Objective To investigate the relationship of vascular endothelial growth factor(VEGF)with the invasion and metastasis of non-Hodgkin lymphoma.Methods The levels of serum VEGF was measured by enzyme linked-immunoadsorbent assay(ELISA).Comparing the parameters between NHL group and the control group.Compared the parameters with different groups divided by clinical stage,the effect of the treatment,the level of plasma LDH and effect of treatment.Analyzed the correlation of the levels of serum VEGF and plasma LDH in patients of NHL.Results The levels of serum VEGF are remarkablely higher in patients than that in the control group(P＜0.05).The levels of serum VEGF in the group of Ⅲ,Ⅳ clinical stage are higher than that in the group of Ⅰ,Ⅱ clinical stage,but no significant difference(P＞0.05)were observed.The level of serum VEGF is higher in the group of none CR than the group of CR(P＜0.05).The level of serum VEGF is higher in the group of non-normal level of plasma LDH than group of normal LDH level(P＜0.05).The levels of VEGF and LDH are significantly correlated each other(P＜0.01).Conclusion The angiogenesis are important for tumor metastasis in patients of NHL.The serum VEGF can be used as prognosis parameters in patients with NHL.

Objective To report a case of primary breast T-cell lymphoblastic lymphoma/leukemia (T-LBL/ALL) and study its clinico-pathological features and treatment,to improve the recognition of T-LBL/ ALL.Methods A case of primary breast T-LBL/ALL was reported and reviewed the literatures.Results The female patient was 17 years old,was diagnosed as primary breast T-LBL/ALL who presented with multiple bilateral breast masses and left axillary lymph node enlargement for two months.The patient was treated with modified BFM-90 and achieved complete remission.The patient was in complete remission 12 months after diagnosis at present and till in follow-up.Conclusion Primary breast T-LBL/ALL is very rare and highly aggressive with bad prognosis.T-cell lymphoblastic leukemia chemotherapy regimens is often effective.

Objective To investigate the effect of letrozole in decreasing the early-stage ovarian hyperstimulation syndrome (OHSS) occurrence during the luteal phase for patients of OHSS high-risk after oocyte retrieval.Methods A total of 176 high-risk OHSS patients were randomly divided into two groups after oocyte retrieval.Patients in experiment group (n=86) received 5 mg letrozole per day from the retrieval day and last for 5 days.Others in control group (n=90) received placebo.The serum concentration of FSH,LH,estradiol (E2),progesterone (P) and vascular endothelial growth factor (VEGF) from the day of hCG injection to days after injection (5 days,8 days,10 days) were measured.And the incidence of moderate and severe OHSS was observed.Results The concentration of E2 on the indicated days (5 days,8 days,10 days after hCG injection) in experiment group and control group were (5 727±2 089) versus (11 826±4 281) pmol/L,(1 613±879) versus (7 925±3 507) pmol/L,(193±90) versus (1 628±888) pmol/L; the concentration of VEGF on the indicated days in the two groups were (80± 14) versus (108± 19) ng/L,(66± 11) versus (126± 14) ng/L,(48±7) versus (148± 14) ng/L; the concentration of E2 and VEGF were lower than those in control group (all P＜0.01).The FSH concentration in experiment group were (2.1 ± 1.1) and (3.5± 1.3) U/L on the day of fifth and eighth day after hCG injection,which were significantly higher than (0.7±0.3) and (0.7±0.4) U/L in control group (P＜0.05); the LH concentration in experiment group were (0.26±0.19) and (0.72±0.60) U/L on the day of fifth and eighth day after hCG injection,which were significantly higher than (0.11 ±0.03) and (0.14±0.08) U/L in control group (P＜0.05).The incidence of moderate and severe OHSS was signicantly decreased after letrozole treatment compared with control group [2％ (2/86) versus 12％ (1 1/90),P＜0.05].Conclusion Administration of 5 mg/d letrozole for 5 days during the luteal phase can reduce the E2 and VEGF levels for the high-risk OHSS patients who needed cryopreserve all embryos,and also reduce the occurrence of early OHSS.

Objective To reveal the tendency in clinical nutrition research in chinese journals by bibliometric analysis.Methods Literature was searched in Chinese Biomedical Databases (CBM) of SinoMed.By using Noteexpress software,the year distribution,document cartier classifications,research areas,cited frequency of articles and first author distribution were analyzed.Results The number of Chinese literature on clinical nutrition had increased steadily from 1 paper in 1974 to 1980 papers in 2011.The journals with more clinical nutrition articles are mainly professional journals,accounted for 9.21％.Research in the recent 5 years was mainly focused on the modes and timing of nutrition support.The proportions of studies on parenteral nutrition and enternal nutrition were close.Conclusion Clinical nutrition has became one of the hot research topics in China in recent years,although the appropriate and reasonable use of clinical nutrition remain challenging.

Objective To investigate the correlation of P-gP,bel-2,STAT3,IL-6,IL-10 and the resistance lymphoma cells to chemotherapeutic agents.Methods There were 28 patients,among them were divided into three groups:refractory lymphoma,lymphoma which is sensitive to agents and lymphodenitis.P-glycoprotein(P-gp)on lymphoma cell membrane,STAT3,bcl-2,IL-6 and IL-10 level into lymphonla cell were detected using FCM,and the correlation between them and chemotherapy efficacy were analysed. Results In refractory lymphoma patients,P-gp and hcl-2 are significant higher than that of the group which is sensitive to agents(P:0.01,P=0.039),but STAT3,IL-6 and IL-10 were not significant different between these two groups(P>o.05).P-gp is significant higher in lymphoma than in lymphodenitis(P=0.01).STAT3 in lymphoma is significant lower than that of in lymphodenitis (P=0.04).The level bcl-2,IL-6 and IL-10 between lymphoma and lymphodenitis are not significant different(P>0.05).Conclusion The expression level of bel-2 and p-gP is correlated to resistance to the chemotherapeutic agents in lymphoma cells.STAT3 play a role in lymphoma cell signal transduction,but it is not certain in lymphoma cell muhidrug resistance.

Objective To investigate the correlation of T cell subgroups and natural killer (NK) cell's activity level of peripheral blood of the patients with refractory lymphoma. Methods Flow cytometry was applied to detect T cell subgroups' level and NK cell's activity of peripheral blood in 60 early cure lymphoma patients with chemotherapy before and 20 normal controls , after chemotherapy follow-up they were divided into 30 cases of difficult cure group and 30 cases of effective group. Results Compared with the normal controls, CD+4, CD+4/CD+8 and NK cell in lymphoma patients with chemotherapy before decreased (30.17±8.63 vs 46.52±1.39, t =12.218, P ＜0.05; 0.86±0.45 vs 1.64±0.05, t =11.225, P ＜0.05; 12.39±7.08 vs 19.29±0.84,t =6.365, P＜0.05), while CD+3 and CD+8 cell increased (76.14±10.71 vs 70.48±1.44, t =-3.439, P＜0.05;40.28±14.03 vs 28.35±0.73, t =-5.625, P ＜0.05). Compared with effective group, CD+4 CD+4/CD+8 and NK cell in difficult response group with chemotherapy before decreased (27.70±7.81 vs 33.13±8.82, t =2.163, P =0.036;0.67±0.27 vs 1.10±0.52, t =3.272, P =0.003; 9.87±6.60 vs 15.40±6.58, t =2.771, P =0.008), while CD+3 and CD+8 cell increased (79.67±8.18 vs 71.91±12.00, t =-2.540, P =0.015; 44.70±13.99 vs 34.98±12.41, t =-2.416,P =0.020). Conclusion The detection of T cell subgroups' level and NK cell' s activity in early lymphoma patients before chemotherapy may play a role to diagnose and predict the outcome of refractory lymphoma patients.

Objective To evaluate percutaneous intratumoral injection of chemotherapeutic agents lipiodol emulsion (CALE) for the treatment of primary liver cancer. Methods This study included 57 patients of hepatocellular carcinoma (n=49) and intrahepatic cholangiocarcinoma (n=8).53 were male and 4 were female,with a mean age of 48.02 years(range,19～70 years).In all,ninety CALE injections were assigned to 90 target areas within the lesions.Before the procedures,transcathetcr arterial chemoembolization (n=55) or infusion (n=2) was carried out in these patients.By arteriography,low blood supply of target areas was showed or it was concluded that superselective catheterization of supply arteries of lesions could not accomplished.Percutaneous intratumoral CALE injection was carried out under fluoroscopy or CT guidance.Therapeutic effect,side effect and complications were assessed based on clinical manifestation,laboratory examination and fluoroscopy or CT one week after procedure.Follow-up was carried out after 1,3,6 months and 1 year,and once every six months thereafter.Local recurrences were treated according to patients'will.Results 90 sessions of percutaneous injection were successfully performed on 57 patients,with 100% technique success rate.The volume of CALE iniected per session ranged 3.0-7.0 ml(mean,6.0 ml) in target size less than 3 cm,12.0-20 ml(mean,15 ml)in target size of 3-5 cm and 24-40 ml in target larger than 5 cm.Serum AFP was positive in 43 patients and decreased to normal in 14 patients(28%).54 lesions(60%)were with well distribution of the lipiodol-chemotherapy mixture on CT 1 month after procedure.Follow-up ranged from 2 months to six years(mean,16 months).The median survival time was 400 d.The cumulative survival rates at 200 d,600d was 85%and 30%,respectively.Complications included fever (n=22,24.4%),nausea and vomit(n=11,12.2%),and pain at the puncture site (n=17,18.9%).Conclusions Percutaneous intratumor CALE injection is safe and effective for the treatment of primary liver cancer.

Objective: To explore injury related mortality among children aged 0-14 years in Hunan, to provide reliable data support for injury prevention among children aged 0-14 years in the region. Methods: A descriptive analysis on child mortality data from 2014 to 2021 of injuries collected from 28 death surveillance spots in Hunan was conducted. Results: The mortality rate of injures among children aged 0-14 years in Hunan decreased from 20.19/100 000 (adjusted mortality: 25.32/100 000) in 2014 to 11.05/100 000 (adjusted mortality: 13.71/100 000) in 2021 (APC=-9.4%, P <0.05), and the annual average mortality rate was 14.86/100 000, there were 17.29/100 000 boys and 11.96/100 000 girls, with statistically significant gender differences ( χ 2= 27 835.54 , P <0.05). The average mortality rate of drowning among different causes of injury and death was 5.98/100 000, followed by the average mortality rate of road traffic accidents of 3.38/100 000. Conclusion There is a downward trend of deaths due to injures for children aged 0-14 years in Hunan during 2014-2021, with an obvious gender difference. Drowning and traffic accidents are the main cause of injury related deaths for children aged 0-14 years. Steady monitoring of children injury is vital for children injury prevention. Children safety and health education, and related effective policies and legal provisions should be developed and enhanced.

Objective: To observe the effects of the method of combining free superficial temporal fascia flaps with skin grafts in repairing deep wounds in posterior ankle region of extensively burned patients. Methods: From September 2013 to February 2017, 11 extensively burned patients with deep tissue defects in posterior ankle region were treated in our unit. Two patients had tissue defects in bilateral posterior ankle regions. The wound sizes ranged from 5.8 cm×4.6 cm to 11.7 cm×5.2 cm. Free superficial temporal fascia flaps with the same sizes as the wounds were designed and resected to repair wounds in posterior ankle regions after debridement. The proximal end of superficial temporal veins and posterior tibial veins were performed with end-to-end anastomosis, and superficial temporal arteries and posterior tibial arteries were performed with end-to-side anastomosis. Skin grafts were resected to cover the superficial temporal fascia flaps according to patients′ condition of donor sites. The donor sites were sutured directly. Results: All fascial flaps in 11 patients survived, while 2 skin grafts had partial necrosis, and they healed after secondary skin graft. All patients were followed up for 6 to 13 months, and the shape and function of the operation sites in all patients recovered well. Conclusions The method of combining free superficial temporal fascia flaps with skin grafts can repair deep wounds in posterior ankle regions of extensively burned patients. It has the advantages of good appearances in the recipient sites, strong resistances to infection of fascia flaps, minimal damages to the donor sites, short course of disease, and good prognosis of patients.