Objective:To analyze clinical characteristics, treatment, and prognosis of B-cell lymphoma, unclassifiable, with features in-termediate between diffuse large B-cell lymphoma and Burkitt lymphoma (DLBCL/BL). Methods:The clinical and pathological data of 13 DLBCL/BL patients, who were treated in the First Affiliated Hospital of Zhengzhou University between January 2013 and December 2014, were collected. Overall survival (OS) and progression-free survival (PFS) were estimated by the Kaplan-Meier method. Through the log-rank test, survival curves were compared among groups classified by clinical stage, age, serum lactate dehydrogenase (LDH) lev-el, international prognostic index (IPI) score, or first chemotherapy regimen. Results:Among the 13 patients with DLBCL/BL, 12 pa-tients showed extra-nodal involvement. The median OS and PFS were only 10 and 6 months, respectively. Univariate analysis showed that the LDH levels and IPI scores exerted statistically significant effects on prognosis. Some borderline differences in survival were not-ed among the CHOP, CHOP-like, and intensive chemotherapy groups. Conclusion:DLBCL/BL is an aggressive B-cell lymphoma with a short survival time. The majority of patients presented extra-nodal involvement. DLBCL/BL did not respond well to CHOP or CHOP-like regimen, and more intensive chemotherapy may improve survival. Elevated LDH levels and high IPI scores were predictors of poor sur-vival.

Objective:To investigate the clinical significance of detecting Epstein Barr virus (EBV) infection in evaluating recent curative and long-term effects in patients with extranodal natural killer (NK)/T-cell lymphoma. Methods:The EBV-DNA copies in the plasma of 109 patients, who were pathologically and immunohistochemically diagnosed with extranodal natural killer/T-cell lymphoma in the First Affiliated Hospital of Zhengzhou University between January 2011 and April 2014, were monitored via quantitative re-al-time polymerase chain reaction. Subsequently, the difference in recent curative and long-term effects between EBV positive and EBV negative patients was compared. Results:Among the 109 patients with extranodal NK/T-cell lymphoma, 34 (64.2%) cases of EBV posi-tive patients were at the advanced stage (Ⅲ~Ⅳ stages), and 22 (39.3%) cases of EBV negative patients were at the terminal stage (Ⅲ~Ⅳstages). EBV positive patients who accompanied by B symptoms were 33 (62.3%) , and there were 21 (37.5%) cases with B symptoms in EBV negative patients, the differences between stages and B symptoms were statistically significant. The attained objec-tive response rate of the EBV-DNA negative patients (34, 60.7%) was significantly higher than that of the EBV-DNA positive patients (22, 41.5%) (P<0.05). Similarly, the 2-year progression-free survival (PFS) rate of EBV negative patients was better than that of EBV positive patients (P<0.05). Conclusion:Detecting EBV in plasma has clinical significance in evaluating the recent curative effect and the 2-year PFS rate in patients diagnosed with extranodal NK/T-cell lymphoma.

Objective To study the risk factors of lymph node metastasis in the central neck compartment of thyroid carcinoma,and to explore the reasonable range of lymph node dissection in central neck dissection for clinically node-negative papillary thyroid microcarcinoma patients.Methods From Dec.2015 to Dec.2016,a total of 200 patients with CN0 papillary thyroid carcinoma were randomly divided into two groups according to the registration number:unilateral central neck dissection group and bilateral central neck dissection group in Department of Thyroid Surgery,Fujian Medical University Union Hospital.The risk factors of lymph node metastasis and value of bilateral central neck dissection were analyzed.Results The risk factors of lymph node metastasis in the central papillary thyroid carcinoma were ≥0.7 cm in diameter and older than 45 years in age and gender in male.Further analysis found that contralateral central lymph node metastasis occurred in patients with tumor diameter ≥0.5 cm.The positive rate was 22％.The number of lymph nodes detected in the unilateral and bilateral central areas was 9.53±6.04 and 12.19±7.18,P=0.035,respectively.The positive numbers of lymph nodes were 1.17±1.47 and 2.11±2.75,P=0,022 respectively.Conclusion In patients with tumor diameter ≥0.5 cm,bilateral central neck dissection is conducive to improving the thoroughness of tumor dissection and does not increase the risk of complications.

Objective To explore the mechanism and inhibition of botulinum toxin type A (BTXA) on hypertrohic scar fibroblasts.Methods The cells were treated by 0 (control),0.2,0.4,0.8 U/ml BTXA for 48 h.Cell viability was detected by MTT assay.Cell apoptosis was detected by Hoechst staining.Cell cycle was detected by flow cytometry.The level of cell cycle related protein D1 (Cyclin D1),proliferation nuclear antigen (PCNA) and activation of phosphatidylinositol 3 kinase (PI3K) / protein kinase B (AKT) signaling pathway were assayed by western blot.Results Compared with control group(0.75±0.07),0.2,0.4,0.8 U/mL BTXA(0.59 ± 0.06,0.43 ± 0.04,0.34± 0.03) inhibited hypertrohic scar fibroblasts cell viability,increased cell apoptotic rate[control group(2.38±0.24)％;BTXA(15.79±1.54)％,(27.32±2.69)％,(38.46±3.90)％],down-regulated the expression of Cyclin D1(control group 1.57±0.18;BTXA 0.93±0.07,0.42±0.04,0.35±0.03) and PCNA(control group 1.46±0.16;BTXA 0.50±0.05,0.59±0.05,0.37±0.03),inhibited the expression of PI3K(control group 0.98±0.06;BTXA 0.49±0.04,0.50±0.04,0.39±0.03) and the phosphorylation of AKT(control group 1.38±0.08;BTXA 0.97±0.06,0.60±0.04,0.29± 0.02),made cell cycle arrested in G1 phase,The difference was statistically significant (P＜0.05).Conclusion These results suggested BTXA inhibit proliferation via blocking the activation of PI3K/AKT signal pathway and down-stream related cell cycle related protein.

Background and purpose:Extranodal natural killer/T-cell lymphoma (ENKTL) is a form of non-Hodgkin’s lymphoma. The ENKTL incidence in China is much higher than that in the Western countries. The disease is highly malignant, not sensitive to chemotherapy, has short survival period and poor prognosis. Epstein-Barr virus (EBV) infection has close relationship with the development of the disease. However, there are still a few patients without EBV infection. This study aimed to discuss the clinical features and prognosis of EBV-encoded small RNA (EBER) in situ hybridization negative ENKTL.Methods:From Aug. 2011 to Oct. 2015, 326 cases were diagnosed with ENKTL from the First Affliated Hospital of Zhengzhou University. The expression of EBER was detected by in situ hy-bridization technique. The clinical pathological characteristics and prognosis of EBER-negative patients were analyzed. Results:In 326 patients with ENKTL, the negative rate of EBER was 2.45% (8/326). In 8 EBER-negative patients, the median survival time was 17 months. The log-rank test revealed that there was a signiifcant difference between EBER-negative and EBER-positive curves (χ2=6.407,P=0.011). Multivariate Cox proportional hazards regression analysis showed that in EBER-negative ENKTL, only lactate dehydrogenase (LDH) predicted survival time (P=0.008). EBV-DNA copy number in plasma was not signiifcantly correlated with survival time (P>0.05).Conclusion:The inci-dence of EBER-negative ENKTL is low. Patients with EBER-negative ENKTL have poorer prognosis than EBER-posi-tive patients. Elevated LDH may be a factor indicating poor prognosis.

Objective To investigate the hepatoprotective effects of Paeoniae Radix Rubra (PRR) at different doses against α-naphthylisothiocyanate (α-NIT)-induced acute cholestatic hepatitis in rats.Methods Rats were ig administrated with vehicle or PRR [(1,9,18,36,54,72,and 81 g/(kg·d)] 3 d before and 2 d after α-NIT (60 mg/kg) ig administration.The general status of rats,histopathology of liver,serum alanine aminotransaminase,aspartate aminotransaminase,total bilirubin,direct bilirubin,and alkaline phosphatase levels,were observed at respective time points (24 and 48 h) after α-NIT administration.Using cluster analysis and correspondence analysis,the dose-effect-response relationships of PRR were evaluated.Results The results showed that compared with model group,the serum biochemistry index significantly decreased with the increasing of PRR dosage (P ＜ 0.01),and the change and necrosis of hepatic cellula,and inflammatory cell infiltration were gradually alleviated.However,the improvement was not obviously found in the low-dose group [1 g/(kg·d)].The cluster analysis and correspondence analysis results showed that different doses of PRR could significantly ameliorate α-NIT-induced acute cholestatic hepatitis of rats in a dose-dependent manner.Conclusion The experiments show that administration doses of PRR in clinical use should be added properly in order to gain the expectant therapeutic effect,especially in the treatment of heavy acute cholestasis hepatitis.

AIM: To explore the expression and significance of receptor tyrosine kinase anexelekto (Axl) in nasopharyngeal carcinoma (NPC).METHODS: Immunohistochemistry was used to detect the Axl protein expression of 78 patients with NPC and 32 patients with nasopharyngeal chronic inflammation (NPI).The correlations between the Axl protein levels and the clinical parameters of NPC patients were analyzed.NPC cells were cultured in vitro, and the expression of Axl in well differentiated CNE1 cells, poorly-differentiated CNE2Z cells and undifferentiated C666-1 cells was detected by immunofluorescence staining.After treatment of the CNE1and C666-1 cells with Axl specific inhibitor TP-0903, CCK-8 assay was used to detect cell viability, flow cytometry was adopted to analyze the cell cycle distribution, qPCR was used to examine the mRNA levels of Axl and proliferating cell nuclear antigen (PCNA), and Western blot was used to examine the protein expression of Axl and p-Axl.RESULTS: Axl protein was localized in the cell membrane and cytoplasm.The rate of high expression of Axl in NPC was significantly higher than that in NPI (P<0.01).High Axl expression showed no correlations with NPC patients'' age, gender and M stage, while positively correlated with the clinical stage, T stage and N stage (P<0.05).Axl protein showed a low level in the CNE1 cells, but showed a high level in CNE2Z and C666-1 cells.TP-0903 inhibited cell viability in concentration and time dependent manners.TP-0903 at 2 nmol/L showed significant inhibitory effects, as evidenced by arresting the cell cycle at G0 phase and reducing Axl activity and PCNA expression.CONCLUSION: High expression of Axl promotes the clinical progress of NPC.TP-0903 significantly inhibits the viability of NPC cells, suggesting that Axl may be a valuable target in the NPC treatment.

To explore the drug indications in Treatise on Febrile and Miscellaneous Diseases,taking ephed-ra,cassiatwig,peony and pinellia as examples.Using inferential validity of sufficient condition hypothet-ical proposition and necessary condition hypothetical proposition of propositional logic,to confirm the indi-cation of ephedra,cassia twig,peony and pinellia.It stated that ephedrais was used for edema in excess pattern,cassia twig was used for dysuria with loose stool,peony was suitable for bellyache in no-deficien-cy-cold pattern,and pinellia for vomiting.It is more intuitive and reliable to use inferential validity in the study on drugs.And researchers can grasp the correspondence between drugs and syndromes more easily. Meanwhile,the effectiveness of thinking structure could be guaranteed as much as possible,when the in-dications of drugs is explained.

With the deepening of the reform of the medical and health system and the continuous optimization of the medical order,it is especially important to organize the development of admission and discharge standards and improve the service of preparing patients for discharge.In recent years,the research and application of machine learning technology in the medical field has been intensifying,and it has unique advantages in processing data and risk prediction research.Therefore,this paper reviews the development process,types of machine leaming,the content and effects of its application in patient discharge preparation services,and the current problems,in order to provide references for healthcare professionals to implement the best clinical decisions and further improve the patient discharge preparation service model.

Objective:To investigate how medical students process Western medicine(WM)terms vs.traditional Chinese medicine(TCM)terms and how this is impacted by analogical priming from the perspective of cognitive neuroscience.Methods:The experiments were designed as a 2(TCM terms vs.WM terms)x 2(correct terms vs.incorrect terms)x 2(analogical priming task vs.non-priming task)scheme.A total of 26 medical stu-dents completed a non-priming judgment task and an analogical priming judgment task on medical terms.During the tasks,the participants were asked to make correct/incorrect judgments on WM terms and TCM terms,and their behavioral data and event-related potentials(ERPs)were recorded.Results:Behaviorally,the response speed and accuracy of WM terms were higher than those of TCM terms(both P＜.001),indicating a prominent concreteness effect.Analogical priming shortened the response time to medical terms(P＜.001),and the response time to TCM terms was shortened more significantly(P=.001).For ERPs,WM terms induced a larger P200(an early positive ERP component),a smaller N400(a negative ERP component),and a higher late positive ERP component,indicating supe-riority of attention adjustment,smaller-scale semantic activation,and a higher cost of late semantic analysis and integration.However,the analogical priming eliminated the difference between WM and TCM terms in P200 and N400 while maintaining it in the LPC.This suggests that WM terms are sensitive to analogical attention adjustment,and TCM terms are susceptible to analogical semantic integration.Conclusion:Our findings suggest that WM and TCM disease behavior terms may initially differ in concreteness or the use of a verbal-linguistic system.Analogy is more conducive to understanding TCM terms.This research provides important neuroscientific evidence of the difference in thinking between TCM and WM.