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Objective To explore the features of non-Hodgkin lymphoma (NHL) with hemophagocytic syndrome (HPS) as the initial manifestation at diagnosis. Methods The morbidity and treatment of two B-cell NHL patients with HPS as the initial manifestation were retrospectively analyzed, and the literature were reviewed at home and abroad. Results Two B-cell NHL patients with HPS were treated with the HLH-94 protocol to control febrile condition. After then, R-CHOP protocol (dexamethasone substituted for prednisone) was used and their results were good. In reviewing the literature, it was felt that the main sub-type of B-cell lymphoma-associated HPS (B-LAHPS) was diffuse large B-cell lymphoma. However, sub-types of T-cell lymphoma-associated HPS (T-LAHPS) had no significant difference. The incidence of T-LAHPS was significantly higher than that of B-LAHPS in China and South Korea, but there was no significant difference in the Western countries. T-cell lymphomas were more vulnerable to HPS. The median age of B-LAHPS patients at diagnosis was significantly higher than that of T-LAHPS patients. The median survival and overall survival time of B-LAHPS patients were longer than those of T-LAHPS patients by virtue of the application of rituximab. Conclusion B-cell NHL with HPS as the initial manifestation treated with the 2004-HLH plus R-CHOP protocol could achieve good outcomes.
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Objective To review the trends of survival rates and complications in extremely low birth weight (ELBW) infants and to improve the prognosis of ELBW infants.Method From January 1999 to December 2015,ELBW infants in our hospital were retrospectively studied.Their survival rates and complications were compared among groups with different birth weight,and the risk factors for survival were identified using multivariate unconditional logistic regression analysis.Result A total of 243 ELBW infant were collected.The median gestational age of ELBW infant was 27.3 weeks (23 ～ 34 weeks),and their median birth weight was 890 g (490 ～ 995 g).Excluding 40 cases refused treatment,the cure and survival rates of the remaining 203 ELBW infants were 43.8％ (89/203) and 65.0％ (132/203),respectively.The survival rate in ELBW infant with birth weight ＜ 600 g was 0/3,increased to 70.8％ (68/96) when birth weight was 900 ～ 999 g,with an ascending trend with increased birth weight (x2 trend =12.673,P ＜0.001).The most common complications of 243 cases were neonatal respiration distress syndrome [87.7％ (213/243)],sepsis [45.3％ (110/243)],intraventricular hemorrhage [37.4％ (91/243)],bronchopulmonary dysplasia [36.6％ (89/243)] and pheumonia [36.6％ (89/243)].The incidence of complications (including intracerebral hemorrhage and hydrocephalus),decreased with increased birth weight.Multivariate unconditional logistic regression analysis found that birth weight below 800 g (＜ 700 g:OR =22.333,95％ CI 1.493 ～ 334.148,P =0.024;700 ～ 799 g:OR =3.573,95％ CI 1.075 ～ 11.874,P =0.038),stage Ⅲ necrotizing enterocolitis (OR =8.803,95％ CI 1.308 ～ 59.244,P =0.025),stage Ⅲ and Ⅳ of intraventricular hemorrhage (OR =8.902,95％ CI 1.127 ～ 70.338,P =0.038) and mechanical ventilation (OR =3.597,95％ CI 1.043 ～ 12.410,P =0.043) were risk factors affecting the ELBW infant's survival.Conclusion As birth weight increases,the survival rate also increases,and the rate of complications decreases.Birth weight,stage Ⅲ necrotizing enterocolitis,stage Ⅲ and Ⅳ intraventricular hemorrhage and mechanical ventilation are risk factors for the ELBW infant's survival.
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AIM:To explore an ideal method to induce the differen-tiation of human umbilical cord mesenchy-mal stem cells (hUCMSCs) into neuron-like cells and to provide some evidence for the transplantation of hUCMSCs for spi-nal cord injury .METHODS:The hUCMSCs were isolated from human umbilical cord digested with collagenase Ⅱ.The hUCMSCs was verified by flow cytometry analysis .The passage 5 cells were randomly divided into 4 groups.The differentiation of hUCMSCs was induced by bFGF in group A , bFGF and BDNF in group B, or BHA, bFGF and BDNF in group C, while the cells in group D served as a control group cultured with DMEM-F12 and 10%FBS.Two weeks later , the expression of nestin , neurofilament protein H ( NEFH) and glial fibrillary acidic protein ( GFAP) was detected by real-time PCR and immunocytochemistry .The morphological changes of cells were observed under an atomic force microscope . RESULTS:Mesenchymal stem cells were isolated and cultured from human umbilical cord by enzyme digestion .hUCMSCs expressed CD29, CD44 and CD105, but no CD34, CD45 or HLA-DR.After cultured with inducing medium for 2 weeks, the cells were successfully induced into neuron-like cells.The appearance of the cells had great change .The induced hUC-MSCs developed round cell bodies with multiple neurite-like extensions observed under an atomic force microscope .The re-sult of real-time PCR showed that nestin was positive in A , B and C groups , and NEFH was positive in A and B groups , but GFAP was negative in 4 groups.The difference of nestin and NEFH expression among the induced groups was signifi -cant (P<0.05).CONCLUSION:Mesenchymal stem cells were isolated and cultured from human umbilical cord by en-zyme digestion in vitro, and all the hUCMACs presented stable biological properties .Moreover, hUCMSCs were induced to differentiate into neuron-like cells in vitro via bFGF combined with BDNF .
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Objective To study the predictive validity of general movements (GMs) assessment for motor development outcomes in neonatal purulent meningitis.Methods According to the inclusion criteria,excluding other cerebral injury diseases,a total of 34 cases of neonatal purulent meningitis,who took part in our follow-up clinic after discharged from neonatal intensive care unit of the Second Affiliated Hospital of Wenzhou Medical University from December 2012 to December 2013,were confirmed as the participants.Infants' GMs recordings during writhing movements period (at least once at 0-3 months) and fidgety movements period (at least once at 3-5 months) were collected and assessed.Motor development outcomes was determined at least after one year old with Alberta Infant Motor Scale(AIMS).Predictive validity in each period were calculated with AIMS results as the golden standard.Results Among the 34 cases,there were 24 males and ten females,and four preterm infants and 30 term babies.The age at follow-up was from 12 months to 23 months old.Ultimately,one (3％) infant with spastic cerebral palsy,seven (21％) with motor retardation and 26 (76％) with normal motor development were diagnosed.The sensitivity,specificity,positive predictive value,negative predictive value,Youden index and residual error rate for the writhing movements period in prediction of motor development outcomes were 87.5％,46.2％,33.3％,95.6％,33.7％ and 12.5％,respectively.And the corresponding figures for the fidgety movements period were 87.5％,88.5％,70.0％,95.8％,76.0％ and 12.5％,respectively.Conclusions GMs assessment could be an accurate predictive tool for later motor developmental outcomes in neonates with purulent meningitis,especially in fidgety movements period.
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Objective To analyze the clinical efficacy and safety of different ways iron therapy in hemodialy -sis patients with renal anemia .Methods 68 cases of chronic renal failure patients treated with hemodialysis were randomly divided into two groups according to the digital form ,each group had 34 cases.The control group was treated with oral iron while the observation group took intravenous iron ,the clinical efficacy of the two groups was observed . Results The total effective rate of the observation group was 61.76% significantly higher than that of the control group′s 32.35%(χ2 =4.781,P=0.029);Two groups of patients′Hb,Hct,SF,TSAT were significantly improved after treatment than before(t =4.931,4.213,5.429,5.107,7.018,6.472,7.821,7.530,all P <0.05),these parameters of the observation group were significantly improved than that of the control group ( t =4.082,3.968, 4.395,4.139,all P <0.05).Conclusion Intravenous iron approach can significantly improve anemia state in patients with CRF hemodialysis , increased serum iron indicators significantly , improved erythropoiesis , and quickly replenish iron stores,correct anemia in patients with CRF .
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@#ObjectiveTo study the characteristic findings on MRI in children surviving premature delivery with cerebral palsy.MethodsThe clinical data and MR imaging in 16 cases surviving premature delivery with cerebral palsy was retrospectively analyzed, compared with 16 healthy and age-matched controls.Results16 cases were final diagnosed as cerebral palsy with spstic diplegia. MRI features of children surviving premature delivery with cerebral palsy included abnormally high signal intensity in the periventricula white matter on T2WI, marked loss of periventricular deep white matter, ventriculomegaly with or without irregular ventricular outline and atrophy of the corpus callossum. These features were consistent with periventricular leukomalacia(PVL).ConclusionPVL was the characteristic findings on MRI in children surviving premature delivery with cerebral palsy. The characteristic findings of PVL was useful in determining the etiology and type of cerebral palsy in children.