Clinical significance of co-mutation of BRAF V600E and TERT promoter in diagnosis and treatment of papillary thyroid carcinoma / 中华内分泌外科杂志

BRAF V600E mutation is a common gene mutation in papillary thyroid carcinoma (PTC) , which is associated with the occurrence, development, and prognosis of PTC. TERT promoter mutations are rare in PTC, but PTC with its mutations is more aggressive and has a worse prognosis. Clinically, a small number of PTC patients have both BRAF V600E mutation and TERT promoter mutations. This article provides a brief overview of the co-mutation of BRAF V600E and TERT promoter and the occurrence and development, clinical diagnosis, surgical strategies, postoperative adjuvant treatment, and prognosis of PTC.

The 1-year follow-up results of intraprocedural valve-in-valve deployment for treatment of aortic regurgitation following transcatheter aortic valve replacement (TAVR) in a single center / 中国胸心血管外科临床杂志

@#Objective    To evaluate the efficiency and safety of intraprocedural valve-in-valve deployment for treatment of aortic regurgitation following transcatheter aortic valve replacement (TAVR). Methods    Consecutive patients (n=333) who diagnosed with severe aortic stenosis and underwent TAVR in Zhongshan Hospital affiliated to Fudan University from October 3rd, 2010 to April 21st, 2021 were included. There were 208 males and 125 females aged 76.0±7.0 years. There were 316 patients underwent simple TAVR (simple TAVR group) and 17 patients underwent intraprocedural valve-in-valve deployment following TAVR (valve-in-valve group). Their clinical and echocardiographic outcomes were evaluated and compared. Results    There was no significant difference between the two groups of patients at postoperative 30 d and 1 year in all-cause mortality (4.4% vs. 0, P=1.000; 6.3% vs. 0, P=1.000), incidence of pacemaker implantation (10.4% vs. 17.6%, P=1.000; 11.8% vs. 17.6%, P=1.000), incidence of ischemic stroke (1.3% vs. 0, P=1.000; 1.3%  vs. 0, P=1.000), mean trans-aortic pressure gradient (11.4±6.4 mm Hg vs. 8.9±4.9 mm Hg, P=0.099; 10.5±7.6 mm Hg vs. 11.2±5.2 mm Hg, P=0.432), left ventricular ejection fraction (62.0%±9.0% vs. 57.0%±12.0%, P=0.189; 63.0%±7.0% vs. 60.0%±8.0%, P=0.170), and incidence of mitral valve dysfunction (0.6% vs. 5.9%, P=1.000; 0.6% vs. 5.9%, P=1.000). Conclusion    It is feasible to treat perivalvular leakage with valve-in-valve technology in the procedure of TAVR, and the short and medium-term effects are satisfied.

Clinical analysis of liposomal doxorubicin-based regimens for treatment of adult patients with T-cell lymphoma / 肿瘤研究与临床

Objective:To explore the therapeutic effects and adverse reactions of the liposomal doxorubicin-based regimens in the treatment of adult patients with T-cell lymphoma.Methods:The clinical data of patients with T-cell lymphoma who were diagnosed and treated in Beijing Shijitan Hospital of Capital Medical University from August 2012 to May 2016 was retrospectively analyzed. All patients received chemotherapy containing liposomal doxorubicin. The clinical manifestations, treatment results, and adverse reactions were observed.Results:A total of 16 patients were enrolled, with a median age of 50.5 years old (16-81 years old), of which 7 patients were newly treated and 9 patients were retreated (including 5 refractory patients). Eleven of the 16 patients were evaluated for efficacy, including 4 cases of complete remission (CR) and 4 cases of partial remission (PR), the overall response rate was 72.8% (8/11). With a median follow-up of 11 months, the 2-year progression-free survival rate and overall survival rate were 42.4% and 41.6%. All 5 primary skin T-cell lymphoma patients were refractory or relapsed with 1 case of CR and 4 cases of PR after treatment. The adverse reactions were acceptable.Conclusions:The remission rate of liposomal doxorubicin-based regimens for treatment of adult patients with T-cell lymphoma is promising, especially for newly-treated patients. Primary skin T-cell lymphoma patients might be more likely to benefit from liposomal doxorubicin-based regimens.

Effect of transcutaneous electrical acupoint stimulation on intestinal mucosal injury in patients undergoing laparoscopic radical resection of colorectal cancer / 中华麻醉学杂志

Objective To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on intestinal mucosal injury in patients undergoing laparoscopic radical resection of colorectal cancer.Methods Fifty-six American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients,aged 35-64 yr,with body mass index of 18-25 kg/m2,scheduled for elective laparoscopic radical resection of colorectal cancer,were selected and divided into 2 groups (n =28 each) using a random number table method:general anesthesia group (group G) and TEAS combined with general anesthesia group (group TG).In group TG,patients received continuous TEAS at bilateral Neiguan,Hegu,Zusanli,Shangjuxu and Xiajuxu acupoints from 30 min before anesthesia induction until the end of surgery,with a frequency 2/100HZ,disperse dense waves,intensity the maximum current that could be tolerated (3-8 mA).After induction of anesthesia,the patients were endotracheally intubated and mechanically ventilated,and combined intravenous-inhalational anesthesia was used to maintain anesthesia in both groups.Peripheral venous blood samples were collected when entering the operating room (T1),at the end of operation (T2),and at 24 and 72 h after operation (T3,4) for determination of intestinal fatty acid binding protein (I-FABP) and diamine oxidase (DAO) in palsma using enzyme-linked immunosorbent assay.Quality of Recovery-9 (QoR9) was used to assess the postoperative quality of recovery at 24 h before surgery (T0),T3 and T4.Results The concentrations of plasma I-FABP and DAO were significantly higher at T2 and T3 than at T1 in G and TG groups (P＜0.05).Compared with the baseline at T0,QoR-9 scores were significantly decreased at T3 and T4 in G and TG groups (P＜0.05).Compared with group G,the concentrations of plasma I-FABP at T2-T4 and DAO at T2 and T3 were significantly decreased,and QoR-9 scores were increased at T3 and T4 in group TG (P＜0.05).Conclusion TEAS can attenuate intestinal mucosal injury in patients undergoing laparoscopic radical resection of colorectal cancer.

Analysis of the factors affecting the formation of tophi / 中华风湿病学杂志

Objective To explore the factors what may influence the formation of tophi by high frequency ultrasound.Methods The gouty patients who were experiencing an acute attack and were clinically diagnosed with gouty arthritis were divided into two groups:the tophi group (44 cases) and the no tophi group (101 cases) group,clinical data and ultrasound features of joints were collected.The differences of ultrasound features and clinical characteristics between the two groups were analyzed.Results ① Ultrasound features showed that synovitis (x2=8.479,P=0.004) and effusion (x2=9.740,P=0.002) of the first metatarsophalangeal joint (MTP1) were most frequently observed in the no tophi group;bone erosion of MTP1 (x2=9.593,P=0.003),double contour (DC) sign (x2=14.069,P=0.000) and bone erosion (x2=5.870,P=0.020) of ankle joint,DC sign of knee joint (x2=8.224,P=0.006) were most frequently observed in the tophi group.Hyperechoic aggregates of MTP1 (x2=9.649,P=0.003) were most frequently observed in no tophi group.(②) Logistic regression analysis showed that MTP1 was the first attacked joint [OR=9.725,95％CI(2.765,34.209),P=0.000],the multiple joints involved [OR=1.908,95％CI (1.190,3.057),P=0.007] and bone erosion of MTP1 [OR=4.339,95％CI(1.300,14.490),P=0.017] were the main risks of the formation of tophi.Synovitis of MTP1 often presented in no tophi patients [OR=0.108,95％CI(0.026,0.441),P=0.002].Conclusion High frequency ultrasound combine with clinical data is of great value for evaluating the development and treatment of gout.

Qualitative and quantitative analysis of wrist joint in rheumatoid arthritis by contrast-enhanced ultrasound and its clinical value / 中华超声影像学杂志

Objective To evaluate the value of contrast-enhanced ultrasound (CEUS) in detection of synovial hyperplasia in wrist joint of patients with rheumatoid arthritis (RA) and to explore the correlation with disease activity . Methods Thirty-nine RA patients with their wrist involved were examined by CEUS . The imaging features of synovitis were observed and the analysis of time intensity curve ( TIC ) was performed by contrast dynamic software . Some quantitative parameters were obtained from these fitting curves including basic intensity ( a0 ) ,increased intensity ( a1 ) ,descending slope ( a2 ) ,ascending slope ( a3 ) , timetopeak(TTP),peakintensity(PI),actualpeakintensity(PI-a0),arrivaltime(AT),andareaunder the curve ( AUC) . And the correlation between these parameters with clinical activity index was analyzed . Results 35 .9％ (14/39) synovitis showed a centripetal enhancement pattern supplied by ring-like or arc-shaped arterials peripherally while 64 .1％ (25/39) showed diffusely entire enhancement . All the lesions were heterogeneous enhanced ,87 .2％ (34/39) of which exhibited hyperenhancement . The detection rate of perfusion defects was 41 .0％ (16/39) . The disease activity in the diffuse enhancement group was higher than that in the centripetal enhancement group ( 4 .64 ± 1 .09 vs 3 .69 ± 0 .67 , P = 0 .005 ) . CEUS quantitative parameters a3 and ( PI-a0 ) were positively correlated with erythrocyte sedimentation rate ( ESR) ( r =0 .465 , P =0 .006 ;r =0 .325 , P =0 .043) ,however TTP had a negative relationship ( r = -0 .352 , P =0 .041) . Conclusions Active synovitis usually represents as a diffuse enhancement pattern . A higher a3 and PI ,and a shorter TTP indicate a higher disease activity . CEUS plays a great role in monitoring RA disease activity both from qualitative and quantitative aspect .

Effect of isoflurane preconditioning on expression of hippocampal GluR1 subunits-containing AMPA receptors in a rat model of focal cerebral ischemia-reperfusion / 中华麻醉学杂志

Objective To evaluate the effect of isoflurane preconditioning on the expression of hippocampal GluR1 subunits-containing α-amino-3-hydroxy-5-methyl-4-isoxazolepropionate(AMPA)receptors in a rat model of focal cerebral ischemia-reperfusion(I/R).Methods Forty-eight pathogen-free healthy male Sprague-Dawley rats,weighing 250-280 g,aged 7-8 weeks,were divided into 3 groups(n=16 each)using a random number table:sham operation group(group S),focal cerebral I/R group(group I/R)and isoflurane preconditioning group(group IPC).Focal cerebral I/R was induced by occlusion of the middle cerebral artery for 2 h followed by reperfusion to induce cognitive decline in I/R and IPC groups. Rats were exposed to 1.5% isoflurane for 1 h every day for 5 consecutive days,and the model was established at 24 h after the last exposure in group IPC. Eight rats in each group were selected to perform Morris water maze test for 6 consecutive days starting from 9 or 23 days after operation. The rats were sacrificed at 14 and 28 days after operation,and the hippocampal tissues were obtained for determination of the expression of GluR1 mRNA(by using real-time polymerase chain reaction)and GluR1 protein(by Western blot).Results Compared with group S,the escape latency was significantly prolonged at each time point after operation,the frequency of crossing the original platform quadrant and percentage of swimming distance at the original platform quadrant were decreased at 14 and 28 days after operation,and the expression of GluR1 protein and mRNA was down-regulated at 14 days after operation in I/R and IPC groups(P<0.05).Compared with group I/R,the escape latency was significantly shortened at 10-13 days after operation,the percentage of swimming distance at the original platform quadrant and frequency of crossing the original platform quadrant were increased at 14 days after the operation,and the expression of GluR1 protein and mRNA was up-regulated at 14 days after operation in group IPC(P<0.05).Conclusion The mechanism by which isoflurane preconditioninig improves the cognitive function is related to up-regulation of the expression of hippocampal GluR1 subunits-containing AMPA receptors in a rat model of focal cerebral I/R.

Curative effect of urinary kallidinogenase combined with ozagrel sodium on acute cerebral infarction / 军事医学

Objective To evaluate the clinical efficacy of urinary kallidinogenase combined with sodium ozagrel on acute cerebral infarction.Methods Totally 170 cases of acute cerebral infarction were randomly and equally divided into control group and treatment group.The control group was treated with ozagrel sodium while the treatment group was given urinary kallidinogenase combined with ozagrel sodium.The clinical efficacy, HINSS score, infarct volume, blood rheology and adverse reactions of the two groups were observed.Results There was no significant difference in such general data as gender, age, site of disease and complications between the two groups (P>0.05).The efficacy of the treatment group was significantly better than that of the control group (Z=-2.28, P=0.02).The NIHSS score before and after treatment was (23.38±3.24) vs (12.22±7.17) respectively in the control group,and (23.18±2.96) vs (9.16±6.95) in the treatment group.The effect in the treatment group was better than in the control group (t=2.83,P<0.05).The infarct volume before and after treatment was (5.99±0.60) vs (5.00±0.34)respectively in control group, and(5.99+0.62) vs (4.00±0.21)in the treatment group.The effect in the treatment group was better than in the control group (t=23.11,P<0.05).Blood rheology indexes, fibrinogen, plasma viscosity, whole blood low shear viscosity and whole blood viscosity improvement in the treatment group were better than those in the control group (t=14.67,7.35,19.70和5.33,P<0.05).The two groups were not significantly different in the incidence of adverse reactions.Conclusion Yuri Klein combined with ozagrel sodium can effectively treat acute cerebral infarction by repairing the damaged neurons and improving the prognosis of patients,without obvious adverse reactions.It is worthy of clinical promotion.

Effect of isoflurane preconditioning on autophagy during focal cerebral ischemia-reperfusion injury in rats / 中华麻醉学杂志

Objective To evaluate the effect of isoflurane preconditioning on autophagy during focal cerebral ischemia-reperfusion (I/R) injury in rats.Methods Thirty-six healthy male Sprague-Dawley rats,weighing 250-280 g,aged 7-8 weeks,were divided into 3 groups (n =12 each) using a random number table:sham operation group (group S),cerebral I/R group (group I/R) and isoflurane preconditioning group (group IP).Focal cerebral I/R was induced by 2 h middle cerebral artery occlusion followed by 24 reperfusion.Group IP inhaled 1.5％ isoflurane for 1 h per day for 5 consecutive days,the other two groups only inhaled 30％ oxygen,and focal cerebral I/R was induced at 24 h after the last inhalation.At 24 h of reperfusion,neurologic deficit was assessed and scored,the rats were then sacrificed,and brains were removed for determination of cerebral infarct size (using triphenyl tetrazolium chloride staining) and expression of microtubule-associated protein 1 light chain 3-Ⅱ (LC3-Ⅱ) and Beclin-1 (by Western blot).Results Compared with group S,the neurologic deficit scores and cerebral infarct size were significantly increased,and the expression of hippocampal LC3-Ⅱ and Beclin-1 was significantly up-regulated in I/R and IP groups (P＜0.05).Compared with group I/R,the neurologic deficit scores and cerebral infarct size were significantly decreased,and the expression of hippocampal LC3-Ⅱ and Beclin-1 was significantly upregulated in group IP (P ＜ 0.05).Conclusion The mechanism by which isoflurane preconditioning ameliorates focal cerebral I/R injury is related to enhancement of autophagy in the rats.

Effect of ORM1 genetic polymorphism on time-course of muscle relaxation induced by rocuronium / 中华麻醉学杂志

Objective To evaluate the effect of ORM1 genetic polymorphism on the time-course of muscle relaxation induced by rocuronium.Methods Seventy American Society of Anesthesiologists physical status [or Ⅱ patients,aged 25-55 yr,scheduled for elective gynecological laparoscopic surgery,with body mass index of 20-25 kg/m2,were enrolled in this study.Anesthesia was induced with iv midazolam and fentanyl and target-controlled infusion of propofol.After the patients lost consciousness,neuromuscular block was assessed with TOF Watch-SX using single stimulation of the ulnar nerve.When the maximal twitch depression was achieved,tracheal intubation was facilitated with rocuronium 0.6 mg/kg.The patients were mechanically ventilated.End-tidal carbon dioxide partial pressure was maintained at 35-45 mmHg.The onset time,nonresponse time,clinical duration,75％ recovery time and recovery index of rocuronium were recorded.Peripheral venous blood samples were collected before surgery for determination of concentrations of plasma alpha1 acid glycoprotein,C-reactive protein (by enzyme-linked immunosorbent assay)and albumin (by biochemical method).ORM1 genotypes were detected by polymerase chain reaction-restriction fragment length polymorphism.The patients were divided into 3 groups according to the ORM1 genotypes:wild homozygote (ORM1*F1/*F1) group (AA group),mutation heterozygote (ORM1'F1/*S)group (AG group) and mutation homozygote (ORM1*S/*S) group (GG group).Results There were 40 cases in group AA,25 cases in group AG,and 5 cases in group GG.There were no significant differences in plasma alphal acid glycoprotein,albumin and C-reactive protein concentrations between the three groups (P＞0.05).Compared with group AA,the clinical duration,75％ recovery time and recovery index of rocuronium were significantly prolonged (P＜0.05),and no significant change was found in the onset time and nonresponse time in AG and GG groups (P＞0.05).Conclusion ORM1 genetic polymorphism is one of the genetic factors which affect the time-course of muscle relaxation induced by rocuronium.

Angiotensin II type 1 receptor is required for the cardiac fibrosis triggered by mechanical stress independent of Ang II in mice / 中国病理生理杂志

AIM:We investigated how AT 1-R stimulated by mechanical stresses induces cardiac fibrosis .METHODS:We produced in vivo cardiac pressure overload model in angiotensinogen knockout ( ATG-/-) mice and in vitro mechanically-stretched cell model in cultured neonatal cardiac cells of ATG-/-mice both lack the participation of Ang II .RESULTS: Pressure overload for 4 weeks in ATG-/-mice induced myocardial hypertrophy accompanied by the significant interstitial fibrosis , however , the TGF-β, a key regulatory factor of fibrosis, was not significantly increased in these ATG-/-mice.Meanwhile, the inhibitor for AT1-R significantly inhibited mechani-cal stress-induced cardiac fibrosis in these ATG-/-models whereas inhibition of TGF-βdid not.CONCLUSION:The results showed that mechanical stress-induced fibrotic responses through AT 1-R required the phosphorylation of Smad 2 but not the involvement of TGF-β.

Isoflurane preconditioning improves learning and memory functions in focal cerebral ischemia-reperfusion injury in rats by upregulating hippocampal AMPA receptor GluR1 subunit / 国际脑血管病杂志

Objective To investigate the effect of isoflurane preconditioning on rat learning and memory in cerebral ischemia-reperfusion injury and its possible mechanism.Methods Thirty-six adult male Sprague-Daw ley rats w ere randomly divided into a sham operation group, a cerebral ischemia-reperfusion group, and an isoflurane preconditioning group (n=12 in each group). A model of middle cerebral artery occlusion and ischemic-reperfusion w as induced by a modified intraluminal suture method. The rats of the isoflurane preconditioning group inhaled 1.5%isoflurane for 1 hour per day for 5 d. At 24 h after the last preconditioning, a model of MCAO w as made. At 24 h after MCAO, the infarct volume w as detected by using 2,3,5 chlorinated diphenyl tetrazolium staining. At day 1, 3, 7, and 14 after MCAO, the modified Neurological Severity Score (mNSS) were performed. At day 9 after MCAO, the Morris w ater maze test w as used to evaluate the learning and memory of rats. At day 14, Western blotting w as used to detect the protein expression level of hippocampal tissue glutamate receptor 1 (GluR1) on the side of ischemia. Results No obvious infarcts w ere observed in the rats of the sham operation group. The infarct volume in the isoflurane preconditioning group w as significantly smal er than that of the cerebral ischemia-reperfusion group (26.383%±3.128%vs.19.107%±1.661%;P<0.05). No neurological deficit w as observed in the sham operation group (score 0). The mNSS scores at day 1, 3, 7, and 14 after MCAO in the isoflurane preconditioning group w ere decreased significantly (day 1:9.000 ±1.195 vs.11.500 ±1.414;day 3:6.6250 ±1.407 vs.6.625 ±1.407vs.6.625 ±1.407; day 7: 5.875 ±0.707 vs.7.375 ±1.407; and day 14:3.375 ±1.187 vs.5.125 ±1.246;al P<0.05). The Morris w ater maze show ed that the escape latencies at day 1-5 after MCAO in the isoflurane preconditioning group w ere al significantly shorter than those in the cerebral ischemia-reperfusion group (day 1: 95.992 ±15.734 s vs.103.008 ±11.654 s; day 2: 70.949 ±14.708 s vs. 94.705 ±14.709 s;day 3:39.660 ±7.413 s vs.65.716 ±10.155 s;day 4:22.692 ±5.778 s vs.35.240 ±8.553 s;day 5: 14.906 ±4.336 s vs.22.890 ±10.381 s; al P<0.05). The numbers of crossing platform (4.556 ± 1.333 vs.2.889 ±1.536 ) and the percentages of time spent in the target quadrant ( 33.014%±5.223%vs. 21.978%±6.697%) in the isoflurane preconditioning group w ere significantly increased than in the cerebral ischemia-reperfusion group (al P<0.01). The levels of hippocampal GluR1 protein on the ischemic sides in the sham operation group, ischemia-reperfusion group, and isoflurane preconditioning group w ere 0.871 ±0.153, 0.456 ±0.130, and 0.689 ±0.126, respectively. There w ere significant differences among the 3 groups ( F=18.329, P<0.001) and the isoflurane preconditioning group w as significantly higher than the ischemia-reperfusion group (P<0.05). Conclusions Isoflurane preconditioning can improve the learning and memory in cerebral ischemia-reperfusion in rats, its mechanism may be associated w ith the uprelagating GluR1 expression in the hippocampus.

Molecular cloning, in vitro expression and bioactivity of TRAIL (TNFSF10) gene from finless porpoises / 生物工程学报

To construct soluble TNF related apoptosis inducing ligand (TRAIL) expression system and investigate the effect of the expression product on tumor cell. It may provide valuable information for research into the immune system of the finless porpoise. The full-length cDNA of TRAIL (designated fTRAIL) was cloned from the total RNA of the finless porpoises blood using RT-PCR techniques and then the extracellular soluble fragments of fTRAIL (designated fsTRAIL) was ligated into pET43.1a. Recombinant soluble fTRAIL (pET43.1a-fsTRAIL) fused with Nus-his tag was efficiently expressed in Escherichia coli BL21 (DE3) and the Nus-His-fsTRAIL protein was purified. The expression of Nus-His-fsTRAIL was verified by Western blotting. In vitro, the effects of the purified Nus-His-fsTRAIL protein on Jurkat and HeLa cells were etected by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrasodium bromide (MTT) assay, TrypanBlue and Flow Cytometry analysis. The expression system pET43.1a-fsTRAIL was constructed and Nus-His-fsTRAIL protein was expressed successfully. In vitro, the Nus-His-fsTRAIL protein was able to inhibit the proliferation and induce apoptosis of Jurkat and HeLa cells in a dose-dependent manner. The Nus-His-fsTRAIL protein has anti-tumor activity against Jurkat and HeLa cells in vitro.

Teniposide-based regimen for 16 patients with primary central nervous system lymphoma / 肿瘤研究与临床

Objective To investigate the therapeutic effect and adverse effects of the teniposide-based regimen in patients with primary central nervous system lymphoma (PCNSL). Methods Between March 2011 and July 2013, 16 patients with PCNSL were diagnosed and treated. The clinical characteristics, diagnosis,therapy, results and adverse effects were analyzed. Results Totally 16 patients were enrolled and diagnosed as primary central nervous system diffuse large B-cell lymphoma. All patients received teniposide-based regimen chemotherapy and 9 patients received teniposide plus rituximab. The overall response rate was 87.5 % (14/16), including 10 cases of CR and 4 cases of PR. With a median follow-up of 13.5 months, the progression-free survival (PFS) and overall survival (OS) rates of 2 years were 29.9 % and 66.7 %, respectively. The mainly hematological adverse events were neutropenia, including grade 3 in 4 cases (25 %) and grade 4 just in one case. There was one case of treatment related death. Conclusions The response rate of teniposide-based regimen for PCNSL is promising. The 2 year PFS and OS rates are even higher than results of traditional high-dose methotrexate regimen. The teniposide-based regimen is well tolerated, and the adverse events are acceptable.

Clinical features and therapeutic effect of 15 mantle cell lymphoma patients / 军事医学

Objective To analyze the clinical characteristics and recent curative effect of mantle cell lymphoma (MCL) after conventional treatment.Methods Clinical data of 15 MCL patients admitted in the Affiliated Hospital of Academy of Military Medical Sciences between August 2004 and October 2013 were retrospectively analyzed.Results The median age of those patients was 59 and the male to female ratio was 1.5∶1.Fourteen(93%)cases were in Ann-Arbor stages Ⅲ -Ⅳ, 15 cases (100%)primarily with lymph node involvement,7 cases (47%)with bone marrow involvement,4 cases (27%)with gastrointestinal involvement,and 3 cases (20%)with orbit involvement.Less than 40% expression of Ki-67 was observed in 9 cases (60%),while 6 cases were with more than 40% (40%).One case was blastic variant.First-line therapy was CHOP-like regimens,which were combined with rituximab in 8 of the 15 cases.In this study,the median survival time was 12 months (3 -64),and the overal response rate was 80%after induction chemotherapy.The current survival of 7 /9 cases with less than 40% expression of Ki-67 was 8 -64 months,2 /6 cases with more than 40% expression of Ki-67 was 8 and 9 months,respectively.Conclusion MCL mostly occurs in older males.Extranodal invasion is common in MCL as an aggressive tumor.The efficacy of traditional chemotherapy is currently limited.Blastic variant or high expression of Ki-67 is an adverse prognostic indicator.

Efficacy of bendamustine hydrochloride in patients with rituximab-refractory indolent B-cell non-Hodgkin's lymphoma：results from a phaseⅢmulticenter study / 中国肿瘤临床

Objective:To evaluate the efficacy and toxicity of single-agent bendamustine in patients with indolent B-cell non-Hodgkin's lymphoma (NHL) refractory to rituximab. Methods:Between April 2010 and April 2013, 100 patients with rituximab-refrac-tory indolent B-cell NHL from 8 institutions were enrolled. Bendamustine was administered at 120 mg/m2 on days 1 and 2 every 21 days for 6-8 cycles. The primary endpoint was the overall response rate (ORR). The secondary endpoints included disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and safety. Results:One hundred patients with a median age of 56 (rang-ing from 28 to 74) years were recruited in this clinical study. The total number of chemotherapy was 447 cycles, and the median number was 4 cycles. Ninety-three patients could be evaluated for efficacy. Fifteen patients (16.1%) had complete remission (CR), 52 (55.9%) had partial remission (PR), 22 (23.7%) had stable disease (SD), and 4 (4.3%) had progression disease (PD). The ORR and DCR were 72%and 95.7%, respectively. After a median follow-up of 26.6 months (ranging from 2 to 48.4 months), 59 patients (63.4%) had PD.The median PFS was 8.53 (95%CI:6.518-10.542) months, and PFS rate for 1 year was (40.6±5.3)%. Forty-eight patients (48%) had 3/4 grade adverse events, including leucopenia (26%), neutropenia (24%), and anemia (11%). Conclusion:Single-agent bendamustine produced a high rate of objective responses in patients with rituximab-refractory indolent B-cell NHL and could be one of the new op-tions for second-line treatment of these patients. The most common adverse event is hematologic toxicity.

Application of Strain Ratio on the Diagnosis of Thyroid Malignant Tumor Using Different Calculation Methods / 中国医学影像学杂志

PurposeThe restriction of strain ratio (SR) in the diagnosis of thyroid malignant tumor are caused mainly because of disadvantages including low sensitivity, in this research the authors used different calculation methods of strain ratio based on the size of tumors, to explore the clinical application value of them on the differentiation of benign and malignant thyroid nodules.Materials and Methods Data of 336 patients with thyroid nodule (340 nodules) who underwent elasticity imaging and ultrasound-guided fine-needle aspiration were retrospective analyzed, with the pathology combined follow up acted as golden standards, fixed surface area assay and true surface area assay of strain ratio were compared on the differential diagnosis of benign and malignant thyroid nodules with various size.Results Among 340 thyroid nodules, there were 91 small nodules and 249 big nodules. Pathological results showed that 36 of 91 small nodules and 104 of 249 big nodules were malignant, while the others were benign. The true surface area assay was significantly better for the diagnosis of smaller thyroid nodules with longitudinal diameter and transverse diameter8mm (χ2=57.08,P<0.01). The sensitivity, specificity and consistency for the diagnosis of malignant nodules of true surface area assay were 57.10%, 83.00% and 72.30% (Kappa=0.413), which were 73.60%, 85.00% and 72.30% (Kappa=0.590) in the fixed surface area assay, and 85.00%, 85.50% and 85.30% (Kappa=0.699) in the selective usage of two methods according to the tumor size, respectively.Conclusion The sensitivity is highest when using the two methods selectively according to the nodule size, with a better consistence rate with pathological results as well.

Impact of huolong moxibustion on TNF-α and pain degree in the patients of discogenic low back pain / 中国针灸

<p><b>OBJECTIVE</b>To discuss the impact of huolong moxibustion on pain degree in the patients of discogenic low back pain and the effect mechanism.</p><p><b>METHODS</b>Sixty-five patients were randomized into an observation group (33 cases) and a control group (32 cases). In the observation group, huolong moxibustion was applied along the distribution of the Governor Vessel, once a day. In the control group, the routine traction combined with massage therapy was adopted, once a day. In the two groups, the treatment was given 6 times a week, at interval of 1 day. In 3 weeks of treatment, pain score and serum tumor necrosis factor α (TNF-α) level were compared with those before treatment in the two groups.</p><p><b>RESULTS</b>Compared with those before treatment, pain score and TNF-α level were reduced significantly after treatment in the two groups (both P < 0.05). The results in the observation group were lower than those in the control group (pain score: 1.95 ± 0.61 vs 2.11 ± 0.61; TNF-α: (1.33 ± 0.30) nmol/L vs (1.55 ± 0.48) nmol/L, (both P < 0.05).</p><p><b>CONCLUSION</b>Huolong moxibustion significantly alleviates pain in the patients of discogenic low back pain and its effect mechanism is possibly relevant with TNF-α reducing.</p>

Perspective research of preliminarily diagnosed angioimmunoblastic T-cell lymphoma with dose-adjusted EPOCH regimen / 中国肿瘤临床

Objective:The effect and side effect of the dose-adjusted EPOCH regimen were evaluated perspectively for the pre-liminarily diagnosed angioimmunoblastic T-cell lymphoma. Methods: Nine cases of untreated angioimmunoblastic T-cell lymphoma were diagnosed and enrolled in our department from September 2008 to September 2012. All patients received dose-adjusted EPOCH regimen as first-line chemotherapy. Results: The median age of 9 patients was 54 years. The male-to-female ratio was 2∶1. About 88.9%of all patients were at Ann Arbor stageⅢ/Ⅳ, and 77.8%presented with B symptoms. Anemia was found in 66.7%of 9 patients, and lactate dehydrogenase elevated in 55.6%of patients. After an average of 4.7 cycles of chemotherapy of dose-adjusted EPOCH regi-men, the complete remission rate was 22.2%, and the total response rate was 66.7%. With a median follow-up of 20 months, the 4-year progression-free survival rate was 11.1%, and the overall survival rate was 33.3%. The median survival time was 19 months. The most common adverse events of EPOCH chemotherapy were hematologic toxicity. Grades 3-4 neutropenia and thrombocytopenia were re-ported in 77.8%and 33.3%of patients. Febrile neutropenia was observed in 44.4%of patients. Non-treatment-related mortality was al-so noted. Conclusion: The results of our research showed no clear benefit of treating preliminarily diagnosed angioimmunoblastic T-cell lymphoma with dose-adjusted EPOCH regimen. The main adverse events were hematologic toxicity and could be tolerated.

Role of mitochondrial ATP-sensitive potassium channel in mitigation of cerebral ischemia-reperfusion injury by isoflurane preconditioning in rats: the relationship with JNK signaling pathway / 中华麻醉学杂志

Objective To evaluate the role of mitochondrial ATP-sensitive potassium (mitoKATP) channel in mitigation of cerebral ischemia-reperfusion (I/R) injury by isoflurane preconditioning in rats and the relationship with c-Jun N-terminal kinase (JNK) signaling pathway.Methods Thirty-two male Sprague-Dawley rats,weighing 280-320 g,were randomly divided into 4 groups (n =8 each) using a random number table:sham operation group (group S),group I/R,isoflurane preconditioning group (group Ⅰ-pre),and 5-hydroxydecanoate (5-HD,a selective mitoKATP channel antagonist) group.Cerebral I/R was produced by modified 4-vessel technique described by Pulsinelli in anesthetized rats.In group Ⅰ-pre,the rats were exposed to 1.5％ isoflurane for 1 h everyday for 5 consecutive days before ischemia.In group 5-HD,5-HD 15 mg/kg was injected intraperitoneally at 30 min before ischemia and the other procedures were similar to those previously described in group Ⅰ-pre.Neurological behavior was evaluated at 24 h of reperfusion.The rats in each group were sacrificed at 72 h of reperfusion,and the brains were removed for determination of neuronal apoptosis (by TUNEL) and expression of caspase-3 and phosphor-JNK (p-JNK) protein (using Western blot) in hippocampal tissues.Apoptotic rate was calculated.Results Compared with group S,the number of grid cross was significantly decreased,hanging time was shortened,apoptotic rate was increased,and caspase-3 expression was up-regulated in I/R,Ⅰ-pre and 5-HD groups,the expression of p-JNK protein was up-regulated in IR and 5-HD groups,and no significant change was found in the expression of p-JNK protein in group Ⅰ-pre.Compare with group I/R,the number of grid cross was significantly increased,hanging time was prolonged,apoptotic rate was decreased,and the expression of caspase-3 and p-JNK protein was downregulated in group Ⅰ-pre,and no significant change was found in the parameters mentioned above in group 5-HD.Compared with group Ⅰ-pre,the number of grid cross was significantly decreased,hanging time was shortened,apoptotic rate was increased,and the expression of caspase-3 and p-JNK protein was up-regulated in group 5-HD.Conclusion The mitoKATP channel is involved in mitigation of cerebral I/R injury by isoflurane preconditioning through blocking the JNK signaling pathway in rats.