Preparation and cellular uptake study of anemoside B4 and PD-L1 siRNA co-delivered cRGD-modified targeting liposomes / 中国药房

OBJECTIVE To prepare anemoside B4 （AB4） and programmed cell death ligand 1 （PDL1） siRNA （siP） co- delivered cRGD-modified targeting liposomes （AB4/siP-c-L）， and to study the cellular uptake in vitro. METHODS The cRGD- modified AB4-loaded targeted liposomes （AB4-c-L） were prepared by ethanol injection. AB4-c-L was mixed with 20 nmol/L siP in the same volume and AB4/siP-c-L was obtained through electrostatic adsorption. The particle size， Zeta potential， morphology， encapsulation efficiency and drug content， in vitro release behavior and serum stability of AB4/siP-c-L were investigated by laser scattering particle size tester， transmission electron microscopy， ultrafiltration centrifugation， dialysis and agar-gel electrophoresis block test. Cellular uptake of AB4/siP-c-L by Lewis lung cancer cells LLC and its intracellular localization were evaluated by flow cytometry and confocal laser scan technique. RESULTS The average particle size of AB4/siP-c-L was （187.4±3.1） nm， and the Zeta potential was （33.5±1.4） mV. AB4/siP-c-L was spheroidal in shape. The encapsulation efficiency and content of AB4 were （95.2±0.4） % and （1.0±0.2） mg/mL， respectively. AB4/siP-c-L could better package siP， and exhibited good serum stability， obvious pH sensitivity and sustained release property. The uptake rate of AB4/siP-c-L by LLC cells was significantly higher than that of free drug， and was able to accumulate in cytoplasm. CONCLUSIONS AB4/siP-c-L can effectively realize the co-loading of AB4 and gene drug siP， which has certain in vitro targeting to LLC cells.

Role of blood pressure on stroke-related mortality: a 45-year follow-up study in China / 中华医学杂志(英文版)

BACKGROUND@#Hypertension is associated with stroke-related mortality. However, the long-term association of blood pressure (BP) and the risk of stroke-related mortality and the influence path of BP on stroke-related death remain unknown. The current study aimed to estimate the long-term causal associations between BP and stroke-related mortality and the potential mediating and moderated mediating model of the associations.@*METHODS@#This is a 45-year follow-up cohort study and a total of 1696 subjects were enrolled in 1976 and 1081 participants died by the latest follow-up in 2020. COX proportional hazard model was used to explore the associations of stroke-related death with baseline systolic blood pressure (SBP)/diastolic blood pressure (DBP) categories and BP changes from 1976 to 1994. The mediating and moderated mediating effects were performed to detect the possible influencing path from BP to stroke-related deaths. E value was calculated in the sensitivity analysis.@*RESULTS@#Among 1696 participants, the average age was 44.38 ± 6.10 years, and 1124 were men (66.3%). After a 45-year follow-up, a total of 201 (11.9%) stroke-related deaths occurred. After the adjustment, the COX proportional hazard model showed that among the participants with SBP ≥ 160 mmHg or DBP ≥ 100 mmHg in 1976, the risk of stroke-related death increased by 217.5% (hazard ratio [HR] = 3.175, 95% confidence interval [CI]: 2.297-4.388), and the adjusted HRs were higher in male participants. Among the participants with hypertension in 1976 and 1994, the risk of stroke-related death increased by 110.4% (HR = 2.104, 95% CI: 1.632-2.713), and the adjusted HRs of the BP changes were higher in male participants. Body mass index (BMI) significantly mediated the association of SBP and stroke-related deaths and this mediating effect was moderated by gender.@*CONCLUSIONS@#In a 45-year follow-up, high BP and persistent hypertension are associated with stroke-related death, and these associations were even more pronounced in male participants. The paths of association are mediated by BMI and moderated by gender.

Chinese consensus on diagnosis and treatment of intestinal Beh?et′s disease / 中华消化杂志

Beh?et′s syndrome is a kind of chronic systemic vasculitis with involvement of multiple organs. Intestinal involvement of Beh?et′s syndrome is presently named as intestinal Beh?et′s syndrome. Recently, there is considering another kind of disease type with only typical intestinal ulcers. Since it is difficult to differentiate intestinal Beh?et′s syndrome from Crohn′s disease, intestinal tuberculosis, intestinal lymphoma, and intestinal manifestations of many other autoimmune diseases, and there is limited evidence for the therapy of intestinal Beh?et′s syndrome, proposing diagnosis and treatment recommendations for intestinal Beh?et′s syndrome through evidence-based judgment will be of great significance for clinical practice.

Cardiometabolic disease patterns among elderly patients with colorectal cancer in China / 中华肿瘤杂志

Objective: To explore the distribution patterns of cardiometabolic diseases (CMD) in elderly patients with colorectal cancer, and provide a reference for the prevention and treatment of cardiovascular metabolic diseases in these patients. Methods: Clinical data of 3 894 elderly patients with colorectal cancer from January 2008 to March 2018 admitted in the Chinese PLA General Hospital were recruited and the incidence rate of CMD was retrospectively analyzed. The influence factors of elderly patients with colorectal cancer combined with CMD were analyzed by multivariate Logistic regression model. Results: The morbidity rate of CMD in elderly patients with colorectal cancer is 33.4% (1 301/3 894), among them, the morbidity rate of the male was 31.9% (768/2 409), and that of the female was 35.9% (533/1 485). There was not significant difference between these two sex (P=0.074). The morbidity rates of CMD in patients of 65-74 years, 75-84 years and ≥85 years were 30.6% (754/2 462), 37.0% (479/1 294) and 49.3% (68/138), respectively, with significant differences (P<0.001). Multiple Logistic regression analysis revealed that female (OR=1.213, 95%CI: 1.056-1.394), age (75-84 years group: OR=1.344, 95%CI: 1.164-1.552; ≥85 years group: OR=2.345, 95%CI: 1.651-3.331) and body mass index (BMI 18.5-24.9 kg/m(2) group: OR=1.319, 95%CI: 1.065-1.638; ≥25 kg/m(2) group: OR=2.041, 95%CI: 1.627-2.561) were independent risk factors for elderly colorectal cancer patients with CMD. Conclusion: The morbidity rate of CMD in elderly patients with colorectal cancer increases with age and it is urgent to strengthen multidisciplinary cooperation and develop reasonable treatment plans to extend the survival and life quality of these patients.

Research advance of population pharmacokinetics of imipenem-cilastatin in special status populations / 中国药房

Imipenem-cilastatin is a broad-spectrum carbapenem antibiotic drug that has been widely used in clinical practice ， but there is a lack of guidelines and expert consensus on the development of individualized regimens for special status populations [e.g. continuous renal replacement therapy （CRRT）patients，extracorporeal membrane oxygenation （ECMO）patients， critically ill burn patients ，neonates and children]. In this paper ，by searching population pharmacokinetics research of imipenem- cilastatin in special status populations ，it is recommended that imipenem-cilastatin is given 1 to 3 g/d for CRRT patients ；500 mg to 1 g，q6 h for burn patients ；750 mg to 1 g，q6 h for ECMO patients ；20 mg/kg or 25 mg/kg，q8 h for neonates ；and 25 mg/kg，q6 h for children.

Analysis of clinical index changes of right heart hypofunction in patients with primary myelofibrosis / 白血病·淋巴瘤

Objective:To investigate the changes of related indicators of right heart hypofunction in patients with primary myelofibrosis (PMF).Methods:The clinical data of 55 PMF patients in the Second People's Hospital of Lianyungang in Jiangsu Province and Jiangsu Province Hospital from January 2015 to August 2019 were retrospectively analyzed. The differences in right heart function-related echocardiographic indexes and biochemical indexes between pre-fibrosis/early stage fibrosis patients and obvious stage fibrosis patients were compared. Single factor linear regression method was used to analyze the correlations of pulmonary artery pressure with biochemical indexes.Results:The hemoglobin level [119 g/L (47-224 g/L) vs. 78 g/L (33-182 g/L)] and platelet count [233×10 12/L (5×10 12/L-984×10 12/L) vs. 117×10 12/L (7×10 12/L-731×10 12/L)] of patients in the pre-fibrosis/early stage fibrosis group were higher than those in the obvious stage fibrosis group, and the differences were statistically significant (both P<0.05). Among 22 patients with complete results of cardiac ultrasound, 90.9% (20/22) patients had increased pulmonary artery pressure, 72.7% (16/22) patients had increased left atrial diameter, and 90.9% (20/22) patients had increased right ventricular diastolic diameter. There were no patients with abnormal ejection fraction. The pulmonary artery pressure [48 mmHg (46-90 mmHg) vs. 33 mmHg (20-50 mmHg) (1 mmHg = 0.133 kPa)], left ventricular diastolic diameter [46 mm (36-50 mm) vs. 47 mm (43-53 mm)] and fractional shortening rate [38.1% (36.0%-38.9%) vs. 35.4% (32.7%-37.8%)] of patients in the pre-fibrosis/early stage fibrosis group were higher than those in the obvious stage fibrosis group, and the differences were statistically significant (all P < 0.05). The pulmonary artery pressure of patients had positive correlations with age ( r = 0.590), serum ferritin (SF) ( r = 0.608), lactate dehydrogenase (LDH) ( r = 0.711) and soluble growth-stimulating expression gene 2 (ST-2) ( r = 0.580)(all P<0.05), and had negative correlation with platelet count ( r = -0.596, P = 0.003). Conclusion:PMF patients are prone to right heart hypofunction, the pulmonary artery pressure is higher in older patients and patients with high SF, LDH and ST-2 levels and low platelet count.

Periprostatic fat thickness measured on MRI correlates with lower urinary tract symptoms, erectile function, and benign prostatic hyperplasia progression / 亚洲男科学杂志(英文版)

This study investigated the correlation between periprostatic fat thickness (PPFT) measured on magnetic resonance imaging and lower urinary tract symptoms, erectile function, and benign prostatic hyperplasia (BPH) progression. A total of 286 treatment-naive men diagnosed with BPH in our department between March 2017 and February 2019 were included. Patients were divided into two groups according to the median value of PPFT: high (PPFT >4.35 mm) PPFT group and low (PPFT <4.35 mm) PPFT group. After the initial evaluation, all patients received a combination drug treatment of tamsulosin and finasteride for 12 months. Of the 286 enrolled patients, 244 completed the drug treatment course. Patients with high PPFT had larger prostate volume (PV; P = 0.013), higher International Prostate Symptom Score (IPSS; P = 0.008), and lower five-item version of the International Index of Erectile Function (IIEF-5) score (P = 0.002) than those with low PPFT. Both high and low PPFT groups showed significant improvements in PV, maximum flow rate, IPSS, and quality of life score and a decrease of IIEF-5 score after the combination drug treatment. The decrease of IIEF-5 score was more obvious in the high PPFT group than that in the low PPFT group. In addition, more patients in the high PPFT group underwent prostate surgery than those in the low PPFT group. Moreover, Pearson's correlation coefficient analysis indicated that PPFT was positively correlated with age, PV, and IPSS and negatively correlated with IIEF-5 score; however, body mass index was only negatively correlated with IIEF-5 score.

Risk Factors Associated with Impaired Ovarian Reserve in Young Women of Reproductive Age with Crohn’s Disease

Background/Aims@#Crohn’s disease (CD) primarily affects young female adults of reproductive age. Few studies have been conducted on this population’s ovarian reserve status. The aim of study was to investigate potential risk factors associated with low ovarian reserve, as reflected by serum anti-Müllerian hormone (AMH) in women of reproductive age with CD. @*Methods@#This was a case-control study. Cases included 87 patients with established CD, and healthy controls were matched by age, height and weight in a 1:1 ratio. Serum AMH levels were measured by enzyme-linked immunosorbent assay. @*Results@#The average serum AMH level was significantly lower in CD patients than in control group (2.47±2.08 ng/mL vs. 3.87±1.96 ng/mL, respectively, P<0.001). Serum AMH levels were comparable between CD patients and control group under 25 years of age (4.41±1.52 ng/mL vs. 3.49±2.10 ng/mL, P=0.06), however, serum AMH levels were significantly lower in CD patients over 25 years of age compared to control group (P<0.05). Multivariable analysis showed that an age greater than 25 (odds ratio [OR], 10.03; 95% confidence interval [CI], 1.90–52.93, P=0.007), active disease state (OR, 27.99; 95% CI, 6.13–127.95, P<0.001) and thalidomide use (OR, 15.66; 95% CI, 2.22–110.65, P=0.006) were independent risk factors associated with low ovarian reserve (serum AMH levels <2 ng/mL) in CD patients. @*Conclusions@#Ovarian reserve is impaired in young women of reproductive age with CD. Age over 25 and an active disease state were both independently associated with low ovarian reserve. Thalidomide use could result in impaired ovarian reserve.

Prescription compatibility connotation and action mechanism of Siwu Decoction in treating primary dysmenorrhea / 中国中药杂志

The aim of this paper was to study the prescription compatibility connotation in the treatment of primary dysmenorrhea(PD) and verify the mechanism as predicted by network pharmacology of Siwu Decoction(SWD). Mice PD model was constructed by using estradiol benzoate-oxytocin. PD mice were randomly divided into 8 groups, namely normal group, model group, positive group, complete formula group, Rehmanniae Radix Praeparata-free group, Paeoniae Radix Alba-free group, volatile oil-free group, Chuan-xiong Rhizoma and Angelicae Sinensis Radix-free group. Latent time, writhing times, inhibition rate, prostaglandin F_2_α(PGF_2_α) and prostaglandin E_2(PGE_2) levels in serum, endothelin-1, Ca~(2+), expression levels of prostaglandin synthase 2 G/H(PTGS2), estrogen receptor(ESR1), glucocorticoid receptor gene(NR3 C1) mRNA and protein expression levels in the uterus homogenate and pathological changes of uterine tissue were index to explore the prescription compatibility connotation and verify the mechanism of SWD in the treatment of PD. Compared with the extraction liquid of the whole recipe, the effect of Rehmanniae Radix Praeparata-free group and Paeoniae Radix Alba-free group with volatile oil were slightly lower, the effect of essential oil-free group was significantly lower, and the effect of Chuanxiong Rhizoma and Angelicae Sinensis Radix-free group was worse than that of the whole recipe. The relative expression levels of PTGS2 protein and mRNA were significantly reduced by the SWD. The relative expressions of protein and mRNA of ESR1, NR3 C1 were significantly increased. SWD treats PD by regulating the expression of key proteins PTGS2, ESR1 and NR3 C1.Its main medicinal herbs were Angelicae Sinensis Radix and Chuanxiong Rhizoma. Active components were mainly in volatile oil, but Paeo-niae Radix Alba and Rehmanniae Radix Praeparata also had some contributions.

Epidemiological investigation of a family clustering of COVID-19 / 中华流行病学杂志

Objective To investigate the epidemiological characteristics of a family clustering of COVID-19. Methods Field epidemiological survey was conducted. Result Case 1 of the long-term residents from Hubei province was the source of infection of this family clustering. There were 6 cases (from case 2 to case 7) infected in the whole incubation period. The incubation period was more than 14 days for 3 of the second-generation cases. Routes of transmission include respiratory droplets (from case 1 transmitted to case 6, from case 1 to her family members) and closecontact (from case 1 to other cases in her family). All the age groups were generally susceptible, while elderly were easier to progress to critically ill. Besides respiratory symptoms, there were also gastrointestinal symptoms, of which diarrhea was the most common one. Conclusion Family clustering had been an important part for COVID-19 cases.

Effects of Non-selective β-blockers on Mortality of Patients with Cirrhosis and Ascites：A Meta-analysis / 中国药房

OBJECTIVE：To syste matically evaluate the effects of non-selective β-blockers（NSBB）on mortality of patients with cirrhosis and ascites ，and to provide evidence-based reference for clinical drug use. METHODS ：Retrieved from PubMed ，the Cochrane Library ，Embase，Web of Science ，CNKI and Wanfang database ，randomized controlled trials （RCTs）and cohort studies about the effects of NSBB on mortality of patients with cirrhosis and ascites were collected from the date of database establishment to Sept. 30th，2019. The patients in the trial group were treated with NSBB ，the patients in the control group were treated with blank control or isosorbidemononitrate ，variceal ligation or other measures to prevent variceal bleeding. After literature screening and data extraction ，the quality of RCTs and cohort studies were evaluated by using bias risk evaluation tool recommended by Cochrane system evaluator manual 5.1.0 and Newcastle-Ottawa scale . Meta-analysis was performed by using Rev Man 5.3 statistical software. RESULTS ：Totally 18 studies were included ，involving 8 649 patients，4 RCTs and 14 cohort studies. Results of Meta-analysis showed that ，there was no significant difference in all-cause mortality between the patients using NSBB of trial group [RR ＝0.85，95％ CI（0.65，1.11），P＝0.22]，severe ascites [RR ＝0.58，95％ CI（0.15，2.22），P＝0.42] or refractory ascites [RR ＝0.85，95％CI（0.61，1.20），P＝0.36] and the control group. Subgroup analysis showed that ，there was no significant difference in all-cause mortality between the patients using NSBB of trial group and control group according to the research method （RCT vs. cohort study ）and the type of drug use （P＞0.05）. CONCLUSIONS ：The use of NSBB does not increase the incidence of all-cause mortality in cirrhosis patients with ascites ，or even in those with severe ascites or refractory ascites.

Review of Chemical Constituents, Pharmacological Effects and Clinical Applications of Taohong Siwutang and Predictive Analysis of Its Quality Marker / 中国实验方剂学杂志

Taohong Siwutang is a classical famous formula for promoting blood circulation and removing blood stasis. This paper reviewed the research progress of chemical constituents, pharmacological activities, clinical applications of Taohong Siwutang in recent years. At present, the study on the chemical constituents of different extracts of Taohong Siwutang is systematic. The study of its pharmacological effects mostly includes promoting blood circulation and removing blood stasis, regulating menstruation, promoting fracture healing, and so on. In clinical practice, Taohong Siwutang can be used in the treatment of multi-system and multi-viscera diseases, such as gynecological diseases, internal diseases, orthopedic diseases, dermatological diseases, and the like. Based on this, the quality markers of Taohong Siwutang are predicted and analyzed from the perspectives of quality transmissibility and traceability, ingredient specificity, component validity, component measurability, and formula compatibility environment, which is called five principles of quality marker (Q-marker). According to the analysis, ferulic acid, paeoniflorin, amygdalin, albiflorin, hydroxysafflor yellow A, catalpol and gallic acid can be selected as Q-markers of Taohong Siwutang. Subsequently, these Q-markers can be selected as indicators to conduct whole quality control of Taohong Siwutang and establish a quality traceable system by the quality transmitting of medicinal materials, decoction pieces, intermediates and corresponding objects, so as to provide a reference for the study of the whole process quality control system of Taohong Siwutang.

Thalidomide in refractory Crohn′s disease: long-term efficacy and safety / 中华内科杂志

Objective:To analyze the long-term efficacy and safety of thalidomide on refractory Crohn′s disease (CD).Methods:A total of 79 patients with refractory CD in the First Affiliated Hospital of Sun Yat-sen University treated with thalidomide were enrolled in this retrospective study from September 2005 to July 2018. Clinical effects and adverse drug reactions were recorded and assessed.Results:In this cohort,69 patients were treated with thalidomide for ≥6 months. Sixty-eight patients among the 69 patients achieved complete clinical remission and were followed up for a median 33.5 months (range, 7-110 months). Seventeen cases relapsed during follow-up. The cumulative probabilities of remaining in remission at 12, 24, 60 months were 88.6% (95% CI 80.6%-96.6%), 80.7% (95% CI 70.3%-91.1%), 53.7% (95% CI 32.1%-75.3%) respectively. Disease activity was the only variable associated with relapse risk, with a hazard ratio ( HR) of 3.559 for Crohn′s disease activity index (CDAI) ≥220(95% CI 1.213-10.449, P<0.05). Adverse reactions were recorded in 42 (53.2%) patients including12 (15.2%) leading to discontinuation of thalidomide. No serious side effects were observed in all subjects. Conclusions:This study suggests a long-term benefit of maintenance treatment with thalidomide in refractory CD.Moderate to severe patients have an increased risk of relapse. The high incidence of drug adverse reactions may restrain the clinical application of thalidomide.

Prevalence of depression and its determinants among centenarians in Hainan / 中华老年医学杂志

Objective:To investigate the prevalence of depression and to analyze its determinants among centenarians in Hainan.Methods:A cross-sectional study on centenarians was conducted in Hainan from June 2014 to December 2016.A total of 910 centenarians, including 166 males and 744 females, were interviewed in their domiciles by trained investigators.A 15-item Geriatric Depression Scale(GDS-15)was used to assess depression for centenarians, and general sociodemographic details, sleep quality, cognitive function, activities of daily living, and lifestyles were recorded.Multivariate logistic regression analysis was used to determine major related factors for depression in centenarians.Results:Of the 910 centenarians, 292 were regarded as depressed and the prevalence was 32.1%.Univariate analysis showed that there were significant differences in gender, education, marital status, self-reported health, incontinence, dietary habits, sleep quality, activities of daily living, cognitive function, outdoor activities, watching TV, and social engagement between subjects with and without depression( P<0.05). Multivariate logistic regression analysis showed that living conditions, self-reported health, activities of daily living, and sleep quality were independent related factors for depression in centenarians( P<0.05). Among the above related factors, living with families( OR=0.50, P=0.026)and good sleep quality( OR=0.67, P=0.010)were protective factors for depression, whereas poor self-reported health( OR=3.34, P<0.001)and disability( OR=2.37, P=0.002)were risk factors for depression in centenarians. Conclusions:Living conditions, self-reported health, activities of daily living, and sleep quality were independently correlated with depression in Hainan centenarians.This study provides empirical evidence for depression interventions and mental health improvement in centenarians.

Association between hypertension and carotid plaque in a physical examination population: a cross-sectional study / 中华健康管理学杂志

Objective:This study aimed to assess the association between hypertension and carotid plaque in a research population in China.Methods:The subjects of this study were selected from a population undergoing physical examination at the Fourth Medical Center of PLA General Hospital in 2017. We collected information on physical examination, physiological index test, blood pressure indicators were analyzed according as continuous variables (systolic blood pressure, diastolic blood pressure, and pulse pressure) and categorical variables (hypertension and quartile of blood pressure pulse pressure). A multivariate logistic regression model was conducted to estimate the correlation between blood pressure and carotid plaque development.Results:A total of 716 individuals were surveyed, including 321 men (44.8%) and 395 women (55.2%), and the prevalence of hypertension and carotid plaque were 40.9%(293 cases) and 40.4% (289 cases), respectively. The prevalence of carotid plaque was higher in individuals aged ≥60 years, diabetes mellitus, hypertension and increased waist circumference, systolic blood pressure, fasting blood glucose and glycosylated hemoglobin. The prevalence of carotid plaque increased with the increase of the quartile of blood pressure and pulse pressure ( Ptrend<0.05). After adjustment for age, sex, BMI, waist circumference, and total cholesterol, triglyceride, fasting blood glucose, glycosylated hemoglobin, and hemoglobin levels, every 1 mmHg increased systolic blood pressure increases the risk of carotid plaque by 1.4% (95% CI: 1.005-1.024). Compared with the control group, the risk of carotid plaque increased by 86.8% (95% CI: 1.175-2.946) and 84.8% (95% CI: 1.098-3.110) and 119.6% (95% CI: 1.165-4.142) in the group of normal high blood pressure, grade 1 hypertension and grade 2 and grade 3 hypertension, respectively; compared with the control group, the risk of carotid plaque increased by 56.2% in the group of pulse pressure difference≥60 mmHg (95% CI: 1.049-2.326), in which the risk of carotid plaque increased by 73.3% (95% CI: 1.007-2.983) in women with pulse pressure difference≥60 mmHg (1 mmHg=0.133 kPa); in the control group with pulse pressure difference of four categories Q1 (<42 mmHg), the risk of carotid plaque increased by 92.2% (95% CI: 1.173-3.149) and 95.0% (95% CI: 1.147-3.316) in Q3 (50-61 mmHg) and Q4 (≥62 mmHg), respectively. Conclusion:Increased blood pressure or pulse pressure are associated with increased prevalence of carotid plaque. Prevention of elevated blood pressure and pulse pressure might be one of the effective precautions for the prevention of carotid plaque development.

Clinical characteristic analysis of patients with T-cell large granular lymphocytic leukemia combined with pure red cell aplasia / 白血病·淋巴瘤

Objective:To improve the cognition of T-cell large granular lymphocytic leukemia (T-LGLL) combined with pure red cell aplasia (PRCA).Methods:The clinical characteristics, peripheral blood and bone marrow laboratory indicators of 14 newly diagnosed patients with T-LGLL combined with PRCA who were admitted to the Second People's Hospital of Lianyungang Affiliated to Bengbu Medical College and the People's Hospital of Jiangsu Province from August 2010 to October 2019 were retrospectively analyzed.Results:Among the 14 patients, there were 7 males and 7 females, with a median age of 58.5 years (33-75 years). At the first visit, the median white blood cell count was 5.02×10 9/L [(1.45-8.49)×10 9/L], the median absolute value of neutrophils was 1.35×10 9/L [(0.43-7.16)×10 9/L], the median lymphocyte ratio was 0.49 (0.13-0.77), the median hemoglobin was 58 g/L (42-106 g/L), the median red blood cell count was 2.01×10 12/L [(0.99-3.20)×10 12/L], the median reticulocyte count percentage was 0.52 (0.14-3.02), the median platelet was 96×10 9/L [(38-281)×10 9/L], the median large granular lymphocytes accounted for 71% (32%-81%) of lymphocytes. Bone marrow aspiration showed that the median large granular lymphocytes accounted for 0.16 (0.08-0.41) of nuclear cells, and the median serum β 2 microglobulin was 4.85 mg/L (2.81-7.22 mg/L). Two patients had ASXL1 and TET2 mutations, and one of them had STAT3, EP300 and FAM46C mutations. Six patients were T cell receptor (TCR) β and γ-positive, 1 patient were TCRβ-positive, 4 patients were TCRγ-positive, 1 patient was TCRδ-positive, 1 patient was TCRβ, γ and δ-positive, and 1 patient was all negative. Eight cases received cyclosporine therapy, 6 cases were effective; 6 cases received methotrexate combined with hormone therapy, 3 cases were effective. The initial induction therapy was effective in 9 cases, 5 patients who failed in the initial treatment received salvage treatment, and 2 cases were effective. Conclusions:The laboratory characteristics of patients with T-LGLL combined with PRCA are similar to those of simple T-LGLL, anemia is a prominent manifestation accompanied by neutropenia or thrombocytopenia. The large granular lymphocytes are easily seen in peripheral blood and bone marrow, and T monoclonal rearrangement of lymphocytes is an important feature, and the patients respond well to immunosuppressive therapy.

Expressions of tissue factor and vascular endothelial growth factor in diffuse large B-cell lymphoma and their clinical significances / 白血病·淋巴瘤

Objective:To investigate the expressions of tissue factor (TF) and vascular endothelial growth factor (VEGF) in diffuse large B-cell lymphoma (DLBCL) and their clinical significances.Methods:The clinical data of 80 cases of DLBCL diagnosed at the Second People's Hospital of Lianyungang from January 2010 to December 2017 were collected, and 30 cases of reactive hyperplasia of lymph node (RLN) were selected as the controls. The expressions of TF and VEGF in the two groups were detected by using immunohistochemical staining.Results:The positive rate of TF and VEGF in the DLBCL group was higher than that in the RLN group [TF: 86.3% (69/80) vs. 50.0% (15/30) ; VEGF: 90.0% (72/80) vs. 53.3% (16/30) ; both P < 0.01]. And there was a positive correlation between the expression of TF and VEGF ( r = 0.704, P < 0.05). There was no significant difference in the positive rates of TF and VEGF among the patients with different gender, age and Hans subtypes in DLBCL group (all P > 0.05). The positive rate of TF in DLBCL patients with B symptom, increased LDH, physical status grade ≥2, and extranodal lesion number >1 was higher (all P < 0.05). The positive rate of VEGF in patients with Ann Arbor stage Ⅲ-Ⅳ, B symptom, increased LDH, and extranodal lesion number >1 was higher (all P < 0.05). The positive rate of TF in international prognostic index (IPI) high-risk group was higher than that in low-risk group ( P < 0.01); the positive rate of VEGF in IPI high-risk group and middle-high-risk group was higher than that in low-risk group (all P < 0.01). The expressions of TF ( r = 0.491, P < 0.01) and VEGF ( r = 0.529, P < 0.01) were positively correlated with IPI. The overall survival rates of TF and VEGF low-expression group were higher than those of TF and VEGF high-expression group (both P < 0.05). Conclusion:The expressions of TF and VEGF are highly expressed in DLBCL, which is associated with the IPI. It can provide a reference value in evaluating prognosis of DLBCL.

Expressions of tissue factor and vascular endothelial growth factor in diffuse large B-cell lymphoma and their clinical significances / 白血病·淋巴瘤

Objective@#To investigate the expressions of tissue factor (TF) and vascular endothelial growth factor (VEGF) in diffuse large B-cell lymphoma (DLBCL) and their clinical significances.@*Methods@#The clinical data of 80 cases of DLBCL diagnosed at the Second People's Hospital of Lianyungang from January 2010 to December 2017 were collected, and 30 cases of reactive hyperplasia of lymph node (RLN) were selected as the controls. The expressions of TF and VEGF in the two groups were detected by using immunohistochemical staining.@*Results@#The positive rate of TF and VEGF in the DLBCL group was higher than that in the RLN group [TF: 86.3% (69/80) vs. 50.0% (15/30) ; VEGF: 90.0% (72/80) vs. 53.3% (16/30) ; both P < 0.01]. And there was a positive correlation between the expression of TF and VEGF (r = 0.704, P < 0.05). There was no significant difference in the positive rates of TF and VEGF among the patients with different gender, age and Hans subtypes in DLBCL group (all P > 0.05). The positive rate of TF in DLBCL patients with B symptom, increased LDH, physical status grade ≥2, and extranodal lesion number >1 was higher (all P < 0.05). The positive rate of VEGF in patients with Ann Arbor stage Ⅲ-Ⅳ, B symptom, increased LDH, and extranodal lesion number >1 was higher (all P < 0.05). The positive rate of TF in international prognostic index (IPI) high-risk group was higher than that in low-risk group (P < 0.01); the positive rate of VEGF in IPI high-risk group and middle-high-risk group was higher than that in low-risk group (all P < 0.01). The expressions of TF (r = 0.491, P < 0.01) and VEGF (r = 0.529, P < 0.01) were positively correlated with IPI. The overall survival rates of TF and VEGF low-expression group were higher than those of TF and VEGF high-expression group (both P < 0.05).@*Conclusion@#The expressions of TF and VEGF are highly expressed in DLBCL, which is associated with the IPI. It can provide a reference value in evaluating prognosis of DLBCL.

Conducting systematic researches on influencing factors for healthy ageing and promoting scientific implementation of health promotion program for the elderly / 中华流行病学杂志

With the worsening of population ageing in China, the life quality of the elderly is deeply affected by comorbidity, disability, dementia and psychological problems. In China, great achievements have been made in the research of healthy ageing, but due to limitations in research hypothesis, sample size, study design and quality of follow-up, the research findings are insufficient to provide high-quality evidence chain or can’t be adopt in health guidelines or standards for the elderly in China, especially the oldest-old. In this special issue, the team of Healthy Aging and Biomarkers Cohort Study reported a series of new findings on health pattern of the elderly, influencing factors and biomarkers in healthy ageing research to provide more comprehensive scientific evidences for health service and to support scientific implementation of health promotion program for the elderly and promote healthy ageing.

Association between hypertension and carotid plaque in a physical examination population: a cross-sectional study / 中华健康管理学杂志

Objective@#This study aimed to assess the association between hypertension and carotid plaque in a research population in China.@*Methods@#The subjects of this study were selected from a population undergoing physical examination at the Fourth Medical Center of PLA General Hospital in 2017. We collected information on physical examination, physiological index test, blood pressure indicators were analyzed according as continuous variables (systolic blood pressure, diastolic blood pressure, and pulse pressure) and categorical variables (hypertension and quartile of blood pressure pulse pressure). A multivariate logistic regression model was conducted to estimate the correlation between blood pressure and carotid plaque development.@*Results@#A total of 716 individuals were surveyed, including 321 men (44.8%) and 395 women (55.2%), and the prevalence of hypertension and carotid plaque were 40.9%(293 cases) and 40.4% (289 cases), respectively. The prevalence of carotid plaque was higher in individuals aged ≥60 years, diabetes mellitus, hypertension and increased waist circumference, systolic blood pressure, fasting blood glucose and glycosylated hemoglobin. The prevalence of carotid plaque increased with the increase of the quartile of blood pressure and pulse pressure (Ptrend<0.05). After adjustment for age, sex, BMI, waist circumference, and total cholesterol, triglyceride, fasting blood glucose, glycosylated hemoglobin, and hemoglobin levels, every 1 mmHg increased systolic blood pressure increases the risk of carotid plaque by 1.4% (95%CI: 1.005-1.024). Compared with the control group, the risk of carotid plaque increased by 86.8% (95%CI: 1.175-2.946) and 84.8% (95%CI: 1.098-3.110) and 119.6% (95%CI: 1.165-4.142) in the group of normal high blood pressure, grade 1 hypertension and grade 2 and grade 3 hypertension, respectively; compared with the control group, the risk of carotid plaque increased by 56.2% in the group of pulse pressure difference≥60 mmHg (95%CI: 1.049-2.326), in which the risk of carotid plaque increased by 73.3% (95%CI: 1.007-2.983) in women with pulse pressure difference≥60 mmHg (1 mmHg=0.133 kPa); in the control group with pulse pressure difference of four categories Q1 (<42 mmHg), the risk of carotid plaque increased by 92.2% (95%CI: 1.173-3.149) and 95.0% (95%CI: 1.147-3.316) in Q3 (50-61 mmHg) and Q4 (≥62 mmHg), respectively.@*Conclusion@#Increased blood pressure or pulse pressure are associated with increased prevalence of carotid plaque. Prevention of elevated blood pressure and pulse pressure might be one of the effective precautions for the prevention of carotid plaque development.