Objective To compare the effect and safety of rituximab plus CHOP (R-CHOP) and CHOP regimens for the treatment of newly diagnosed patients with early-stage primary gastric diffuse large B-cell lymphoma (PG-DLBCL). Methods A total of 65 patients with PG-DLBCL were retrospectively divided into two groups: 35 patients were treated with R-CHOP regimen, the others with CHOP regimen. NHL international efficacy assessment and WHO criteria were used to assess the therapeutic and the adverse reactions respectively. Results The complete remission (CR) rate of R-CHOP group was 74.3 % (26/35), which was significantly higher than that of CHOP group [50.0 % (15/30), P< 0.05], but the adverse reactions rates of two groups had no significant difference (P>0.05). The Kaplan-Meier survival analysis showed that the five-year survival rates of two groups had no significant difference (88.6%vs 75.0%, P>0.05). The PFS of R-CHOP group was better than that of CHOP group (94.4 months vs 74.9 months, P< 0.05). Conclusion Compared with CHOP regimen , R-CHOP regimen increases the therapeutic efficacy in patients with PG-DLBCL, and dose not increase the adverse reactions.

Objective To evaluate the performance of desmoglein (Dsg)1 enzyme-linked immunosorbent assay (ELISA) in the detection of serum antibodies in patients with pemphigus foliaceus (PF). Methods Sera were obtained from 80 patients with PF and 132 human controls including 33 patients with bullous pemphigoid, 3 patients with linear IgA bullous dermatosis, 2 patients with acquired bullous epidermolysis, 20 patients with systemic lupus erythematosus (SLE), etc, and subjected to a random and blind test by Dsg1 ELISA and indirect immunofluorescence (IIF) on monkey oesophagus. Results The Dsg1 ELISA was positive in 75 (93.8%) patients with PF and 5 (3.8%) human controls (including 1 case of bullous pemphigoid, 1 case of SLE, 1 case of dermatomyositis, 1 case of eczema and 1 normal human control with indeterminate value), and IIF was positive in 71 (88.8%) patients with PF, but in none of the controls. The sensitivity and specificity was 93.8% (95% CI: 0.85 - 0.98) and 96.2% (95% CI: 0.91 - 0.99) respectively for Dsg1 ELISA in the serodiagnosis of PF, 88.8% (95% CI: 0.82 - 0.96) and 100% (95% CI: 0.96 - 1.00) respectively for IIF. There was no statistical difference in the sensitivities (P= 0.289) or specificities (P= 1.000) between the two test methods.Conclusions Dsg1 ELISA is a simple, sensitive and specific serological detection method, and can serve as an adjunct in the diagnosis of PF.

Objective To evaluate the sensitivity and specificity of BP180NC16a-ELISA in the diagnosis of bullous pemphigoid (BP). Methods A multi-center, randomized, double-blind, parallel-controlled study was conducted. Sera were collected from 106 patients with clinically confirmed active BP and 106 control subjects including patients with non-BP bullous diseases, scleroderma, psoriasis or systemic lupus erythematosus,late pregnant women and healthy blood donors. BP180NC16a-ELISA was performed on these sera. The IgG antibody levels measured by ELISA kit were compared with those measured by indirect immunofluorescence (IIF) test. Results Of the 106 BP sera, 81 were positive for BP180NC16a-ELISA with a sensitivity of 76.4%,83 for ⅡF test with a sensitivity of 78.3%. Among the 106 control serum samples, 95 were negative for BP180NC16A-ELISA with a specificity of 89.6%, and 102 for ⅡF test with a specificity of 96.2%. There was no significant difference between the two tests in dignostic sensitivity and specificity for BP (both P ＞ 0.05).Conclusion BP180NC16A-ELISA may serve as an adjuvant tool for the diagnosis of BP.

Objective:To investigate the effect of high-frequency repetitive transcranial magnetic stimulation(rTMS)on cue attention in male patients with alcohol use disorder (AUD) after the acute withdrawal.Methods:A total of 90 male patients AUD who were hospitalized in the Second Affiliated Hospital of Kunming Medical University and Psychiatric Hospital of Yunnan province from May 2020 to December 2020 were enrolled, then they were divided into study group and control group using random number table.Because 18 cases fell out during the study, 36 cases were included in each of the two groups.After the alcohol withdrawal syndrome eliminated, the study group received high-frequency rTMS at 10 Hz for 14 consecutive days, and the control group was administrated by sham rTMS.At baseline and after true or sham rTMS, the cognitive psychology experiment Oddball paradigm was completed, and the behavioral data of the subjects were collected.Paired-sample t-test was used to compare the changes of the two groups before and after treatment.Data analysis were conducted using SPSS 21.0 software. Results:There was no statistical difference between the study group and the control group in terms of drinking level, cognition level and demographic data(all P>0.05). In the Oddball paradigm, compared with the control group((526.72±75.30)ms, (0.98±0.02))the reaction time((497.93±64.51)ms, t=3.145, P=0.008) and accuracy rate((0.99±0.01), t=-2.803, P=0.016) in alcohol-related cues were significantly improved in the study group after rTMS intervention, but in the control group, there were no statistical differences(both P>0.05), whether the cue was alcohol related or not. Conclusion:The results suggest that the rTMS can enhance the attention bias of alcohol-related cues and change the impulse process partly.

Objective This study evaluated the effects of health education promoting therapeutic lifestyle changes in a population with dyslipidemia. Methods Patients with dyslipidemia were randomly assigned to one of four groups: the current group (CG) received conventional health guidance, the educational course (EC) group attended six lectures as part of an educational course, the phone call (PC) group received twice-monthly follow-up by telephone,and the comprehensive group(EC+PC)attended both the educational course and received follow-up telephone calls. Total cholesterol (TC), total triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein (HDL-C), and the knowledge, attitude, and behavior (KAP) score for blood lipids were compared within each group and among groups. Results A total of 214 patients were enrolled and completed the study: 62 patients in CG,49 patients in EC,56 patients in PC,and 47 patients in EC+PC.There were significant differences in the EC,PC,and EC+PC groups after the 24-week intervention. For example, pre- and post-intervention values for each group were as follows:EC group:(5.74±0.69)mmol/L and(5.14±0.87)mmol/L for TC,35.22±1.67 and 42.96±5.72 for KAP;PC group:(5.63±0.58)mmol/L and(5.22±1.07)mmol/L for TC, 34.54.±0.97and 39.41±5.03 for KAP;EC+PC group:(5.60±0.48)mmol/L and(4.00±0.79)mmol/L for TC,35.44±1.80 and 45.05±3.19 for KAP, respectively (P<0.05). The CG group showed no significant differences before and after treatment:(5.66±0.54)vs.(5.32±1.28)mmol/L for TC,34.37±0.65 vs.35.28±4.02 for KAP(P>0.05).In a comparison among the four groups,the EC and PC groups showed greater improvements than the CG group.Moreover, the EC+PC group showed statistically significant differences in the results compared with the other three groups (P< 0.05). Conclusion An educational course combined with telephone follow-up calls was more effective than a single intervention in improving blood lipids and enhancing the health awareness of patients with dyslipidemia.This combined health education model not only improves the effectiveness of treatment to some degree,but also plays a role in its supervision and management.Furthermore,it may also assist in the implementation of continuous nursing services in medical institutions.

Objective:To explore the clinical features and risk factors of in-hospital mortality in idiopathic inflammatory myopathies (IIM) patients.Results:We retrospectively analyzed clinical records of polymyositis (PM), classic dermatomyositis (CDM) and clinically amyopathic dermatomyositis (CADM) patients admitted to the First Affiliated Hospital of Zhejiang University from February 2011 to February 2019. The deceased group was defined as the patients who died in hospital or within 2 weeks after hospital discharge, while the survival group was defined as the survival patients. The clinical features were described. Risk factors for deceased patients were identified by logistic regression analysis.Results:The in-hospital mortality rate of IIM patients ( n=424) was 9.4%. The hospitalization time was longer in deceased group ( n=40) [0.9(0.5, 1.0) m vs 0.6(0.4, 1.0) m, Z=-2.159, P<0.05]. Ferritin [1170.8(757.6, 3 759.9) μg/L vs 374.9(182.1, 993.4) μg/L, Z=-4.665], red blood cell distribution width (RDW) [15.2(14.5, 16.3)% vs 14.4(13.5, 15.2)%, Z=-3.066], CRP con-centrations [11.3(4.4, 36.9) mg/L vs 5.1(1.8, 17.2) mg/L, Z=-2.667] and neutrophil-to-lymphocyte ratio (NLR) [10.1(5.5, 18.9) vs 4.2(2.6, 6.5), Z=-5.108] were higher in deceased group ( P<0.05). Proportion of patients with high levels of CEA (45.0% vs 12.5%, χ2=15.745), glutamyl transpeptidase (γ-GT) (55.0% vs 23.8%, χ2=11.578), fucosidase (AFU) (35.0% vs 10.0%, χ2=10.902) and with complications [including pro-gressive in-terstitial lung disease (ILD) (60.0% vs 16.3%, χ2=23.934), pulmonary infection (72.5% vs 20.0%, χ2=31.360), hemophagocytic lymphohistiocytosis (35.0% vs 1.3%, χ2=27.771) and low T3 syndrome (50.0% vs 17.5%, χ2=16.644) were higher in deceased group ( P<0.05). Steroid pulse therapy and intravenous immuno-globulin therapy were more common in deceased group. Higher on-admission disease activity [ OR=1.593, 95% CI(1.255, 2.022), P<0.001], progressive ILD [ OR=5.600, 95% CI(1.510, 20.772), P=0.010] and pulmonary infection [ OR=6.771, 95% CI(2.031, 22.574), P=0.002] were independent risk factors for death in IIM patients. In su-bsection analysis, pulmonary infection and respiratory failure were short-term adverse prognostic factors for IIM patients with progressive ILD, while heliotrope rash, progressive ILD and increased steroid dose therapy were short-term adverse prognostic factors for IIM patients with pulmonary infection. Conclusion:High disease activity at admission, progressive ILD and pulmonary infection are the independent risk factors for death in IIM patients. Therefore, it is necessary to closely monitor above indicators during hospitalization.

The interaction of gut microbiota and its metabolites with the host not only plays an important role in maintaining gut homeostasis and host health, but also is a key link in responding to pathogen infections. A thorough understanding of the changes in gut microbiota and its metabolites during infection, as well as their role and mechanism in host defense against infection, is helpful to guide anti-infection treatment. This review focuses on the role of gut microbiota and their metabolites in host defense against bacterial, fungal, and viral infections, and reveals that they can exert anti-infection effects through resistance mechanisms (inducing antimicrobial substances, training immunity, inhibiting pathogen respiration, directly neutralizing pathogens, immune regulation) and tolerance mechanisms (altering energy metabolism patterns of microbiota, cell proliferation and tissue damage repair, maintaining physiological signal transduction in extraintestinal organs, inflammation regulation, maintaining the integrity of the intestinal barrier), and also summarizes measures to regulate gut microbiota against pathogen infections, in order to provide more ideas for novel anti-infection prevention and treatment strategies targeting gut microbiota and its metabolites.

Schizophrenia is a serious mental disease. The diagnosis of schizophrenia so far relies heavily on subjective evidence, including self-reported experiences by patients, manifestations described by relatives, and abnormal behaviors assessed by psychiatrists. The diagnosis, monitoring of the disease progression and therapy efficacy assessment are challenging due to the lack of established laboratory biomarkers. Based on the current literature, clinical consensus, guidelines, and expert recommendations, this review highlighted evidence-based potential laboratory biomarkers for the diagnosis of schizophrenia, including genetic biomarkers, neurotransmitters, neurodevelopmental-related proteins, and intestinal flora, and discussed the potential future directions for the application of these biomarkers in this field, aiming to provide an objective basis for the use of these biomarkers in the early and accurate diagnosis, treatment, and prognosis and rehabilitation assessment of schizophrenia.

OBJECTIVETo evaluate the safety and immunogenicity of seasonal inactivated influenza vaccine (split virion) and to analyze its cross-reactive antibody responses to H7N9 avian influenza virus.

METHODSAn open-labeled clinical trial was carried out in infants aged 6-35 months, adults aged 18-60 years and the elderly aged >60 years. After vaccinations (one dose for adults and the elderly and two doses for infants), adverse events were observed. Serum samples were obtained before vaccination and 21 days after vaccination from adults and elderly subjects. Three types of antibody against seasonal influenza virus and antibody against H7N9 avian influenza virus were tested using microhemagglutination inhibition (HI) assay. Immunogenicity of the vaccine was evaluated based on the immunogenicity criteria for adults and the elderly, set by the Committee for Medicinal Products for Human Use (CHMP) for the European Medicines Agency.

RESULTSA total of 202 subjects (65 infants, 69 adults and 68 elderly) were enrolled and injected for at least one dose. The overall rate of adverse events was 12.4% (25/202) and most of them were under systemic reaction. No serious adverse event was reported. Pre- and post-vaccination serum samples were collected from 124 subjects (64 adults, 60 elderly). After 21 days of vaccination, the sero-conversion rate, sero-protection rate, and geometric mean titer (GMT) ratio (post-/pre-vaccination) of antibody against seasonal influenza virus were 78.1%-90.6%, 92.2%-100.0% and 7.9-41.0 among adults while 66.7%-83.3%, 86.7%-100.0% and 5.7-20.4 among the elderly, respectively. However, after vaccination, both sero-conversion rate and sero-protection rate of antibody against H7N9 avian influenza virus among adults and the elderly became zero, with GMT ratio between 1.2 and 1.4.

CONCLUSIONThis trial vaccine appeared to have good safety and immunogenicity but inducing no cross-reactive antibody response to H7N9 avian influenza virus.

Adult ; Aged ; Aged, 80 and over ; Antibodies, Viral ; blood ; Antibody Formation ; Child, Preschool ; Cross Reactions ; Hemagglutination Inhibition Tests ; Humans ; Infant ; Influenza A Virus, H7N9 Subtype ; Influenza Vaccines ; immunology ; therapeutic use ; Middle Aged ; Vaccines, Inactivated ; immunology ; therapeutic use ; Young Adult

Primary familial brain calcification (PFBC) is an inherited neurodegenerative disorder mainly characterized by progressive calcium deposition bilaterally in the brain, accompanied by various symptoms, such as dystonia, ataxia, parkinsonism, dementia, depression, headaches, and epilepsy. Currently, the etiology of PFBC is largely unknown, and no specific prevention or treatment is available. During the past 10 years, six causative genes (SLC20A2, PDGFRB, PDGFB, XPR1, MYORG, and JAM2) have been identified in PFBC. In this review, considering mechanistic studies of these genes at the cellular level and in animals, we summarize the pathogenesis and potential preventive and therapeutic strategies for PFBC patients. Our systematic analysis suggests a classification for PFBC genetic etiology based on several characteristics, provides a summary of the known composition of brain calcification, and identifies some potential therapeutic targets for PFBC.
Animals ; Brain Diseases/therapy* ; Xenotropic and Polytropic Retrovirus Receptor ; Brain/pathology*