Objective To study the expressions and significance of bcl-6 and Ki-67 in diffuse large B-cell lymphoma(DLBCL).Methods Immunohistochemistry technique was used to detect the expressions of bcl-6 and Ki-67 in the tissues of 90 DLBCL patients. 20 cases of reactive hyperplasia of lymph node (RH) were used as control. Results Positive expression rate of bcl-6 are 54.44 ％(49/90), 15.00 ％(3/20) in DLBCL or RH tissues respectively (x2=10.214,P=0.001). There were correlations between bcl-6 expression and Ann Arbor clinical stage, LDH, B symptoms, or Hans classification (x2=5.257,5.257,4.704,16.024 respectively,all P＜0.05).The high expression rate of Ki-67 were 80.00 ％(72/90),20.00 ％(4/20)in DLBCL or RH tissues respectively (x2=27.585,P=0.000). There were correlations between Ki-67 expression and Ann Arbor clinical stage,IPI or recent effect (x2=5.889,6.451,6.024 respectively,all P＜0.05).Conclusion There are significant correlations between the aberrant expression of bcl-6 or Ki-67 and Ann Arbor clinical stage,IPI or Hans classification. The expressions of bcl-6 and Ki-67 may provide important information for the clinical therapy and prognosis of DLBCL.

Objective To improve the awareness of the treatment and mechanisms of the gastric mucosa-associated lymphoid tissue lymphoma with secondary thrombocytosis. Methods One case of gastric MALT lymphoma with secondary thrombocytosis was reported and reviewed the literatures. Results The patient received anti-Hp therapy,with remission of gastric MALT lymphoma, platelet count also will return to normal levels. Conclusion It is shown that anti-Hp therapy of gastric MALT lymphoma with secondary thrombocytosis is an effective treatment.

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 study the biological features and prognostic factors of mantle ceil lymphoma (MCL).Methods The clinical data of 39 cases of MCL were analyzed prospectively.The fellow-up informations were also studied.Age,sex,B symptoms,Ann-Arbor staging,bone marrow and lympho node biopsies were assessed.Serum lactate dehydrogenates(LDH) and β2-microglobulin (β2-MG) level,Cyclin D1 expression and immunophenotype were investigated.Results The median age of patients was 62 years old (range 43-80).The male-to-female ratio was 5.5:1,a clear predominante of male patients.Thirty-five (89.7 ％)cases presented with advanced stage disease (Ann Arbor stage Ⅲ to Ⅳ) at initial diagnosis.CD20 was positive expressed in 39 patients,that all cases expressed B-cell markers.Majority of cases were positive for Cyclin D1 (84.7 ％) and CD5 (64.1％).Conclusion MCL is a special type of B-cell originated non-Hodgkin lymphoma (NHL).The clinical data suggest considerable clinical heterogeneity and it has characteristics of both indolent and aggressive NHL that some patients show a chronic/indolent course,while others have a more fulminant course and short survival.LDH,β2-MG and Cyclin D1 arc the important prognostic factors.

Objective To investigate the change of CD_4~+CD_(25)~(high)CD_(127)~(low)> regulatory T cells (Trcg cells) sub-group level in peripheral blood of non-Hodgkin lymphama (NHL) patients, and to explore its clinical significance. Methods Treg cells levels in peripheral blood of lymphoma patients and normal were detected by flow cytometry, followed by statistical analysis. Results In the 65 cases of NHL patients, Treg cells in peripheral blood were (6.72±1.38) %, higher than that in the normal control group (5.65±0.68) % (P <0.05). Percentage of Treg cells are significantly different between clinical stages and normal: [P <0.05, normal control group (5.65±0.88) %, Ⅰ -Ⅱ period (6.08±1.18) %, Ⅲ-Ⅳ period (6.95±0.85) %]. The percentage of Treg cells are also different among pathological types of patients and normal [P <0.05, normal control group (5.65± 0.68) %. The percentage of Treg diffuse large B-cell lymphoma (5.83±0.95) % and other subtypes of lymphoma (7.83±1.76) %]were observed. It is not sure that Treg cells percentage among patients with different levels of lactate dehydrogenase and normal are significantly different. [P >0.05, normal control group (5.65±0.68) %, patients with normal LDH group (6.97±1.20) %, patients with lactate dehydrogenase (6.54±1.02) %]. Conclusion Treg cells induced by tumor and could inhibit the immune cells, Treg cells percentage in peripheral blood of tumor patients is higher than that the normal control group, and increased with the clinical staging, so the percentage of Treg cells may serve as a clinical indicator to evaluate tumor load.

OBJECTIVE:To observe clinical efficacy and safety of sitagliptin combined with metformin in the treatment of type 2 diabetes complicating with metabolic syndrome. METHODS:Totally 80 patients with type 2 diabetes complicating with meta-bolic syndrome were divided into the observation group and control group with 40 cases in each group according to simple random sampling method. Both groups were given same diet and exercise plan;control group was additionally given metformin orally,0.5 g each time,tid;observation group was additionally given sitagliptin,100 mg each time,qd,on the basis of control group. Treat-ment course of 2 groups lasted for 12 weeks. The waist circumference(WC),body mass index(BMI),blood glucose,blood lip-id,fasting insulin (FINS) and serum adiponectin were detected in 2 groups,and steady-state model insulin resistance index (HOMA-IR)and whole body insulin sensitivity index(WBISI)were calculated. The occurrence of ADR was observed. RESULTS:Before treatment,there were no statistically significant differences between 2 groups in WC,BMI,systolic blood pressure,diastol-ic blood pressure,triglycerides,cholesterol,high-density lipoprotein cholester,low-density lipoprotein cholesterol,fasting plasma glucose,2 h postprandial blood glucose,FINS,HOMA-IR,WBISI and serum adiponectin(P>0.05). After treatment,the above indexes of 2 groups were obviously improved,and the improvement of observation group was significantly better than that of con-trol group,with statistical significance(P<0.05). 2 cases and 3 cases were withdraw from the study in control group and observa-tion group because of ADR,respectively.There was no statistically significant difference in the incidence of ADR between 2 groups (P>0.05). CONCLUSIONS:Sitagliptin combined with metformin shows significant clinical efficacy in the treatment of type 2 di-abetes complicating with metabolic syndrome. Its mechanism may be related to reducing insulin resistance,enhancing insulin sensi-tivity,decreasing patients’body weight and up-regulating serum adiponectin level.

Objective To investigate the changes of peripheral blood T cell subsets and serum soluble interleukin-2 receptor (sIL-2R),vascular endothelial growth factor (VEGF) and LDH in patients with diffuse large B cell lymphoma,and to investigate their relationship of the cellular immune function,clinical stage and disease progression.Methods 35 cases of DLBCL patients were selected as observe group,20 cases of healthy individuals as normal control group.Peripheral blood T cell subsets were detected by flow cytometry.Serum soluble interleukin-2 receptor (sIL-2R) and vascular endothelial growth factor (VEGF) were detected by ELISA assay.Serum levels of LDH were detected by the rate method for measuring.Results The expression levels of CD4,NK cells and CD4/CD8 ratios in all patients with DLBCL were lower than healthy individuals [(68.62±12.82) ％ vs(73.00±6.12) ％,(14.28±7.93) ％ vs (39.49±12.01) ％,(1.03±0.84) vs (1.45±0.28),all P ＜ 0.05].Serum sIL-2R in patients with DLBCL was significantly higher than healthy individuals [(501.50±157.70).μg/L vs (128.30±82.40) μg/L,P＜ 0.001].Serum levels of sIL-2R with Ⅲ-Ⅳ stage in patients with DLBCL was higher than that in ones with Ⅰ-Ⅱ stage [(618.38±192.22) μg/L vs (432.45±75.48)μg/L,P ＜ 0.05].Serum expression levels of sIL-2R in patients with DLBCL with B symptoms was higher than that in ones with A symptoms [(616.50±183.03) μg/L vs (441.52±103.48) μg/L,P ＜ 0.01].The expression levels of VEGF,LDH in patients with DLBCL were higher than healthy individuals [(304.03±163.05) pg/ml vs (156.25±47.83) pg/ml,(300.74±300.91) U/L vs (177.00±32.14) U/L,both P ＜ 0.05].The high expression level of serum sIL-2R was correlated with low CD4/CD8 ratio (r =0.4635,P ＜ 0.05).The high expression levels of serum sIL-2R was correlated with the high expression levels of serum VEGF,LDH (r =0.447,P ＜ 0.05; r =0.448,P ＜ 0.05).Conclusion High expression levels of serum sIL-2R in DLBCL are closely associated to low cellular immune function,tumor burden in vivo,disease progression and invasion.

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 investigate the correlation between expression levels of serum cytokines IL-2,IL-6, IL-8, IL-10, TNF-α and IFN-γ in patients with diffuse large B-cell lymphoma(DLBCL) and chemotherapy resistance. Methods 30 cases of DLBCL patients with chemotherapy resistant, 30 cases of DLBCL patients with chemotherapy sensitive and 20 cases of healthy individuals as normal control group were enrolled. The levels of serum cytokines IL-2, IL-6, IL-8, IL-10, TNF-α and IFN-γbefore, during and after treatment in both DLBCL groups and normal control group were detected by ELISA assay. Results The expression level of serum IL-6 and IL-10 before treatment in DLBCL patients with chemotherapy resistance was significantly higher than that in DLBCL patients with chemotherapy sensitive and normal control group (P ＜ 0.05), however,that after treatment in DLBCL patients with chemotherapy resistance was significantly lower than that before treatment (P = 0.02, P = 0.015). The level of serum IL-6 and IL-10 in patients with DLBCL recurrence into drug resistance was higher than that during of remission (P = 0.004, P ＜0.001). Before treatment, the expression level of serum IL-6 in patients with Ⅲ-Ⅳ stage in chemotherapy resistant group was significantly higher than that in ones with Ⅰ - Ⅱ stage(P ＜0.05). Levels of IL-2, IL-8, TNF-α and IFN-γin chemotherapy resistant group, chemotherapy sensitive group and the normal control group were no differences (P ＞0.05).Conclusion The expression levels of the serum IL-6 and IL-10 were closely correlated with the chemotherapy efficacy of DLBCL, they may be involved in drug resistance of DLBCL.

Objective To detect serum CA125 and VEGF in patients of non-Hodgkin lymophoma (NHL) involved in bone marrow and analyse prognostic criteria for NHL. Methods The clinical data of 97 patient were chosen as research objects. They were all first-visit patients. Bone marrow infiltrated with lymphoma cell leukemia of 50 patients were identified by bone marrow aspiration or bone marrow biopsy 46 cases of normal bone marrow were used as controls. The serum CA125 and VEGF were detected by ELISA before treatment. Results Among 97 cases of non-Hodgkin disease, there were 50 cases of bone marrow infiltrated lymphoma cells with a incidence rate of 51.5 %. CA125 and VEGF level in the patients whose bone marrow or lymphoma cell leukemia existed NHL cells was much higher than that of NHL with negative bone marrow infutration (P <0.05). Conclusion CA125 and VEGF can be concluded clinical markers which decide bone marrow or lymphoma cell leukem of the NHL patients whether existed NHL cells or not.