Follicular lymphoma (FL) is a subtype of B cell lymphoma,which derived from follicular germinal center.As the most common type of indolent lymphoma,the overall prognosis of FL is good.However,the prognosis of FL is heterogeneous.With the application of rituximab,the therapeutic effect and the prognosis of the disease is further improved.For the relapsed / refractory patients,especially who have received first-line chemotherapy with rituximab in the early,transplantation is an important choice.Compared with the previous conventional myeloablative conditioning regimen,reduced-intensity conditioning (RIC) effectively reduced the non-relapse mortality (NRM),extended the allogeneic transplantation recipients,but the high rate of relapse after transplantation is the main defect.The application of donor lymphocyte infusion after transplantation therapy not only can reduce the recurrence rate but also treat the disease relapse.In the future,the improvement of transplantation strategy and the application of new drugs may bring new ideas and opportunities for FL therapy.

Objective : To investigate the role of hepatic long-chain non-coding RNA (lncRNA) H19 in key genes associated with glucose metabolism disorder induced by p,p′-dichlorodiphenyldichloroethylene (p,p′-DDE). Methods: Human embryonic liver CCC-HEL-1 cells were divided into the DMSO group, 0.1 μmol/L p,p′-DDE group, 1 μmol/L p,p′-DDE group, 10 μmol/L p,p′-DDE group, small interference RNA (siRNA)+DMSO group and siRNA+10 μmol/L p,p′-DDE group. The promoter region methylation, mRNA expression and protein expression of hepatocyte nuclear factor 4α (HNF4α), forkhead box transcription factor O1 (FoxO1) and insulin-like growth factor (IGF2) were detected in CCC-HEL-1 cells using the bisulfite method, real-time fluorescence quantitative PCR (qPCR) assay and BCA assay, respectively. The changes in H19 mRNA expression, the methylation of associated genes in the promoter region and transcriptional expression were compared in CCC-HEL-1 among groups. Results: Exposure to p,p′-DDE alone at different doses resulted in an increase in H19 expression, and the H19 mRNA expression was higher in the 10 μmol/L p,p′-DDE group than in the DMSO group [(1.31±0.25) vs. (1.02±0.22); P<0.05]. Lower methylation of the HNF4α gene in the pro moter region [(38.59±32.77)% vs. (61.43±24.64)%; P<0.05] and higher HNF4α mRNA expression [(1.33±0.26) vs. (1.03±0.28); P<0.05] were detected in the 10 μmol/L p,p′-DDE group than in the DMSO group, while no significant differences were detected between the two groups in terms of the methylation of FoxO1 and IGF2 genes in the promoter region, FoxO1 and IGF2 mRNA and protein expression (P>0.05). Following siRNA-induced H19 knockdown, higher methylation of the HNF4α gene in the promoter region [(71.33±22.23)% vs. (38.59±32.78)%; P<0.05], lower HNF4α mRNA expression [(0.71±0.17) vs. (1.33±0.26); P<0.05], higher methylation of FoxO1 gene in the promoter region [(47.73±34.24)% vs. (25.09±25.35)%; P<0.05] and higher IGF2 mRNA [(1.39±0.25) vs. (0.80±0.20); P<0.05] were found in the siRNA+DMSO group than in the 10 μmol/L p,p′-DDE group, and higher IGF2 protein expression was detected in the siRNA+DMSO group than in the DMSO group [(1.03±0.11) vs. (0.74±0.12); P<0.05]. Conclusion Hepatic H19 may alter HNF4α, FoxO1 and IGF2 transcription and expression through mediating the methylation of genes in the promoter region, thereby playing a role in p,p′-DDE-induced glucose metabolism disorders.

Objective To investigate influencing factors of perioperative myocardial injury in patients undergone percutaneous coronary intervention (PCI). Methods Ninty one patients with coronary heart disease (including stable angina and unstable angina) underwent PCI, the perioperative myocardial injury incidence were observed prospectively by monitoring the preoperative and postoperative high sensitivity troponin protein levels to investigate the influencing factors of perioperative myocardial injury by Logistic regression analysis. Results There were no statistically significance in perioperative myocardial injury incidence (62.5%vs 68.7%, P=0.618) and perioperative myocardial infarction incidence (29.2%vs 20.9%, P=0.411) between stable angina and unstable angina groups . These factors of perioperative myocardial injury in patients undergone PCI by Logistic regression analysis were analysed, and we found that the influencing factors were the application loading dose rosuvastatin before PCI, preoperative statin therapy more than one month, apolipoprotein A levels and total stent length. Conclusion Application loading dose of rosuvastatin before PCI, preoperative statin therapy more than one month, apolipoprotein A levels are related to perioperative myocardial injury reduction, whereas the total length of the stent is associated with an increased occurrence of perioperative myocardial injury.

Objective To explore the clinical characteristics,pathological features,therapy and prognosis of a case of splenic marginal zone lymphoma (SMZL) with central recurrence,evaluation the safety and efficacy of rituximab intrathecal injection combined with intravenous chemotherapy.Methods Retrospectively analyze the case of SMZL with the central recurrence,and review the relevant literatures.Results According to the tests of MICM of bone marrow,spleen pathology,PET-CT and laboratory examination (LDH),patient was diagnosed as SMZL,IV group B,IPI and aaIPI was high risk group.After first-line therapy,the patient achieved complete remission.But then the central nervous system relapsed.The patients was treated with rituximab intrathecal injection combined with intravenous chemotherapy,the central focus disappeared.Conclusion SMZL belongs to low-grade lymphoma,which combined with central nervous system relapse is very rare.Rituximab intrathecal injection combined with intravenous chemotherapy in the treatment of the patients is safe to use,and have good clinical efficacy.

Objective To investigate the effect of baseline Left-ventricular ejection fraction (LVEF) on the cardiac resynchronization therapy (CRT). Methods A retrospective analysis of patients with heart failure was performed. Fifty-four patients [aged (59.73 ± 11.61)years, 31 males, 23 females] who underwent CRT/CRTD were divided into 2 groups according to LVEF ( group A, LVEF≤ 35%; group B, LVEF > 35% ). NYHA class, LVEF,CRT respond rates and medical adverse event (MAE) due to worsening heart failure were detected at 3 and 12 months post-surgery. Results The score of NYHA class changing wasn′t different between these two group. Compared to group B, LVEF was markedly increased (5.08 ± 2.81)% vs (2.45 ± 1.80)%, P < 0.05;(5.38 ± 2.92)% vs (2.39 ± 3.53)%, P < 0.05)at 3 and 12 months post-surgery. Similarly, group A owned high CRT response rates(66.1% vs 33.9%, P < 0.05; 81.25% vs 47.83%, P < 0.05) at the both two time points. At 12 months post-surgery , LVED decreased and the MAE was similar in all groups. Conclusion Patients with EF≤ 35% have more increases in LVEF and own high CRT response rates post-CRT.

Objective To investigate the prognosis of children with acute kidney injury(AKI)treated with peritoneal dialysis(PD)following cardiopulmonary bypass.Methods A retrospective study of 46 children aged under 14 years old with AKI treated by using PD following cardiopulmonary bypass from Jan.2006 through Dec.2010.All of them were divided into three groups,namely group A(AKI Ⅰ),group B(AKI Ⅱ)and group C(AKI Ⅲ)according to the stratification of RIFLE criteria.The timing of PD was depended on the phase of AKI.The ICU length of stay,total duration of mechanical ventilation,total amount of peritoneal dialysate and the length of PD were compared among three groups.Their APACHE Ⅱ score,sequential organ failure assessment(SOFA)score,serum interleukin-6(IL-6),oxygenate index,serum creatinine,and mean arterial pressure were also compared between before PD and after PD for 48 hours.One-way ANOVA was used for statistical analysis between different phases of AKI.Data got before PD and after PD for 48 hours were analyzed with paired Student' s t-test.Results The APACHE Ⅱ score,SOFA score and serum IL-6 before PD were higher in patients with phase Ⅲ of AKI than those in patients with phases Ⅰ and Ⅱ of AKI(P ＜ 0.01).There were no significant differences in APACHE Ⅱ score and SOFA score between patients with phases Ⅰ of AKI and patients with phase Ⅱ of AKI before PD(P ＞0.05),but serum IL-6 before PD,ICU length of stay,total duration of mechanical ventilation,total amount of peritoneal dialysate and the length of PD in patients with phase Ⅱ of AKI were higher or longer than those in patients with phase Ⅰ of AKI(P ＜ 0.01).After PD for 48 hours,APACHE Ⅱ score,SOFA score,serum IL-6,oxygenate index,serum creatinine and mean arterial pressure improved insignificantly in patients with phase Ⅲ of AKI(P ＞0.05),but those were improved significantly in patients with phases Ⅰand Ⅱ of AKI(P ＜ 0.05),while serum IL-6 in patients with phase Ⅱ of AKI was still higher than that in patients with phase Ⅰ of AKI(P ＜ 0.01).Conclusions Therapeutic effect of PD on children with AKI following CPB is better if PD is started in the phases Ⅰ and Ⅱ of AKI,especially in the phase Ⅰ of AKI.The RIFLE criteria and IL-6 are useful guidance to the assessment of patients' illness.

Objective To explore the feasibility of extending liver blood perfusion cessation by ultrasound combining microbubbles.Methods The livers of 9 healthy rabbits were treated with a pulsed therapeutic ultrasound device,in presence of microbubbles.For quantification of liver perfusion,contrastenhanced ultrasonography was performed on 6 rabbits before treatment and at different time points of 0 min,30 min,60 min and 48 hours after treatment.Pathological examination of the treated livers was performed immediately after treatment on the other 3 rabbits.Results The liver blood perfusion almost vanished immediately after treatment,remained at a low perfusion level from 30 to 60 min,and completely recovered 48 hours later.The peak intensity dropped from ( - 51.88 ± 4.26)dB to ( - 62.53 ± 4.83)dB after treatment and rose up to ( - 52.00 ± 4.60) dB 48 hours later.The peak intensities before treatment and 48 hours after treatment were significantly higher than those of 0 min,30 min and 60 min time points after treatment( P ＜0.05).Pathological examination showed significant swelling of hepatocytes and hemorrhage around portal veins.Conclusions Microbubbles enhanced ultrasound can induce liver blood perfusion cessation for up to 1 hours.The mechanism could be swelling of hepatocytes and hemorrhage of portal track.

With thousands of sequenced 16 S rRNA genes available,and advancements in oligonucleotide microarray technology,the detection of microorganisms in microbial communities consisting of hundreds of species may be possible.The existing algorithms developed for sequence-specific probe design are not suitable for applications in large-scale bacteria detection due to the lack of coverage,flexibility and efficiency.Many other strategies developed for group-specific probe design focus on how to find a unique group-specific probe that can specifically detect all target sequences of a group.Unique group-specific probe for each group can not always be found.Hence,it is necessary to design non-unique probes.Each probe can specifically detect target sequences of a different subgroup.Combination of multiple probes can achieve higher coverage.However,it is a time-consuming task to evaluate all possible combinations.A feasible algorithm using relative entropy and genetic algorithm (GA) to design group-specific non-unique probes was presented.

Objective:To investigate the effect and prognostic factors of rituximab-containing chemotherapy regimen in treatment of patients with mantle cell lymphoma (MCL).Methods:The clinical data of 56 patients aged ≤65 years in the First Affiliated Hospital of Soochow University from June 2007 to November 2018 were retrospectively analyzed. Rituximab-containing chemotherapy regimen was used, and the effects of clinical features, treatment regimen and biological indexes on overall survival (OS) and progression-free survival (PFS) were observed.Results:The median age of 56 patients was 57 years old, including 43 males and 13 females. Among these cases, 24 patients received R-CHOP chemotherapy regimen; 29 patients received cytarabine-containing chemotherapy regimen, including R-hyper CVAD/R-MA regimen used in 15 patients and R-CHOP alternating with R-DAHP regimen used in 14 patients; and 3 patients received other treatment regimens. Among 56 patients, 19 patients received autologous hematopoietic stem cell transplantation (ASCT) consolidation therapy. The median OS time was 74 months, 2-year OS rate was 83.8%, 3-year OS rate was 70.9%, 2-year PFS rate was 72.0% and 3-year PFS rate was 49.7%. International prognostic index (IPI) high-risk and receiving ASCT or not during the treatment were independent influencing factors of OS and PFS in MCL patients. The overall response rate (ORR) in cytarabine-containing regimen group was higher compared with that in R-CHOP regimen group (93.1% vs. 83.3%), and there was no statistically significant difference ( χ2=0.465, P=0.495). In addition, there were no significant differences between two groups in both OS ( χ2=0.291, P=0.590) and PFS ( χ2=0.912, P=0.339). ASCT consolidation prolonged the median OS time (72 months vs.124 months, χ2=3.973, P=0.040) and the median PFS time (34 months vs. 90 months, χ2=3.984, P=0.046) in MCL patients achieving remission after induction therapy. Among patients in simplified MCL IPI (sMIPI) score middle-high risk group, compared with those not receiving ASCT, patients receiving ASCT therapy could obtain better OS and PFS (OS: χ2=5.037, P=0.025; PFS: χ2=6.787, P=0.009); among patients of sMIPI score low risk, there were no statistically significant differences in OS and PFS between the group receiving ASCT and not (all P > 0.05). Conclusions:Cytarabine-containing chemotherapy regimen has no predicatively satisfactory value in improving the prognosis and survival for MCL patients. For MCL patients who have achieved remission after reduction therapy and those in sMIPI score middle-high risk group, ASCT consolidation therapy can improve the prognosis and can be taken as the first-line consolidation treatment in young patients.

Objective Fecal biomarkers have emerged as an important tool for assessing and monitoring disease activity in patients with inflammatory bowel disease ( IBD) .We aimed to investigate the diagnostic value of fecal neopterin and calprotectin in pa-tients with active inflammatory bowel disease and made comparison with that of serum C-reactive protein ( CRP) . Methods A total of 151 consecutive patients with IBD (84 CD and 67 UC) provided 2 gram fecal samples for the measurement of fecal neopterin( FNP) and calprotectin( FCP) concentrations and 2 milliliter blood samples for the serum C-reactive protein measurement before undergoing a colonoscopy.ELISA was applied in the measurement.Clinical disease activities were scored independently according to the Best Crohn′s Disease Activity Index(CDAI) in patients with CD, while the Modi-fied Mayo Scores in patients with UC.Comaprison was made in the relativity of each fecal marker and IBD activity score, the optimum value of diagnosing IBD acitivity as to each fecal marker, as well as sensitivity, specificity, moreover, receiver operating characteristic curve ( ROC) was drawn.50 healthy volunteers who received a normal colonoscopy were also enrolled as the control group and asked to give a 2 gram fresh stool sample. Results The FNP and FCP concentrations in patients with IBD were significantly higher than those in healthy control group(P<0.05).Both FNP and FCP concentrations differed significantly in clinically active IBD when compared with those in patients with inactive disease( P<0.001) .In CD patients, the correlation coefficients of FNP and FCP with CDAI were 0.55 and 0.59, respectively(P<0.001).In UC patients, the correlation coefficients of FNP and FCP with Mayo scores were 0.74 and 0.77, respectively( P<0.001) .The correlation coefficients of serum CRP in CD and UC patients with clinical scores were 0.49 and 0.60, respectively(P<0.001).The area under the ROC curve(AUC) of FNP and FCP for the diagnosis of clinical activity in pa-tients with CD were 0.75 and 0.80, respectively.The AUC of FNP and FCP in UC patients were 0.85 and 0.90, respectively.The AUC of serum CRP in patients with CD and UC were 0.65 and 0.74, respectively.When combined FNP with FCP, the AUC in pa-tients with CD and UC were 0.85 and 0.92, respectively. Conclusion FNP is a novel reliable and non-invasive biomarker to evalu-ate clinical disease activity in patients with IBD as accurate as FCP, It is advisable to combine FNP with FCP to evaluate disease activi-ty in patients with IBD.