Objective To evaluate the clinical efficacy and toxicity of rituximab combined with CHOP (R-CHOP) in the treatment of relapsed or refractory diffuse large B cell lymphoma (DLBCL).Methods 30 patients were enrolled.All patients,pathologically confirmed to be CD20 positive DLBCL (all in stages Ⅲ-Ⅳ ), were relapsed or refractory after received 2-6 cycles of chemotherapy. Then all of them received R-CHOP schedule for 4 to 6 cycles, each cycle was 21 days. Clinical data before and after R-CHOP were collected.A retrospective analysis of the R-CHOP therapy,either compared to the literature or self-control was performed to evaluate the efficacy and toxicity. Results All the 30 patients were evaluable, induding 15 cases were complete remission (CR), 10 cases were partial remission (PR), 3 cases were stable disease (SD),and 2 cases were progressed disease (PD).The CR rate was 50.0 ％ (15/30),the total response rate (RR) was 83.3 ％ (25/30).All patients were well tolerated to the therapy.Only 3 cases were Ⅱ degree neutropenia,1 case was Ⅰ degree thrombocytopenia, and 2 cases suffered nausea and other mild gastrointestinal discomfort. Conclusions R-CHOP regimen could also achieve good response for relapsed or refractory DLBCL significantly.The common adverse effects of rituximab were mild.All the patients were well tolerated.

Objective To investigate secretory IgA change in uremic patients ane its relationship with inflammation. Methods Sixty uremic noneialysis patients( uremic non eialysis group)ane 60 hemoeialysis patients( hemoeialysis group ),the other 40 healthy volunteers( control group ) were selectee as our subjects. Enzyme linkee immunosorbent assay( ELISA)methoe were appliee to eetect the fecal secretory IgA content. Immune nephelometry were usee to measure the level of high sensitivity C reactive protein(hs-CRP). Results The level of fecal secretory IgA expression in hemoeialysis group((2. 39 ± 0. 81)μmol/ L)ane the non eialysis group((2. 43 ± 0. 84)μmol/ L)were significantly lower than that of the control group((2. 89 ± 0. 87)μmol/ L),ane the eifference was significant(F = 5. 042,P < 0. 01),while there was no significant eifference between the eialysis group ane the non eialysis group(P > 0. 05). The negative correlation was seen between secretory IgA content ane hs-CRP in patients(r = - 0. 629,P < 0. 01). Conclusion The secretory IgA eecreasee in patients with or without uremic eialysis ane it is correlatee with inflammatory state.

Objective:To investigate the relationship between DNA methyltransferase (DNMT1) and EZH2 gene expression levels and their clinical significance in patients with acute myeloid leukemia (AML). Methods:The mRNA expression levels of DNMT1 and EZH2 in 50 AML cases and 30 healthy controls were quantified through real-time PCR. The relationship among DNA methyltransferase (DNMT1) and EZH2, clinicopathological factors, and prognosis was analyzed. Results:The mRNA expression of DNMT1 in the AML cases (2.72 ± 0.73) was significantly higher than that in the healthy controls (0.89 ± 0.27) (P<0.01). The mRNA expression of EZH2 in the AML cases (4.39±1.06) was also significantly higher than that in the healthy controls (1.87±0.33) (P<0.01). The expression of DNMT1 was positive-ly associated with that of EZH2 (r=0.51, P=0.002). The expression of DNMT1 was also associated with PB%and WBC≥50 × 109/L (P<0.05). The overall survival of the group with a high-mRNA-expressing DNMT1 was 15 months (95%CI=9-19 months). This period was significantly shorter than that of the group with low-mRNA-expressing DNMT1 (32 months, 95%CI=27-40 months;P=0.006). Conclu-sion:DNMT1 and EZH2 expression levels were downregulated. These levels were associated with poor AML prognosis. The expression of DNMT1 was also positively associated with that of EZH2.

Objective nvestigate the propofol combined with fentanyl anesthesia in orthopedic manual reduction applications.MethodsAugust 2015 to December 2016 in our hospital treated 120 cases of acute long bone closed fracture and ankle, shoulder dislocation and other patients, efficient analysis anesthesia, surgery time, patient recovery time, propofol is added volume and total volume, and detection 3min, 1min, 3min, 5min and waking SpO2, HR, MAP, RR values.Two groups of patients after treatment, were given nursing intervention, such as routine diet guidance, nutrition support, health education.after administration before it is administered.Resultsanesthetic effect experimental group total efficiency is higher, the difference was statistically significant (P<0.05);after simultaneous administration of all patients 1min, 3min, 5min signs were lower than prodrug 3min signs, the difference statistically significant (P<0.05), after clear signs of its former administration 3min with no significant difference;experimental group recovery time, propofol bolus of propofol than with total control were lower, the difference was statistically significant (P<0.05);and the two groups were similar to the operation time, the difference was not statistically significant.ConclusionIn summary, propofol combined with fentanyl anesthesia for patients to take the treatment of orthopedic manual reduction obviously worthy of clinical use.

Objective To analyze the causes of preoperative misdiagnosis of primary gallbladder carcinoma,and the effective measures of prevention of the misdiagnosis.Methods We retrospectively analyzed the clinicalrecords of 52 cases with primary gallbladder carcinoma that had been treated in our hospital in 10 years,and analyzed the causes of misdiagnosis.Results Nineteen cases were diagnosed preoperatively(36.5%),while 33 cases were misdiagnosed before operation(63.5%),including misdiagnsed as cholecystolithiasisin 13 cases,gallbladder polyps in 8cases,atrophic cholecystitis in 4cases,hepatic hilar cholangiocarcinoma in 3 cases,tumor of liver in 4 cases,and Mirizzi syndrome in 1 case.There were 29 casesdiagnosed during operation(55.8%),and 4 cases misdiagnosed intratoperatively(7.7%).Misdiagnosiswas due to several reasons:complicated with other gallbladder disease,lack of distinctive clinical features of gallbladder carcinoma,over dependence on imaging methods,and not doing fast frozen section duringoperation in dubious cases.Conclusions In suspected cases with high risk of gallbladder cancer,imagingstudies should be performed,and,if necessary,invasive studies and even exploratory laparotomy should be done.Also,intraoperative rapid frozen section can result in early discovery and treatment,and is conducive to improvement of prognosis of gallbladder carcinoma.

Objective To investigate the incidence of contrast-induced nephropathy (CIN) in the elderly undergoing coronary angiography and the correlated clinical risk factors.Methods 0.90% sodium chloride (1 ml · kg~-1 · h~-1 ) was administered 6 hours before and 12 hours after contrast media administration for 195 elderly patients,and the dose of sodium chloride was half when the patients were suffering from severe congestive heart failure.The levels of serum creatinine (Scr) and cystatin C were measured 3 days before and on the 2nd,5th day after the administration of contrast,respectively .Results(1) The incidence of CIN was 8.7% (17/195).The renal function of 11 cases recovered to baseline level 3 months after the use of contrast,2 cases had transformation to chronic renal failure but without undergoing maintenance hemodialysis,and 3 cases were dependent on maintenance hemodialysis,while 1 case developed multiple organ dysfunction until death.(2) There was no significant difference between pre-and post-contrast administration in the level of cystatin C (t=O.137,P= 0.891). But the concentration of Scr was reduced significantly on the 2nd day compared with the baseline (t=4.776,P = 0.000).Both the cystatin C and Scr recovered to the baseline on the 5th day.(3) There were no significant differences between the CIN and non-CIN group in gender,the dose of contrast,the baseline Scr,and the proportion of coronary heart disease.But there were significant differences in age,the baseline serum cystatin C,the proportions of diabetes mellitus,hypertension and congestive heart failure.(4) The clinical risk factors of CIN were the baseline Scr (OR = 1.039),the baseline serum cystatin C (OR=6.654),diabetes mellitus (OR=8.104) and congestive heart failure (OR=9.597) according to the analysis of logistic regression.ConclusionsWith the hydration and the use of low-osmolar nonionic contrast,it is safe to receive contrast examination for the elderly patients.The baseline serum levels of Scrand cystatin C,diabetes mellitus and congestive heart failure are the clinical risk factors of CIN.Compared with Scr,serum cystatin C is the more powerful predictor for the development of CIN.

Objective To explore the increasing risk of herpes zoster and its possible mechanisms for hematologic disorders treated with arsenic trioxide (ATO). Methods The cases were divided into study group (with ATO) and control group (without ATO). The incidence rate of herpes zoster was compared between the two groups, and then the average cycles of chemotherapy were compared between the patients complicated with herpes zoster or not in study group. Results The rate of herpes zoster was significantly higher in study group than that in control group (χ2 =4.492, P =0.034). The rates of herpes zoster were 23.95 % (23/96) in study group and 7.89 % (3/38) in control groups. Patients in study group with herpes zoster had received 7.60 cycles and those without herpes zoster 7.72 cycles of chemotherapy on average (Z=0.976, P=0.296).Conclusion The risk of herpes zoster complication in hematologic disorders was increased after ATO treatment which probably activated varicella-zoster virus.

Objective To explore the medium effect of social support in process of attachment styles and coping styles on criminal juveniles and adolescents with mood disorders.Methods The survey used in the research included Experiences of Close Relationships Inventory (ECR),Social Support Revalued Scale(SSRS) and Coping Style Questionnaire(CSQ) conducted by three groups:177 criminal juveniles,80 adolescents with mood disorders and 163 normal teenagers.Results Firstly,there were significant differences in the avoidant attachment,attachment anxiety,objective support,subjective support,utilization of support,solving problem,rationalization,self-accusation and retreat among three groups (F=7.902,8.047,59.009,19.248,5.304,7.596,10.652,6.699,11.009;P＜0.05).Secondly,attachment avoidance had significant negative correlation with both utilization of support and help seeking behaviors in the group of mood disorders (r =-0.470,-0.350; P＜ 0.01).Similarly,avoidant attachment had significant negative correlation with both subjective support and utilization of support respectively (r=-0.232,-0.235 ; P＜0.01) in the group of criminal juveniles.The subjective support had significant positive correlation with solving problem (r=0.272,P＜0.01) and as well as the utilization of support with both solving problem and help seeking behaviors (r=0.258,0.424; P＜ 0.01).Attachment anxiety had significant negative correlation with objective support and had significant positive correlation with self-accusation respectively (r=-0.253,0.300;P＜0.01).Finally,utilization of support as a medium completely effect on the process of avoidant attachment and help seeking behaviors in the group of mood disorder and criminal juveniles.Moreover,subjective support and utilization of support as medium both affected a part in the process of avoidant attachment and solving problem for the group of criminal juveniles.Conclusion First,both adolescents with mood disorders and criminal juveniles have unsafe attachment mode,which are lacked social support and easy to take negative coping styles.Yet,the level of attachment avoidance and subjective support of criminal juveniles was found different compared to teenagers with mood disorder.Second,the attachment styles for both adolescents with mood disorders and criminal juveniles have impact on coping styles by the means of social support,but there were slightly different way.

To explore the intervention effects of Xiaopi Pill (XPW), a compound traditional Chinese herbal medicine, on the development progress of dimethylnitrosamine (DMN)-induced liver fibrosis in rats.