Clinical analysis of 82 cases of primary mediastinal large B cell lymphoma / 中华血液学杂志

<p><b>OBJECTIVE</b>To investigate the clinical features and prognostic factors of primary mediastinal large B-cell lymphoma (PMLBCL).</p><p><b>METHODS</b>The clinical data of 82 patients with PMLBCL enrolled from January 2000 to January 2008 were retrospectively studied. All these patients were treated in four affiliated hospitals of Central South University,Hunan province. The prognostic factors were investigated.</p><p><b>RESULTS</b>Of the 82 patients, 45 were men and 37 were women, the ratio was 1.22:1. The median age was 29.5 (ranged from 12 to 78) years old. There were 40 (48.78%) patients in stage I/II, 42 (51.22%) in stage III/IV. The complete response (CR) rate was 13.4% (11/82), and the overall response rate 76.83% (63/82). The 5-year overall survival was 58%. The univariate analysis indicated that the poor prognostic factors included stage III/IV(P=0.005), without rituximab (P=0.004), without radiotherapy (P=0.000), LDH ≥ ULN (upper limit of normal) (P=0.000), disease progression (P=0.000), international prognostic index (IPI)≥ 2 (P=0.000) and superior vena cava syndrome (P=0.015). Chemo-therapy alone (P=0.000) predicted poor outcome. Combination therapy (such as chemo-radiotherapy, chemotherapy combined with rituximab) had better prognosis. Compared to second-line treatment, rituximab as the first-line treatment can prolong PFS, but had no effect on the OS. In multivariate analysis, chemo-radiotherapy and IPI were independently related to prognosis.</p><p><b>CONCLUSION</b>PMLBCL mostly affects young adults, male patients were slightly more than female patients. It presents with a typical bulky mediastinal mass at diagnosis, which constricts surrounding organs. Patients treated with rituximab or radiation therapy had better prognosis. Rituximab is recommended to be used for the first-line treatment.</p>

Research on relevance between mitochondrial ATP synthase and malignant tumor / 生物医学工程学杂志

Mitochondrial adenosine triphosphate (ATP) synthase is the key enzyme of mitochondrial oxidative phosphorylation reaction. The down-regulation of the mitochondrial ATP synthase is a hallmark of most human carcinomas, which is the embodiment of the bioenergetic signature of cancer in the performance of the decreased oxidative phosphorylation and increased aerobic glycolysis. Combining with the bioenergetic signature of cancer, studies showed that mitochondrial ATP synthase and multidrug resistance and adverse prognosis of tumor were closely related. Its mechanisms are related to post-transcriptional regulation of the ATP synthase, the hypermethylation of the ATP synthase gene and the inhibitor peptide of the mitochondrial ATP synthase, called ATP synthase inhibitory factor 1 (IF1). In this review, we stress the biological characteristics of mitochondrial ATP synthase and the relationship between ATP synthase and multidrug resistance and prognosis of Malignant tumor, in order to find a new way for tumor therapy.

The Contemplation on the Relationship Between Constructing the Harmonious Campus and Deepening the Quality Education / 中华医学教育探索杂志

The meaning of "harmonious campus" includes the harmony of cultural values,the harmony between human beings and the environment and the harmony between people.The relationship of constructing the harmonious campus and deepening the quality education is dialectical.Culture quality education supplies the conceptive condition and substantial content for the construction of harmonious campus.Constructing a harmonious campus is good for achieving the concept and content of culture quality education.Constructing the harmonious campus should follow the principle of thematic priorities,system and history.

Correlation analysis between plasma homocysteine level and polymorphism of homocysteine metabolism related enzymes in ischemic cerebrovascular or cardiovascular diseases / 中华血液学杂志

<p><b>OBJECTIVE</b>To investigate the changes of plasma homocysteine (Hcy) level in patients with ischemic cerebrovascular or cardiovascular disease and analyze the relationship between plasma Hcy levels and the mutations in Hcy metabolism related enzymes, including methylene tetrahydrofolate reductase (MTHFR) C677T, cystathionine beta-synthetase (CBS) 844ins68 and methionine synthetase (MS) A2756G.</p><p><b>METHODS</b>By using the HPLC-FLD method, the plasma total homocysteine (tHcy) concentration was determined in 86 patients with cerebral infarction, 66 with myocardial infarction and 80 healthy controls. The association of plasma tHcy levels with cardiovascular or cerebrovascular disease and mutations of MTHFR C677T, CBS 844 ins 68 and MS A2756G were evaluated by statistic methods.</p><p><b>RESULTS</b>In the patient groups, the plasma tHcy concentrations increased significantly as compared with healthy controls. The individuals homozygous for MTHFR C677T mutation had significantly higher plasma Hcy levels.</p><p><b>CONCLUSION</b>Hyperhomocysteinemia is an important risk factor for ischemic cerebrovascular and cardiovascular disease. The homozygosity of MTHFR C677T may contribute to the increase of plasma Hcy and vascular damage.</p>

Bioethical Issues and Strategies in the Treatment of Extremely Preterm Infants / 中国医学伦理学

Objective To observe some current dilemmas in the treatment of extremely preterm infants and to explore the method to solve the problems.Methods To analyze the problems with Bioethics.Results To advance some methods for solving the bioethical problems associated with medical staffs,parents,and the society.Conclusions Medical staffs should keep studying professional knowledge,understand the advances in the treatment of extremely preterm infants,improve the ability and skills to inform parents,diagnose and treat according to related guidelines,respect the rights and decision of the parents,and provide scientific guidance.The parents should be actively involved in medical activities and informed the rights,responsibilities in the treatment of their infants.Society should also take into consideration the interests of this special group in the field of insurance with the development of economy.

On the Conception of Top-Quality Course Construction of Medical Ethics / 中国医学伦理学

In top-quality course construction of medical ethics,it is necessary to attach importance to practical operation as well as the consistency of theoretical logic.To well adapt to the current medical practice and medical technical advances,the idea of medical ethics should include virtue,harmony and value.Virtue is the prominent concept in top-quality course construction of medical ethics.Harmony is the core idea of medical ethics,and value is the innovative idea to solve the questions caused by life technologies.Therefore,in the top-quality course construction of medical ethics,coordination and unification of the above three ideas must be maintained in order to defend the demonstration significance of top-quality course of medical ethics.

Autonomy,the Other and Euthanasia / 中国医学伦理学

The accomplishment of voluntary active euthanasia must involve the concept of "the other".The whole autonomy is an Abstract theoretical principle,which meets logic difficulty in real practice."The other" limits autonomy on the attitude towards life,family relationship,social relationship,physicians,and so on,which is also the practical basis for the accomplishment of euthanasia.When an individual chooses the will of performing euthanasia,he or she should abide by the principles of respect,communion and autonomy.These principles should also be followed in the future legislation of euthanasia.