Comparison of the efficacy of femoral stable interlocking intramedullary nail and proximal femoral nail anti-rotation in the treatment of anterograde intertrochanteric fractures / 中华骨科杂志

Objective:To evaluate the effect of femoral stable interlocking intramedullary nail (FSIIN) and proximal femoral nail anti-rotation (PFNA) in the treatment of anterograde intertrochanteric fractures.Methods:From June 2015 to December 2020, 68 cases with surgically treated of femoral intertrochanteric fractures were included. Among them, there were 37 cases (17 males and 20 females) in proximal femoral nail antirotation (PFNA) group, and the age ranged from 48 to 78 years (62.9±7.1 years); 18 cases were on the left and 19 cases on the right; AO/OTA classification: 16 cases of A1 type and 21 cases of A2 type. And there were 31 cases (18 males and 13 females) in FSIIN group without distal locking, the age ranged from 47 to 84 years (62.4±8.6 years); 15 cases were on the left and 16 cases on the right; AO/OTA classification: 11 cases of A1 type and 20 cases of A2 type. Fracture fixation time, incision length and number, intraoperative blood loss, fracture healing time, visual analogue scale (VAS) and Harris scores at the last follow-up were compared between the two fixation methods.Results:Both groups were followed up, and the follow-up time was 15.3±3.9 months in the FSIIN group and 15.7±3.9 months in the PFNA group, and the difference was not statistically significant ( t=0.42, P=0.675). In FSIIN group, the fracture fixation time was 26.6±11.5 min, the total incision length was 7.6±1.8 cm, the intraoperative blood loss was 107.6±42.8 ml and the fracture healing time was 10.1±1.3 weeks. In PFNA group, the fracture fixation time was 40.3±10.8 min, the total incision length was 12.2±1.8 cm, the intraoperative blood loss was 209.4±52.0 ml and the fracture healing time was 16.3±1.6 weeks. In FSIIN group, the fracture fixation time ( t=3.46, P<0.001), total incision length ( t=2.39, P=0.020), intraoperative blood loss ( t=3.16, P<0.001), fracture healing time ( t=2.80, P<0.001) were all less than those in PFNA group, and the difference was statistically significant. The VAS score of FSIIN group was 1.4±0.5 points, and that of PFNA group was 1.6±0.6 points, and the difference was not statistically significant ( t=0.68, P=0.503). The Harris score was 84.5±2.2 in FSIIN group and 83.3±2.5 in PFNA group, and the difference was not statistically significant ( t=0.63, P=0.530). At the last follow-up, 29 patients in the FSIIN group were very satisfied with the operation, and 2 patients were satisfied with the operation, with a satisfaction rate of 100%. In PFNA group, 30 patients were very satisfied with the operation, 7 patients were satisfied with the operation, and the satisfaction rate was 100%. Conclusion:Compared with PFNA, micro-invasive and micro-stress shielding methodes of FSIIN in the fixation of anterograde intertrochanteric fractures is more minimally invasive, simple, time-saving, less bleeding, less risk, less pain, minimal stress shilding and enhanced recovery after surgery. The effect of treatment is similar in FSIIN and PFNA group.

Exhaustion of CD8 / 中国实验血液学杂志

OBJECTIVE@#To investigate the changes in function of CD8@*METHODS@#Flow cytometry was used to detect the expressions of PD-1, TIM-3, and LAG-3, which were the markers of exhausted CD8@*RESULTS@#The expressions of inhibitory receptors (PD-1, TIM3 and LAG-3) on CD8@*CONCLUSION@#The exhausted CD8

Establishment of Secondary HLH Mouse Model and Effect of Ruxolitinib on Disease Manifestations of Model Mide / 中国实验血液学杂志

OBJECTIVE@#To establish a secondary hemophagocytic lymphohistiocytosis(HLH) mouse model, and to investigate the effect of ruxolitinib on the disease manifestation of model mice.@*METHODS@#Wild type C57BL/6 mice were randomly divided into 4 groups: two groups of mice were intraperitoneally injected with CpG oligodeoxynucleotide 1826 (CpG-ODN1826) every other day to induce HLH, and other two groups were control groups. One group of the CpG-ODN1826 groups and one of the control groups were given ruxolitinib, and other two groups were given the same amount of PBS. Blood samples, serum ferritin and hepatic/spleen weights of experimental mice were detected and serum cytokine levels were measured by ELISA.@*RESULTS@#Compared with the control groups, the levels of white blood cells, hemoglobin and platelets in the CpG-ODN1826 groups were significantly lower (P＜0.05); and liver/body weight, spleen/body weight, serum ferritin, sCD25, IL-10, IL-1β, IFN-Ƴ, IL-12p70, GM-CSF, TNF-α and IL-18 levels significantly increased (P＜0.05). There was no significant difference in the levels of IL-2, IL-4, IL-5, IL-6, IL-22, IL-13, IL-27 and IL-23 between the two groups (P＞0.05). The spleen in CpG group had disordered internal structure, expanding red pulp and hyperplastic nucleated cells. The liver had severe perivascular inflammations. The spleen/weight of the ruxolitinib-treated mice in the CpG-ODN1826 group was significantly smaller than that of the unapplied ruxolitinib (P＜0.05).@*CONCLUSION@#The CpG-ODN1826 can induce secondary HLH symptoms in wild type C57BL/6 mice. Ruxolitinib can alleviate the symptoms of splenomegaly in HLH model mice.

The importance of appling laboratory tests in diagnosing hemophagocytic lymphohistocytosis / 中华检验医学杂志

It is a challenge in diagnosis of hemophagocytic lymphohistocytosis (HLH).Rapid diagnosis is the key to make decisions in clinical management of HLH.The timely and reliable diagnosis of HLH can be assisted by laboratory tests including nature killer (NK) cell activity, sCD25, hemophagocytosis, ferritin, surface CD107a, and genetic testing.Here is introduced lab assays and evaluate the clinical applications in HLH.The aim is to raise awareness of the values of laboratory evaluations in diagnosing HLH.

Treatment outcomes and prognostic analysis of 61 Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis / 中华血液学杂志

<p><b>OBJECTIVE</b>To investigate the outcomes, survival status, and the prognostic factors of Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) patients.</p><p><b>METHODS</b>A retrospective study was carried out to analyze the clinical data of 61 EBV-HLH cases, from January 2008 to July 2014. Prognostic factors were analyzed through COX model (single factor and multiple factors).</p><p><b>RESULTS</b>A total of 246 patients with HLH were diagnosed, among which 102 cases were with EBV infection (including 61 EBV-HLH, 36 lymphoma associated HLH, 5 primary HLH. Among the 61 cases, 40 were male and 21 were female, with a ration of 1.9:1. The median age was 28 years (range, 12-78). 1, 3, 6 and 12-month overall survival rates of 61 EBV-HLH were 65.6%, 47.5%, 32.4%, and 25.0%, respectively. The median follow-up time was 3 (0.5-28) months. 12 patients didn't use etoposide within 4 weeks after diagnosis, while HLH-94 protocol was used in 33 patients and HLH-2004 protocol was used in 16 patients. Response rates of theses three groups were 33.3%, 51.5%, and 43.8%, respectively (P=0.401). There was statistically difference between the group without etoposide and the HLH-94/ HLH-2004 group in the overall survival rate (P=0.033). Serum albumin level (P=0.033) and whether EBV could became negative (P=0.010) were independent predictors for EBV-HLH.</p><p><b>CONCLUSION</b>EBV-HLH patients have severe clinical feature and poor prognosis. Early application of immune chemotherapy based on etoposide can improve survival. Serum albumin level and whether EBV can become negative are independent prognostic factors for survival.</p>

Performance of computer-assisted imaging system in detection of squamous intraepithelial lesion of uterine cervix / 中华病理学杂志

<p><b>OBJECTIVE</b>To evaluate the performance of computer-assisted imaging system in the detection of cervical squamous intraepithelial lesion and quality-assurance.</p><p><b>METHODS</b>Manual PAP screening (n = 140 580) and image-assisted screening (n = 32 885) were compared for the detection rates of squamous cell abnormalities, the atypical squamous cells (ASC) to squamous intraepithelial lesion (SIL) ratio, the positive rates of high risk human papillomavirus (HR-HPV) test in the case of atypical squamous cells of undetermined significance (ASC-US), and the correlation between cytopathology and histopathology.</p><p><b>RESULTS</b>Compared with manual screening, computer-assisted imaging system showed increased overall positive detection by 0.32%, decreased detection of ASC by 0.21%, increased detection of low-grade squamous intraepithelial lesion (LSIL) by 0.22%, increased detection of high-grade squamous intraepithelial lesion or worse (HSIL) by 0.31%, and decreased ASC to SIL ratio from 2.59 to 1.60. Computer-assisted imaging system did not change the HR-HPV positive rate of the patients who were ASC-US, or the coincidence rate between cytopathology and histopathology. Moreover, the productivity of the laboratory operation increased 58.33%.</p><p><b>CONCLUSION</b>Computer-assisted imaging system significantly increases the overall positive detection rate of cervical SIL, improves accuracy and work efficiency of screening, decreases the ASC/SIL rate, and strengths the quality-assurance of laboratory testing.</p>