Objective To evaluate the clinical efficacy and toxicity of EPOCH regimen in the treatment of elderly patients with peripheral T-cell lymphoma. Methods Twenty-eight elderly patients with pathologically diagnosed peripheral T-cell lymphoma were treated with EPOCH regimen, including 96-hour continuous infusion of etoposide 50 mg/m2, epirubincin 12 mg/m2 and vincristin 0.4 mg/m2 on daysl through 4,cyclophosphamide 750 mg/m2 given as intravenous bolus on day 5 and prednisone 60 mg/m2 administered orally on daysl through 5. The EPOCH regimen was repeated very 21 days. Clinical efficacy and safety profiles of EPOCH regimen was systemically reviewed and analysed. Results All the 28 patients received a total of 85 cycles of EPOCH regimen. The median cycles was two courses. Fifteen patients achieved complete response, while five cases obtaining partial response. The overall response rate was 71.4 %. The median survival time was 20 months. In newly diagnosed patients, complete response rate (CR) as well as partial response (PR) and overall response rate (OR) reached 64.7 %, 23.5 % and 88.2 %, respectively, which was significantly higher than that in refractory cases, whose CR, PR and OR were 36.4 %, 9.1% and 45.5 %(λ 2 = 5.99, P ＜0.05). In addition, the median survivalduration of newly diagnosed patients was longer than that of refractory cases, whose median survival time was 24 and 13 months, respectively. The major adverse events was myelosuppression with grade 3-4 neutropenia and thrombocytopenia in 53.6 % and 50.0 % cases.Non-hematologic toxicities were moderate and uncommon. The frequency of adverse effects in de novo patients showed little difference in comparison with that in refractory ones (P＞0.05). Conclusion EPOCH regimen was an effective and well tolerated therapeutic schedule for elderly patients with peripheral T-cell lymphoma.

OBJECTIVE:To establish the method for simultaneous determination of 5 saponins in Lonicerae Flos. METHODS:Using macranthoidin B as a reference,HPLC method was adopted to calculate the relative correction factor(RCF)of it to macran-thoidin A,dipsacoside B,macranthoside A and macranthoside B. The contents of above 4 saponins were calculated through RCF. Using the contents of saponins determined by external standard method as measured value,the calculated value was compared with measured value. RESULTS:The linear ranges of macranthoidin A,macranthoidin B,dipsacoside B,macranthoside A and macran-thoside B were 0.316-6.32 μg(r=0.9973),0.453-9.06 μg(r=0.9982),0.231-4.62 μg(r=0.9996),0.342-6.84 μg(r=0.9984) and 0.147-2.94 μg(r=0.9961),respectively. RSDs of precision,stability and reproducibility tests were all lower than 2.0%. The recoveries were 97.74%-104.51%(RSD=2.37%,n=6)、96.70%-103.20%(RSD=2.37%,n=6)、96.12%-103.61%(RSD=2.45%, n=6)、98.80%-104.70%(RSD=2.32%,n=6)、99.21%-102.92%(RSD=1.39%,n=6),respectively. There was no statistical sig-nificance between calculated value and measured value(P>0.05). CONCLUSIONS:The method is simple,precise,stable and re-producible. It can be used for the determination of saponins in Lonicerae Flos.

Purpose To analyze the image quality of brain CT with 256-slice wide detector axial scanning mode,routine axial scanning mode and spiral scanning mode,and to provide a more effective brain CT examination method for patients.Materials and Methods The prospective study was conducted on 90 patients accepting routine brain CT examination,and they were randomly divided into three groups.CT examination with 160 mm axial scanning mode,40 mm axial scanning mode and 40 mm spiral scanning mode were respectively conducted using GE Revolution CT.The scanning condition was adjusted to remain constant radiation dose,and then the image quality was analyzed.CT attenuation of gray and white matter,contrast-to-noise ratio (CNR) of white-gray matter and image noise of the three scanning modes were compared.Subjective scoring on image quality of the three scanning modes was also performed.Results On body lateral cerebral ventricle level,there were no significant difference in CT attenuation of gray and white matter and CNR (P＞0.05).On centrum semiovale level,the CT attenuation of gray matter [(31.71 ± 1.82) HU],white matter [(22.97± 1.50) HU] and CNR 2.05±0.42 of 160 mm axial scanning mode was significantly different from the other two scanning modes (F=26.74,47.16 and 3.85,P＜0.05).On centmm semiovale level,image noise of 160 mm axial scanning mode was lower than the other two kinds of scanning methods (F=6.31,P＜0.05),in the basal ganglia and posterior fossa there were no statistically significant differences in the image noise between the three scanning modes (P＞0.05).The subjective score of the three scanning modes all met the diagnostic requirements,and there was no significant difference (P＞0.05).The effective dose and scanning time of 160 mm axial scanning mode was lower than those of the other two scanning modes,and the X-ray utilization was higher.Conclusion 160 mm wide detector axial scanning mode is more suitable for brain CT scan,and it can be used as the preferred scanning mode in the emergency and among non-cooperative patients.

Objective To exoplore the causes in healing difficulties of osteoporotic fracture, and to study the feasible approaches and methods for clinical treatment of osteoporotic fracture. Methods Forty female Sprague-Dawley rats, used as donor animals, were divided randomly into ovariectomized (OVX) group and control (CON) group, with each group of 20 animals. OVX group was subjected to bilateral ovariectomy and CON group was subjected to sham operation. Four months after surgery, the rats were sacrificed, and long bones of the extremities were harvested respectively for preparation of bone matrix gelatin (BMG) in terms of Urist's method. BMG implants obtained from OVX and CON rats were implanted into left and right femoral muscle pouches respectively of 17 female SD rats. The host rats were killed after 14-day feeding, and tissue block of BMG implants were removed for histologic study, alkaline phosphatase (ALP) activity, and calcium content (CA) determination, respectively. Results ALP activity of BMG tissue block from OVX group was (7.22? 2.59)U/g, and that from CON group was (12.01?6.18)U/g. Significant difference was found between the two groups (P

Objective To assess the value of magnetic resonance imaging for acute pancreatitis.Methods 77 patients of acute pancreatitis were examined with holding breath MRI sequence.Transverse scan:2D Flash T 1WI/T 1W+FS,TSE T 2WI+FS or HASTE+FS,Trufisp.Coronals scan:2D Flash T 1W+FS.MRCP was used in 34 patients.2D Flash dynamic contrast enhanced were used in 77 patients.Results 59 cases of acute edematous pancreatitis showed swelling and low signal intensity on T 1WI and higher signal intensity on T 2WI.Excepted the above findings,18 cases of hemorrhagic necrosis pancreatitis alos showed the higher signal intensity on T 1WI and peripancreatic exudative hydrops.Conclusion MRI is a reliable method for demonstrating acute pancreatitis.

OBJECTIVEA study was conducted to investigate the effects of Porphyromonas gingivalis lipopolysaccharide (Pg-LPS) on the expression of regulated upon activation normal T-cell expressed and secreted (RANTES) and fractalkine in human umbilical vein endothelial cells (HUVECs).

METHODSHUVECs were incubated with different concentrations of Pg-LPS (200, 500, and 1000 ng x mL(-1)) for 1, 6, 12, and 24 h, respectively. Then real time quantitative polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent method (ELISA) were adopted to detect the protein levels and mRNA levels of RANTES and fractalkine.

RESULTSThe RANTES protein levels and mRNA levels, as well as fractalkine mRNA levels, were significantly higher in all experimental groups of 1, 6, and 12 h than in the control group (P<0.05), except the expression of RANTES mRNA in 200 ng x mL(-1) group of 12 h and RANTES protein in 200 ng x mL(-1) group of 1 h. The expression levels of RANTES mRNA and fractalkine mRNA were highest in 1000 ng x mL(-1) group of 6 h and were 4.88- and 6.20-fold higher, respectively, than those in the control group. The expression levels of RANTES protein, mRNA, and fractalkine mRNA decreased 6 h after stimulation, and were significantly higher than those in the control group (P<0.05) in the RANTES and fractalkine in HUVEC, and such expression is important in the development of atherosclerosis 500 ng x mL(-1) group of 24 h. There was a significant difference between the expression of fractalkine mRNA in 1000 ng x mL(-1) group of 6 and 12 h than in the control group (P<0.05).

CONCLUSIONPg-LPS infection might up-regulate the expression of RANTES and fractalkine in HUVEC, and such expression is important in the development of atherosclerosis.

Atherosclerosis ; Cells, Cultured ; Chemokine CCL5 ; genetics ; metabolism ; Chemokine CX3CL1 ; analysis ; genetics ; metabolism ; Enzyme-Linked Immunosorbent Assay ; Human Umbilical Vein Endothelial Cells ; metabolism ; Humans ; Lipopolysaccharides ; pharmacology ; Porphyromonas gingivalis ; immunology ; isolation & purification ; RNA, Messenger ; analysis ; Reverse Transcriptase Polymerase Chain Reaction ; Up-Regulation

Objective:To explore the value of improved sequential organ failure assessment (ISOFA) in predicting the prognosis of Klebsiella pneumoniae sepsis. Methods:The clinical data of 379 patients with Klebsiella pneumoniae sepsis admitted to the First Hospital of Jilin University from January 1, 2018 to June 30, 2019 were retrospectively analyzed.They were divided into survival group and death group according to the 28-day prognosis, and the age, gender, C-reactive protein, procalcitonin, grade of bacterial resistance, and the occurrence of septic shock of the two groups were compared.Statistical analysis was conducted by using independent sample t test, Mann-Whitney U test and chi-square test. Risk factors for the prognosis of the disease was analyzed by logistic regression analysis.The correlation between ISOFA and other scoring system including Charlson′s weighted index of comorbidities (WIC), national early warning system (NEWS), acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), simplified acute physiology scoreⅡ (SAPSⅡ), mortality in emergency department sepsis score (MEDS), sequential organ failure assessment (SOFA), acute gastrointestinal injury (AGI) was determined by Spearman correlation coefficient.The area under the receiver operating characteristic curve (AUROC) was used to compare the evaluation value of each scoring system for the prognosis of Klebsiella pneumoniae sepsis. The clinical significance of ISOFA risk stratification was evaluated by Kaplan-Meier survival curve. Results:Among the 379 patients with Klebsiella pneumoniae sepsis, 278 were in the survival group and 101 were in the death group.The differences of age, gender, the occurrence of septic shock, grade of bacterial resistance, C-reactive protein, procalcitonin, WIC, NEWS, APACHEⅡ, SAPSⅡ, MEDS, SOFA, AGI and ISOFA score between the two groups were all statistically significant ( t=-3.218; χ2=6.781, 24.374 and 27.208, respectively; Z=-3.689, -5.022, -4.396, -4.697, -7.438, -6.348, -6.358, -8.676, -6.680 and -11.658, respectively; all P<0.01). The calculation method of ISOFA was obtained by single factor analysis: ISOFA=SOFA+ 1.5×AGI.Multivariate logistic regression suggested that ISOFA, gender, SOFA, procalcitonin, C-reactive protein, and bacterial resistance were independent risk factors for the prognosis of the disease. The Spearman correlation coefficients of ISOFA and WIC, NEWS, APACHEⅡ, SAPSⅡ, MEDS and SOFA were 0.327, 0.371, 0.614, 0.564, 0.578 and 0.847, respectively. The AUROC and its 95% confidence interval for WIC, NEWS, MEDS, SAPSⅡ, APACHEⅡ, SOFA alone, SOFA plus AGI, and ISOFA to predict the prognosis of Klebsiella pneumoniae sepsis were 0.646 (0.584-0.708), 0.657 (0.597-0.716), 0.712 (0.654-0.771), 0.713 (0.653-0.773), 0.749 (0.693-0.806), 0.788 (0.737-0.838), 0.872 (0.826-0.917) and 0.891 (0.845-0.937), respectively.The results showed that ISOFA had the best predictive effect.The Kaplan-Meier survival curve suggested that there were statistical differences in survival rate among ISOFA low-risk level, medium-risk level, and high-risk level (all P<0.01). Conclusion:ISOFA has important clinical significance in predicting the prognosis of Klebsiella pneumoniae sepsis.

Prostate cancer is a common malignancy in elderly men. Assessment of life expectancy is crucial for the treatment decision. However, accurate evaluation of individual life expectancy is still a challenge for us. By now, the life expectancy assessment methods mainly include query life table, online prediction questionnaire, gait speed monitoring, considering complications, and comprehensive prediction model. The first three evaluation methods are more convenient and have strong clinical feasibility. Complication calculation and comprehensive model are less convenient but may improve the accuracy of life expectancy prediction. The application of comprehensive prediction model is recommended at present. The prediction methods need further optimization and verification.

OBJECTIVE: To explore the application value of postmortem multi-slice spiral computed tomography (MSCT) in cases of fall from height through observing and analyzing the injury features of the fall and reconstructing the process of the fall based on the the above procedure. METHODS: One real fatal case due to fall from height was fully examined using MSCT and three-dimensional reconstruction technique. Analyzing the manner and cause of death through combination of MSCT and systemic autopsy was also implemented. The differences between autopsy and MSCT in getting information of injuries were compared. RESULTS: Fractures involving multiple body regions and liver rupture were found through MSCT and three-dimensional reconstruction. The autopsy got the same results with imageological examination. The case of death was deduced to be fall leading to systemic polytrauma. CONCLUSION Application of MSCT can be used as the complimentary for traditional autopsy in the analysis of injury manner of fall from height.
Autopsy ; Death ; Forensic Pathology ; Fractures, Bone ; Humans ; Multiple Trauma ; Tomography, Spiral Computed

Objective To improve lesion detection of the radial head with adjusted elbow joint lateral position on X-ray.Methods (1)20 subjects underwent elbow joint CT three-dimensional reconstruction (average intensity projection),which was as X-ray radio-graphy image.The tilt angle of the humerus and the projection direction for fully display of the radial head in projection images and the tilt angle of the humerus against detector in X-ray radiography were measured.(2)20 subjects (patients and volunteers)with el-bow joint disease underwent routine and improved elbow joint lateral position were enrolled.And assessed the bare blocking rate of the radial head articular surface of the two positions.Results (1)The angle between the the humerus and the direction of projection were 49°-60°and 30°-41°in CT and X-ray,respectively.The average angle was (35.5±1)°.(2).The blocking rate and bare bloc-king rate of the radial head articular surface in routine elbow joint lateral position were 71.6%-100% and 0%-28.4%,respective-ly.The average rate of bare blocking was 14.2%.Fracture 13 cases and 5 cases of suspected fractures.The blocking rate and bare blocking rate of the radial head articular surface in improved elbow joint lateral position were 4.8%-25% and 75%-95.2%,re-spectively.The average rate of bare blocking was 85.1%.Fracture 1 7 cases and 1 case of suspectet fractures.Conclusion The im-proved elbow joint lateral position of X-ray can display the radial head articular surface better than the routine position.