min at 500 cmH 2O irrigation pressure. When combined with the F10/12 sheath, only the F7.5 flexible scope was able to maintain a safe intrapelvic pressure of only 25.90 cmH 2O throughout. Analysis of the variability of intrapelvic pressure using the combination of instruments as the grouping variable suggested a significant overall difference( P<0.05). Analysis of the variability between groups using the different flexible scope as the grouping variable showed that the F7.5 scope group had significantly lower intrapelvic pressure compared to the other four groups( P<0.05). Conclusions:The F7.5 super thin flexible scope has the best intrapelvic pressure control of the five flexible scopes due to the significantly reduced ratio of endoscope-sheath diameter for the instrument combination and the ability to fit a thinner guide sheath while maintaining safe pelvic pressure.
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Objective:To investigate the effects of hemophagocytic syndrome also known as hemophagocytic lymphohistiocytosis (HLH) on the clinical features and therapeutic efficacy of patients with Epstein-Barr virus-positive T-cell lymphoma (EBV-TCL).Methods:The clinical data of patients with EBV-TCL diagnosed by pathological examination in the First Affiliated Hospital of Guangzhou Medical University from November 2015 to August 2020 were retrospectively analyzed. According to whether they were accompanied with HLH at the time of onset, patients were divided into HLH group (10 cases) and non-HLH group (13 cases), and the clinical features and prognosis of the two groups were compared. The curative effects of different treatment methods and patients with different plasma EBV-DNA titers were compared.Results:Among 23 patients, 3 cases (13.0%) were in Ann Arbor stage Ⅰ-Ⅱ, 20 cases (87.0%) were in stage Ⅲ-Ⅳ; the International Prognostic Index (IPI) score was 1 point in 3 cases (13.0%), 2 points in 4 cases (17.4%), 3 points in 8 cases (34.8%), 4 points in 8 cases (34.8%). In the HLH group, there were 2 cases of aggressive NK-cell leukemia and 3 cases of childhood systemic EBV-TCL. There were no cases of above two pathological types in the non-HLH group. In the HLH group, the proportions of patients with fever, bone marrow invasion, IPI score > 2 points, and EBV-DNA > 10 4 copies/ml were higher than those in the non-HLH group (all P < 0.05). The objective response rate (complete remission plus partial remission) of all patients after chemotherapy was 47.8% (11/23); there were 3 cases undergoing hematopoietic stem cell transplantation in both the HLH group and the non-HLH group, and all achieved objective remission. The objective remission of 7 patients and 10 patients who did not undergo hematopoietic stem cell transplantation in the HLH group and non-HLH group after lymphoma chemotherapy had 0 case and 5 cases, respectively, and the difference was statistically significant ( P = 0.044). In the chemotherapy alone group, 5 of 17 patients had objective remission, 6 patients in the chemotherapy plus transplantation group had objective remission, and the difference was statistically significant ( P = 0.039). Among 16 patients whose plasma EBV-DNA titers turned negative, 11 patients had objective remission, and 7 patients whose plasma EBV-DNA titers were continuously positive had no objective remission, and the difference was statistically significant ( P = 0.001). The 1-year overall survival rate of all patients was 69.3%, and the 2-year overall survival rate was 52.0%. In the HLH group, the 1-year and 2-year overall survival rates of 7 patients receiving chemotherapy alone and 3 patients receiving chemotherapy plus transplantation were 42.9% and 66.7%, respectively. In the non-HLH group, the 1-year overall survival rates of 10 patients receiving chemotherapy alone and 3 patients receiving chemotherapy plus transplantation were 80.0% and 100.0%, respectively; the 2-year overall survival rates were 26.7% and 100.0%,respectively. The overall survival of patients receiving chemotherapy plus transplantation was better than that of those receiving chemotherapy alone in both the HLH group and the non-HLH group, and differences were statistically significant (all P < 0.05). Conclusions:The general clinical stage of patients with EBV-TCL is later, and the prognosis of EBV-TCL patients with HLH is worse. The therapeutic efficacy may be related to plasma EBV-DNA titers. Hematopoietic stem cell transplantation can improve the remission rate.
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Alterations of the lactoferrin gene are associated with an increased incidence of tumor,however,the exact mechanisms involved in the anti-tumor activity of lactoferrin are still unclear.Several studies suggest that lactoferrin can affect the initiation and development of tumors via different mechanisms such as damaging cell membranes,inducing apoptosis,blocking cell cycle,regulating cellular immune response and inhibiting angiogenesis in different cancer cell lines.Further study about the mechanism can provide new ideas for clinical prevention and treatment of tumors.
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Objective To investigate the expression of HOXB7 in colorectal cancer and its relationship with clinicopathological factors and prognosis.Methods Eighty-seven patients with colorectal cancer were retrospectively analyzed.The expression of HOXB7 mRNA and protein in colorectal cancer tissues was detected by RT-PCR and immunohistochemical methods.Their correlation with clinicopathological parameters and prognosis was analyzed.Results The relative expression level of HOXB7 mRNA in colorectal cancer tissue was(42.4 ± 16.3),which was significantly higher than(19.4 ± 7.6) in the paracancerous normal tissue(P＜0.05).The positive expression rate of HOXB7 protein in colorectal cancer tissues was 73.9％,which was obviously higher than 10.3 ％ in the paracancerous normal tissue (P＜ 0.05);expression of HOXB7 protein was significantly correlated with the TNM stage,lymph node metastasis and distant metastasis(P＜0.05),moreover the patients with HOXB7 positive expression had poorer prognosis.Conclusion HOXB7 protein expression is up-regulated in colorectal cancer tissue,and its high expression is correlated with the clinicopathological factors and prognosis in the patients with colorectal cancer.
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Objective:This study aims to examine the clinicopathological features, diagnosis, and treatment of pulmonary margin-al zone B-cell lymphoma of mucosa-associated lymphoid tissue (PMZL-MALT). Methods:The clinicopathological features and immu-nohistochemical staining of CD20, CD79a, CD5, CD10, CD23, CyclinD1, and Ki-67 in seven patients with PMZL-MALT were ana-lyzed. Results:These patients, with a median age of 58 years, included three males and four females. Most of the patients suffered from cough, anhelation, and irregular fever. No specific imaging manifestation was observed. Tumor cells were positive for CD19 and CD20 but negative for CD5, CD10, and CyclinD1. The positive rate of Ki-67 was low. Conclusion:PMZL-MALT cases are easily misdiag-nosed because of the absence of specific clinical characteristics and X-ray features. Final diagnosis depends on pathological examina-tions.
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Objective To investigate the distribution of TCR Vβ genealogy and clonal expansion in peripheral blood after infusing mesenchymal stem cells (MSC) in patients with chronic GVHD. Methods The complementarity determining region 3 (CDR3) of 24 TCR Vβ subfamily genes in peripheral blood mononuclear cell from 1 case with cGVHD after allogeneic hematopoietic stem cell transplantation (Allo-HSCT),who were treated with infusing MSC,were amplified using RT-PCR. The blood samples were taken at the first and the fifth day after 1st infusion; and the first day,the 10 th day and the 20 th day after the second infusion of MSC,as well as the MSC infused as control . The products were labelled by fluorescein and then analyzed the CDR3 size with gene scan technique to determine the clonality of T cells. Results There were no expression of TCR Vβ subfamily with the MSC infused and after the 1st day of the first infusion of MSC. Then 3,10,14,10 Vβ subfamilies clones are appeared at the other time points,of which were polyclone and oligoclone predominately. In the same time,the manifestations of cCVHD have been abated. Conclusion MSC played a certain role in reviving the immune function of the patients after Allo-HSCT and mitigating the disease of chronic GVHD. Lineage analysis of TCR Vβ subfamily showed some predominant expression.
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Objective To explore the value of brainstem auditory evoked potential(BAEP),visual evoked potential(VEP)and Revised Visual Retention Test(VRT)in detecting impairment of central nervous system in patients with acute leukemia(AL).Methods Neuropack-Ml type evoked potential machine(Japan)was used to check brainstem auditory evoked potential(BAEP)and visual evoked potential(VEP).BAEP,VEP and VRT were examined in 30 cases with acute leukemia(group AL)and in 30 age and sex matched healthy subjects as a control(groupC).Indexes of BAEP including peak latency(PL)of waves I ,IB ,V and inter-peak latency(IPL)of waves Ⅰ～Ⅲ,Ⅲ ～Ⅴ,Ⅰ～Ⅴand indexes of VEP(P100PL)were determined.VRT was accomplished meanwhile applying B method with C pattern,C method with D pattern,D method with E pattern.The correct scores and error scores were recorded separately.Results BAEP:the abnormal rate of the group AL was 23.3 %.Compared with control group,we found significant longer latency of wave Ⅲ、Ⅴ(P＜0.05)and significant elongation in the mean inter-peak latencies of Ⅰ～Ⅴ(P＜0.05).VEP:the abnormal rate of the group AL was 26.7% ,the P100 PL of the patients was longer than that in the control group(P＜0.05).VRT:the abnormal rate of the group AL was 33.3%.The results of VRT showed that the score in the group AL in D method with E pattern was lower than that in the control group(P＜0.05).Conclusion BEAP,VEP and VRT could detect the impairment of central nervous system in patients with acute leukemia sensitively,and give clues to early diagnosis of central nervous system leukemia(CNSL).