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Epstein-Barr virus (EBV) -positive diffuse large B-cell lymphoma, not otherwise specified (DLBCL-NOS), an aggressive B-cell lymphoma associated with chronic EBV infection, is an entity included in 2016 World Health Organization classification of lymphoid neoplasms. EBV-coding RNA (EBER) is expressed in the nucleus of these tumor cells. EBV -positive DLBCL can be mostly found in the elderly who have poor immunochemotherapy effect and short overall survival time, and this poor prognosis is inconsistent with international prognostic index (IPI) stratification. CD30 and programmed death 1/programmed death ligand 1 are expected to be the potential prognostic indicators and therapeutic targets. This paper reviews the relationship between EBV-positive DLBCL-NOS and EBV infection, clinicopathological characteristics, prognostic evaluation factors and treatment in the era of new drugs.
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Primary biliary cholangitis (PBC) is an autoimmune disease commonly observed in middle-aged women, and it may progress to liver cirrhosis and liver failure. Ursodeoxycholic acid and obeticholic acid are the only first - and second-line drugs approved by the FDA, but about 40% of patients are insensitive to UDCA. Studies are being conducted on a variety of second-line drugs such as fibrates and immunosuppressive drugs, and liver transplantation is the only treatment method for end-stage PBC. This article reviews the research advances in the treatment of PBC and related mechanisms, in order to provide a reference for clinical practice.
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T lymphocyte immune dysfunction plays an important role in the occurrence and development of chronic obstructive pulmonary disease (COPD), but the specific mechanism is not fully understood. Programmed cell death 1 (PD-1) negatively regulates the activation and effector function of T lymphocytes by binding to its ligand PD-L1, thus participating in the maintenance of immune tolerance. Recent studies have found that blocking the PD-1/PD-L1 signaling pathway can improve T-cell depletion and enhance the ability of anti-infection in COPD patients. Therefore, understanding the regulatory effects of PD-1 on T lymphocytes is of great significance to studying the pathogenesis and clinical treatment of COPD. This article briefly reviewed the research progress in PD-1 in terms of structure, function, T cell regulation and relationship with COPD.
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ObjectiveTo investigate the effect of primary duct closure and T-tube drainage after laparoscopic common bile duct exploration, as well as the criteria for clinical application of primary duct closure. Methods A retrospective analysis was performed for the clinical data of patients with common bile duct stones who were treated in The First Hospital of Jilin University from July 2014 to July 2015, and 51 patients who met the inclusion criteria were enrolled. Among these patients, 26 underwent primary closure of the common bile duct and 25 underwent T-tube drainage. The change in total bilirubin after surgery, time to recovery of gastrointestinal function, volume of peritoneal drainage at 1 day after surgery, time of removal of peritoneal drainage tube, complications, length of postoperative hospital stay, and total hospital fee were analyzed and compared between the two groups. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. ResultsThe length of postoperative hospital stay and total hospital fee showed significant differences between the two groups (t=-7.067, P＜0.001; t=-3.126, P=0.003). One patient in each group experienced a complication and was cured after treatment. ConclusionOn the basis of strict control of surgical indications, the primary closure of common bile duct after laparoscopic common bile duct exploration has the advantages of a short length of hospital stay, low hospital fee, and high quality of life, and is safe and feasible. Therefore, it holds promise for clinical application.
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OBJECTIVE:To establish a method for the determination of related substances in methylacrylic acid- ethyl acrylate copolymer. METHODS:HPLC was performed on the column of Agilent C18 with mobile phase of methanol-phosphate buffer(70∶30,V/V) at the flow rate of 1.0 ml/min,the detection wavelength was 202 nm,column temperature was 20 ℃,and the sample size was 20 μl. RESULTS:The linear range was 0.001%-0.015% for both methylacrylic acid(r=0.999 4)and ethyl acrylate(r=0.999 1);RSDs of precision,stability and reproducibility tests were lower than 2%;the average recoveries of methylacrylic acid and ethyl acrylate were respectively 86.59%(RSD=2.3%,n=9)and 91.24%(RSD=3.5%,n=9). CONCLUSIONS:The method is simple,accurate and reproducible,and can be used for the contents determination of related substances in methyl acrylic acid-eth-yl acrylate copolymer.
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AIM:To observe the effects of Huoxue-Yiqi-Bushen prescription on the hemorrheological parame-ters and endothelial nitric oxide synthase ( eNOS) activity in the aged patients with hip arthroplasty at postoperative period. METHODS:The patients ( n=60) operated by the same group of doctors were randomly divided into traditional Chinese medicine ( TCM) group, low-molecular-weight heparin ( LMWH) group and control group.Postoperative patients in TCM group were administrated with Huoxue-Yiqi-Bushen prescription.In LMWH group, 20 patients received LMWH postopera-tively.The patients in control group took aspirin enteric-coated tablets.The eNOS activity, nitric oxide (NO) content and hemorrheological parameters were observed before operation and 1 d and 10 d after operation.RESULTS: No significant difference of eNOS activity, NO content, whole blood viscosity (WBV), plasma viscosity (PV), hematocrit (HCT), erythrocyte aggregation index ( EAI) , index of rigidity ( IR) , erythrocyte deformation index ( EDI) and erythrocyte electro-phoresis time (EET) between 3 groups 1 d after operation was found, while significant difference (P<0.01) appeared be-tween TCM group and control group 10 d after operation.CONCLUSION:Huoxue-Yiqi-Bushen prescription can effective-ly increase eNOS and NO levels and improve hemorrheological parameters at postoperative period in aged patients with hip arthroplasty.
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BACKGROUND: Vertebral reconstruction is stil a chal enge for spinal surgeons. Ideal reconstruction materials should have good osteogenesis ability, reliable support performance, low price and simple operating steps. OBJECTIVE:To investigate the effect and feasibility of al ogenic cortical ring packed with autogenous cancellous bone in the reconstruction of rabbit cervical vertebra defect. METHODS:Cervical vertebra defect models were established by resection of the fourth cervical vertebra in rabbits. Frozen-dried humeral cortical ring of rabbits was made to prepare the al ogenic cortical ring which was packed with autogenous cancellous bone. Then, al ogenic cortical ring packed with autogenous cancellous bone, single al ogenic cortical ring and autogenous iliac bone were used to repair rabbit cervical vertebra defects. RESULTS AND CONCLUSION:The X-ray, histopathological examination, and scanning electron microscope examinations al showed that the bone union was most significant in group reconstructed with al ogenic cortical ring packed with autogenous cancellous bone. The alkaline phosphates activity in serum was higher in groups reconstructed with al ogenic cortical ring packed with autogenous cancellous bone and with autogenous iliac bone than in group reconstructed with only al ogenic cortical ring at 2 and 4 weeks after operation (P<0.01), but there was no difference between the former two groups. The biomechanical examination showed that the stability of al ogenic cortical ring packed with autogenous cancellous bone was higher than that of autogenous iliac bone at 1 month after operation (P<0.01). These findings indicate that the effect of al ogenic cortical ring packed with autogenous cancellous bone in the reconstruction of rabbit cervical vertebra defects is satisfactory, with a good biocompatibility, which is a promising method for the reconstruction of vertebral defects.
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BACKGROUND: Many scholars adopt allograft interbody fusion for vertebral body resection and reconstruction, bone fusion time is better than autologous bone graft's, and its integration provides an early support and stabilizing, but the preparation of allogeneic bone graft material is easy to destroy b0ne-inducing factor in matrix, which is not conducive to bone growth. OBJECTIVE: To innovatively design and verify the ability of reconstructing rabbit cervical vertebrae with the compound of humeral cortical ring allograft (HCA) packed with red bone marrow (RBM) and autogenous cancellous bone (ACB). DESIGN, TIME AND SETTING: Randomized controlled animal experiment was performed at the laboratory of Orthopedic Department in Renmin Hospital of Wuhan University, between October 2004 and March 2006. MATERIALS: Sixty healthy adult New Zealand white rabbits, of either sex, body mass of 2.0-2.5 kg, were involved in this study. Twelve rabbits were used for HCA preparation, while the remaining 48 rabbits were randomly divided into 3 groups with sixteen rats in each group. Autologous RBM was extracted from the anterior superior lilac spine through puncture; ACB was obtained from td-cortical bone of rabbit iliac crest. Autologous RBM and ACB were compounded and filled in the self-made HCA. METHODS: Models of the fourth cervical vertebrae defect were created by surgery to simulate tumor resection in New Zealand white rabbits, which were divided into 3 groups randomly. Combined transplant group was treated with the compound of RBM+ACB+HCA; autologous bone transplant group with autogenous lilac crest; HCA transplant group with HCA. MAIN OUTCOME MEASURES: Vertebral reconstructions were evaluated by X-ray, histopathological observation and scanning electron microscope, as well as measurement of serum alkaline phosphates at different periods postoperatively. RESULTS: Eight weeks post-surgery, graft materials fused with the upper and lower cervical fusion, a large number of bone callus were observed in combined transplant group and autologous bone transplant group; HCA transplant group was present with a small amount of callus growth and poor fusion. Serum alkaline phosphatase levels were elevated in all groups, significantly higher in combined transplant group and autologous bone transplant group compared with HCA transplant group (P < 0.01 ). There were no significant differences of serum alkaline phosphatase levels between combined transplant group and autologous bone transplant group at 4 weeks or among 3 groups 8 weeks (P > 0.05). Histological analysis exhibited numerous mature bone matrix, bone trabecula and bone marrow cavity formed in combined transplant group and autologous bone transplant group. Scanning electron microscopy showed that many new bone formations in combined transplant group and autologous bone transplant group.CONCLUSION: The compound of RBM+ACB+HCA and autogenous lilac crest transplantation can efficiently reconstruct cervical vertebrae, RBM+ACB can improve the reconstruction efficiency of HCA, and could use as a matedal in cervical reconstruction.